Risk factors of child mortality in Ethiopia: Application of multilevel two-part model

Abstract

The child mortality rate is an essential measurement of socioeconomic growth and the quality of life in Ethiopia which is one among the six countries that account for half of the global under-five deaths. Therefore, this study aimed to identify the potential risk factors for child mortality in Ethiopia. Data for the study was drawn from the Ethiopian Demographic and Health Survey data conducted in 2016. A two-part random effects regression model was employed to identify the associated predictors of child mortality. The study found that 53.3% of mothers did not face any child death, while 46.7% lost at least one. Vaccinated child (IRR = 0.735, 95%CI: 0.647, 0.834), were currently using contraceptive (IRR = 0.885, 95%CI: 0.814, 0.962), who had antenatal care visit four or more times visit (IRR = 0.841, 95%CI: 0.737,0.960), fathers whose level of education is secondary or above(IRR = 0.695, 95%CI: 0.594, 0.814), mothers who completed their primary school(IRR = 0.785, 95%CI: 0.713, 0.864), mothers who have birth interval greater than 36 months (IRR = 0.728, 95%CI: 0.676, 0.783), where the age of the mother at first birth is greater than 16 years(IRR = 0.711, 95%CI: 0.674, 0.750) associated with the small number of child death. While multiple births (IRR = 1.355, 95%CI: 1.249, 1.471, four and above birth order (IRR = 1.487, 95%CI: 1.373, 1.612) and had working father (IRR = 1.125, 95%CI: 1.049, 1.206) associated with a higher number of child death. The variance components for the random effects showed significant variation of child mortality between enumeration areas. Policies and programs aimed at addressing enumeration area variations in child mortality need to be formulated and their implementation must be strongly pursued. Efforts are also needed to extend educational programmers aimed at educating mothers on the benefits of the antenatal checkup before first birth, spacing their birth interval, having their child vaccinated, and selecting a safe place of delivery to reduce child mortality.

Impact of high-risk fertility behaviours on underfive mortality in Asia and Africa: evidence from Demographic and Health Surveys

“…Though many studies have identified a wide array of risk factors of underfive mortality such as size of child at birth [ 20 ] and women empowerment [ 21 ], antenatal care attendance [ 22 ], our criterion for including confounding variables was that they should be associated with both HRFB and underfive mortality. As only those confounding factors can be appropriate for this study which occurred before HRFB and by implication before birth of the index child, size of child at birth, antenatal care attendance and women’s empowerment are, therefore, not included in the list of confounding factors.…”

Risk factor of neonatal mortality in Ethiopia: multilevel analysis of 2016 Demographic and Health Survey

“…Previous studies conducted in Ethiopia to investigate the risk factors of neonatal mortality were institutionalbased [14,15] and considering only individual-level factors [11][12][13]. However, neonatal mortality can be affected by community-level factors, such as the source of drinking water [16,17], types of toilet facilities [18,19], and cluster (enumeration area) [20,21]. Moreover, the uses of a single-level logistic regression analysis approach to analyze data with a hierarchical structure (i.e., neonates nested within communities) violate the regression's independence assumptions [22].…”

Newborns and Under-5 Mortality in Ethiopia: The Necessity to Revitalize Partnership in Post-COVID-19 Era to Meet the SDG Targets

“… 15 Low birth-weight, home delivery, lack of skilled birth attendants, low vaccination rate, poor access to maternal and child health services, born from poor and illiterate women in rural settings are the common predictors to newborns and under-5 mortality in Ethiopia. 16 - 19 In general, equality and inequity to basic health determinants are predictors of child mortality. 20 …”