1.Effect of Maternal Education and Outreach Services on Child Mortality in a Zambian Village
Tsutomu SHIODA ; Nanako TAMIYA ; Kouichiro TABUCHI ; Osamu YOSHIDA ; Hideki YAMAMOTO
Journal of International Health 2009;24(2):77-86
Objective
To examine the effects of the educational status of mothers and outreach services on childhood mortality in a Zambian village
Methods
The study design was a cross-sectional descriptive study. A survey was carried out in a village of Zambia in 2007. Five Japanese medical and nursing students interviewed mothers who had children under five years old. A structured questionnaire was used to collect information on social and educational factors and their experience of child deaths. In total, 73 mothers were interviewed, but three subjects were excluded because their records were inadequate. Information on the remaining 70 subjects was analyzed. The relationship between the dependent variable (child death rate per household) and independent variables (mother's characteristics, community circumstances) was examined. In this study, we used “the numbers of babies or young children who had died without defining age by care takers in a household” (child death rate per household) as a measure of child mortality.
Results
Of the 70 mothers, 30 were literate (42.9%). 33 mothers received health information from an outreach program and 22 from community health workers (CHWs).
The mother's education and the availability of health information from the outreach program were significantly related to lower child death rate per household (p=0.015 and p=0.019 respectively). The relationship between the mother's literacy and child death rate per household also showed an inverse tendency. Mothers with some education who received health information from the outreach program had reduced child death rate per household.
After stratification by maternal age (younger or older than 30 years), greater education, literacy and outreach program of the younger mothers were more strongly associated with decreased child death rate per household.
Conclusions
Education and community learning are important for the health of children. Maternal educational level and a community-based approach have strong impacts on child survival.