Department of Epidemiology & Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an, 710061, Shaanxi Province, China.
School of Public Health, Asmara College of Health Sciences, Asmara, Eritrea.
BMC Pediatr. 2022 Jun 13;22(1):341. doi: 10.1186/s12887-022-03362-7.
Mortality at a young age is key to public health measures. This study aims to describe the burden, trend, and associated factors of under-five mortality rate (U5MR) in Zambia from 2007-to-2018.
A sample of 29,274 children under-five were analyzed from the Zambia demographic and health survey (ZDHS). Univariate and bivariate analysis were used to identify factors influencing U5M.
Pooled prevalence of U5MR in Zambia was 84.4/ 1000 live-births. Over 15 years, U5M has declined by 49% (from 118.7 to 60.5/1000 live-births). Compared to children of teenage (≤19 years) mothers the likelihood of U5M was lower by 24 to 37% among children of 20 to 34 years old mothers. The likelihood of U5M was lower by 23% (AOR, 0.77 95%CI, 0.58-1.04) for poorest, 27% (AOR, 0.73 95%CI, 0.55-0.98) for poorer, and 19% (AOR, 0.81 95%CI, 0.62-1.07) for middle as compared to the richest households. The likelihood of U5M was 21% (AOR, 0.79 95%CI, 0.67-0.93) lower among rural residents. Multiple-born children died 2.54 times (95%CI, 1.95-3.98) higher than the single-born. Male children (AOR, 1.28, 95% CI, 1.23-1.46), smaller than average birth size (AOR, 1.78; 95% CI, 1.52-2.09), and no ANC visit (AOR, 3.17, 95% CI, 2.74-3.67) were associated with U5M. The likelihoods of U5M were significantly higher in the Eastern, Luapula, and Muchinga regions than in the Central.
This study revealed that Zambia has made a gain on child survival. Further efforts targeting mothers, children, and provinces are needed to scale up the decline and achieve the SDG3.
儿童死亡率是公共卫生措施的关键。本研究旨在描述 2007 年至 2018 年赞比亚五岁以下儿童死亡率（U5MR）的负担、趋势和相关因素。
本研究分析了来自赞比亚人口与健康调查（ZDHS）的 29274 名五岁以下儿童的数据。使用单变量和双变量分析来确定影响 U5M 的因素。
赞比亚的 U5MR 总流行率为 84.4/1000 活产儿。在 15 年期间，U5M 下降了 49%（从 118.7 降至 60.5/1000 活产儿）。与 19 岁以下（≤19 岁）母亲的儿童相比，20 至 34 岁母亲的儿童 U5M 的可能性低 24%至 37%。与最富裕家庭相比，最贫困家庭（AOR，0.77 95%CI，0.58-1.04）、较贫困家庭（AOR，0.73 95%CI，0.55-0.98）和中等收入家庭（AOR，0.81 95%CI，0.62-1.07）的 U5M 可能性分别降低 23%、27%和 19%。与农村居民相比，U5M 的可能性低 21%（AOR，0.79 95%CI，0.67-0.93）。多胎儿童的死亡率比单胎儿童高 2.54 倍（95%CI，1.95-3.98）。男童（AOR，1.28，95%CI，1.23-1.46）、出生体重低于平均值（AOR，1.78；95%CI，1.52-2.09）和没有产前护理（ANC）就诊（AOR，3.17，95%CI，2.74-3.67）与 U5M 相关。与中部地区相比，东部、卢阿普拉和马钦加地区的 U5M 发生率显著更高。
本研究表明，赞比亚在儿童生存方面取得了进展。需要进一步针对母亲、儿童和省份开展工作，以扩大下降幅度并实现可持续发展目标 3。
