Contextual Effect of Village and Other Determinants on Infant Mortality: A Multilevel Analysis from Karanganyar, Central Java

Endang Palupi1), Harsono Salimo2), Bhisma Murti1)


1)Masters Program in Public Health, Universitas Sebelas Maret

2)Department of Pediatrics, Dr. Moewardi Hospital, Surakarta



Background: Rural children face higher mortality rates than their urban counterparts. Although the rural disadvantage in average child survival in developing countries is firmly established, its explanation is less clear. Several studies suggest that household-level factors appear to be important in explaining rural-urban differences in child mortality. This study aimed to examine the contextual effect of village and other determinants on infant mortality in Karanganyar, Central Java.

Subjects and Method: A cross-sectional study was conducted in Karanganyar, Central Java, from February to May 2020. A sample of 200 infants aged 1 to 23 months was selected by fixed disease sampling. The dependent variable was infant mortality. The independent variables were exclusive breastfeeding, nutritional intake, immunization status, maternal education, family income, and contextual effect of village. The data were collected by questionnaire and analyzed by a multiple multilevel logistic regression run on Stata 13.

Results: Infant mortality decreased with exclusive breastfeeding (b= -5.10; 95% CI= -9.60 to -0.59; p= 0.026), high family income (b= -5.96; 95% CI= – 9.91 to -2.02; p= 0.003), high maternal education (b= -4.09; 95% CI= -7.79 to -0.38; p= 0.030), and complete immunization (b= -4.67; 95% CI= -8.69 to -0.67; p= 0.022). Infant mortality increased with poor nutritional status (b= 4.99; 95% CI= 1.79 to 8.19; p= 0.002). Village had contextual effect on infant mortality with ICC= 32%.

Conclusion: Infant mortality decreases with exclusive breastfeeding, high family income, high maternal education, and complete immunization. Infant mortality increases with poor nutritional status. Village has contextual effect on infant mortality.

Keywords: infant mortality, contextual effect of village

Correspondence: Endang Palupi. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: Mobile: +6281331872723.


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