Child Mortality In Nigeria Research Articles

Prevalence and of Factors Associated With Under-Five Child Mortality in Nigeria: A Comparative Study Between Cox PH and Cox Frailty Model

Prevalence and of Factors Associated With Under-Five Child Mortality in Nigeria: A Comparative Study Between Cox PH and Cox Frailty Model

Spatial prediction of childhood malnutrition across space in Nigeria based on point-referenced data: an SPDE approach

Malnutrition remains a leading cause of child mortality in Nigeria. The spatial analysis based on areal level approaches could, in reality, conceal variations at smaller units. Using point-referenced data from Nigeria Demographic and Health Survey, we quantify the prevalence of malnutrition among under-five children in Nigeria at 1.63 by 1.63km spatial resolution, and compute the exceedance probability maps for stunting, wasting and underweight at 20% threshold level using the stochastic partial differential equation approach with Bayesian inference based on integrated nested Laplace approximation. Results show divergence prevalence of the malnutrition indicators among children living in neighbouring locations and that the prevalence of stunting and underweight increase with age. The prevalence of stunting was uneven among children living in Kebbi, Zamfara, Sokoto, Kaduna, Kano, Katsina, Bauchi, Gombe and Taraba states with more concentrations in the northern fringes of some of the states. Except for few locations in about three states, the probability is more than 90% that the prevalence of stunting in all parts of the country exceeds 20% but this was not the case for wasting. The findings can assist in location-specific policy formulation and implementations.

Foreign Aid and Child Mortality Rate in Nigeria

Several factors have attributed to the high child mortality rate, including poverty, age of women at birth, and length of the interval between births. Besides, the lack of financial resources in developing countries has been a challenge in addressing the prevalent high child mortality rate. Thus, this study seeks to examine the relationship between foreign aid and infant mortality in Nigeria from 1981 to 2018. Employing Auto-Regressive Distributed Lag (ARDL) technique, the study observed that foreign aid, government expenditure on health, real GDP, and carbon dioxide emission negatively impacted child mortality. Hence, the study concludes that foreign aid reduces child mortality in Nigeria. The study recommends that the government ensure that all foreign aid and grants use immediately to reduce child mortality by building the necessary infrastructure and making it readily available.JEL Classification: F35, I19.How to Cite:Adebanji, F. B., Nwosa, P. I., Ojo, O. O., & Alake, O. J. (2020). Foreign Aid and Child Mortality Rate in Nigeria. Signifikan: Jurnal Ilmu Ekonomi, 9(2), 187-194. https://doi.org/10.15408/sjie.v9i2.14960.

Modeling and Forecasting Under-Five Mortality Rate in Nigeria using Auto-Regressive Integrated Moving Average Approach

Nigeria’s efforts aimed at reducing avoidable child deaths have been met with gradual and sustained progress. Despite the decline in childhood mortality in Nigeria in the last two decades, its prevalence still remain high in comparison to the global standard of mortality for children under the age of five which stands at 25 deaths per 1000 live births. Knowledge of the chances of Nigeria achieving this goal for childhood mortality will aid proper interventions needed to reduce the occurrence. Therefore, this paper employed the Auto-Regressive Integrated Moving Average (ARIMA) model for time series analysis to make forecast of under-five mortality in Nigeria up to 2030 using data obtained from the United Nation’s Inter Agency Group for Childhood Mortality Estimate (UN-IGME). The ARIMA (2, 1, 1) model predicted a reduction of up to 37.3% by 2030 at 95% confidence interval. Results from the study also showed that a reduction of over 300% in under-five mortality is required for Nigeria to be able to achieve the SDG goal for under-five mortality.

