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

Author(s):  
Pramesh Ghimire ◽  
Kingsley Agho ◽  
Osita Ezeh ◽  
Andre Renzaho ◽  
Michael Dibley ◽  
...  

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.

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Eugene Budu ◽  
Ebenezer Kwesi Armah-Ansah ◽  
Ebenezer Agbaglo ◽  
...  

Abstract Background Under-five mortality in Chad reached a minimum value of 119 deaths per 1000 live births in 2018, compared with a maximum of 250 in 1972. Despite this decline in the  mortality trend, for every six children in Chad, one dies before the age of five. This study, therefore, investigated the proximate, intermediate, and distal determinants of under-five mortality in Chad. Methods We used data from the 2014–15 Chad's Demographic and Health Survey. Data of 7782 children below 5 years were used for the study. Both descriptive and multivariable hierarchical logistic regression analyses were performed. Statistical significance was declared at p < 0.05. Results Under-five mortality was found to be 130 deaths per 1000 live births in Chad, with variations across the various population sub-groups. For distal predictors, the likelihood of death was higher in children born in the FChari Baguirmi region (AOR = 3.83, 95% CI: 1.81–8.14). Children whose mothers belonged to the Baguirmi/Barma ethnic group (AOR = 8.04, 95% CI: 1.75–36.99) were more likely to die before the age of five. On the contrary, the likelihood of under-five mortality was low among children born in rural areas (AOR = 0.73, 95% CI: 0.55–0.97). With the intermediate predictors, the likelihood of under-five deaths was higher among children whose mothers had no formal education (AOR = 1.72, 95% CI: 1.06–2.77). Regarding the proximate predictors, the odds of under-five deaths was higher among male children (AOR = 1.03, 95% CI: 1.05–1.63) and first rank children (AOR = 1.58, 95% CI: 1.13–2.21). Conclusion The study found that the determinants of under-five mortality in Chad are region of residence, place of residence, ethnicity, education, sex of child, and birth rank. These findings show that both socio-economic and proximate factors explain the disparities in under-five mortality in Chad. The identification of these factors can be pivotal towards the design of evidence-based interventions intended to improve child survival. Therefore, improving maternal education while refocusing and re-packaging existing strategies to target selected sub-regional populations with high under-five mortality is urgently required.


2020 ◽  
Author(s):  
Wullo Sisay ◽  
Getayeneh Antehunegn Tesema ◽  
Misganaw Gebrie Worku ◽  
Dessie Abebaw Angaw

Abstract Background: The under-five mortality rate is the probability that a newborn will die before reaching the age of five years. It is usually expressed as a rate per 1000 live births. Nearly 7 million children worldwide die before their fifth birthdays, with almost all of such death occurring in developing countries Objective: To assess the trend and factors associated with under-five mortality in Ethiopia further analysis of 2000-2016 Ethiopian demographic and health survey: a decomposition analysis Methods: A secondary serial cross-sectional analysis was conducted utilizing data from four rounds of EDHS administered in 2000, 2005, 2011 and 2016. The Ethiopian health and demographic survey in 2000-2016 used a two-stage stratified sampling technique to select a nationally representative sample. In the first stage the total number of enumeration areas was 539 in 2000, 540 in 2005, 624 in 2011 and 645 EAs in 2016 were selected with probability proportional to EA size and with independent selection in each sampling stratum. In the second stage of selection, a fixed number of 28 households per cluster were selected with an equal probability systematic selection from the newly created household listing. Result: Looking at the overall trend, Ethiopia has shown a significant decrease in under-five mortality over the study period from 166 per 1000 births in 2000 to 67 per 1000 birth in 2016 with annual rate of reduction of 3.7%. The trends in under-five mortality showed a variation according to their characteristics. Among home delivery, the largest decrement was observed around 6.5% decrease from 2000 to 2016 and in health facility delivery decreased by 8.3% The decomposition analysis shows that 100.74% of the decrease in under-five mortality was accredited to the difference in the effects of characteristics. Conclusion: Under-five mortality decreased significantly over the last one and a half decades. One of the remarkable findings from the decomposition analysis is the effect of education, place of delivery and maternal age. the government of Ethiopia shall do all daughters will be educated and to build health facilities the whole place of the country Keywords: Under-five mortality decomposition analysis, trend


2021 ◽  
Author(s):  
Delelegn Emwodew ◽  
Binyam Tariku ◽  
Getanew Aschalew ◽  
Elias Seid ◽  
Samuel Hailegebreal ◽  
...  

