Infant mortality in Sudan: Health equity, territorial disparity and social determinants of health

Abstract

Recognition of, and acting on, Social Determinants of Health is crucial for reducing health inequalities and territorial disparities and hence improving health of the whole population. Although Sudan was among the first countries which adopted a roadmap for Health in All Policies, health inequity remains an important challenge for health makers in this country. This paper illustrates the urgent need to reduce health inequalities in Sudan by acting on Social Determinants of Health. Descriptive statistics and Principal Components Analysis were used to get summarized multidimensional data information. Statistical significance of differences was tested by Pearson’s chi-squared. A large territorial disparity was found between the 18 states. Infant mortality rate is more than three times higher in East Darfur (88.5) than in River Nile (28.1). Ratios of 1.9 and 1.6 were indicated for income and mother education respectively. A lower gap was seen for milieu (1.2) and gender (1.34). The difference was statistically significant for states (p-value <0.0001), income (p-value <0.001) and education (p-value <0.005). Urgent strategies are needed by acting sufficiently on social determinants of health like milieu, gender, education, income and territoriality in order to reduce avoidable heath inequalities and unacceptable territorial disparities in Sudan.