Background
Methods
Source of data
Study outcome
Study setting
Explanatory variables
Analytical procedure
Test of proportionality under survival analysis
Models with and without frailty terms
The proportional hazards model without a frailty term
The proportional hazards model with a frailty term
Description of exponential, Weibull and Gompertz distributions
Exponential and Weibull distributions
Gompertz distribution
Bayesian proportional hazards model with/without a frailty term
Results
Descriptive characteristics of the study participants
Characteristics | Burkina Faso | Benin | Cote D’Ivoire | Ghana | Gambia | Guinea | Liberia |
Total | 15,162 | 12,290 | 7149 | 5675 | 7798 | 6977 | 6432 |
Mothers’ characteristic | |||||||
Current age (mean + S.E) | 29.2 ± 0.08 | 29.27 ± 0.08 | 28.65 ± 0.13 | 30.54 ± 0.14 | 29.17 ± 0.13 | 28.48 ± 0.14 | 28.37 ± 0.16 |
Current age group | |||||||
15–19 | 707 (4.66) | 415 (3.37) | 534 (7.47) | 203 (3.57) | 380 (4.87) | 670 (9.61) | 599 (9.32) |
20–24 | 3617 (23.85) | 2293 (18.66) | 1669 (23.35) | 968 (17.06) | 1657 (21.25) | 1582 (22.68) | 1645 (25.57) |
25–29 | 3978 (26.23) | 3839 (31.24) | 1994 (27.89) | 1419 (25.01) | 2218 (28.44) | 1797 (25.75) | 1667 (25.92) |
30–34 | 3304 (21.79) | 3021 (24.58) | 1459 (20.42) | 1413 (24.9) | 1787 (22.91) | 1254 (17.98) | 1115 (17.33) |
35–39 | 2146 (14.16) | 1743 (14.18) | 905 (12.66) | 1050 (18.51) | 1086 (13.93) | 1014 (14.54) | 877 (13.63) |
40–44 | 1102 (7.27) | 752 (6.12) | 452 (6.32) | 482 (8.5) | 534 (6.84) | 495 (7.09) | 393 (6.11) |
45–49 | 309 (2.04) | 228 (1.85) | 135 (1.89) | 139 (2.45) | 136 (1.75) | 164 (2.35) | 136 (2.12) |
Age at first birth (mean + S.E) | 18.89 ± 0.04 | 20.01 ± 0.06 | 18.77 ± 0.08 | 20.75 ± 0.12 | 19.31 ± 0.08 | 18.15 ± 0.07 | 18.49 ± 0.07 |
Age at first birth group | |||||||
< 15 | 442 (2.92) | 844 (6.87) | 560 (7.83) | 175 (3.08) | 625 (8.01) | 804 (11.53) | 439 (6.82) |
15–19 | 9448 (62.32) | 5274 (42.92) | 4037 (56.46) | 2371 (41.78) | 3847 (49.34) | 4168 (59.74) | 4010 (62.34) |
20–24 | 4507 (29.73) | 4446 (36.18) | 2069 (28.94) | 2089 (36.81) | 2557 (32.79) | 1572 (22.53) | 1618 (25.16) |
25–29 | 653 (4.31) | 1386 (11.28) | 418 (5.84) | 798 (14.06) | 651 (8.35) | 340 (4.87) | 318 (4.94) |
30–34 | 96 (0.63) | 272 (2.21) | 50 (0.7) | 208 (3.67) | 105 (1.35) | 78 (1.12) | 43 (0.67) |
> 34 | 15 (0.1) | 67 (0.54) | 16 (0.23) | 34 (0.6) | 12 (0.15) | 15 (0.21) | 4 (0.07) |
Highest educational level | |||||||
No education | 12,784 (84.32) | 8717 (70.93) | 4544 (63.56) | 1552 (27.36) | 4648 (59.61) | 5437 (77.92) | 2680 (41.66) |
Primary | 1610 (10.62) | 2068 (16.83) | 1869 (26.15) | 1141 (20.1) | 1122 (14.39) | 843 (12.09) | 1960 (30.47) |
Secondary | 695 (4.59) | 1372 (11.16) | 662 (9.26) | 2730 (48.1) | 1777 (22.79) | 609 (8.73) | 1610 (25.02) |
Higher | 72 (0.48) | 133 (1.08) | 74 (1.03) | 252 (4.44) | 251 (3.21) | 88 (1.26) | 183 (2.85) |
Current employment status | |||||||
Not currently employed | 3427 (22.6) | 3760 (30.6) | 2085 (29.16) | 1174 (20.68) | 4060 (52.07) | 1418 (20.33) | 2745 (42.68) |
Currently employed | 11,735 (77.4) | 8529 (69.4) | 5064 (70.84) | 4501 (79.32) | 3738 (47.93) | 5559 (79.67) | 3687 (57.32) |
Marital status | |||||||
Not current married | 410 (2.7) | 702 (5.71) | 1081 (15.13) | 814 (14.35) | 496 (6.37) | 495 (7.09) | 1572 (24.44) |
Currently married/union | 14,752 (97.3) | 11,588 (94.29) | 6068 (84.87) | 4861 (85.65) | 7301 (93.63) | 6482 (92.91) | 4860 (75.56) |
Residence | |||||||
Urban | 2546 (16.79) | 4995 (40.64) | 2688 (37.6) | 2553 (44.99) | 3724 (47.76) | 1832 (26.26) | 3207 (49.85) |
Rural | 12,616 (83.21) | 7295 (59.36) | 4461 (62.4) | 3122 (55.01) | 4074 (52.24) | 5144 (73.74) | 3226 (50.15) |
Wealth | |||||||
Poorest | 3142 (20.72) | 2536 (20.64) | 1770 (24.76) | 1258 (22.17) | 1566 (20.09) | 1569 (22.49) | 1557 (24.2) |
Poorer | 3317 (21.87) | 2451 (19.94) | 1592 (22.27) | 1193 (21.03) | 1715 (21.99) | 1535 (21.99) | 1438 (22.36) |
Middle | 3283 (21.66) | 2417 (19.67) | 1360 (19.03) | 1111 (19.57) | 1560 (20) | 1433 (20.53) | 1358 (21.12) |
Richer | 3147 (20.76) | 2469 (20.09) | 1346 (18.82) | 1069 (18.84) | 1584 (20.32) | 1371 (19.65) | 1217 (18.92) |
Richest | 2273 (14.99) | 2416 (19.66) | 1081 (15.13) | 1044 (18.4) | 1373 (17.6) | 1070 (15.33) | 862 (13.4) |
Religion | |||||||
Christian | 4033 (26.6) | 6907 (56.2) | 2876 (40.23) | 4291 (75.61) | 188 (2.41) | 545 (7.81) | 5428 (84.38) |
Muslim | 9678 (63.83) | 2916 (23.73) | 2986 (41.76) | 964 (16.99) | 7609 (97.58) | 6126 (87.81) | 749 (11.65) |
No religion | 158 (1.04) | 626 (5.09) | 1002 (14.01) | 236 (4.16) | 0 (0.01) | 283 (4.05) | 219 (3.41) |
Other religion | 1 (0.01) | 1554 (12.65) | 286 (4) | – | – | 23 (0.33) | 1 (0.01) |
Traditional | 1291 (8.51) | 287 (2.33) | – | 183 (3.23) | – | – | 35 (0.55) |
Child characteristics | |||||||
Birth type | |||||||
Singleton | 14,576 (96.14) | 11,686 (95.09) | 6815 (95.33) | 5388 (94.94) | 7538 (96.67) | 6673 (95.65) | 6197 (96.33) |
Multiple | 586 (3.86) | 604 (4.91) | 334 (4.67) | 287 (5.06) | 260 (3.33) | 304 (4.35) | 236 (3.67) |
Sex of child | |||||||
Male | 7683 (50.67) | 6322 (51.45) | 3601 (50.37) | 2962 (52.2) | 3965 (50.85) | 3576 (51.25) | 3284 (51.05) |
Female | 7479 (49.33) | 5967 (48.55) | 3548 (49.63) | 2713 (47.8) | 3833 (49.15) | 3401 (48.75) | 3149 (48.95) |
Child size at birth | |||||||
Large | 4629 (30.53) | 2215 (18.02) | 3552 (49.68) | 2899 (51.09) | 3964 (50.84) | 3372 (48.33) | 2973 (46.23) |
Average | 8534 (56.28) | 8408 (68.41) | 2475 (34.62) | 1880 (33.13) | 2173 (27.86) | 2706 (38.79) | 2182 (33.92) |
Small | 1999 (13.18) | 1667 (13.57) | 1122 (15.69) | 896 (15.78) | 1661 (21.3) | 899 (12.89) | 1277 (19.85) |
Birth order | |||||||
1st-3rd | 7813 (51.53) | 7345 (59.76) | 4215 (58.96) | 3539 (62.35) | 4334 (55.58) | 3818 (54.72) | 3857 (59.96) |
4th–6th | 5058 (33.36) | 3952 (32.16) | 2103 (29.41) | 1692 (29.82) | 2483 (31.84) | 2242 (32.13) | 1833 (28.5) |
7th + chi | 2291 (15.11) | 993 (8.08) | 831 (11.63) | 444 (7.83) | 981 (12.58) | 917 (13.15) | 743 (11.54) |
Preceding birth interval | |||||||
< 12 months | 2848 (18.78) | 2695 (21.93) | 1678 (23.47) | 1393 (24.55) | 1730 (22.19) | 1586 (22.73) | 1633 (25.39) |
11 to 23 months | 1531 (10.1) | 1412 (11.49) | 755 (10.57) | 550 (9.7) | 856 (10.98) | 663 (9.5) | 705 (10.96) |
24 to 35 months | 4660 (30.74) | 3416 (27.8) | 1806 (25.27) | 1297 (22.86) | 2520 (32.32) | 1885 (27.02) | 1496 (23.25) |
> 35 months | 6123 (40.38) | 4766 (38.78) | 2909 (40.69) | 2434 (42.89) | 2691 (34.51) | 2843 (40.75) | 2599 (40.4) |
Delivery type | |||||||
Skilled delivery | 10,099 (66.61) | 10,888 (88.6) | 4206 (58.84) | 4147 (73.07) | 4905 (62.91) | 2836 (40.65) | 3580 (55.65) |
Unskilled delivery | 5062 (33.39) | 1401 (11.4) | 2943 (41.16) | 1528 (26.93) | 2893 (37.09) | 4141 (59.35) | 2853 (44.35) |
Delivery mode | |||||||
SVD | 14,871 (98.08) | 11,597 (94.37) | 6951 (97.23) | 4954 (87.3) | 7641 (97.99) | 6806 (97.56) | 6185 (96.16) |
Caesarea | 291 (1.92) | 692 (5.63) | 198 (2.77) | 721 (12.7) | 157 (2.01) | 170 (2.44) | 247 (3.84) |
Death status | |||||||
Alive | 13,828 (91.2) | 11,725 (95.4) | 6567 (91.86) | 5423 (95.56) | 7498 (96.15) | 6386 (91.53) | 5988 (93.09) |
