Ethnic differentials in under-five mortality in Nigeria (original) (raw)
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Ethnicity & Health Ethnic differentials in under-five mortality in Nigeria
Objective. There are huge regional disparities in under-five mortality in Nigeria. While a region within the country has as high as 222 under-five deaths per 1000 live births, the rate is as low as 89 per 1000 live births in another region. Nigeria is culturally diverse as there are more than 250 identifiable ethnic groups in the country; and various ethnic groups have different sociocultural values and practices which could influence child health outcome. Thus, the main objective of this study was to examine the ethnic differentials in under-five mortality in Nigeria. Design. The study utilized 2008 Nigeria Demographic and Health Survey (NDHS) data. We analyzed data from a nationally representative sample drawn from 33,385 women aged 15-49 that had a total of 104,808 live births within 1993-2008. In order to examine ethnic differentials in under-five mortality over a sufficiently long period of time, our analysis considered live births within 15 years preceding the 2008 NDHS. The risks of death in children below age five were estimated using Cox proportional regression analysis. Results were presented as hazard ratios (HR) with 95% confidence intervals (CI). Results. The study found substantial differentials in under-five mortality by ethnic affiliations. For instance, risks of death were significantly lower for children of the Yoruba tribes (HR: 0.39, CI: 0.37-0.42, p < 0.001), children of Igbo tribes (HR: 0.58, CI: 0.55-0.61, p < 0.001) and children of the minority ethnic groups (HR: 0.66, CI: 0.64-0.68, p < 0.001), compared to children of the Hausa/Fulani/Kanuri tribes. Besides, practices such as plural marriage, having higher-order births and too close births showed statistical significance for increased risks of under-five mortality (p < 0.05). Conclusion. The findings of this study stress the need to address the ethnic norms and practices that negatively impact on child health and survival among some ethnic groups in Nigeria.
European Journal of Development Studies
Under-five mortality rate in Nigeria is among the world’s highest with northern Nigeria having the most appalling under-five health indicators. Despite the streams of studies, research on Nigeria, there is still a gap on the cultural, maternal, and environmental factors contributing to the high under-five mortality in the identified hotspots in Nigeria. The study utilized data from the 2013 Nigeria Demographic Health Survey (NDHS) reports. Results revealed that Spatial dependence across the study area was confirmed with Moran’s I testing positive (0.4689 and a P-value of 0.01), an indication of the presence of auto correlation. Six states namely Zamfara, Bauchi, Jigawa, Sokoto, Kebbi and Katsina, were identified as having the highest under-five mortality rates ranging from 162-221 deaths per 1000 live births from the spatial analysis. The variables identified as contributing to the high under-five mortalities in these states were maternal education, Age of the mother, religion, weal...
International Journal of Environmental Research and Public Health
The northern geopolitical zones (NGZs) continue to report the highest under-5 mortality rates (U5MRs) among Nigeria’s six geopolitical zones. This study was designed to identify factors related to under-5 mortality (U5M) in the NGZs. The NGZ populations extracted from the 2018 Nigeria Demographic and Health Survey were explored to assess the factors associated with U5M using logistic regression, generalised linear latent, and mixed models. Between 2013 and 2018, the northwest geopolitical zone reported the highest U5MR (179 deaths per 1000 live births; 95% confidence interval [CI]: 163–194). The adjusted model showed that geopolitical zone, poor household, paternal occupation, perceived children’s body size at birth, caesarean delivery, and mothers and fathers’ education were highly associated with increased odds of U5M. Other significant factors that influenced U5M included children of fourth or higher birth order with shorter interval ≤ 2 years (adjusted odds ratio [aOR] = 1.68; C...
Central to Millennium Development Goals (MDGs) is the reduction of under-five mortality by two-third between 1990 and 2015. At the end of MDGs, child mortality is still very high in Nigeria. This necessitates the urgent needs to have clear understanding about the dynamics of child mortality in different societies of the country. This paper examines the nexus between maternal age at first birth and level of childhood mortality most especially within the socio-economic structure of Yoruba society in Nigeria. The understanding of this relationship is of direct relevance to governments and non-State actors working on child health with the aim to achieve the stated MDGs goal and its associated targets. To achieve the objective of the study, quantitative data were generated from 1,000 women in one of the six Yoruba speaking States in Nigeria: Osun State. A multistage random sampling technique was adopted to select the respondents, while percentages, means, standard deviation, Pearson chi square, t-test, analysis of variance and post hoc test of homogeneous were adopted to analyze generated data. Findings of the study show significant relationships between maternal age at first birth and childhood mortality level within the socio-demographic characteristics of women (such as place of residence, current age, occupational status, educational level, marital status, form of marriage and number of children ever born). Specifically, women who had their first birth below age 20 years exhibit significant higher number of childhood mortality in comparison with women who had their first birth by age 20 years and above at P<0.01 most especially when the later were at similar categories to the former. Thus, age at first birth is a strong determinant of relatively high childhood mortality level in the study area. Consequently, it is imperative for government and non-State actors working on child health in the region to develop appropriate policies and programmes that will address and inhibit early age at first birth in order to reduce significantly the level of childhood mortality in Yoruba society of Nigeria.