Health care expenditure and child mortality in Nigeria

PurposeHealth improves the proficiency and output generated by individuals. It also raises physical as well as mental abilities, which are required for the growth and advancement of any economy. Many infant diseases have been recognised via contemporary technology in a bid to tackle these diseases. However, children within the African continent (Including Nigeria) die en masse from diseases. This has made the government of Nigeria allocate sizeable part of the nation's budget to healthcare system. The allocation to health is, however, yet to translate to improved health condition for Nigerians. It does not measure up to the World Health Organization's (WHO) standards for apportioning budget to the health sector. This study also analyses empirically the impact of healthcare expenses on the mortality level of infants as well as Nigeria's neonatal mortality level.Design/methodology/approachThe paper focuses on Nigeria. Vector auto regression model techniques, unit root tests and cointegration test were carried out using time series date for the period between 1986 and 2016.FindingsThe outcome has revealed that expenditure on healthcare possesses a negative correlation with the mortality of infants and neonates. The study discovers that if the Nigerian government raises and maintains health expenditure specifically on activities focused on minimising infant mortality, it will translate to reduction in infant mortality in Nigeria.Originality/valueThis paper has contributed exhaustively to solution to poor expenditure on healthcare, especially child mortality, in Nigeria.

Disparities and Inequality in Infant and Child Mortality among the 36 states and Federal Capital Territory (FCT, Abuja), Nigeria.

The paper investigates the disparities in infant and child mortality in Nigeria over the last two decades. The major contribution of this study is to document the disparities in infant and child mortality in Nigeria at the state level. The paper employs both descriptive statistics, multivariate logistics regression, and multilevel logistics regression on data from IPUMS-Demographic and Health Surveys (IPUMS-DHS), 1990, 1999, 2003, 2008 and 2013 Version 5 datasets. The paper uses a multilevel logistic regression analysis on 216,049 observations nested within 1,766 clusters or neighborhoods in the 36 states and FCT, Abuja, Nigeria. The paper finds that disparity in infant and child mortality is correlated to disparity in wealth, mother's educational attainment, and access to health care in Nigeria. Additionally, the study finds wide disparities in both infant and child mortality among the 36 states and FCT, Abuja, Nigeria. Conclusion and policy implication. The paper finds evidence of clustering effect at both community and individual levels suggesting little difference in infant and child mortality within clusters. This is very significant when we connect the instability in certain states of Nigeria to the health of children in those states.

A Bayesian Hierarchical Analysis of Geographical Patterns for Child Mortality in Nigeria

Background:In an epidemiological study, disease mapping models are commonly used to estimate the spatial (or temporal) patterns in disease risk and to identify high-risk clusters, allowing for health interventions and allocation of the resources. The present study proposes a hierarchical Bayesian modeling approach to simultaneously capture the over-dispersion due to the effect of varying population sizes across the districts (regions), and the spatial auto-correlation inherent in the childhood mortality at districts (state) level in Nigeria.Methods:This cross-sectional study was based on 31842 children data extracted from the 2013 Nigeria Demographic and Health Survey (DHS). Of these children, 2886 died before reaching the age of five years. A Standardized Mortality Ratio (SMR) was estimated for each district (state) and mapped to highlight the risk patterns and detect an unusual low (high) clusters relative risk of childhood mortality. Generalized Poisson regression models were formulated with random effects to estimate the mortality risk and then explored to investigate the relationship of under-five child mortality and the regional risk factors. The random effects are formulated to reflect the potential tendency of “neighbouring” regions to have similar risk patterns and the spatial heterogeneity effect was used to capture geographical inequalities in the mortality outcomes. The models were implemented using a full Bayesian framework. All model parameters were estimated in WinBUGSviaMarkov Chain Monte Carlos (MCMC) simulation techniques.Results:The results showed that of the economically deprived households, 2.088: 95% CI (1.088, 3.165) were significantly associated with childhood mortality, while unhygienic sanitation and lack of access to improved water sources were positively associated with child mortality, but not statistically significant at 5% probability level. The geographical variation of the under-five mortality prevalence was found to be attributed to 69% clustering and 31% was due to spatial heterogeneity factors. The predicted probability maps identified clusters of high risk mortality in the northern regions and low prevalence of concentrated mortality in the south-west regions of Nigeria.Conclusion:The results demonstrated the flexibility of the approach that explored the geographical variation in the potential risk factors of child mortality and that it provides a better understanding of the regional variations of mortality risks. Nonetheless, both representations can help to provide information for the initiation of public health interventions.