Dead | 1334 (8.8) | 565 (4.6) | 582 (8.14) | 252 (4.44) | 300 (3.85) | 591 (8.47) | 444 (6.91) |
Characteristics | Mali | Nigeria | Niger | Sierra Leone | Togo | Overall | |
Total | 9964 | 30,540 | 12,767 | 8359 | 6581 | 129,693 | |
Mothers’ characteristic | |||||||
Current age (mean + S.E) | 28.51 ± 0.1 | 29.38 ± 0.07 | 28.88 ± 0.11 | 28.91 ± 0.12 | 30.07 ± 0.11 | 29.13 ± 0.03 | |
Current age group | |||||||
15–19 | 739 (7.42) | 1531 (5.01) | 728 (5.7) | 830 (9.93) | 240 (3.64) | 7577 (5.84) | |
20–24 | 2112 (21.2) | 5961 (19.52) | 2714 (21.26) | 1696 (20.29) | 1150 (17.48) | 27,064 (20.87) | |
25–29 | 2846 (28.57) | 8510 (27.86) | 3534 (27.68) | 2085 (24.94) | 1857 (28.22) | 35,744 (27.56) | |
30–34 | 2128 (21.36) | 6702 (21.95) | 2805 (21.97) | 1586 (18.97) | 1540 (23.41) | 28,114 (21.68) | |
35–39 | 1347 (13.52) | 4747 (15.54) | 1822 (14.27) | 1313 (15.71) | 1101 (16.74) | 19,152 (14.77) | |
40–44 | 600 (6.03) | 2228 (7.3) | 855 (6.7) | 536 (6.42) | 496 (7.53) | 8925 (6.88) | |
45–49 | 191 (1.92) | 861 (2.82) | 310 (2.43) | 313 (3.75) | 196 (2.97) | 3118 (2.4) | |
Age at first birth (mean + S.E) | 18.61 ± 0.07 | 19.32 ± 0.07 | 18.04 ± 0.05 | 18.75 ± 0.06 | 20.33 ± 0.08 | 19.1 ± 0.02 | |
Age at first birth group | |||||||
< 15 | 1151 (11.55) | 2469 (8.09) | 1159 (9.08) | 836 (10) | 265 (4.03) | 9770 (7.53) | |
15–19 | 5374 (53.94) | 15,784 (51.68) | 8190 (64.15) | 4557 (54.52) | 2836 (43.1) | 69,898 (53.89) | |
20–24 | 2673 (26.83) | 8599 (28.16) | 2774 (21.73) | 2305 (27.57) | 2566 (38.99) | 37,775 (29.13) | |
25–29 | 595 (5.97) | 2907 (9.52) | 562 (4.4) | 541 (6.47) | 713 (10.83) | 9882 (7.62) | |
30–34 | 140 (1.41) | 678 (2.22) | 80 (0.62) | 104 (1.24) | 178 (2.71) | 2032 (1.57) | |
> 34 | 30 (0.31) | 103 (0.34) | 1 (0.01) | 16 (0.19) | 22 (0.34) | 336 (0.26) | |
Highest educational level | |||||||
No education | 8283 (83.13) | 15,093 (49.42) | 10,963 (85.87) | 5574 (66.69) | 2681 (40.74) | 82,958 (63.96) | |
Primary | 896 (8.99) | 5879 (19.25) | 1268 (9.93) | 1167 (13.96) | 2407 (36.57) | 22,230 (17.14) | |
Secondary | 717 (7.2) | 7826 (25.62) | 497 (3.89) | 1504 (17.99) | 1392 (21.16) | 21,390 (16.49) | |
Higher | 67 (0.67) | 1742 (5.7) | 39 (0.3) | 114 (1.36) | 101 (1.53) | 3115 (2.4) | |
Current employment status | |||||||
Not currently employed | 5641 (56.62) | 9500 (31.11) | 9876 (77.36) | 2064 (24.7) | 1327 (20.17) | 47,078 (36.3) | |
Currently employed | 4323 (43.38) | 21,040 (68.89) | 2891 (22.64) | 6294 (75.3) | 5253 (79.83) | 82,615 (63.7) | |
Marital status | |||||||
Not current married | 251 (2.52) | 1289 (4.22) | 238 (1.86) | 1313 (15.7) | 476 (7.23) | 9136 (7.04) | |
Currently married/union | 9712 (97.48) | 29,251 (95.78) | 12,529 (98.14) | 7046 (84.3) | 6105 (92.77) | 120,557 (92.96) | |
Residence | |||||||
Urban | 1932 (19.39) | 10,617 (34.76) | 1630 (12.77) | 2265 (27.1) | 2363 (35.9) | 40,351 (31.11) | |
Rural | 8032 (80.61) | 19,924 (65.24) | 11,137 (87.23) | 6094 (72.9) | 4218 (64.1) | 89,342 (68.89) | |
Wealth | |||||||
Poorest | 2029 (20.36) | 7248 (23.73) | 2526 (19.79) | 1850 (22.13) | 1441 (21.9) | 28,492 (21.97) | |
Poorer | 2075 (20.83) | 7104 (23.26) | 2597 (20.34) | 1760 (21.06) | 1316 (20) | 28,092 (21.66) | |
Middle | 2053 (20.6) | 5758 (18.85) | 2671 (20.92) | 1734 (20.74) | 1304 (19.82) | 26,043 (20.08) | |
Richer | 2106 (21.14) | 5392 (17.66) | 2749 (21.53) | 1643 (19.65) | 1284 (19.52) | 25,378 (19.57) | |
Richest | 1700 (17.07) | 5039 (16.5) | 2224 (17.42) | 1372 (16.42) | 1234 (18.76) | 21,688 (16.72) | |
Religion | |||||||
Christian | 416 (4.18) | 11,185 (36.62) | – | 1537 (18.39) | 3429 (52.11) | 40,835 (31.49) | |
Muslim | 9198 (92.32) | 19,066 (62.43) | – | 6797 (81.32) | 1224 (18.6) | 67,315 (51.9) | |
No religion | 243 (2.44) | – | – | 4 (0.04) | 622 (9.46) | 3393 (2.62) | |
Other religion | 106 (1.07) | 9 (0.03) | – | 17 (0.21) | 4 (0.06) | 2001 (1.54) | |
Tradition | – | 281 (0.92) | – | 3 (0.04) | 1301 (19.77) | 3381 (2.61) | |
Child characteristics | |||||||
Birth type | |||||||
Singleton | 9640 (96.75) | 29,475 (96.51) | 12,338 (96.64) | 8172 (97.77) | 6260 (95.13) | 124,759 (96.2) | |
Multiple | 324 (3.25) | 1065 (3.49) | 429 (3.36) | 186 (2.23) | 320 (4.87) | 4934 (3.8) | |
Sex of child | |||||||
Male | 5141 (51.59) | 15,399 (50.42) | 6448 (50.51) | 4126 (49.36) | 3320 (50.45) | 65,826 (50.76) | |
Female | 4823 (48.41) | 15,142 (49.58) | 6319 (49.49) | 4233 (50.64) | 3261 (49.55) | 63,867 (49.24) | |
Child size at birth | |||||||
Large | 4313 (43.29) | 13,350 (43.71) | 2374 (18.59) | 3731 (44.63) | 2228 (33.86) | 49,601 (38.24) | |
Average | 4295 (43.11) | 12,531 (41.03) | 7059 (55.29) | 3196 (38.24) | 3274 (49.75) | 58,713 (45.27) | |
Small | 1355 (13.6) | 4659 (15.26) | 3334 (26.11) | 1432 (17.13) | 1079 (16.39) | 21,379 (16.48) | |
Birth order | |||||||
1st-3rd | 5172 (51.91) | 15,716 (51.46) | 5371 (42.07) | 4444 (53.17) | 3901 (59.29) | 69,525 (53.61) | |
4th–6th | 3526 (35.39) | 9705 (31.78) | 4456 (34.9) | 2783 (33.29) | 2018 (30.66) | 41,850 (32.27) | |
7th + chi | 1265 (12.7) | 5120 (16.76) | 2940 (23.03) | 1131 (13.54) | 662 (10.05) | 18,318 (14.12) | |
Preceding birth interval | |||||||
< 12 months | 1948 (19.55) | 6135 (20.09) | 1932 (15.14) | 1763 (21.09) | 1584 (24.07) | 26,925 (20.76) | |
11 to 23 months | 1563 (15.69) | 5481 (17.95) | 2397 (18.77) | 896 (10.72) | 638 (9.7) | 17,449 (13.45) | |
24 to 35 months | 2887 (28.97) | 9630 (31.53) | 4724 (37) | 2199 (26.31) | 1597 (24.27) | 38,118 (29.39) | |
> 35 months | 3566 (35.79) | 9295 (30.43) | 3714 (29.09) | 3500 (41.88) | 2761 (41.96) | 47,201 (36.39) | |
Delivery type | |||||||
Skilled delivery | 5624 (56.44) | 10,831 (35.46) | 3801 (29.77) | 4812 (57.57) | 4800 (72.95) | 70,529 (54.38) | |
Unskilled delivery | 4340 (43.56) | 19,709 (64.54) | 8966 (70.23) | 3547 (42.43) | 1780 (27.05) | 59,163 (45.62) | |
Delivery mode | |||||||
SVD | 9690 (97.25) | 29,910 (97.93) | 12,584 (98.56) | 8016 (95.91) | 6144 (93.36) | 125,350 (96.65) | |
Caesarea | 274 (2.75) | 631 (2.07) | 183 (1.44) | 342 (4.09) | 437 (6.64) | 4343 (3.35) | |
Death status | |||||||
Alive | 9268 (93.02) | 27,898 (91.35) | 11,738 (91.94) | 7703 (92.16) | 6206 (94.31) | 120,228 (92.7) | |
Dead | 695 (6.98) | 2643 (8.65) | 1029 (8.06) | 656 (7.84) | 375 (5.69) | 9465 (7.3) |
Under-five mortality rates per 1000 livebirths
Model evaluation and cross validation checks
Models | DIC | BF |
---|---|---|
M1 | 58,449.67 | – |
M2 | 57,975.33 | 261.74 |
M3 | 57,183.99 | 578.34 |
M4 | 58,440.43 | 29.02 |
M5 | 57,977.01 | 299.73 |
M6 | 57,146.23 | 641.48 |
Predictors of under-5 mortality in West Africa
Burkina Faso | Benin | Cote D’lvoire | Ghana | Gambia | Guinea | Liberia | |
Characteristics | HR [95% CI] | HR [95% CI] | HR [95% CI] | HR [95% CI] | HR [95% CI] | HR [95% CI] | HR [95% CI] |
Mothers’ characteristics | |||||||
Mother’s current age | |||||||
15–19 | 1.82 [1.28–2.23]* | 1.08 [0.86–1.33] | 1.23 [1.07–1.41]* | 0.99 [0.70–1.29] | 4.51 [3.28–6.03]* | 1.78 [1.29–2.4]* | 1.24 [0.94–1.59] |
20–24 | 1.00 [0.77–1.28] | 1.86 [1.57–2.18]* | 0.6 [0.51–0.69]* | 1.18 [0.90–1.5] | 1.44 [1.11–1.79]* | 1.12 [1.02–1.26]* | 0.99 [0.77–1.25] |
