Infant and Child Survival in Bhutan: A Life Table Analysis

by Tashi Dorjee, Master of Arts in Demography (2010)

Using the 2000 National Health Survey of Bhutan, this study examined the pattern, levels, trends of and differentials in infant and child survival by selected demographic, socioeconomic, and proximate background characteristics. It primarily used the life table technique; however, it also estimated conventional measures of infant mortality rate, child mortality rate and under-five mortality rate. It worked on a created child file from women’s birth histories. It has shown that infant and child mortality has been rapidly declining over time. Infant mortality rate has gone down from 87 during the period 1985-1989 to 66 infant deaths per 1000 live births during the 1995-2000 periods. Child mortality rate has also gone down from 52 to 17 child deaths per 1000 children during the same period. Under-five mortality rate has fallen from 130 to 80 infant and child deaths per 1000 live births during the same period.

In terms of differentials, the study has shown that there is higher male mortality both at infancy as well as at the older ages in childhood. Urban infant and child mortality is higher than that of the rural. The East region exhibited much higher infant and child mortality than the West or Central. The higher the mother’s education, the lower is the chances of dying of births and children, working mothers have lower infant and child mortality than their non-working counterparts. Infant and child mortality is higher among those whose mothers are at high risk maternal ages (ages less than 19 years and above 35 years) than those whose are in the prime reproductive age group (20-35years old). Children born after a short period of birth interval was observed to be experiencing higher mortality than those born after long birth interval. Birth order and infant and child survival were not significantly associated when birth order was taken alone. However, further examining closely the birth order differentials controlling for sex and one given socioeconomic variable, fourth or higher order births are more likely to be associated with female infant and child mortality than first or lower order births.

Among the variables indicating mothers’ health, the institutional delivery with the professional birth attendant has an advantage over the home delivery that was mostly attended by unskilled traditional birth attendants. However, access to safe drinking water is only significantly related to infant and child mortality among female births to mothers with no education and who were unemployed while access and use of toilet facilities is also only significantly associated with infant and child mortality only among females in the rural areas whose mothers had no formal schooling and had 1-5 years formal schooling and unemployed as well as among males whose mothers with 1-5 years of formal schooling.