Risk factors of under-five mortality in Ethiopia using count data regression models, 2021

BACKGROUND: Despite the global reduction in under-five mortality, still many children die before their fifth birthday in Ethiopia. The main aim of this study was to identify determinants of under-five mortality using count data regression models based on 2019 Ethiopia mini demography and health survey data. METHODS: The data source for this study was the 2019 Ethiopia mini demography and health survey data. Various count data regression models were applied to identify the determinants of under-five mortality. RESULTS: A total of 5,535 mothers with children aged 0–59 months were included in the study. Of the total, 1,277 (23.07%) women had lost at least one child by death before celebrating fifth birthday. Zero-Inflated Poisson model was found to be the best model, and it revealed that mother's age, marital status, mother's age at 1st birth, place of delivery, current contraceptive type used, type of cooking fuel, residence, region, religion, time to get drinking water, number of children at home, birth order, and birth type were significant factors that determine U5 mortality in Ethiopia. Mothers aged 15–24 years (IRR = 1.24, p = 0.007) and above 24 years (IRR = 1.66, p = 0.000) at their 1st births, mothers from rural area (IRR = 1.27, p = 0.000), mothers traveled for 1–30 min (IRR = 1.62, p = 0.000) and >30 min (IRR = 1.82, p = 0.000) to get drinking water, mothers used charcoal (IRR = 1.86, p = 0.009) and wood (IRR = 1.64, p = 0.033), children with birth order of 2nd-3rd (IRR = 3.91, p = 0.000), 4th -5th (IRR = 13.14, p = 0.000), 5th and above (IRR = 38.17, p = 0.000), and multiple born children (IRR = 1.5, p = 0.000) had higher risk of under-five mortality while mothers aged 25–34 years (IRR = 0.73, p = 0.000), unmarried mothers (IRR = 0.68, p = 0.004), mothers delivered in public health sectors (IRR = 0.59, p = 0.000), mothers used Pill/IUD (IRR = 0.64, p = 0.018), mothers who had 3 to 5 (IRR = 0.51, p = 0.000) and more than 5 (IRR = 0.27, p = 0.000) children at home had lower risk of under-five mortality. CONCLUSIONS: Mothers should be encouraged to deliver at health institutions. Mothers also should be given awareness to use Pill/IUD contraceptive type. Moreover, facilitating rural areas to get electricity and drinking water near to homes helps to reduce the burden of U5M and to be in line with sustainable development goal.