Re-Examining the Correlation of Under-Five Mortality to Economy and Health Expenditure Indicators in Sub-Saharan African Countries (1990-2013)

Angele Mamy, Huilan Xu, Mwita Ngutunyi


Under-five mortality is still a major global burden though much effort has been made to reduce its magnitude as from 1990 to 2013. Child mortality rate is still high in sub-Saharan countries compared to other regions of the world. Understanding both direct and indirect factors contributing to child mortality is of importance in public health in helping tackle the burden of child mortality. In this current review we have explored some of the indirect factors contributing to child mortality at country level, specifically we have done longitudinal (1990 to 2013) and cross-sectional (2012) correlation analysis to determine the correlation of under-five mortality rate to country economy (GDP per capita) and other country health expenditure indicators (Health expenditure %GDP, country Health expenditure per capital, country Public health expenditure) as observed in sub-Saharan countries. We have found very strong negative linear correlation (r=-0.902, p<0.01) between under-five mortality and GDP per capital among sub-Saharan countries as from 1990 to 2013. We also found very strong negative linear correlation between under-five mortality rate and health expenditure per capital (r=-0.917, p<0.01) & percentage public health expenditure (r=-0.902, p<0.01) as from 1990-2013. The correlation between under-five mortality and % GDP used as health expenditure also showed strong negative correlation (r=-0.402, p<0.05) as observed from 1990 to 2013. Cross sectional correlation analysis among variables as observed in 2012 among sub-Saharan countries revealed non-significant to moderate negative linear correlation between under-five mortality rate and GDP per capital so as all other health expenditure indicators stated (r<-0.4). As from year 1990 to 2013, reduction in under-five mortality rate correlated well with increase in country economy (GDP per capital) in majority of sub-Saharan African countries. We have come into terms with the fact that increase in sub-Saharan country economy played significant indirect role in reduction of under-five mortality, we propose additional efforts to boost economy in these countries. As from 1990 to 2013, increase in health expenditure [Health expenditure per capita, Total Health expenditure (Given as % of GDP) and Public Health expenditure] correlated well with reduction in under-five mortality rate. Together with other focused intervention, we propose more funding of health sector plans in order to boost pace in which desired outcomes are achieved overtime (eg. reduction in under-five mortality).


Child Mortality; Correlation Analysis; Health Expenditure; Sub-Saharan Africa

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