Title: Causes, consequences, and remedies of child mortality in rural Ethiopia

1. Introduction

This term paper examines the causes, consequences and remedies of child mortality in rural
Ethiopia that focusing on factors such as limited healthcare access, poor sanitation, malnutrition,
and lack of parental education. It emphasizes the need for interventions to mitigate these issues
and improve child health outcomes. It uses the problem tree methodology to visualize the
interrelationships between factors, facilitating communication among stakeholders. It also
highlights the need for education and awareness among parents to improve childcare practices
and nutrition. (Dercon & Porter, 2014; Tadesse et al., 2020).

In rural Ethiopia child mortality is a result of inadequate healthcare, poor sanitation, malnutrition, and
lack of education among parents. These factors contribute to high preventable diseases and health
complications, exacerbated by inadequate healthcare infrastructure, poor sanitation, and malnutrition.
Lack of parental awareness perpetuates this cycle. (Dercon & Porter, 2014; Tadesse et al., 2020)

Addressing child mortality in rural Ethiopia requires a multifaceted approach, including

expanding healthcare services, promoting sanitation and hygiene, and addressing malnutrition
through food security interventions and nutritional education. Additionally, enhancing parental
education about child health and nutrition is crucial to prevent illness and death, and to improve
overall child well-being. (Dercon & Porter, 2014; Tadesse et al., 2020).
So the purpose of study aims to identify factors contributing to high child mortality rates in
Ethiopia's rural areas and to inform policymakers and public health practitioners about
challenges faced by these communities and develop targeted interventions. The study also
explores potential remedies to improve child health outcomes and foster sustainable
development, addressing the lack of education and awareness among parents. (Dercon & Porter,
2014; Tadesse et al., 2020).

Research on child mortality in rural Ethiopia aims to advance global health equity and achieve
the Sustainable Development Goals. It emphasis on challenges faced by rural populations, such
as access to healthcare, sanitation, and nutrition. The findings inform advocacy efforts and
mobilize resources for targeted interventions to improve child survival and well-being. Lack of
education and awareness among parents perpetuates poor health outcomes, (Dercon & Porter,
2014; Tadesse et al., 2020).
To analyze systematically the causes and consequences of child mortality, a problem tree analysis is
crucial for understanding the issue. It helps to identify root factors and develop targeted
interventions. This approach allows stakeholders to prioritize resources and implement evidence-
based strategies. The tree methodology facilitates communication and collaboration, enabling
sustainable solutions. Lack of education and awareness among parents about proper childcare
practices and nutrition perpetuates poor health outcomes in rural communities. (Rogers, 2010).
A problem tree is a tool used to improve accountability and transparency in interventions aimed
at addressing child mortality in rural Ethiopia. It also to helps identify causes and consequences
of child mortality, track progress, and evaluate the effectiveness of strategies. This process
fosters participatory decision-making and empowers local communities to take ownership of
their health, promoting sustainable solutions to reduce child mortality. The tree methodology
also helps address the lack of education and awareness among parents about proper childcare
practices and nutrition. (Rogers, 2010). And the problem tree of the causes and consequences of
child mortality in rural Ethiopia is presented as follows;

2. Causes of child mortality in rural Ethiopia

2 .1. Limited access to healthcare services

Rural Ethiopia faces significant child mortality due to limited access to essential maternal and
child health services due to scarcity of facilities. This leads to delayed medical care, increased
risk of complications, and limited opportunities for community development, including
psychological distress experienced by rural communities. Deribew et al. (2007) found that
limited access to healthcare facilities was associated with higher under-five mortality rates,
highlighting the critical role of healthcare infrastructure in reducing child mortality. Ethiopia
faces significant barriers to healthcare access due to long distances, poor infrastructure, and
geographical issues. This delay can lead to preventable illnesses, complications, and child
mortality, necessitating urgent attention for development. Asfaw and Simane (2016) discuss the
challenges of accessing healthcare services in rural Ethiopia and emphasize the need for
interventions to improve healthcare infrastructure and reduce geographical barriers to access,
ultimately reducing child mortality rates in rural communities.

