Explaining Inter-regional Differentials in Child Mortality in Rural Ethiopia A Count Data Decomposition Analysis

Abstract

Using data from the Ethiopian Demographic and Health Survey, 2016 for a total of 1,295
number of under-five child deaths, this study examined the major determinants of inter-regional
differentials in under-five child mortality in rural Ethiopia. An extended detailed Oaxaca-Blinder
decomposition technique to negative binomial regression model was employed to examine the
relative contribution of various factors to regional differentials in under-five child mortality.
Findings of decomposition analysis indicated that large portion of the regional differentials
remained unexplained, being the lowest between Tigrai and Benshangul-Gumuz (12 percent) and
the highest in Tigrai-Gambella regions (37 percent). The explained regional gap was due to
differences in the distributions of measured factors across regions mainly attributable to
differences in short birth-spacing, higher birth-order, antenatal visits, women without education,
home delivery, large household size, and poorest households' economic status. Hence,
understanding inter-regional differentials in under-five child mortality and developing
appropriate policies and strategies could further reduce the rate of under-five child mortality.
On top of strengthening the health extension program in rural Ethiopia, this study suggests that
more sustained efforts focused on improving households' economic status and women's education
should be a prior agenda of the country.