Determinants and Trends of Under-Five Child Mortality in Ethiopia: A Multi-level Logistic Modeling Approach

Abstract

The burden of under-five mortality remains unevenly distributed. About 80 percent of under-five deaths occur in two regions, sub-Saharan Africa and South Asia. Ethiopia is among the six countries that account for half of the global under-five deaths. The aim of this study was to identify the significant socio-economic and demographic factors influencing under-five child mortality and evaluate the variation among the regional states of Ethiopia. In this study, the 2000, 2005, 2011 and 2016 EDHS data were used to describe the trend of under-five mortality in Ethiopia. The 2016 EDHS data have been used to analyze determinants and variation of under-five mortality by background characteristics. Single-level logistic regression and multilevel logistic regression models were used to identify the major risk factors of under-five mortality and regional variations in under-five child mortality in Ethiopia using the 2016 EDHS data. The results from single-level and multilevel logistic regression analyses showed that Sex of a child, Age of a child in month, Birth type, Birth order number, Number of Household size, Breastfeeding status, Educational level of mother’s, Place of residence and type of toilet facility had significant effects on under-five child mortality and there is variation of under-five child mortality from region to region. Conversely, preceding birth interval, wealth index Household, Source of drinking water and place of delivery were found insignificant. The results revealed variation of under-five child mortality from region to region. The multilevel logistic regression analysis result showed that the effects of breastfeeding varied across regions whereas the effects of other covariates on under-five child mortality remained fixed across regions.