Determinants of under-five mortality in Uganda

Abstract

Reducing under-five mortality is a key target of public health policies in many developing countries and is also viewed as an indicator of the economic development. Globally, under-five mortality rates have declined over the past decade due to various efforts and strides to improve the mortality rates for the purpose of attain SDG goal 3.2 of at least 25 per 1000 live births. Despite the various efforts to lower the mortality rate in Uganda, the under-five mortality rate is still unacceptably high compared to the SDG 3.2 target. The under-five mortality rate fell from 90 per 1000 live births in 2011 to 64 in 2016 and 52 per 1000 live births in 2022. One can argue that Uganda has registered an improvement in reducing under-five mortality but it has remained unclear in existing literature why the under-five mortality rate has remained high above the SDG target. Thus, this study aimed to determine the factors that affect under-five mortality in Uganda. Using a Logistic regression and Cox regression on 2016 Uganda Demographic Health Survey (UDHS) dataset, the study demonstrates that the education of the mother, age of the mother, more than 4 ANC visits, female-born child and desire for more children had a negative relationship with under-five mortality. Borehole as a source of drinking water, higher birth order and never breastfed had a positive relationship with under-five mortality. The study findings imply that to reduce under-five mortality, health workers should sensitise pregnant women about the importance of having more than four ANC visits, encourage them to exclusively breastfeed their babies, and use more effective family planning methods to prevent unwanted pregnancies and have few children. Teenage pregnancies and marriages should be avoided as they contribute to under-five mortality. The government should also lay strategies to increase the enrolment and retention of female children at the primary and secondary school levels and extend cleaner and safer piped water services to households and the general public. Key Words: Under-five mortality, Antenatal Care, survival analysis, Cox regression, logistic regression.