Determinants of Under-five Mortality Due to Pneumonia: A Negative Binomial Regression Analysis
Keywords:
Child, Indonesia;, Negative Binomial;, Pneumonia;, Under-five Mortality.
Abstract
Pneumonia is one of the main causes of under-five mortality in Indonesia. In under-fives, pneumonia
is the number one killer in the world. Meanwhile, in Indonesia, it ranks second after diarrhea. On
average, the disease affects half a million children a year. This study aims to identify and analyze the
risk of variables that affect the number of under-five mortality due to pneumonia in Indonesia in 2021.
The novelty of this research focuses on the macro variables used, making it easier for policy makers to
make decisions. The research method used is negative binomial regression. The results showed that the
highest number of under-five mortality due to pneumonia was in Central Java Province. Meanwhile, the
lowest was in Jambi Province, South Sumatra, Riau Islands, DKI Jakarta, North Kalimantan, Southeast
Sulawesi, and Papua. The per capita income significantly reduces the number of under-five mortality
due to pneumonia, while the number of under-fives with severe pneumonia significantly reduces the
number of under-five mortality due to pneumonia in Indonesia. The government needs attention to
reduce the death rate of children under five due to pneumonia by providing social protection in the
fields of health and education for underprivileged communities.
References
Argawu, A. S. and Mekebo, G. G. (2022). Risk factors of under-five mortality in ethiopia using count data regression models, 2021.
Annals of Medicine and Surgery, page 104764. doi: https://doi.org/10.1016/j.amsu.2022.104764.
Aurellia, N. A., Ramadhani, A. A., Pamungkas, K. A., and Kartiasih, F. (2023). Determinan kejadian wasting pada balita. In Seminar
Nasional Official Statistics, volume 2023, pages 167–178. doi: https://doi.org/10.34123/semnasoffstat.v2023i1.1901.
Bakare, A. A., Graham, H., Agwai, I. C., Shittu, F., King, C., Colbourn, T., Iuliano, A., Aranda, Z., McCollum, E. D., Isah, A.,
et al. (2020). Community and caregivers perceptions of pneumonia and care-seeking experiences in nigeria: A qualitative study.
Pediatric pulmonology, 55:S104–S112. doi: https://doi.org/10.1002/ppul.24620.
Belantika, B. T., Rohmad, B., Arandita, H. D. N., Hutasoit, D. R., and Kartiasih, F. (2023). Factors affecting poverty using a
geographically weighted regression approach (case study of java island, 2020). Optimum: Jurnal Ekonomi dan Pembangunan,
13(2):141–154. doi: https://doi.org/10.31849/jieb.v20i2.12259.
Bitew, F. H., Nyarko, S. H., Potter, L., and Sparks, C. S. (2020). Machine learning approach for predicting under-five mortality
determinants in ethiopia: evidence from the 2016 ethiopian demographic and health survey. Genus, 76:1–16. doi: https://doi.org/
10.1186/s41118-020-00106-2.
Hardinata, R., Oktaviana, L., Husain, F. F., Putri, S., and Kartiasih, F. (2023). Analisis faktor-faktor yang memengaruhi stunting
di indonesia tahun 2021. In Seminar Nasional Official Statistics, volume 2023, pages 817–826. doi: https://doi.org/10.34123/
semnasoffstat.v2023i1.1867.
He, C., Kang, L., Miao, L., Li, Q., Liang, J., Li, X., Wang, Y., and Zhu, J. (2015). Pneumonia mortality among children under 5 in
china from 1996 to 2013: an analysis from national surveillance system. PloS one, 10(7):e0133620. doi: https://doi.org/10.1371/
journal.pone.0133620.
Jullien, S., Pradhan, D., Tshering, T., Sharma, R., Dema, K., Garcia-Garcia, S., Ribo, J. L., Mu ´ noz-Almagro, C., and Bassat, Q. ˜
(2020). Pneumonia in children admitted to the national referral hospital in bhutan: A prospective cohort study. International
Journal of Infectious Diseases, 95:74–83. doi: https://doi.org/10.1016/j.ijid.2020.04.017.
