Birhanie Atalay Liknaw, Tessema Zemenu Tadesse, Endalew Bekalu, Tamirat Koku Sisay
Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
BMC Pediatr. 2025 Feb 8;25(1):103. doi: 10.1186/s12887-025-05454-6.
An estimated 75.8 under-five deaths per 1000 live births occurred in sub-Saharan Africa. This study aimed to investigate the prevalence and factors associated with under-five mortality in Sub-Saharan Africa.
This study was based on secondary data sources from 33 Sub-Saharan countries' recent Demography and Health surveys from 2010 to 2020. A weighted sample of 360,397 under-five children was included in the study. Bayesian multilevel binary logistic regression was fitted using the brms R package. Besides, leave one out information criteria was used for model comparison. The adjusted odds ratio (AOR) and its 95% credible interval (CrI) were reported for significant factors associated with under-five mortality.
not applicable.
The prevalence of under-five mortality in sub Saharan Africa was 62 per 1000 live births (95%CI (56.29, 68.29). In sub region of SSA, it was 65 in central, 52 in eastern, 50 in southern and 73 in western region per 1000 live births. Multiple birth (AOR = 5.27; 95%CrI: 4.72, 5.87), number of under-five children 3 to 5 (AOR = 3.31; 95%CrI: 3.01, 3.60), caesarean section delivery (AOR = 1.64; 95%CrI: 1.47, 1.83), being unmarried (AOR = 1.16; 95%CrI 1.08, 1.26), using unimproved toilet (AOR = 1.08;95%CrI: 1.02, 1.16), birth order of 4th to 6th (AOR = 1.18; 95%CrI:1.1, 1.25),were risk factors of under-five mortality. Whereas, being female (AOR = 0.86; 95%CrI: 0.82, 0.91), preceding birth interval of 24-35 months (AOR = 0.61; 95%CrI: 0.57, 0.65) and above 36 months (AOR = 0.48; 95%CrI: 0.43, 0.49), ANC visit (AOR = 0.80; 95%CrI: 0.74 0.86), contraceptive use (AOR = 0.57; 95%CrI: 0.53, 0.61), were preventive factors of under-five mortality.
Under-five mortality remains the highest in sub-Saharan Africa. Most of the risk factors of under-five mortality were found to be preventable. Policymakers and other stakeholders should enhance maternal education, lengthen birth interval, ANC visit, improved toilet facilities and, giving special attention to small size child and cesarean section delivery to reduce under-five mortality.
撒哈拉以南非洲地区估计每1000例活产中有75.8例五岁以下儿童死亡。本研究旨在调查撒哈拉以南非洲地区五岁以下儿童死亡率的患病率及其相关因素。
本研究基于2010年至2020年33个撒哈拉以南国家近期人口与健康调查的二手数据来源。研究纳入了360397名五岁以下儿童的加权样本。使用brms R包进行贝叶斯多水平二元逻辑回归。此外，采用留一法信息准则进行模型比较。报告与五岁以下儿童死亡率相关的显著因素的调整比值比（AOR）及其95%可信区间（CrI）。
不适用。
撒哈拉以南非洲地区五岁以下儿童死亡率为每1000例活产62例（95%CI（56.29，68.29））。在撒哈拉以南非洲地区的各个次区域，每1000例活产中，中部地区为65例，东部地区为52例，南部地区为50例，西部地区为73例。多胞胎（AOR = 5.27；95%CrI：4.72，5.87）、五岁以下儿童数量为3至5个（AOR = 3.31；95%CrI：3.01，3.60）、剖宫产（AOR = 1.64；95%CrI：1.47，1.83）、未婚（AOR = 1.16；95%CrI 1.08，1.26）、使用未改善的厕所（AOR = 1.08；95%CrI：1.02，1.16）、出生顺序为第4至6胎（AOR = 1.18；95%CrI：1.1，1.25），是五岁以下儿童死亡的危险因素。而女性（AOR = 0.86；95%CrI：0.82，0.91）、上次生育间隔为24至35个月（AOR = 0.61；95%CrI：0.57，0.65）和36个月以上（AOR = 0.48；95%CrI：0.43，0.49）、产前检查（AOR = 0.80；95%CrI：0.74，0.86）、使用避孕药具（AOR = 0.57；95%CrI：0.53，0.61），是五岁以下儿童死亡的预防因素。
撒哈拉以南非洲地区五岁以下儿童死亡率仍然最高。大多数五岁以下儿童死亡的危险因素是可以预防的。政策制定者和其他利益相关者应加强孕产妇教育、延长生育间隔、进行产前检查、改善厕所设施，并特别关注低体重儿童和剖宫产分娩，以降低五岁以下儿童死亡率。
