Prevalence and Triggering Factors of Children Under 5 Mortality in Bangladesh: A Multilevel analysis of 2022 Demographic and health survey data

Introduction: Under-five child mortality remains a significant public health challenge in Bangladesh, despite substantial progress in recent decades. This study investigates the individual and communitylevel determinants of under-five mortality in Bangladesh using data from the 2022 Bangladesh Demographic and Health Survey (BDHS).

Methods: This study examined Bangladeshi under-five mortality and its causes using a thorough analytical method. Descriptive statistics like frequency tables described the study population. Bivariate studies using the chi-square test found significant connections between independent variables and child mortality. Multilevel modeling techniques were employed to address the hierarchical data structure, creating distinct models to analyze individual-level factors and community-level factors. This concept examines individual and contextual factors affecting under-5 mortality at multiple levels.

Results: The research showed significant risk variables linked to under-five mortality. Maternal age of 15–24 years was associated with an increased risk of child mortality relative to higher mother’s age. Families consisting of four or fewer people showed higher child death rates in comparison to larger families (OR: 0.471, 95% CI: 0.317–0.700). Children born at home had an elevated risk of mortality relative to those delivered in healthcare institutions, however this correlation was not statistically significant (OR: 1.322, 95% CI: 0.804–2.17). The absence of antenatal care visits was significantly correlated with increased mortality risk, while four or more visits delivered significant protective benefits (OR: 0.492, 95% CI: 0.269–0.904). At the community level, unsecured water sources posed a significant risk factor and it increase the mortality risk by 29%. Communities with a lower average maternal age were also at a higher risk, as areas with higher average maternal age showed a 46% reduction in child mortality (OR: 0.542, 95% CI: 0.242–0.724).

Conclusion: The research highlights the urgent need for focused healthcare initiatives and enhancements at the grassroots level to reduce under-five mortality in Bangladesh. Lower mother age, insufficient antenatal care appointments, absence of tetanus toxoid vaccination, and sources of contaminated water were recognized as critical risk factors associated with child mortality. Enhancing maternal healthcare services, advocating for sufficient antenatal care, guaranteeing vaccine coverage, and increasing access to safe water in high-risk populations are critical actions. These findings offer evidence-based insights for policymakers and healthcare practitioners to formulate effective, targeted measures to meet Bangladesh's child survival objectives under the Sustainable Development Goals.

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