Abstract Background: Childhood stunting is a major challenge to the growth and development of nations by affecting millions of children across the world. Although Ethiopia has made steady progress in reducing stunting, the prevalence of stunting is still one of the highest in the world. This study aims to investigate the spatial variation and factors associated with childhood stunting in Ethiopia.Methods: This study is a secondary data analysis of the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). A total of 4,971 children aged 0–59 months were included in the analysis. The Getis-Ord statistics tool has been used to identify areas with high and low hotspots of stunting. A multilevel logistic regression model was used to identify factors associated with stunting.Results: The prevalence of stunting was found to be 36.86% in Ethiopian under-five children. Statistically significant hotspots of stunting were found in northern parts of Ethiopia. Both individual and community-level factors determined the odds childhood stunting among under-five children. Children in the age group between 24–35 months were more likely to be stunted than children whose age was less than one year [AOR = 3.74; 95 % CI: (3.04–4.59)]. Children with mothers who had completed higher education had lower odds of being stunted compared to children whose mothers had no formal education [AOR = 0.55; 95%CI: (0.38–0.82)]. Children from the poorest wealth quintile had higher odds of being stunted compared to children from the richest wealth quintiles [AOR = 2; 95 % CI: (1.46–2.73)]. Children living in Tigray (AOR =3.64; 95 % CI: 2.17–6.11), Afar (AOR 2.02; 95 % CI 1.19-3.39), Amhara (AOR =2.29; 95 % CI: 1.37–3.86), Benishangul Gumz (AOR=1.87; 95% CI: 1.10-3.17) and Harari (AOR=1.95; 95% CI: 1.17-3.25) regions were more likely to be stunted compared to children living in Addis Ababa.Conclusion: This study showed that both individual and community-level factors were significant predictors of childhood stunting. Improving maternal education, improving the economic status of households, improving age-specific child feeding practice, and providing additional resources to regions with high hotspots of childhood stunting are recommended.


2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Kyi Thar Min ◽  
Thae Maung Maung ◽  
Myo Minn Oo ◽  
Tin Oo ◽  
Zaw Lin ◽  
...  

Abstract Background Malaria is one of the top-five contributors to under-5 deaths in Myanmar. Use of insecticide-treated nets (ITN) and receiving early appropriate care in case of fever are the core interventions to prevent malaria and its complications and thereby deaths. This study aimed to assess among the under-five children, (a) utilization of ITNs and its associated factors, (b) care-seeking behaviour among their caregivers and its associated factors and uptake of malaria testing among those with fever in the last 2 weeks. Methods This was a cross sectional study using secondary analysis of Myanmar Demographic and Health Survey (MDHS) conducted in 2015–2016. Multivariable logistic regression was used to explore the factors associated with non-utilization of ITNs and not seeking care for fever. Effect sizes have been presented using odds ratios with 95% confidence intervals. Data analysis was done using svyset command in STATA to account for the multi-stage sampling design of the survey. Results Of 4597 alive under-five children, 80.5% did not sleep under an ITN last night. The factors significantly associated with non-utilization of ITNs were residing in malaria elimination regions (aOR = 2.0, 1.3–3.2), urban residence (aOR = 1.8, 1.2–2.9), staying in delta region (aOR = 8.7, 4.7–12.2), hilly region (aOR = 3.0, 2.0–4.6, and having highest wealth quintile (aOR = 1.8, 1.1–3.0). Around 16% had fever in the last 2 weeks, of whom 66.7% sought care for fever and 3% got tested for malaria. Nearly half (50.9%) of the caregivers sought care from a government health facility, followed by private hospital/doctor (27.8%), shop (8.0%), village health worker (4.4%) and pharmacy (3.1%). The factors associated with not seeking care for fever were residing in specific geographical locations (hilly, delta and central plains compared to coastal region) and having lowest wealth quintile (aOR = 2.3, 1.1–5.7). Conclusions This study highlighted that ownership and utilization of ITNs was very poor among under-5children. Care-seeking behaviour of the caregivers of under-5 children in case of fever was dismal with two-thirds not seeking care. The programme should seriously consider addressing these barriers if Myanmar is to achieve zero malaria deaths by 2030.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Justice Moses K. Aheto ◽  
Robert Yankson ◽  
Michael Give Chipeta

