Socioeconomic and environmental determinants of under-five mortality in Gamo Gofa Zone, Southern Ethiopia: a matched case control study

Abstract

Background: Despite global declaration of the right to life as a fundamental human right and substantial progress in reducing childhood mortality, unacceptably high number of children still die before their fifth birthday every day. Different factors have been studied and implicated for under-five mortality with mixed results. Mortality studies in the current study sites were lacking. Therefore, this study examined environmental and socioeconomic determinants of under-five mortality.

Methods: The study applied a matched case control study design on 381 cases of children who died before their fifth birthday and 762 controls born within 1 month in the same locality as the cases. We conducted weighted conditional logistic regression to assess the association between selected factors and mortality status.

Result: The odds of death was found to be significantly lower among children of mothers whose educational status was grade nine or above (Adjusted odds ratio (AOR) of 0.34(0.16-0.72)). The odds of death was significantly higher among children whose mothers' marital status were separated/divorced or widowed (AOR of 3.60(1.23-10.47)) and whose fathers were daily laborers (AOR of 2.34(1.29-4.23)). Presence of separate kitchen in the household for cooking was a proximate factor which was significantly associated with under-five mortality with AOR of 1.77(1.16-2.70).

Conclusion: Socioeconomic factors like maternal education, husband occupation and marital status of the mother were shown to be significantly associated with under-five mortality. Hence, in order to enhance reduction in childhood mortality, investing on maternal education targeting those at risk groups is recommended.

Keywords: Childhood mortality; Determinants of under-five mortality; Ethiopia; Gamo Gofa; Infant mortality; Under-five mortality.

Fig. 1

Conceptual framework, showing the operation of proximate and socioeconomic determinants of under-five mortality (adapted from Henry Mosley and Lincoln Chen’s analytic framework for the study of determinants of childhood mortality)