Determinants of under-five mortality in Ethiopia using the recent 2019 Ethiopian demographic and health survey data: nested shared frailty survival analysis.

Autor: Ayele BA; Amhara Regional Health Bureau, Wogeda Primary Hospital, Wogeda, Amhara, Ethiopia. belete413@gmail.com., Abebaw Tiruneh S; Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia., Azanaw MM; Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia., Shimels Hailemeskel H; Department of Neonatal Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia., Akalu Y; Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia., Ayele AA; Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
Jazyk: angličtina
Zdroj: Archives of public health = Archives belges de sante publique [Arch Public Health] 2022 May 13; Vol. 80 (1), pp. 137. Date of Electronic Publication: 2022 May 13.
DOI: 10.1186/s13690-022-00896-1
Abstrakt: Background: Worldwide, there is remarkable progress in child survival in the past three decades. Ethiopia is off-track on sustainable development targets in under-five mortality since 2020. Therefore, this study aimed to investigate time to death and its associated factors among under-five children in Ethiopia.
Methods: Nationally representative demographic and health survey data were used for this study. A total of 5772 under-five children were included. Data were analyzed using R software. Semi-parametric nested shared frailty survival analysis was employed to identify factors affecting under-five mortality. Adjusted hazard ratio (AHR) with 95% Confidence interval (CI) was reported and log-likelihood was used for model comparison. Statistical significance was declared at P-value < 0.05.
Results: The weighted incidence of under-five death before celebrating the first fifth year was 5.76% (95% CI: 5.17 - 6.40). Female sex and under-five children living in urban areas were high probability of survival than their counterparts. After controlling cluster and region level frailty, multiple births (AHR = 7.03, 95% CI: 4.40-11.24), breastfed within one hour after birth (AHR = 0.41, 95% CI: 0.28-0.61), preceding birth interval 18-23 months (AHR = 1.62, 95% CI: 1.12 -2.36), and under-five children younger than 18 months (AHR = 2.73, 95% CI: 1.93 -3.86), and teenage pregnancy (AHR = 1.70, 95% CI: 1.01-2.87) were statistically significant factors for time to under-five death.
Conclusion: Even though Ethiopia has a significant decline under-five death, still a significant number of under-five children were dying. Early initiation of breastfeeding, preceding birth interval and teenage pregnancy were the preventable factors of under-five mortality. To curve and achieve the SDG targets regarding under-five mortality in Ethiopia, policymakers and health planners should give prior attention to preventable factors for under-five mortality.
(© 2022. The Author(s).)
Databáze: MEDLINE
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