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What explains the Rural-Urban Gap in Infant Mortality — Household or Community Characteristics?

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  • Ellen van de Poel

    (Erasmus University Rotterdam)

  • Owen O'Donnell

    (Erasmus University Rotterdam, University of Macedonia, Thessaloniki, Greece)

  • Eddy Van Doorslaer

    (Erasmus University Rotterdam)

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.

Suggested Citation

  • Ellen van de Poel & Owen O'Donnell & Eddy Van Doorslaer, 2007. "What explains the Rural-Urban Gap in Infant Mortality — Household or Community Characteristics?," Tinbergen Institute Discussion Papers 07-067/3, Tinbergen Institute.
    • Handle: RePEc:tin:wpaper:20070067
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    2. 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.
    3. 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.
    4. Makate, Marshall & Makate, Clifton, 2016. "The causal effect of increased primary schooling on child mortality in Malawi: Universal primary education as a natural experiment," Social Science & Medicine, Elsevier, vol. 168(C), pages 72-83.
    5. Lilipramawanty Kewok Liwin & Brian Houle, 2019. "The effects of household and community context on mortality among children under five in Sierra Leone: Evidence from the 2013 Demographic and Health Survey," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 40(11), pages 279-306.
    6. Makate, Marshall & Makate, Clifton, 2016. "The Evolution of Socioeconomic-Related Inequalities in Maternal Healthcare Utilization: Evidence from Zimbabwe, 1994-2011," MPRA Paper 83897, University Library of Munich, Germany, revised 12 Jan 2018.
    7. 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.
    8. Claus C. Pörtner & Yu-hsuan Su, 2018. "Differences in Child Health Across Rural, Urban, and Slum Areas: Evidence From India," Demography, Springer;Population Association of America (PAA), vol. 55(1), pages 223-247, February.
    9. Jona Schellekens, 2021. "Maternal education and infant mortality decline: The evidence from Indonesia, 1980–2015," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 45(24), pages 807-824.
    10. 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.
    11. Filippo Temporin, 2020. "How Does Deprivation Affect Early-Age Mortality? Patterns of Socioeconomic Determinants of Neonatal and Postneonatal Mortality in Bolivia," Demography, Springer;Population Association of America (PAA), vol. 57(5), pages 1681-1704, October.
    12. Günther Fink & Isabel Günther & Kenneth Hill, 2014. "Slum Residence and Child Health in Developing Countries," Demography, Springer;Population Association of America (PAA), vol. 51(4), pages 1175-1197, August.
    13. Pieter Bakx & Claudine de Meijer & Frederik Schut & Eddy van Doorslaer, 2015. "Going Formal or Informal, Who Cares? The Influence of Public Long‐Term Care Insurance," Health Economics, John Wiley & Sons, Ltd., vol. 24(6), pages 631-643, June.
    14. Philippe Bocquier & Rafael Costa, 2015. "Which transition comes first? Urban and demographic transitions in Belgium and Sweden," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 33(48), pages 1297-1332.
    15. 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.
    16. Gebrehiwot , Tagel & Hassen, Sied, 2022. "Impact of Energy Access on Food Security and Child Nutrition: Panel Data Evidence from Rural Ethiopia," EfD Discussion Paper 22-11, Environment for Development, University of Gothenburg.
    17. 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.
    18. 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.

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    More about this item

    Keywords

    Sub-Saharan Africa; rural-urban inequality; infant mortality; decomposition; unobserved heterogeneity;
    All these keywords.

    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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