Risk factors for under-five mortality in Ethiopia: Evidence from the 2016 Ethiopian Demographic and Health Survey

Abstract

Background. The under-five child mortality (U5CM) rate is the most important sensitive indicator of the socioeconomic and health status of a community, and the overall development of a nation. Despite the world having made substantial progress in reducing child mortality since 1990, the global U5CM rate was 41 per 1 000 in 2016. The rate is higher in Ethiopia than in several other low- and middle-income countries. Objectives. To estimate the effects of socioeconomic and demographic factors on U5CM in Ethiopia. Methods. A community-based cross-sectional study was conducted on 10 641 under-five children. The 2016 Ethiopian Demographic and Health Survey data were used for this research. Binary logistic regression was employed to identify factors affecting the U5CM rate. Results. The U5CM rate was 60 deaths per 1 000 live births. Children who were delivered at home (adjusted odds ratio ( aOR) 1.30; 95% CI 1.04 - 1.63) and male (aOR 1.36; 95% CI 1.15 - 1.60) were at an increased risk of death. Children whose family size was between 1 and 3 (aOR 5.54; 95% CI 4.08 - 7.54), and 4 and 6 (aOR 1.94; 95% CI 1.55 - 2.43) were more likely to die before age 5 than those whose family size was ≥6. First-born (aOR 0.49; 95% CI 0.36 - 0.67), second- or third-born (aOR 0.51; 95% CI 0.39 - 0.67) and fourth- or fifth-born (aOR 0.71; 95% CI 0.56 - 0.91) children were less likely to die than those who were sixth-born and above. Similarly, singleton children (aOR 0.20; 95% CI 0.15 - 0.28), children residing in urban communities (aOR 0.55; 95% CI 0.40 - 0.76) and children whose families had protected sources of water (aOR 0.84; 95% CI 0.71 - 0.99) had reduced risks of death compared with their respective counterparts. Conclusions. The present study identified risk factors for under-five mortality in Ethiopia. Programmes to reduce under-five mortality in Ethiopia must focus on the place of delivery, households with unprotected sources of drinking water and families residing in rural areas.