title: Determinants of under-five mortality in rural and urban Kenya.
abstract: BACKGROUND
  The disparity in under-five year-old mortality rates between rural and urban areas in Kenya (also reported in other in sub-Saharan African countries), is a critical national concern. The objective of this study was to investigate the influence of geographical location and maternal factors on the likelihood of mortality among under-five children in rural and urban areas in Kenya.
  
  
  METHODS
  Data from the 2008-2009 Kenya Demographic and Health Survey were used to determine mortality among under-five children (n=16,162) in rural and urban areas in the 5 years preceding the survey. Multivariate analysis was used to compare the influence of key risk factors in rural and urban areas.
  
  
  RESULTS
  Overall, the likelihood of death among under-five children in the rural areas was significantly higher than that in the urban areas (p<0.05). Household poverty was a key predictor for mortality in the rural areas, but the influence of breastfeeding was similar in the two areas. The likelihood of under-five mortality was significantly higher in the rural areas of Coast, Nyanza and Western Provinces than in Central Province.
  
  
  CONCLUSIONS
  The study shows that the determinants of under-five mortality differ in rural and urban areas in Kenya. Innovative and targeted strategies are required to address rural poverty and province-specific sociocultural factors in order to improve child survival in rural Kenya.
authors.affiliation: African Population and Health Research Center, Nairobi, Kenya. rettarh@aphrc.org
authors.forename: R R
authors.initials: RR
authors.lastname: Ettarh
authors.forename: J
authors.initials: J
authors.lastname: Kimani
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data; D046688:Child Mortality; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya / Q000453:epidemiology; D008423:Maternal Age; D015999:Multivariate Analysis; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult