Seasonal variations in under-five mortality, stratified by neonatal, post-neonatal and child mortality, in Korogocho and Viwandani urban slums in Nairobi, Kenya: a time-series analysis on secondary data from the Nairobi Urban Health and Demographic Survei

Type Thesis or Dissertation - Master of Medical Science in International Health
Title Seasonal variations in under-five mortality, stratified by neonatal, post-neonatal and child mortality, in Korogocho and Viwandani urban slums in Nairobi, Kenya: a time-series analysis on secondary data from the Nairobi Urban Health and Demographic Survei
Author(s)
Publication (Day/Month/Year) 2015
Abstract
Background Globally, the amount of people living in urban poor settings is increasing rapidly.
In order to effectively direct resources and achieve equity in health, an understanding of how
contextual factors are affecting mortality in marginalised groups is first needed.
Aim This study aims at clarifying if seasonality can be associated with mortality in different
child age spans i.e. neonatal, post-neonatal and children under five in two urban slum settlements
in Nairobi, Kenya.
Methodology Secondary seasonal mortality data from the Nairobi Urban Health and
Demographic Surveillance System (NUHDSS), collected in the years 2008–2010 in Viwandani
and Korogocho slums in Nairobi, Kenya was decomposed into seasonal components with a
moving average comparison. Seasonal indices were created on disaggregated data for the
different mortality groups and gender strata.
Results The annual mean prevalence of under-five mortality [U5M] and neonatal mortality
[NM] was 86 and 20 respectively. Overall U5M increased from April–August. Post-neonatal
mortality [PM] had the earliest onset (April–May) followed by NM (May–August). Child
mortality [CM] had two peaks, June–August and November.
Conclusion The displayed seasonal pattern in NM, PM, CM and U5M seemingly corresponded
to the yearly fluctuation of temperature and precipitation, with a predominant intensification in
the wettest and coldest months. CM seemed to be the only group with increased mortality also in
the second rain period, not reflected in the overall mortality index. These findings could be used
to set the agenda for preventative interventions aimed at reducing childhood mortality and
morbidity

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