Contribution of water, sanitation, hygiene and basic education to reduce under-five mortality in Sudan

Until 2015, the under-five mortality rate (U5MR) in Sudan was 65.9 per 1,000 livebirths, higher than the MDG4 target and it has to be reduced by 5.04% per year from its 2020 level to achieve the SDG3.2 by 2030. This target cannot be achieved without improvements in access to safe drinking water (ASW), sanitation and hygiene (ISF) (WASH) and basic education. An estimated autoregressive distributed lag (ARDL) bounds test model confirms a long-run equilibrium relationship between U5MR, WASH, basic education, economic growth and health care. In the short run, U5MR decelerates itself with a coefficient of 0.56. Sanitation and basic education significantly reduce U5MR. Collectively, health care and economic growth affect U5MR adversely. In the long run, declines of U5MR are driven respectively by access to sanitation, hygiene and basic education (a factor of −1.79), economic growth (a factor of −0.21), and health care (a factor of −0.18). The study recommends the promotion of access to safe drinking water with investments on sanitation and hygiene of 32 million $US annually between 2020 and 2030, in order to meet the SDG3.2 in Sudan. Skilled physicians and full vaccination of children can be more effective in reducing U5MR, dependent on progress in safe WASH services.