Determinant factors of under-five mortality in Southern Nations, Nationalities and People’s region (SNNPR), Ethiopia

Abstract Background Child mortality is a key indicator of the performance of the health system of a nation. Impressive progress in the reduction of under-five mortality has been made in Ethiopia. However, still there are some regions where the under-five mortality rates are high. Southern Nations, Nationalities, and Peoples’ Region (SNNPR) is among those regions in Ethiopia with high under-five mortality rates. This study aimed to identify the determinant factors of under-five mortality in SNNPR. Methods Data used for the study were drawn from the 2016 EDHS. A total of 1277 under-five children were included in the study. A multivariable logistic regression model was fitted to identify determinant factors associated with under-five mortality. Results Children with second or third birth order (OR = 1.316, 95% CI: (1.097, 2.343)), fourth or fifth birth order (OR = 1.934, 95% CI: (1.678, 3.822)), sixth or above birth order (OR = 3.980, 95% CI: (2.352, 6.734)) were significantly associated with increased risk of under-five mortality as compared to those with first birth order. Increased risk of under-five mortality was also significantly associated with a family size of five or more (OR = 3.397, 95% CI: (1.702, 6.782)) as compared to the family size of less than five; smaller size at birth (OR = 1.714, 95% CI: (1.120, 2.623)) as compared to larger size at birth; multiple births (OR = 1.472, 95% CI: (1.289, 2.746)) as compared to singletons. On the other hand, female children (OR = 0.552, 95% CI: (0.327, 0.932)), children born at health institutions (OR = 0.449, 95% CI: (0.228, 0.681)) and children who were breastfed (OR = 0.657, 95% CI: (0.393, 0.864)) were significantly associated with decreased risk of under-five mortality as compared to male children, those born at home and those who were not breastfed respectively. Conclusions Sex of a child, birth order, size of a child at birth, place of delivery, birth type, breastfeeding status, and family size were significant factors associated with under-five mortality in SNNPR, Ethiopia. Thus, planning and implementing relevant strategies that focus on those identified determinant factors of under-five mortality is required for the improvement of child survival in SNNPR, Ethiopia.

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Long-term mortality rates and associated risk factors following primary and revision knee arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.104b1.bjj-2021-0753.r1 ◽

2022 ◽

Vol 104-B (1) ◽

pp. 45-52

Author(s):

Liam Zen Yapp ◽

Nick D. Clement ◽

Matthew Moran ◽

Jon V. Clarke ◽

A. Hamish R. W. Simpson ◽

...

Keyword(s):

General Population ◽

Knee Arthroplasty ◽

Mortality Rates ◽

Factors Associated ◽

Revision Knee Arthroplasty ◽

Risk Of Mortality ◽

Increased Risk ◽

Male Sex ◽

Long Term Mortality

Aims The aim of this study was to determine the long-term mortality rate, and to identify factors associated with this, following primary and revision knee arthroplasty (KA). Methods Data from the Scottish Arthroplasty Project (1998 to 2019) were retrospectively analyzed. Patient mortality data were linked from the National Records of Scotland. Analyses were performed separately for the primary and revised KA cohorts. The standardized mortality ratio (SMR) with 95% confidence intervals (CIs) was calculated for the population at risk. Multivariable Cox proportional hazards were used to identify predictors and estimate relative mortality risks. Results At a median 7.4 years (interquartile range (IQR) 4.0 to 11.6) follow-up, 27.8% of primary (n = 27,474/98,778) and 31.3% of revision (n = 2,611/8,343) KA patients had died. Both primary and revision cohorts had lower mortality rates than the general population (SMR 0.74 (95% CI 0.73 to 0.74); p < 0.001; SMR 0.83 (95% CI 0.80 to 0.86); p < 0.001, respectively), which persisted for 12 and eighteight years after surgery, respectively. Factors associated with increased risk of mortality after primary KA included male sex (hazard ratio (HR) 1.40 (95% CI 1.36 to 1.45)), increasing socioeconomic deprivation (HR 1.43 (95% CI 1.36 to 1.50)), inflammatory polyarthropathy (HR 1.79 (95% CI 1.68 to 1.90)), greater number of comorbidities (HR 1.59 (95% CI 1.51 to 1.68)), and periprosthetic joint infection (PJI) requiring revision (HR 1.92 (95% CI 1.57 to 2.36)) when adjusting for age. Similarly, male sex (HR 1.36 (95% CI 1.24 to 1.49)), increasing socioeconomic deprivation (HR 1.31 (95% CI 1.12 to 1.52)), inflammatory polyarthropathy (HR 1.24 (95% CI 1.12 to 1.37)), greater number of comorbidities (HR 1.64 (95% CI 1.33 to 2.01)), and revision for PJI (HR 1.35 (95% 1.18 to 1.55)) were independently associated with an increased risk of mortality following revision KA when adjusting for age. Conclusion The SMR of patients undergoing primary and revision KA was lower than that of the general population and remained so for several years post-surgery. However, approximately one in four patients undergoing primary and one in three patients undergoing revision KA died within tenten years of surgery. Several patient and surgical factors, including PJI, were associated with the risk of mortality within ten years of primary and revision surgery. Cite this article: Bone Joint J 2022;104-B(1):45–52.

