Table 1.

Characteristics of included studies (n = 22).

First author	Year	Study design	Method(s)	Study area	Objective(s)	Data source and sample size	Factors associated with under-five child mortality
Abir [38]	2015	Cross-sectional	Multilevel models	Country-wide (Bangladesh)	To identify factors associated with mortality in children under 5 years of age	Bangladesh DHS 2004, 2007, and 2011 (combine) (n = 16,722 live births)	Working status of mother; working (AOR = 1.67, 95%CI = 1.34, 2.08, p value < 0.001), maternal highest level of education; secondary or more with Ref to no education (AOR = 0.41, CI = 0.26, 0.63; p value < 0.001), previous death of siblings; yes (AOR = 6.00, CI = 4.28, 8.40; p value < 0.001), no. of children under age 5 at home; 3 and above (AOR = 0.11, CI = 0.08, 0.15, p value < 0.001), TT vaccination at pregnancy; one TT with Ref to never (AOR = 0.74, CI = 0.56, 0.96; p value = 0.023), 2 and more TT (AOR = 0.53, CI = 0.42, 0.66, p value < 0.001), delivery complications; any complications with Ref to none (AOR = 0.66, CI = 0.53, 0.84, p value = 0.001), contraceptive use; yes (AOR = 0.33, CI = 0.27, 0.40, p value < 0.001), Mother's age at child birth; 30-39 with Ref to <20 (AOR = 1.64, CI = 1.01, 2.65, p value = 0.046), birth rank and birth interval; 2nd/3rd birth rank, ≤2 years interval with Ref to 2nd/3rd birth rank, ≤2 years interval (AOR = 2.18, CI = 1.48, 3.21, p value < 0.001), 4th birth rank, ≤2 years interval (AOR = 2.73, CI = 1.76, 4.23, p value < 0.001), birth place and mode of delivery; home with Ref to health facilities without caesarean (AOR = 0.58, CI = 0.41, 0.82, p value = 0.002)
Andegiorgish [32]	2022	Cross-sectional	Multilevel regression model	Country-wide (Zambia)	To describe the burden, trend, and associated factors of under-five mortality rate	Zambia DHS 2007, 2013-14, and 2018 (combine) (n = 29,274 live births)	Maternal age; 20-24 with Ref to 15-19 years (AOR = 0.74, p value < 0.05), 25-29 years (AOR = 0.61, p value < 0.01), 30-34 years (AOR = 0.63, p value < 0.05), wealth index; poorer with Ref to richest (AOR = 0.73, p value < 0.05), place of residence; rural with Ref to urban (AOR = 0.79, p value < 0.001), ANC visits; no ANC as compared to had at least one ANC visits (AOR = 3.17, p value < 0.001), birth type; multiple birth with Ref single (AOR = 2.54, p value < 0.001), size of child at birth; below average with Ref to average (AOR = 1.78, p value < 0.001), child sex; male with Ref to female (AOR = 1.28, p value < 0.001), regions; eastern with Ref to central (AOR = 1.52, p value < 0.01) Luapula (AOR = 1.50, p value < 0.01) Muchinga (AOR = 1.43, p value < 0.01)
Arku [28]	2016	Cross-sectional	Indirect demographic method and Bayesian spatial model	Country-wide (Ghana)	To estimate the under-five child mortality and its social and environmental risk factors	110 districts (10% random sample of Ghana's 2000 and 2010 National Population and Housing Census), and indirect demographic methods and Bayesian spatial model was used to estimate under-five mortality	Use of LPG in household for cooking (RR = 11.1%, 95%CI = 3.0%, 18.8%) associated with lower under-five mortality.
