ArticleJournal of health, population, and nutrition2024
Modeling time to death for under-five children in Malawi using 2015/16 Demographic and Health Survey: a survival analysis.
Article in Journal of health, population, and nutrition, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 8 citations in OpenAlex.
- Survival analysis of maternal, household, environmental, and child-level determinants of under-five mortality in Nigeria.BMC pediatrics · 2026Article
- Survival analysis of under-five mortality predictors: evidence from the 2011 and 2022/23 mozambique demographic and health surveys.BMC public health · 2026Article
- Survival analysis of environmental determinants related to child mortality in Liberia.BMC pediatrics · 2026Article
- Survival Machine-Learning Approach for Predicting Under-Five Mortality in Low Sociodemographic Index States of India.Journal of research in health sciences · 2025Article
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3 authors at 2 institutions in 3 countries.
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Abstract
backgroundMalawi has one of the highest under-five mortality rates in Sub Sahara Africa. Understanding the factors that contribute to child mortality in Malawi is crucial for the development and implementation of effective interventions to reduce child mortality. The aim of this study is to use survival analysis in modeling time to death for under-five children in Malawi. In turn, identify potential risk factors for child mortality and inform the development of interventions to reduce child mortality in the country.
methodThis study used data from all births that occurred in the five years leading up to the 2015/16 Malawi Demographic and Health Survey. The Frailty hazard model was applied to predict infant survival in Malawi. In this analysis, the outcome of interest was death and it had two possible outcomes: "dead" or "alive". Age at death was regarded as the survival time variable. Infants who were still alive at the time of the study as of the day of the interview were considered as censored observations in the analysis.
resultsA total of 17,286 live births born during the 5 years preceding the survey were analysed. The study found that the risk of death was higher among children born to mothers aged 30-39 and 40 or older compared to teen mothers. Infants whose mothers attended fewer than four antenatal care visits were also found to be at a higher risk of death. On the other hand, the study found that using mosquito nets and early breastfeeding were associated with a lower risk of death, as were being male and coming from a wealthier household.
conclusionThe study reveals a notable decline in infant mortality rates as under-five children age, underscoring the challenge of ensuring newborn survival. Factors such as maternal age, birth order, socioeconomic status, mosquito net usage, early breastfeeding initiation, geographic location, and child's sex are key predictors of under-five mortality. To address this, public health strategies should prioritize interventions targeting these predictors to reduce under-five mortality rates.
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