ArticleBMC public health2026
Survival analysis of under-five mortality predictors: evidence from the 2011 and 2022/23 mozambique demographic and health surveys.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundUnder-five mortality (U5M) is a critical indicator for assessing the overall health status of a population. Mozambique faces challenges in this area, and understanding risk factors is essential for developing effective interventions. This study aimed to identify predictors of under-five mortality through survival analysis among children in Mozambique.
methodsThis study used data from the 2011 (n = 7,647) and 2022/23 (n = 6,783) Mozambique Demographic and Health Surveys (MDHS), nationally representative surveys based on a multistage, stratified cluster sampling design. Under-five mortality was defined as the death of a live-born child before 60 months of age. Kaplan-Meier methods and Cox proportional hazards regression were used to estimate survival and identify predictors of mortality.
resultsIn 2011, 5.7% of children died before reaching age five and 4.7% within the first year of life. By 2022/23, these proportions had declined to 3.7% and 3.0%, respectively. A lower risk of mortality was observed among female children (2022/23: AHR = 0.56; 95% CI: 0.35-0.90), those living in households with five or more members (2011: AHR = 0.57; 95% CI: 0.43-0.76), and those in households with three or more children under five years of age (2011: AHR = 0.33; 95% CI: 0.18-0.61; 2022/23: AHR = 0.28; 95% CI: 0.13-0.61). In contrast, higher mortality risk was identified among children residing in urban areas (AHR = 1.42; 95% CI: 1.03-1.96), those reported to use bed nets for sleeping (2022/23: AHR = 2.39; 95% CI: 1.30-4.40), those with low birth weight (2011: AHR = 2.08; 95% CI: 1.30-3.33), and those delivered at home or outside public health facilities.
conclusionThese findings highlight the importance of strengthening maternal education and increasing investment in health systems to reduce under-five mortality in Mozambique. Expanding resources for maternal, neonatal, and child health services, particularly prenatal and obstetric care, is essential to further improve child survival outcomes.
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