Jullien, S., Richard-Greenblatt, M., Ngai, M., Lhadon, T., Sharma, R., Dema, K., Kain, K. C., and Bassat, Q. (2022). Performance
of host-response biomarkers to risk-stratify children with pneumonia in bhutan. Journal of Infection, 85(6):634–643. doi: https:
//doi.org/10.1016/j.jinf.2022.10.010.
Kartiasih, F. and Pribadi, W. (2020). Environmental quality and poverty assessment in indonesia. Jurnal Pengelolaan Sumberdaya
Alam Dan Lingkungan (Journal of Natural Resources and Environmental Management), 10(1):89–97. doi: https://doi.org/10.
29244/jpsl.10.1.89-97.
Keddy, K. H., Saha, S., Okeke, I. N., Kalule, J. B., Qamar, F. N., and Kariuki, S. (2021). Big data, biomarkers and proteomics:
informing childhood diarrhoeal disease management in low-and middle-income countries. EBioMedicine, 73. doi: https://doi.org/
10.1016/j.ebiom.2021.103668.
Kementerian Kesehatan Republik Indonesia (2021). Profil Kesehatan Indonesia. Kementerian Kesehatan Republik Indonesia. Jakarta:
UNICEF Indonesia.
Kutner, M. H., Nachtsheim, C. J., Neter, J., and Li, W. (2005). Applied linear statistical models. McGraw-hill.
Lamberti, L. M., Irena, Z.-G., Christa, L. F. W., Theodoratou, E., Nair, H., Harry, C., and Black, R. E. (2013). Pneumonia and cost.
http://www.biomedcentral.com/1471-2458/13/S3/S18, 13(3):1–8. http://www.biomedcentral.com/1471-2458/13/S3/S18.
Le Roux, D. M., Myer, L., Nicol, M. P., and Zar, H. J. (2015). Incidence and severity of childhood pneumonia in the first year
of life in a south african birth cohort: the drakenstein child health study. The Lancet Global Health, 3(2):e95–e103. doi: https:
//doi.org/10.1016/S2214-109X(14)70360-2.Marangu, D. and Zar, H. J. (2019). Childhood pneumonia in low-and-middle-income countries: an update. Paediatric respiratory
reviews, 32:3–9. doi: https://doi.org/10.1016/j.prrv.2019.06.001.
McAllister, D. A., Liu, L., Shi, T., Chu, Y., Reed, C., Burrows, J., Adeloye, D., Rudan, I., Black, R. E., Campbell, H., et al. (2019).
Global, regional, and national estimates of pneumonia morbidity and mortality in children younger than 5 years between 2000 and
2015: a systematic analysis. The Lancet Global Health, 7(1):e47–e57. doi: https://doi.org/10.1016/S2214-109X(18)30408-X.
Noor, M., Riyanto, S., Wardani, M. K., Borneo, S. H., and Borneo, A. S. H. (2016). Faktor-faktor yang mempengaruhi kejadian
pneumonia pada balita di wilayah kerja puskesmas guntung payung tahun 2013. Jurnal Kesehatan Indonesia, 4(2).
Rahman, A. E., Hossain, A. T., Nair, H., Chisti, M. J., Dockrell, D., El Arifeen, S., and Campbell, H. (2022). Prevalence of
hypoxaemia in children with pneumonia in low-income and middle-income countries: a systematic review and meta-analysis. The
Lancet Global Health, 10(3):e348–e359. doi: https://doi.org/10.1016/S2214-109X(21)00586-6.
Ramandey, D. E. M., Made, N., Kurniasari, D., and Widyanthini, D. (2018). Faktor-faktor yang mempengaruhi kejadian pneumonia
pada balita di rumah sakit ibu anak permata hati kabupaten klungkung tahun 2015-2017. Arc. Com. Health, 5(2):11–17. doi:
https://doi.org/10.24843/ach.2018.v05.i02.p02.
Rigustia, R., Zeffira, L., and Vani, A. T. (2019). Faktor risiko yang berhubungan dengan kejadian pneumonia pada balita di puskesmas
ikur koto kota padang. Health and Medical Journal, 1(1):22–29. doi: https://doi.org/10.33854/heme.v1i1.215.
