Maternal education and infant mortality in Thailand : comparison between the proportional hazards models with multiplicative and additive risk functions

Thesis (Ph. D.)--University of Hawaii at Manoa, 1995.Includes bibliographical references (leaves 180-199).Microfiche.xii, 199 leaves, bound ill. 29 cmThis study has two objectives: (1) to compare the fit of the proportional hazards models with the multiplicative risk function to the one with the additive risk function by applying both functional forms to infant mortality data, and (2) to investigate the association between maternal education and other socioeconomic, demographic, environmental and health care factors in relation to infant mortality in Thailand. The data, used in this study, came from the 1987 Thailand Demographic and Health Survey (1987 TDHS). Results showed that the proportional hazards model with the multiplicative risk function fitted the infant mortality data in Thailand better than the additive one. The investigation of the associations between maternal education and its associations with other factors mentioned above in relation to infant mortality suggested that maternal education had a significant negative effect numerically on infant mortality even when all other variables under study were controlled. The education was strongly associated with family economic condition, place of residence, toilet facilities, and birth order greater than one with short preceding birth intervals. There was suggestion of interaction effects between maternal education, on the one hand, and place of residence, birth order greater than one with short preceding birth interval, and health care utilization, on the other, on infant mortality. The effects of these factors were significantly reduced if maternal education was increased from lower than secondary to at least secondary level. Suggestions are offered to reduce infant mortality in Thailand as follows: 1. The compulsory education should be strengthened and controlled to ensure that all graduates from school could read with comprehension. 2. Different governmental departments, such as education, public health, economic, community development, should take part in planning for reducing infant mortality. 3. Safe drinking water supply should be launched and carried out by local authorities; special attention should be paid for those living in urban areas, where safe water supplies were not accessible. 4. Breastfeeding program should be initiated to encourage working mothers to breastfeed their children during working hours