Structured additive regression models with spatial correlation to estimate under-five mortality risk factors in...

Area of Science:

• Demography
• Public Health
• Epidemiology

Background:

• Sub-Saharan Africa faces the highest child mortality rates globally.
• Ethiopia has observed a significant reduction in child mortality.
• Identifying factors influencing under-five mortality is critical for targeted interventions.

Purpose of the Study:

• To identify key risk factors associated with under-five mortality in Ethiopia.
• To analyze the impact of family size, household wealth, and maternal age on child survival.
• To inform public health strategies for reducing child mortality.

Main Methods:

• Utilized the 2011 Ethiopian Demographic and Health Survey data.
• Employed a structured additive logistic regression model.
• Accounted for spatial correlation and potential nonlinear effects of covariates.

Main Results:

• Increased family size, particularly approaching seven members, correlates with higher under-five mortality risk.
• Greater household wealth is associated with lower child mortality rates.
• Older maternal age is linked to a diminished risk of child mortality before age five.

Conclusions:

• The developed model effectively integrates nonlinear covariate effects, spatial correlation, and heterogeneity.
• Identified risk factors provide evidence-based targets for Ethiopian government interventions.
• Findings support the development of priority areas to combat under-five mortality.