Socio-demographic and healthcare predictors of infant mortality in West Nile region, Uganda

Abstract

Infant mortality remains a major public health concern in Uganda, particularly in underserved regions such as West Nile. Despite national improvements in child survival, the region continues to record infant mortality rates significantly higher than the national average. This study examined the socio-demographic and healthcare predictors of infant mortality in the West Nile region of Uganda for the period 2019–2024, aiming to provide region-specific evidence to inform targeted health interventions and policy decisions. The study employed a quantitative cross-sectional design, using data collected from 200 mother–infant pairs who had experienced a live birth within five years preceding the survey. Infant mortality status (alive or dead before one year) was treated as the dependent variable, while maternal education, household income, maternal age, distance to the nearest health facility, and immunization status were analyzed as independent variables. Data analysis involved descriptive statistics, bivariate analysis, and binary logistic regression. Descriptive findings revealed that approximately 20% of infants had died before reaching one year of age, indicating that infant mortality remains a significant challenge in the region. Most mothers had low levels of education, with only a small proportion attaining tertiary education. Household incomes were predominantly low, and a considerable number of households were located more than 5 km from the nearest health facility. Although immunization coverage was relatively high, a notable proportion of infants had not completed the recommended immunization schedule. Bivariate analysis showed clear associations between infant mortality and all selected predictors. Higher infant deaths were observed among mothers with no or primary education, low-income households, very young and older mothers, households located far from health facilities, and infants who were not fully immunized. These patterns suggest that both socio economic conditions and access to healthcare play important roles in infant survival. Multivariable logistic regression results indicated that maternal education and immunization status were statistically significant predictors of infant mortality. Household income and distance to health facilities showed marginal significance, while maternal age exhibited a U shaped relationship, with higher risks among adolescent and older mothers. The model demonstrated good overall fit and explained a meaningful proportion of variation in infant mortality outcomes.