Spatial differentials in childhood mortality in Mozambique

Martin Bangha, University of Pennsylvania

Despite dramatic improvements in mortality in Africa during the second half of the twentieth century, Africa at the turn of the 21st century remains the world’s region with the highest mortality levels. Both childhood and adult mortality remain generally high with wide disparities among and within groups in the population. Among the notable features of African mortality trends over the last two or so decades has been remarkable stagnations and reversals of the post World War II mortality gains. Explaining these stagnations or reversals of mortality in several African countries is an ongoing subject of intensive scholarly research. Because, these reversals coincided in most cases with the advent of the HIV/AIDS pandemic, this has taken precedence in the frequent explanations. However, the stagnation or reversal does not seem to be uniform across countries or localities and population groups. Indeed wide disparities exist among and within groups even in the same country. As such global estimates have often been accused of frequently masking the “unfinished health agenda” in many countries. In this paper, we use a unique power of census data in conjunction with GIS to assess the magnitude of geographic differences in child health. The 1997 census is used to localize childhood mortality to the district level and thereby, highlight the magnitude and dimension of inequalities in Mozambique. More specifically, the children ever born and children surviving data included in the census are used to estimate and map childhood mortality risk by district. The standardized mortality index that combines child mortality experience of women is also computed. Furthermore, a number of socioeconomic and household environmental characteristics are considered for an insight into the differentials in mortality.