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Abstract Introduction Mortality under five years is an important indicator and a significant index for assessing the health and general wellbeing of a country. Even though global efforts to reduce under-five mortality have yielded some positive results, the rates are still high in most low- and middle-income countries. There is general consensus that migration and its associated remittances alleviate poverty at the rural places of origin. This tends to improve household living standards and leads to improvement in child health and survival. This paper seeks to investigate the impact of maternal migration on under-five mortality in two districts in the Upper East Region of Ghana. Methods This study used data from the Health and Demographic Surveillance System (HDSS) of the Navrongo Health Research Centre (NHRC) in Ghana. All children (20,990) born in the study area between 2000 and 2014 were included in the analysis. The outcome variable in the analysis was the survival status of the children (dead or alive). The main independent variable is migration status of the mothers (migrants and non-migrants). The Proportional Hazard Model, with a Weibull distribution, was used to examine the effect of the independent variables on the survival outcomes of the children. Results The results showed that children of migrant (in-migrant or return migrant) mothers are 49% less likely to die compared with children of non-migrant mothers [aOR = 0.513; (CI = 0.451-0585)]. In terms of migration duration before return, survival benefit was highest for children whose mothers had been away for one year and more. Other factors that were associated with increased risk of under-five mortality include children of mothers without education, children of mothers age 15–19 years, children born outside health facility, first order births, multiple births and children without grandmothers in their households. Conclusion The study has established that maternal migration, irrespective duration, contribute to child survival. Specifically, children of migrant mothers have a better survival chance than children of non-migrant mothers. To improve child survival in these poor rural settings, we recommend the promotion of conducive migration opportunities to enable women to earn some income to support their households in terms of childcare and survival.

Abstract Introduction Essentially all women and babies irrespective of their economic and social status should reach their full potential for health and well-being. The study assessed the readiness of mothers and their preparedness for birth across three disadvantaged rural districts in Ghana. Methods A multi-centre quantitative survey from January to December 2018 using a multistage sampling approach was employed. Using a structured questionnaire data from mothers attending antenatal and postnatal clinics in three main ecological zones of Ghana were collected. Women who provided informed consent were consecutively recruited until the sample size was achieved. For categorical data, summary tables, proportions and percentage are presented. Multivariate logistic regression analysis determined the effect of selected characteristics on birth preparedness. Ethics approval was obtained from the Navrongo Health Research Centre. Results A total of 1058 mothers were enrolled: 33.6%, 33.4% and 33.0% respectively from the Ada west, Upper Denkyira west and Builsa south districts. About 94% of the women had prior knowledge of birth preparedness. Approximately 22.6% (95%CI 20.1, 25. 2) of the mothers were assessed to have poor birth preparedness: 8.0% in Builsa south, 27.8% in Ada west and 31.7% in Upper Denkyira west. Prenatal and postnatal data showed no statistically significant difference in poor preparedness (21.9% vs 23.3%; p-value > 0.05). Maternal age, employment status, religious affiliation and parity were not associated with birth preparedness (p-value > 0.05). Area of study (P

Introduction: Environmental exposures, such as ambient air pollution and household fuel use affect health and under-5 mortality (U5M) but there is a paucity of data in the Global South. This study examined early-life exposure to ambient particulate matter with a diameter of 2.5 µm or less (PM2.5), alongside household characteristics (including self-reported household fuel use), and their relationship with U5M in the Navrongo Health and Demographic Surveillance Site (HDSS) in northern Ghana. Methods: We employed Satellite-based spatiotemporal models to estimate the annual average PM2.5 concentrations with the Navrongo HDSS area (1998 to 2016). Early-life exposure levels were determined by pollution estimates at birth year. Socio-demographic and household data, including cooking fuel, were gathered during routine surveillance. Cox proportional hazards models were applied to assess the link between early-life PM2.5 exposure and U5M, accounting for child, maternal, and household factors. Findings: We retrospectively studied 48,352 children born between 2007 and 2017, with 1872 recorded deaths, primarily due to malaria, sepsis, and acute respiratory infection. Mean early-life PM2.5 was 39.3 µg/m3, and no significant association with U5M was observed. However, Children from households using “unclean” cooking fuels (wood, charcoal, dung, and agricultural waste) faced a 73 % higher risk of death compared to those using clean fuels (adjusted HR = 1.73; 95 % CI: 1.29, 2.33). Being born female or to mothers aged 20–34 years were linked to increased survival probabilities. Interpretation: The use of “unclean” cooking fuel in the Navrongo HDSS was associated with under-5 mortality, highlighting the need to improve indoor air quality by introducing cleaner fuels.