The determinants of birth registration among children under five in Eastern and Western Uganda.

Abstract

Birth registration provides legal identity and access to healthcare, education, and social protection, yet many children in low- and middle-income countries remain unregistered. In Uganda, coverage varies by region and population group despite efforts by NIRA and government. This study therefore examined the determinants of birth registration among children under five years in Eastern and Western Uganda. A cross-sectional analytical study was conducted using secondary data from the 2016 Uganda Demographic and Health Survey (UDHS) PR dataset including children under five years residing in Eastern and Western Uganda. Birth registration was the dependent variable, while socio-demographic characteristics, maternal factors, and household characteristics were examined as independent variables. Descriptive statistics and bivariate analysis were used to assess factors associated with birth registration, with statistical significance considered at p < 0.05. The descriptive analysis showed that most children were aged 4 years (21.4%), with a nearly equal distribution of males (50.2%) and females (49.8%). The majority of respondents had attained primary education (62.3%), belonged to the lowest wealth quintile (26.2%), lived in male-headed households (74.1%), and resided in rural areas (82.5%). More respondents were from Eastern Uganda (57.1%) than Western Uganda (42.9%), and over half were married (58.4%).Bivariate analysis using the Chi-square test showed that child age (χ² = 33.542, p < 0.001), wealth index (χ² = 22.217, p < 0.001), place of residence (χ² = 5.201, p = 0.023), and region (χ² = 32.991, p < 0.001) were significantly associated with birth registration. The study concludes that birth registration among children under five is influenced by a combination of demographic and socioeconomic factors such as the child's age, place of residence, household wealth, maternal education, and region of residence were. These findings suggest that disparities in access to birth registration services persist and require targeted interventions to improve registration coverage.