RT Journal Article SR Electronic T1 Exploring spatiotemporal distribution of under-five mortality in Ethiopia: further analysis of Ethiopian Demographic and Health Surveys 2000, 2005, 2011 and 2016 JF BMJ Paediatrics Open JO BMJ Paediatrics Open FD BMJ Publishing Group Ltd SP e001047 DO 10.1136/bmjpo-2021-001047 VO 5 IS 1 A1 Liyew, Alemneh Mekuriaw A1 Kassie, Ayenew A1 Teshale, Achamyeleh Birhanu A1 Alem, Adugnaw Zeleke A1 Yeshaw, Yigizie A1 Tesema, Getayeneh Antehunegn YR 2021 UL http://bmjpaedsopen.bmj.com/content/5/1/e001047.abstract AB Objective The aim of this study was to explore spatiotemporal distribution of under-five mortality in Ethiopia using data from four (2000, 2005, 2011 and 2016) consecutive demographic and health surveys.Methods A total of 41 498 children were included from four consecutive Ethiopian Demographic and Health Surveys. The geospatial analysis was conducted by using ArcGIS V.10.7 and saTScan V.9.6. Thus, spatial autocorrelation, hotspot analysis, spatial interpolation and spatial scan statistics were carried out for each survey separately to show the temporal pattern of geographically risk areas of under-five mortality in Ethiopia. Finally, the most under-five mortality rate (U5MR) risk areas in each survey period were mapped.Results Under-five mortality was spatially clustered in Ethiopia (Moran’s Index: 0.046–0.096, p<0.01). The Benishangul-Gumuz region was consistently at a higher risk in the last two decades. Additional hotspot areas were detected at Afar and Amhara (in 2000, 2005, 2016), at Gambala (in 2011) and the South Nation Nationality and People’s (SNNP) Region (in 2016). Moreover, 160 primary clusters were identified. Of these, 85 clusters (log-likelihood ratio (LLR)=13.10, p<0.01) were from Benishangul-Gumuz and Amhara regions (in 2000); 67 clusters (LLR=12.93, p<0.01) were from Afar and Amhara regions (in 2005); 4 clusters (LLR=10.54, p<0.01) were from Benishangul-Gumuz region (in 2011); and another 4 clusters (LLR=11.85, p<0.01) were from Afar region (in 2016).Conclusion High-risk areas were detected mainly in the Benishangul-Gumuz and Afar regions. As a result, designing under-five population targeted intervention programmes in those high-risk geographical regions was vital to reduce under-five mortality in Ethiopia.Data are available in a public, open access repository. The datasets we used for this study were publicly available at http://www.dhsprogram.com.