Trends and Factors Associated with Under-5 Mortality in Northwest Nigeria (2008–2018)

Abstract

Background:The Nigeria Demographic and Health Survey (NDHS) revealed that the underfive mortality rate (U5MR) in the northwest geopolitical zone (NWGZ), Nigeria, increased by 1.1% from 185 to 187 deaths per 1,000 live births between 2013 and 2018, indicating a setback to the previously reported modest improvement in U5MR.Objectives: This study sought to examine trends and factors related to under-5 mortality (U5M) in NWGZ from 2008 to 2018. Methods:A combined NWGZ dataset extracted from the 2008, 2013 and 2018 NDHSs, with a sample of 32,015 singleton live births, including 3,745 under-5 deaths, was used. The U5MRs for each survey year and potential independent factors were obtained using the STATA "syncrmrates" command, and then the trends were examined. A logistic regression generalised linear latent and mixed model was used to explore the potential factors associated with U5M in NWGZ. Findings:In NWGZ, the U5MR declined by only 8.2% (from 195 to 179 per 1,000 live births between 2008 and 2018, respectively), with a similar trend observed among its seven states. Multivariable analyses indicated that maternal education (no formal or primary education), maternal non-use of contraception, a mother's perception of the baby being small or very small, birth order (second to fourth or higher) with a shorter birth interval (≤2 years), younger or older maternal age (<20 years or ≥40 years old) and rural residence were significantly associated with U5M in NWGZ. Conclusion:Interventional initiatives including educating mothers on the benefits of contraceptive use, child spacing, kangaroo mother care of small-sized babies and promoting regular check-ups for older mothers will substantially reduce U5M in NWGZ.

Maternal demographic and socioeconomic correlates of child mortality in Papua New Guinea: Evidence from the integrated Health and Demographic Surveillance System

“…Compared with women who were aged 40-49 years, the child under 5 mortality rate was higher among those aged 15-19 and 20-24 years. This is consistent with findings from other countries with similar health facilities such as Nigeria [12], Bangladesh [56], and Ethiopia [57]. In PNG, adolescent girls between the ages of 15 and 19 years are frequently falling pregnant [58] putting themselves at higher risk of experiencing under-five mortality.…”

“…Biologically, these women are physically immature, vulnerable and not ready to become mothers [12]. They lack the psychological and social skills necessary to deal with pregnancy, their child's health, and parenting in general [59].…”

“…Between 2014-2023, studies from LMICs have examined demographic and socioeconomic factors associated with child mortality. Geographic region/residence [5,[11][12][13][14][15][16][17], ethnicity [18], mother's age [12,17,[19][20][21], marital status [19], sex of child [5], maternal education [5,12,17,19,22], maternal literacy [23], religion [17], breastfeeding [18,21], child death experience [24] place of delivery [5], type of births and delivery [5,11,18,22], high birth order [12], presence of antenatal (ANC) checks [21], tetanus vaccination status [24], contraception use [11][12][13]24], unmet need for family planning [25], distance from health facility [26], mother's working status [20], paternal occupation [13], and household wealth index [5,13,17,…”

Trends and Determinants of Neonatal Mortality in Rural Ethiopia

“…In study conducted with DHS data from Ghana the risk of neonatal mortality Among mothers who did not attend ANC, was approximately five times as high as the risk of neonatal deaths for mothers who attended ANC. Consistent finding was reported across the study conducted in Afghanistan, Nigeria and Ethiopia[7,25,26].…”

“…It has been observed that the male neonate had a higher likelihood of dying in the first four week of life when compared to their female counterpart. This finding was consistently found in the study conducted using DHS data in Zambia [24], Afghanistan [25], Nigeria [26], Burundi [21] and Bangladesh [27].…”