Factors Affecting Under-Five Mortality in Ethiopia: A Multilevel Negative Binomial Model
Bisrat Misganew Geremew1, Kassahun Alemu Gelaye1, Alemakef Wagnew Melesse1
1Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Pediatric Health, Medicine and Therapeutics
|January 7, 2021
Summary
Under-five mortality in Ethiopia is reduced by maternal education and facility births, but increased by factors like childhood diarrhea. Addressing regional disparities and promoting female education are key to reducing child deaths.
Area of Science:
- Public Health
- Demography
- Child Survival
Background:
- Globally, under-five mortality rates have declined, yet millions of children still die annually before their fifth birthday.
- Ethiopia faces a significant challenge, with 67 deaths per 1000 live births reported in the 2016 Ethiopian Demographic and Health Survey (EDHS).
Purpose of the Study:
- To identify key factors influencing under-five mortality in Ethiopia.
- Utilizing data from the 2016 EDHS to analyze determinants of child mortality.
Main Methods:
- Analysis of weighted data from 11,023 under-five children from the 2016 EDHS.
- Application of a multilevel negative binomial regression model to identify significant factors.
- Reporting adjusted incidence rates (ARR) with 95% confidence intervals (CI) and p-values <0.05.
Main Results:
- Maternal higher education (ARR=0.25) and delivery in a health facility (ARR=0.86) were associated with reduced under-five mortality.
- Factors increasing mortality included female-headed households (ARR=1.32), childhood diarrhea (ARR=1.23), and multiple births (ARR=1.80).
- Regional variations were observed, with Addis Ababa showing reduced (ARR=0.52) and Amhara region showing increased (ARR=1.43) mortality.
Conclusions:
- Under-five mortality remains a critical public health issue in Ethiopia.
- Maternal education, facility delivery, and birth spacing are protective factors.
- Interventions should focus on enhancing female education, improving access to healthcare, and addressing regional disparities to reduce child mortality.
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