Child Mortality

32

Child Mortality
Figure CM. 6: Under-5 mortality rates by demographic characteristics, Ghana, 2011

First births and higher order births generally face an elevated risk of mortality. Data from the MICS 2011 confirm
this pattern for the most part. Birth orders seven and higher experience the highest levels of childhood mortality,
while mortality is lowest for second and third order births. For example, under-5 mortality rate is estimated at 114
deaths per 1,000 live births for birth order seven and higher, 75 deaths per 1,000 live births for birth orders 2-3, and
89 deaths per 1,000 live births for birth order 1 (Figure CM.6).
The birth interval also affects survival when there is an interval of less than two years between pregnancies,
demonstrating the importance of spacing on child survival. This is fairly consistent in all childhood mortality
indicators. For example, infant mortality rate for children born at less than a two-year interval is 75 deaths per 1,000
live births and 37 deaths per 1,000 live births when the birth interval is 3 years. This means that the children born at
less than a two-year interval are more than twice likely to die before their first birthday compared to the ones born
at 3 years interval. Under-five mortality rate is 112 deaths per 1,000 live births for birth intervals of less than 2 years
and 69 deaths per 1,000 live births when a birth occurs 3 years after a previous birth. Children born at less than a
two-year interval are more (1.6 times) likely to die before their fifth birthday compared to the ones born at 3 years
interval.
Table CM.3: Early childhood mortality rates by demographic characteristics
Neonatal, post neonatal, Infant and Under-five mortality rates for the 10-year period preceding the survey by
demographic characteristics, Ghana, 2011
Background
Characteristics

Neonatal
mortality rate
(NMR)
[1]

Post neonatal
mortality rate
(PNMR)
[2]

Infant mortality
rate(1q0) [3]

Child
mortality rate
(4q1)
[4]

Under five
mortality rate
(5q0)
[5]

Male

37

21

58

39

94

Female

27

18

45

31

75

<20

35

29

64

44

105

20-34

29

19

48

33

79

35-49

41

18

59

36

92

35

20

56

35

89

2-3

24

17

41

36

75

4-6

34

20

55

32

85

7+

48

28

76

41

114

<2

46

29

75

40

112

2 years

26

16

42

41

81

3 years

21

15

37

34

69

4+ years

25

13

38

21

59

Total

32

21

53

31

82

Sex of child

Mothers age

Birth order

Previous birth intervals

[1] MICS indicator 1.3

[2] MICS indicator 1.4
[3] MICS indicator 1.1; MDG indicator 4.1
[4] MICS indicator 1.5;
[5] MICS indicator 1.2, MDG indicator 4.2

33

34

V.

Nutrition

35
35

Nutritional Status
Childrens nutritional status is a reflection of their overall health. When children have access to an adequate
food supply, are not exposed to repeated illness, and are well cared for, they reach their growth potential.
Malnutrition is associated with more than half of all child deaths worldwide. Undernourished children are
more likely to die from common childhood ailments, and for those who survive, have recurring sicknesses
and faltering growth. Three-quarters of the children who die from causes related to malnutrition were
only mildly or moderately malnourished showing no outward sign of their vulnerability. The Millennium
Development target is to reduce by half the proportion of people who suffer from hunger between 1990
and 2015. A reduction in the prevalence of malnutrition will also assist in the goal to reduce child mortality.
In a well-nourished population, the distribution of height and weight for children under age five is similar
to that of a reference population. Hence under-nourishment in a population can be gauged by comparing
childrens anthropometric measurements with that of a reference population. The reference population
used in this report is based on new WHO growth standards1 . Each of the three nutritional status indicators
can be expressed in standard deviation units (z-scores) from the median of the reference population.
Weight-for-age is a measure of both acute and chronic malnutrition. Children whose weight-for-age is more
than two standard deviations below the median of the reference population are considered moderately or
severely underweight while those whose weight-for-age is more than three standard deviations below the
median are classified as severely underweight.
Height-for-age is a measure of linear growth. Children whose height-for-age is more than two standard
deviations below the median of the reference population are considered short for their age and are classified
as moderately or severely stunted. Those whose height-for-age is more than three standard deviations
below the median are classified as severely stunted. Stunting is a reflection of chronic malnutrition as a
result of failure to receive adequate nutrition over a long period and recurrent or chronic illness.
Finally, children whose weight-for-height is more than two standard deviations below the median of the
reference population are classified as moderately or severely wasted, while those who fall more than three
standard deviations below the median are classified as severely wasted. Wasting is usually the result of a
recent nutritional deficiency. The indicator may exhibit significant seasonal shifts associated with changes
in the availability of food or disease prevalence.
In Ghana MICS4, weights and heights of all children under 5 years of age were measured using anthropometric
equipment recommended by UNICEF (www.childinfo.org). Findings in this section are based on the results
of these measurements.

1 http://www.who.int/childgrowth/standards/second_set/technical_report_2.pdf