CHILD-MORTALITY IN A COLLAPSING AFRICAN SOCIETY

A cohort study of mortality among under-5-year-olds was carried out in two Somali villages in 1987-89, a period of economic and political co llapse in the rural parts of the country. Analysed was the relative im portance of the social characteristics for under-5-year-old mortality against a background of deteriorating political and economic condition s. Mortality increased among under-5-year-olds from 1987 (211 per 1000 ) to 1988 (323 per 1000) to 1989 (414 per 1000). The mortality risk wa s more pronounced for boys than girls and was more so for infants than children aged 1-4 years. The major signs prior to death were respirat ory infections, diarrhoeal diseases, fever/malaria and tetanus in the neonatal period. Over the 3-year study period mortality rates for diar rhoeal diseases increased significantly, while those for respiratory i nfections and diseases preventable by immunization increased more slow ly. The increasing trend in under-5-year-old mortality was more pronou nced in instances when the mother derived her major income from source s other than farming and in larger households.