Socioeconomic and environmental determinants of under-five mortality in Gamo Gofa Zone, Southern Ethiopia: a matched case control study

Abstract

BackgroundDespite global declaration of the right to life as a fundamental human right and substantial progress in reducing childhood mortality, unacceptably high number of children still die before their fifth birthday every day. Different factors have been studied and implicated for under-five mortality with mixed results. Mortality studies in the current study sites were lacking. Therefore, this study examined environmental and socioeconomic determinants of under-five mortality.MethodsThe study applied a matched case control study design on 381 cases of children who died before their fifth birthday and 762 controls born within 1 month in the same locality as the cases. We conducted weighted conditional logistic regression to assess the association between selected factors and mortality status.ResultThe odds of death was found to be significantly lower among children of mothers whose educational status was grade nine or above (Adjusted odds ratio (AOR) of 0.34(0.16–0.72)). The odds of death was significantly higher among children whose mothers’ marital status were separated/divorced or widowed (AOR of 3.60(1.23–10.47)) and whose fathers were daily laborers (AOR of 2.34(1.29–4.23)). Presence of separate kitchen in the household for cooking was a proximate factor which was significantly associated with under-five mortality with AOR of 1.77(1.16–2.70).ConclusionSocioeconomic factors like maternal education, husband occupation and marital status of the mother were shown to be significantly associated with under-five mortality. Hence, in order to enhance reduction in childhood mortality, investing on maternal education targeting those at risk groups is recommended.

Maternal and child characteristics and health practices affecting under-five mortality: A matched case control study in Gamo Gofa Zone, Southern Ethiopia

“…Socioeconomic and demographic characteristics (the results are presented elsewhere [ 36 ]), personal illness control related variables, child feeding and newborn care related variables and other maternal and child related variables.…”

“…were computed using principal component analysis of reported ownership of household assets and maternal decision related variables, respectively (the details of the variables and assumptions are presented elsewhere [ 36 ]).…”

“…The framework classifies distal factors into three levels (individual, household and community). Accordingly, first a model for distal factors was fitted (the findings for distal factors are presented elsewhere [ 36 ]). As community level factors were controlled at design stage by matching of the two groups (cases and controls), we only included individual and household level distal factors in the models.…”

“…As described in detail elsewhere [ 36 ], model diagnostic was conducted following each model using different STATA commands. Presence of interaction/effect modification was also assessed for suspected variables.…”

“…The determinant factors for this study were framed using Henry Mosley and Lincoln Chen’s analytic framework for the study of determinants of under-five mortality. The adapted conceptual framework for the overall determinants of under-five mortality is presented elsewhere [ 36 ].…”