Authors
Kabeya Clement Mulamba
Published in
BMC public health. Jul 11, 2026. Epub Jul 11, 2026.
Abstract
This study applied a spatial multilevel modelling approach to the latest Demographic and Health Survey data from the Democratic Republic of the Congo to examine the association between maternal empowerment and infant and under-five mortality. To improve temporal alignment between women's empowerment and child mortality outcomes, the analysis was restricted to births occurring within the five years preceding the survey. The econometric modelling accounted for the hierarchical structure of the data, with children nested within clusters and clusters within provinces, and decomposed maternal empowerment into within-cluster and contextual (cluster-level) components. The results indicate that, after controlling for child-, maternal-, household-, cluster-, and province-level factors, neither the within-cluster component nor the cluster-level mean of maternal empowerment shows a robust average association with infant or under-five mortality. In contrast, substantial heterogeneity in child mortality persists at both the cluster and province levels, with particularly strong variation at the cluster level. These findings suggest that child mortality in the Democratic Republic of the Congo is more strongly shaped by local contextual conditions and demographic factors than by a uniform average effect of maternal empowerment, underscoring the importance of multilevel policy responses that address both household-level disadvantage and place-based inequalities.
PMID:
42436439
Bibliographic data and abstract were imported from PubMed on 12 Jul 2026.
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