Determinants and Regional Differences in Under-Five Mortality in Ethiopia Using Multilevel Count Analysis

Abstract

Under-five mortality is a leading indicator of child health and overall development. The underfive mortality rate is the probability of a child born in a specified year dying before reaching the age of five. The aim of this study was to investigate the determinants and regional differences in under-five mortality in Ethiopia. The data for this study were obtained from the EDHS 2016, which was a nationally representative survey of children in the age group 0-5 years, and multi-level count regression analysis was used to analyze the data. 42.7% of the mothers have faced any at least one under five child death (U5CD) in their lifetime and 1.8% of them experienced at least five U5CD. The findings revealed that toilet facility, birth order, place of delivery, place of residence, source of drinking water, family size and sex of the household head were predictors of under-five mortality. The incidence rates are high in Amhara, Dire Dawa and SNNP, while lower rates are estimated in Addis Ababa, Harari and Oromia. The government and other concerned bodies should focus on the realization of access to safe water for all households and the community as a whole in Ethiopia, in order to minimize the under-five child mortality. Toilet facility plays an important role in child survival. The multilevel analysis further showed that there were substantial under-five death variations per mother among regions in Ethiopia, and were significant (random intercept variance = 2 = 0.313, P- value <0.001).