Intra-demographic birth risk assessment scheme and infant mortality in Nigeria

Ayo S Adebowale

doi:10.1080/16549716.2017.1366135

Abstract

ABSTRACT Background: Infant mortality (IM) is high in Nigeria. High-risk birth can limit a newborn’s survival chances to the first year of life. The approach used in investigating the relationship between high-risk birth and IM in this study is yet to be documented in Nigeria. Objectives: The Intra-Demographic Birth Risk Assessment Scheme (IDBRAS) was generated and its relationship with IM was examined. Methods: 2013 Nigeria demographic and health survey data were used. Mothers who gave birth in the 5 years before the survey were investigated (n = 31,155). IDBRAS was generated from information on maternal age at childbirth, parity and preceding birth interval and was disaggregated into low, medium and high. Data were analysed using the Cox proportional hazard and Brass 1-parameter models (α = 0.05). Results: Infant mortality rate was 88.4, 104.7 and 211.6 per 1000 live births among women with low, medium and high level of IDBRAS respectively. The rate of increase of reported infant deaths between low and high IDBRAS was 0.1932 (R 2 = 0.5326; p < 0.001). The prevalence of medium- and high-risk birth was 24.6 and 4.2% respectively. The identified predictors of IM were place of residence, marital status and size of the child at birth. The hazard ratio of IM was higher among women with medium (HR = 1.35; 95% CI = 1.22–1.48, p < 0.001) and high IDBRAS (HR = 1.73; 95% CI = 1.48–2.02, p < 0.001) than among those with low IDBRAS. Controlling for other correlates barely changed this pattern. Conclusions: The risk and level of IM increased as the level of IDBRAS increases in Nigeria. IDBRAS was an important predictor of IM. Maintaining a low level of IDBRAS will facilitate a reduction in IM rate in Nigeria.

Highlights

Infant mortality (IM) is high in Nigeria
This study aims to establish a relationship between intra-demographic birth risk assessment scheme (IDBRAS) and infant mortality in Nigeria
The fitted line indicates a positive relationship with infant mortality and that a unit increase in IDBRAS will increase the proportion of women who have experienced infant death in the 5 years before the survey by 19.32%

Summary

Introduction

Infant mortality (IM) is high in Nigeria. High-risk birth can limit a newborn’s survival chances to the first year of life. The infant mortality rate has been declining in most developing countries in the past two decades [1]. The mortality and morbidity associated with high-risk birth are enormous and the poor economic conditions in developing countries like Nigeria aggravate the problem. Nigeria is a high-fertility country with a total fertility rate of 5.5 and infant mortality rate of 68 per 1000 live birth [9]. These high demographic parameters classify Nigeria among countries where demographic transition is yet to begin [1]. The interaction between socioeconomic, biological and environmental factors often leads to a decrease in this survival chance [13]

Objectives

Methods

Results

Conclusion