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Vienna Yearbook of Population Research 2025Population inequality matters
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Verlag der Österreichischen Akademie der Wissenschaften Austrian Academy of Sciences Press
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Vienna Yearbook of Population Research 2025, pp. 329-371, 2025/12/17
Population inequality matters
Despite significant progress in reducing child mortality, Nepal’s under-five mortality rate remains above the Sustainable Development Goal (SDG) target of 20 deaths per 1000 live births. This study examines the heterogeneity in under-five mortality by household generations and household structure using pooled data from six rounds of the Nepal Demographic and Health Survey (1996–2022). Multivariable logistic regression models reveal that children in one- or two-generation households face higher mortality risks compared to those in three- or more-generation households. Additionally, nuclear households exhibit slightly elevated mortality risks compared to extended households. A nonlinear multivariate decomposition analysis identifies birth cohort, household wealth and maternal education as key contributors to widening mortality disparities, while maternal age at birth and preceding birth interval help to narrow these gaps. The findings underscore the role of family structure in shaping child survival outcomes and highlight the need for targeted interventions to address persistent inequalities in under-five mortality in Nepal.
Keywords: Child mortality; Mortality inequality; Family structure; Pooled birth history; Demographic and Health Surveys; Nonlinear decomposition