Abstract
Background: Ethiopia is ranked as the fifth of heavy under-five death burdened countries with the highest burden in its rural areas. This study aimed to identify the determinants of under-five deaths in rural parts of Ethiopia.
Study Design: A population-based cross-sectional study.
Methods: The data for this study was extracted from the 2016 Ethiopian Demographic and Health Survey. Descriptive analysis, non-parametric estimation, and Cox proportional hazards regression model were used to examine the determinants of under-five mortality.
Results: A total of 7301 under-five eligible children from rural areas were involved in this survey, and 6.5% of the cases were passed away before reaching their fifth birthday. Male children’s death accounted for 59.7% of the death rate in the participants. An estimated median survival time was 31 months [95% CI: 30-32]. About 83% of children’s death occurred among children delivered at home. Cox proportional hazard regression model revealed that gender, delivery-place, family-size, mother’s education, number of children, contraceptive use, and source of drinking water had significant effects on survival time of under-five children. Under-five mortality was significantly fewer in female children (HR  =  0.728; 95% CI: 0.606-0.875, P =  0.001), children delivered at health facilities (HR  =  0.738; 95% CI: 0.572-0.951, P =  0.019), and those from secondary and above educated mothers (HR  =  0.464; 95% CI: 0.301-0.714, P =  0.001), compared to the reference category.
Conclusion: Significant risk factors were associated with under-five mortality in rural areas. Delivering in health facilities, uses of contraceptives, mother’s education, and improvement of infrastructures should be areas of concern to decrease under-five children’s deaths.
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