| Summary: | Introduction: Child morbidity and mortality in resource-limited settings is a major public health problem. The previous studies were mainly concerned with determining the prevalence of child deaths and identifying associated factors. Extracting knowledge and discovering insights from hidden patterns in child data through supervised machine learning algorithms is limited. Therefore, this study aimed to predict the under-five death of children using a best performance-supervised machine learning algorithm. Methods: A total of 1813 samples were used from the 2019 Ethiopian Demographic and Health Survey dataset. 70% and 30% of total instances were used for training the model and measuring the performance of each algorithm with 10-fold cross-validation techniques respectively. Five supervised machine learning algorithms were considered for model building and comparison. All the included algorithms were evaluated using confusion matrix elements. Information gain value was used to select important attributes to predict child deaths. The If/then logical association was used to generate rules based on relationships among attributes using Weka version 3.8.6 software. Results: J48 is the second-best performance algorithm next to the random forest to predict child death, with 77.8% and 93.9% accuracy, respectively. Late initiation of breastfeeding, mothers with no formal education, short birth intervals, poor wealth status of the mother, and unexposed to media were the top five important attributes to predict child deaths. A total of six associated rules were generated that could determine the magnitude of child deaths. Of these, if children were rural residents, had a short birth interval, and if born as multiples (twins), then the probability of child death was 83.6%. Conclusions: Five machine learning algorithms were included to predict child deaths and generate rules. Hence, the random forest algorithm was the best algorithm to predict child deaths. However, the study was limited since important attributes were not included in the data source, and irrelevant values were found. So, researchers are encouraged to use machine learning algorithms for future studies including important attributes that could predict child death. The current findings would be useful for stakeholders’ preparedness, and taking proactive childcare interventions. Encouraging women in education, media access, and economic development programs are essential interventions for child death reduction.
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