Children who were vaccinated, breast fed and from low parity mothers live longer: A community based case-control study in Jimma, Ethiopia

Abstract

BackgroundImproving child survival through various health interventions has been one of the main preoccupations of public health programs in developing nations. However, efforts to understand the child death determinants and determine whether the health interventions are really contributing to the reduction of mortality were not satisfactory. The purpose of this study is to identify determinants and causes of child mortality.MethodsThe study was conducted in the town of Jimma, Ethiopia, using a case control study design. Cases were identified through enumeration of all children and deaths prior to interview of the study subjects. Controls were under five children of the same age (+/-2 months) residing in the nearest household. Data was entered into EPI -info 6.4 software and analyzed using SPSS.ResultsSeventy four cases and 222 controls were included in the study. The study found that children who never breast fed [OR = 13.74, 95%CI (3.34, 56.42]] and children with mothers having more than five children [OR = 3.34, 95%CI (1.27, 8.76)] were more likely to die than their counterparts. Vaccination reduced the risk of death [OR=.26, 95%CI (0.10, 0.67) significantly. Pneumonia was the most common immediate cause of death [29.7% (95% CI (19.66, 41.48)] followed by acute diarrhea and malaria each contributing for 23% [95%CI (13.99, 34.21)] of deaths.ConclusionImmunization, breastfeeding and low parity mothers were independently found to be protective from childhood death. Strengthening the child survival initiatives, namely universal child immunization, family planning and breast feeding -- is strongly recommended.

Childhood Mortality: Trends and Determinants in Ethiopia from 1990 to 2015—A Systematic Review

“…In study done in Jimma from 2004 to 2005, higher level of wealth index was associated with a significant reduction in CM. Excess in mortality was observed in children who reside in household with a floor made of earth compared to that in a household with a floor made of cement [31]. Parental factors affected infants relatively more than the children, especially with regard to Acute Respiratory Infection (ARI) mortality.…”

“…Further analysis in both 2000 and 2005 EDHS confirmed that breastfeeding is the most important factor for reducing IM and death rate was lower for neonates who were put to breast immediately upon birth [29]. Children never breastfed had higher risk of dying than those who were breastfed [31]. The likelihood of death among children who were not breastfed was 6 times higher compared to their counterparts [23].…”

“…A community based case control study conducted in Jimma revealed excess mortality among children who had never been immunized [31]. Unvaccinated children had highest U5M compared to those who were vaccinated at least once [36].…”

The effect of social determinants on immunization programs

“…29 In Ethiopia, studies led to the recommendation to educate mothers on the importance of family planning, breast feeding and immunization programs in efforts to reduce child morbidity and mortality. 30 Social support for women, especially for mothers of newborns, was also identified as an important element in shaping attitudes toward health and care of children. 31 In marginalized, extremely poor and hard to reach areas, mobilization of social support networks, combined with education and communication, were found to be effective in overcoming gender barriers and resistance to vaccination programs.…”

Determinants of Infant Mortality in Cities of the Jequitinhonha Valley, Minas Gerais, Brazil

“…9 Nesse cenário, o estudo dos fatores de risco para o óbito infantil possibilita identificar necessidades de saú-de de subgrupos populacionais que estão expostos a diferentes fatores de risco, compreender elementos da cadeia de eventos relacionados à determinação da MI dessa população específi-ca, além de ser essencial para subsidiar intervenções de saúde pública voltadas para a redução do risco de morte infantil. 10 Os óbitos infantis são mortes precoces e, em sua maioria, consideradas evitáveis por atuação dos serviços de saúde, entre outras ações e políticas. 3 Sendo assim, o estudo foi desenvolvido com o objetivo de analisar os determinantes da MI em municípios localizados no Vale do Jequitinhonha, Minas Gerais.…”