Individual- and Contextual-Level Determinants of Social Inequities in Under-Five Mortality in Nigeria: Differentials by Religious Affiliation of the Mother

Abstract

In sub-Saharan Africa, social factors such as religion have been linked with significant child morbidity and mortality. In religiously multi-denominational societies, one dominant religious group tends to subject the other groups to some form of economic, social or political discrimination, resulting in inequities in child survival. This study assessed the influence of individual- and community-level indicators underlying the association between religion and under-five mortality using multilevel logistic regression modelling. There is a significant association between religion and under-five mortality, which is considerably attenuated by sequentially adjusting for other risk factors. The effect of religion on under-five mortality is influenced by contextual-level characteristics of the community. Traditional religion is associated with under-five mortality, which is attributed to individual- and community-level indicators. Policy measures aimed at tackling child health inequities due to social factors such as religion need to consider the significance of the context in which mothers in different communities live, when healthcare interventions are being planned.