Abstract
INTRODUCTION: under-five mortalities (U5M) are significant in determining the level of health development of a country. Most countries work to reduce the U5M rate; however, not all achieve the goal, including Rwanda. This study intends to explore factors associated with under-five mortality in Rwanda. METHODS: the study is a quantitative retrospective study using cross-sectional survey data of the Rwanda Demographic Health Survey 2019-2020. Permission for access to data was obtained from the DHS program website. The children dataset (KR) was used with a total of 8092 children. Data analysis used STATA-15 software. Descriptive information had been presented using frequency tables, charts, and graphs. A bivariate analysis using Chi-square was conducted to determine factors associated with U5M. Variables with significant association (P<0.05) in the bivariate analysis were considered for multivariate analysis with logistic regression. P-value <0.05 was declared as a significant association. RESULTS: the mortality level in 2019/2020 was at 3.66% linked to maternal and child-related factors; low birth weight was (AOR=6.93, 95% CI=4.44-10.81). Postnatal checkup was (AOR= 0.42, CI=0.22-0.81); (P-value <0.009). Delivery at health facility (AOR =0.32, CI=0.13-0.77); (P-value =0.011). The significant socio-economic factors of U5M were the number of household members (p-value=0.002), (AOR=0.59, 95% CI=0.42-0.83) and the partner´s education of secondary level (OR=0.47,95% CI=0.27-0.82); (P-value=0.008) and higher level (AOR=0.29,95% CI=0.11-0.78); (P-value=0.015). CONCLUSION: results showed that low birth weight and inadequate post-natal check-up visits are the main associated factors of under-five child mortality. In contrast, the remaining factors were all found to be protective.