Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), No. 1023 Shatai South Road, Baiyun District, Guangzhou, Guangdong 510515, China.
Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, No. 76 Yanta West Road, Xi'an 710061, China.
Health Policy Plan. 2022 Nov 14;37(10):1210-1220. doi: 10.1093/heapol/czac070.
High under-five mortality rate remains one of the public health challenges, especially in Sub-Saharan Africa, accounting for more than half of all global cases. Sierra Leone was and is still one of the countries with the highest under-five mortality rate. Using the latest 2019 Sierra Leone Demographic and Health Survey data, we investigated factors associated with under-five mortality in Sierra Leone. A total of 9771 mothers aged 15-49 years in the country were interviewed and included in the analysis. The dependent variable is child status (dead = 1; alive = 0). A total of 871 (9%) children died before their fifth birthday. The maternal age of 20-24 years [adjusted odds ratios (AOR) = 0.46; 95% confidence interval (CI) = 0.33-0.64; P < 0.001] up to 40-44 years (AOR = 0.43; CI = 0.27-0.7; P = 0.001), currently breastfeeding (AOR = 0.20; CI = 0.17-0.24; P < 0.001), maternal media exposure and usage of reading newspapers/magazines less than once a week (AOR = 0.48; CI = 0.28-0.85; P = 0.011) were more likely to enhance child survivability through their fifth birthday. Also, the child sex being female (AOR = 0.68; CI = 0.59-0.79) was more likely to survive under-five mortality compared to their male counterpart. On the other hand, mothers who listened to radio at least once a week (AOR = 1.31; CI = 1.08-1.59; P = 0.007) watched television less than once a week (AOR = 1.48; CI = 1.16-1.90), had two (AOR = 3.4, CI = 2.78-4.16; P < 0.001) or three and above birth (AOR = 8.11; CI = 6.07-10.83; P < 0.001) in five years, had multiple birth children (AOR = 1.41; CI = 1.08-1.86) and very small-sized child at birth (AOR= 1.95; CI = 1.41-2.70) were more likely to lose their children below the age of 5 years. The factors contributing to under-five mortality in Sierra Leone are critical to ensuring child survival and improving maternal health. Breastfeeding, maternal age, media exposure, child's sex, multiple birth type, very small-sized child and the total number of births in 5 years were significant drivers of under-five mortality. The result affirms the need for attention to be focused on enhancing the survival rate of under-five children in Sierra Leone.
五岁以下儿童死亡率高仍然是公共卫生面临的挑战之一，尤其是在撒哈拉以南非洲地区，该地区占全球所有病例的一半以上。塞拉利昂过去和现在都是五岁以下儿童死亡率最高的国家之一。利用最新的 2019 年塞拉利昂人口与健康调查数据，我们调查了塞拉利昂五岁以下儿童死亡的相关因素。共对该国 15-49 岁的 9771 名母亲进行了访谈，并将其纳入分析。因变量是儿童的生存状况（死亡=1；存活=0）。共有 871 名（9%）儿童在五岁生日前死亡。20-24 岁的母亲年龄[调整后的优势比（AOR）=0.46；95%置信区间（CI）=0.33-0.64；P<0.001]到 40-44 岁（AOR=0.43；CI=0.27-0.7；P=0.001）、正在母乳喂养（AOR=0.20；CI=0.17-0.24；P<0.001）、母亲接触媒体和每周使用报纸/杂志少于一次（AOR=0.48；CI=0.28-0.85；P=0.011），更有可能使儿童活到五岁。此外，女孩（AOR=0.68；CI=0.59-0.79）的存活几率高于男孩。另一方面，每周至少听一次广播的母亲（AOR=1.31；CI=1.08-1.59；P=0.007）每周看电视少于一次（AOR=1.48；CI=1.16-1.90），在五年内生育两个（AOR=3.4；CI=2.78-4.16；P<0.001）或三个及以上（AOR=8.11；CI=6.07-10.83；P<0.001）、多胎生育（AOR=1.41；CI=1.08-1.86）和出生时体型非常小的儿童（AOR=1.95；CI=1.41-2.70）更有可能失去五岁以下的孩子。塞拉利昂五岁以下儿童死亡的相关因素对于确保儿童生存和改善产妇健康至关重要。母乳喂养、母亲年龄、媒体接触、儿童性别、多胎类型、体型非常小的儿童和五年内的总生育数是五岁以下儿童死亡的重要驱动因素。这一结果证实了需要关注提高塞拉利昂五岁以下儿童的生存率。
