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Risk factors for under-5 mortality: evidence from Bangladesh Demographic and Health Survey, 2004–2011
  1. Tanvir Abir1,
  2. Kingsley Emwinyore Agho1,
  3. Andrew Nicolas Page1,
  4. Abul Hasnat Milton2,
  5. Michael John Dibley3
  1. 1School of Science and Health, University of Western Sydney, New South Wales, Australia
  2. 2Faculty of Health and Medicine, Centre for Clinical Epidemiology & Biostatistics (CCEB), School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
  3. 3Sydney School of Public Health, University of Sydney, Newcastle, New South Wales, Australia
  1. Correspondence to Tanvir Abir; T.Abir{at}uws.edu.au

Abstract

Objective The aim of this study was to identify factors associated with mortality in children under 5 years of age using a nationally representative sample of singleton births for the period of 2004–2011.

Design, setting and participants Pooled 2004, 2007 and 2011 cross-sectional data sets of the Bangladesh Demographic and Health Surveys were analysed. The surveys used a stratified two-stage cluster sample of 16 722 singleton live-born infants of the most recent birth of a mother within a 3-year period.

Main outcome measures Outcome measures were neonatal mortality (0–30 days), postneonatal mortality (1–11 months), infant mortality (0–11 months), child mortality (1–4 years) and under-5 mortality (0–4 years).

Results Survival information for 16 722 singleton live-born infants and 522 deaths of children <5 years of age included: 310 neonatal deaths, 154 postneonatal deaths, 464 infant deaths, 58 child deaths and 522 under-5 deaths. Multiple variable analysis showed that, over a 7-year period, mortality reduced significantly by 48% for postneonatal deaths, 33% for infant deaths and 29% for under-5 deaths, but there was no significant reduction in neonatal deaths (adjusted OR (AOR)=0.79, 95% CI 0.59 to 1.06) or child deaths (AOR=1.00, 95% CI 0.51 to 1.94). The odds of neonatal, postneonatal, infant, child and under-5 deaths decreased significantly among mothers who used contraceptive and mothers who had other children aged 3 years or older. The risk of neonatal, postneonatal, infant, child and under-5 deaths was significantly higher in mothers who reported a previous death of a sibling.

Conclusions Our study suggests that family planning is needed to further reduce the overall rate of under-5 deaths in Bangladesh. To reduce childhood mortality, public health interventions that focus on child spacing and contraceptive use by mothers may be most effective.

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