Paternal Social Determinants of Childhood Mortality in Zimbabwe
Laston Gonah1, Dumisani Sibanda1, Sibusiso C Nomatshilla1
1Department of Public Health, Faculty of Medicine and Health Sciences, Walter Sisulu University, South Africa.
Insights
Paternal factors like education and employment significantly impact child survival in Zimbabwe. These social determinants are interconnected with other factors, highlighting a complex interplay in reducing under-five mortality.
Area of Science:
- Public Health
- Demography
- Sociology
Background:
- Child mortality studies in Zimbabwe predominantly focus on child and maternal factors.
- Paternal social determinants of under-five mortality remain under-researched.
Purpose of the Study:
- To investigate the role of paternal social determinants in infant and childhood mortality in Zimbabwe.
- To analyze the influence of paternal age, education, wealth, employment, and location on child survival.
Main Methods:
- Cross-sectional analysis of secondary data from the 2015 Zimbabwe Demographic Health Survey (ZDHS).
- Multivariate logistic regression and Cox regression for infant and child mortality analyses.
- Kaplan-Meier survival curves to assess paternal factors' impact on under-five survival.
Main Results:
- Younger paternal age, lower paternal education, lower household wealth index, paternal unemployment, and rural residence are associated with increased childhood mortality.
- These paternal factors are interconnected and contribute to observed mortality outcomes.
Conclusions:
- Paternal characteristics are significant contributors to child survival but do not act in isolation.
- Child survival is shaped by complex interactions between child, household (paternal and maternal), community, and policy-level factors.
- Social determinants of child survival are interlinked and interdependent, with no single factor being solely sufficient to determine outcomes.
Abstract:
Introduction: In Zimbabwe, studies have mainly focused on child and maternal factors contributing to under‑5‑year mortality, and little has been published concerning the paternal social determinants, which are also important. Aim: The goal of this paper is to investigate the paternal social determinants of infant and childhood mortality in Zimbabwe. Methods: The study analyzed cross‑sectional secondary data from the Zimbabwe Demographic Health Survey (ZDHS) 2015 to investigate paternal determinants of infant and child mortality. Multivariate logistic regression and Cox regression were conducted for separate analyses of infant and child data to determine the odds and risk of death informed by paternal factors. Kaplan-Meier survival curves were used to determine the importance of paternal factors in determining under‑five survival. Results: Younger paternal age, lower level of education, lower wealth index, unemployment, and rural geographical location are important contributing factors for childhood mortality, and these factors were found to be interconnected and interrelated in producing the observed outcomes. Conclusion: Paternal characteristics are important contributing factors for child survival, but not alone. The interaction between child characteristics, household (paternal and maternal), community, and public/global‑policy‑level factors is important in shaping observed childhood mortality outcomes. Social determinants for child survival are interlinked and interdependent on each other in producing the observed childhood mortality outcomes, and no one factor is more important than the other. Each factor represents an important component but not one that is individually sufficient to produce an outcome.
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