Sari, V. K. and Prasetyani, D. (2021). Socioeconomic determinants of infant mortality rate in asean: a panel data analysis. JAS
(Journal of ASEAN Studies), 9(1). doi: https://doi.org/10.21512/JAS.V9I1.7280.
Singh, G. K. and Stella, M. Y. (2019). Infant mortality in the united states, 1915-2017: large social inequalities have persisted for
over a century. International Journal of Maternal and Child Health and AIDS, 8(1):19. doi: https://doi.org/10.21106/ijma.271.
Tadesse Zeleke, A. (2022). Effect of health extension service on under-five child mortality and determinants of under-five child
mortality in derra district, oromia regional state, ethiopia: A cross-sectional study. SAGE Open Medicine, 10:20503121221100610.
doi: https://doi.org/10.1177/20503121221100610.
UNICEF (2021). Laporan tahunan 2021. Jakarta: United Nations Childrens Fund (UNICEF).
UNICEF et al. (2020). Nutrition, for every child: Unicef nutrition strategy 2020–2030. UNICEF, New York: United Nations Childrens
Fund.
Vicasco, M. A. N. and Handayani, D. (2020). Literature review: Analisis faktor risiko pneumonia pada balita. In PROSIDING
NATIONAL CONFERENCE FOR UMMAH, volume 1.
Wang, J., Cao, H., Sun, D., Qi, Z., Guo, C., Peng, W., Sun, Y., Xie, Y., Liu, X., Li, B., et al. (2019). Associations between ambient air
pollution and mortality from all causes, pneumonia, and congenital heart diseases among children aged under 5 years in beijing,
china: a population-based time series study. Environmental research, 176:108531. doi: https://doi.org/10.1016/j.envres.2019.
108531.
Watkins, K. and Sridhar, D. (2018). Pneumonia: a global cause without champions. The Lancet, 392(10149):718–719. doi: https:
//doi.org/10.1016/S0140-6736(18)31666-0.
Woldeamanuel, B. T. and Aga, M. A. (2021). Count models analysis of factors associated with under-five mortality in ethiopia.
Global Pediatric Health, 8:2333794X21989538. doi: https://doi.org/10.1177/2333794X21989538.
Yatnaningtyas, R., Latra, I. N., and Andari, S. (2016). Identifikasi faktor-faktor yang mempengaruhi pneumonia pada balita di
surabaya menggunakan geographically weighted negative binomial regression. Jurnal Sains dan Seni ITS, 5(2). doi: https:
//doi.org/10.12962/j23373520.v5i2.16597.
Annals of Medicine and Surgery, page 104764. doi: https://doi.org/10.1016/j.amsu.2022.104764.
Aurellia, N. A., Ramadhani, A. A., Pamungkas, K. A., and Kartiasih, F. (2023). Determinan kejadian wasting pada balita. In Seminar
Nasional Official Statistics, volume 2023, pages 167–178. doi: https://doi.org/10.34123/semnasoffstat.v2023i1.1901.
Bakare, A. A., Graham, H., Agwai, I. C., Shittu, F., King, C., Colbourn, T., Iuliano, A., Aranda, Z., McCollum, E. D., Isah, A.,
et al. (2020). Community and caregivers perceptions of pneumonia and care-seeking experiences in nigeria: A qualitative study.
Pediatric pulmonology, 55:S104–S112. doi: https://doi.org/10.1002/ppul.24620.
Belantika, B. T., Rohmad, B., Arandita, H. D. N., Hutasoit, D. R., and Kartiasih, F. (2023). Factors affecting poverty using a
geographically weighted regression approach (case study of java island, 2020). Optimum: Jurnal Ekonomi dan Pembangunan,
13(2):141–154. doi: https://doi.org/10.31849/jieb.v20i2.12259.
Bitew, F. H., Nyarko, S. H., Potter, L., and Sparks, C. S. (2020). Machine learning approach for predicting under-five mortality
determinants in ethiopia: evidence from the 2016 ethiopian demographic and health survey. Genus, 76:1–16. doi: https://doi.org/
10.1186/s41118-020-00106-2.
