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  1. Maternal determinants of child survival in a rural African community.

    Article - En anglais


    The aim was to determine maternal factors related to child survival in the rural area of Bwamanda, Northern Zaire.


    A prospective study of 30-months mortality was carried out in a cohort of 776 children aged 0-3 months, obtained by random cluster sampling.

    Inclusion criteria were exclusive breastfeeding, no severe prematurity and absence of severe protein-energy malnutrition, diarrhoea or acute respiratory infection.

    Mortality was recorded by regular home visits and inspection of hospital and funeral registers.

    Maternal factors that remain stable during follow-up were studied.


    Factors associated with excess mortality in bivariate and multiple logistic regression analysis were :

    • (i) mother has parity>5 (relative risk [RR]=1.5-4.2) ;

    • (ii) distance from the health centre>5 km (RR=0.9-2.9) ;

    • (iii) invaliding maternal diseases (RR=1.2-9.0).

    Maternal school education (conditional odds ratio [OR]=1.0-5.0) was significant in the multiple regression.

    In contrast to the other risk factors, mother-child separation or problems with breastfeeding were rare and did not significantly increase mortality.


    Chronic stress situations created by maternal invalidity, high parity and distance from health care facilities, increase child mortality.

    Acute stress in the mother-child dyad seemed to be efficiently compensated for.

    In subsistence economy areas, maternal school education can be a disadvantage.

    Mots-clés Pascal : Mortalité, Survie, Enfant, Homme, Nourrisson, Epidémiologie, Mère, Facteur risque, Parité, Santé, Niveau étude, Accessibilité, Soin, Zaïre, Afrique, Milieu rural, Prospective

    Mots-clés Pascal anglais : Mortality, Survival, Child, Human, Infant, Epidemiology, Mother, Risk factor, Parity, Health, Education level, Accessibility, Care, Zaire, Africa, Rural environment, Prospective

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0474387

    Code Inist : 002B30A01A2. Création : 10/04/1997.