Woldeamanuel Berhanu Teshome, Aga Merga Abdissa
Salale University, Oromia, Ethiopia.
Glob Pediatr Health. 2021 Feb 10;8:2333794X21989538. doi: 10.1177/2333794X21989538. eCollection 2021.
. Under-five mortality has continued a key challenge to public health in Ethiopia, and other sub-Saharan Africa countries. The threat of under-five mortality is incessant and more studies are needed to generate new scientific evidence. This study aimed to model the number of under-five deaths a mother has experienced in her lifetime and factors associated with it in Ethiopia. . A retrospective cross-sectional study based on data obtained from the Ethiopian Demographic and Health Survey (DHS), 2016 was used. The response variable was the total number of under-five children died per mother in her lifetime. Variables such as maternal socioeconomic and demographic characteristics, health, and environmental factors were considered as risk factors of under-five mortality. Hurdle negative binomial (HNB) regression analysis was employed to determine the factors associated with under-five mortality. . The data showed that 27.2% (95%CI: 0263, 0.282) of women experienced under-five deaths. The study revealed the age of mother at first birth, the age of mother at the time of under-five mortality occurred, number of household members, household access to electricity, region, educational level of the mother, sex of household head, wealth index, mother residing with husband/partner at the time of under-five mortality occurred as factors associated with under-five mortality. Age of mother at first birth 18 to 24 (IRR = .663; 95%CI: 0.587, 0.749), 25 or higher years old (IRR = 0.424; 95%CI: 0.306, 0.588), access to electricity (IRR = 0.758; 95%CI: 0.588, 0.976), primary education level of the mother (IRR = 0.715; 95%CI: 0.584, 0.875) and the richer wealth index (IRR = 0.785; 95%CI: 0.624, 0.988) were associated with reduced incidence of under-five mortality controlling for other variables in the model. Whereas older age of mother 35 to 39 (IRR = 5.252; 95%CI: 2.992, 9.218), 40 to 44 (IRR = 7.429; 95%CI: 4.188, 13.177), 45 to 49 (IRR = 8.697; 95%CI: 4.853, 15.585), being a resident of the Benishangul-gumuz region (IRR = 1.781; 95%CI: 1.303, 2.434), female household head (IRR = 1.256; 95%CI: 1.034, 1.525) were associated with an increased incidence of under-five mortality. . The findings suggested that early age of mothers' at first birth and old ages of mothers', female household head and being uneducated were found to increase the incidence of the under-five mortality, whereas access to electricity and living with husband was statistically associated with reduced incidence of under-five mortality. The implication of this study is that policymakers and stakeholders should provide health education for mothers not to give birth at an earlier age and improve living standards to achieve sustainable development goals.
五岁以下儿童死亡率仍然是埃塞俄比亚以及撒哈拉以南非洲其他国家公共卫生面临的一项关键挑战。五岁以下儿童死亡的威胁持续存在,需要开展更多研究以产生新的科学证据。本研究旨在对埃塞俄比亚一位母亲一生中经历的五岁以下儿童死亡数量及其相关因素进行建模。
采用了一项基于2016年埃塞俄比亚人口与健康调查(DHS)数据的回顾性横断面研究。响应变量是每位母亲一生中五岁以下儿童死亡的总数。诸如母亲的社会经济和人口特征、健康状况以及环境因素等变量被视为五岁以下儿童死亡率的风险因素。采用障碍负二项式(HNB)回归分析来确定与五岁以下儿童死亡率相关的因素。
数据显示,27.2%(95%置信区间:0.263,0.282)的女性经历过五岁以下儿童死亡。该研究揭示,首次生育时母亲的年龄、五岁以下儿童死亡发生时母亲的年龄、家庭成员数量、家庭是否通电、地区、母亲的教育水平、户主性别、财富指数、五岁以下儿童死亡发生时母亲是否与丈夫/伴侣同住等因素与五岁以下儿童死亡率相关。首次生育时母亲年龄在18至24岁(发病率比[IRR]=0.663;95%置信区间:0.587,0.749)、25岁及以上(IRR=0.424;95%置信区间:0.306,0.588)、通电(IRR=0.758;95%置信区间:0.588,0.976)、母亲的小学教育水平(IRR=0.715;95%置信区间:0.584,0.875)以及较富裕的财富指数(IRR=0.785;95%置信区间:0.624,0.988)与控制模型中其他变量时五岁以下儿童死亡率的降低相关。而母亲年龄在35至39岁(IRR=5.252;95%置信区间:2.992,9.218)、40至44岁(IRR=7.429;95%置信区间:4.188,13.177)、45至49岁(IRR=8.697;95%置信区间:4.853,15.585)、居住在本尚古勒-古穆兹地区(IRR=1.781;95%置信区间:1.303,2.434)、女性户主(IRR=1.256;95%置信区间:1.034,1.525)与五岁以下儿童死亡率的增加相关。
研究结果表明,母亲首次生育年龄较小、母亲年龄较大、女性户主以及未受过教育会增加五岁以下儿童死亡率,而通电和与丈夫同住与五岁以下儿童死亡率的降低在统计学上相关。本研究的意义在于,政策制定者和利益相关者应向母亲提供健康教育,使其不要过早生育,并提高生活水平以实现可持续发展目标。