Paternal Social Determinants of Childhood Mortality in Zimbabwe

VARIABLE	CHILD IS ALIVE (FREQUENCY)
VARIABLE	YES	NO	TOTAL
Under‑5‑year mortality by age category
Neonates (< 28 days old)	461	84	545
Infants (28 days ≤ age ≤1 year)	992	353	1,345
Children (1 year < age ≤ 5 years)	3,136	746	3,882
Total	4,589 (79.5%)	1,183 (20.5%)	5,772 (100%)^*
Under‑5‑year mortality by province
Manicaland	558	189	747
Mashonaland Central	542	151	693
Mashonaland East	422	145	567
Mashonaland West	559	174	733
Matabeleland North	365	93	458
Matabeleland South	284	54	338
Midlands	543	125	668
Masvingo	495	112	607
Harare	541	99	640
Bulawayo	280	41	321
Total	4,589 (79.5%)	1,183 (20.5%)	5,772 (100%) *
Under‑5‑year mortality by sex
Male	2,256	645	2,901
Female	2,333	538	2,871
Total	4,589 (79.5%)	1,183 (20.5%)	5,772 (100%) *
Under‑5‑year mortality by geographical location
Urban	1,699	309	2,008
Rural	2,890	874	3,764
Total	1,183 (20.5%)	1,183 (20.5%)	5,772 (100%) *
Father’s age group (years)
15–19			49
20–24			243
25–29			643
30–34			901
35–39			824
40–44			599
45–49			385
50–54			243
Total			3,887*
Father’s level of education
No education			42
Primary			957
Secondary			2,358
Higher			530
Total			3,887*

[i] *Total number of children (5,722) differed from the total number of fathers (3,887) due to a father/household having more than one eligible child. The sample size of 5,722 was used in the final analysis, as each child was treated independently.

Table 2

Bivariate logistic regression of paternal factors for infant mortality.

CHILD ALIVE	ODDS RATIO	P > Z	95% CONFIDENCE INTERVAL
Father’s age (years)
15–19	1.35	0.000	1.24	1.67
20–24	1.22	0.002	1.15	2.34
25–29	1.13	0.031	1.05	1.87
30–34	1.09	0.341	0.96	2.11
35–39	1.01	0.401	0.88	1.77
40–44	0.91	0.002	0.60	0.98
45–49	0.80	0.001	0.73	0.94
50–54	1	–	–	–
Residence
Urban	1	–	–	–
Rural	1.31	0.000	1.18	1.45
Paternal education
No education	1.36	0.006	1.13	1.74
Primary	1.13	0.041	1.04	2.31
Secondary	0.96	0.021	0.66	1.42
Higher	1	–	–	–
Religion
Apostolic sect	1.22	0.087	.73	1.98
Christian	0.86	0.213	0.44	1.77
Other	1	–	–	–
Wealth index
Poorer	1.29	0.014	1.10	2.09
Middle	1.11	0.023	0.91	1.60
Richer	0.87	0.004	0.79	0.96
Richest	1	–	–	–
Father’s smoking
Smoker	1.13	0.295	0.90	1.41
Non‑smoker	1	–	–	–
Employment status
Unemployed	1.76	0.001	1.32	1.94
Employed	1	–	–	–
Work category
White collar	1	–	–	–
Blue collar	1.21	0.031	1.00	1.31
Alcohol intake
Yes	1.11	0.468	0.84	1.47
No	1	–	–	–

Table 3

Bivariate logistic regression of paternal factors for child mortality.