Ayele [22]	2015	Cross-sectional	Structured additive logistic regression model	Country-wide (Ethiopia)	To estimate the under-five mortality risk factors	Ethiopian DHS 2011 (n = 26,370 live births)	Distance to fetch water; 31-60 min. with Ref to on the premises (AOR = 1.076, CI = 1.030, 1.086) more than 60 min. (AOR = 1.096, CI = 1.013, 1.199), source of drinking water; tap water with Ref to unprotected water (AOR = 0.941, CI = 0.841, 0.986), cooking fuel; electricity/gas with Ref to straw/animal dung (AOR = 0.920, CI = 0.811, 0.986), type of toilet; no toilet facility with Ref to toilet with flush/pit latrine (AOR = 1.037, CI = 1.005, 1.157), other toilet type (AOR = 0.969, CI = 0.850, 0.998), type of floor; cement with Ref to wood (AOR = 1.281, CI = 1.072, 1.392), earth/sand/dung (AOR = 1.345, CI = 1.044, 1.466), type of roof; corrugated iron/metal with Ref to thatch/leaf/mud (AOR = 0.996, CI = 0.886, 0.998), mat/plastic sheet/wood (AOR = 0.998, CI = 0.979, 0.998), type of wall; cane/trunk/bamboo with Ref to wood planks/shingles (AOR = 0.811, CI = 0.801, 0.934), smoking habit; no (AOR = 0.807, CI = 0.601, 0.987), region, place of residence; rural (AOR = 1.094, CI = 1.014, 1.099), working status of mother; no (AOR = 0.957, CI = 0.837, 0.995), sex of child; female (AOR = 0.787, CI = 0.747, 0.971).
Becher [19]	2009	Cross-sectional	Penalized splines and Cox regression model	Country-wide (rural Burkina Faso)	To investigate the effect of multiple risk factors for childhood mortality	Nouna DSS, (children born alive between Jan 1, 1998, and Dec 31, 2001, and mortality follow-up to five years) (n =8,986 live births)	Sex of child; male (HR = 1.14, p value = 0.04), ethnic group; Peulh with Ref to Bwaba (HR = 1.39, p value = 0.03), religion; natural/other with Ref to Muslim (HR = 1.43, p value = 0.02), type of birth; twin with Ref to single (HR = 1.85, p value < 0.01), age of mother at birth; young (<18 years) with Ref to middle (18-34) (HR = 1.29, p value < 0.01), distance to next health center; >10 km (HR = 1.39, p value < 0.01).
Conombo [20]	2017	Cross-sectional	Logistic regression	Country-wide (Burkina Faso)	To examine the effects of risk factors on under-five mortality	Burkina Faso DHS-2010 (n = 15,044 live births)	Preceding birth interval; 18-23 with Ref to <18 months (OR = 0.56, 95%CI = 0.36, 0.88, p value = 0.011), 24-29 (OR = 0.43, CI = 0.28, 0.65, p value < 0.001), 30-35 (OR = 0.35, CI = 0.23, 0.54, p value < 0.001), 36-41 (OR = 0.27, CI = 0.17, 0.43, p value < 0.001), 42-47 (OR = 0.19, CI = 0.11, 0.33, p value < 0.001), 48-53 (OR = 0.26, CI = 0.14, 0.50, p value < 0.001), breastfeeding; never breastfeed with Ref to ever (OR = 2.89, CI = 1.96, 4.26, p value < 0.001), type of birth; twin with Ref to single (OR = 3.75, CI = 2.78, 5.06, p value < 0.001), birth order; 2 with Ref to 1 (OR = 0.41, CI = 0.21, 0.80, p value = 0.009), 3 with Ref to 1 (OR = 0.44, CI = 0.22, 0.91, p value = 0.026), size at birth; (OR = 1.17, CI = 1.07, 1.28, p value = 0.001); region (p values < 0.05)
