134 International Journal of Statistics in Medical Research, 2014, 3, 134-144
E-ISSN: 1929-6029/14 © 2014 Lifescience Global
Application of Cox’s Proportional Hazard Model and Construction
of Life Table for Under-Five
Salam Shantikumar Singh
*
Department of Statistics, Pachhunga University College, Aizawl-Mizoram, India
Abstract: A primary data of 836 eligible women in the age group of 15-49 years is used to determine the causal effects
of covariates on under-five mortality. The eight covariates viz., number of family members (NHM), type of toilet facility
(TTF), total children ever born (TCB), parity (PAR), duration of breastfeeding (DBF), use contraceptive (CMT), DPT and
ideal number of girl (ING) are considered as covariates of the study. By applying Cox’s regression analysis, six
covariates viz., TTF, NHM, CMT, DBF, DPT and ING have substantially and significantly effect on under-five mortality.
Further, a life table of under-five children under study is constructed using the estimate of survival function obtained from
Cox’s regression model.
Keywords: Under-five, Covariates, Cox’s regression, hazard function and life table.
1. INTRODUCTION
The first five years of life are the most crucial to the
physical and intellectual development of children and
can determine their potential to learn and thrive for a
life time. That is why it is specifically stated as one of
the goals of the millennium development goals (MDGs)
to reduce child mortality by two-thirds by 2015.
Although there has been a substantial reduction in
infant and child mortality rates in most developing
countries in the recent past, it still remains a major
public health issue in South Asian countries particularly
in India.
Mortality and its converse indicator, longevity or life
expectancy are among the most important measures of
well-being and development in developing countries.
Since child mortality has an overwhelming influence on
life expectancy, it is important to analyze the
determinants of child mortality in India and particularly
in the state of Manipur. Moreover, child mortality
indicates the health status of not only child but also the
health status of mothers as well as society as a whole.
The child mortality has received a new momentum of
the study since there is a strong association ship
between mortality and fertility as high mortality
corresponds high fertility and vice-versa. Thus, the
study of especially on child has as immense
contribution towards the regulation of population growth
and enhancing the health status of the society.
The general medical definition distinguishes
mortality of a child with respect to the child age: death
within the first week of life is included with prenatal
*Address correspondence to this author at the Department of Statistics,
Pachhunga University College, Aizawl, Mizoram, PIN NO. 796001, India;
Tel: (+91)8732843655; E-mail: shantikumarsalam@yahoo.co.in
mortality (which also includes late foetal mortality) and
death within the first month is referred to as neonatal
mortality, and death within one year is referred to as
infant mortality. The death under five is referred to as
child mortality (WHO, (2005) [1]). Since peri and
neonatal mortality is heavily influenced by prematurity,
fatal genetic conditions of the foetus, and problems
associated with delivery. The mortality after first month,
which is mostly related to socio-economic and health
conditions of the household. It is possible to analysis
the determinants of child mortality at various levels of
causality (Mosley & Chen (1984) [2]). The biomedical
and epidemiological literature typically focuses on the
immediate determinants of child mortality, in particular
the impact of various diseases and weakened
resistance. In contrast, socio-economic, environment &
sanitation, medical and health care, demographic,
exposure to mass media, etc., are usually focused on
underlying determinants of child mortality that make
children more vulnerable to the attack of various
diseases. Moreover, the child mortality rates vary from
countries to countries and even within the country also
it is varied in region to region and state to state. In
developed countries, the main factor influencing on
child mortality is demographic factors whereas socio-
economic, health care, etc., are main factors
influencing on child mortality in developing countries.
Thus, the study of child mortality is different from
country to country and region to region.
1.1. Review of Literature
From the past research findings, it is known that
parity (birth order) is associated with infant and child
mortality. Hobcraft et al. (1985) [3] indicate that beyond
the first year of the morality of first born children is on
average slightly lower than for children of birth orders 2