Ayele Dawit G, Zewotir Temesgen T, Mwambi Hemry
Department of Epidemiology, Bloomberg School of Public Health, The Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, 21205, USA.
School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Pietermaritzburg, Private Bag X01, Scottsville, 3209, South Africa.
J Health Popul Nutr. 2017 Jun 2;36(1):25. doi: 10.1186/s41043-017-0103-3.
The risk of a child dying before reaching 5 years of age is highest in sub-Saharan African countries. But in Ethiopia, under-five mortality rates have shown a substantial decline.
For this study, the Cox regression model for fixed and time-dependent explanatory variables was studied for under-five mortality in Ethiopia. We adapted survival analysis using the Cox regression model with 2011 Ethiopian Demographic and Health Survey data.
From the results, it was found that under-five children who live in Addis Ababa had a lower hazard (risk) of death (p value = 0.048). This could be as a result of higher health facilities and living standards in Addis Ababa, compared to other regions. Under-five children who lived in rural areas had a higher hazard (risk) of death compared to those living in urban areas. In addition, under-five children who lived in rural areas had 18% (p value = 0.01) more hazard (risk) of death than those living in urban areas. Furthermore, with older mothers, the chance of a child dying before reaching the age of 5 is lower.
The chances of a child dying before reaching the age of 5 are less if the mother does not become pregnant again before the child reaches the age of 5. Therefore, giving birth when older and not becoming pregnant again before the child reaches the age of 5 is one means of reducing under-five mortality.
撒哈拉以南非洲国家儿童在5岁前死亡的风险最高。但在埃塞俄比亚，五岁以下儿童死亡率已大幅下降。
在本研究中，对埃塞俄比亚五岁以下儿童死亡率的固定和时间依赖性解释变量的Cox回归模型进行了研究。我们使用2011年埃塞俄比亚人口与健康调查数据，采用Cox回归模型进行生存分析。
结果发现，生活在亚的斯亚贝巴的五岁以下儿童死亡风险较低（p值 = 0.048）。这可能是因为与其他地区相比，亚的斯亚贝巴的卫生设施和生活水平更高。与生活在城市地区的儿童相比，生活在农村地区的五岁以下儿童死亡风险更高。此外，生活在农村地区的五岁以下儿童比生活在城市地区的儿童死亡风险高18%（p值 = 0.01）。此外，母亲年龄较大时，孩子在5岁前死亡的几率较低。
如果母亲在孩子5岁之前不再怀孕，孩子在5岁前死亡的几率就会降低。因此，晚育且在孩子5岁之前不再怀孕是降低五岁以下儿童死亡率的一种方法。
