Cultural, socioeconomic, and demographic factors contributing to child mortality: evidence from Sierra Leone demographic and health survey 2019
Abstract Background Child mortality, defined as the likelihood of an infant dying before the age of five, is still a significant concern in developing countries with limited healthcare facilities. Sierra Leone, with a child mortality rate of 68.418 deaths per 1,000 live births in 2024—one of the hig...
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2025-08-01
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| Online Access: | https://doi.org/10.1186/s12889-025-22191-8 |
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| author | Mohammad Salim Zahangir Fariha Khanam Lisa Mahmuda Al Neyma Md Rasel Hossain Sawasan Tabassum Tanvir Faisal Rakin Mohmmad Omar Faruk Kabir Hossain |
| author_facet | Mohammad Salim Zahangir Fariha Khanam Lisa Mahmuda Al Neyma Md Rasel Hossain Sawasan Tabassum Tanvir Faisal Rakin Mohmmad Omar Faruk Kabir Hossain |
| author_sort | Mohammad Salim Zahangir |
| collection | DOAJ |
| description | Abstract Background Child mortality, defined as the likelihood of an infant dying before the age of five, is still a significant concern in developing countries with limited healthcare facilities. Sierra Leone, with a child mortality rate of 68.418 deaths per 1,000 live births in 2024—one of the highest globally—necessitates urgent public health interventions to mitigate this critical issue. This study examined the cultural, socioeconomic, and demographic factors associated with under-five mortality in Sierra Leone. Methods This investigation used data from the Sierra Leone Demographic and Health Survey 2019, comprised of 4540 mothers aged 15–49 years who had at least one child who died under the age of five. The significance of explanatory variables was evaluated using a variety of bivariate statistical analyses, including the Mann-Whitney U (MWU) test, Kruskal-Wallis H (KWH) test, and Kendall’s tau_b and Spearman’s rho correlation. Additionally, several multivariate regression models were used to investigate the factors that influence child mortality. Result The results showed that increasing maternal age (IRR: 0.95, 95% CI: 0.932–0.968), living in the North-Western region (IRR: 0.110, 95% CI: 0.016–0.770), higher maternal education (IRR: 0.563, 95% CI: 0.189–1.676), higher father education (IRR: 0.816, 95% CI: 0.678–0.981), fewer children under five in the family (IRR: 0.853, 95% CI: 0.796–0.913), and being a working mother (IRR: 0.831, 95% CI: 0.705–0.980) reduced the risk of under-five mortality. However, the risk of under-five mortality increased with the total number of children ever born (IRR: 1.411, 95% CI: 1.263–1.577), younger maternal age at first birth (IRR: 1.032, 95% CI: 1.014–1.064), shorter preceding birth intervals (IRR: 1.006, 95% CI: 1.004–1.009), and having twin children (IRR: 9.792, 95% CI: 1.789–53.59). Conclusion The study highlights the urgent need to strengthen maternal and child healthcare services, particularly for younger mothers, promote family planning programs to ensure optimal birth spacing, and increase healthcare facilities in regions with high child mortality. |
| format | Article |
| id | doaj-art-bc3bb277a72a43edae87d80f3153ba2d |
| institution | Kabale University |
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| publishDate | 2025-08-01 |
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| spelling | doaj-art-bc3bb277a72a43edae87d80f3153ba2d2025-08-20T04:03:13ZengBMCBMC Public Health1471-24582025-08-0125111210.1186/s12889-025-22191-8Cultural, socioeconomic, and demographic factors contributing to child mortality: evidence from Sierra Leone demographic and health survey 2019Mohammad Salim Zahangir0Fariha Khanam Lisa1Mahmuda Al Neyma2Md Rasel Hossain3Sawasan Tabassum4Tanvir Faisal Rakin5Mohmmad Omar Faruk6Kabir Hossain7Department of Statistics, Noakhali Science and Technology UniversityDepartment of Oceanography, Noakhali Science and Technology UniversityDepartment of Statistics, University of ChittagongDepartment of