Efficacy of deep learning methods for predicting under-five mortality in 34 low-income and middle-income countries

Abstract

Objectives: To explore the efficacy of machine learning (ML) techniques in predicting under-five mortality (U5M) in low-income and middle-income countries (LMICs) and to identify significant predictors of U5M.

Design: This is a cross-sectional, proof-of-concept study.

Settings and participants: We analysed data from the Demographic and Health Survey. The data were drawn from 34 LMICs, comprising a total of n=1 520 018 children drawn from 956 995 unique households.

Primary and secondary outcome measures: The primary outcome measure was U5M; secondary outcome was comparing the efficacy of deep learning algorithms: deep neural network (DNN); convolution neural network (CNN); hybrid CNN-DNN with logistic regression (LR) for the prediction of child's survival.

Results: We found that duration of breast feeding, number of antenatal visits, household wealth index, postnatal care and the level of maternal education are some of the most important predictors of U5M. We found that deep learning techniques are superior to LR for the classification of child survival: LR sensitivity=0.47, specificity=0.53; DNN sensitivity=0.69, specificity=0.83; CNN sensitivity=0.68, specificity=0.83; CNN-DNN sensitivity=0.71, specificity=0.83.

Conclusion: Our findings provide an understanding of determinants of U5M in LMICs. It also demonstrates that deep learning models are more efficacious than traditional analytical approach.

Keywords: community child health; deep learning; machine learning; maternal medicine; random forest; under-five mortality.

Figure 1

Architecture of the deep neural network (DNN)-convolution neural network (CNN) ensemble model. FC, fully connected.

Figure 2

Feature importance using random forest.

Figure 3

Micro-average receiver operating characteristic (ROC) curve before feature selection. CNN, convolution neural network; DNN, deep neural network; LR, logistic regression.

Figure 4

Micro-average receiver operating characteristic (ROC) curve after feature selection. CNN, convolution neural network; DNN, deep neural network; LR, logistic regression.