Risk Factors for Under-Five Child Mortality: Evidence from Bangladesh Multiple Indicator Cluster Survey (MICS) 2019

Abstract

Every year, millions of children under the age of five deaths for various reasons, and some of these deaths may be avoided if more people were aware of the situation and taken action. Despite the fact that Bangladesh's under-five child mortality rate has decreased significantly over the last decade, and it is still too high to meet the Sustainable Development Goals (SDGs). The major goal of the study was to figure out what risk (socio-economic and demographic) factors influence under-five child mortality in Bangladesh. Nationally representative cross-sectional secondary data from the Multiple Indicator Cluster Survey (MICS) 2019, Bangladesh had been used in this study. The outcome variable was the under-five child survival status (alive or dead). Kaplan–Meier log-rank test and Cox Proportional Hazard (PH) model with a 95% confidence interval (CI) were fitted to identify associated risk factors for under-five child mortality. This analysis was performed using STATA version 16. The study showed that among 5112 under-five children, 170 (3.3%) were dead. Cox proportional hazard model revealed that mother's education [secondary (HR: 0.57, 95% CI: (0.32, 1.01), p=0.045), higher (HR: 0.46, 95% CI: (0.23, 0.90), p=0.024)], higher birth order [HR: 1.43, 95% CI: (1.23, 1.80), p=0.008], size of child at birth [HR: 2.30, 95% CI: (1.23, 4.28), p=0.009], taking antenatal care [HR: 0.83, 95% CI: (0.56, 1.24), p= 0.099] had a significant effect on child mortality. Under-five child mortality rate was varied among divisions and highest mortality rate was found in Sylhet [HR: 1.98, 95% CI: (0.91, 4.17), p=0.088]. This study identified potential risk factors for under-five child mortality, which will help policymakers take appropriate steps to reduce child mortality in Bangladesh, such as community-based educational programs for mothers and public health interventions centered on birth.