Factors associated with under-five child mortality in Kenya: a systematic review and meta-analysis

Abstract

Introduction Notwithstanding the notable progression in reducing the under-five child mortality in Kenya, the rate remains above the global target. The mortality levels in the under-five population is associated with various socioeconomic, environmental and demographic factors. Studies have been conducted using demographic and health surveys yielding inconclusive results on determinants of under-five mortality in Kenya. Consequently, this study involves systematic review and metaanalysis synthesis of results in existing studies on factors associated with under five mortality in Kenya. Method International electronic databases including Google scholar, Research gate, PubMed, Cochrane Library and other local like university of Nairobi repository were searched systematically. All identified studies written in English and reported the determinants of under-five mortality in Kenya were considered as per inclusion criteria. Data were extracted on excel sheets and transferred to the paper on tables. The associations between the factors and under-five mortality were examined and meta-analysis done by Mantel-Haenszel method using R statistical software version 4.0.3. Results After a review of retrieved 37 articles, 8 studies satisfied the criteria for inclusion and were incorporated in review and meta-analyzing the results. Three studies were meta-analyzed. The review revealed high under-five mortality in rural Kenya compared to urban Kenya (RˆR=1.05,95%CI,0.89;1.25). Although the point estimate shows an increased risk of 5%, the confidence interval differs by indicating no statistical difference between factors associated with under-five mortality. Although previous studies have pointed different factors as having more effect to under-five mortality such as maternal education, this study however, found no significant difference between factors associated with under-five mortality in Kenya. Conclusion In this review and meta-analysis, the correlation of under-five mortality and factors under examination showed no significant difference between them. Additionally, under-five population deaths are above the global target.