Background:
Under-five mortality is one of the indicators of the millennium development
goals (MDGs) for the child mortality reduction goal. Understanding the social
determinants of under-five mortality is helpful to narrow the gap between
different social classes. Therefore, this study focused on the social
determinants of under-five mortality inEthiopiausing EDHS 2011 data.
Methods: The data source for this analysis was the 2011 EDHS which was undertaken
over a five-month period from 27 December, 2010 to 3 June, 2011. The sample was
selected using a stratified, two-stage cluster design. Samples of 16,515 women
of reproductive age were interviewed. The questionnaire used to collect information
from these women who had among other things such as background characteristics of women,
birth history of these women and the survival of each birth at the time of the interview.
Births that had occurred to women in the last 10 years prior to the date of the interview were extracted for the analysis. Descriptive statistical methods were
used to describe the distribution of the characteristics of the data. Kaplan
Meier plots and incidence rates per 1000 person years were used to compare
survival across different categories of the risk factors. The effect of the
risk factors on survival was analyzed using Cox proportional hazards regression. Data management and analysis were carried out using
STATA 10. Results: A total of 23,581 under-five children were included in the
study. The under-five mortality incidence rate in Ethiopia for the last ten
years was 29.6 per 1000 person years. Maternal education beyond primary level
of education reduced the risk of under-five mortality by about half. A
significant reduction in risk of under-five mortality was observed among births
to mothers residing in richest households. The hazard ratio (HR) was higher for
under-five mortality among boys than daughters, twins than singleton, teen age
mother than higher ages and short births than optimal. Conclusions: Empowering
mothers with education and making them productive for improving their
income are important aspects for reducing under-five mortality. Emerging
regions were disadvantaged on the incidence of under-five mortality; however,
there was a positive result in narrowing the urban-rural under-five
References
[1]
United Nations (2003) Indicators for monitoring the millennium development goals: Definitions, rationale, concepts and sources. Statistics and Statistical Methods Publications, New York.
[2]
United Nations (2012) The millennium development goals report 2012. Department of Economic and Social Affairs, New York.
[3]
WHO (2011) Rio political declaration on social determinants of health. WHO, Rio de Janeiro.
[4]
Tanja, H., Anton, K., Caspar, L. and Johan, M. (2005) Determinants of under-5 mortality among the poor and the rich: A cross-national analysis of 43 developing countries. International Journal of Epidemiology, 34, 12571265. doi:10.1093/ije/dyi190
[5]
Diddy, A. (2011) Regional inequalities in under-5 mortality in Nigeria: A population-based analysis of individual- and community-level determinants. Antai Population Health Metrics, 9, 6. doi:10.1186/1478-7954-9-6
[6]
Gbenga, K., Victor, A. and Olalekan, U. (2012) Risk factors and a predictive model for under-five mortality in Nigeria: Evidence from Nigeria demographic and health survey. BMC Pregnancy and Childbirth, 12, 10.
doi:10.1186/1471-2393-12-10
[7]
Nure Alam, S., Nuruzzaman, H. and Abdul, G. (2011) Differentials and determinants of under-five mortality in Bangladesh. International Journal of Current Research, 3, 142-148.
[8]
Mohamed, M., Adil, S., David, A. and Eihab, E. (2009) Level and determinants of infant and child mortality in Malakal Town—Southern Sudan. Sudanese Journal of Public Health, 4, 250-255.
[9]
Ettarh, R. and Kimani, J. (2012) Determinants of under-five mortality in rural and urban Kenya. Rural Remote Health, 12, 1812.
[10]
Xu, Y.H., Huang, H.W. and Yang, R.L. (2011) The under-five mortality rate and the causes of death in Zhejiang Province between 2000 and 2009. Zhongguo Dang Dai Er Ke Za Zhi, 13, 561-564.
[11]
United Nations Children’s Fund (2012) Committing to child survival: A promise renewed. Progress Report, New York.
[12]
Central Statistical Agency [Ethiopia] and ICF International (2012) Ethiopia demographic and health survey 2011. Central Statistical Agency and ICF International, Addis Ababa, Ethiopia and Calverton.
[13]
Kana, F. (2010) Variations in attitudinal gender preferences for children across 50 less-developed countries. Demographic Research, 23, 1031-1048.
doi:10.4054/DemRes.2010.23.36
[14]
Siddhi, H. and Bela, G. (1997) A prospective cohort study on the survival experience of under five children in rural western India. Indian Pediatrics, 34, 995-1001.
[15]
Cleland, G. and Van Ginneken, K. (1988) Maternal education and child survival in developing countries: The search for pathways of influence. Social Science & Medicine, 27, 1357-1368. doi:10.1016/0277-9536(88)90201-8
[16]
Shea, R. (2008) Further evidence of the effects of preceding birth intervals on neonatal, infant, and under-five-years mortality and nutritional status in developing countries: Evidence from the demographic and health surveys. Macro International Inc., Bethesda.
[17]
Nazrul, M., Kamal, H. and Korban, A. (2009) Factors influencing infant and child mortality: A case study of Rajshahi District, Bangladesh. Journal of Human Ecology, 26, 31-39.
