Socioeconomic, demographic and environmental factors associated with under-five mortality among children in Kenya: Analysis of 2022 Kenya Demographic and Health Survey

Background: Under-five mortality remains a critical public health challenge globally, particularly in low- and middle-income countries such as Kenya. Despite recent declines in mortality rates, Kenya continues to face a high burden of child deaths due to preventable or treatable conditions such as pneumonia, malaria, and malnutrition. This study aimed to assess the predictors of under-five mortality in Kenya using nationally representative data, in order to inform evidence-based interventions and policies . Methods: This is a cross-sectional study that utilized the Kenyan demographic and health survey dataset of 2022. Data collection for this study was based on the 2022 Kenya Demographic and Health Survey (KDHS) dataset. The study focused on the relevant variables from the women's and household questionnaires to assess factors influencing under-five mortality, ensuring alignment with the study objectives. Data cleaning and analysis were performed using STATA 17 software. Descriptive, Univariate analysis, bivariate logistic and multivariate logistic regression were performed at p < 0.05 and 95% confidence interval. Results: A total of 19,530 children under five years were included in the analysis, with 694 reported deaths. The study found that second-born twins had a significantly higher mortality risk compared to first-born twins (AOR = 0.19), and mothers using modern contraceptives had 3.31 times higher odds of child mortality compared to those using folkloric methods (AOR = 3.31). Furthermore, shorter birth intervals were linked to higher risks, with those having two or more births in the last five years facing increased mortality odds. Conclusion: This study provides important insights into the factors influencing child mortality in Kenya. The findings highlight the significant role of being a second-born twin, antenatal care, family planning practices, and number of births in the last five years in determining child health outcomes. By addressing these factors through targeted interventions and improved healthcare practices, it is possible to make substantial progress in reducing under-five mortality rates. Our research contributes to the broader understanding of child mortality determinants and offers a foundation for future studies aimed at mitigating this critical public health issue.