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Estimation of a structural model of the determinants of neonatal mortality in Hungary, 1984–88 and 1994–98

We developed and evaluated a structural model of the determinants of neonatal mortality in Hungary that embodies the causal mechanisms by which its proximate and indirect determinants—socio-economic, behavioural, and biological—are related. The statistical model used distinguishes between endogenous and exogenous variables and allows the causal effect of each to be correctly estimated. Unobserved variables are integrated into the model, which was tested using Hungarian data for the periods 1984–88 and 1994–98. The principal findings are as follows: weight at birth and duration of gestation are the most important of the (direct) causal determinants of neonatal mortality. Mother's age has an indirect and detrimental effect: when mothers are older than 30 years of age, the risk of lower birth weight or multiple births and, in consequence, neonatal mortality is increased. Father's age has no direct or indirect causal effect on neonatal mortality.