Under-five Child Survival and Asociated Risk Factors in Zambia

Background: Under-five mortality remains a global public health challenge faced by several developing countries particularly those in Sub-Sahara African. This study aimed to analyse risk factors for under-five mortality in Zambia. Methods: In order to achieve this objectives, the most recent 2018 Zambia Demographic and Health Survey Children’s dataset was used. Microsoft Excel 2013 and Stata 13 software were used to analyse the data by first establishing percentage and graphical distributions of variables of interest and thereafter apply Survival analysis to produce Kaplan – Meier results with the log-rank test and Cox proportional hazard regression models. Results: Our findings show that various factors pose risks to under-five mortality. In this regard, the mother’s education, higher birth order, being from a household classified as rich and residing in rural areas has a protective effect for under-five mortality, while older mothers and being in female headed household increases the risk of under-five mortality. Conclusion and Policy Implication: It is clear that Under-five mortality remains high in Zambia and influenced in a significant way by two major factors – older ages at birth for mothers and female headed households. While the latter is a result of society and community settings and how they interact with various cultural and traditional norms as well as power relations and the gender perspective, the former could be associated with access to comprehensive reproductive health services coupled with access to education. In view of the findings, the study has important policy implications at national level in monitoring the implementation of various infant and under five interventions aimed at reducing IMR and U5M and also to ensure that it achieves the SDG 3.2, as such, all interventions should have a demographic and socio-economic lens at all levels of service provision and implementation. Nonetheless, these should be implemented in line with known high impact under-5 interventions already being implemented if maximum results are to be achieved.