Determinants of Early Neonatal Mortality in Nigeria: Results from 2013 Nigeria DHS

Abstract

Child mortality remains a significant public health challenge particularly in developing countries of sub-Saharan Africa where around 50% of the global 6.3 million children die before their fifth birth day. Additionally, all the 16 countries with under-5 mortality rate of more than 100 per 1000 live births are located in sub-Saharan Africa and the region experienced one of the slowest annual rates of reduction in child mortality of 2.7% between 1990 and 2012 [1]. Of the 6.3 million child death estimated to have occurred worldwide in 2032, around 44% of these deaths took place during the neonatal period (i.e. within the first 28 days of life) and a further 75% of these neonatal deaths occurred during the first week of life (i.e. the early neonatal period) [2,3]. It follows that around 33% (or 2.1 million) of the global child death took place during the early neonatal period while the remaining 67% takes place in the remaining 1818 days. These deaths are substantial and targeting their determinants in the form of programmatic interventions will lead to significant reduction in child mortality overall. Therefore, strategies that promote better survival during the early neonatal period will have the greatest impact to reduce the overall child mortality as well as sustaining the progress made in reducing child mortality thus far. In Nigeria, child mortality continues to be a public health challenge despite adopting the various international health agendas aimed at reducing child mortality such as millennium development goals (MDGs), partnerships for maternal, neonatal and child health (PMNCH) and the Countdown Strategy. Despite keying into these programs, neonatal, infant, child and under-5 mortality rates remain high at 37, 69, 64 and 128 per 1000 live births respectively and Nigeria’s contribution to the global burden of child mortalityis immensely huge at around 13% (or 804,000 child deaths) in 2013 [4,5]. Nigeria’s contribution to global pool of child mortality has marginally decreased from 849,000 in 1990 to 827,000 in 2012 while there is a reversal in the expected decline as neonatal deaths increasing from 207, 000 to 267,000 during the same period [4]. Past literature on the subject matter have continued to give more emphasis on either under-five mortality [6-11] or on neonatal mortality [12,13] ignoring the significant proportion of early neonatal deaths as an important component of both Research Article Abstract