Under-5 Mortality and Its Associated Factors in Northern Nigeria: Evidence from 22,455 Singleton Live Births (2013-2018).

Osita K Ezeh,Anastasia O Odumegwu,Felix A Ogbo,Gladys H Oforkansi,Piwuna C Goson,Tanko Ishaya,Kingsley E Agho,Uchechukwu D Abada

doi:10.3390/ijerph18189899

Abstract

The northern geopolitical zones (NGZs) continue to report the highest under-5 mortality rates (U5MRs) among Nigeria’s six geopolitical zones. This study was designed to identify factors related to under-5 mortality (U5M) in the NGZs. The NGZ populations extracted from the 2018 Nigeria Demographic and Health Survey were explored to assess the factors associated with U5M using logistic regression, generalised linear latent, and mixed models. Between 2013 and 2018, the northwest geopolitical zone reported the highest U5MR (179 deaths per 1000 live births; 95% confidence interval [CI]: 163–194). The adjusted model showed that geopolitical zone, poor household, paternal occupation, perceived children’s body size at birth, caesarean delivery, and mothers and fathers’ education were highly associated with increased odds of U5M. Other significant factors that influenced U5M included children of fourth or higher birth order with shorter interval ≤ 2 years (adjusted odds ratio [aOR] = 1.68; CI: 1.42–1.90) and mothers who did not use contraceptives (aOR = 1.41, CI: 1.13–1.70). Interventions are needed and should primarily spotlight children residing in low-socioeconomic households. Educating mothers on the benefits of contraceptive use, child spacing, timely and safe caesarean delivery and adequate care for small-sized babies may also reduce U5M in Nigeria, particularly in the NGZs.

Highlights

IntroductionUnder-5 mortality (U5M), which is defined as the death of children aged between
Information relating to a weighted total of 87,877 singleton and multiple live births in the northern geopolitical zones (NGZs) was reported by women aged 15–49 years old, consisting of 26,293 live births from NE; 39,928 live births from North West (NW); and 21,656 live births from NC
Data from all three geopolitical zones (NC, NE and NW) were pooled for the analysis of characteristics related to under-5 mortality (U5M) in the NGZs because few singleton deaths were recorded during the 2018 Nigeria Demographic and Health Survey (NDHS) for each geopolitical zone and more than 80% of the population share a similar culture and religion

Summary

Introduction

Under-5 mortality (U5M), which is defined as the death of children aged between. 0 and 59 months [1], remains a challenging public health issue in Nigeria. Of the 5.2 million global deaths of children younger than 5 years old in 2019, Nigeria contributed nearly 0.9 million of these deaths, which earned Nigeria the highest contributor to global U5M [1]. An overwhelming number of these deaths are preventable or treatable illnesses with optimal healthcare and affordable, accessible and cost-effective interventions [2]. In 2017, for example, diarrhoea- and lower respiratory tract infection-related deaths accounted for approximately 13% and 19%, respectively, of U5M in Nigeria [3].

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Discussion

Conclusion