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The impact of prenatal care quality on neonatal, infant and child mortality in Zimbabwe: evidence from the demographic and health surveys

Makate, Marshall and Makate, Clifton (2016): The impact of prenatal care quality on neonatal, infant and child mortality in Zimbabwe: evidence from the demographic and health surveys. Published in: Health Policy and Planning , Vol. 32, No. 3 (1 April 2017): pp. 395-404.

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Abstract

Abstract: The effect of the quality of prenatal care on child mortality outcomes has received less attention in sub-Saharan Africa. This study sought to explore the consequence of the quality of prenatal care and its individual components on neonatal, infant and under-five mortality using the three most recent rounds of the nationally representative Demographic and Health Survey data for Zimbabwe conducted in 1999, 2005/06 and 2010/11. The model for the demand for the quality of prenatal care is estimated using an OLS regression while the child mortality models are estimated using standard probit regressions. Since infant mortality rates and access to quality prenatal care might differ by rural and urban residence, we estimate separate models for the overall sample, urban and rural samples. The results indicate that a one-unit increase in the quality of prenatal care lowers the risks of neonatal, infant and under-five mortality by nearly 36%, 29.31%, and 27.53% respectively for the overall sample. The probability of neonatal, infant and under-five mortality is lowered by about 41.67%, 35.18%, and 30.77% respectively for urban-born children following a one-unit increase in the quality of prenatal care. For the rural sample, we found that a one-unit increase in the quality of prenatal care lowers the risks of neonatal, infant and under-five mortality by nearly 34.61%, 27.12%, and 25.35% respectively. These findings are all statistically significant at the 1% significance level. Examining the effect of individual prenatal care components on child mortality revealed that blood pressure checks, information on pregnancy complications, iron supplementations, and tetanus vaccinations are all important in lowering child deaths. Overall, our results suggest the need for public health policy makers in Zimbabwe to focus on ensuring high-quality prenatal care especially in low-income and rural segments of the population to save Zimbabwe’s children.

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