Determinants of under-five mortality in Sri Lanka: A multilevel analysis of 2016 Sri Lankan DHS data.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2023
Historique:
received: 02 09 2022
accepted: 14 07 2023
medline: 11 9 2023
pubmed: 8 9 2023
entrez: 8 9 2023
Statut: epublish

Résumé

Under-five mortality (U5M) is considered a major public health issue directly impacts a country's development. This study analyzed the prognostic factors of U5M in Sri Lanka using data from the 2016 Demographic and Health Survey (DHS) of 8123 children. The study employed both a binary logistic regression model (BLRM) and a binary logistic random intercept multilevel model (BLRIMM) and compared the accuracy of each model's prediction percentage. The results showed that the BLRIMM had a higher correct prediction percentage (98.67%) compared to the BLRM (98.31%). The study found that children who were not breastfed (Odds Ratio (OR) = 116.74, 95% Confidence Interval (CI) = 62.97-216.41), were part of multiple births (OR = 3.73, 95% CI = 1.21-11.51), did not have a normal delivery (OR = 1.86, 95% CI = 1.11-3.12), were born to mothers who had experienced previous miscarriages or child loss (OR = 2.27, 95% CI = 1.26-4.11), and were born to mothers with a higher Body Mass Index (BMI) (OR = 1.05, 95% CI = 1.003-1.10) had higher odds of U5M. The odds of U5M were found to be lower among Buddhists (OR = 0.06, 95% CI = 0.01-0.50), Hindus (OR = 0.05, 95% CI = 0.01-0.46), and Roman Catholics (OR = 0.032, 95% CI = 0.003-0.307) compared to the "Other Religions" category in the dataset. The estimated covariance parameter of the random intercept (0.8231, p-value = 0.0405) indicated significant unobserved cluster-level variation in U5M. The study's results emphasize the importance of addressing religion related differences of U5M and improving maternal education regarding healthy lifestyle, proper food intake, the significance of breastfeeding, safe delivery methods, safety measures during pregnancy and childbirth in cases of multiple births, and proper child care after birth.

Identifiants

pubmed: 37682906
doi: 10.1371/journal.pone.0291246
pii: PONE-D-22-24499
pmc: PMC10490942
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0291246

Informations de copyright

Copyright: © 2023 Thabrew et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Kaludura Anupama Seuwandi Thabrew (KAS)

Faculty of Arts & Science, Sri Lanka Technological Campus, Padukka, Sri Lanka.

Marina Roshini Sooriyarachchi (MR)

Department of Statistics, Faculty of Science, University of Colombo, Colombo, Sri Lanka.

Dushantha Nalin K Jayakody (DNK)

School of Engineering, Sri Lanka Technological Campus, Padukka, Sri Lanka.
TECHLAB-Centro de Investigação em Tecnologias, Universidade Autónoma de Lisboa, Lisbon, Portugal.

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