Inequality in Early Childhood Mortality: An Ecological Analysis Within Nepal

Objective: The objective of the study was to analyse inequalities in under-five mortality primarily across levels of maternal education and the ecological region of Nepal. Methods: Data on 5,038 children under the age of five from the 2016 Nepal Demographic and Health Survey were used in the analysis. Two measures of inequality, the Slope Index of Inequality and the Relative Index of Inequality were calculated across levels of maternal education and ecological regions of Nepal. Results: Significant inequalities exist in the under-five mortality rate in Nepal. The mortality rate is high among the children born to mothers with no education and in the mountain ecological region compared to mothers with higher education levels and those in the Terai region. Conclusion: There are significant inequalities in childhood mortality in Nepal based on maternal education and ecological region. Interventions targeted specifically for mothers with low or no education and households in the mountain region are critically needed to reduce inequality.