Page 18 - IJPS-9-2

International Journal of

Population Studies

RESEARCH ARTICLE
Exploring the most dominant drivers

of inequalities in child survival in
Ethiopia: Dominance analysis

Negussie Shiferaw Tessema * and Nigatu Regassa Geda 2,3
1
1 Center of Population Studies, College of Development Studies, Addis Ababa University, Addis
Ababa, Ethiopia
2 College of Development Studies, Addis Ababa University, Addis Ababa, Ethiopia
3 College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada

Abstract
Inequalities in child survival are a global public health concern. Over the past decade,
Ethiopia has made remarkable progress in improving child survival. Despite this promising
development, inequalities in child survival among the various population groups
remained a pressing public health concern. The purpose of this paper is to examine the
dominant drivers of inequality in child survival indicators (undernutrition, anemia, and
under-five mortality) in Ethiopia. Dominance analysis was used based on a pooled total
sample of 48,422 under-five children drawn from five rounds of Ethiopia Demographic
and Health Surveys conducted from year 2000 to 2019. Childhood undernutrition,
childhood anemia, and under-five mortality were the three outcome variables, and the
*Corresponding author: five dimensions of inequality were considered as key predictor variables. The dominance
Negussie Shiferaw Tessema analysis revealed that maternal education, place of residence, and household wealth
(ntshiferaw@gmail.com) index were the three most dominant drivers of inequalities in childhood undernutrition,
Citation: Negussie S.T., & accounting for 83.48% of the predicted variances. The regional category was found to be
Nigatu R.G. (2023). Exploring the first-ranked key driver of inequalities in childhood anemia, accounting for 50.56% of
the most dominant drivers of the predicted variance. The dominance analysis also indicated that maternal education,
inequalities in child survival in
Ethiopia: Dominance analysis. child sex, and place of residence were the three most dominant drivers of inequality in
International Journal of Population under-five mortality, accounting for 89.3% of the predicted variance. This study provides
Studies, 9(2): 12-25. empirical evidence that maternal education (individual level), household asset based
https://doi.org/10.36922/ijps.427
wealth index (household level), and place of residence (community level) were the most
Received: December 19, 2022 dominant drivers of inequality in child survival. This suggests interventions in reducing
Accepted: March 29, 2023 inequalities in child survival need to start at the community level, notwithstanding the
importance of household and individual level influences.
Published Online: April 14, 2023
Copyright: © 2023 Author(s).
This is an Open Access article Keywords: Dominant drivers; Dominance analysis; Inequalities; Child survival; Under-five
distributed under the terms of the mortality; Ethiopia
Creative Commons Attribution
License, permitting distribution,
and reproduction in any medium,
provided the original work is
properly cited. 1. Introduction
Publisher’s Note: AccScience
Publishing remains neutral with 1.1. Background
regard to jurisdictional claims in
published maps and institutional Inequalities in child survival are a global public health concern (Brault et al., 2020; Cha
affiliations. & Jin, 2020). Although reducing inequalities in child survival are given due attention

Volume 9 Issue 2 (2023) 12 https://doi.org/10.36922/ijps.427