Spatio-temporal modelling of under-five mortality in Lesotho using demographic and health survey data

Afr Health Sci. 2023 Sep;23(3):168-180. doi: 10.4314/ahs.v23i3.21.

Abstract

Background: Lesotho is in the Sustainable Development Goal (SDG) region which aims to reduce the under-five mortality (U5M) to the average of 25 deaths per 1000 live births by the end of 2030 under the sustainable development goals (SDGs) initiative by the United Nations.

Methodology: This paper makes use of the Lesotho Demographic and Health Survey (LDHS dataset, which focuses on female reproductive ages 15-49 and male reproductive ages 15-54 The spatio-temporal models were used in this study to investigate how the proposed covariates change over time.

Results: The results showed that children who were breastfed had a lower odd of death compared to children who were not breastfed, children from more educated mothers had significantly lower odds of U5M compared to those from less educated mothers. Having a larger number of children under the age of five also contributed significantly to an increased risk of U5M. The likelihood of U5M increased with age.

Conclusion: The study recommends that mothers of under-five children be educated about breastfeeding and encouraged to use contraception in order to postpone birth and reduce parity. Rural development should be prioritized through improved primary health care; and public health services should be made more accessible to rural residents.

Keywords: Integrated Laplace nested approximation; Lesotho demographic and health survey data; Spatio-temporal modelling; under-five mortality.

MeSH terms

  • Child
  • Child Mortality*
  • Female
  • Health Surveys
  • Humans
  • Infant
  • Infant Mortality*
  • Lesotho / epidemiology
  • Male
  • Pregnancy
  • Risk Factors