Determinants of trends in neonatal, post-neonatal, infant, child and under-five mortalities in Tanzania from 2004 to 2016

Abstract

Background Under-five mortality is still a major health issue in many developing countries like Tanzania. To achieve the Sustainable Development Goal target of ending preventable child deaths in Tanzania, a detailed understanding of the risk factors for under-five deaths is essential to guide targeted interventions. This study aimed to investigate trends and determinants of neonatal, post-neonatal, infant, child and under-five mortalities in Tanzania from 2004 to 2016. Methods The study used combined data from the 2004–2005, 2010 and 2015–2016 Tanzania Demographic and Health Surveys, with a sample of 25,951 singletons live births and 1585 under-five deaths. We calculated age-specific mortality rates, followed by an assessment of trends and determinants (community, socioeconomic, individual and health service) of neonatal, postneonatal, infant, child and under-five mortalities in Cox regression models. The models adjusted for potential confounders, clustering and sampling weights. Results Between 2004 and 2016, we found that neonatal mortality rate remained unchanged, while postneonatal mortality and child mortality rates have halved in Tanzania. Infant mortality and under-five mortality rates have also declined. Mothers who gave births through caesarean section, younger mothers (< 20 years), mothers who perceived their babies to be small or very small and those with fourth or higher birth rank and a short preceding birth interval (≤2 years) reported higher risk of neonatal, postneonatal and infant mortalities. Conclusion Our study suggests that there was increased survival of children under-5 years in Tanzania driven by significant improvements in postneonatal, infant and child survival rates. However, there remains unfinished work in ending preventable child deaths in Tanzania.

Trends and factors associated with the utilisation of antenatal care services during the Millennium Development Goals era in Tanzania

“…Study factors were selected based on past studies from LMICs [14,33,34,40,41] and data availability in the TDHS. These factors were broadly classified into predisposing, enabling, need and community-level factors based on the conceptual model of health services utilization, proposed by Andersen to explain the conditions that favour or hinder an individual from seeking health care [42].…”

“…Although Tanzania was one of the countries that achieved a key target of the Millennium Development Goals (MDG-4, to reduce child mortality) [13,14], recent evidence from the country has indicated that 8200 maternal deaths occurred in 2015 [7]. This suggests that MDG-5 (to improve maternal health) still needs significant attention in Tanzania.…”

Prevalence, Trends, and Drivers of the Utilization of Unskilled Birth Attendants during Democratic Governance in Nigeria from 1999 to 2018

“…Detailed information on the survey methodology is provided in the final NDHS reports [24][25][26][27][28]. In the present study, a total weighted sample of 103,903 most recent live-birth children under 5 years of age was used to minimize the potential effect of recall bias, consistent with Measure DHS approach [24] and used in previously published studies [29][30][31][32].…”

“…The NDHS categorized household wealth index into five quintiles (poorest, poorer, poor, rich, or richest). In this study, the household wealth index was reclassified as 'poor', 'middle', or 'rich', to increase the sample within each category, consistent with past studies [31,37,38]. Media exposure included frequency of reading magazines or newspapers, frequency of listening to the radio, and frequency of watching TV, which were grouped as 'Yes' or 'No'.…”

Magnitude and trends in socio-economic and geographic inequality in access to birth by cesarean section in Tanzania: evidence from five rounds of Tanzania demographic and health surveys (1996–2015)

“…In Tanzania, the probability of children under five dying before celebrating their fifth birthday is 53 deaths per 1000 live births. While neonatal mortality remained unchanged, Tanzania had seen a fall in the burden of post neonatal mortality rates, child mortality rates, infant mortality and under-five mortality rates [25]. Individuals aged 15 to 60 have a probability of dying of 299 and 222 deaths per 1000 population respectively.…”