Child Health and Mortality in Ethiopia: Insights from Leverage Statistical Models

Child morbidity affects a child's development, growth, and the overall well-being of society. This study aimed to examine the comorbidity of children in a sample of Ethiopian children based on the Performance Monitoring for Action Ethiopia community survey (PMA-ET), as well as the existence of child-specific, regional variation in children's comorbidity and its relationship to socioeconomic and demographic variables in families. We enrolled 2581 children suffering from different illnesses from six different regions of the country. Maximum likelihood estimates in generalized linear mixed models (GLMMs) were used to assess children's comorbidity status. We used the DHARMa package in R to provide readily interpretable scaled residuals and test functions for typical model misspecification problems for the fitted GLMMs. GLMMs with two random intercept models show the presence of child morbidity variations. Cough, fever, and diarrhea were found to be the most frequent types of children's illnesses among the main illness categories that were recorded. Cooking fuel, wealth quartiles, mothers’ marital status, mother age, parity, residence, mother’s education status, and availability of electricity were significantly associated with children's morbidity. These data show that variations in children's comorbidity were associated with both regional and child-specific characteristics. Thus, general principles for designing policies and interventions are required to reduce child comorbidity.