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Factors Associated with Nutritional Status of the Under Five Children

Asian Journal of Medical Sciences ◽

10.3126/ajms.v1i1.2927 ◽

2010 ◽

Vol 1 (1) ◽

pp. 6-8 ◽

Cited By ~ 3

Author(s):

Amita Pradhan

Keyword(s):

Body Mass Index ◽

Nutritional Status ◽

Body Mass ◽

Multinomial Logistic Regression ◽

Wealth Index ◽

Significant Variable ◽

Under Five ◽

Factors Associated ◽

Female Headed Households ◽

Size At Birth

Objective: To identify factors associated to the nutritional status of under five children.Method: The data used in this analysis are from Demographic and Health Survey 2006 conducted in Nepal. Total 5262 cases are included in the present study. A multinomial logistic regression model is used to study the relation between various factors and nutritional status.Results: Increasing body mass index of mothers and wealth index shows decreasing likelihood of malnutrition among children. Rural children show insignificant higher likelihood of different forms of underweight and wasting as compared to urban area. Frequency of listening radio does not show significant association in case of mild and moderate wasting and shown very high unusual odds ratio in case of severe wasting. Similarly, lower frequency of watching television also does not show significantly higher likeliness of different form of stunting, underweight and wasting. Female children are more likely to be stunted, underweight and wasted as compared to male. Female headed households are more likely to have moderately and mildly stunted children and mixed results are observed for underweight and wasting. The likelihood for all forms of malnutrition is higher among children with smaller than average size at birth as compared to average or bigger size at birth. Mixed results are observed regarding likelihood of different forms of malnutrition among children with mothers having different educational level.Conclusion: Body mass index of mothers is found significant variable while explaining children's nutritional status. Similarly, Size at birth is significantly associated with nutrition during the childhood.Keywords: Stunting; wasting; under weight; under five childrenDOI: 10.3126/ajms.v1i1.2927Asian Journal of Medical Sciences Vol.1(1) 2010 p.6-8

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Under-Five Mortality and Associated Factors: Evidence from the Nepal Demographic and Health Survey (2001–2016)

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16071241 ◽

2019 ◽

Vol 16 (7) ◽

pp. 1241

Author(s):

Pramesh Ghimire ◽

Kingsley Agho ◽

Osita Ezeh ◽

Andre Renzaho ◽

Michael Dibley ◽

...

Keyword(s):

