Regional Variation In Under-Five Mortality In Rural Ethiopia

Abstract

Childhood mortality is a crucial socioeconomic development aspect for any nation as it represents the health condition of a people. This study set out to establish how, despite the decrease in childhood mortality rates since 1990, regional variation in under-five mortality continues to be pronounced in rural Ethiopia. Ethiopia Demographic and Health Survey 2011 data was used for the survey, where a total of 9668 live births formed the sample out of which 725 children had died before their fifth birthday. The child survival framework development by Mosley and Chen (1984) was used to conceptualise the study. Direct approach in the estimation of under-five mortality rates and logistic regression were the main data analysis methods. The study results indicated marked regional variation in childhood mortality rates with Benishangul-Gumuz and Gambela recording 193 and 160 deaths per 1000 live births respectively as Tigray and Dire Dawa recorded 127 and 119 deaths out of 1000 live births respectively. Higher mortality rates were obtained among children of women with primary education and higher, from the poorest wealth index, mother’s age at birth below 18 years, male children, birth order 1-2, with short preceding birth intervals and from households with unsafe sources of drinking water and unimproved types of toilet facilities. Bivariate regression analysis results indicated that region of residence, wealth index, mother’s age at birth and birth spacing had a significant influence on under-five deaths. Mother’s age at birth and birth spacing were significant in the high mortality regions while wealth index, mother’s age at birth, child’s sex and birth spacing had significant influence in the low mortality regions. The results established that region of residence had significant effect on under-five mortality in regression models without proximate determinants but had mixed significance in models with proximate determinants. Wealth index, mother’s age at birth and birth spacing had significant effect on under-five mortality in the full regression model. The implication of the study findings is that stakeholders should develop programmes aimed at addressing specific determinants of under-five mortality in the different regions of rural Ethiopia. The programmes should also encourage increasing the maternal age at the birth of the child and longer birth spacing durations.