The Determinants of Infant and Child Mortality in Developing Countries: The Case of Sub-Sahara Africa

The objectives of this paper are to: a) examine the determinants of the variations in the crude birth rates (CBR) mortality rates for the less than one year old infants (IMR) and for the less than five-year old children (CMR) b) account for the possible endogeneity or feed-back effects between the crude birth rate (CBR) and child mortality rate (CMR) c) draw conclusions based on the results and d) make some policy recommendations for reducing the relatively high child mortality rate in Sub-Saharan Africa. In particular the study will explore the effects of economic (income per capita-IPC government expenditures on health and nutrition--PHL) demographic (crude birth rate-CBR female education-EDF female labor force participation rate-FLR) health care aspects (access to safe water-WTR immunization-IMZ under weight births-UWB malnutrition-MLN) and structural adjustment factors (Debt/GDP Ratio-DGR) on CBR IMR and CMR respectively. Initially single multiple regressions are run to identify factors directly influencing infant and child mortality rates and the crude birth rates. Recognizing the endogeniety of the crude birth rate and infant or child mortality rate a simultaneous equations model is constructed and estimated by the Two Stage Least Squares Method (2SLS). The test is conducted using cross-section data for thirty-four Sub Sahara African countries for which complete data are available. Based on the results from the 2SLS estimation the indirect effects (multiplier effects of elasticities) of the exogenous policy variables on the endogenous variables are computed. This exercise is particularly important for evaluating the responsiveness of infant or child mortality rates to the various exogenous policy instruments. The paper is organized as follows. Section two gives the theoretical and empirical underpinnings of the crude birth rate (CBR) infant and child mortality rate (IMR and CMR) models. The OLS results and interpretations of the single equation models are provided in section three. The results and interpretations of the endogenous variables (CBR and CMR) and presented in section four. In section five we compute the elasticities of the CBR and CMR to infer their sensitivity to changes in the various policy instruments. Based on the results the paper draws some conclusions and makes some policy recommendations for reducing infant child mortality rates in Sub--Sahara Africa in section six. (excerpt)