Proximate and socio-economic determinants of under-five mortality in Benin, 2017/2018.
child health
health policy
public health
Journal
BMJ global health
ISSN: 2059-7908
Titre abrégé: BMJ Glob Health
Pays: England
ID NLM: 101685275
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
27
04
2020
revised:
11
07
2020
accepted:
14
07
2020
entrez:
27
8
2020
pubmed:
28
8
2020
medline:
25
6
2021
Statut:
ppublish
Résumé
Globally, under-five mortality has declined significantly, but still remains a critical public health problem in sub-Saharan African countries such as Benin. Yet, there is no empirical information in the country using a nationally representative data to explain this phenomenon. The aim of this study was to examine how proximate and socio-economic factors are associated with mortality in under-five children in Benin. We analysed data of 5977 under-five children using the 2017 to 2018 Benin Demographic and Health Surveys. Multivariable hierarchical logistic regression modelling technique was applied to investigate the factors associated with under-five mortality. The fit of the models were assessed using variance inflation factor and Pseudo R The study revealed an under-five mortality rate of 96 deaths per 1000 live births in Benin. Regarding the socio-economic determinants, the risk of death was found to be higher in children born in the Plateau region (aOR=3.05; 95% CI: 1.29 to 7.64), in rural areas (aOR=1.45; 95% CI: 1.07 to 1.98) and children with ≥4 birth rank and >2 years of birth interval (aOR=1.52; 95% CI: 1.07 to 2.17). Among the proximate determinants, we found the probability of death to be higher in children whose mothers had no postnatal check-up (PNC) visits after delivery (aOR=1.79; 95% CI: 1.22 to 2.63), but there was no significant association between individual-level/household-level factors and under-five mortality. This study has established that socio-economic and proximate factors are important determinants of under-five mortality in Benin. Our findings have shown the need to implement both socio-economic and proximate interventions, particularly those related to PNC visits when planning on under-five mortality. To achieve this, a comprehensive, long-term public health interventions, which consider the disparity in the access and utilisation of healthcare services in Benin are key.
Sections du résumé
BACKGROUND
Globally, under-five mortality has declined significantly, but still remains a critical public health problem in sub-Saharan African countries such as Benin. Yet, there is no empirical information in the country using a nationally representative data to explain this phenomenon. The aim of this study was to examine how proximate and socio-economic factors are associated with mortality in under-five children in Benin.
METHODS
We analysed data of 5977 under-five children using the 2017 to 2018 Benin Demographic and Health Surveys. Multivariable hierarchical logistic regression modelling technique was applied to investigate the factors associated with under-five mortality. The fit of the models were assessed using variance inflation factor and Pseudo R
RESULTS
The study revealed an under-five mortality rate of 96 deaths per 1000 live births in Benin. Regarding the socio-economic determinants, the risk of death was found to be higher in children born in the Plateau region (aOR=3.05; 95% CI: 1.29 to 7.64), in rural areas (aOR=1.45; 95% CI: 1.07 to 1.98) and children with ≥4 birth rank and >2 years of birth interval (aOR=1.52; 95% CI: 1.07 to 2.17). Among the proximate determinants, we found the probability of death to be higher in children whose mothers had no postnatal check-up (PNC) visits after delivery (aOR=1.79; 95% CI: 1.22 to 2.63), but there was no significant association between individual-level/household-level factors and under-five mortality.
CONCLUSION
This study has established that socio-economic and proximate factors are important determinants of under-five mortality in Benin. Our findings have shown the need to implement both socio-economic and proximate interventions, particularly those related to PNC visits when planning on under-five mortality. To achieve this, a comprehensive, long-term public health interventions, which consider the disparity in the access and utilisation of healthcare services in Benin are key.
Identifiants
pubmed: 32843572
pii: bmjgh-2020-002761
doi: 10.1136/bmjgh-2020-002761
pmc: PMC7449341
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: SY is editorial board member of this journal.
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