Zewudie Addisalem Tebeje, Gelagay Abebaw Addis, Enyew Engidaw Fentahun
Department of Population Studies, College of Social Sciences and Humanities, University of Gondar, Gondar, Ethiopia.
Department of Reproductive Health, Institute Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Int J Pediatr. 2020 Sep 18;2020:7471545. doi: 10.1155/2020/7471545. eCollection 2020.
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.
To identify and analyze factors that may have a significant influence on under-five mortality in Ethiopia.
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, 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.
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.
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.
五岁以下儿童死亡率是衡量各国儿童健康水平和总体发展情况的主要指标,它反映了特定人群的生活质量,以预期寿命来衡量。
确定并分析可能对埃塞俄比亚五岁以下儿童死亡率有重大影响的因素。
基于2016年埃塞俄比亚人口与健康调查(EDHS)数据,对18008户家庭进行了一项具有全国代表性的横断面研究和定量研究。使用SPSS 20版统计软件进行分析。采用了双变量和多变量分析。在多变量分析中,p值小于0.05被认为具有统计学意义,并用95%置信区间(CI)的比值比来评估五岁以下儿童死亡率的决定因素。
共有10641名儿童纳入研究,应答率为99.0%。农村居民的五岁以下儿童死亡率(调整后比值比[AOR]=1.802,95%CI:1.251,2.595)、未进行母乳喂养(AOR=2.956,95%CI:2.490,3.511)、多胞胎(AOR=4.755,95%CI:3.440,6.572)、男性(AOR=1.363,95%CI:1.153,1.612)、头胎(AOR=1.592,95%CI:1.275,1.992)以及家庭规模为六人及以上(AOR=2.187,95%CI:1.769,2.707)。家庭规模的增加会增加五岁以下儿童死亡率的风险。
多因素逻辑分析表明,居住地、母亲教育水平、宗教、当前母乳喂养状况、分娩类型、孩子性别、出生顺序和家庭规模是五岁以下儿童死亡率的重要预测因素。因此,政府政策、非政府组织及所有相关机构应关注五岁以下儿童死亡率的主要决定因素,并加大力度降低五岁以下儿童死亡率,同时应修订健康干预政策。