Sustainable Development ◽

Health Survey ◽

Child Survival ◽

Common Factors ◽

Demographic And Health Survey ◽

Sustainable Development Goal ◽

Development Goal ◽

Live Births ◽

Under Five ◽

Factors Associated

Child mortality in Nepal has reduced, but the rate is still above the Sustainable Development Goal target of 20 deaths per 1000 live births. This study aimed to identify common factors associated with under-five mortality in Nepal. Survival information of 16,802 most recent singleton live births from the Nepal Demographic and Health Survey for the period (2001–2016) were utilized. Survey-based Cox proportional hazard models were used to examine factors associated with under-five mortality. Multivariable analyses revealed the most common factors associated with mortality across all age subgroups included: mothers who reported previous death of a child [adjusted hazard ratio (aHR) 17.33, 95% confidence interval (CI) 11.44, 26.26 for neonatal; aHR 13.05, 95% CI 7.19, 23.67 for post-neonatal; aHR 15.90, 95% CI 11.38, 22.22 for infant; aHR 16.98, 95% CI 6.19, 46.58 for child; and aHR 15.97, 95% CI 11.64, 21.92 for under-five mortality]; nonuse of tetanus toxoids (TT) vaccinations during pregnancy (aHR 2.28, 95% CI 1.68, 3.09 for neonatal; aHR 1.86, 95% CI 1.24, 2.79 for post-neonatal; aHR 2.44, 95% CI 1.89, 3.15 for infant; aHR 2.93, 95% CI 1.51, 5.69 for child; and aHR 2.39, 95% CI 1.89, 3.01 for under-five mortality); and nonuse of contraceptives among mothers (aHR 1.69, 95% CI 1.21, 2.37 for neonatal; aHR 2.69, 95% CI 1.67, 4.32 for post-neonatal; aHR 2.01, 95% CI 1.53, 2.64 for infant; aHR 2.47, 95% CI 1.30, 4.71 for child; and aHR 2.03, 95% CI 1.57, 2.62 for under-five mortality). Family planning intervention as well as promotion of universal coverage of at least two doses of TT vaccine are essential to help achieve child survival Sustainable Development Goal (SDG) targets of <20 under-five deaths and <12 neonatal deaths per 1000 births by the year 2030.

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Determinants of Under-Five Child Mortality in Arab Countries. Are the Effects Homogeneous Across Birth Order and Among Countries?

European Review Of Applied Sociology ◽

10.2478/eras-2021-0009 ◽

2021 ◽

Vol 14 (23) ◽

pp. 34-49

Author(s):

Chellai Fatih

Keyword(s):

Birth Order ◽

Child Mortality ◽

Rural Areas ◽

Urban Areas ◽

Arab Countries ◽

Policy Implications ◽

Educational Levels ◽

Under Five ◽

Risk Of Death ◽

Increased Risk

Abstract Under-five-child mortality remains a major challenge for governments in the Arab world to achieve Sustainable Development Goals. Thus, further studies are needed to analyze the determinants of child mortality. The Multiple Indicators Cluster Surveys (MICS) datasets of six Arab countries (Algeria, Egypt, Iraq, Mauritania, Sudan, and Tunisia) have been used, which are consisting of 249.000 children nested within 54.644 mothers. The study was designed in a women-parity-covered one to six birth order. Binary multivariable logistic models were used to estimate the risk ratios of death by adjusting for child sex, birth outcome (twin vs. singleton), mother’s education level, maternal age, previous birth interval, place of residence (rural vs. urban), and the family wealth index. The findings revealed that the under-five child mortality rates were 87, 70,66,35,36, and 21 per 1000 live births in Sudan, Mauritania, Egypt, Iraq, Algeria, and Tunisia, respectively). First-born infants in these six countries have a higher risk of mortality during their five years of life. Second, third-and fourth-born infants were at a decreased risk of death compared to first-born infants in all countries; in contrast, fifth-and-sixth-born infants were at an increased risk in all countries except Sudan and Mauritania. Twin children have a higher risk of death than singletons in all countries and across all birth orders. Children of mothers with higher educational levels living in urban areas are at lower risk of death than their peers across all birth orders. Regarding policy implications, decision-makers can target three main axes: first, enhancing women’s educational levels; second, increasing birth intervals (birth spacing policies); and third, improving living standards and healthcare strategies, especially in rural areas to improve child and mother health.

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Predictors of Underweight among Children Under-five in Ethiopia

10.21203/rs.3.rs-1090215/v1 ◽

2021 ◽

Author(s):

Gebremedhin Desta ◽

Natnael Mamuye ◽

Martin Sagayam Kulandairaj ◽

Denekew Bitew ◽

Bezarede Mekonnen ◽

...

Keyword(s):

Birth Order ◽

Educational Level ◽

Employment Status ◽

Descriptive Statistics ◽

Personal Hygiene ◽

Age Group ◽

Under Five ◽

Proximate Factors ◽

Size At Birth ◽

Significant Factors

Abstract 9013 under-five children were included for study. Descriptive Statistics and POM were employed identify socio-economic, demographic, and proximate factors of underweight to children among regions of Ethiopia. SAS version 9.4 was used. About 25.3% of children in Ethiopia were underweighted. POM showed that sex, residence, size at birth, age group, incidence of diarrhea, educational level, breastfeeding status, mothers’ employment status, and birth order were found to be significant factors of underweight. Improvement of education for caring child in appropriate age needed. Personal hygiene be improved to prevent exposures to diarrhea and environmental sanitation.

