The impact of household wealth on child survival in Ghana|
Lartey, Stella T.; Khanam, Rasheda & Takahashi, Shingo
Background: Improving child health is one of the major policy agendas for most of the governments, especially in
the developing countries. These governments have been implementing various strategies such as improving
healthcare financing, improving access to health, increasing educational level, and income level of the household
to improve child health. Despite all these efforts, under-five and infant mortality rates remain high in many
developing nations. Some previous studies examined how economic development or household’s economic
condition contributes to child survival in developing countries. In Ghana, the question as to what extent does
economic circumstances of households reduces infant and child mortality still remain largely unanswered. Thus, the
purpose of this study is to investigate the extent to which wealth affects the survival of under-five children, using
data from the Demographic and Health Survey (DHS) of Ghana.
Methods: In this study, we use four waves of data from Demographic and Health Surveys (DHS) of Ghana from
1993 to 2008. The DHS is a detailed data set that provides comprehensive information on households and their
demographic characteristics in Ghana. Data was obtained by distributing questionnaires to women (from 6000
households) of reproductive age between 15 and 49 years, which asked, among other things, their birth history
information. The Weibull hazard model with gamma frailty was used to estimate wealth effect, as well as the trend
of wealth effect on child’s survival probability.
Results: We find that household wealth status has a significant effect on the child survival in Ghana. A child is
more likely to survive when he/she is from a household with high wealth status. Among other factors, birth spacing
and parental education were found to be highly significant to increase a child’s survival probability.
Conclusions: Our findings offer plausible mechanisms for the association of household wealth and child survival.
We therefore suggest that the Government of Ghana strengthens and sustains improved livelihood programs,
which reduce poverty. They should also take further initiatives that will increase adult education and improve
health knowledge. To the best of our knowledge, this is the first study in Ghana that combines four cross sectional
data sets from DHS to study a policy-relevant question. We extend Standard Weibull hazard model into Weibull
hazard model with gamma frailty, which gives us a more accurate estimation. Finally, the findings of this study are
of interest not only because they provide insights into the determinants of child health in Ghana and other
developing countries, but they also suggest policies beyond the scope of health.
Child survival; Household wealth; Weibull hazard model; Gamma frailty; Ghana