National level factors associated with child underweight and infant mortality rates. Multi-country evidence

Research Paper (postgraduate), 2016

17 Pages











Although various analyses have identified structural factors having statistically significant associations with child underweight and infant mortality rates, their focus has only thinly involved national level data from multiple countries. Using national level data from 62 countries, the present analysis determined the statistical relationships of child underweight and infant mortality rates with structural factors, such as poverty, education, antenatal care, skilled providers, contraceptive use, and access to water and sanitation. The two dependent variables were both statistically significantly associated with all the seven independent variables. The strengths of their bivariate association were mainly moderate to high, while the direction of the associations of child underweight and infant mortality rates were positive with poverty and negative with the other factors. When the development level of countries was used as the control variable, many of the observed associations considerably weakened in terms of their statistical significance and strength. Overall, the analysis underscores the importance of structural factors and development level of countries as influencers of health outcomes involving children and infants.

Keywords: child underweight, infant mortality, poverty, education, antenatal care, skilled providers, contraceptive use, water, sanitation, multi-country evidence


The global human population has been burgeoning each year at approximately 1.13% (Mashegoane, 2016), or 80 million new birth entrants, with high growth numbers coming from the South, such as Africa and Asia (Bongaarts, 2009). Given the fast ageing populations of the North, the global South’s births would be a crucial source of human labor for the growth and expansion of both the global and regional economies. Despite technological innovations that purport to supplant human labor, human resources are simply irreplaceable; for example, they far excel machines with respect to general problem solving and creative abilities (Andrews, 2015) and to complex human-to-human social and interpersonal relationships.

Although the flows of new live births are considerably sustained, the quality level of these births, in terms of their exposure to the risks of being underweight and of dying, varies. Overall, the global South’s births—compared to their Northern counterparts—are prone to suffer from the aforementioned risks in multiple folds. For instance, in the industrialized countries, such as Japan and Germany, the infant mortality rates are 2.13 and 3.46 deaths, respectively, per 1,000 live births (Index Mundi, 2015a; 2015b). In contrast, in the developing world, such as Somalia and Cambodia, the parallel rates are staggeringly high, at 100.14 and 51.36 deaths, respectively (Index Mundi, 2015c; 2015d). These figures strongly demonstrate the primacy of live birth-related risks in the global South. In fact, the then Millennium Development Goals (2000-2015) as well as the present Sustainable Development Goals (2016-2030) were set precisely to address these geographic-bound risks. To understand and resolve these risks, systematic research on the factors associated with their occurrence has been carried out over the years. This paper seeks to contribute to the prevailing body of knowledge by further analyzing the examined relationships of child underweight and infant mortality rates with structural factors.


Besides being valued at the micro level, such as the family, human births serve a number of highly critical development functions at the country level. Essentially, new births are the future generations of leaders and members, who are expected to collectively carry out the tasks and responsibilities needed for their country to function effectively in physical, cultural, social, economic and political terms. Given proper socialization, new births are vital instruments that will work for the continuity of their own country’s national development.

The processes and the outcomes related to transforming new births into productive citizens are not independent from the country’s development level. The decades-long data from the UNDP’s Human Development Reports ( underscore that the world is far from having a monolithic level of development. For instance, based on re-analyzed data of the 188 countries covered in the Human Development Report, 23.4% had a low level of development, 19.6% had a moderate level of development, and 29.3% and 27.7% had a high and a very high level of development, respectively. These disparate figures underscore the varying levels of wherewithal and capabilities that countries have at their disposal for improving their pool of human resources, including the new birth entrants.

Countries with elevated levels of development tend to have more financial resources and better development goals, bureaucracies, infrastructures, systems and services, or vice versa. This means that highly developed countries, as a result of their being well equipped, provide their own citizens with, among others, better and more accessible employment and income-generating opportunities, educational services, health services, and environmental systems. Consequently, national level rates in countries under this category, such as those related to poverty, education, quality health care, and access to water and sanitation, are also high, and relative to those reported in countries with lower development levels, are much better. These conditions do not only bring about physical, material or economic changes in citizens but also psychological, emotional and social changes, all of which confluence on national level outcomes on child underweight and infant mortality rates. For example, if critical masses of women are educated, use contraceptives and have good access to clean water and sanitation, their relevant knowledge, attitudes and practices would be improved, and thus affecting the health of their children. There are empirical research findings on the relationships of child underweight and infant mortality rates with structural variables.


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National level factors associated with child underweight and infant mortality rates. Multi-country evidence
De La Salle University  (Department of Behavioural Sciences)
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children, underweight children, infant mortality
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Romeo Lee (Author)Kennith Gregory Dillena (Author), 2016, National level factors associated with child underweight and infant mortality rates. Multi-country evidence, Munich, GRIN Verlag,


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