Ettarh [33]	2012	Cross-sectional	Multivariate analysis (hazard ratio)	Country-wide (Kenya)	To compare the influence of geographical location and key maternal factors on under-five deaths	Kenya DHS 2008-2009 (n = 16,162 live births)	Place of residence; rural (HR = 3.61, 95%CI = 1.27, 10.32, p value < 0.05), age of mother; ≥32 with Ref to 15-20 years (HR = 0.32, CI = 0.17, 0.60, p value < 0.01), birth order; 2-3 with Ref to 1 (HR = 2.60, CI = 1.03, 6.58, p value < 0.05), ≥4 (HR = 3.77, CI = 1.41, 10.09, p value < 0.05), wealth index; middle with Ref to low (HR = 0.74, CI = 0.59, 0.93, p value < 0.05), highest (HR = 0.77, CI = 0.58, 0.98, p value < 0.05), province/region (p value for HR < 0.05), duration of breastfeeding; >12 months with Ref to <6 months (HR = 0.13, CI = 0.02, 0.84, p value < 0.05)
Ezeh [25]	2015	Cross-sectional	Cox proportional hazard regression model	Country-wide (Nigeria)	To identify the factors associated with under-five mortality	Nigeria DHS 2003, 2008 and 2013 (n = 66,154 live births, combined sample)	Birth order and birth interval; 1st child with Ref to 2nd or 3rd child, interval > 2 years (AHR = 1.42, p value < 0.001), 2nd or 3rd child, interval ≤ 2 years (AHR = 1.48, p value < 0.001), 4th or higher, interval ≤ 2 years (AHR = 1.89, p value < 0.001), household wealth index; middle with Ref to rich (AHR = 1.42, p value = 0.001), poor (AHR = 1.43, p value = 0.001), mother's education; no education with Ref to secondary or higher (AHR = 1.19, p value = 0.032), place of residence; rural (AHR = 1.29, p value = 0.001), sex of child; male (AHR = 1.24, p value < 0.001), mode of delivery; caesarean with Ref to noncaesarean (AHR = 1.74, p value = 0.001), size of child at birth; small or very small with Ref to average or large (AHR = 1.47, p value < 0.001), mother's age; less than 20 with Ref to 30-39 (AHR = 1.44, p value = 0.004), 40-49 (ARH = 1.47, p value < 0.001)
Fenta [23]	2020	Cross-sectional	Two-part random-effects regression model (negative binomial hurdle model)	Country-wide (Ethiopia)	To identify the potential risk factors for child mortality	Ethiopian DHS 2016 (n = 14,370 live births)	Child vaccination; yes (IRR = 0.735, 95%CI = 0.647, 0.834), family size; (IRR = 0.968, CI = 0.956, 0.980), age of mother; (IRR = 1.052, CI = 1.047, 1.056), ANC visit; 1-3 with Ref to no (IRR = 0.841, CI = 0.737, 0.960), 4 or above (IRR = 0.814, CI = 0.702, 0.944), previous birth interval; 25-36 months with Ref to ≤24 months (IRR = 0.836, CI = 0.787, 0.889), 37 and above (IRR = 0.728, CI = 0.676, 0.783), use of contraceptive; yes (IRR = 0.885, CI = 0.814, 0.962), father's education; secondary and above with Ref to no education (IRR = 0.695, CI = 0.594, 0.814), mother's education; primary with Ref to no education (IRR = 0.785, CI = 0.713, 0.864), father's occupation; had working with Ref to no (IRR = 1.125, CI = 1.049, 1.206), place of delivery; private sector with Ref to home (IRR = 0.609, CI = 0.405, 0.916), type of births; multiple with Ref to single (IRR = 1.355, CI = 1.249, 1.471), age of mother at first birth; 17 and above with Ref to ≤16 (IRR = 0.711, CI = 0.674, 0.750), birth order; 1-3 with Ref to first (IRR = 1.372, CI = 1.262, 1.491), 4 and above (IRR = 1.487, CI = 1.373, 1.612), religion; Muslim with Ref to orthodox (IRR = 1.255, CI = 1.129, 1.394), between enumeration area (level 2) (IRR = 0.526, CI = 0.474, 0.548)