In rural Ethiopia's healthcare shortage results in inadequate coverage of essential maternal and
child health services, increasing the risk of adverse health outcomes and mortality. A study by
Tessema et al. (2021) highlights the negative impact of healthcare shortages on maternal and
child health in rural Ethiopia, emphasizing the need for interventions to improve access to skilled
healthcare providers and address workforce disparities. Fekadu et al. (2016) examines the
geographical distribution of healthcare professionals in Ethiopia and highlights the challenges of
healthcare access in rural areas, emphasizing the importance of addressing workforce disparities
to improve maternal and child health outcome

Due to chronic shortage of essential medical supplies, Ethiopia faces child mortality
compromising care quality and increasing risk of adverse health outcomes, necessitating urgent
attention for improved maternal and child health interventions. A study by Kinfu et al. (2019)
examines Ethiopia's primary healthcare facilities' shortage of essential medicines, highlighting
stock outs and inadequate supply chain management. It emphasizes the need for interventions to
improve access to medical supplies in rural areas, particularly in diagnosing and treating
childhood illnesses. Kebede et al. (2019) assesses the availability and functionality of medical
equipment in healthcare facilities in Ethiopia and underscores the need for investments in
medical equipment and infrastructure to improve healthcare delivery and child health outcomes
in rural areas.

2.2 Poor Sanitation and Hygiene Practices

Poor sanitation and hygiene practices in rural Ethiopia, including lack of clean water sources,
significantly contribute to child mortality rates due to waterborne diseases, (UNICEF, 2019).
According to a study by Gebru et al. (2018), conducted in rural Ethiopia, the absence of clean water
sources exacerbates the problem, as community’s softly on unsafe water from rivers, ponds, or
unprotected wells. This contaminated water is a breeding ground for pathogens, increasing the likelihood
of diarrheal diseases among children.
Additionally, poor sanitation practices, including open defecation due to the lack of proper toilet facilities,
further contaminate the environment, perpetuating the cycle of disease transmission (UNICEF, 2019).
The WHO reports that in rural Ethiopia, approximately 297,000 children under five die annually from
diarrheal diseases due to inadequate water, sanitation, and hygiene practices, (WHO, 2020 Sustainable
water and sanitation interventions are crucial for reducing child mortality rates and improving
health outcomes in rural Ethiopian communities. Poor sanitation practices increase the risk of
waterborne diseases and preventable illnesses. A study by Hailu et al. (2019) investigated
inadequate sanitation in rural Ethiopia leads to higher rates of diarrheal diseases and child
mortality, exacerbated by malnutrition, intestinal parasites, and chronic infections. Mihrete et al.
(2018) found that improved sanitation facilities in rural Ethiopia reduced malnutrition rates and
improved child health, emphasizing the need to address poor sanitation practices.

Poor sanitation and hygiene practices in rural Ethiopia increase child mortality by increasing the risk of
infectious diseases and malnutrition. Inadequate personal hygiene, such as hand washing, can transmit
pathogens, leading to diarrheal and respiratory infections. Unsafe food handling and preparation further
compromise child health. A study by Derso et al. (2021) Poor hygiene practices among caregivers of
under-five children in rural Ethiopia are linked to diarrheal diseases, malnutrition, and increased
mortality risk due to inadequate hand washing and unsanitary living conditions. Assefa et al.
(2020) examined the association between hygiene practices and nutritional status among under-five
children in rural Ethiopia and found that poor hygiene behaviors were significantly associated with higher
rates of malnutrition, emphasizing the importance of promoting proper hygiene practices to improve child
health outcomes.

Malnutrition, particularly food insecurity, significantly impacts child mortality in rural Ethiopia
by weakening the immune system and increasing susceptibility to infectious diseases. Inadequate
dietary intake and limited access to nutrient-rich foods compromise children's nutritional status,
impairing growth and development .A study by Berhane et al. (2018) investigated the association
between food insecurity and child mortality in rural Ethiopia and found that food-insecure
households were more likely to experience child deaths compared to food-secure households,
highlighting the critical role of food security in child health outcomes.

In rural Ethiopia's food insecurity leads to poverty, malnutrition, and child mortality. Families
prioritize food over essential needs, compromising health outcomes. Malnourished children face
developmental delays, reduced cognitive function, and increased infection risk, limiting future
earning potential. A study by Hussen et al. (2019) examined the association between food
insecurity and child development outcomes in rural Ethiopia and found that food-insecure
households were more likely to have children with poor developmental outcomes, underscoring
the long-term consequences of food insecurity on child well-being.

