Under-Five Mortality Rate in Sudan: Statistical Analysis of Social Determinants of Health and Health Equity

Abstract

The focus on health equity has grown in importance, leading to a widespread recognition that action on Social Determinants of Health is crucial for reducing inequalities in health. Sudan was among the first countries which adopted a roadmap for Health in All Policies. However, efficient actions to reduce health inequalities need to be enhanced. This paper illustrates the need to act on Social Determinants of Health to reduce health inequalities in Sudan. Descriptive statistics was used to get summarised information. Statistical significance of differences was tested by Pearson’s chi-squared. For the interaction between the 13 variables at the same time, Principal Components Analysis was carried out. As an attempt to explain Under-Five Mortality Rate (U5MR) by the remaining variables Multiple Regression was applied. Huge gaps were found between the 18 states. Contraception varied from 26.5% in Khartoum to 2.9% in Central Darfur; home delivery increased from 27.1% in Northern to 91.4% in West Kordofan and early childbearing was higher in Blue Nile (23.4%) than in Northern (8.6%). Under-five mortality rate is nearly four times higher in East Darfur (112) than in Northern (30). A ratio greater than two was indicated for mother education and income. A lower gap was seen for milieu and gender. The difference was statistically significant for education (p-value <0.005), income (p-value <0.001) and states (p-value <0.0001). The U5MR in Sudan is influenced by social determinants of health like milieu, gender, education, income and territoriality. A large gap was found between states in term of U5MR. Serious efforts must be devoted to reducing heath inequalities by acting on social determinants of health in Sudan. Furthermore, in order to control the U5MR in Sudan we need to act simultaneously on Contraception, use of improved water, Literacy young women and stunted.