Ghimire [37]	2019	Cross-sectional	Survey-based Cox proportional hazard model	Country-wide (Nepal)	To identify the factors associated with under-five child mortality	Nepal DHS (2001-2016) (n = 16,802 live births)	Previous dead child; yes (AHR = 15.97, 95%CI = 11.64, 21.92, p value < 0.001), tetanus toxoids (TT) vaccination during pregnancy; one TT with Ref to two or more TT (AHR = 1.54, CI = 1.09, 2.16, p value 0.013), no TT (AHR = 2.39, CI = 1.89, 3.01, p value < 0.001), contraceptives use; no (AHR = 2.03, CI = 1.57, 2.62, p value < 0.001), ethnicity; Madhesi with Ref to Brahmin/Chhetri (AHR = 1.73, CI = 1.29, 2.32, p value < 0.001), mother's literacy level; cannot read with Ref to can read (AOR = 1.33, CI = 1.03, 1.72, p value = 0.031), mother's occupation; agriculture with Ref to not working (AHR = 1.45, CI = 1.06, 1.96, p value = 0.018), skilled/professional (AHR = 2.15, CI = 1.40, 3.30, p value < 0.001), mother's age; 20-29 with Ref to 40-49 years (AHR = 1.88, CI = 1.24, 2.86, p value = 0.003), < 20 (AHR = 2.76, CI = 1.57, 4.85, p value < 0.001), birth rank and birth interval; 1st child with Ref to 2nd/3rd birth rank, >2 years (AHR = 2.55, CI = 1.77, 3.68, p value < 0.001), 4th/higher birth rank, interval > 2 years (AHR = 0.36, CI = 0.24, 0.52, p value < 0.001), 4th/higher birth rank, interval ≤ 2 years (AHR = 0.62, CI = 0.42, 0.91, p value = 0.015)
Gutema [24]	2022	Open cohort population-based longitudinal surveillance design	Multilevel logistic regression	KHDSS, eastern Ethiopia	To assess under-five mortality focusing on the trends and associated factors based on 2008-2016 data in KHDSS	KHDSS in Kersa district, East Hararghe Zone, Oromia region, Ethiopia (n = 18,759 live births)	ANC visits; yes (AOR = 0.61, 95%CI = 0.49, 0.74), education of mother; elementary with Ref to no-education (AOR = 0.58, CI = 0.49, 0.68), birth weight; normal with Ref to low (AOR = 0.78, CI = 0.64, 0.95), big (AOR = 5.16, CI = 1.98, 13.47), window presence in the house; yes (AOR = 0.80, 95%CI = 0.67, 0.95), occupation of mother; employed (AOR = 0.66, 95%CI = 0.48, 0.91), family size; two and/or less with Ref to more than 5 (AOR = 0.37, CI = 0.22, 0.37), 3-4 (AOR = 0.38, CI = 0.31, 0.45)
Hammer [21]	2006	Cross-sectional/cohort	Cox proportional hazards regression	Sub-Saharan Africa (Burkina Faso)	To identify the effect of risk factors for childhood mortality	DSS and DHS (1998-1999) of Burkina Faso (n = 6,195 for DSS, n = 4,957 for DHS live births)	Birth order; first with Ref to 2-4 (HR = 1.22, 95%CI = 1.04, 1.43, p value = 0.02), multiple birth (HR = 3.19, CI = 2.51, 4.05, p value < 0.01), family size; 7-10 with Ref to ≤6 (HR = 0.79, CI = 0.69, 0.91, p value < 0.01), >11 (HR = 0.66, CI = 0.58, 0.76, p value < 0.01), religion; Catholic with Ref to Muslim (HR = 0.84, CI = 0.73, 0.98, p value = 0.03), traditional (HR = 1.30, CI = 1.09, 1.54, p value < 0.01)
Iddrisu [29]	2020	Cross-sectional	Logistic regression model using frequentist and Bayesian framework	Country-wide (Ghana)	To identify the risk factors of child mortality	Ghana DHS 2014 (n = 5,884 live births)	Mode of delivery; caesarean section with Ref to not caesarean section (AOR = 1.449, 95%CI = 1.005, 2.089, p value < 0.05), size of child at birth; average with Ref to small (AOR = 0.498, CI = 0.362, 0.684, p value < 0.05), large (AOR = 0.513, CI = 0.384, 0.685, p value < 0.05), mother's education; formal education with Ref to no formal education (AOR = 0.766, CI = 0.596, 0.984, p value < 0.05)
