Multilevel analysis of individual- and community-level determinants of birth certification of children under-5 years in Nigeria: evidence from a household survey

Abstract

Promoting birth certification is central to achieving legal identity for all - target 16.9 of the 2030 Sustainable Development Goals. Nigeria is not on track to achieve this goal with its low coverage of birth certification (BC). This study is aimed at identifying patterns of BC and its associated individual- and community-level factors, using pooled cross-sectional data from three rounds (2008, 2013, and 2018) of the nationally representative Nigerian Demographic and Health Survey. A weighted sample of 66,630 children aged 0–4 years was included, and a two-level multilevel logistic model which accommodates the hierarchical nature of the data was employed. Of the total sample, 17.1% [95% CI: 16.3–17.9] were reported to be certified. Zamfara state (2.3, 95% CI: 0.93–3.73) and the Federal Capital Territory (36.24, 95% CI: 31.16–41.31) reported the lowest and the highest BC rates. Children with an SBA [AOR = 1.283, 95% CI: 1.164–1.413] and with at least one vaccination [AOR = 1.494, 95% CI: 1.328–1.681] had higher odds of BC. The AOR for mothers with at least one prenatal visit was 1.468 [95% CI: 1.271–1.695], and those aged 30–34 years at the time of birth [AOR = 1.479, 95% CI: 1.236–1.772] had the highest odds. Further, the odds of BC increased the most for mothers [AOR = 1.559, 95% CI: 1.329–1.829] and fathers [AOR = 1.394, 95% CI: 1.211–1.605] who were tertiary-educated. In addition, children in middle-income [AOR = 1.430, 95% CI: 1.197–1.707] or rich wealth HHs [AOR = 1.776, 95% CI: 1.455–2.169] or those whose families had bank accounts [AOR = 1.315, 95% CI: 1.187–1.456] had higher odds. Living in non-poor and within close proximity to a registration center (RC) act as protective factors for BC, while living in poor communities [AOR = 0.613, 95% CI: 0.486–0.774] and more than 10kms from an RC reduce the odds of BC [AOR = 0.466, 95% CI: 0.377–0.576]. The study identified several protective and risk factors which policymakers can adopt as strategic areas for universal birth certification. National and sub-national programs should integrate non-formal institutions as well as target child and maternal utilization of healthcare services to promote BC in Nigeria.

The Role of Legal Practitioners in Mitigating Corporate Risks in Nigeria: A Comprehensive Review of Existing Literature on the Strategies and Approaches Adopted by Legal Practitioners in Nigeria to Mitigate Corporate Risks

“…The study found that GDP has a positive significant effect on residential property development, while interest rate and inflation rate have negative significant effects (Olatunji & Adewusi, 2023). Anaduaka (2022) conducted a multilevel analysis using a two-level multilevel logistic model to identify patterns of birth certification and its associated individual-and community-level factors in Nigeria. The study identified several protective and risk factors which can be strategic areas for universal birth certification (Anaduaka, 2022).…”

“…Anaduaka (2022) conducted a multilevel analysis using a two-level multilevel logistic model to identify patterns of birth certification and its associated individual-and community-level factors in Nigeria. The study identified several protective and risk factors which can be strategic areas for universal birth certification (Anaduaka, 2022).…”

Receipt of seasonal malaria chemoprevention by age-ineligible children and associated factors in nine implementation states in Nigeria

“…It is an intriguing nding that such a large proportion of much older children received SMC medicines despite the obvious age difference between them and under-5 children. However, such children may not be distinguishable from under-5 children by mere physical appearance, due to the prevalence of malnutrition and stunting in the study setting, and SMC community distributors' di culty in ascertaining children's age due to absence of veri able home-based birth and civil registration records [8][9][10][11].From an operational perspective, however, administering SMC medicines to ineligible children presents a substantial challenge, particularly in terms of ensuring the availability of su cient SPAQ stock levels to reach the entire target population of eligible children. This has important implications for reaching and sustaining high target population coverage, while maintaining optimal levels of programmatic impact and effectiveness in SMC delivery settings.…”

“…However, in low and middle -income countries, civil registration and identi cation systems are often underdeveloped [8][9][10][11]. Coupled with the high prevalence of malnutrition and stunting in regions with high malaria attack rates, determining children's age with accuracy is therefore often challenging [6].…”

Determinants of birth registration in sub-Saharan Africa: evidence from demographic and health surveys

“…Eleven (11) explanatory variables were considered for inclusion into the study based on their availability in the DHS dataset as well their association with birth registration from previous studies (9,(16)(17)(18). We further segregated the variables into the individual level and the household/community level.…”