Time to death and its determinants among under-five children in Sub-Saharan Africa using the recent (2010–2018) demographic and health survey data: country-based shared frailty analyses

BMC Pediatrics

Belayneh Kefale¹  Melaku Tadege Engdaw²  Bedilu Abebe²  Alemayehu Digssie Gebremariam²  Sofonyas Abebaw Tiruneh²  Desalegn Tesfa²  Melkalem Mamuye Azanaw²  Tsion Dessalegn² 

[1] Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia;Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia;

关键词: Survival status;    Under-five mortality;    Determinant factors;    Shard frailty;    Sub-Saharan Africa;   

DOI  :  10.1186/s12887-021-02950-3

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY