Unlocking the Puzzle: Under-Five Mortality and Its Determinants in Africa". A Systematic Review

Purpose Mortality among children under five is a critical measure of public health, amenable to preventive interventions. Despite global strides in reducing fatalities in this age group, disparities persist, notably in Sub-Saharan Africa.This study aimed to systematize knowledge on factors contributing to under-five mortality in Africa, emphasizing sociodemographic and health aspects. Methods A systematic review was conducted adhering to PRISMA guidelines. Articles were sourced from Lilacs, Scielo, and Medline via PubMed, BVS Google Scholar, and grey literature. Keywords and Boolean operators facilitated relevant study retrieval. Articles on children under five, published between January 2013 and December 2022, in English, Portuguese, or Spanish, in peer-reviewed journals were included. Methodological quality assessment utilized the Joanna Briggs Institute tool. Results Among 694 identified studies, only 30 met inclusion criteria. Socioeconomic factors like poverty and maternal education, alongside maternal age extremes, multiparity, inadequate prenatal care, and low birth weight, emerged as primary determinants of child mortality. Conclusion Addressing social disparities, particularly through maternal education and improved primary healthcare services, is crucial for curbing under five mortality in Africa.