Assessing Individual- and Community-Level Variability in Predictors of Neonatal, Infant, and Under-Five Child Mortality in Ethiopia Using a Multilevel Modeling Approach

Kenenisa Abdisa Kuse; Teshita Uke Chikako; John Elvis Hagan Jr; Abdul-Aziz Seidu; Bright Opoku Ahinkorah

doi:10.3390/children9071071

Assessing Individual- and Community-Level Variability in Predictors of Neonatal, Infant, and Under-Five Child Mortality in Ethiopia Using a Multilevel Modeling Approach

Children (Basel). 2022 Jul 18;9(7):1071. doi: 10.3390/children9071071.

Authors

Kenenisa Abdisa Kuse¹, Teshita Uke Chikako², John Elvis Hagan Jr^{3

4}, Abdul-Aziz Seidu^{5

6}, Bright Opoku Ahinkorah⁷

Affiliations

¹ Department of Statistics, Bule Hora University, Bule Hora P.O. Box 144, Ethiopia.
² Wondo Genet College of Forestry and Natural Resource, Hawassa University, Hawassa P.O. Box 05, Ethiopia.
³ Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast PMB TF0494, Ghana.
⁴ Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, P.O. Box 10 01 31, 33501 Bielefeld, Germany.
⁵ College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia.
⁶ Centre for Gender, Takoradi Technical University, Takoradi P.O. Box 256, Ghana.
⁷ School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW 2007, Australia.

Abstract

Background: In low-and middle-income countries, child mortality rates are basic indicators of a country’s socio-economic situation and quality of life. The Ethiopian government is currently working to reduce child mortality to accomplish its long-term development goals. Using data from the Ethiopian Mini Demographic and Health Survey, 2019, this study analyzed the determinants of child mortality in Ethiopia. Methods: A total of 4806 children were considered in the final analyses. Multivariate analysis was used to estimate the effects of the predictors simultaneously on each child mortality outcome. Results: The findings revealed that 31.6% of children died during the neonatal stage, 39.1% during the infant stage, and 48.5% during the under-five stage. Variation in child mortality was discovered between Ethiopian community clusters, with the result of heterogeneity between clusters on newborn mortality (χ2 = 202.4, p-value < 0.0001), (χ2 = 777.35, p-value < 0.0001), and (χ2 = 112.92, p-value < 0.0001). Children’s neonatal, infant, and under-five mortality intracluster correlation coefficient (ICC) were 0.35, 0.33, and 0.36, respectively, across communities. Conclusions: In Ethiopia, under-five mortality remains a serious public health issue, with wide variations and high rates among community clusters. Intervention measures focusing on lowering rates of household poverty, increasing education opportunities, and improving access to health care could assist in reducing child mortality in Ethiopia.

Keywords: EMDHS; Ethiopia; child mortality; community; multivariable multilevel.

Grants and funding

The authors sincerely thank Bielefeld University, Germany, for providing financial support through the Open Access Publication Fund for the article processing charge.