Determinants of under-five mortality in Africa: evidence from a two-decade panel analysis for public health policy

Abstract Background Child survival is a critical indicator for a nation’s health and its progress is important in attaining the Sustainable Development Goals. Understanding the regional and country-specific dynamic and interplay of various determinants of under-five child mortality is vital for the African continent, which remains one of the most vulnerable regions for child mortality globally. Methods This study investigates the association of economic, health-related, social and demographic, environmental, and infrastructure-related factors with under-five child mortality. It integrates generalisable regional associations using a standard fixed-effects panel model and examines illustrative country-specific associations of the selected determinants through multiple linear regression, based on a balanced panel dataset of 45 countries over a 22-year period. Results Fixed-effect analysis reveals that the diphtheria-tetanus-pertussis (DTP) immunisation and total fertility r