Apparent overuse of antibiotics in the management of watery diarrhoea in children in Abakaliki, Nigeria

BackgroundDiarrhoea remains an important cause of childhood mortality in Nigeria, with Rotavirus and Cryptosporidium reported to have the highest contribution. However, high use of antibiotics for treatment of paediatric diarrhoea has been observed, although World Health Organization guidelines discourage the use of antibiotics for treating acute diarrhoea. Here we investigated more closely management and treatment practices for acute paediatric diarrhoea, both in home and healthcare settings.MethodsChildren under 5 years of age (n = 199) presenting at healthcare centres in Abakaliki, Nigeria with acute watery diarrhoea were included in the study. Background information on the children was collected by questionnaire, including home treatments, and clinical information including symptoms and treatment were provided by the healthcare centres. Analysis of faecal samples from the children indicated that over 90% had Rotavirus infection and over 6% Cryptosporidium infection. Data were compiled in a spreadsheet and analysed for associations between variables and use of antibiotics using logistic regression analysis.ResultsAlthough most children were treated supportively (oral rehydration solution and intravenous fluids at home and in healthcare settings, respectively) over 15% were given anti-diarrhoea drugs at home and over 85% were also prescribed antibiotics at the healthcare centre, mostly ciproflaxin, but also metronidazole and gentamycin. The only variable positively associated with antibiotic prescription was diarrhoea more than three times per 24 h at admission.ConclusionsIt is clear that young children presenting with acute watery diarrhoea to healthcare centres in Abakaliki are likely to be prescribed antibiotics, despite there being no obvious reason that this treatment is appropriate. Our study results support the need for institution-based antimicrobial stewardship being implemented in Nigeria.

A Multilevel Hazards Model for Child Mortality In Nigeria

Many researchers have devoted considerable attention to the impact of individual-level factors on child mortality, but little is known about how family and community characteristics affect health of children. Trend in child mortality as well as its determinants, has long been the subject of academic and policy debates. In spite of this, the problem of child mortality remains as daunting as ever. In fact, advancement in medical sciences and the upsurge in information and telecommunication technology equipment have not significantly reduced child mortality in the country, unlike in the West. The Multilevel proportional hazards model for data that are hierarchically clustered at three levels was applied to the study of covariates of child mortality in Nigeria. This study merges two parallel developments of statistical tools for data analysis: statistical methods known as hazard models that are used for analyzing event-duration data and statistical methods for analyzing hierarchically clustered data known as multilevel models. These developments have rarely been integrated in research practice and the formalization and estimation of models for hierarchically clustered survival data remain largely uncharted. The model was estimated using the Newton-Raphsons numerical search approach. The model accounts for hierarchical clustering with three random effects or frailty effects. We assume that the random effects are independent and follow the Exponential and Weibull distribution. The results indicate that bio-demographic factors are more important in infancy while socioeconomic factors and household and environmental conditions have a greater effect in childhood. Furthermore, there is significant variation in child mortality risks even after controlling for measured determinants of mortality. Also, factors that fall under family and community level are more significant indicating that child survival is most controlled or determined by family and community factors and variables at the child level is not weighty. This suggests that there may exits unobserved or unobservable factors related to mortality.

A Multilevel Hazards Model for Child Mortality in Nigeria

Many researchers have devoted considerable attention to the impact of individual-level factors on child mortality, but little is known about how family and community characteristics affect health of children. Trend in child mortality as well as its determinants, has long been the subject of academic and policy debates. In spite of this, the problem of child mortality remains as daunting as ever. In fact, advancement in medical sciences and the upsurge in information and telecommunication technology equipment have not significantly reduced child mortality in the country, unlike in the West.

Death of preceding child and maternal healthcare services utilisation in Nigeria: investigation using lagged logit models