CHILD ALIVE	ODDS RATIO	P > Z	95% CONFIDENCE INTERVAL
Father’s age (years)
15–19	1.35	0.000	1.24	1.48
20–24	1.22	0.001	1.02	1.78
25–29	1.13	0.021	1.05	1.65
30–34	1.11	0.022	1.01	2.31
35–39	1.08	0.041	0.98	1.33
40–44	0.90	0.004	0.40	0.98
45–49	0.78	0.011	0.68	0.95
50–54	1	–	–	–
Paternal education
No education	1.18	0.006	1.01	1.95
Primary	1.11	0.021	1.03	1.33
Secondary	0.87	0.002	0.53	0.97
Higher	1	–	–	–
Wealth index
Poorer	1.40	0.001	1.11	2.30
Middle	1.09	0.021	1.01	1.98
Richer	0.82	0.025	0.68	0.97
Richest	1	–	–	–
Father’s smoking
Smoker	1.01	0.955	0.78	1.31
Non‑smoker	1	–	–	–
Residence
Urban	1	–	–	–
Rural	1.86	0.0021	1.00	1.43
Work category
White collar	1	–	–	–
Blue collar	1.01	0.0028	1.00	1.22
Alcohol intake
Yes	1.13	0.478	0.81	1.56
No	1	–	–	–
Religion
Apostolic sect	0.85	0.072	0.98	1.00
Christian	1	–	–	–
Employment status
Unemployed	1.27	0.0032	1.19	2.03
Employed	1	–	–	–

Table 4

Adjusted logistic regression for infants.

VITAL STATUS OF CHILD/INFANT	ODDS RATIO	P > Z	[95% CONFIDENCE INTERVAL]
Maternal age	1.23	0.0158	1.02	1.64
Maternal education	0.51	0.026	0.28	0.92
Preceding birth interval	0.98	0.034	0.97	1.00
Birth size	0.92	0.633	0.66	1.29
Paternal geographical location (urban versus rural)	0.78	0.0016	0.20	0.96
Level of education
Primary	0.74	0.808	0.67	1.20
Secondary	0.60	0.686	0.50	1.17
Higher	1.56	0.742	0.11	2.09
Wealth index
Poorer	1.52	0.0081	1.40	1.84
Middle	0.90	0.0468	0.27	0.98
Richer	0.94	0.0420	0.21	1.21
Richest	0.68	0.0023	0.21	0.83
Religion
Apostolic	0.64	0.535	0.16	2.61
Christian	0.37	0.203	0.08	1.71
Other	0.52	0.371	0.12	2.20
Work category
White collar	0.85	0.0230	0.37	0.96
Blue collar	1.92	0.179	1.31	2.69
Age category	1.05	0.892	0.49	2.25
Smoking status	1.29	0.532	0.58	2.82
Alcohol intake	1.98	0.095	0.89	2.40

Table 5

Adjusted logistic regression for children.

VITAL STATUS OF INFANT/CHILD	ODDS RATIO	P > Z	[95% CONFIDENCE INTERVAL]
Maternal age	1.93	0.000	1.69	2.20
Maternal education	0.51	0.000	0.38	0.69
Place of residence	0.73	0.004	0.33	0.88
Level of education
Primary	0.69	0.542	0.21	2.27
Secondary	.058	0.373	0.18	1.92
Higher	0.66	0.532	0.18	2.42
Wealth index
Poorer	1.49	0.002	1.16	1.56
Poor	0.79	0.021	0.42	1.00
Middle	0.83	0.033	0.37	0.89
Richest	0.89	0.0.001	0.34	0.93
Religion
Apostolic	1.29	0.575	0.53	3.10
Christian	1.30	0.564	0.53	3.16
Other	1.06	0.897	0.43	2.60
Work category
White collar	0.55	0.038	0.31	0.97
Blue collar	0.68	0.114	0.41	1.10
Age category	1.09	0.678	0.75	1.54
Smoking status	1.22	0.404	0.77	1.94
Alcohol intake	0.93	0.710	0.63	1.38

Kaplan–Meier survival estimates for father’s age.

Kaplan–Meier survival estimates for father’s age group.

Survival estimate for father’s wealth index.

Survival estimate for father’s work category.

Survival estimates for father’s level of education.

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DOI: https://doi.org/10.5334/aogh.4591 | Journal eISSN: 2214-9996

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Language: English

Submitted on: Oct 21, 2024

Accepted on: Dec 4, 2024

Published on: Dec 24, 2024

Published by: Ubiquity Press

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

Social determinants of health,

paternal determinants,

under‑five‑year mortality,

© 2024 Laston Gonah, Dumisani Sibanda, Sibusiso C Nomatshilla, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 90 (2024): Issue 1

Paternal Social Determinants of Childhood Mortality in Zimbabwe

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