Predictive models and under-five mortality determinants in Ethiopia: evidence from the 2016 Ethiopian Demographic and Health Survey

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Abstract Background There is a dearth of literature on predictive models estimating under-five mortality risk in Ethiopia. In this study, we develop a spatial map and predictive models to predict the sociodemographic determinants of under-five mortality in Ethiopia.Methods The study data were drawn from the 2016 Ethiopian Demographic and Health Survey. We used machine learning algorithms such as random forest, logistic regression, and Cox-proportional hazard models to predict the sociodemographic risks for under-five mortality in Ethiopia. The Receiver Operating Characteristic curve was used to evaluate the predictive power of the models.Results There are considerable regional variations in under-five mortality rates in Ethiopia. The under-five mortality prediction ability was found to be 88.7% for the random forest model, 68.3% for the logistic regression model, and 68.0% for the Cox-Proportional Hazard model. Maternal age at birth, sex of a child, previous birth interval, water source, contraceptive use, health facility delivery services, antenatal and post-natal care checkups have been found to be significantly associated with under-five mortality in Ethiopia.Conclusions The random forest machine learning algorithm produces a higher predictive power for under-five mortality risk factors for the study sample. There is a need to improve the quality and access to health care services to enhance childhood survival chances in the country.

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