Kandala [34]	2014	Cross-sectional	Logistic regression and multivariate Bayesian geo-additive survival analysis	Country-wide (DR of Congo)	To examine province-level geographic variation in under-five mortality and accounting risk factors of under-five mortality	Congo DHS 2007 (n = 8,992 live births)	Preceding birth interval; <24 months with Ref to ≥24 months (AOR = 1.14, 95%CI = 1.04, 1.26), place of delivery; home with Ref to hospital (AOR = 1.13, CI = 1.01, 1.27), marital status of mother; single with Ref to married (AOR = 1.16, CI = 1.03, 1.33)
Kayode [26]	2012	Cross-sectional	Multiple logistic regression	Country-wide (Nigeria)	To determine risk factors of under-five mortality	Nigeria DHS 2008 (n = 28,647 live births)	Maternal age; 26-30 with Ref to ≤20 years (OR = 1.70, 95%CI = 1.30, 2.22, p value 0.001), 31-35 (OR = 2.48, CI = 1.84, 3.33, p value = 0.001), >35 (OR = 2.87, CI = 2.10, 3.91, p value = 0.001), maternal age at first marriage; 20-24 with Ref to <15 years (OR = 0.80, CI = 0.70, 0.90, p value = 0.001), ≥25 (OR = 0.70, CI = 0.57, 0.85, p value = 0.001), use of contraception; traditional with Ref to no method (OR = 0.69, CI = 0.51, 0.85, p value = 0.017), health seeking behavior; average with Ref to low (OR = 0.06, CI = 0.05, 0.07, p value = 0.001), preceding birth interval; 18-36 with Ref to <18 months (OR = 0.30, CI = 0.26, 0.34, p value = 0.001), >36 (OR = 0.09, CI = 0.07, 0.10, p value = 0.001), breastfeeding; >18 with Ref to <6 months (OR = 0.43, CI = 0.35, 0.53, p value = 0.001), birth order; 2, 3, or 4 with Ref to 1 (OR = 1.93, CI = 1.56, 2.37, p value = 0.001), birth weight; small with Ref to normal (OR = 1.31, CI = 1.09, 1.58, p value = 0.004), family size; >5 with Ref to 1-5 (OR = 3.54, CI = 3.07, 4.08, p value = 0.001), type of toilet; bad toilet with Ref to good toilet (OR = 1.77, CI = 1.46, 2.14, p value = 0.001), fuel source; kerosene with Ref to gas (OR = 0.52, CI = 0.44, 0.63, p value = 0.001), others (OR = 0.28, CI = 0.23, 0.34, p value = 0.001), no. of wives; more wives with Ref to one (OR = 1.47, CI = 1.30, 1.66, p value = 0.001), type of residence; rural (OR = 1.53, CI = 1.16, 1.14, p value = 0.002)
Motsima [30]	2016	Cross-sectional	Multiple logistic regression	Country-wide (Lesotho)	To determine the factors associated with under-five child mortality	Lesotho DHS -2009 (n = 3,999 live births)	Sex of child; female (OR = 0.62, CI = 0.42, 0.91, p value = 0.016), type of births; multiple (OR = 2.72, CI = 1.02, 7.23, p value = 0.046), breastfeeding duration; 13-18 with Ref to 0-12 months (OR = 0.14, CI = 0.072, 0.27, p value < 0.001), 19 and above (OR = 0.02, CI = 0.0064, 0.0684, p value < 0.001), source of energy; other with Ref to electricity; (OR = 2.54, CI = 1.32, 4.85, p value = 0.005), marital status; formerly married with Ref to married (OR = 2.26, CI = 1.56, 4.37, p value < 0.001)
