Abstract
Background: Under-five mortality rates in South Africa have been found to be high amongst the previously disadvantaged populations and social groups. Certain geographic areas such as Tembisa in the province of Gauteng, South Africa, have particularly high mortality rates due to an inadequate health policy during apartheid and after.
Objectives : The main aim of this study was to identify the factors associated with under-Five Mor-tality at Tembisa Hospital, Gauteng Province, South Africa
Methods: This was a Case-control study of 674 under-five year old children who were admitted between 2017 and 2020 at Tembisa Hospital. Cases consisted of 337 children who were admitted into the hospital and died, while controls were the children admitted during the same period but did not die. Hospital data records were used to identify the cases and controls. Data was analysed using EPINFO 7.2 for crude analysis and Logistic regression in SPSS version 26.
Results: Out of a total 674 under-five participants in the study, half had died (n=337) and 337 (50%) had lived during the period 2017 to 2020. children born to mothers aged 30-34 years were more likely to die compared to mother aged 25 to 29 years (OR = 3.21, 95% CI (1.14-8.98) Unem-ployed mothers were more likely to have their under-five child die compared to employed mothers at 95% CI, i.e., (AOR: 1.97; 95% CI: 1.43–2.71). Children who had not been up to date with their immunization were significantly more likely to have died (AOR 1.94, 95% CI (1.42-2.66). Children living in informal housing were significantly more likely to have died (OR 2.05, 95% CI:1.50-2.80). Children without piped water in their homes, nor flushing toilets were significantly more likely to be dead in adjusted ratio analysis AOR 1.82, 95% CI (1.28-2.60) and AOR 2.77 CI (1.49-5.12), re-spectively.
Conclusion: Mother’s age, employment status and incomplete immunization were associated with increased risk of under-5 mortalities. Similarly, living in houses built with inadequate housing mate-rials with no piped water and flushing toilet have shown an increased risk for under-five mortality in South Africa.
Keywords: Under-five mortality, environmental factors, socio-economic factors, maternal and bio-logical factors, Gauteng, South Africa.