Small area clustering of under-five children's mortality and associated factors using geo-additive Bayesian discrete-time survival model in Kersa HDSS, Ethiopia

Melkamu Dedefo Gishu, Haramaya University and Kersa HDSS
Lemessa Oljira Hordofa, Haramaya University
Nega Assefa Kassa, Haramaya University

Background: Child mortality reflects country's level of socio-economic development and quality of life. This study explored the small area clustering of under-five mortality and associated factors in Kersa Health and Demographic Surveillance System (HDSS), Eastern Ethiopia. Methods: The study population included all children under the age of five years during the time September, 2008 to August 31, 2012 registered in Kersa HDSS site. A flexible Bayesian geo-additive discrete-time survival mixed model was used. Results: Among the factors that are significantly associated with Under-five mortality with posterior odds ratio and 95% credible sub-districts are maternal educational status 1.31(1.13 1.49), place of delivery 1.016(1.013 1.12), live birth at a delivery 0.35(0.23 1.83 ), low wealth index 1.26(1.10 1.43 ) middle wealth index 0.95 (0.84 1.07) pre-term 1.95(1.27,2.91), post-term 0.74(0.60,0.93) and antenatal visit 1.19(1.06, 1.35). Conclusion: This study reveals geographic patterns in rates of Under-five mortality and some important determinants of under-five mortality.