탄자니아 5세 미만 아동 사망 결정 요인

Abstract

Background: As an important market for health equity and access, under-five mortality is a primary measure for socioeconomic development. Tanzania has made remarkable progress in reducing child mortality over the last two decades. However the under-5 mortality rate in Tanzania is still higher that the under-5 mortality rates of several low-and middle income countries(LMIC). Objective: The objective of this study was to investigate the mortality risk factors among under-five children in Tanzania and recommend the potential policy interventions to reduce under-five mortality improve children's health. Method: The most recent dataset of the Tanzania National Health Survey(TDHS) 2015-16 was used in this study. All statistical analysis were carried out using the SAS version 9.4. Analyses were conducted on 10,064 children. The outcome variable is child survival status(alive or dead). Logistic regresiion models were employed to investigate determinants of under-five mortality. The fit of the model was checked using Variance Inflation Factor and Hosmer -Lemeshow -goodness of fit test. A p-value<0.05 was used to declare statistical significance. Result: Sex of child, Mother’s age at birth, Current contraceptive method, Place of residence, Region, Wealth index were key factors associated with under-five mortality. A male child was significantly higher the odds of under-5 mortality(OR=1.34, 95%, CI 1.098-1.625). And The under-5 mortality was higher in children born to mothers aged <20 years when compared to that in children born to mothers aged >=20 years and <35 years(OR=0.58, 95%, CI 0.422-0.786) The likelihood of under-five mortality was also significantly higher among children born in the Dodoma(OR=2.48, 95%, CI 1.329-4.627) and Dar es salam(OR=2.08, 95%, CI 1.208-3.590) and those living in urban areas(OR=1.38, 95%, CI 1.098-1.625). The likelihood of under-five mortality was also higher among children born in the wealth index of poor (OR-1.36, 95%, CI 1.008-1.845) and the wealth index of rich (OR=1.38, 95%, CI 1.098-1.625) when compared to that in children born in the wealth index of poorest. Conclusion: This study identified critical risk factors for under-five mortality and highlights the need for strengthening of maternal and child health interventions, The finding of this study suggest that increased contraception coverage and addressing regional disparities in child health could help inform health policy and intervention strategies aimed at improving child survival. The present study also serves as a basis for future studies in evaluating health policies.