The World Health Organization (WHO) found that 6.6 million children under five died in 2012 (WHO 2013). Almost half of all of these child deaths take place in the first month of life, and 75% of all under five deaths occur within the child's first year of life (WHO 2013). The aim of this study is to compare the most influential factors that decrease infant and neonatal mortality in order to find where policy makers, governments, and international organizations need to focus their efforts in order to get all countries on track for Millennium Development Goal 4 to reduce child mortality. Mosley and Chen (1984) suggest that infant mortality should be studied more as a process with multifactorial origins opposed to an acute, single phenomenon. To study the multifaceted nature of infant mortality they suggest grouping select variables into broad categories. This paper uses this model to test the contribution of the following four types of factors: 1) healthcare system 2) social determinants 3) reproductive behavior and 4) national context in order to understand which category impacts infant mortality most significantly. This study utilizes the Demographic and Health Surveys and was estimated using a discrete time hazard model. Results suggest that social determinants reduce infant mortality most significantly over the other three factors and that maternal education is the key to reaching Millennium Development Goal 4. This research suggests that healthcare interventions, although important, are not a substitute for mother's education. The combination of prenatal care and maternal education will ensure the safest first year for a child.



College and Department

Family, Home, and Social Sciences; Sociology



Date Submitted


Document Type





infant mortality, Millennium Development Goals, maternal education

Included in

Sociology Commons