Prevalence and risk factors associated with under-five mortality in the Solomon Islands: an investigation from the 2015 Solomon Islands demographic and health survey data

BACKGROUND: Annually, over five million children die before their fifth birthday worldwide, with 98% of these deaths occurring in low-and middle-income countries. The prevalence and risks for under-five mortality are not well-established for the Solomon Islands. METHODS: We used the Solomon Islands Demographic and Health Survey 2015 data (SIDHS 2015) to estimate the prevalence and risk factors associated with under-five mortality. FINDINGS: Neonatal, infant, child and under-five mortality prevalence were 8/1000, 17/1000, 12/1000 and 21/1000 live births, respectively. After adjustment for potential confounders, neonatal mortality was associated with no breastfeeding [aRR 34.80 (13.60, 89.03)], no postnatal check [aRR 11.36 (1.22, 106.16)], and Roman Catholic [aRR 3.99 (1.34, 11.88)] and Anglican [aRR 2.78 (0.89, 8.65); infant mortality to no breastfeeding [aRR 11.85 (6.15, 22.83)], Micronesian [aRR 5.54 (1.67, 18.35)], and higher birth order [aRR 2.00 (1.03, 3.88)]; child mortality to multiple gestation [aRR 6.15 (2.08, 18.18)], Polynesian [aRR 5.80 (2.48, 13.53)], and Micronesian [aRR 3.65 (1.46, 9.10)], cigarette and tobacco [aRR 1.77 (0.79, 3.96)] and marijuana use [aRR 1.94 (0.43, 8.73)] and rural residence [aRR 1.85 (0.88, 3.92)]; under-five mortality to no breastfeeding [aRR 8.65 (4.97, 15.05)], Polynesian [aRR 3.23 (1.09, 9.54)], Micronesian [aRR 5.60 (2.52, 12.46)], and multiple gestation [aRR 3.34 (1.26, 8.88)]. Proportions of 9% for neonatal and 8% of under-five mortality were attributable to no maternal tetanus vaccination. INTERPRETATION: Under-five mortality in the Solomon Islands from the SIDHS 2015 data was attributable to maternal health, behavioural, and sociodemographic risk factors. We recommended future studies to confirm these associations. FUNDING: No funding was declared to support this study directly.