| dc.description.abstract | Despite the tremendous strides made in reducing childhood mortality, global infant mortality rate remains high, at 28 deaths per 1,000 live births. About 53 percent of the global infant deaths occur in Sub-Saharan Africa. Majority of these deaths are as a result of improper access to prenatal care, childbirth delivery care and postnatal care services. These are correlated to geographical, socioeconomic, demographic and distance factors and yet it is not clearly documented. Infant mortality rate still remains high at 36 deaths per 1,000 live births in Kenya. Notably, in Kakamega County, the rate is at 37 deaths per 1,000 live births. This study aimed at examining rural-urban differentials in infant mortality in Kakamega Central Sub-County, Kakamega County, Kenya. The specific objectives of the study were to: establish the influence of geographical area of residence on the death of infants in rural and urban areas of Kakamega Central Sub-County; examine the influence of socioeconomic factors on the death of infants in rural and urban areas of Kakamega Central Sub-County; examine the influence of demographic factors on the death of infants in rural and urban areas of Kakamega Central Sub-County; and to assess the influence of the distance covered to the nearby medical facility on the death of infants in rural and urban areas of Kakamega Central Sub-County. A cross-sectional research design was used. Systematic random sampling was employed to obtain a sample of 422 mothers within the reproductive age range of 15 to 49 years. Purposive sampling was used to arrive at key informants that were engaged in the study. Primary data was collected by administering structured questionnaires, interviewing key informants and observation and photography. Secondary data was obtained from the 2019 Kenya Population and Housing Census. Content validity ratio was computed to test data validity while data reliability was tested by computing Cronbach’s alpha coefficient of internal consistency. Qualitative data on nature of roads, level of education of the mother and maternal occupation were analysed by coding, creating categories, themes and patterns. Quantitative data on population density, number of health facilities, age of the mother and distance were analysed by descriptive statistics and multinomial logistic regression analyses. The study revealed that the main contributors to rural-urban differentials in infant mortality in Kakamega Central Sub-County were nature of roads (aOR = 3.867; 95% CI = 1.079 – 3.857), first births (aOR = 3.492; 95% CI = 0.992 – 2.291) and high order births (aOR = 1.881; 95% CI = 0.584 – 6.063) in rural areas. Nature of roads and order of the index birth were insignificant in explaining urban infant mortality. In urban areas, a ≤ 24 months wait period prior to the index birth was significantly associated with post-neonatal (aOR = 3.294; 95% CI = 1.224 – 8.863) and infant (aOR = 3.616; 95% CI = 1.342 – 9.740) mortalities in comparison with a > 24 months wait period. A distance of 1.1 to 3.9 kilometres from one’s residence to the nearby medical facility had a higher likelihood of neonatal mortality (aOR = 2.127; 95% CI = 1.197 – 3.781) compared to an at most 1 kilometre distance. Wait period prior to the index birth and distance were not significant in rural mortalities. The study concluded that nature of roads, order of the index birth, wait period prior to the index birth, and distance were the main contributors to rural-urban differentials in infant mortality in Kakamega Central Sub-County. The study recommends concerted efforts towards road maintenance in rural areas; encouraging beyond-primary level female education; advocating for childbearing during the middle reproductive ages; and research on the influence of culture on infant mortality. | en_US |