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Determinants of Under-Five Child Mortality in Ethiopia: Analysis Using Ethiopian Demographic Health Survey, 2016

International Journal of Pediatrics ◽

10.1155/2020/7471545 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Addisalem Tebeje Zewudie ◽

Abebaw Addis Gelagay ◽

Engidaw Fentahun Enyew

Keyword(s):

Birth Order ◽

Child Mortality ◽

Family Size ◽

Multivariable Analysis ◽

Cross Sectional Study ◽

Multiple Birth ◽

Cross Sectional ◽

Under Five ◽

Logistic Analysis ◽

Multivariable Analyses

Background. Under-five mortality rate is a leading indicator of the level of child health and the overall development in countries which indicate the quality of life of a given population, as measured by life expectancy. Objectives. To identify and analyze factors that may have a significant influence on under-five mortality in Ethiopia. Methods. A national representative cross-sectional study and a quantitative study were conducted among 18,008 households selected based on 2016 EDHS data. The analysis was done using SPSS version 20 statistical software. Both bivariate and multivariable analyses were employed. In multivariable analysis, p value less than 0.05 was considered statistically significant and odds ratio with 95% CI (confidence interval) was used to assess the determinants of under-five child mortality. Results. A total of 10,641 children were included in the study with a 99.0% response rate. The U5CM for being a rural resident (AOR=1.802, 95% CI: 1.251, 2.595), not breastfeeding (AOR=2.956, 95% CI: 2.490, 3.511), having multiple birth (AOR=4.755, 95% CI: 3.440, 6.572), male gender (AOR=1.363, 95% CI: 1.153, 1.612), having first birth order (AOR=1.592, 95% CI: 1.275, 1.992), and having family size six and above (AOR=2.187, 95% CI: 1.769, 2.707). The increment of family size increases the risk of U5CM.Conclusion. Multivariate logistic analysis reflected that place of residence, mothers’ educational level, religion, current breastfeeding status, type of birth, sex of child, birth order, and family size were found to be significant predictors of under-five child mortality. So, government policy, nongovernmental organizations, and all concerned bodies should be focused on the major determinants of under-five child mortality and put in a lot more effort to reduce under-five child mortality, and health intervention policies should be revised.

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Neonatal and child mortality data in retrospective population-based surveys compared with prospective demographic surveillance: EN-INDEPTH study

Population Health Metrics ◽

10.1186/s12963-020-00232-1 ◽

2021 ◽

Vol 19 (S1) ◽

Author(s):

Tryphena Nareeba ◽

◽

Francis Dzabeng ◽

Nurul Alam ◽

Gashaw A. Biks ◽

...

Keyword(s):

Survey Data ◽

Child Survival ◽

Population Based ◽

Mortality Data ◽

Surveillance Systems ◽

Age At Death ◽

Middle Income ◽

Under Five ◽

Factors Associated ◽

Mortality Estimates

Abstract Background Global mortality estimates remain heavily dependent on household surveys in low- and middle-income countries, where most under-five deaths occur. Few studies have assessed the accuracy of mortality data or determinants of capturing births in surveys. Methods The Every Newborn-INDEPTH study (EN-INDEPTH) included a large, multi-country survey of women aged 15–49 interviewed about livebirths and their survival status in five Health and Demographic Surveillance Systems (HDSSs). The HDSSs undertake regular household visits to register births and deaths for a given population. We analysed EN-INDEPTH survey data to assess background factors associated with not recalling a complete date-of-birth. We calculated Kaplan-Meier survival estimates for both survey and HDSS data and describe age-at-death distributions during the past 5 years for children born to the same women. We assessed the proportion of HDSS-births that could be matched on month-of-birth to survey-births and used regression models to identify factors associated with matching. Results 69,176 women interviewed in the survey reported 109,817 births and 3064 deaths in children under 5 years in the 5 years prior to the survey. In the HDSS data, the same women had 83,768 registered births and 2335 under-five deaths in the same period. A complete date-of-birth was not reported for 1–7% of survey-births. Birthdates were less likely to be complete for dead children and children born to women of higher parity or with little/no education. Distributions of reported age-at-death indicated heaping at full weeks (neonatal period) and at 12 months. Heaping was more pronounced in the survey data. Survey estimates of under-five mortality rates were similar to HDSS estimates of under-five mortality in two of five sites, higher in the survey in two sites (15%, 41%) and lower (24%) in one site. The proportion of HDSS-births matched to survey-births ranged from 51 to 89% across HDSSs and births of children who had died were less likely to be matched. Conclusions Mortality estimates in the survey and HDSS were not markedly different for most sites. However, neither source is a “gold standard” and both sources miss some events. Research is required to improve capture and accuracy to better track newborn and child survival targets.