Hardinata, R., Oktaviana, L., Husain, F. F., Putri, S., and Kartiasih, F. (2023). Analisis faktor-faktor yang memengaruhi stunting
di indonesia tahun 2021. In Seminar Nasional Official Statistics, volume 2023, pages 817–826. doi: https://doi.org/10.34123/
semnasoffstat.v2023i1.1867.
He, C., Kang, L., Miao, L., Li, Q., Liang, J., Li, X., Wang, Y., and Zhu, J. (2015). Pneumonia mortality among children under 5 in
china from 1996 to 2013: an analysis from national surveillance system. PloS one, 10(7):e0133620. doi: https://doi.org/10.1371/
journal.pone.0133620.
Jullien, S., Pradhan, D., Tshering, T., Sharma, R., Dema, K., Garcia-Garcia, S., Ribo, J. L., Mu ´ noz-Almagro, C., and Bassat, Q. ˜
(2020). Pneumonia in children admitted to the national referral hospital in bhutan: A prospective cohort study. International
Journal of Infectious Diseases, 95:74–83. doi: https://doi.org/10.1016/j.ijid.2020.04.017.
Jullien, S., Richard-Greenblatt, M., Ngai, M., Lhadon, T., Sharma, R., Dema, K., Kain, K. C., and Bassat, Q. (2022). Performance
of host-response biomarkers to risk-stratify children with pneumonia in bhutan. Journal of Infection, 85(6):634–643. doi: https:
//doi.org/10.1016/j.jinf.2022.10.010.
Kartiasih, F. and Pribadi, W. (2020). Environmental quality and poverty assessment in indonesia. Jurnal Pengelolaan Sumberdaya
Alam Dan Lingkungan (Journal of Natural Resources and Environmental Management), 10(1):89–97. doi: https://doi.org/10.
29244/jpsl.10.1.89-97.
Keddy, K. H., Saha, S., Okeke, I. N., Kalule, J. B., Qamar, F. N., and Kariuki, S. (2021). Big data, biomarkers and proteomics:
informing childhood diarrhoeal disease management in low-and middle-income countries. EBioMedicine, 73. doi: https://doi.org/
10.1016/j.ebiom.2021.103668.
Kementerian Kesehatan Republik Indonesia (2021). Profil Kesehatan Indonesia. Kementerian Kesehatan Republik Indonesia. Jakarta:
UNICEF Indonesia.
Kutner, M. H., Nachtsheim, C. J., Neter, J., and Li, W. (2005). Applied linear statistical models. McGraw-hill.
Lamberti, L. M., Irena, Z.-G., Christa, L. F. W., Theodoratou, E., Nair, H., Harry, C., and Black, R. E. (2013). Pneumonia and cost.
http://www.biomedcentral.com/1471-2458/13/S3/S18, 13(3):1–8. http://www.biomedcentral.com/1471-2458/13/S3/S18.
Le Roux, D. M., Myer, L., Nicol, M. P., and Zar, H. J. (2015). Incidence and severity of childhood pneumonia in the first year
of life in a south african birth cohort: the drakenstein child health study. The Lancet Global Health, 3(2):e95–e103. doi: https:
//doi.org/10.1016/S2214-109X(14)70360-2.Marangu, D. and Zar, H. J. (2019). Childhood pneumonia in low-and-middle-income countries: an update. Paediatric respiratory
reviews, 32:3–9. doi: https://doi.org/10.1016/j.prrv.2019.06.001.
McAllister, D. A., Liu, L., Shi, T., Chu, Y., Reed, C., Burrows, J., Adeloye, D., Rudan, I., Black, R. E., Campbell, H., et al. (2019).
Global, regional, and national estimates of pneumonia morbidity and mortality in children younger than 5 years between 2000 and
2015: a systematic analysis. The Lancet Global Health, 7(1):e47–e57. doi: https://doi.org/10.1016/S2214-109X(18)30408-X.
Noor, M., Riyanto, S., Wardani, M. K., Borneo, S. H., and Borneo, A. S. H. (2016). Faktor-faktor yang mempengaruhi kejadian
pneumonia pada balita di wilayah kerja puskesmas guntung payung tahun 2013. Jurnal Kesehatan Indonesia, 4(2).
