{"title":"Multilevel zero inflated and hurdle models for under five-child mortality in Indonesia","authors":"MadonaYunita Wijaya","doi":"10.4103/shb.shb_252_23","DOIUrl":null,"url":null,"abstract":"Introduction: Overcoming under-five mortality rate remains a great challenge for Indonesia to meet the national target despite its notable advancements and progress in reducing child mortality rate. Therefore, understanding risk factors of under-five mortality is essential to enhance the health and well-being of children. This research seeks to investigate associated factors of under-five mortality in Indonesia by using the 2017 Indonesia Demographic and Health Survey data. Methods: The multilevel zero-inflated and multilevel hurdle models are considered to handle unobserved heterogeneity that may occur at province level, and to model prevalence and risk of child death as a joint process, which are reported in terms of odds ratio (OR) and incidence ratio rate (IRR), respectively. Results: Lower number of household members (IRR = 0.803, 95% confidence interval [CI]: 0.784–0.823), older mother's age at first birth (IRR = 1.020, 95% CI: 1.007–1.032), higher number of children ever born (IRR = 1.491, 95% CI: 1.450–1.533), lower mother's education (IRR = 1.224, 95% CI: 1.013–1.479), and lower father's education (IRR = 1.232, 95% CI: 1.015–1.495) are significantly associated with higher total death numbers in children before the age of 5 years. Furthermore, the odds of no child death are significantly higher among mother who use a contraceptive method (OR = 11.088, 95% CI: 6.659–18.462) and among household in higher quantile wealth (OR = 1.133, 95% CI: 1.005–1.277). Conclusion: This evidence-based empirical highlights priority risk factors that might provide insight for policymakers, health professional, and the community in general to design appropriate intervention to help reduce the burden of under-five mortality in the country.","PeriodicalId":34783,"journal":{"name":"Asian Journal of Social Health and Behavior","volume":"34 1","pages":"0"},"PeriodicalIF":5.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian Journal of Social Health and Behavior","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/shb.shb_252_23","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Overcoming under-five mortality rate remains a great challenge for Indonesia to meet the national target despite its notable advancements and progress in reducing child mortality rate. Therefore, understanding risk factors of under-five mortality is essential to enhance the health and well-being of children. This research seeks to investigate associated factors of under-five mortality in Indonesia by using the 2017 Indonesia Demographic and Health Survey data. Methods: The multilevel zero-inflated and multilevel hurdle models are considered to handle unobserved heterogeneity that may occur at province level, and to model prevalence and risk of child death as a joint process, which are reported in terms of odds ratio (OR) and incidence ratio rate (IRR), respectively. Results: Lower number of household members (IRR = 0.803, 95% confidence interval [CI]: 0.784–0.823), older mother's age at first birth (IRR = 1.020, 95% CI: 1.007–1.032), higher number of children ever born (IRR = 1.491, 95% CI: 1.450–1.533), lower mother's education (IRR = 1.224, 95% CI: 1.013–1.479), and lower father's education (IRR = 1.232, 95% CI: 1.015–1.495) are significantly associated with higher total death numbers in children before the age of 5 years. Furthermore, the odds of no child death are significantly higher among mother who use a contraceptive method (OR = 11.088, 95% CI: 6.659–18.462) and among household in higher quantile wealth (OR = 1.133, 95% CI: 1.005–1.277). Conclusion: This evidence-based empirical highlights priority risk factors that might provide insight for policymakers, health professional, and the community in general to design appropriate intervention to help reduce the burden of under-five mortality in the country.