Prevalence of under-5 mortality and its associated risk factors in Afghanistan

Introduction: Under-five mortality rate (U5MR) is a crucial indicator of the health in a society. The determinant of under-five mortality is essential for designing effective intervention programs that enhances the survival of young children. Objectives: The present study aims to determine the prevalence of under-five mortality and its associated risk factors in the country of Afghanistan. Methods: Latest round of Afghanistan Demographic and Health Survey (AfDHS, 2015) was used in the present study. The sample size was 1640 ever-married women (15-49 years) with at least one child younger than five years preceding the survey. Bivariate and multivariate regression analysis was applied to examine the risk factors associated with U5M. Results: The results of the present study found that those mothers delivered babies with birth size small or very small and birth interval 2 years experienced highest under-five mortality with 77 and 67 per 1000 live births as compared to their counterparts, respectively. Those mothers with non-institutional delivery experienced more mortality with 62 per 1000 live birth than those mothers delivered babies at institutions. Survival analysis showed that those mothers delivered babies with their birth size small or very small were 2.3 times more likely to have the risk of U5M [HR = 2.30, 1.93-2.73] and the rural children were 1.84 times more likely to have the risk of death than their counterparts [HR = 1.84, 1.36-2.47]. Those mothers accessed at least one antenatal care and birth interval 2 years were 31% [HR = 0.69, 0.57-0.82] and 28% [HR = 0.72, 0.61-0.86] less likely to have the risk of under-five mortality than their counterparts at significant level. Conclusion: The finding concludes that birth size (small or very small), birth interval (<2 years), children residing in rural area, and no antenatal care were more likely to have risk of under-five mortality. These prominent risk factors for U5M addressed through effective intervention in proposed to be reducing U5M in Afghanistan.