Rahman, A. E., Hossain, A. T., Nair, H., Chisti, M. J., Dockrell, D., El Arifeen, S., and Campbell, H. (2022). Prevalence of
hypoxaemia in children with pneumonia in low-income and middle-income countries: a systematic review and meta-analysis. The
Lancet Global Health, 10(3):e348–e359. doi: https://doi.org/10.1016/S2214-109X(21)00586-6.
Ramandey, D. E. M., Made, N., Kurniasari, D., and Widyanthini, D. (2018). Faktor-faktor yang mempengaruhi kejadian pneumonia
pada balita di rumah sakit ibu anak permata hati kabupaten klungkung tahun 2015-2017. Arc. Com. Health, 5(2):11–17. doi:
https://doi.org/10.24843/ach.2018.v05.i02.p02.
Rigustia, R., Zeffira, L., and Vani, A. T. (2019). Faktor risiko yang berhubungan dengan kejadian pneumonia pada balita di puskesmas
ikur koto kota padang. Health and Medical Journal, 1(1):22–29. doi: https://doi.org/10.33854/heme.v1i1.215.
Sari, V. K. and Prasetyani, D. (2021). Socioeconomic determinants of infant mortality rate in asean: a panel data analysis. JAS
(Journal of ASEAN Studies), 9(1). doi: https://doi.org/10.21512/JAS.V9I1.7280.
Singh, G. K. and Stella, M. Y. (2019). Infant mortality in the united states, 1915-2017: large social inequalities have persisted for
over a century. International Journal of Maternal and Child Health and AIDS, 8(1):19. doi: https://doi.org/10.21106/ijma.271.
Tadesse Zeleke, A. (2022). Effect of health extension service on under-five child mortality and determinants of under-five child
mortality in derra district, oromia regional state, ethiopia: A cross-sectional study. SAGE Open Medicine, 10:20503121221100610.
doi: https://doi.org/10.1177/20503121221100610.
UNICEF (2021). Laporan tahunan 2021. Jakarta: United Nations Childrens Fund (UNICEF).
UNICEF et al. (2020). Nutrition, for every child: Unicef nutrition strategy 2020–2030. UNICEF, New York: United Nations Childrens
Fund.
Vicasco, M. A. N. and Handayani, D. (2020). Literature review: Analisis faktor risiko pneumonia pada balita. In PROSIDING
NATIONAL CONFERENCE FOR UMMAH, volume 1.
Wang, J., Cao, H., Sun, D., Qi, Z., Guo, C., Peng, W., Sun, Y., Xie, Y., Liu, X., Li, B., et al. (2019). Associations between ambient air
pollution and mortality from all causes, pneumonia, and congenital heart diseases among children aged under 5 years in beijing,
china: a population-based time series study. Environmental research, 176:108531. doi: https://doi.org/10.1016/j.envres.2019.
108531.
Watkins, K. and Sridhar, D. (2018). Pneumonia: a global cause without champions. The Lancet, 392(10149):718–719. doi: https:
//doi.org/10.1016/S0140-6736(18)31666-0.
Woldeamanuel, B. T. and Aga, M. A. (2021). Count models analysis of factors associated with under-five mortality in ethiopia.
Global Pediatric Health, 8:2333794X21989538. doi: https://doi.org/10.1177/2333794X21989538.
Yatnaningtyas, R., Latra, I. N., and Andari, S. (2016). Identifikasi faktor-faktor yang mempengaruhi pneumonia pada balita di
surabaya menggunakan geographically weighted negative binomial regression. Jurnal Sains dan Seni ITS, 5(2). doi: https:
//doi.org/10.12962/j23373520.v5i2.16597.
Published
2023-10-31
How to Cite
[1]
D. Prawidia, L. Zhafirah, N. Saputra, F. Kartiasih, and U. Sahu, “Determinants of Under-five Mortality Due to Pneumonia: A Negative Binomial Regression Analysis”, Jurnal Varian, vol. 7, no. 1, pp. 59 - 66, Oct. 2023.
Issue
Section
Articles
This work is licensed under a Creative Commons Attribution 4.0 International License.