Determinants of Under Five Mortality in South Eastern Nigeria20190806 79550 1xskpg4
Journal of Community Medicine and Public Health Care, 2019
Abstract Background: Under-five mortality is a major public health indicator hence its inclusion among the Sustainable Development Goals (SDGs). Identifying the determinants of under-five mortality is a major step in tackling under-five mortality. While it is important to determine factors that affect under-five mortality at the national level, is it also very important to disaggregate data to determine the peculiarities and differences at the geopolitical zones. This zoomed into the South-eastern geo-political zone of Nigeria. Methods: This was a population based cross-sectional study. Secondary data of the 2013 Nigeria Demographic and Health Survey (NDHS) was analyzed. Though the NDHS was a nationally representative study, only data from the South-east geo-political zone was included in analysis. The aim of the study was to identify determinants of under-five mortality. Univariate and multivariate logistic regression were carried out. Results: This study revealed several determinants of under-five mortality in the South-east geo-political zone of Nigeria. Children who reside in Anambra state had lower odds of under-five mortality compared with the children who reside in the four states. The following factors reduced the odds of under-five mortality: female gender, maternal education, maternal age less than 35 years, maternal use of modern family planning, family belonging to the middle and rich wealth index. Conclusion: this study has identified important risk factors that should be considered in the formulation of policies that combat under- five mortality in the South-east geo-political zone of Nigeria. Keywords: South-east Nigeria; Under-five mortality
The Prevalence and Determinants of Under-Five Mortality in Benue State, Nigeria
This study examines the prevalence, and the socioeconomic and demographic determinants of under-five mortality in Benue State, Nigeria. Using a purposive random sampling technique, a total of 1,500 questionnaires were administered to women aged 15 to 49 years and who have ever given birth in 30 communities from 10 sampled local government areas in the state. In addition, focus group discussions and key informant interviews formed sources of data for this research. The analysis of data was carried out using descriptive statistics, child survival analysis, and probit regression model. The pattern of the prevalence of infant and child mortality showed that there are three major child killers in the study area: malaria (38.2%), complications at birth (29.5%), and measles (16.9%). The survival probability results show that children born to parents living in an urban area have more chances (72.6%) of survival, as against 71.4% for children born to parents living in a rural area. The probit regression analysis showed that the pregnancies ever had by the mothers has a greater marginal effect on child survival (6.7%) than the current age of mothers at birth (3.7%) and the age of mother at marriage (0.9%). Based on the findings, recommendations such as empowerment and education of mothers are suggested.
Ethnicity and child mortality in sub-Saharan Africa
Analysis of recent survey data reveals large differentials in child mortality among ethnic groups in countries throughout sub-Saharan Africa. These disparities correspond with the prominence of specific ethnic groups in the national political economy. In many countries where heads of state since independence have come from one or two ethnic groups-as in Côte d'Ivoire, Kenya, and Niger-these groups have experienced levels of early child mortality at least one-third lower than those of other groups. In other countries where there have been several transitions in state control, as in Ghana and Uganda, descendants of precolonial kingdoms such as Ashanti and Buganda have experienced much lower mortality than others. In most countries, the lower mortality of potent ethnic groups-who typically represent small proportions of national populations-is strongly related to economic privilege. Persistent inequalities among African ethnic groups deserve strong consideration in planning economic development and child health strategies.
GeoJournal
Neonatal, infant, and Under-five mortality remain high with a slight improvement over the decades in Nigeria. This paper identifies the effect of maternal and health care practices on under-five survival in Nigeria. This study considers the risk of dying for 0-60 months children with identification of the time period of survival to death across the six geopolitical regions in Nigeria. The study uses data from the Demographic and Health Survey 2018 being the latest in Nigeria to explain the underlying factors associated with under-five mortality. The Kaplan Meier analysis and the Cox proportional regression were used to estimate the time between the period of birth and the event of death. Findings revealed that up to 71% of death in under-five children occurred between 0 and 12 months with a decrease in risk found as age increase after 24 months. All death occurred in children with no intake of any vaccination, 69% in children not delivered at government or private health centres, and 74% in rural communities, Result of the Cox proportional hazard regression indicates that mother's age 15-30, education, poor nutrition and unchecked breastfeeding practices after birth increases the hazard of child mortality.
Under-five Mortality in Nigeria: Effects of Neighbourhood Contexts
Despite global decline in childhood mortality, under-5 mortality remains high in Nigeria. With about 1 in 6 children dying before the age of 5, Nigeria is not on track to achieve the Millennium Development Goal 4. While many studies on childhood mortality in Nigeria have established individual level factors as important determinants of under-five mortality, similar studies on the effects of neighbourhood contexts have been minimal. Hence, this study examines the effects of neighbourhood contexts on under-5 mortality in Nigeria. The study utilized 2003 and 2008 Nigeria Demographic and Health Survey data. Multilevel Cox regression analysis was performed on a nationally representative sample of 6028 children (nested within 3775 women, who were nested within 365 communities-2003 NDHS) and 28,647 children (nested within 18028 women, who were nested within 888 communities-2008 NDHS). Results established region of residence, place of residence, ethnic diversity, neighbourhood infrastructures, and community socioeconomic contexts as important determinants of under-five mortality in Nigeria. For instance, findings showed that being born or raised in poor neighbourhoods (HR: 1.54, p<0.05), rural communities (HR: 1.25, p<0.05), and Northeastern region (HR:1.56, p<0.05) was associated with elevated hazards of death before age 5. Policies to achieve under-5 mortality reduction in Nigeria must involve community-level interventions aimed at improving child survival in the deprived neighbourhoods.