Naz [39]	2021	Cross-sectional	Cox proportional hazards regression	Country-wide (Pakistan)	To examine the effect of socioeconomic status and type of residence on under-five mortality	Pakistan DHS 2017/18 (n = 19,190 live births)	Mother's education; educated (HR = 0.75, CI = 0.60, 0.93, p value < 0.001), mother's employment; working (HR = 1.25, CI = 1.00, 1.06, p value < 0.10), birth spacing; 2-3 with Ref to <2 years (HR = 0.57, CI = 0.46, 0.71, p value < 0.001), >3 years (HR = 0.56, CI = 0.45, 0.69, p value < 0.001), mother's age at first birth; ≥18 years (HR = 0.79, CI = 0.65, 0.95, p value < 0.001), birth size; average with Ref to small (HR = 0.64, CI = 0.51, 0.78, p value < 0.001)
Naz [35]	2020	Cross-sectional	Cox proportional hazards model	Country-wide (Sierra Leone)	To point out crucial risk factors of under-five mortality	Sierra Leone DHS 2013 (n = 24,742 live births)	Age of mother at first birth; >18 with Ref to ≤18 years (AHR = 0.92, 95%CI = 0.86, 0.98, p value < 0.001), sex of child; female (AHR = 0.90, CI = 0.84, 0.96, p value < 0.001), number of children in the house; 3-4 child with Ref to 1-2 child (AHR = 0.40, CI = 0.34, 0.46, p value < 0.001), 5 and above (AHR = 0.35, CI = 0.28, 0.41, p value < 0.001), birth interval; >3 years with Ref to <2 years (AHR = 0.70, CI = 0.49, 0.98, p value < 0.05), size of child at birth; smaller than average with Ref to very small (AHR = 0.56, CI = 0.47, 0.66, p value < 0.001), average or larger (AHR = 0.55, CI = 0.46, 0.65, p value < 0.001)
Ogbo [36]	2019	Cross-sectional	Cox proportional hazards model	Country-wide (Tanzania)	To investigate the trends and determinants of neonatal, postneonatal, infant, child, and under-five mortalities in Tanzania from 2004 to 2016	Tanzanian DHS 2004-2005, 2010, 2015-2016 (n = 25,951 live births, combine of three Tanzanian DHS)	Type of residence; rural (AHR = 0.79, 95%CI = 0.67, 0.93), mother's education; primary with Ref to secondary or higher (AHR = 1.38, CI = 1.06, 1.80), birth rank and birth interval; first child with Ref to 2 or 3 child, interval > 2 (AHR = 1.39, CI = 1.18, 1.63), 2 or 3 child, interval ≤ 2 (AHR = 1.43, CI = 1.14, 1.79), 4 or more child, interval ≤ 2 (AHR = 1.58, CI = 1.27, 1.98), sex of child; male (AHR = 1.21, CI = 1.07, 1.37), size of child at birth; small or very small with Ref to average or larger (AHR = 1.90, CI = 1.59, 2.27)
Rhoda [27]	2019	Cross-sectional descriptive study	Binary logistic regression	Federal capital territory of Nigeria	To examine the effect of demographic and socioeconomic characteristics of women to under-five child mortality	Primary data (n = 200 live births)	Education of mother (beta coefficient = 34.44, p value = 0.019), main occupation of mother (beta coefficient = 274.48, p value = 0.005), ethnic group (beta coefficient = 617.81, p value = 0.091), average monthly income of mother (beta coefficient = 300.42, p value = 0.064)
Vanthy [40]	2019	Cross-sectional	Weibull hazards regression	Country-wide (Cambodia)	To define persistent and emerging factors associated with under-five mortality in Cambodia	Cambodian DHS 2010 and 2014 (n = 8232 Cambodian DHS 2010, n = 7,165 Cambodian DHS 2014)	Type of birth; twin (CDHS 2010: AHR = 2.08, 95%CI = 1.05, 4.13), birth interval; 2-3 years with Ref to <2 years (CDHS 2010: AHR = 0.49, CI = 0.32, 0.76; CDHS 2014: AHR = 0.48, CI = 0.24, 0.95), more than 3 years (CDHS 2010: AHR = 0.59, CI = 0.41, 0.86; CDHS 2014: AHR = 0.47, CI = 0.25, 