Women’s position in the household as a determinant of neonatal mortality in sub-Saharan Africa

Abstract

Background. The burden of under-five mortality in sub-Saharan Africa (SSA) is highest during the neonatal period, with over 40% of cases occurring during the first month of life. There is a paucity of evidence on the influence of women’s household position on neonatal survival in SSA. 

Objective. To assess the influence of women’s household position on neonatal survival in SSA. 

Methods. We analysed pooled data (N=191 514) from the demographic and health surveys of 18 countries in SSA. Cox proportional hazards regression analysis was used to explore statistically significant relationships. 

Results. Findings support the hypothesis that a low position of a woman in the household is significantly associated with high neonatal mortality, as children of women who experienced a high position in the household had a significantly lower risk of neonatal mortality (hazard ratio 0.85, confidence interval 0.76 - 0.95; p<0.05) than those whose mothers experienced a low household position. 

Conclusion. This study concludes that improving women’s household position through enhanced socioeconomic status could substantially contribute to reducing neonatal mortality in SSA.