Study Variables Unadjusted Adjusted
Country level factors
Country of survey: HR (95% CI) P-value HR (95% CI) P-value
Burundi 1.00 1.00
DRC 1.77 (1.32, 2.37) <0.001 1.41 (1.04, 1.92) 0.027
Rwanda 1.19 (0.85, 1.66) 0.316 1.05 (0.74, 1.47) 0.792
Tanzania 1.51 (1.09, 2.08) 0.012 1.37 (0.98, 1.92) 0.066
Uganda 1.68 (1.27, 2.23) <0.001 1.26 (0.94, 1.71) 0.127
Socioeconomic factors
Maternal literacy:
Can read 1.00
Cannot read 0.98 (0.81, 1.18) 0.826
Place of residence:
Urban 1.00
Rural 0.93 (0.76, 1.14) 0.493
Maternal education:
Higher education 1.00
Secondary education 1.03 (0.50, 2.10) 0.946
Primary education 1.05 (0.52, 2.10) 0.893
No education 0.74 (0.36, 1.52) 0.410
Maternal occupation:
Not working 1.00
Skilled/Professional 1.12 (0.83, 1.52) 0.455
Agriculture 0.99 (0.75, 1.30) 0.921
Wealth index:
Rich 1.00
Middle 1.23 (0.95, 1.59) 0.117
Poor 1.02 (0.79, 1.32) 0.873
Maternal working status:
Currently working 1.00
Currently not working 1.00 (0.80, 1.25) 0.976
Maternal factors
Mother’s desire for pregnancy:
Wanted then 1.00
Wanted later 0.86 (0.70, 1.07) 0.176
Wanted no more 1.19 (0.88, 1.59) 0.259
Use of contraceptives:
Currently using 1.00
Currently not using 1.99 (1.59, 2.48) <0.001 1.81 (1.43, 2.29) <0.001
Previous death of baby:
No 1.00
Yes 5.21 (4.25, 6.38) <0.001 10.3 (7.75, 13.68) <0.001
Maternal smoking status:
Non-smoker 1.00
Smoker 0.79 (0.29, 2.14) 0.640
Mother’s age at first birth:
<20 1.00
20-24 0.92 (0.75, 1.12) 0.398
25+ 0.88 (0.64, 1.21) 0.424
Child factors
Sex of child
Male 1.00
Female 0.81 (0.67, 0.97) 0.024 0.79 (0.65, 0.96) 0.018
Perceived birth size:
Average 1.00
Smaller than average 1.95 (1.55, 2.47) <0.001 1.88 (1.47, 2.39) <0.001
Larger than average 1.08 (0.87, 1.33) 0.509 1.05 (0.84, 1.33) 0.655
Combined birth order and birth interval:
-2nd or 3rd child, > 2 years interval 1.00
-First child 1.96 (1.51, 2.56) <0.001 3.05 (2.28, 4.07) <0.001
-2nd or 3rd child, ≤ 2 years interval 0.97 (0.65, 1.44) 0.864 0.81 (0.53, 1.23) 0.323
-4th or more child, > 2 years interval 1.19 (0.91, 1.55) 0.196 0.48 (0.36, 0.66) <0.001
-4th or more child, ≤ 2 years interval 2.00 (1.45, 2.77) <0.001 0.79 (0.55, 1.14) 0.213
Environmental factors
Type of cooking fuel:
Non-solid fuels 1.00
Solid fuels 0.61 (0.29, 1.31) 0.206
Type of water sources
Improved water sources 1.00
Unimproved water sources 1.23 (1.02, 1.48) 0.034
Type of sanitation facility:
Improved facility 1.00
Unimproved facility 1.16 (0.96, 1.40) 0.130
Health service factors
Antenatal IFA supplementation:
Yes 1.00
No 1.10(0.90, 1.34) 0.366
Tetanus Toxoid (TT) injection
2+ TT 1.00
1 TT 1.05 (0.84, 1.31) 0.685 1.27 (1.00, 1.61) 0.046
No TT 1.25 (1.00, 1.56) 0.052 1.36 (1.04, 1.78) 0.023
Antenatal care (ANC) visits:
4+ANC 1.00
1-3 ANC 1.17 (0.97, 1.42) 0.103 1.13 (0.92, 1.38) 0.262
N0 ANC 2.34 (1.62, 3.40) <0.001 1.62 (1.06, 2.48) 0.027
Delivery assistance:
Health professional* 1.00
Others 1.07 (0.88, 1.29) 0.513
Place of delivery:
Health facility 1.00
Home 1.00 (0.80, 1.25) 0.977
Mode of delivery:
Non-caesarean section 1.00
Caesarean section 1.92 (1.48, 2.48) <0.001 1.89 (1.40, 2.55) <0.001