Approximation of the Cox survival regression model by MCMC Bayesian Hierarchical Poisson modelling of factors associated with childhood mortality in Nigeria

Abstract

The need for more pragmatic approaches to achieve sustainable development goal on childhood mortality reduction necessitated this study. Simultaneous study of the influence of where the children live and the censoring nature of children survival data is scarce. We identified the compositional and contextual factors associated with under-five (U5M) and infant (INM) mortality in Nigeria from 5 MCMC Bayesian hierarchical Poisson regression models as approximations of the Cox survival regression model. The 2018 DHS data of 33,924 under-five children were used. Life table techniques and the Mlwin 3.05 module for the analysis of hierarchical data were implemented in Stata Version 16. The overall INM rate (INMR) was 70 per 1000 livebirths compared with U5M rate (U5MR) of 131 per 1000 livebirth. The INMR was lowest in Ogun (17 per 1000 live births) and highest in Kaduna (106), Gombe (112) and Kebbi (116) while the lowest U5MR was found in Ogun (29) and highest in Jigawa (212) and Kebbi (248). The risks of INM and U5M were highest among children with none/low maternal education, multiple births, low birthweight, short birth interval, poorer households, when spouses decide on healthcare access, having a big problem getting to a healthcare facility, high community illiteracy level, and from states with a high proportion of the rural population in the fully adjusted model. Compared with the null model, 81% vs 13% and 59% vs 35% of the total variation in INM and U5M were explained by the state- and neighbourhood-level factors respectively. Infant- and under-five mortality in Nigeria is influenced by compositional and contextual factors. The Bayesian hierarchical Poisson regression model used in estimating the factors associated with childhood deaths in Nigeria fitted the survival data.

Mortalidade infantil associada às iniquidades sociais: revisão de escopo

“…Poisson modelling of factors associated with childhood mortality in Nigeria (60) 2021/ Nigéria Estudo transversal/ n=não informado Regressão de Poisson hierárquicos.…”

“…• A baixa escolaridade materna está associada a maior taxa de mortalidade infantil (2)(3)(4)(5)(6)(7)(8)11,(21)(22)(23)(25)(26)(27)32,33,35,(41)(42)(43)(44)(45)49,52,54,(58)(59)(60)(62)(63)(64)(65) , a alta taxa de mortalidade infantil (3,19,36,49,(55)(56)(57) , a mortalidade evitável no primeiro dia (30) e a mortalidade infantil prematura em unidade terapia intensiva neonatal (16) .…”

“…• A pobreza (2,8,22,23,32,46,51,53,60,62) e segregação estão diretamente relacionadas com altas taxas de mortalidade infantil (29,44) .…”

“…• Em áreas rurais é mais alta a taxa de mortalidade infantil (36,49,56,60) , a taxa de mortalidade perinatal (6) e as chances de mortalidade neonatal e mortalidade infantil (2,23,25,31,39,46,51,53,54,58,64,65) . Nascimentos em zona rural foi relacionado a mortalidade infantil, que reduz conforme o aumento do nível de urbanização (15,32) .…”

Determinants associated with infant mortality in Ethiopia: Using the recent 2019 Ethiopia mini demographic and health survey

“…related with infant death. When compared to maternal age at first birth infants whose age at first birth were(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32) than whose age less than 16 to infant age, the odds of infant death were 0.541 times (AOR = 0.541, 95%CI: 0.353, 0.827) lower. Those who had breastfed a 0.022 (AOR = 0.022, 95% CI: 0.014, 0.034, P<0.000) times less risk of infant death compared to other infants.…”