Housing materials as predictors of under-five mortality in Nigeria: evidence from 2013 demographic and health survey

Abstract

BackgroundNigeria is among countries with high Under-Five Mortality (U5M) rates worldwide. Both maternal and childhood factors have been linked to U5M in the country. However, despite the growing global recognition of the association between housing and quality of life, the role of housing materials as predictors of U5M remain largely unexplored in Nigeria. This study, therefore, investigated the relationship between housing materials and U5M in Nigeria.MethodsThe study utilised the 2013 Nigeria Demographic and Health Survey data. A representative sample of 40,680 households was selected for the survey. The sample included 18,516 women of reproductive age who had given birth in the past 5 years prior the survey; with attention on the survival status of the index child (the most recent delivery). Data were analysed using descriptive statistics, Chi-square, Cox-proportional hazard and Brass 2-parameter models (α = 0.05).ResultsThe hazard ratio of U5M was 1.46 (C.I = 1.02–1.47, p < 0.001) and 1.23 (C.I = 1.24–1.71, p < 0.001) higher among children who lived in houses built with inadequate and moderate housing materials respectively than those in good housing materials. Under-five deaths show a downward trend (slope = −0.4871) relative to the housing materials assessment score. The refined U5M rate was 143.5, 127.0 and 90.8 per 1000 live birth among women who live in houses built with inadequate, moderate and adequate housing materials respectively. Other predictors of U5M were; the size of the child at birth, preceding birth interval, prenatal care provider, residence and education. Under-five death reduces with increasing maternal level of; education, wealth quintile, media exposure and housing material type and mostly experienced by Muslim women (6.0%), rural women (6.5%) and women residence in the North-West geopolitical zones (6.9%).ConclusionsLiving in houses built with poor housing materials promoted U5M in Nigeria. Provision of sustainable housing by the government and the maintenance of existing housing stock to healthful conditions will play a significant role in reducing the burden of U5M in Nigeria.

Intra-demographic birth risk assessment scheme and infant mortality in Nigeria

“…More high IDBRAS was found among rural than among urban women and greater prevalence among married than unmarried women. These findings are in agreement with the earlier studies conducted in Nigeria and other parts of sub-Saharan Africa if IDBRAS was disentangled into its main components [5,31]. …”

“…Being a male child, residence in a rural area, small at delivery and a single mother predisposed children to higher childhood mortality in Nigeria. The direction of the relationship between these factors and infant mortality as established in this study is consistent with what is known in this area of research [5,16,31,32]. …”

“…In such a situation, there is a feasibility of higher-parity women and high birth frequency resulting from shorter birth intervals. The inverse patterns in proportion of women with high IDBRAS exhibited by level of education and household wealth were similar and expected as found in previous studies [14,31]. More high IDBRAS was found among rural than among urban women and greater prevalence among married than unmarried women.…”

Risk factors for under-five mortality in Ethiopia: Evidence from the 2016 Ethiopian Demographic and Health Survey

“…In sub-Saharan Africa, 1 in 12 children dies before 6 months, which is 12 times higher than the average figure of 1 in 147 children in developed countries. [5] The U5CM rate is estimated to be high (67 deaths per 1 000 live births) in Ethiopia, which means that 1 in every 15 children dies before reaching the age of 5 years. [6] This rate is higher than in several other low-and middleincome countries, and it is one of the challenges that the country needs to address.…”

Nutrition-specific and sensitive drivers of poor child nutrition in Kilte Awlaelo-Health and Demographic Surveillance Site, Tigray, Northern Ethiopia: implications for public health nutrition in resource-poor settings

“…Socio-economic position was measured using wealth index, applying principal component analysis [56,57], from a wide range of variables such as accessibility to improved water and sanitation services as defined by the WHO/UNICEF Joint Monitoring Program (JMP) ladders [58], levels of housing quality computed by replicating a prior research work [59], availability and quantity of agricultural ownership (farmland, bee hive, cart, livestock and food crops produced), access to electricity, media (created from single or joint ownership of TV or radio or phone), and other household ownerships like a bed with sofa, use of non-biomass energy source for food cooking etc. Detail of our methodology for generating wealth index is provided in Appendix D of the supplementary material.…”