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What explains the rural-urban gap in infant mortality: Household or community characteristics?

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  • Ellen Poel
  • Owen O'donnell
  • Eddy Doorslaer

Abstract

The rural-urban gap in infant mortality rates is explained using a new decomposition method that permits identification of the ontribution of unobserved heterogeneity at the household and the community level. Using Demographic and Health Survey data for six Francophone countries in Western Sub-Saharan Africa, we find that differences in the distributions of factors that determine mortality – not differences in their effects – explain almost the entire gap. Higher infant mortality rates in rural areas mainly derive from the rural disadvantage in household level characteristics; both observed and unobserved, which explain three-quarters of the gap. Among the observed characteristics, household environmental factors—potable water, electricity and quality of housing materials—are the most important contributors explaining 38% of the gap. Unobserved household level determinants explain 10% of the gap. Community level determinants explain 13% of the gap, including 3% that is due to unobservable community level heterogeneity. This discussion paper has resulted in a publication in Demography , 2009, 46(4), 827-51.
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  • Ellen Poel & Owen O'donnell & Eddy Doorslaer, 2009. "What explains the rural-urban gap in infant mortality: Household or community characteristics?," Demography, Springer;Population Association of America (PAA), vol. 46(4), pages 827-850, November.
    • Handle: RePEc:spr:demogr:v:46:y:2009:i:4:p:827-850
    DOI: 10.1353/dem.0.0074
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    3. Makate, Marshall & Makate, Clifton, 2016. "Demand for prenatal care and its impact on neonatal, infant and child mortality in Zimbabwe: Evidence from the Demographic and Health Surveys," MPRA Paper 72805, University Library of Munich, Germany, revised 31 Jul 2016.
    4. Owen O’Donnell & Eddy van Doorslaer & Adam Wagstaff, 2012. "Decomposition of Inequalities in Health and Health Care," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 17, Edward Elgar Publishing.
    5. Babigumira, Ronnie & Angelsen, Arild & Buis, Maarten & Bauch, Simone & Sunderland, Terry & Wunder, Sven, 2014. "Forest Clearing in Rural Livelihoods: Household-Level Global-Comparative Evidence," World Development, Elsevier, vol. 64(S1), pages 67-79.
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    8. Cavatorta, Elisa & Shankar, Bhavani & Flores-Martinez, Artemisa, 2015. "Explaining Cross-State Disparities in Child Nutrition in Rural India," World Development, Elsevier, vol. 76(C), pages 216-237.
    9. Makate, Marshall & Makate, Clifton, 2016. "The Evolution of Socioeconomic-Related Inequalities in Maternal Healthcare Utilization: Evidence from Zimbabwe, 1994-2011," MPRA Paper 72718, University Library of Munich, Germany, revised 24 Jul 2016.
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    11. Okechukwu Dennis Anyamele & John Obioma Ukawuilulu & Benedict Ndubisi Akanegbu, 2017. "The Role of Wealth and Mother’s Education in Infant and Child Mortality in 26 Sub-Saharan African Countries: Evidence from Pooled Demographic and Health Survey (DHS) Data 2003–2011 and African Develop," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 130(3), pages 1125-1146, February.
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    13. Nandita Saikia & Abhishek Singh & Domantas Jasilionis & Faujdar Ram, 2013. "Explaining the rural-urban gap in infant mortality in India," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 29(18), pages 473-506.
    14. Gintare Mazeikaite & Cathal O’Donoghue & Denisa M. Sologon, 2021. "What Drives Cross-Country Health Inequality in the EU? Unpacking the Role of Socio-economic Factors," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 155(1), pages 117-155, May.
    15. Okechukwu D. Anyamele & Benedict N. Akanegbu & Jean-Claude Assadand John O. Ukawuilulu, 2017. "Differentials in Infant and Child Mortality in Nigeria: Evidence from Pooled 2003 and 2008 DHS Data," Advances in Management and Applied Economics, SCIENPRESS Ltd, vol. 7(6), pages 1-5.
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    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I31 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - General Welfare, Well-Being
    • O53 - Economic Development, Innovation, Technological Change, and Growth - - Economywide Country Studies - - - Asia including Middle East

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