Under-Five Mortality and Associated Risk Factors in Children Hospitalized at David Bernardino Pediatric Hospital (DBPH), Angola: A Hierarchical Approach

Israel C. Avelino (), Joaquim Van-Dúnem and Luís Varandas ()
Additional contact information
Israel C. Avelino: Global Health and Tropical Medicine (GHTM), LA-REAL, Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, 1169-056 Lisboa, Portugal
Joaquim Van-Dúnem: Faculty of Medicine, Agostinho Neto University, Luanda 815, Angola
Luís Varandas: Global Health and Tropical Medicine (GHTM), LA-REAL, Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, 1169-056 Lisboa, Portugal

IJERPH, 2024, vol. 21, issue 8, 1-16

Abstract: Reducing under-five mortality is a crucial indicator of overall development in a country. However, in Angola, understanding the factors contributing to hospital deaths in this vulnerable demographic remains incomplete despite improvements in healthcare infrastructure and public health policies. With one of the highest under-five mortality rates in sub-Saharan Africa, Angola faces significant challenges such as malaria, malnutrition, pneumonia, neonatal conditions, and intestinal infectious diseases, which are the leading causes of death among children. This study aimed to identify factors associated with hospital deaths among children aged 28 days to five years admitted to DBPH in Luanda between May 2022 and June 2023. Using a hospital-based case-control design, the study included 1020 children, among whom 340 experienced hospital deaths. Distal and intermediate determinants emerged as primary predictors of hospital mortality, showing significant associations with: mother without schooling (OR [95%CI] 4.3 [1.2–15.7], p < 0.027); frequent alcohol consumption during pregnancy (OR [95%CI] 3.8 [2.5–5.9], p < 0.001); hospital stay ≤24 h (OR [95%CI] 13.8 [6.2–30.8], p < 0.001); poor nutritional status (OR [95%CI] 2.1 [1.4–3.2], p < 0.001); short interbirth interval (OR [95%CI] 1.7 [1.1–2.5], p < 0.014); maternal age ≤19 years (OR [95%CI] 5.6 [3.0–10.8], p < 0.001); and maternal age ≥35 years (OR [95%CI] 2.1 [1.2–3.7], p < 0.006). These findings highlight the preventable nature of most under-five hospital deaths and underscore the urgent need to address social inequities and improve the quality of primary healthcare services to effectively reduce child mortality in Angola.

Keywords: under-five mortality; Angola; determinants of health; child healthcare; case-control study (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/21/8/1062/pdf (application/pdf)
https://www.mdpi.com/1660-4601/21/8/1062/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:21:y:2024:i:8:p:1062-:d:1455713

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().