Research Article: Survival Analysis of Under Five Mortality in Rural Parts of Ethiopia

Authors

  • Yared Seyoum Addis Ababa University
  • M.K. Sharma Addis Ababa University

DOI:

https://doi.org/10.6000/1929-6029.2014.03.03.6

Keywords:

Under five mortality, maternal, socioeconomic and environmental factor

Abstract

Child mortality is a factor that is associated with the well-being of a population and it is taken as an indicator of health development and socioeconomic status. According to the 2011 UN report during the last 10 years, the death rate for children under five has decreased by 35% worldwide. UNICEF in 2008 reported that Ethiopia has reduced under-five mortality by 40 percent over the past 15 years. From the EDHS 2011 report child mortality rate in Ethiopia was reduced from 50/1000 deaths in 2005 to 31/1000 deaths in 2011. The Ethiopian Demographic and Health Survey data are used for the study. In this paper we have attempted to find out the impact of socioeconomic, demographic and environmental factors in the context of under five mortality. In this attempt we first analyzed our data using Kaplan-Meier non-parametric method of estimation of survival function and also using lifetable. We have also used Log-Rank test to compare different survival functions and found that sex, type of birth, religion, mothers' education, birth order, maternity age, source of drinking water and region have statistically significant difference in the under five survival time. We have also used Cox proportional hazard model to identify the covariates which influence the under five mortality. But we found that our data do not fulfill the proportionality assumption of Cox proportional model in case of infant and child mortality. Then we applied stratified Cox proportional model to our data to find out the potential covariates which influence under five mortality and found birth order, mothers' education level, sex, type of birth and the interaction of birth order and sex as vital factors for the deaths occurring under the age of five. The Cox proportional hazard models which were used separately for each stratum also identified mothers' educational level, sex, type of birth, and the interaction of sex and water supply as the risk factors for the death of infants. Whereas for child stratum; type of birth, mothers' education, sex and the interaction of water supply and sex were the risk factors associated with the death of children.

References

[1] Federal Ministry of Health. Essential Health Service Package for Ethiopia. Addis Ababa; 2005 August 2005.
[2] Ministry of Finance and Economic Development (MoFED). ‘Ethiopia: Progress toward achieving the MDGs’, 2008.
[3] Ringheim K, Teller C, Sines E. Ethiopia at a crossroads: Demography, Gender, and Development, Addis Ababa, Ethiopia 2009.
[4] Desta M. Infant and Child Mortality in Ethiopia: The role of Socioeconomic, Demographic and Biological factors in the previous five years period of 2000 and 2005, Lund University 2011.
[5] World Bank. World Development Indicators (WDI). The World Bank Online Database, Washington, DC: World Bank 2004.
[6] Ethiopia Demographic and Health Survey, Central Statistical Agency, Addis Ababa 2011.
[7] Cox DR. 'Regression models and life tables', Journal of the Royal Statistical Society; series B 1972; 34: 187-220.
[8] Hosmer DW, Lemeshow S, May S. Applied survival analysis regression modeling of time to event data. John Wiley and Sons, Inc., New York 2008. http://dx.doi.org/10.1002/9780470258019
[9] Collett D. Modeling survival data in medical research, Second edn, Chapman and Hall/CRC, London 2003.
[10] Aguirre PG. 'Child mortality and reproductive patters in urban', Bolivia, CDE working paper No. 95-28, Center for Demography and Ecology, University of Wisconsin-Madison 1995.
[11] Mahfouz MS, Surur AA, Ajak DAA, Eldawi EA. 'Level and Determinants of Infant and Child Mortality in Malakal Town – Southern Sudan, Sudanese Journal of Public Health 2009; 4(2): 250-255.
[12] Caldwell JC. Education as a factor in mortality decline: An examination of Nigerian data. Population Studies 1979; 33(3): 395-413. http://dx.doi.org/10.2307/2173888
[13] Ezra M, Gurum E. Breastfeeding, birth intervals and child survival: analysis of the 1997 community and family survey data in southern Ethiopia’. Ethiopian Journal of Health Development 2002; 16: 41-51. http://dx.doi.org/10.4314/ejhd.v16i1.9825
[14] Kumar P, Gemechis F. Infant and child mortality in Ethiopia: As statistical analysis approach. Ethiopian Journal of Science and Education 2010; 5(2): 51-57.
[15] Desai S, Alva S. Maternal education and child health: Is there a strong causal relationship? Demography 1998; 35(1): 71-81. http://dx.doi.org/10.2307/3004028
[16] Balk D, Tom P, Adam S, Fern G, Melissa N. Spatial Analysis of Childhood Mortality in West Africa', Calverton, Maryland, USA: ORC Macro and Center for International Earth Science Information Network (CIESIN), Columbia University 2003.
[17] Mustafa E, Odimegwu C. Socioeconomic determinants of infant mortality in Kenya: Analysis of Kenya DHS 2003, 2008.
[18] Kombo J, Ginneken V. Determinants of infant and child mortality in Zimbabwe: Result of multivariate hazard analysis 2009.

Downloads

Published

2014-08-05

How to Cite

Seyoum, Y., & Sharma, M. (2014). Research Article: Survival Analysis of Under Five Mortality in Rural Parts of Ethiopia. International Journal of Statistics in Medical Research, 3(3), 266–281. https://doi.org/10.6000/1929-6029.2014.03.03.6

Issue

Section

General Articles