Predictors of Time-to-Death Among Under-Five Children in Benishangul-Gumuz Regional State, Ethiopia: A Cross-Sectional Study

Abstract

Background: Although Ethiopia attained the fourth-millennium development goal, it promised to decrease the under-five children's death rate in 2015. However, the under-five children death rate has still remained a major public health problem in the Benishangul-Gumuz Regional State at the country level. Therefore, this study aimed to assess the predictor factors associated with the under-five children death rate in the Benishangul-Gumuz Regional State. Methods: A community-based retrospective cross-sectional study design was used. The information gathered from 906 children born five years preceding the survey was measured. Variables such as maternal and child demographic characteristics, health, and environmental factors were measured as predictor factors of under-five children's death rate. The study used descriptive statistics, and Cox Proportional-hazard (PH) regression model to identify the major significant predictor factors associated with under-five children's death rate. Results: The overall prevalence of experiencing under-five children death rate was 9.3% [95%CI: 0.0738, 0.112] in the Benishangul-Gumuz Regional State. The Cox PH regression model analysis revealed, being multiple births (AHR = 2.17; 95% CI (1.17–4.20)), using unprotected well water (AHR = 2.13; 95% CI (1.32–3.42)), parity between 6–8 (AHR = 3.16; 95% CI (1.40–7.16)) and 9 and above (AHR = 7.86; 95% CI (2.23–27.72)), the agricultural sector of mother’s occupation (AHR = 0.39; 95% CI (0.20–0.76)) and family size (AHR = 0.74; 95% CI (0.60–0.93)) were significantly associated with a higher risk of under-five children death rate. An increment in family size and parity increases the risk of under-five children's death rate. Conclusions: The study identified the source of drinking water, family size, parity, mother’s occupation and type of childbirth were the predictor factors significantly associated with under-five children death. The prevalence of under-five children death rate shows that Benishangul-Gumuz Regional State was experiencing a higher death rate than the national level. Therefore, both government policymakers and other concerned organizations should be given special attention to the major predictor factors of the under-five children's death rate and do greater emphasis on decreasing under-five children's death rate, and health intervention policies must be studied.