Identification of Risk Factors and Regional Differentials in Under-Five Mortality in Ethiopia Using Multilevel Count Model
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Date
2011-06
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Publisher
Addis Abeba university
Abstract
Under-five death (U5CD) is used as a population health indicator. It remains a big issue for
developing countries, especially as researchers attempt to distinguish what factors contribute to
the high levels. However under five death is still an issue and most studies have not considered
regional variations of mothers in their studies.
Objective:
The Objective of this study is to investigate and quantify the regional variation of under-five
death per mother and explore the major risk factors of under-five child death taking into
consideration various demographic, socio-economic and health and environmental factors.
Method:
Thus, the study analyzes responses mothers on the number of deaths of children aged less than
60 months that they have experienced in their lifetime. Single and multilevel count model are
used to explore the major risk factors and regional differentials in under-five mortality in
Ethiopia.
Result and conclusion:
Descriptive statistics results show that nationally approximately one third (36%) of mothers
have lost at least one under-five child in their lifetime. This figure (percent) is almost similar in
all regions except Addis Ababa (which is 16%). The single level Poisson regression (multiple
regression) results showed higher incidence rate of under-five deaths for SNNP, Gambela and
Ben-Gumuz, while lower rates were estimated for Somalia and Addis Ababa. It was observed
that regional differences in under-five mortality were reduced in magnitude when controls were
added in the regression model. The relationship between under-five mortality and the
explanatory variables age at first birth, mother education level, religion, employment status of
mother and economic status of mother are significant. The preliminary plot of
estimated/predicted U5CD for all regions versus different predictors shows mortality varies
between regions of Ethiopia. The multilevel analysis further showed that there are substantial
under-five death variations per mother among regions in Ethiopia, and are significant (𝝈 𝒖𝟎
𝟐 =
0.14, se= 0.021 and P-value <0.0001).
Key words: U5CD, Poisson, Extra-Poisson, Negative binomial, Multilevel, MLwiN
Description
Keywords
U5CD, Poisson, Extra-Poisson, Negative Binomial, , Multilevel, Mlwin