Related Experiment Video
Updated: Mar 1, 2026
Establishing a Competing Risk Regression Nomogram Model for Survival Data
Published on: October 23, 2020
Survival analysis of under-five mortality using Cox and frailty models in Ethiopia
Dawit G Ayele1, Temesgen T Zewotir2, Hemry Mwambi2
1Department of Epidemiology, Bloomberg School of Public Health, The Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, 21205, USA. EJIGMUL@YAHOO.COM.
Insights
Ethiopian under-five mortality has declined. Children in Addis Ababa and those with older mothers face lower risks, while rural children have higher mortality risks.
Area of Science:
- Demography
- Public Health
- Epidemiology
Background:
- Sub-Saharan Africa faces the highest child mortality rates globally.
- Ethiopia has experienced a significant reduction in under-five mortality.
- Understanding regional and demographic factors is crucial for further reductions.
Purpose of the Study:
- To analyze the determinants of under-five mortality in Ethiopia.
- To identify key risk factors influencing child survival rates.
Main Methods:
- Survival analysis using the Cox regression model.
- Utilized data from the 2011 Ethiopian Demographic and Health Survey.
- Examined fixed and time-dependent explanatory variables.
Main Results:
- Children in Addis Ababa had a significantly lower risk of death (p=0.048).
- Rural children faced an 18% higher risk of death compared to urban children (p=0.01).
- Children born to older mothers had a lower risk of mortality.
Conclusions:
- Living in Addis Ababa and having an older mother are protective factors.
- Rural residence is a significant risk factor for under-five mortality.
- Spacing births (not becoming pregnant again before the child is 5) reduces mortality risk.
Background:
The risk of a child dying before reaching 5 years of age is highest in sub-Saharan African countries. But in Ethiopia, under-five mortality rates have shown a substantial decline.
Methods:
For this study, the Cox regression model for fixed and time-dependent explanatory variables was studied for under-five mortality in Ethiopia. We adapted survival analysis using the Cox regression model with 2011 Ethiopian Demographic and Health Survey data.
Results:
From the results, it was found that under-five children who live in Addis Ababa had a lower hazard (risk) of death (p value = 0.048). This could be as a result of higher health facilities and living standards in Addis Ababa, compared to other regions. Under-five children who lived in rural areas had a higher hazard (risk) of death compared to those living in urban areas. In addition, under-five children who lived in rural areas had 18% (p value = 0.01) more hazard (risk) of death than those living in urban areas. Furthermore, with older mothers, the chance of a child dying before reaching the age of 5 is lower.
Conclusion:
The chances of a child dying before reaching the age of 5 are less if the mother does not become pregnant again before the child reaches the age of 5. Therefore, giving birth when older and not becoming pregnant again before the child reaches the age of 5 is one means of reducing under-five mortality.
Related Concept Videos
01:21Cancer Survival Analysis
01:20Comparing the Survival Analysis of Two or More Groups
01:15Assumptions of Survival Analysis
01:18Introduction To Survival Analysis
The primary goal of survival analysis is to estimate survival time—the time...
01:14Parametric Survival Analysis: Weibull and Exponential Methods
Weibull Distribution
The Weibull distribution is a flexible model used in parametric survival analysis. It can handle both increasing and decreasing hazard rates, depending on its shape parameter...
01:24Kaplan-Meier Approach