Socio-demographic analysis of early age mortality in the southeastern part of Turkey

Kazım Tuğ, Hacettepe University

Although level of early age mortality is in a decreasing trend in Turkey, regional disparities still come out as an ultimate problem. The Southeast Anatolia Region (SEAR), containing nine provinces and approximately ten percent of population, has always been one of the forehead regions influencing the country average strongly in terms of socio-economic and demographic conditions, particularly for early age mortality level. The most recent national research, TDHS-2003, indicated this difference clearly and estimated IMR for Turkey as 29 per thousand whereas this is 38 for the region. Therefore, interaction of early age mortality with socio-demographic factors and availability of the data obtained from TDHS-2003 have both enabled the realization of focusing on this region separately. In this study, four groups of proximate (maternal, environmental, nutritional, health care factors) and some socio-economic variables are described by following the Mosley and Chen’s conceptual framework. The aim of this classification is to compare the conditions of region within the country and to analyze the influence of the factors on mortality. Mortality is computed by using Child Mortality Index (CMI) which is the dependent variable of this study. In multivariate analyses, each group of proximate variables is tested by adding socio-economic factors into linear regression models. According to empirical results, although proximate variables cause variation in CMI in descriptive tables, multivariate analyses do not provide significant results. The models composed of environment and health care related factors (eg. type or place of delivery, antenatal care) become meaningful only in the existence of socio-economic variables (e.g. education, characteristics of marriage, family type, mother tongue) but still explain only 14 percent of total change in mortality. Another important point is the changing effects of cultural factors in the SEAR and Turkey that implies strong association of cultural norms with early age mortality in the region.