Factors Associated with Infant Mortality in Malawi

Objective: Despite the large reduction in infant mortality rates in the last two decades, the burden of infant mortality is still high in Malawi. Because few studies have specifically addressed the determinants of infant mortality in Malawi, this exploratory study identified a series of distal, intermediate, and proximal factors related to infant mortality using a conceptual framework that explains the risk in developing countries. The objective of this study was to examine the effects of family and socioeconomic factors on the risk of an infant dying before the age of 12 months. Methods: In this study, we analyzed the 2004 and 2010 data of the Malawi Demographic and Health Surveys. This study adopted a cross-sectional study design involving 4,698 and 12,174 singleton births in the years 2004 and 2010, respectively. Multiple logistic regression models were used to estimate the effects of selected variables on infant mortality. Results: In the multivariate logistic regression analyses, women who resided in wealthy urban areas were 58% less likely to report infant deaths than those in rural areas [odds ratio (OR)=0.48]. Infants who were second or third in birth order were less likely to die before 12 months. However, cesarean section delivery was found to be a risk factor associated with infant mortality in the year 2004 (OR=1.95). By contrast, women who were in the highest 20% of household wealth, who resided in the northern region, and were in the 20-29 age group were less likely to report infant deaths. However, cesarean section delivery (OR=1.42), male infants (OR=1.26), and small size at birth (OR=1.63) were the significant predictors of infant mortality in the year 2010. Furthermore, the mother's education and household wealth were not significant predictors of infant mortality in Malawi. Conclusion: The present study shows that improving the quality of life in rural areas, evenly distributing health care delivery services and other social economic factors across the nation, and improving maternal health care, neonatal care, and nutrient intake could decrease infant mortality in Malawi.