# Predictors of Survival in Under-Five Children with Low Birth Weight: A Population-Based Study in Indonesia

## TL;DR

This study identifies factors that influence the survival of under-five children with low birth weight in Indonesia using demographic and health survey data.

## Contribution

The study provides new insights into predictors of survival for low birth weight children in Indonesia using population-based data.

## Key findings

- Exclusive breastfeeding and adequate antenatal care reduce the risk of under-five mortality in low birth weight children.
- Children born in health facilities had a higher risk of death compared to those born elsewhere.
- Maternal delivery complications and household residence significantly influence the survival of low birth weight children.

## Abstract

Background/Objectives: The under-five mortality rate (U5MR) remains a serious health challenge in Indonesia, with low birth weight (LBW) being a key risk factor. This study aimed to identify predictors of survival among under-five children with LBW using data from the 2017 Indonesia Demographic and Health Survey (IDHS). Methods: This cross-sectional study included 625 children under five with LBW. The dependent variable was under-five mortality (children aged 0–59 months), while the independent variables include child (gender), maternal (age at delivery, education, empowerment, delivery complications, and breastfeeding history), health service (antenatal care-ANC and place of delivery), and household (wealth quintile and residence) factors. Data were obtained from the 2017 IDHS using household and women’s questionnaires and analyzed using univariate analysis, Kaplan–Meier estimation, and Cox regression. Results: 41 of 625 children born with LBW died before the age of five. The Kaplan–Meier estimation found that maternal (delivery complications and breastfeeding history), health service (ANC history and place of delivery), and household factors (residence) significantly influenced the survival of LBW children. The Cox regression results showed that LBW children who were breastfeed and whose mother had adequate antenatal care visits had a lower risk of under-five mortality. Surprisingly, children born in health facilities had a significantly higher risk of death compared to those born elsewhere. Conclusions: Exclusive breastfeeding, adequate antenatal care, and place of delivery are important determinants of survival among children born with LBW. This support targeted interventions to improve the survival chances of children born with LBW, particularly in their early years of life.