2.1.3 Prevalent malnutrition

Malnutrition in rural Ethiopia, primarily due to lack of nutritious food, significantly contributes
to child mortality. Factors like poverty, limited agricultural productivity, and seasonal food
insecurity hinder access to essential nutrients, leading to malnutrition, stunting, and wasting,
thereby increasing the risk of mortality. A study by Gebreyesus et al. (2018) investigated that
low dietary diversity in rural Ethiopia leads to higher child mortality rates, emphasizing the need
for access to nutritious food to reduce poverty and malnutrition, which in turn affects children's
health and future earning potential. Belachew et al. (2013) examined the determinants of child
malnutrition in rural Ethiopia and found that households with low food security were significantly
associated with higher rates of child malnutrition, emphasizing the critical role of access to nutritious
food in improving child health outcomes.

Inadequate breastfeeding practices in rural Ethiopia increase child mortality by denying infants
essential nutrients, antibodies, and protection against infections. Factors like cultural beliefs, lack
of knowledge, and socio-economic constraints contribute to delayed initiation, early introduction
of complementary foods, and lack of exclusive breastfeeding, leading to higher rates of
malnutrition and othe illnesses. A study by Tamiru et al. (2015) assessed the prevalence and
determinants of exclusive breastfeeding in rural Ethiopia and found that suboptimal
breastfeeding practices were associated with higher rates of infant morbidity and mortality,
underscoring the importance of promoting and supporting optimal breastfeeding practices to
reduce child mortality rates in rural settings.

2 .1.4 Lack of Education and Awareness among Parents

Rural Ethiopian parents' lack of education and awareness contributes to child mortality by
limiting their knowledge of essential health practices, preventive measures, and healthcare-
seeking behaviors, leading to suboptimal childcare, delayed medical care, and increased
vulnerability to diseases. A study by Assefa et al. (2021) examined the association between
parental education levels and child mortality in rural Ethiopia and found that children born to
mothers with higher levels of education had significantly lower mortality rates compared to those
born to mothers with lower levels of education, highlighting the critical role of parental
education in improving child health outcomes.

Low literacy rates increase child mortality by limiting parents' access to health information,
leading to suboptimal childcare, delayed healthcare-seeking behaviors, and inadequate feeding
practices in Ethiopia. According to Gizaw et al. (2013) investigated the association between parental
literacy levels and child mortality in rural Ethiopia and found that children born to illiterate mothers had
significantly higher mortality rates compared to those born to literate mothers, underscoring the
importance of literacy and education in improving child health outcomes Cultural beliefs and practices,
including traditional healing practices and early marriage, contribute to child mortality and
maternal health complications. Tadesse et al. (2018) explored the impact of cultural beliefs and
practices on child health outcomes in rural Ethiopia and found that adherence to certain cultural
norms was associated with higher rates of child mortality, highlighting the need to address
cultural factors in efforts to improve child health.

3. Consequences of child mortality in rural Ethiopia

3.1 Loss of Human Capital

Child mortality in rural Ethiopia significantly reduces human capital, affecting future workforce,
economic development, and perpetuating poverty. Premature deaths deprive communities of
skills, talents, and contributions, diminishing the labor force and hindering economic growth. A
study by Geda et al. (2015) investigated the economic impact of child mortality in Ethiopia and
found that the loss of human capital due to child mortality resulted in significant economic costs,
highlighting the importance of reducing child mortality to enhance human capital development
and socioeconomic progress.

It also leads to decreased productivity and innovation, stifling economic growth and social
development. Premature deaths deprive society of potential workers, skills, and talents,
exacerbate poverty, perpetuating underdevelopment, and hindering living standards
improvement. A study by Dercon and Porter (2014) examined the long-term economic consequences of
child mortality in Ethiopia and found that the loss of human capital due to child mortality led to
significant reductions in productivity and innovation, emphasizing the need for investments in child
health to promote economic growth and development.

3.2 Emotional and psychological impact

In rural Ethiopia child mortality significantly impacts families, causing grief, trauma, and
depression. The loss can disrupt family dynamics, strain relationships, and erode social support
networks, exacerbating psychological distress and causing long-lasting emotional and
psychological effects on parents, siblings, and extended family members. A study by Teklay et
al. (2020) explored the emotional and psychological impact of child mortality on families in rural
Ethiopia and found that bereaved parents experienced significant levels of grief and trauma,
highlighting the need for comprehensive support services to address the emotional needs of
affected families.

