Under-five mortality among displaced populations in Meheba refugee camp, Zambia, 2008-2014

Abstract

Background: Under-five mortality, which is the probability of a child dying before their fifth birthday, is of concern in Zambia as infant and child mortality rates are important social indicators. Displaced population in camps provide a basis for under-five mortality surveillance because detailed registration databases have been developed. Additionally, health data routinely collected on mortality allowed for a review of mortality trends and identification of correlating factors to under-five mortality. Literature suggests a number of factors that influence child mortality including biological, socio-econimic and environmental factors. However, while progress in reducing mortality is evident disparities in under-five mortality trends have been observed.

Methods: The study examined differential levels and trends of under-five mortality with correlating factors in Meheba refugee camp in Zambia which is presently in its post emergency phase. The retrospective cross-sectional study reviewed the ProGres and Health Information System (HIS) databases under-five mortality data for a seven (7) year period (2008-2014) and included all children aged less than five years in each year of review. STATA 12 (including Ordinary Least Squares Regression) and Microsoft Excel 2010 where used for data analysis and computation of findings.

Results: Malaria and respiratory infections accounted for 81 % of under-five deaths while cases of Diarrhoea were responsible for 10 % of reported mortalities. Seventy five percent (75 %) of all mortalities were reported in children aged less than 1 year (<1 year). While no significant variations in mortality were noted as a result of time, increased frequency of visits to health centre significantly (P < 0.05) reduced mortalities in children by 3/1000 in each year.

Conclusion: In addition to improving health infrastructure and reducing distances to health facilities, the study also recommends sensitization programmes targeted at ensuring accessibility to health care services for children under-5 years. The study found that increased health centre visitations were associated with reduction in under-five mortality and encourages initiatives targeted at sensitizing communities to seek health care. Furthermore, collaboration between the health systems, community and Non Governmental Organisations (NGOs) is key in addressing higher infant mortality observed. It is envisaged that this will contribute to the reduction in mortality cases and will compliment already existing strategies.

Keywords: Displaced populations; Post emmergency phase; Refugee camps; Underfive mortality.

Fig. 1

Under-five mortality (/1000 population), Meheba Refugee camp, Zambia, 2008–2014. Legend: UNHCR/Solwezi DMO HIS, 2015

Fig. 2

Number of deaths under the age of 5 years by age group, Meheba Refugee camp, Zambia, 2008–2014. Legend: UNHCR/Solwezi DMO HIS, 2015

Fig. 3

Number of Deaths by Cause under age of 5 years, Meheba Refugee camp, Zambia, 2008–2014. Legend: UNHCR/Solwezi DMO HIS, 2015

Fig. 4

Under-five mortality rate (/1000 population) by average number of health facility attendance, Meheba Refugee camp, Zambia, 2008–2014. Legend: UNHCR/Solwezi DMO HIS, 2015

Fig. 5

First health facility attendance by age group, Meheba Refugee camp, Zambia, 2008–2014. Legend: UNHCR/Solwezi DMO HIS, 2015