Mortality Decline in Kenya: A Reexamination of Recent Under-Five Mortality Estimate

Abstract

This study examined the extent of birth displacement and its effect on the under-five mortality estimates in Kenya. Using data from 2003 and 2008/09 Kenya Demographic and Health Surveys, we evaluate the variability of birth displacement by region and place of residence based on the survival status of the child. We compute birth ratios for children born in the 5th calendar year preceding each survey and note the possible effect on under-five mortality estimates. Results show that under-five mortality estimates in 2008/09 survey are smaller than that of a similar period in 2003 survey by 17 percent. Overall, birth ratios for the 5th calendar year were below 100 percent suggesting presence of birth displacement. However, there was no variance in the displacement between surviving and dead children, hence modest impact on the under-five mortality rate. Evidence suggests that the remarkable decline in the under-five mortality rate recorded in 2008/09 is a function of both overestimation of mortality rate in 2003 survey and underestimation in 2008/09 survey. We recommend that data from more than one source be used to interpret under-five mortality decline and further research should be conducted linking the observed mortality decline to the delivery of known effective interventions.