25–29 | 1.20 [0.94–1.50] | 1.23 [1.06–1.42]* | 0.74 [0.65–0.84]* | 1.30 [0.96–1.72] | 1.52 [1.22–1.84]* | 1.26 [1.11–1.44]* | 0.90 [0.78–1.03] |
30–34 | 0.98 [0.76–1.17] | 1.47 [1.21–1.75]* | 0.85 [0.70–1.01] | 1.72 [1.44–2.01]* | 0.81 [0.58–1.07] | 0.63 [0.55–0.73]* | 0.94 [0.83–1.05] |
35–39 | 1.07 [0.80–1.34] | 1.01 [0.84–1.22] | 1.49 [1.28–1.73]* | 0.80 [0.53–1.14] | 0.81 [0.64–1.03] | 0.57 [0.46–0.70]* | 0.56 [0.44–0.69]* |
40–44 | 0.88 [0.70–1.09] | 1.63 [1.34–1.97]* | 0.93 [0.71–1.18] | 0.88 [0.58–1.28] | 2.20 [1.66–2.84]* | 0.72 [0.65–0.79]* | 0.60 [0.53–0.68]* |
45–49 | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
Mother’s age at first birth | |||||||
< 15 years | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
15–19 years | 1.00 [0.74–1.43] | 1.52 [1.37–1.69]* | 1.04 [0.88–1.21] | 1.19 [0.92–1.57] | 0.32 [0.27–0.37]* | 1.02 [0.86–1.20] | 1.18 [0.99–1.37] |
20–24 years | 1.00 [0.76–1.27] | 1.70 [1.41–2.03]* | 0.89 [0.75–1.04] | 1.47 [1.23–1.76]* | 0.19 [0.14–0.27]* | 1.50 [1.26–1.78]* | 1.3 [1.08–1.54]* |
25–29 years | 1.06 [0.71–1.71] | 1.31 [1.13–1.51]* | 0.51 [0.44–0.59]* | 1.52 [1.10–2.00]* | 0.36 [0.26–0.49]* | 1.79 [1.37–2.23]* | 0.93 [0.76–1.14] |
30–34 years | 0.68 [0.20–1.49] | 0.33 [0.26–0.41]* | 1.11 [0.85–1.41] | 1.45 [1.12–1.84]* | 0.62 [0.47–0.82]* | 0.42 [0.36–0.50]* | 1.00 [0.79–1.25] |
> 34 years | 1.15 [0.55–2.44] | 0.78 [0.65–0.92]* | 1.53 [1.25–1.84]* | 1.64 [1.13–2.32]* | 1.33 [0.97–1.81] | 0.53 [0.44–0.62]* | 0.45 [0.35–0.58]* |
Highest level of education | |||||||
No education | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
Primary | 0.81 [0.71–0.92] | 0.85 [0.73–0.97]* | 1.18 [1.01–1.37]* | 0.91 [0.73–1.13] | 1.26 [0.86–1.76] | 1.02 [0.88–1.17] | 0.77 [0.63–0.94]* |
Secondary | 0.84 [0.76–0.92] | 0.86 [0.72–1.01] | 0.64 [0.46–0.86]* | 0.66 [0.51–0.84]* | 1.07 [0.701–1.51] | 0.67 [0.56–0.80]* | 0.80 [0.67–0.96]* |
Tertiary | 1.64 [1.33–2.03] * | 0.89 [0.72–1.07] | 0.52 [0.37–0.72]* | 1.43 [0.89–2.13] | 2.40 [1.27–4.18]* | 0.90 [0.71–1.15] | 1.16 [0.79–1.68] |
Current employment status | |||||||
Currently employed | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
Currently unemployed | 1.22 [1.02–1.43]* | 1.21 [1.03–1.39]* | 0.93 [0.82–1.06] | 0.96 [0.76–1.21] | 0.78 [0.63–0.97]* | 0.59 [0.52–0.67]* | 1.11 [1.04–1.18]* |
Marital status | |||||||
Not currently married | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
Currently married/union | 0.65 [0.48–0.84]* | 0.65 [0.56–0.75]* | 0.99 [0.86–1.14] | 0.52 [0.35–0.71]* | 0.63 [0.43–0.93]* | 0.49 [0.4–0.61]* | 0.62 [0.53–0.71]* |
Residence | |||||||
urban | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
Rural | 1.3 [1.06–1.61]* | 1.82 [1.57–2.09]* | 1.44 [1.21–1.68]* | 1.05 [0.84–1.32] | 0.16 [0.12–0.2]* | 0.62 [0.51–0.73]* | 0.96 [0.78–1.18] |
Wealth | |||||||
Poorest | 1.53 [1.23–1.8]* | 0.91 [0.79–1.08] | 1.17 [0.96–1.4] | 0.86 [0.64–1.12] | 0.99 [0.73–1.29] | 1.09 [0.97–1.23] | 1.08 [0.94–1.24] |
Poorer | 1.62 [1.35–1.99]* | 0.83 [0.73–0.94]* | 0.77 [0.66–0.89]* | 0.99 [0.72–1.3] | 0.54 [0.36–0.74]* | 1.16 [1.01–1.32]* | 1.3 [1.14–1.49]* |
Middle | 1.38 [1.12–1.71]* | 0.97 [0.84–1.08] | 1.04 [0.87–1.24] | 1.23 [0.95–1.58] | 0.79 [0.53–1.11] | 1.18 [1.00–1.37] | 1.49 [1.25–1.72]* |
Richer | 1.38 [1.14–1.71]* | 0.69 [0.6–0.78]* | 1.14 [0.97–1.32] | 1.32 [1.08–1.6]* | 0.51 [0.39–0.65]* | 0.45 [0.37–0.52]* | 1.05 [0.90–1.22] |
Richest | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
Religion | |||||||
Christian | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
Muslim | 1.12 [0.96–1.29] | 0.78 [0.68–0.90]* | 1.19 [1.02–1.38]* | 1.45 [1.10–1.87]* | 0.13 [0.11–0.17]* | 1.01 [0.87–1.18] | 1.71 [1.39–2.09]* |
