Multilevel survival analysis of factors associated with under-five mortality in Manipur.
| Autor: | Singh LS; Research Scholar, Department of Statistics, Manipur University, Imphal, Manipur, India., Singh SS; Assistant Professor, Department of Statistics, Manipur University, Imphal, Manipur, India. |
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| Jazyk: | angličtina |
| Zdroj: | Indian journal of public health [Indian J Public Health] 2023 Jan-Mar; Vol. 67 (1), pp. 72-77. |
| DOI: | 10.4103/ijph.ijph_969_22 |
| Abstrakt: | Background: Child mortality is a major public health issue. The studies on under-five mortality that ignore the hierarchical facts mislead the interpretation of the results due to observations in the same cluster sharing common cluster-level random effects. Objectives: The present study uses a multilevel model to analyze under-five mortality and identify the significant factors for under-five mortality in Manipur. Methods: National Family Health Survey-5 (2019-21) data are used in the present study. A multilevel mixed-effect Weibull parameter survival model was fitted to determine the factors affecting under-five mortality. We construct three-level data, individual levels are nested within primary sampling units (PSUs), and PSUs are nested within districts. Results: Out of the 3225 under-five children, 85 (2.64%) died. The three-level mixed-effects Weibull parametric survival model with PSUs nested within the districts, the likelihood-ratio test with Chi-square value = 10.98 and P = 0.004 < 0.05 indicated that the model with random-intercept effects model with PSUs nested within the districts fits the data better than the fixed effect model. The four covariates, namely the number of birth in the last 5 years, age of mother at first birth, use of contraceptive, and size of child at birth, were found as the risk factor for under-five mortality at a 5% level of significance. Conclusions: In the random-intercept effect model, the two estimated variances of the random-intercept effects for district and PSU levels are 0.27 and 0.31, respectively. The values indicate variations (unobserved heterogeneities) in the risk of death of the under-five children between districts and PSUs levels. Competing Interests: None |
| Databáze: | MEDLINE |
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