Application of count models in the determination of under five mortality rate in South Africa

Abstract

Under-Five Mortality (U5M) remains a major health challenge in most sub Saharan African countries including SouthAfrica,despite the significant progress made in child survival and the government’s efforts and commitment to reduce U5M. The failure of achieving the fourth Millennium Development Goal (MDG) by 2015 has led to an implementation of Sustainable Development Goal 3 (SDG3) which aims to have no more than 25 deaths per 1000 live births by 2030. To achieve this goal, more information is needed. Hence, the purpose of this study was to apply count models to identify the determinants of underfive mortality rate in South Africa. To identify these determinants, the study reviewed generalized linear models and utilised the 2016 South African Demographic and Health Survey data. The models studied were Logistic Regression (LR), Poisson Regression (PR) and Negative Binomial Regression (NBR). The findings revealed that baby postnatal check-up, child’s health prior discharge, child birth size, toilet facility, maternal education, province, residence and water source were significantly associated with U5M in South Africa. It was further concluded that children who are at high risk of dying before the age of five are those who did not attend their postnatal check-up within the first two months, those whose health was not checked prior discharge, whose birth size was very small, whose household utilised bucket toilets, who resided in Western Cape, North West and Mpumalanga province, who resided in urban areas as well as those whose household utilized piped, tube well and spring water as source of drinking water.