The recent rise of childhood mortality in Sub-Saharan Africa: The case of Kenya

Collins Omondi Opiyo, University of Pennsylvania


This study is conceived against the backdrop of deteriorating child survival circumstances in Kenya. It adopts a systematic and comprehensive analysis of the recent childhood mortality patterns using various demographic and statistical data and methods. We use the own-children method proposed by Preston and Palloni (1977) and data from the four censuses to provide new estimates of childhood mortality rates. We also apply survival analysis techniques to data from the four DHSs and administrative records to examine the age structure and determinants of the rising childhood mortality rate. The new estimates show significant impact of using a different mortality model (INDEPTH Model Life Tables for Sub-Saharan Africa). The INDEPTH tables are believed to accurately reflect contemporary mortality dynamics, including the impact of HIV/AIDS. The own-children method performs satisfactorily in the era of fertility transitions and HIV/AIDS, in addition to minimizing the idiosyncratic errors concomitant with the traditional Brass estimates. There is much to be gained in the understanding of mortality dynamics by examining sub-groups and sub-periods of childhood. Evidence shows presence of a steep age gradient and considerable sub-group differentials in childhood mortality risks. The huge intra-country differentials observed mirror co-existence of pockets of "First" and "Third" worlds in the same country. Overall, the early 1990s marked the onset of an unprecedented deterioration in child survival in post-Independence Kenya. HIV/AIDS prevalence is not only associated with the largest increase in childhood mortality rate during this period, but changed the dynamics as well. Apparently, context matters most —macro-level factors drive both national trends and the intra-country differentials in childhood mortality rates. The Government and its development partners should implement an integrated program well-targeted to the needs and locations of children at different stages of the life course. Future research will focus on improving data collection, modifying the INDEPTH life tables to handle cause-specific analyses, and exploring the differentials in cost-effectiveness and sustainability of health interventions in Sub-Saharan Africa.

Subject Area

Public policy|Epidemiology|Demography

Recommended Citation

Opiyo, Collins Omondi, "The recent rise of childhood mortality in Sub-Saharan Africa: The case of Kenya" (2009). Dissertations available from ProQuest. AAI3363577.