Socioeconomic inequality and determinants of low birth weight in Kenya: a multilevel analysis using 2022 demographic and health survey.

Abstract

Background: Socioeconomic inequality remains a critical determinant of health outcomes worldwide, particularly in low- and middle-income countries. In Kenya, one of the most pressing maternal and child health challenges is the high prevalence of low birth weight (LBW), which is a key indicator of infant health and a strong predictor of neonatal and child morbidity and mortality. Therefore, exploring socioeconomic inequality and the determinants of LBW in Kenya is essential for developing effective policies and interventions.

Methods: A cross-sectional study was conducted using secondary data from the 2022 Kenyan Demographic and Health Survey. A weighted total sample of 4717 live births in the two years prior to the survey was included in the study. The concentration index and concentration curve were used to investigate socioeconomic inequality in LBW among newborns. In addition, a multilevel regression model was used to identify the determinants, and the adjusted odds ratio with a 95% confidence interval was used to determine statistical significance.

Results: The prevalence of low birth weight among live births in Kenya was 8.71%. It was inequitably distributed across socioeconomic groups, with a concentration index of (-0.0295), with a higher concentration of LBW infants among mothers living in the lowest socioeconomic quintile. Mothers without formal education, poor wealth index, female sex, multiple births, and antenatal care visits were all significant predictors of LBW.

Conclusion: This study highlights that LBW remains a significant issue in Kenya, disproportionately concentrated in households in the lowest socioeconomic quintile. Factors such as lack of maternal education, poverty, being female, being a twin, and inadequate antenatal care visits were significant predictors. To address these issues, it is important to improve maternal education, economic prosperity, healthcare accessibility, gender-sensitive approaches, and specialized care for multiple pregnancies, and encourage regular antenatal care visits for better birth outcomes and to reduce LBW prevalence. Hence, Kenyan governments and non-governmental organizations should address the complex factors to improve birth outcomes and reduce LBW.