Mothers’ Risk for Experiencing Neonatal and Under-Five Child Deaths in Nepal: The Role of Empowerment

Objectives: We examined if women’s empowerment measures correlated with their risks for experiencing neonatal and under-five child deaths in Nepal controlling for their sociodemographic characteristics and access to health services. Methods: We analyzed data from 8873 women using the 2011 Nepal Demographic and Health Survey. Results: About 10 and 21 % of the women had ever experienced neonatal and under-five child death respectively. Among the empowerment measures—age at first marriage, education, employment, participation in women’s groups, and ability to make intra-household decisions—women’s early marriage and lack of education were risk factors whereas their participation in women’s groups was a protective factor against child death. Women married by age 15 were three times as likely to experience neonatal death and two times as likely to experience under-five child death as women married at age 20 and after. Also, women without any formal education were twice as likely to experience neonatal death as women with beyond primary education and those belonging to women’s groups were 34 % less likely to experience neonatal death. Among the control variables, women who used institutional delivery were significantly less likely to have experienced neonatal death. Also, women residing in the districts with the community-based newborn care program (CB-NCP) were 35 % less likely to experience neonatal mortality controlling for other factors. Conclusions: To reduce childhood mortality, health and social work professionals should work with the local community to delay girls’ age at marriage, to improve girls’ opportunity for education, and to promote their access to health services.