What is it about?

Under-five mortality (U5M) means the number of children under five years old who die. This is considered a major public health concern and it affects how a country grows and improves. Our study looked at the factors associated with U5M in Sri Lanka using information from the demographic health survey conducted in 2016. We used data from 8,123 children in the survey and employed two models: one called the binary logistic regression model (BLRM) and another called the binary logistic random intercept multilevel model (BLRIMM) to predict the U5M of children using the collected data. We then compared the accuracy of each model’s prediction percentage. We found that BLRIMM was more accurate (98.67%) than BLRM (98.31%) and used the results of BLRIMM to determine the associated factors and the effects of these factors on the U5M of children in Sri Lanka.

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Why is it important?

The research discovered that kids who weren't breastfed had a much higher chance of U5M. This was also true for children who were part of a multiple birth (like twins or triplets), were not born through a normal delivery, had mothers who had lost a baby before, or were born to mothers with higher body weights. On the other hand, children from Buddhist, Hindu, and Roman Catholic families had a much lower chance of U5M compared to those from other religious backgrounds considered in the study. In conclusion, the study highlights the need to address differences related to religion in under-five mortality and to educate mothers about healthy habits, proper nutrition, breastfeeding, safe delivery practices, and how to care for their children after birth, especially in cases of multiple births.


We hope that this article contributes to the existing literature on U5M. The findings can be used by relevant authorities to make informed decisions for policy formulation. They can also help plan effective health programs, raise awareness about the prognostic factors, encourage the use of antenatal care facilities and other health services. Additionally, they can promote ways to reduce U5M in Sri Lanka, which could potentially save lives in the future.

Anupama Thabrew
Sri Lanka Technological Campus

Read the Original

This page is a summary of: Determinants of under-five mortality in Sri Lanka: A multilevel analysis of 2016 Sri Lankan DHS data, PLoS ONE, September 2023, PLOS,
DOI: 10.1371/journal.pone.0291246.
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