Socioeconomic, demographic and environmental factors associated with under-five mortality among children in Kenya: analysis of the 2022 Kenya demographic and health survey.

backgroundUnder-five mortality remains a critical public health challenge globally, particularly in low- and middle-income countries such as Kenya. Despite recent declines in mortality rates, Kenya continues to face a high burden of child deaths due to preventable or treatable conditions such as pneumonia, malaria, and malnutrition. This study aimed to assess the predictors of under-five mortality in Kenya using the 2022 Kenya Demographic and Health Survey (KDHS) to inform evidence-based interventions and policies.

methodsThis cross-sectional study utilised the 2022 Kenya Demographic and Health Survey (KDHS) dataset, focusing on variables from women's and household questionnaires relevant to under-five mortality. Data were cleaned and analysed using STATA 17 software. Descriptive statistics, univariate, bivariate, and multivariate logistic regression analyses were performed at p < 0.05 with 95% confidence intervals, accounting for the complex survey design.

resultsA total of 19,530 children under five years were included in the analysis, with 694 reported deaths. Second-born twins had a significantly higher mortality risk than first-born twins (AOR = 0.19, 95% CI: 0.05-0.68), and mothers using modern contraceptives had 3.31 times higher odds of child mortality compared to those using folkloric methods (AOR = 3.31, 95% CI: 1.97-5.55). Mothers with 1-4 antenatal care (ANC) visits had 2.55 times higher odds of child mortality (AOR = 2.55, 95% CI: 1.04-6.23) compared to those with no visits. Mothers with two or three births in the last five years had increased mortality odds (AOR = 2.59, 95% CI: 1.26-5.32; AOR = 6.15, 95% CI: 1.57-24.03, respectively), highlighting the risks of short birth intervals.

conclusionThis study provides important insights into the factors influencing child mortality in Kenya. These findings suggest the need for targeted interventions, such as scaling up Kangaroo Mother Care for twins, integrating family planning counselling into Kenya's Linda Mama program to promote optimal birth spacing, and improving ANC quality to address high-risk pregnancies. Our research contributes to the broader understanding of child mortality determinants and offers a foundation for future studies aimed at mitigating this critical public health issue.