Regional Disparities in Under-Five Mortality in Ethiopia: A Cross-Sectional Analysis of Nationally Representative Sample
Gebreyohannis, Birhane (2016)
Gebreyohannis, Birhane
2016
Master's Degree Programme in Health Sciences
Terveystieteiden yksikkö - School of Health Sciences
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Hyväksymispäivämäärä
2016-10-07
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:tuni-202002192193
https://urn.fi/URN:NBN:fi:tuni-202002192193
Tiivistelmä
Background: Reduction of inequalities has been the ultimate objective of the global social and health strategy. It is yet an internationally endorsed target stipulated among the 17 Sustainable Development Goals (SDGs) set to be achieved by 2030. Identifying the determinants and extent of perceived inequality in under-five children mortality amongst regions in Ethiopia is central in order to take appropriate policy actions and this requires an evidence based approach. This study evaluates the regional disparities for the risk of under-five mortality in Ethiopia. The study analyzed various biological, environmental and socio-economic factors explaining the regional disparities for the risk of under-five mortality using a nationally representative sample of women who gave birth during last five year preceding the survey.
Methods: A nationally representative cross-sectional data from the 2011 Ethiopia Demographic and Health Survey (EDHS) was used. Data comprised 11,184 children born within five years preceding the survey. Demographic information including maternal and child characteristics, socio-economic characteristics and environmental characteristics were measured from home interview. Cox proportional hazard regression analysis was used to calculate hazard ratios (HRs) and their 95% confidence interval (CI) for the regional disparities in under-five mortality.
Results: The prevalence of under-five mortality at national level was 7.2 deaths per 100 live births (N=809) with the highest mortality in Benishangul Gumuz region (9.2 deaths per 100 live births, adjusted HR 2.11, 95% CI 1.06 – 4.19) and lowest in Addis Ababa as the reference group (3.6 deaths per 100 live births). In multivariate analysis, contraceptive use (being not user), parity (having more than one child), size of the child at birth (being either large or very small), and sex of the child (being male) were significantly associated with under-five mortality. Environmental characteristics contributed relatively little to the under-five mortality.
Conclusions: The findings suggest that significant disparity on under-five children mortality exist among regions of Ethiopia. Child, environmental and socio-economic factors explain the relationship between region of residence and under-five mortality. Child survival interventions shall target on these factors to minimize inequality differentials and thereby reduction in the under-five mortality in the country.
Methods: A nationally representative cross-sectional data from the 2011 Ethiopia Demographic and Health Survey (EDHS) was used. Data comprised 11,184 children born within five years preceding the survey. Demographic information including maternal and child characteristics, socio-economic characteristics and environmental characteristics were measured from home interview. Cox proportional hazard regression analysis was used to calculate hazard ratios (HRs) and their 95% confidence interval (CI) for the regional disparities in under-five mortality.
Results: The prevalence of under-five mortality at national level was 7.2 deaths per 100 live births (N=809) with the highest mortality in Benishangul Gumuz region (9.2 deaths per 100 live births, adjusted HR 2.11, 95% CI 1.06 – 4.19) and lowest in Addis Ababa as the reference group (3.6 deaths per 100 live births). In multivariate analysis, contraceptive use (being not user), parity (having more than one child), size of the child at birth (being either large or very small), and sex of the child (being male) were significantly associated with under-five mortality. Environmental characteristics contributed relatively little to the under-five mortality.
Conclusions: The findings suggest that significant disparity on under-five children mortality exist among regions of Ethiopia. Child, environmental and socio-economic factors explain the relationship between region of residence and under-five mortality. Child survival interventions shall target on these factors to minimize inequality differentials and thereby reduction in the under-five mortality in the country.