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Associations of Birthweight and Maternal Fertility Problems with Childhood Cancers.

Blood ◽

10.1182/blood.v106.11.4546.4546 ◽

2005 ◽

Vol 106 (11) ◽

pp. 4546-4546

Author(s):

M. Tevfik Dorak ◽

Donna M. Hammal ◽

Mark S. Pearce ◽

Richard J.Q. McNally ◽

Louise Parker

Keyword(s):

Birth Weight ◽

Birth Order ◽

Gestational Age ◽

Reproductive History ◽

Maternal History ◽

Disease Etiology ◽

Childhood All ◽

Increased Risk ◽

History Of ◽

Size At Birth

Abstract Higher birthweight, maternal history of miscarriage and low birth order have been associated with increased risk of childhood leukaemias and some solid tumours. No study has investigated these factors together and differences in disease etiology between girls and boys have been generally overlooked. In a retrospective case-control study, 732 childhood (≤15 yr) cancer cases from the population-based Northern Region Young Persons’ Malignant Disease Registry (NRYPMDR) whose hospital birth records could be accessed and 3723 controls matched for date and hospital of birth were compared. We examined maternal reproductive history and birthweight for gender-specific associations using conditional logistic regression. In univariate analysis, maternal history of miscarriage showed an association with all cancers (OR = 1.29; 95% CI = 1.05 to 1.62, P = 0.02). In individual cancer groups, this association was significant for acute lymphoblastic leukaemia (ALL) (n=225, OR = 1.56; 95% CI = 1.07 to 2.27, P = 0.02), and marginally significant in osteosarcoma and neuroblastic tumours (neuroblastoma and ganglioneuroblastoma). There was no significant association with birth order. Being first born was a weak risk factor for ALL in boys only (OR=1.3, 95% CI = 0.8 to1.8). In boys but not in girls, the risk of ALL increased with birthweight (OR = 1.06 per 100 gr increase; 95% CI = 1.01 to 1.11, P = 0.01). When birthweights were normalized using UK standards for gestational age and gender, the associations were not more marked. A multivariate model for ALL confirmed the independence of associations with miscarriage history and birthweight. Gestational age was not a risk marker and did not explain the associations with birth weight and miscarriage history. Consideration of gender unravelled significant associations of maternal reproductive history and size at birth with childhood cancer markedly different between girls and boys. Most notably, associations with birth weight and miscarriage and the weak association with being first-born in childhood ALL were all stronger in males. The findings for birthweights normalized for gestational age suggested that size at birth rather than in utero growth trajectory is of etiologic importance in childhood ALL.

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Factors associated with declining under-five mortality rates from 2000 to 2013: an ecological analysis of 46 African countries

BMJ Open ◽

10.1136/bmjopen-2015-007675 ◽

2016 ◽

Vol 6 (1) ◽

pp. e007675 ◽

Cited By ~ 19

Author(s):

Aaron M Kipp ◽

Meridith Blevins ◽

Connie A Haley ◽

Kasonde Mwinga ◽

Phanuel Habimana ◽

...

Keyword(s):

Mortality Rates ◽

African Countries ◽

Ecological Analysis ◽

Under Five ◽

Factors Associated

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Birth Order and Delinquency: Findings From a Youth Training Centre

Australian & New Zealand Journal of Criminology ◽

10.1177/000486587400700306 ◽

1974 ◽

Vol 7 (3) ◽

pp. 179-183 ◽

Cited By ~ 3

Author(s):

E.J.D. Ogden ◽

D.J. de L. Horne

Keyword(s):

Birth Order ◽

Family Size ◽

Large Family ◽

Retrospective Evaluation ◽

Training Centre ◽

Factors Associated ◽

Large Family Size ◽

Evaluation Of Data ◽

The Relationship ◽

Youth Training

THE AIM of this study was to carry out a retrospective evaluation of data on admissions to a youth training centre in Victoria, Australia, to determine the relationship between birth order and risk of delinquency. The findings confirmed the results of other studies (e.g. Biles, 1971) that middle children were at greatest risk. Other factors associated with ‘risk’ were large family size and educational retardation.

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