1 Policy Brief Explaining the Health Status of Children in Sierra Leone: Parental Socioeconomic Status and Demand for Health Inputs. By Mohamed Jalloh and Santigie Mohamed Kargbo 1. Background In most developing countries, maternal and child health issues have received considerable attention in public health policies and pose formidable challenges. Several studies provide evidence of a strong relationship between socioeconomic factors such as economic growth, poverty, water and sanitation, education and gender and health outcomes. A good number of researchers have shown that a mother’s use of child health care is influenced by the risk of child mortality. It is thus been emphasized in the literature that the decision to obtain health inputs is confronted with the potential issue of self-selection and hence endogeneity. Sierra Leone is one of those countries having the poorest health indicators in the world, with an infant mortality rate of 89 per 1,000 live births and an under-five mortality rate of 140 per 1,000 live births (SLDHS, 2008). This is probably due to the fact that about 72 percent of birth cases are delivered at home whereby only 42.4 percent of the women had skilled attendant at delivery and about 25 percent are delivered in health facilities, mostly public facilities. Thus it is imperative for a study to examine the dynamics of the relationship Key Points • The risk of child mortality influences mothers’ use of child health care services • Maternal education has a positive and significant effect on delivery care • Relative to children born in poorer households, the likelihood of infant and under-five mortality is lower for children born in richer households • The Likelihood of infant and under-five mortality is higher if the child is one of multiple births