Statistics, University of ChittagongDepartment of Statistics, University of ChittagongQueen Elizabeth HospitalDepartment of Statistics, University of ChittagongDepartment of Statistics, University of ChittagongAbstract Background Child mortality, defined as the likelihood of an infant dying before the age of five, is still a significant concern in developing countries with limited healthcare facilities. Sierra Leone, with a child mortality rate of 68.418 deaths per 1,000 live births in 2024—one of the highest globally—necessitates urgent public health interventions to mitigate this critical issue. This study examined the cultural, socioeconomic, and demographic factors associated with under-five mortality in Sierra Leone. Methods This investigation used data from the Sierra Leone Demographic and Health Survey 2019, comprised of 4540 mothers aged 15–49 years who had at least one child who died under the age of five. The significance of explanatory variables was evaluated using a variety of bivariate statistical analyses, including the Mann-Whitney U (MWU) test, Kruskal-Wallis H (KWH) test, and Kendall’s tau_b and Spearman’s rho correlation. Additionally, several multivariate regression models were used to investigate the factors that influence child mortality. Result The results showed that increasing maternal age (IRR: 0.95, 95% CI: 0.932–0.968), living in the North-Western region (IRR: 0.110, 95% CI: 0.016–0.770), higher maternal education (IRR: 0.563, 95% CI: 0.189–1.676), higher father education (IRR: 0.816, 95% CI: 0.678–0.981), fewer children under five in the family (IRR: 0.853, 95% CI: 0.796–0.913), and being a working mother (IRR: 0.831, 95% CI: 0.705–0.980) reduced the risk of under-five mortality. However, the risk of under-five mortality increased with the total number of children ever born (IRR: 1.411, 95% CI: 1.263–1.577), younger maternal age at first birth (IRR: 1.032, 95% CI: 1.014–1.064), shorter preceding birth intervals (IRR: 1.006, 95% CI: 1.004–1.009), and having twin children (IRR: 9.792, 95% CI: 1.789–53.59). Conclusion The study highlights the urgent need to strengthen maternal and child healthcare services, particularly for younger mothers, promote family planning programs to ensure optimal birth spacing, and increase healthcare facilities in regions with high child mortality.https://doi.org/10.1186/s12889-025-22191-8Child mortalityUnder-five deathsDemographic factorsSocioeconomic factorsCultural factorsSierra Leone |
| spellingShingle | Mohammad Salim Zahangir Fariha Khanam Lisa Mahmuda Al Neyma Md Rasel Hossain Sawasan Tabassum Tanvir Faisal Rakin Mohmmad Omar Faruk Kabir Hossain Cultural, socioeconomic, and demographic factors contributing to child mortality: evidence from Sierra Leone demographic and health survey 2019 BMC Public Health Child mortality Under-five deaths Demographic factors Socioeconomic factors Cultural factors Sierra Leone |
| title | Cultural, socioeconomic, and demographic factors contributing to child mortality: evidence from Sierra Leone demographic and health survey 2019 |
| title_full | Cultural, socioeconomic, and demographic factors contributing to child mortality: evidence from Sierra Leone demographic and health survey 2019 |
| title_fullStr | Cultural, socioeconomic, and demographic factors contributing to child mortality: evidence from Sierra Leone demographic and health survey 2019 |
| title_full_unstemmed | Cultural, socioeconomic, and demographic factors contributing to child mortality: evidence from Sierra Leone demographic and health survey 2019 |
| title_short | Cultural, socioeconomic, and demographic factors contributing to child mortality: evidence from Sierra Leone demographic and health survey 2019 |
| title_sort | cultural socioeconomic and demographic factors contributing to child mortality evidence from sierra leone demographic and health survey 2019 |
| topic | Child mortality Under-five deaths Demographic factors Socioeconomic factors Cultural factors Sierra Leone |
| url | https://doi.org/10.1186/s12889-025-22191-8 |
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