ArticleBMJ public health2024
Influence of demographic, socioeconomic and geographical variability on children under-five mortality in The Gambia: an application of survival analysis.
Article in BMJ public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Survival analysis of maternal, household, environmental, and child-level determinants of under-five mortality in Nigeria.BMC pediatrics · 2026Article
- Trends, sex and socioeconomic inequalities, and future projections of under-five mortality in Ghana from 1992 to 2035.Scientific reports · 2026Article
- Survival analysis of environmental determinants related to child mortality in Liberia.BMC pediatrics · 2026Article
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Authors and funding
6 authors.
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Abstract
Background: There has been a notable decline in child mortality globally, yet Gambia continues to face a high mortality rate among children under five, which poses a serious public health challenge. This research delves into the differences in demographic, socioeconomic and geographic aspects that affect the survival rates of children under five in The Gambia. Methods: In this study, a retrospective cross-sectional approach was adopted, which is quantitative. The researchers used data from the Gambia Demographic Health Survey conducted in 2019-2020. To analyse the impact of demographic, socioeconomic and geographical factors on the survival of children under 5 years of age in The Gambia, we applied Kaplan-Meier survival estimates along with the Cox proportional hazards model. Results: The weighted under-five mortality (U5M) rate was 52 per 1000 live births. Our Kaplan-Meier survival estimates illustrate that most under-five mortalities occur within the first 48-60 months after birth, with children from the poorest families facing the highest risk. Conversely, children from the wealthiest families are least affected by geographical regions and the household wealth index. At the multivariable level, the results suggest that fathers with secondary education levels had 36% (HR=0.64; 95% CI 0.42 to 0.97) lower risk of U5M than those with tertiary educational levels. Among the eight regions, Janjanbureh (HR=1.93; 95% CI 1.02 to 3.63), Kuntaur (HR=2.13; 95% CI 1.13 to 4.03) and Mansakonko (HR=1.96; 95% CI 1.03 to 3.74) reported higher risks of U5M compared with those from Banjul after controlling for confounders. Conclusion: The research highlights considerable differences based on demographics, socioeconomic conditions and geography in the mortality rates among children under five in The Gambia. This underscores the urgent need for specific strategies targeting the most at-risk areas and socioeconomic groups to improve child survival outcomes.
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