Abstract Background Under-five mortality (U5M) rates are among the health indicators of utmost importance globally. It is the goal 3 target 2.1 of the Sustainable Development Goals that is expected to be reduced to at least 25 per 1000 livebirths by 2030. Despite a considerable reduction in U5M observed globally, several countries especially those in sub-Saharan Africa (SSA) like Ghana are struggling to meet this target. Evidence-based targeting and utilization of the available limited public health resources are critical for effective design of intervention strategies that will enhance under-five child survival. We aimed to estimate and map U5M risk, with the ultimate goal of identifying communities at high risk where interventions and further research can be targeted. Methods The 2014 Ghana Demographic and Health Survey data was used in this study. Geostatistical analyses were conducted on 5884 children residing in 423 geographical clusters. The outcome variable is child survival status (alive or dead). We employed a geostatistical generalised linear mixed model to investigate both measured and unmeasured child specific and spatial risk factors for child survival. We then visualise child mortality by mapping the predictive probability of survival. Results Of the total sampled under 5 children, 289 (4.91%) experienced the outcome of interest. Children born as multiple births were at increased risk of mortality with an adjusted odds ratio (aOR) (aOR: 8.2532, 95% CI: [5.2608–12.9477]) compared to singletons. Maternal age increased risk of mortality (aOR: 1.0325, 95% CI: [1.0128–1.0527]). Child’s age (aOR: 0.2277, 95% CI: [0.1870–0.2771]) and number of children under 5 within each household (aOR: 0.3166, 95% CI: [0.2614–0.3835]) were shown to have a protective effect. Additionally, mothers with secondary education level (aOR: 0.6258, 95% CI: [0.4298–0.9114]) decreased the risk of U5M. The predicted U5M risk in 2014 was at 5.98%. Substantial residual spatial variations were observed in U5M. Conclusion The analysis found that multiple births is highly associated with increased U5M in Ghana. The high-resolution maps show areas and communities where interventions and further research for U5M can be prioritised to have health impact.


Author(s):  
Idongesit Eshiet

This chapter addresses the feasibility of Nigeria achieving Target 3.1 of Sustainable Development Goal 3, which aims at reducing maternal deaths to less than 70 per 100,000 live births by 2030. Maternal deaths occur due to lack of access to maternal healthcare, which encompasses the healthcare dimensions of family planning, preconception, prenatal, and postnatal care for women. Nigeria is presently the second largest contributor to maternal deaths globally, having a maternal mortality ratio of 814 per 100,000 live births. Will Nigeria achieve this goal by 2030? This chapter assesses the maternal health landscape of Nigeria and the measures taken by the government to address maternal health from the perspective of the feasibility of achieving SDG 3, Target 3.1 by 2030.


Author(s):  
Idongesit Eshiet

This chapter addresses the feasibility of Nigeria achieving Target 3.1 of Sustainable Development Goal 3, which aims at reducing maternal deaths to less than 70 per 100,000 live births by 2030. Maternal deaths occur due to lack of access to maternal healthcare, which encompasses the healthcare dimensions of family planning, preconception, prenatal, and postnatal care for women. Nigeria is presently the second largest contributor to maternal deaths globally, having a maternal mortality ratio of 814 per 100,000 live births. Will Nigeria achieve this goal by 2030? This chapter assesses the maternal health landscape of Nigeria and the measures taken by the government to address maternal health from the perspective of the feasibility of achieving SDG 3, Target 3.1 by 2030.


PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0249006
Author(s):  
Pisey Vong ◽  
Pannee Banchonhattakit ◽  
Samphors Sim ◽  
Chamroen Pall ◽  
Rebecca S. Dewey

Background Unhygienic disposal of children’s stools affects children’s health in terms of their susceptibility to many diseases. However, there are no existing studies into the impact of unhygienic stool disposal in Cambodia. Therefore, this study aimed to identify factors associated with the unhygienic disposal of children’s stools among children under the age of five in Cambodia. Methods An analytical cross-sectional study was conducted using data from the Cambodia Demographic and Health Survey (CDHS) 2014. A multivariable binary logistic regression was conducted using Stata to analyze factors associated with the unhygienic disposal of children’s stools. Results Overall, the prevalence of practicing unhygienic disposal of children’s stools was 29.27% (95%CI: 27.51%- 31.09%). Factors statistically associated with this practice were: living in the Central Plain, Plateau and Mountains, Coastal and Sea regions (AOR = 1.65; 95% CI: 1.33–2.04), (AOR = 2.53; 95% CI: 1.98–3.24) and (AOR = 4.16; 95% CI: 3.15–5.48) respectively, poor household wealth (AOR = 1.58; 95% CI: 1.31–1.91), the mother having no education (AOR = 1.45; 95% CI: 1.14–1.85), a high number of children aged under five (AOR = 1.11; 95% CI: 1.03–1.20), being in the “other” religious category (AOR = 1.77; 95% CI: 1.25–2.51), living in a household with unimproved toilet facilities (AOR = 1.22; 95% CI: 1.11–1.34), living in a household with inadequate hygiene (AOR = 1.33; 95% CI: 1.12–1.59), and the household not being visited by a family planning worker in the last year (AOR = 1.45; 95% CI: 1.19–1.77). However, an increase in the child’s age by even a month had significant negative associations with unhygienic practice (AOR = 0.65; 95% CI: 0.60–0.70), even when controlling for other covariates. Conclusion Almost one third of the mothers do not practice hygienic disposal of children’s stools in Cambodia. Unhygienic practices were more prevalent in certain regions, and were also associated with low wealth, lack of education, an increase in the number of children under five in the household, religion, lack of sanitation and access to healthcare professionals. Conversely, the child’s age was found to be positively associated with the hygienic disposal of children’s stools.


Sign in / Sign up

Export Citation Format

Share Document