Magnitude and causes of under-five mortality in the North Shewa Zone, Ethiopia

IntroductionGlobally around 5 million children under the age of 5 years die every year. Ethiopia is one of five countries that contribute to more than half of these deaths. In the absence of a national vital registry system in Ethiopia, there is a lack of high-quality data regarding causes of death. MethodsWe conducted a verbal autopsy study among under-five deceased children at the Birhan health and demographic site (HDSS) located in the North Shewa zone, Ethiopia. All deaths of under five children, which occurred in the time period from March 1, 2019 to February 29, 2020 at the Birhan HDSS, were identified. The under-five mortality rate (U5MR) was computed using a Kaplan-Meier approach. The world health organization verbal autopsy questionnaire was administered to mothers or caregivers of the deceased child after a minimum mourning period of 42 days. The causes of death were then determined by the InterVA-5 algorithm. ResultsThere were 90 under-five deaths resulting in an estimated U5MR of 45.3 per 1000 live births. The majority (62.2%) of deaths occurred during the neonatal period. The leading causes of death in under-five children were birth asphyxia (20, 27.0%), prematurity (19, 25.7%) and meningitis and encephalitis (8, 10.8%) while leading causes of neonatal deaths were birth asphyxia (19, 38.0%), prematurity (18, 36.0%) and neonatal sepsis (6, 12.0%). ConclusionsThere is a high under-five mortality rate at the study site, with most deaths occurring in the neonatal period. Birth asphyxia and prematurity contributed to more than half of the under-five deaths suggesting that follow-up and management during pregnancy, labor and delivery should be strengthened to avert a significant proportion of under-five deaths. O_TEXTBOXWhat is already known on this topic O_LIEthiopia is one of the countries with the highest deaths of under 5 children but because absence of national vital registry system there is lack of high-quality data regarding causes of death. C_LI What this study adds O_LIBirth asphyxia and prematurity are the commonest causes of death contributing to more than half of the under-five deaths. C_LI How this study might affect research, practice or policy O_LIFollow-up and management during pregnancy, labor and delivery should be strengthened to avert a significant proportion of under-five deaths. C_LI C_TEXTBOX