Childhood mortality rates differ in rural, urban areas - Says 2008 GDHS

Story: Salome Donkor
The 2008 Ghana Demographic and Health Survey (GDHS) has established that childhood mortality rates in the country differ by residence. According to the survey, the under-five mortality rate for the 10-year period before the survey in urban areas is 75 per 1,000 live births compared to 90 per 1,000 live births in rural areas.
The report however indicated that childhood mortality is decreasing in Ghana. Currently, 50 children per 1,000 live births die before their first birthday. It gave the breakdown as 30 per 1,000 live births, before the age of one month and 21 per 1,000 between one and 12 months.
These figures, according to the survey, showed dramatic decreases over the 20-year period since the 1988 GDHS. The report indicated that under five mortality rate in the country per 1,000 live births was 155 in 1988, which decreased to 119 in 1993, then decreased further to 108 in 1998 and increased to 111 in 2003.
In respect of infant mortality rates, the figures for the country per 1,000 live births during the same period were, 77 in 1988, 66 in 1993, 57 in 1998, 64 in 2003 and 50 in 2008.
Various reasons are attributed to the decrease in infant and under five mortality rates. According to the survey, spacing children, at least 24 months apart, reduces risk of infant death, indicating that, in Ghana, the median birth interval is 40 months. However, about 1 in 7 (14 per cent) infants in Ghana, are born less than two years after a previous birth.
Infants born less than two years after a previous birth have particularly high infant mortality rates (131 deaths per 1,000 live births) compared with 58 for infants born four years after the previous birth).
The GDHS also said almost all Ghanaian women (95 per cent) receive some antenatal care from skilled provider, most commonly from a nurse or midwife (63 per cent) and a doctor (24 per cent), adding that more than three-quarters of women had the recommended four or more antenatal visits, and 55 per cent of women had an antenatal care visit by their fourth month of pregnancy, as recommended.
Accessing antenatal and postnatal care enabled more women to take iron tablets or syrup and intestinal parasite drugs during their last pregnancy before the survey. Women who received antenatal care during their most recent births were informed of the signs of the complications of pregnancy, and were also protected against neonatal tetanus.
The survey indicated that over the past two decades, vaccination coverage had increased from 47 per cent in 1988 to 79 per cent in 2008. It said 79 per cent of Ghanaian children, aged 12 - 23 months, received all recommended vaccines (one dose of BCG and measles and three doses each of DPT and polio) at any time prior to the survey.
The report said during the two weeks before the survey, 1 in 5 Ghanaian children under five had diarrhoea, adding that the rate was highest (33 per cent) among children aged 12 - 23 months, and advised mothers to give children who had diarrhoea more fluids, particularly oral rehydration salts (ORS) since the survey established that the majority of mothers (90 per cent) know about ORS packets.
The World Health Organisation (WHO) recommends that children receive nothing but breast milk (exclusive breastfeeding) for the first six months of life. Infants should not be given juices, other milks or complementary foods until six months of age, yet 17 per cent of Ghanaian infants under six months receive complementary foods.
To reduce the risk of malnutrition, the survey recommends that complementary foods should be introduced when a child is six months old, in addition to breastfeeding.
The Infant and Young Child Feeding (IYCF) practices recommend that children aged between 6 and 8 months should be fed from three or more food groups at least twice a day in addition to breastfeeding, and for children aged between 9 to 23, at least three times a day.
The GDHS, which also included haemoglobin testing for women aged 15 to 49 and children 6-59 months, established that more than three-quarters of children (78 per cent) have some form of anaemia.
It said anaemia among children was higher in rural areas than in urban areas, and decreased as mother’s education and wealth increase, adding that almost 9 in 10 children in the Upper East and Upper West regions are anaemic.
The 2008 GDHS was designed to provide data for monitoring the population and health situation in the country and has brought to the fore information that can guide policy formulation, implementation and evaluation.
The objective of the survey was to provide up-to-date information on fertility, family planning, childhood mortality, nutrition, maternal and child health, domestic violence and related knowledge and behaviour on HIV and AIDS.