BMC Pediatr. 2025 Nov 5;25(1):909. doi: 10.1186/s12887-025-06215-1.
ABSTRACT
BACKGROUND: The under-five children mortality rate (U5CM) is still a global public health concern, especially in Ethiopia and other countries in Sub-Saharan Africa (SSA). Unfortunately, the issue is notably underestimated and underreported, making it difficult to fully assess the severity of the crisis in the nation-state’s emerging regions. Regrettably, no research has been done to determine the time-to-death and its predictors for children under five in the developing regions of Ethiopia. Thus, the aim of this study was to determine the time-to-death and its predictor factors among children under five years old in the developing regions of Ethiopia from March 21, 2019, to June 28, 2019.
METHODS: This is a secondary analysis of data collected in a cross-sectional study that was done among under-five children in the developing regions of Ethiopia between March 21, 2019, and June 28, 2019. The Kaplan-Meier (K-M) survival curve was utilized to display the statistically significant variance across categorical variables, and the survival time was evaluated using the log-rank test. The Cox Proportional Hazards (PH) regression model analysis of bivariable and multivariable variables was fitted to identify the predictor factors of time-to-death. The investigation’s findings were presented utilizing tables, text, graphs, and charts. The degree of significance was determined using an adjusted hazard ratio (AHR) with a 95% confidence interval (CI) and a p-value less than 0.05.
RESULTS: In the study, a total of 2,019 children under five were included. The overall under-five child mortality rate in developing regions of Ethiopia was 8.1% (95% CI 7.0%, 9.4%). In the multivariable Cox PH regression model analysis, multiple birth type (AHR: 2.9, 95% CI: 1.34, 6.46), mothers being AntiNatal Care (ANC) follow-up (AHR: 2.0; 95% CI: 1.08, 3.87), not initiating exclusive breastfeeding (AHR: 2.7, 95% CI: 1.23, 5.78), the female sex of the child (AHR: 0.56, 95% CI: 0.333, 0.934), and the head of household being female (AHR: 0.47, 95% CI: 0.236, 0.923) were recognized as main predictors of time-to-death among under five-children.
CONCLUSIONS: The study highlights an important under-five child mortality rate of 8.1% in the developing regions of Ethiopia. Important predictors identified through multivariable Cox Proportional (PH) regression model analysis include multiple birth type, lack of mother’s antenatal care (ANC) follow-up, the child’s sex, gender of household head, and failure to begin exclusive breastfeeding. Therefore, in order to decrease the high rate of mortality among children under five, the government should emphasize improvement of the ANC services, promote exclusive breastfeeding, make a targeted intervention for multiple births, and support female households in the developing regions of Ethiopia.
PMID:41194207 | DOI:10.1186/s12887-025-06215-1
