Determinants of Infant Mortality in Gezira State, Sudan: A Survival Analysis Using Cox Proportional Hazards Model

Abstract Background: Infant mortality is a critical indicator of population health, with the highest rates observed in sub-Saharan Africa. This study aims to identify factors associated with infant mortality in Gezira State, Sudan. Methods: A cross-sectional survey was conducted from July to December 2021, involving 332 participants selected using simple random sampling. Data was collected through a structured questionnaire, and the Cox proportional hazards regression model was used to identify significant predictors of infant mortality. Results: Significant predictors of infant mortality included parental education, father's occupation, family income, sex of the child, dead siblings, stillbirth, delivery method, birth size, breastfeeding ability, and maternal age-related variables. Several interaction effects were also significant. Conclusion: Efforts to reduce infant mortality in Sudan should prioritize maternal education, healthcare access, and targeted interventions for high-risk groups identified in this study.