Abstract
Background Under-five mortality rate is a leading indicator of the level of child health and the overall development in countries which indicate the quality of life of a given population, as measured by life expectancy. Objectives To identify and analyze factors that may have a significant influence on under-five mortality in Ethiopia. Methods A national representative cross-sectional study and a quantitative study were conducted among 18,008 households selected based on 2016 EDHS data. The analysis was done using SPSS version 20 statistical software. Both bivariate and multivariable analyses were employed. In multivariable analysis, p value less than 0.05 was considered statistically significant and odds ratio with 95% CI (confidence interval) was used to assess the determinants of under-five child mortality. Results A total of 10,641 children were included in the study with a 99.0% response rate. The U5CM for being a rural resident (AOR = 1.802, 95% CI: 1.251, 2.595), not breastfeeding (AOR = 2.956, 95% CI: 2.490, 3.511), having multiple birth (AOR = 4.755, 95% CI: 3.440, 6.572), male gender (AOR = 1.363, 95% CI: 1.153, 1.612), having first birth order (AOR = 1.592, 95% CI: 1.275, 1.992), and having family size six and above (AOR = 2.187, 95% CI: 1.769, 2.707). The increment of family size increases the risk of U5CM.Conclusion Multivariate logistic analysis reflected that place of residence, mothers' educational level, religion, current breastfeeding status, type of birth, sex of child, birth order, and family size were found to be significant predictors of under-five child mortality. So, government policy, nongovernmental organizations, and all concerned bodies should be focused on the major determinants of under-five child mortality and put in a lot more effort to reduce under-five child mortality, and health intervention policies should be revised.
Highlights
The Growth and Transformation Plan of Ethiopia (GTPE) has outlined the strategic measures that can significantly contribute to reducing under-five mortality [1]
The sampling frame used for the 2016 Ethiopia Demographic and Health Survey (EDHS) was the Ethiopia Population and Housing Census, which was conducted in 2007 by the Ethiopia Central Statistical Agency (CSA)
From the study using a binary logistic regression model, we found that the factors that significantly affect under-five mortality in Ethiopia are place of residence, mother’s educational level, source of drinking water, type of toilet facility, religion, wealth index, current contraceptive methods, current breastfeeding status, type of birth, child sex, place of delivery, current marital status, birth order, family size, and region
Summary
The. GTPE MOH has started to make plans for reducing underfive mortality rates to below 30 deaths per thousand live births by 2035 [2]. GTPE MOH has started to make plans for reducing underfive mortality rates to below 30 deaths per thousand live births by 2035 [2] Reaching this low level will require improvements in social-economic status of the population as well as improvement in the direct services provided by the health sector [3]. Multivariate logistic analysis reflected that place of residence, mothers’ educational level, religion, current breastfeeding status, type of birth, sex of child, birth order, and family size were found to be significant predictors of under-five child mortality. Government policy, nongovernmental organizations, and all concerned bodies should be focused on the major determinants of under-five child mortality and put in a lot more effort to reduce under-five child mortality, and health intervention policies should be revised
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