Understanding inequities in child mortality in Egypt: Socioeconomic and proximate factors

ABSTRACT

While there have been notable advancements in child health in Egypt, disparities in child mortality still exist. Understanding these disparities is crucial to addressing them. The objective of this study is to explore the factors linked to child mortality in Egypt, providing a comprehensive understanding of the disparities in child mortality rates. The study utilises cross-sectional data from Egypt's Demographic and Health Survey (EDHS) in 2014 to examine child mortality. The dataset consists of 15,848 observations from mothers with children born within five years prior to the survey. The choice of explanatory variables was guided by the Mosely and Chen Framework and logistic multivariate regression was used to conduct the analyses. The study finds lower education, early childbearing, insufficient birth spacing, lack of breastfeeding, and absence of improved toilet facilities (proxy for living conditions) were all significantly linked to an increased likelihood of child loss. Additionally, poorer people in rural settings experienced the worst child mortality. The findings align with the World Health Organization's Conceptual Framework for Action on the Social Determinants of Health (CSDH). Recommended policy interventions include targeting women in rural areas, improving living conditions and removing financial/other barriers to accessing care.

KEYWORDS:

• Child Health
• child mortality
• health inequities
• social determinants of health
• proximate factors
• Egypt
• rural urban

Acknowledgements

The authors express sincere gratitude to the DHS for availing the dataset that was used in this study. Author M. A. expresses grateful for Society of Friends GdF of the Thünen Institute for their support in presenting this research at the UNICEF conference. Author M. A. is also grateful for the assistance of the UNICEF team and for the faculty of economics and political science of Cairo University who provided support in presenting this work and offering valuable feedback. All the authors contributed to all phases of the manuscript preparation and approval of final draft for submission. M. A.: conceptualized the study, conducted the data analysis, and co-authored the paper. M. F.: conducted the formal analysis, critically reviewed the manuscript, and co-authored the paper.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Since birth weight is not always known for babies, a question was included to obtain the mother’s estimate of the baby’s size for all babies, i.e. whether the baby was very small, smaller than average, or average or larger. This assessment is based on the mother’s own perception of what is a small, average, or large baby and not on a uniform definition.

2 Government medical facilities include urban and rural hospitals, urban and rural health units, etc. The private medical facilities include private hospital/clinic, private doctor. The nongovernmental has Egypt family planning association, csi project and other NGOs.

3 Protected source of drinking water: piped into dwelling, to yard or plot, Public tap or standpipe, tube well or borehole, protected well, spring, truck, cart with small tank, bottled water. Unprotected source of drinking water: unprotected well, spring, surface water like river, dam, lake, ponds, stream and canal and other.

4 Improved sanitation are flush to piped sewer system, to septic tank, to vault (bayara), to pipe connected to canal, to pipe connected to ground water. Unimproved sanitation are flush to somewhere else, pit latrine, without slab or open pit, bucket toilet and others, no facility.