EXCESS FEMALE MORTALITY IN RURAL SOMALIA - IS INEQUALITY IN THE HOUSEHOLD A RISK FACTOR

Gender differences in mortality risks in rural Somali communities were studied to assess their relation to literacy, marital status and fami ly economy between January 1987 and December 1989. In all, 6947 person -years form the basis for the demographic analysis and estimations of mortality rates and survival. Both sexes showed similar mortality risk s in infancy and early childhood, but females demonstrated a greater r isk of dying during their reproductive life than males. Respiratory sy mptoms, diarrhoea, fever and jaundice dominated the symptoms prior to death. Illiteracy in women considerably increased the risk of dying fr om 15 years and onwards particularly when living with literate men. Th e life expectancy from 15 years was 58 for a literate male but only 42 years for an illiterate woman living with a literate head of househol d. Multivariate analyses showed after adjustment for marital status an d literacy that an excess female mortality from 15 years, but especial ly from 45 years, was associated to a household situation, where the w oman did not subside on farming but on other, mainly commercial, activ ities. This vulnerability of females was associated to the recession o f the economy in the pre-war situation in Somalia, a backlash hitting women trying to earn their living. To conclude, gender differences in a number of factors in the household-literacy, marital status and espe cially source of income-were disadvantageous for the women, increasing the mortality risk in this setting. Copyright (C) 1997 Elsevier Scien ce Ltd