Abstract
BackgroundSubstantial global progress has been made in reducing under-five mortality since 1990, yet progress is insufficient to meet the sustainable development goal of 2030 which calls for ending preventable child deaths. There are disproportional survivals among children in the world. Therefore, the study aimed to assess the Survival status of under-five mortality and determinants in Sub-Saharan African Countries using the recent DHS data.MethodsThe data was retrieved from the birth record file from the standard Demographic and Health Survey dataset of Sub-Saharan Africa countries. Countries that have at least one survey between 2010 and 2018 were retrieved. Parametric shared frailty survival analysis was employed.ResultsA total of 27,221 (7.35%) children were died before celebrating their fifth birthday. Children at an early age were at higher risk of dying and then decrease proportionally with increased age. The risk of death among rich and middle family were lowered by 18 and 8% (AHR =0.82, 95% CI: 0.77-0.87) and (AHR = 0.92, 95% CI: 0.87-0.97) respectively, the hazard of death were 11, 19, 17, 90 and 55% (AHR = 1.06, 95% CI: 1.00-1.12), (AHR = 1.11,95%CI:1.04-1.19), (AHR = 1.17, 95% CI:1.12-1.23), (AHR = 1.90, 95%CI: 1.78-2.04) and (AHR = 1.55, 95% CI:1.47-1.63) higher than among children in rural, use unimproved water, delivered at home, born less than 18 months and between 18 and 23 months birth intervals respectively. The hazard of death was 7% among females and low birth weights (AHR = 0.93, 95%CI: 0.90 – 0.97) and (AHR = 0.93 95%CI: 0.89-0.97) respectively. There was also a significant association between multiple births and birth orders (AHR = 2.11, 95%CI: 2.51 – 2.90), (AHR = 3.01, 95%CI: 2.85-3.19) respectively.ConclusionsDeath rate among under-five children was higher at an early age then decreases as age advanced. Wealth status, residence, water source, place of delivery, sex of the child, plurality, birth size, preceding birth interval, and birth order were the most predictor variables. The health care program should be designed to encourage a healthy family structure. The health care providers should intervene in the community to inspire maternal health services.
Highlights
Substantial global progress has been made in reducing under-five mortality since 1990, yet progress is insufficient to meet the sustainable development goal of 2030 which calls for ending preventable child deaths
According to the report of the World Health Organization (WHO) and UNICEF [5, 6], substantial global progress has been made in reducing under-five mortality faster than any other time during the past two decades and since the 1990s, the global U5MR has dropped 53% from 91 per 100 live births in 1990s to 43 in 2015
Among four sub-regions of Sub-Saharan Africa: about four in ten 154,023 (42%) of them reside in the central region
Summary
Substantial global progress has been made in reducing under-five mortality since 1990, yet progress is insufficient to meet the sustainable development goal of 2030 which calls for ending preventable child deaths. According to the report of the World Health Organization (WHO) and UNICEF [5, 6], substantial global progress has been made in reducing under-five mortality faster than any other time during the past two decades and since the 1990s, the global U5MR has dropped 53% from 91 per 100 live births in 1990s to 43 in 2015. Despite these gains, child existence remains an urgent concern. To succeed in the SDGs target, justifiable efforts are needed mainly in developing countries
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