Socio-economic determinants in this study have been defined through the wealth
status, highest education level and the labour participation of the mother. These factors
explain the rising under-five mortality rate in many cities in Sub-Saharan Africa. A
phenomenon, currently facing many cities as Africa embraces urbanization. Their
measurements were used to determine how they work through proximate determinants of
under-five mortality to influence child mortality as expressed in Mosley and Chen framework
of 1984. Measuring the socio-economic determinants of under-five mortality helped to
explain the underlying reasons through a theoretical framework to causes of under-five
mortality in cities of Africa. The dependent variable was under-five mortality in major cities
of Nairobi, Kigali and Dar-es-salaam. The study used secondary data from the Demographic
Health Survey of the three countries whose cities were covered in the study.
The study used logistic regression to establish the effects of socio-economic
determinants on the proximate determinants to influence under-five mortality. The study
found out that socio-economic determinants do not influence the occurrence of under-five
mortality, but act through the proximate determinants to indirectly influence under-five
mortality. Further, this effect was seen through the type of birth where multiple births was
negatively statistically significant in the presence of socio-economic factors. An indication
that multiple births in well-to-do families has little influence in under-five mortality. Age of
the mother at birth was also significant indicating that whether the mother is 35years and
above and as long as they are in the upper quintile of the wealth index, have higher education
and are working, older ages does not affect their under-five mortality experiences. This
scenario was also seen in households which had proper toilets. Lack of toilets was positively
significant, an indication that it increases chances of under-five mortality in the cities.
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Deliveries in private health facilities were also found to be positively statistically
significant. This indicated that there was more likelihood of under-five mortality in private
facilities compared to home deliveries. This may be occasioned by numerous private healthcare
centres which perhaps may not have very qualified personnel to handle emergencies
since many people resort to private healthcare facilities when they are faced with
emergencies. In conclusion, improvement in socio-economic status of a household is
important in reducing child mortality.
Nevertheless, more research is required in finding out how they influence under-five
mortality in the slums of Nairobi, Kigali and Dar-es-Salaam where majority of the urban poor
live.