Residential inequality and spatial patterns of infant mortality in Ethiopia: evidence from Ethiopian Demographic and Health Surveys

• Published in: Tropical Medicine and Health
• Main Authors: Getayeneh Antehunegn Tesema, Achamyeleh Birhanu Teshale
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2021
• Subjects: Infant mortality; Spatial patterns; Ethiopia; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1186/s41182-021-00299-y; https://doaj.org/article/009b4f73272545838292ccb78b1a39ad

Abstract Background Despite the remarkable decrease in infant mortality rate in most countries, the rate of decline is slow and it remains unacceptably high in Sub-Saharan Africa. The progress in infant mortality in Ethiopia is far below the rate needed to achieve the Sustainable Development Goal. Understanding the residential inequality and spatiotemporal clusters of infant mortality is essential to prioritize areas and guide public health interventions. Therefore, this study aimed to investigate the residential inequality and spatial patterns of infant mortality in Ethiopia. Methods A secondary data analysis was done based on the Ethiopian demographic and health surveys conducted in 2000, 2005, 2011, and 2016. A total weighted sample of 46,317 live births was included for the final analysis. The residential inequality was assessed by calculating the risk difference in infant mortality rates between urban and rural live births and presented using a forest plot. For the spatial patterns of infant mortality, the SaTScan version 9.6 and ArcGIS version 10.6 statistical software were used to identify the spatial patterns of infant mortality. Results The study revealed that the infant mortality rate significantly declined from 96.9 per 1000 live births [95% CI 93.6, 104.2] in 2000 to 48.0 per 1000 live births [95% CI 44.2, 52.2] in 2016 with an annual rate of reduction of 3.2%. The infant mortality rate has substantial residential inequality over time, which is concentrated in the rural area. The spatial distribution of infant mortality was significantly clustered at the national level in survey periods (global Moran’s I, 0.04–0.081, p value < 0.05). In 2000, the most likely clusters were found in east Afar and at the border areas of south Amhara and north Oromia regions (LLR = 7.61, p value < 0.05); in 2005, at the border areas of Southern Nations Nationalities and People and in the entire Amhara region (LLR = 10.78, p value< 0.05); in 2011, at Southern Nations Nationalities and People and Gambella regions ...