Crucial predicting factors of under-five mortality in Sierra Leone

Abstract

includes in countries which exhibit the highest prevalence of under-five mortality in the world. A range of factors are known to have challenged the under-five survival in the country; some comprise outbreak of epidemics, socioeconomic inequalities, regional disparities, and unsuccessful implementation of healthcare initiatives. The present study aims to identify crucial predictors of under-five survival. Methods: This paper used the Sierra Leone Demographic and Health Survey (SLDH, 2013). A Cox Proportional Hazards Model was applied to the sample of 24,742 children to analyze the adjusted and unadjusted hazards ratio of crucial risk factors of under-five mortality. Results: The results show that birth interval and birth size are leading risk factors of under-five mortality in Sierra Leone. A birth spacing exceeding three years is associated with the lowest risk compared to 2-3 years and lesser than two years. The average or larger birth size has the lowest hazards followed by smaller than average, and the magnitude of the effect remains the same in adjusted and unadjusted models. The wealth status is a crucial predictor only in the unadjusted model. Mother's age, sex of the child, and a number of children in the household are significant covariates. Conclusion: Given the research findings, this study recommends for reorientation of reproductive healthcare strategies to target the younger mother and birth-spacing, and integration of nutrition-related interventions with the maternal healthcare initiatives to influence the child birth-size.

Are socioeconomic status and type of residence critical risk factors of under-five mortality in Pakistan? Evidence from nationally representative survey

“…The result is consistent with previous research findings which highlighted the negative association of maternal education with childhood mortality in developing countries. [5][6][7][8]42 Our research findings offer support to "Chicago-Columbia hypothesis" which states that female education increases female efficiency in the production of child health. 43 In this study, age of mother at the first delivery was found to be associated with a considerable risk of the survival of under-five children.…”

A Systematic Review of Factors Associated with Under-Five Child Mortality

“…Out of 22 studies, 18 studies were conducted in 11 countries in the Africa region (Burkina Faso [ 19 – 21 ]: 3, Ethiopia [ 22 – 24 ]: 3, Nigeria [ 25 – 27 ]: 3, Ghana [ 28 , 29 ]: 2, Lesotho [ 30 ]: 1, sub-Saharan (combine study of five-country; Chad, Democratic Republic (DR) of Congo, Mali, Niger, and Zimbabwe) [ 31 ]: 1, Zambia [ 32 ]: 1, Kenya [ 33 ]: 1, DR Congo [ 34 ]: 1, Sierra Leone [ 35 ]: 1, and Tanzania [ 36 ]: 1). One study included was conducted in Nepal [ 37 ] and another one in Bangladesh [ 38 ] from South-East Asian region.…”

“…Figure 5 shows factors identified by two or more studies conducted in African countries. Among 18 articles, 9 (50%) articles [ 20 , 24 – 26 , 29 , 31 , 32 , 35 , 36 ] found that the size of child at birth is a major determinant playing an important role in under-five mortality. Age of mother, place of residence, sex of child, and mother's education are other important variables explored by 7 (38.9%) studies conducted in these countries.…”

“…As shown in Figure 2, 22 eligible studies (listed in Table 1) were selected for systematic review from four different regions, namely, Africa, South-East Asia, Eastern Mediterranean, and Western Pacific. Out of 22 studies, 18 studies were conducted in 11 countries in the Africa region (Burkina Faso [19][20][21]: 3, Ethiopia [22][23][24]: 3, Nigeria [25][26][27]: 3, Ghana [28,29]: 2, Lesotho [30]: 1, sub-Saharan (combine study of five-country; Chad, Democratic Republic (DR) of Congo, Mali, Niger, and Zimbabwe) [31]: 1, Zambia [32]: 1, Kenya [33]: 1, DR Congo [34]: 1, Sierra Leone [35]: 1, and Tanzania [36]: 1). One study included was conducted in Nepal [37] and another one in Bangladesh [38] from South-East Asian region.…”

Determinants of under-five mortality in Indonesia: A nationwide study

“…The reasons for under-five mortality are due to many factors, from the community level and socio-economic factors to the individual level (Ogbo et al, 2019;Yaya et al, 2020). Previous research showed that the community level, such as the area of residence, was the most common predictor of under-five mortality (Naz et al, 2020), as geographical areas have different characteristics for health and environmental factors (Chowdhury et al, 2020;Yaya et al, 2020). Several studies in developing countries have shown that maternal socioeconomic characteristics are a strong phenomenon in determining the risk of child mortality (Fikru et al, 2019;Nisar & Dibley, 2014).…”