Abstract

There is a dearth of literature on the use of machine learning models to predict important under-five mortality risks in Ethiopia. In this study, we showed spatial variations of under-five mortality and used machine learning models to predict its important sociodemographic determinants in Ethiopia. The study data were drawn from the 2016 Ethiopian Demographic and Health Survey. We used three machine learning models such as random forests, logistic regression, and K-nearest neighbors as well as one traditional logistic regression model to predict under-five mortality determinants. For each machine learning model, measures of model accuracy and receiver operating characteristic curves were used to evaluate the predictive power of each model. The descriptive results show that there are considerable regional variations in under-five mortality rates in Ethiopia. The under-five mortality prediction ability was found to be between 46.3 and 67.2% for the models considered, with the random forest model (67.2%) showing the best performance. The best predictive model shows that household size, time to the source of water, breastfeeding status, number of births in the preceding 5 years, sex of a child, birth intervals, antenatal care, birth order, type of water source, and mother’s body mass index play an important role in under-five mortality levels in Ethiopia. The random forest machine learning model produces a better predictive power for estimating under-five mortality risk factors and may help to improve policy decision-making in this regard. Childhood survival chances can be improved considerably by using these important factors to inform relevant policies.

Highlights

  • An estimated 5.4 million children under the age of 5 are said to have died in 2017 alone (UNICEF, WHO, World Bank Group, and United Nations, 2018)

  • There were considerable differences by birth intervals with under-five mortality being more prevalent among children with less than 2 years of birth intervals (9.3%) than children with 2–4 and over 4 years of birth intervals (4.45% and 4.53%, respectively)

  • Children who were breastfed within more than 1 h of birth had a significantly higher prevalence of death (9.8%) than those breastfed within 1 h of birth (4.5%) while there was evidence of a significant difference in underfive mortality regarding the number of people in the household

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Summary

Introduction

An estimated 5.4 million children under the age of 5 are said to have died in 2017 alone (UNICEF, WHO, World Bank Group, and United Nations, 2018). In Ethiopia, the under-five mortality rate has declined by twothirds from the 1990 figure of 204 per 1000 live births to 58 per 1000 live births in 2016, and achieving the target for Millennium Development Goal 4 (MDG 4) (You, Hug, Ejdemyr, Idele, et al, 2015). Despite this achievement, the under-five mortality rate in Ethiopia remains higher than those of many low and middle-income countries (LMIC)

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