Abstract
The high infant and child morbidity and mortality in most sub-Saharan African countries, and Nigeria in particular, is a prominent global concern. The objective of this study was to assess factors influencing, and the prevalence of, the experience of child death among rural Nigerian mothers, with the specific aim to investigate whether household headship had an impact on child death. Using data from the 2008 Nigeria Demographic and Health Survey, multivariate logistic regression methods were used to assess the influence of household headship and other associated variables among rural women who experienced child death (n=13 203) in the 5 years preceding the survey. A total of 5632 women (43%) whose most recent birth occurred in the 5 years preceding the survey had reported the death of a child. Women who utilized health services were less likely to report child death than those who never utilized health services. Women who delivered their most recent child at home were more likely (46%; n=4565) to report child death compared with those who delivered in a health facility (32%; n=997). The women who resided in male-headed households had a significantly higher (43%; n=5143) prevalence of child death than women from female-headed households (37%; n=489). After controlling for all covariates in the multivariate logistic regression models, women from female-headed households were 17% less likely to experience child death (odds ratio=0.83; 95% confidence interval 0.71, 0.98) than women from male-headed households. The occurrence of child death is not unusual in rural Nigeria. Multiple frameworks are needed to account for differentials in child mortality. After controlling for other explanatory variables such as age, wealth status, region and place of delivery of recent birth, this study found that household headship remained a strong predictor of child mortality. Recommendations are provided according to the complex interplay of socio-cultural, economic, and situational factors affecting the survival of children in rural Nigeria.
Highlights
The high infant and child morbidity and mortality in most sub-Saharan African countries, and Nigeria in particular, is a prominent global concern
This study investigated the effect of a number of sociodemographic and other factors related to health service utilization and household headship on reporting child deaths in rural Nigeria
The present study found that women with older living children were less likely to report child death, implying that once children pass the critical stages for early mortality, the survival advantage of their siblings increases[24]
Summary
The high infant and child morbidity and mortality in most sub-Saharan African countries, and Nigeria in particular, is a prominent global concern. Methods: Using data from the 2008 Nigeria Demographic and Health Survey, multivariate logistic regression methods were used to assess the influence of household headship and other associated variables among rural women who experienced child death (n=13 203) in the 5 years preceding the survey. The family is the basic social unit in Nigeria, consisting largely of patrilineal extended households where the male is the head of the household, leaving women with less autonomy in health issues These differences are more pronounced in northern than southern Nigeria[4,5,6,7]. Results from the 2008 Nigeria Demographic and Health Survey (DHS) showed that child mortality rates (deaths per 1000 children) ranged from a low of 32 in the south-west zone to 139 in the north-west zone. Total fertility rates were generally higher among rural (6.3 children) compared with urban (4.7 children) women[8]
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