No religion | 1.17 [0.56–1.90] | 0.58 [0.52–0.65]* | 0.96 [0.79–1.14] | 1.13 [0.90–1.45] | 1.84 [1.49–2.3]* | 2.50 [1.90–3.19]* | 0.99 [0.78–1.23] |
Other religion | 0.48 [0.19–1.04] | 1.45 [1.17–1.79]* | 1.02 [0.9–1.15] | – | – | 5.76 [4.74–6.86]* | 1.05 [0.77–1.41] |
Traditional | 1.49 [1.18–1.88]* | 1.18 [0.57–2.05] | – | 1.71 [1.15–2.51]* | – | – | 0.01 [0.00–0.02]* |
Child characteristics | |||||||
Birth type | |||||||
Singleton | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
Multiple | 2.83 [2.41–3.19]* | 2.47 [2.09–2.87]* | 1.79 [1.45–2.19]* | 2.29 [1.68–3.07]* | 1.22 [0.89–1.59] | 1.89 [1.49–2.38]* | 2.23 [1.73–2.8]* |
Sex | |||||||
Female | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
Male | 1.1 [0.95–1.24] | 1.36 [1.2–1.54]* | 1.18 [1.04–1.34]* | 1.2 [0.97–1.49] | 0.84 [0.63–1.09] | 1.22 [1.07–1.39]* | 1.16 [1.01–1.31]* |
Child size at birth | |||||||
Large | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
Average | 1.26 [1.00–1.49] | 0.94 [0.81–1.08] | 1.10 [0.92–1.29] | 0.80 [0.67–0.94]* | 0.76 [0.58–0.96]* | 1.28 [1.06–1.5]* | 0.96 [0.79–1.16] |
Small | 1.37 [0.98–1.71] | 1.66 [1.39–1.95]* | 0.98 [0.87–1.09] | 1.63 [1.33–1.96]* | 0.71 [0.57–0.87]* | 1.49 [1.23–1.79]* | 1.32 [1.09–1.57]* |
Birth order | |||||||
1st-3rd child | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
4th–6th child | 0.99 [0.75–1.22] | 1.39 [1.18–1.62]* | 0.76 [0.66–0.88]* | 1.30 [1.07–1.58]* | 0.86 [0.65–1.13] | 1.46 [1.3–1.64]* | 1.07 [0.9–1.28] |
7th + child | 1.21 [0.86–1.66] | 2.41 [2.19–2.65]* | 0.51 [0.44–0.59]* | 1.85 [1.3–2.56]* | 0.68 [0.53–0.86]* | 1.41 [1.23–1.61]* | 0.93 [0.82–1.04] |
Preceding birth interval | |||||||
< 12 months | 1.46 [1.18–1.79]* | 0.94 [0.84–1.06] | 1.07 [0.89–1.26] | 0.98 [0.79–1.19] | 0.60 [0.49–0.73]* | 0.81 [0.74–0.89]* | 1.24 [1.1–1.41]* |
11 to 23 months | 2.35 [1.95–2.83]* | 1.81 [1.5–2.16]* | 1.86 [1.62–2.12]* | 1.08 [0.89–1.33] | 1.56 [1.35–1.79]* | 1.29 [1.09–1.53]* | 1.73 [1.41–2.1]* |
24 to 35 months | 1.81 [1.56–2.10]* | 1.12 [0.98–1.28] | 1.13 [1.01–1.27]* | 1.01 [0.74–1.34] | 0.65 [0.52–0.82]* | 1.26 [1.10–1.44]* | 1.3 [1.10–1.53]* |
> 35 months | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
Type of delivery | |||||||
Skilled | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
Unskilled | 1.20 [1.03–1.38]* | 0.88 [0.68–1.09] | 1.20 [1.05–1.39]* | 1.59 [1.29–1.9]* | 1.73 [1.26–2.32]* | 1.52 [1.33–1.71]* | 1.32 [1.18–1.46]* |
Delivery mode | |||||||
SVD | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] |
Caesarean | 0.68 [0.5–0.94]* | 0.96 [0.71–1.23] | 0.91 [0.71–1.13] | 1.49 [1.17–1.84]* | 1.66 [1.3–2.08]* | 1.96 [1.64–2.32]* | 0.77 [0.62–0.92]* |
Country | |||||||
Ghana | – | – | – | – | – | – | – |
Burkina Faso | – | – | – | – | – | – | – |
Benin | – | – | – | – | – | – | – |
Cote D’Ivoire | – | – | – | – | – | – | – |
Gambia | – | – | – | – | – | – | – |
Guinea | – | – | – | – | – | – | – |
Liberia | – | – | – | – | – | – | – |
Mali | – | – | – | – | – | – | – |
Nigeria | – | – | – | – | – | – | – |
Niger | – | – | – | – | – | – | – |
Serria Leone | – | – | – | – | – | – | – |
Togo | – | – | – | – | – | – | – |
Gamma | −0.04 [−0.04–0.03]* | −0.05 [−0.06--0.04]* | −0.05 [−0.06--0.04]* | −0.05 [− 0.07--0.04]* | −0.07 [− 0.09--0.05]* | −0.04 [− 0.05--0.03]* | −0.05 [− 0.06--0.04]* |
ln (theta) | −7.75 [−47.5–1.65]* | −0.41 [− 0.96–0.04]* | −1.2 [−1.98--0.62]* | − 70.28 [− 223.76--0.54]* | 0.8 [0.13–1.4] | − 0.94 [− 1.65--0.39]* | −63.19 [− 209.6--1.23]* |
Mali | Nigeria | Niger | Serria Leone | Togo | Overall | ||
