Multilevel modelling of the determinants of under-five deaths in South Africa: Evidence from the 2016 Demographic Health Survey.

Abstract

Although South Africa is among the countries with lower under-five mortality rates in sub-Saharan Africa, the country has failed to meet the national targets set to achieve the Millennium Development Goals. The study aimed to examine multilevel determinants of deaths of children under five in South Africa. Secondary data from the 2016 South Africa Demographic Health Survey was used to conduct bivariate and multilevel logistic regression analyses. The under-five mortality rate was estimated at 42.1 deaths per 1000 live births. The under-five mortality rates were highest in Mpumalanga and lowest in Western Cape. The findings showed that several factors were associated with under-five deaths, namely the sex of the child, population group, mother's level of education, household wealth, type of toilet facility, source of drinking water, and province. The findings call for targeted interventions aimed at reducing under-five deaths among vulnerable groups, i.e., those from a low socioeconomic background, from the black population group, as well as male children.