|Exploring causal pathways for factors associated with neonatal, infant and under-five mortality, analysis of 2015-2016 Myanmar Demographic Health Survey|
||Ngatho Samuel Mugo, Kyaw Swa Mya, and Camille Raynes-Greenow
||Journal of Global Health Reports, 3: e2019015; DOI: 10.29392/joghr.3.e2019015
Children under five
||Background This study explores the intermediate and proximate causal factors associated with under-five mortality in Myanmar in order to help policymakers to assess and formulate appropriate interventions to prevent neonatal, infant and under-five deaths.
Methods We examined the data from the 2015-2016 Myanmar Demographic and Health Survey. The study population consisted of 4198 live born singleton children born within five years prior to the survey. We used logistic binomial regression and multivariate models adjusted for cluster and survey weights to examine the potential factors associated with neonatal, infant and under-five mortality.
Results There were 162 under-five deaths with an estimated neonatal mortality rate of 20 per 1000 live births, an infant mortality rate of 35 per 1000 live births and an under-five mortality rate of 45 per 1000 live births. In the multivariate analysis never breastfeed (adjusted odds ratio (AOR)=36.34, 95% confidence interval (CI)=17.58 to 75.12), unweighed at birth (AOR=4.16, 95% CI=1.58 to 11.00), smaller than average size children (AOR=3.33, 95% CI=1.44 to 7.68), and natural wall material (AOR= 4.22, 95% CI=1.36, 13.09) were risks for neonatal mortality. Children born to the lowest wealth quintile households were more likely to die during the infant (AOR= 2.82, 95% CI=1.28, 6.20) and under five period (AOR= 3.83, 95% CI=1.76, 8.32) compared to those born to the richest wealth quintile households. Preceding birth interval <3 years was associated with infant death (AOR= 2.26, 95% CI=1.31, 3.89) and under five death (AOR= 2.02, 95% CI=1.10, 3.70). Maternal education, age working status, and non-caesarean births were risk factors for infant and under-five mortality.
Conclusions Improving survival of under-five children in Myanmar will require implementing evidence-based interventions that target population sub-groups such as poor households, neonates with low birth weight and size; improving women’s access to family planning services and enhancing women and adolescent girl’s education attainment.