Determinants of Under-Five Mortality in High Mortality Regions of Ethiopia: An Analysis of the 2011 Ethiopia Demographic and Health Survey Data

The study was a secondary analysis of existing data from the 2011 Ethiopia Demographic and Health Survey data. Of the 2097 live births recorded in Affar, Somali, Benishangul-Gumuz, and Gambela regions of Ethiopia between 2006 and 2011, 366 deaths before the age of five years were reported. The univariable and multivariable Cox proportional regression models were fitted to select the factors affecting under-five mortality in these regions. The model revealed that under-five mortality significantly associated with preceding birth interval, family size, birth type, breastfeeding status, source of drinking water, and income of mother. Children born after a preceding birth interval of 2-3 years and 3 years and above were significantly less likely to have died before their fifth birthday than those born within two years. Children who were breastfed, for any period, were 25.5% (HR 1.255, 1.005–1.567, p = 0.045) less likely to have died before their fifth birthday than those who were not breastfed. Increased birth interval time corresponds to a low probability of child mortality. Thus, mothers should be encouraged to wait for a sufficient number of months after a birth to conceive another child. Furthermore, breastfeeding was of paramount importance in the fight against child mortality.