Additionally, Child mortality in rural Ethiopia exacerbates mental health issues like depression,
anxiety, and PTSD, affecting daily life, caregiving, and social relationships, and increasing
mortality risks. A study by Kassa et al. (2019) investigated the mental health consequences of child
mortality on parents in rural Ethiopia and found a high prevalence of depressive symptoms and
psychological distress among bereaved parents, underscoring the need for targeted mental health
interventions to address the emotional impact of child mortality.
3.2 Economic Burden

Mortality in rural Ethiopia significantly impacts families' finances, with medical expenses
leading to financial strain. This can deplete limited resources, pushing families into poverty.
Indirect costs like lost income and limited access to mental health support services further
exacerbate the psychological distress experienced by affected individuals. A study by Kassie et
al. (2019) examined the economic impact of child mortality on households in rural Ethiopia and
found that families faced significant financial burdens, including high medical expenses,
following the death of a child, highlighting the need for financial support mechanisms to
alleviate the economic strain on affected families.
It also significantly impacts families and communities, causing a loss of potential income and
human capital. This perpetuates poverty, economic instability, and exacerbates socioeconomic
inequalities. Premature deaths also hinder access to mental health support services, exacerbating
psychological distress experienced by family members. A study by Dercon and Porter (2014)
examined the long-term economic consequences of child mortality in Ethiopia and found that the
loss of potential income due to child mortality led to significant reductions in household income
and economic growth, underscoring the importance of reducing child mortality to promote
economic prosperity and poverty alleviation.
3.3 Disruption of community development

In rural Ethiopia child mortality hinders community development, particularly in education and
infrastructure. This leads to decreased school attendance, lower literacy rates, and a lack of
investment in essential infrastructure. This perpetuates poverty and underdevelopment,
exacerbating the psychological distress experienced by rural communities. A study by Tadesse et
al. (2020) explored the impact of child mortality on community development in rural Ethiopia
and found that communities experiencing high child mortality rates struggled to make progress
in education and infrastructure development, highlighting the need for targeted interventions to
address the root causes of child mortality.

Child mortality in rural Ethiopia hinders community development, perpetuates poverty, and
contributes to economic instability, preventable diseases, and psychological distress for family
members. A study by Mekonnen et al. (2020) examined the interplay between child mortality, poverty,
and infrastructure in rural Ethiopia and found that communities with high child mortality rates struggled
to break free from poverty cycles and lacked essential infrastructure to support child health and well-
being.

4. Remedies of child mortality in rural Ethiopia

Rural Ethiopia faces significant child mortality due to limited access to healthcare services. To
address this, interventions aimed at improving healthcare accessibility include expanding
infrastructure, increasing healthcare professionals, and implementing outreach programs. These
interventions can facilitate early detection and treatment of childhood illnesses, reducing child
mortality rates. Addressing underlying factors like sanitation, hygiene, malnutrition, and parental
education can also improve child well-being and foster sustainable development. Problem tree
methodology helps visualize the complex interrelationships between factors, facilitating
communication and collaboration among stakeholders. Nigatu et al. (2019) highlights the
importance of enhancing healthcare access in rural Ethiopia, emphasizing its role in reducing
child mortality and improving overall health outcomes.

Poor sanitation and hygiene practices in rural Ethiopia increase child mortality by increasing
waterborne diseases. Interventions like clean water access, sanitation facilities, and hygiene
education are crucial. Addressing malnutrition and enhancing parental education can promote
sustainable solutions. A study by Tadesse et al. (2018) underscores the importance of sanitation
and hygiene interventions in reducing child mortality in rural Ethiopia, emphasizing their role in
preventing waterborne diseases and improving child health outcomes.

5. Conclusion
In general understanding the causes, consequences, and remedies of child mortality in rural Ethiopia is
paramount for effective public health interventions and policy formulation. This provides critical
insights into the complex interplay of factors contributing to child mortality, including limited access to
healthcare services, poor sanitation and hygiene practices, prevalence of malnutrition, and lack of
education and awareness among parents. By comprehensively examining these factors, policymakers and
healthcare practitioners can develop evidence-based interventions that target the root causes of child
mortality and address its consequences. Such interventions have the potential to significantly reduce child
mortality rates and improve overall child well-being in rural Ethiopia, ultimately contributing to the
achievement of global health goals. Therefore, investing in research and interventions aimed at
understanding and addressing child mortality is essential for promoting the health and development of
children in rural Ethiopia and ensuring a brighter future for generations to come.
6. Recommendation
To effectively address the causes of child mortality in rural Ethiopia , targeted interventions should be
implemented, including improving healthcare access, promoting sanitation and hygiene,
addressing malnutrition, and enhancing parental education. These interventions should be
tailored to rural communities, considering factors like geographical remoteness and socio-
economic disparities. Implementing these strategies, integrating them into public health
strategies, can significantly improve the health and well-being of children in these areas.
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