Identifying the determinants and associated factors of mortality under age five in Ethiopia
Hunachew Kibret Yohannis1, Moges Zerihun Fetene2, Habtamu Gebremariam Gebresilassie3
1Statistics Department, Under Natural and Computational Science College, at the University of Gondar, Gondar, Ethiopia. huneastat@gmail.com.
Insights
Under-five mortality in Ethiopia is significantly influenced by maternal age at first birth, education, and region. The zero-inflated negative binomial model best identified these key determinants for child survival.
Area of Science:
- Demography
- Public Health
- Biostatistics
Background:
- Under-five mortality is a critical indicator of population health and socioeconomic status, particularly high in Sub-Saharan Africa.
- Ethiopia faces a significant challenge with high rates of mortality among children under five years old.
- Identifying the specific factors contributing to this mortality is crucial for targeted interventions.
Purpose of the Study:
- To identify the key determinants and associated factors contributing to under-five mortality in Ethiopia.
- To analyze the impact of various demographic and socioeconomic variables on child survival rates.
Main Methods:
- Utilized data from the 2016 Ethiopian Demographic and Health Survey (EDHS).
- Applied count regression models including Poisson, negative binomial, zero-inflated Poisson, and zero-inflated negative binomial.
- Compared model performance using statistical tests like log-likelihood ratio and Akaike information criteria.
Main Results:
- Increased maternal age at first birth was associated with a 2.69% decrease in under-five mortality.
- Mothers with primary and secondary education had 28.31% and 40.96% lower risk, respectively, compared to those with no education.
- Specific regions (Afar, Benishangul Gumuz, Dire Dawa) showed higher under-five mortality risks compared to Tigray.
Conclusions:
- The zero-inflated negative binomial regression model best captured the data's overabundance of zeros and heterogeneity.
- Maternal age at first birth, mother's education level, place of residence, and region were identified as statistically significant factors influencing under-five mortality.
- These findings highlight the importance of maternal characteristics and regional disparities in addressing child mortality in Ethiopia.
Background:
Mortality rate under the age of five is the proportion of deaths of children below the age of 5 years out of 1000 live births. It is related with the living standard of a population, and it is taken as one of the health and socioeconomic status deterioration index. Mortality rate under the age of five also indicates a poor quality life standards of a population. It is very significantly high in Sub-Saharan African countries. Ethiopia is one of these Sub-Saharan African countries where mortality rate under the age five is high. This research work aims to identify the determinants and associated factors of under-five mortality in Ethiopia.
Methods:
The data for this paper were gathered from the EDHS 2016, collected by CSA. In this study, count family models such as Poisson, negative binomial, zero-inflated Poisson and zero-inflated negative binomial regression were applied for analyzing the data. Each of these count models were compared with different statistical tests like log-likelihood ratio test, Akaike information criteria, mean absolute difference, Vuong test and observed versus predicted probability plot.
Results:
The study revealed that as mothers' age at first birth increased by one unit, the average number of under-five mortality rate decreased by 2.69%. In the same way the number of under-five mortality of Afar, Benishangul Gumuz and Dire Dawa were 1.3446, 1.6429 and 1.3320 times more likely to Tigray respectively. The risk of under-five mortality for primary and secondary education level of the mother was 28.31 and 40.96% less likely than to mothers who have no education respectively.
Conclusion:
From the result we found that, there were overabundance zeros and broad heterogeneity in the non-zero outcomes. Zero-inflated negative binomial regression model was found to best fit the data, and from the regression model, age of mothers at first birth, mother's education level, place of residence and region were statistically significant factors of under-five mortality per mother.
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