BMC public health · 2025
Cultural, socioeconomic, and demographic factors contributing to child mortality: evidence from Sierra Leone demographic and health survey 2019.
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Zahangir Mohammad Salim, Lisa Fariha Khanam, Neyma Mahmuda Al, Hossain Md Rasel, Tabassum Sawasan, Rakin Tanvir Faisal, Faruk Mohmmad Omar, Hossain Kabir
Аннотация
BACKGROUND: Child mortality, defined as the likelihood of an infant dying before the age of five, is still a significant concern in developing countries with limited healthcare facilities. Sierra Leone, with a child mortality rate of 68.418 deaths per 1,000 live births in 2024-one of the highest globally-necessitates urgent public health interventions to mitigate this critical issue. This study examined the cultural, socioeconomic, and demographic factors associated with under-five mortality in Sierra Leone.
METHODS: This investigation used data from the Sierra Leone Demographic and Health Survey 2019, comprised of 4540 mothers aged 15-49 years who had at least one child who died under the age of five. The significance of explanatory variables was evaluated using a variety of bivariate statistical analyses, including the Mann-Whitney U (MWU) test, Kruskal-Wallis H (KWH) test, and Kendall's tau_b and Spearman's rho correlation. Additionally, several multivariate regression models were used to investigate the factors that influence child mortality.
RESULT: The results showed that increasing maternal age (IRR: 0.95, 95% CI: 0.932-0.968), living in the North-Western region (IRR: 0.110, 95% CI: 0.016-0.770), higher maternal education (IRR: 0.563, 95% CI: 0.189-1.676), higher father education (IRR: 0.816, 95% CI: 0.678-0.981), fewer children under five in the family (IRR: 0.853, 95% CI: 0.796-0.913), and being a working mother (IRR: 0.831, 95% CI: 0.705-0.980) reduced the risk of under-five mortality. However, the risk of under-five mortality increased with the total number of children ever born (IRR: 1.411, 95% CI: 1.263-1.577), younger maternal age at first birth (IRR: 1.032, 95% CI: 1.014-1.064), shorter preceding birth intervals (IRR: 1.006, 95% CI: 1.004-1.009), and having twin children (IRR: 9.792, 95% CI: 1.789-53.59).
CONCLUSION: The study highlights the urgent need to strengthen maternal and child healthcare services, particularly for younger mothers, promote family planning programs to ensure optimal birth spacing, and increase healthcare facilities in regions with high child mortality.
METHODS: This investigation used data from the Sierra Leone Demographic and Health Survey 2019, comprised of 4540 mothers aged 15-49 years who had at least one child who died under the age of five. The significance of explanatory variables was evaluated using a variety of bivariate statistical analyses, including the Mann-Whitney U (MWU) test, Kruskal-Wallis H (KWH) test, and Kendall's tau_b and Spearman's rho correlation. Additionally, several multivariate regression models were used to investigate the factors that influence child mortality.
RESULT: The results showed that increasing maternal age (IRR: 0.95, 95% CI: 0.932-0.968), living in the North-Western region (IRR: 0.110, 95% CI: 0.016-0.770), higher maternal education (IRR: 0.563, 95% CI: 0.189-1.676), higher father education (IRR: 0.816, 95% CI: 0.678-0.981), fewer children under five in the family (IRR: 0.853, 95% CI: 0.796-0.913), and being a working mother (IRR: 0.831, 95% CI: 0.705-0.980) reduced the risk of under-five mortality. However, the risk of under-five mortality increased with the total number of children ever born (IRR: 1.411, 95% CI: 1.263-1.577), younger maternal age at first birth (IRR: 1.032, 95% CI: 1.014-1.064), shorter preceding birth intervals (IRR: 1.006, 95% CI: 1.004-1.009), and having twin children (IRR: 9.792, 95% CI: 1.789-53.59).
CONCLUSION: The study highlights the urgent need to strengthen maternal and child healthcare services, particularly for younger mothers, promote family planning programs to ensure optimal birth spacing, and increase healthcare facilities in regions with high child mortality.