Characteristics | HR [95% CI] | HR [95% CI] | HR [95% CI] | HR [95% CI] | HR [95% CI] | HR [95% CI] | |
Mothers’ characteristics | |||||||
Mother’s current age | |||||||
15–19 | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | |
20–24 | 1.23 [0.98–1.68] | 0.69 [0.65–0.75]* | 0.45 [0.37–0.54]* | 1.95 [1.58–2.4]* | 1.93 [1.29–2.74]* | 1.59 [1.54–1.64]* | |
25–29 | 1.25 [0.93–1.6] | 0.73 [0.67–0.8]* | 0.59 [0.52–0.67]* | 1.37 [1.15–1.59]* | 1.06 [0.85–1.31] | 1.43 [1.37–1.49]* | |
30–34 | 1.19 [0.94–1.51] | 0.67 [0.63–0.71]* | 0.50 [0.45–0.57]* | 1.14 [0.89–1.46] | 0.79 [0.66–0.93]* | 1.32 [1.27–1.4]* | |
35–39 | 1.2 0 [0.93–1.60] | 0.83 [0.76–0.90]* | 0.50 [0.43–0.58]* | 0.99 [0.80–1.20] | 0.84 [0.72–0.95]* | 1.11 [1.09–1.15]* | |
40–44 | 1.34 [0.92–1.84] | 1.14 [1.08–1.20]* | 0.63 [0.55–0.71]* | 1.40 [1.18–1.71]* | 0.79 [0.65–0.95]* | 1.09 [1.05–1.13]* | |
45–49 | 2.15 [1.7–2.63]* | 0.80 [0.72–0.88]* | 0.43 [0.36–0.51]* | 0.96 [0.76–1.20] | 1.02 [0.74–1.39] | 1.08 [1.02–1.18]* | |
Mother’s age at first birth | |||||||
< 15 years | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | |
15–19 years | 0.91 [0.75–1.12] | 0.92 [0.88–0.96]* | 0.98 [0.84–1.14] | 0.93 [0.8–1.09] | 0.69 [0.54–0.87]* | 1.2 [1.18–1.22]* | |
20–24 years | 0.84 [0.68–1.03] | 0.90 [0.84–0.96]* | 0.89 [0.75–1.04] | 1.05 [0.88–1.24] | 0.73 [0.63–0.84]* | 1.15 [1.11–1.18]* | |
25–29 years | 0.84 [0.63–1.12] | 0.76 [0.71–0.81]* | 0.74 [0.64–0.84]* | 0.91 [0.75–1.1] | 0.47 [0.33–0.64]* | 1.28 [1.20–1.36]* | |
30–34 years | 1.17 [0.84–1.67] | 0.96 [0.91–1.02] | 1.06 [0.97–1.15] | 0.84 [0.69–1.01] | 0.76 [0.6–0.98]* | 1.62 [1.44–1.84]* | |
> 34 years | 1.68 [1.35–2.16]* | 0.99 [0.92–1.06] | 0.83 [0.72–0.95]* | 1.04 [0.86–1.22] | 2.48 [1.79–3.22]* | 2.52 [2.43–2.64]* | |
Highest level of education | |||||||
No education | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | |
Primary | 1.21 [1.06–1.40]* | 0.97 [0.88–1.07] | 0.85 [0.71–1.12] | 1.22 [1.02–1.48]* | 1.13 [0.97–1.33] | 0.91 [0.89–0.94]* | |
Secondary | 0.96 [0.69–1.29] | 0.85 [0.75–0.95]* | 0.94 [0.71–1.20] | 1.35 [1.24–1.48]* | 0.75 [0.61–0.93] | 0.73 [0.69–0.76]* | |
Tertiary | 0.99 [0.84–1.16] | 0.84 [0.78–0.92]* | 0.53 [0.34–0.78]* | 0.61 [0.38–0.89]* | 0.98 [0.77–1.23] | 0.82 [0.78–0.86]* | |
Current employment status | |||||||
Currently employed | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | |
Currently unemployed | 0.74 [0.61–0.92]* | 0.94 [0.86–1.03] | 0.96 [0.82–1.11] | 0.59 [0.48–0.74]* | 1.16 [0.91–1.47] | 0.90 [0.84–0.95]* | |
Marital status | |||||||
Not currently married | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1. [reference] | |
Currently married/union | 0.47 [0.37–0.59]* | 0.94 [0.9–0.98]* | 0.3 [0.24–0.37]* | 0.68 [0.54–0.86]* | 1.46 [1.09–1.89]* | ||
Residence | |||||||
Urban | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | |
Rural | 1.77 [1.41–2.14]* | 1.34 [1.23–1.46]* | 5 [4.49–5.52]* | 1.2 [0.94–1.46] | 0.86 [0.71–1.03] | 1.45 [1.37–1.55]* | |
Wealth | |||||||
Poorest | 1.80 [1.44–2.25]* | 0.63 [0.6–0.66]* | 0.85 [0.73–0.98]* | 0.76 [0.61–0.94]* | 1.61 [1.47–1.77]* | 0.78 [0.74–0.82]* | |
Poorer | 1.21 [0.94–1.52] | 0.67 [0.64–0.71]* | 1.08 [0.93–1.25] | 0.97 [0.75–1.26] | 1.5 [1.27–1.74]* | 0.93 [0.91–0.96]* | |
Middle | 1.61 [1.37–1.88]* | 0.64 [0.59–0.7]* | 1.00 [0.83–1.20] | 0.94 [0.75–1.16] | 0.82 [0.67–0.99]* | 0.87 [0.82–0.92]* | |
Richer | 1.14 [0.96–1.39] | 0.67 [0.64–0.71]* | 1.02 [0.88–1.16] | 0.95 [0.76–1.15] | 0.81 [0.62–1.06] | 0.87 [0.83–0.90]* | |
Richest | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | |
Religion | |||||||
