AccScience Publishing / IJPS / Volume 9 / Issue 2 / DOI: 10.36922/ijps.427
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Exploring the most dominant drivers of inequalities in child survival in Ethiopia: Dominance analysis

Negussie Shiferaw Tessema1* Nigatu Regassa Geda2,3
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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
IJPS 2023, 9(2), 12–25;
Submitted: 19 December 2022 | Accepted: 29 March 2023 | Published: 14 April 2023
© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( )

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 five dimensions of inequality were considered as key predictor variables. The dominance analysis revealed that maternal education, place of residence, and household wealth index were the three most dominant drivers of inequalities in childhood undernutrition, accounting for 83.48% of the predicted variances. The regional category was found to be the first-ranked key driver of inequalities in childhood anemia, accounting for 50.56% of the predicted variance. The dominance analysis also indicated that maternal education, child sex, and place of residence were the three most dominant drivers of inequality in under-five mortality, accounting for 89.3% of the predicted variance. This study provides empirical evidence that maternal education (individual level), household asset based wealth index (household level), and place of residence (community level) were the most dominant drivers of inequality in child survival. This suggests interventions in reducing inequalities in child survival need to start at the community level, notwithstanding the importance of household and individual level influences.

Dominant drivers
Dominance analysis
Child survival
Under-five mortality

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Conflict of interest
The authors declare that they have no competing interest.
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International Journal of Population Studies, Electronic ISSN: 2424-8606 Print ISSN: 2424-8150, Published by AccScience Publishing