Temporal and spatial distribution of under-five mortality and factors associated with multiple cases of under-five deaths within a family in the rural area of Khuzestan, Southern Iran

Abstract

Under-five mortality (U5M) is an important indicator of the overall health and development of society. There is a wide gap in U5M among different countries and also within the countries. This study was carried out to assess the prevalence, as well as the socio-demographic, and health-related causes of U5M in the region of study. A cross-sectional study was conducted among all registered cases of U5M in rural areas of Khuzestan province, Iran, during the years 2011 to 2015. To assess the socio-demographic determinants of U5M, the sample surveyed consists of 320 families with at least one under-five death using a multistage random sampling method. Also, this study evaluated the number of variables, which may increase the chance of families to have more than one U5M. U5M was 26 per 1000 live births in 2011, but decreased to 22 per 1000 live births in 2015. With the highest cumulative incidence of 43 in Masjed Soleyman and the lowest of 15 in Dehdez, infant mortality constitutes 76% of all U5M. Prematurity and congenital anomalies were responsible for 46% of all causes of mortality (that is, U5). Maternal age at delivery <18 years or >35 years (OR = 3.5; 95% CI, 1.29–6.22), marriage duration >9 years (1.85, 1.06–3.21), spouse age gap >5 years (2.32, 1.20–4.50), cesarean section (3.85, 1.19–5.74), delivery interval <3 years (2.83, 1.22–5.58), non-Arab ethnicity (2.58, 1.50–4.44), and mother working in agriculture or animal husbandry (3.93, 1.41–6.94) were the most important determinants associated with more than one child death per family. Spatially, there was a great disparity in U5M with different reduction rate during the 5 years of the study. Marriage age, cesarean delivery, delivery interval, and mother field activity were associated with U5M. This may have implications for the preventive health program.

Geospatial characterizing of Under-Five Mortality in Alexandria, Egypt

“…(26-28) In the same way, Malderen et al, (29) reported that U5M in Sub-Saharan Africa was strongly affected by socioeconomic status like child sex, maternal education, household wealth, and residency. Similar GIS-based study was conducted by, Anafcheh et al, (30) in Iran to determine the spatial distribution of U5M in Khuzestan province. They concluded that there was a great disparity of U5M a cross the province.…”

Under-five Mortality and Associated Factors among Children Born from 15-49 Years Old Mothers in Haramaya Town, Eastern Ethiopia

“…Mother's age was the key factor associated with UFM in Bhutan (Dendup et al, 2018). Multivariate analysis showed that having >1 under-5 child death was associated with maternal age at delivery (<18 or >35) of mothers in a study conducted in Iran (Anafcheh et al, 2018). Compared to those born to younger (≤25 years) mothers, children born to mothers aged 36-40 years, 41-45 years, and more than 45 years had signi cantly lower odds of UFM (Dendup et al, 2018).…”

Under-five Mortality and Associated Factors among Children Born from 15-49 Years Old Mothers in Haramaya Town, Eastern Ethiopia

“…(Dendup et al, 2018). Multivariate analysis showed that having >1 under-5 child death was associated with maternal age at delivery (<18 or >35) of mothers in a study conducted in Iran (Anafcheh et al, 2018). Compared to those born to younger (≤25 years) mothers, children born to mothers aged 36-40 years, 41-45 years, and more than 45 years had signi cantly lower odds of UFM (Dendup et al, 2018).…”