International Journal of Epidemiology 2001;30:447-455
© International Epidemiological Association 2001
Child Health in Africa |
War, famine and excess child mortality in Africa: the role of parental education
a Policy Research Division, The Population Council, One Dag Hammarskjold Plaza, New York, NY 10017, USA. E-mail: gkiros{at}popcouncil.org
b Population Studies and Training Center, Brown University, Box 1916, Providence, RI 02912, USA. E-mail: Dennis_Hogan{at}brown.edu
Abstract
Background Civilian-targeted warfare and famine constitute two of the greatest public health challenges of our time. Both have devastated many countries in Africa. Social services, and in particular, health services, have been destroyed. Dictatorial and military governments have used the withholding of food as a political weapon to exacerbate human suffering. Under such circumstances, war and famine are expected to have catastrophic impacts on child survival. This study examines the role of parental education in reducing excess child mortality in Africa by considering Tigrai-Ethiopia, which was severely affected by famine and civil war during 1973–1991.
Methods This study uses data from the 1994 Housing and Population Census of Ethiopia and on communities' vulnerability to food crises. Child mortality levels and trends by various subgroups are estimated using indirect methods of mortality estimation techniques. A Poisson regression model is used to examine the relationship between number of children dead and parental education.
Results Although child mortality is excessively high (about 200 deaths per 1000 births), our results show enormous variations in child mortality by parental education. Child mortality is highest among children born to illiterate mothers and illiterate fathers. Our results also show that the role of parental education in reducing child mortality is great during famine periods. In the communities devastated by war, however, its impact was significant only when the father has above primary education.
Conclusions Our findings suggest that both mother's and father's education are significantly and negatively associated with child mortality, although this effect diminishes over time if the crisis is severe and prolonged. The policy implications of our study include, obviously, reducing armed conflict, addressing food security in a timely manner, and expansion of educational opportunities.
KEY MESSAGES
- Civilian-targeted warfare and famine have devastated many countries in Africa, including Ethiopia, where these events have had catastrophic impact on child survival.
- This study examines the role of parental education in reducing child mortality during a period of war and famine in Tigrai-Ethiopia.
- We find, as expected, that children born in communities suffering from food shortages and conflict have higher mortality, and child mortality is significantly higher in urban than rural areas.
- Our results show that both mother's and father's education are significantly associated with child survival, although this effect diminishes over time if the crisis is severe and prolonged.
- The policy implications of our study include, obviously, reducing armed conflict, addressing food security in a timely manner, and expansion of educational opportunities.
Keywords Child mortality, parental education, war, famine, disasters, Africa, Ethiopia
Accepted 22 June 2000
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  R. Hong, V. Mishra, and J. Michael Economic Disparity and Child Survival in Cambodia Asia Pac J Public Health, June 1, 2007; 19(2): 37 - 44. [Abstract] [PDF]
|
|
|
|
 |
|
 J. Nielsen, H. Jensen, P. K. Andersen, and P. Aaby Mortality patterns during a war in Guinea-Bissau 1998-99: changes in risk factors? Int. J. Epidemiol., April 1, 2006; 35(2): 438 - 446. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Garfield Commentary: War, famine and excess child mortality in Africa Int. J. Epidemiol., June 1, 2001; 30(3): 456 - 456. [Full Text] [PDF]
|
|