Cause specific under-five mortality rates and associated risk factors among children in northern Ghana between 2007 and 2012 using survival analysis techniques
Abstract
Introduction
This study assessed the causes of under-five (U5) deaths and examined the associated risk factors in northern Ghana.
Methodology
The study analyzed prospectively collected longitudinal data of children born between 1st January 2007 and 31st December 2012 and resident in the Navrongo Health and Demographic Surveillance System (NHDSS) in northern Ghana.
Results
Data from 20,651 children were analyzed with 1,056 under-five deaths and 51,783 person-years of observation. The overall mortality rate was 19.5 person-year of observation. The main cause of under-five deaths were malaria (19.5%). Being male (Hazards ratio [95% CI]; 1.20 [1.06 - 1.36]; p=0.004), children born to single mothers (1.3 [1.18 - 1.59]; p<0.001) and home deliveries (1.29 [1.12 - 1.48]; p<0.001) were associated with increased risk of mortality while children born to women aged 20-34 years (0.81 [0.67 – 0.98]; p=0.0.25) compared to those 19 years and below and those from high socioeconomic households (0.87 [0.74 - 1.03]; p=0.001) were associated with relatively lower risk of death.
Conclusion
Malaria remain the leading cause of under-five deaths in the study area. Adherence to prevailing malaria prevention measures including use of insecticide treated bed-nets, seasonal chemo-prophylaxis, indoor-residual spraying and adequate access to healthcare will greatly improve child survival.
Forced migration and pressure on agro-pastoral resources in the Far-North Region Cameroon
Abstract
Cameroon's rural territories bordering Nigeria have suffered regular violence since 2014. In addition to the loss of life and property, kidnappings for the purpose of hostage-taking and the recruitment of peasants, agro-pastoral resources have been over-exploited in the host territories while the insecure areas have been abandoned. As a result, in addition to the already large number of internally displaced persons, there are migrants returning from insecure areas and ex-hostages of the Boko Haram sect, most of whom have agriculture and livestock as their main activities. This raises the problem of access (re-access) to agro-pastoral resources (agricultural land, pastures, wood resources) in a context of climate change marked by the dwindling of resources, competition between local agro-pastoralists and internally displaced persons on the one hand, and on the other hand between returning migrants, ex-hostages and their communities of origin. Indeed, in addition to the exacerbation of conflicts over land resources in the rural areas affected by the influx of IDPs fleeing the security crisis linked to Boko-haram, one of the issues linked to the return of migrants and ex-hostages, and conditioning their reintegration, is the reappropriation of cultivation areas (farms) abandoned by them and immediately occupied by the peasants and traditional chiefs who have remained in their areas of origin. This study is based on field observation supplemented by the use of documents. It involved the collection of field data through a protocol administered during several missions carried out in the territories concerned (the sudivisions of Koza, Moskota, Mozogo and Mokolo in the Mandara/Mayo Tsanaga Mountains bordering Bornou in Nigeria) which have regularly suffered assaults by the Boko Haram sect), exchange meetings with the various actors involved in the field: Local authorities, municipal authorities, traditional authorities (Lamido and Lawan/Traditional Chiefs), community leaders (Imam, pastor, youth and women's leader, vigilance committee) and NGOs (CARITAS, ALDEPA). Discussions with the farmers focused on the management of agro-pastoral resources and their perception of the ex-hostages and the conditions for their eventual reintegration.
Keywords: Forced migrants; Boko Haram; peasantry; agropastoral resources; pressure, Cameroon.