Christian | 1.00 [reference] | 1.00 [reference] | – | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | |
Muslim | 0.79 [0.55–1.08] | 0.88 [0.81–0.96]* | – | 0.97 [0.83–1.12] | 1.14 [0.94–1.32] | 1.25 [1.17–1.35]* | |
No religion | 1.28 [0.97–1.89] | – | – | 0.36 [0.25–0.52]* | 0.69 [0.59–0.79]* | 2.22 [2.08–2.37]* | |
Other religion | 0.94 [0.69–1.18] | 0.67 [0.63–0.72]* | – | 1.77 [1.3–2.28]* | 1.43 [1.09–1.87]* | 2.01 [1.68–2.45]* | |
Traditional | – | 0.43 [0.39–0.47]* | – | 0.04 [0.00–0.18]* | 1.07 [0.78–1.43] | 1.39 [1.26–1.54]* | |
Child characteristics | |||||||
Birth type | |||||||
Singleton | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | |
Multiple | 2.26 [1.80–2.83]* | 1.03 [0.96–1.10] | 2.93 [2.46–3.49]* | 0.93 [0.79–1.08] | 1.51 [1.15–1.93]* | 2.81 [2.60–3.02]* | |
Sex | |||||||
Female | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | |
Male | 1.25 [1.04–1.47]* | 1.1 [1.05–1.16]* | 0.88 [0.81–0.94]* | 1.12 [0.94–1.31] | 1.01 [0.85–1.19] | 1.14 [1.10–1.18]* | |
Child size at birth | |||||||
Large | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | |
Average | 1.11 [0.95–1.34] | 1.13 [1.06–1.21]* | 1.02 [0.91–1.15] | 0.99 [0.86–1.15] | 1.15 [0.94–1.37] | 1.12 [1.06–1.17]* | |
Small | 1.43 [1.14–1.79]* | 1.43 [1.35–1.52]* | 1.03 [0.9–1.17] | 1.53 [1.26–1.82]* | 1.6 [1.29–1.93]* | 1.48 [1.43–1.52]* | |
Birth order | |||||||
1st-3rd child | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | |
4th–6th child | 0.91 [0.78–1.05] | 0.82 [0.75–0.88]* | 0.96 [0.82–1.12] | 1.09 [0.85–1.35] | 1.12 [0.90–1.39] | 1.32 [1.28–1.36]* | |
7th + child | 1.12 [0.95–1.28] | 0.78 [0.73–0.83]* | 0.82 [0.7–0.95]* | 1.74 [1.44–2.08]* | 0.72 [0.58–0.89]* | 1.62 [1.52–1.70]* | |
Preceding birth interval | |||||||
< 12 months | 2.42 [1.82–3.40]* | 1.21 [1.1–1.32]* | 1.24 [1.10–1.40]* | 1.37 [1.08–1.72]* | 0.78 [0.66–0.93]* | 1.58 [1.49–1.66]* | |
11 to 23 months | 2.64 [2.03–3.40]* | 1.88 [1.69–2.09]* | 1.15 [0.99–1.33] | 2.15 [1.69–2.66]* | 1.97 [1.59–2.43]* | 2.01 [1.90–2.11]* | |
24 to 35 months | 1.85 [1.45–2.31]* | 1.26 [1.15–1.38]* | 0.99 [0.84–1.15] | 1.40 [1.22–1.60]* | 1.65 [1.42–1.91]* | 1.39 [1.34–1.44]* | |
> 35 months | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | |
Type of delivery | |||||||
Skilled | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | |
Unskilled | 0.84 [0.68–1.00] | 1.25 [1.15–1.36]* | 0.80 [0.71–0.90]* | 0.92 [0.78–1.08] | 1.24 [1.01–1.54]* | 1.15 [1.08–1.22]* | |
Delivery mode | |||||||
SVD | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | 1.00 [reference] | |
Caesarean | 1.24 [0.92–1.61] | 0.25 [0.22–0.28]* | 1.11 [0.91–1.34] | 0.68 [0.54–0.83]* | 0.76 [0.59–0.98]* | 1.04 [0.94–1.14] | |
Country | |||||||
Ghana | – | – | – | – | – | 1.00 [reference] | |
Burkina Faso | – | – | – | – | – | 1.65 [1.56–1.74]* | |
Benin | – | – | – | – | – | 0.67 [0.64–0.7]* | |
Cote D’Ivoire | – | – | – | – | – | 0.75 [0.7–0.79]* | |
Gambia | – | – | – | – | – | 0.74 [0.67–0.8]* | |
Guinea | – | – | – | – | – | 0.84 [0.74–0.93]* | |
Liberia | – | – | – | – | – | 1.47 [1.36–1.58]* | |
Mali | – | – | – | – | – | 1.19 [1.06–1.33]* | |
Nigeria | – | – | – | – | – | 1.65 [1.54–1.77]* | |
Niger | – | – | – | – | – | 1.51 [1.38–1.64]* | |
Serria Leone | – | – | – | – | – | 1.86 [1.69–2.03]* | |
Togo | – | – | – | – | – | 0.92 [0.79–1.03] | |
Gamma | −0.03 [−0.04--0.02]* | −0.04 [−0.04−−0.03]* | -0.03 [− 0.03--0.02]* | − 0.05 [− 0.06--0.04]* | −0.03 [− 0.04--0.02]* | −0.04 [− 0.04--0.03]* | |
ln (theta) | −1.07 [−1.91--0.49]* | −1.47 [−1.85--1.16]* | −0.88 [− 1.34--0.5]* | −79.42 [− 220.4--3.38]* | −74.32 [−228.84--1.29]* | −1.17 [− 1.34--1]* |