Estimation of rural and urban under-five mortality rates in Kenya: The role of migration

Analysis of the under-five mortality rate allows policy makers to identify disparities in health outcomes across populations defined by characteristics such as place of residence, income levels, or educational attainment. It also provides guidance for designing health interventions and policies, and for monitoring progress toward program targets. When estimating the under-five mortality rate for a given region using an indirect method based on survey reports, all reported child deaths are typically attributed to the mother’s region of residence at the time of the survey. This assumption can substantially affect regional under-five mortality rates in areas that receive migrants from regions with markedly different mortality regimes. The aim of this study was therefore to establish trends in the under-five mortality rate for rural and urban regions in Kenya while accounting for migration between these regions. This study used secondary data from six demographic and health surveys conducted in Kenya from 1989 to 2014. The Q-FIVE program was used to indirectly derive the set of the under-five mortality rates. These rates were then adjusted for the effects of migration using a sub-area mortality estimation approach. The results reveal that population movement between regions with different mortality rates can alter regional under-five mortality rates. By adjusting the under-five mortality rates derived for each region, we obtained clear and consistent trends across the two regions. Further research should consider the effects of migration across the socioeconomic spectrum.