0.87), age of mother at child birth; more than 40 years with Ref to <20 years (CDHS 2010: AHR = 3.55, CI = 1.80, 7.03; CDHS 2014: AHR = 3.21, CI = 1.13, 9.08), mother's education; primary with Ref to no education (CDHS 2010: AHR = 1.41, CI = 1.04, 1.91), secondary or higher (CDHS 2010: AHR = 1.86, CI = 1.16, 2.97; CDHS 2014: AHR = 1.95, CI = 1.05, 3.62), place of residence; rural CDHS 2014: AHR = 2.99, CI = 1.28, 6.97), region; plain with Ref to Phnom Penh (CDHS 2010: AHR = 2.92, CI = 1.15, 7.39), ANC visit; have ANC (CDHS 2010: AHR = 0.42, CI = 0.29, 0.62; CDHS 2014: AHR = 0.33, CI = 0.18, 0.59), TT vaccination; received >2 dose with Ref to not received at last birth (CDHS 2010: AHR = 0.66, CI = 0.45, 0.97), child vaccination status; not fully immunized with Ref to fully immunized (CDHS 2010: AHR = 01.64, CI = 1.40, 1.93; CDHS 2014: AHR = 3.90, CI = 3.13, 4.86)
Yaya [31]	2018	Cross-sectional	Multivariable Cox proportional hazards regression	Multicountry analysis (five sub-Saharan African countries-Chad, Demographic Republic (DR) of Congo, Mali, Niger, and Zimbabwe)	To examine the maternal factors associated with under-five mortality	DHS data from five sub-Saharan Africa countries (n = 40,754 live births)	Age of mother at first birth; (Mali: HR = 1.07, 95%CI = 1.05, 1.09, p value < 0.05; Zimbabwe: HR = 1.07, CI = 1.03, 1.09, p value < 0.05), place of residence; rural (Chad: HR = 1.11, CI = 1.01, 1.19; DR Congo: HR = 1.29, CI = 1.02, 1.57; Mali: HR = 1.28, CI = 1.01, 1.64; Niger: HR = 1.14, CI = 1.01, 1.33; Zimbabwe: HR = 1.01, CI = 0.83, 1.20, p value < 0.05), education of mother; secondary with Ref to no formal (Zimbabwe: HR = 0.62, CI = 0.38, 0.99, p value < 0.05; higher: HR = 0.47, CI = 0.23, 0.96, p value < 0.05), wealth index; richer with Ref to poorest (DR Congo: HR = 0.89, CI = 0.79, 0.99, p value < 0.05), richest (DR Congo: HR = 0.78, CI = 0.65, 0.94; Niger: HR = 0.84, CI = 0.61, 0.95, p value < 0.05), marital status; not currently married with Ref to currently married/in union (DR Congo: HR = 1.24, CI = 1.11, 1.40; Mali: 2.43, CI = 1.63, 3.64; Niger: HR = 1.59, CI = 1.24, 2.30; Zimbabwe: HR = 1.33, CI = 1.06, 1.67, p value < 0.05), type of birth; multiple (Niger: HR = 1.14, CI = 1.04, 1.31; Zimbabwe: HR = 1.19, CI = 1.01, 1.57, p value < 0.05), mode of delivery; caesarean section (Chad: HR = 1.32, CI = 1.00, 1.77; DR Congo: HR = 1.20, CI = 1.01, 1.43; Mali: HR = 1.42, CI = 1.08, 1.85; Niger: HR = 1.43, CI = 1.06, 1.92; Zimbabwe: HR = 1.49, CI = 1.03, 2.15; p value < 0.05), size of child; small with Ref to large (DR Congo: HR = 1.13, CI = 1.02, 1.19; Niger: HR = 1.15, CI = 1.02, 1.22, p value < 0.05), birth order; 5 and above (Chad: HR = 0.44, CI = 0.40, 0.49; DR Congo: 0.44, CI = 0.39, 0.48, p value < 0.05), birth interval; 18-24 with Ref to <18 (DR Congo: HR = 0.85, CI = 0.74, 0.97), >24 (Chad: HR = 0.88, CI = 0.79, 0.98; DR Congo: HR = 0.85, CI = 0.75, 0.95, p value < 0.05)

OR: odds ratio; RR: risk ratio; AOR: adjusted odds ratio; CI: confidence interval; HR: hazard ratio; AHR: adjusted hazard ratio; IRR: incidence rate ratio; Ref: reference category; DHS: demographic and health survey; DSS: demographic surveillance system; KHDSS: Kersa health and demographic surveillance site.