BackgroundOne of the factors responsible for high level of childhood mortality in Nigeria is poor utilization of maternal healthcare (MHC) services. Another important perspective which has been rarely explored is the influence of childhood death on MHC service utilization. In this study, we examined the relationship between death of preceding child and MHC services utilization [antenatal care (ANC), skilled attendant at birth (SAB), and postnatal care (PNC)] among Nigerian women and across the six geo-political zones of the country.MethodologyWe analyzed reproductive history dataset for 16,747 index births extracted from the 2013 Nigeria Demographic and Health Survey. The main explanatory variable was survival status of preceding child; therefore, only second or higher order births were considered. Analysis involved the use of descriptive statistics and lagged logit models fitted for each measure of MHC utilization. Association and statistical significance were expressed as adjusted odds ratio (AOR) with 95% confidence interval.ResultsThe use of MCH services for most recent births in the 2013 Nigeria DHS were ANC (56.0%), SAB (34.7%), and PNC (27.3%). Univariate models revealed that the death of preceding child was associated with lesser likelihood of ANC (OR = 0.64, CI 0.57–0.71), SAB (OR = 0.56, CI 0.50–0.63), and PNC (OR = 0.65, CI 0.55–0.69). Following adjustment for maternal socio-economic and bio-demographic variables, statistical significance in the relationship disappeared for the three MHC indicators: ANC (AOR = 1.00, CI 0.88–1.14), SAB (AOR = 0.97, CI 0.81–1.15), and PNC (AOR = 0.95, CI 0.83–1.11). There were no significant variations across the six geo-political regions in Nigeria. The likelihood of ANC utilization was higher when the preceding child died in Northcentral (AOR = 1.19, CI 0.84–1.70), Northeast (AOR = 1.26, CI 0.99–1.59), and South-south (AOR = 1.19, CI 0.72–1.99) regions while the reverse is the case in Southeast (AOR = 0.39, CI 0.23–0.60). For the Southeast, similar result was obtained for ANC, SAB, and PNC.ConclusionDeath of a preceding child does not predict MHC services use in Nigeria especially when maternal socio-economic characteristics are controlled. Variations across the Northern and Southern regions did not attain statistical significance. Interventions are needed to reverse the pattern such that greater MHC utilization is recorded among women who have experienced child death.

Individual, Household and Community-Level Effects of Infant and Child Mortality in Nigeria: A Logistic Regression Approach

Research has shown that knowledge about the determinants of childhood mortality at the individual level is not enough to address the problem because the characteristics of the environment where a child is born tend to alter individual level characteristics and thereby affect child survival. The study used data from the 2013 Nigeria Demographic and Health Survey (NDHS). The fact that a child was either dead or alive was assumed to be accurately recorded. Hence, logistic regression model was used to model whether a child is dead or alive with respect to the selected predictor variables. Results from the study reveal that infant and child mortality in Nigeria is determined more by individual household than by community, and that geographical variations also exist. This study has identified significant risk factors that will help policy makers to formulate policies that will improve childhood survival.

Household use of solid fuel for cooking and under-five mortality in Nigeria

Background: Exposure to harmful smoke from household use of solid fuel had continuously contributed to childhood deaths in Nigeria. Objective: This study examined the effects of cooking fuels used by households on childhood mortality in Nigeria. The study derives its relevance from the United Nations Sustainable Development Goals 1, 3 and 7, which focused on issues of poverty, good health, affordable and clean energy. Methods: The 2013 Nigeria Demographic and Health Survey dataset was used for analysis with a selection of 10,983 households. Results: The results show that level of education, wealth-status, place of residence and regional locations are factors influencing the use of solid fuel, and under-five mortality (P<0.01). Conclusion: Therefore, improved level of education, economic conditions, availability and provision of cheap and clean fuel will assist the poor to reduce usage of solid fuel, minimize exposure of young children to dangerous smoke and reduce childhood mortality in Nigeria.

Effect of birth interval and wealth on under-5 child mortality in Nigeria

BackgroundThere exists a number of studies on the causes and determinants of childhood mortality in the developing world. However, to best of our knowledge, none of the existing studies have examined the effect of wealth and birth interval on childhood mortality in Nigeria. This study is an attempt to fill that gap. MethodsData for this study comes from the Nigeria Demographic and Health Survey 2013, which is a nationally representative cross-sectional survey. This study uses information on 119,386 under-5 children to analyze the effect of wealth and birth interval on childhood mortality. Bi-variate and Cox regression technique were applied for analyzing the cross-sectional data drawn from representative survey. ResultsUnder-5 mortality was higher in mothers who were poor, illiterate and working either as a professional/technical worker or as an agricultural worker. Children whose mothers were illiterate and had less than two years of the birth interval had the highest under-5 mortality. Younger mothers (aged less than 20 years) lost more children. Under-5 deaths were more among those mothers who were poor and had less than two years of birth interval. The child mortality was significantly high in poor households with low birth interval. ConclusionUnder-5 mortality is low among those who had higher wealth status and more than two years of birth interval. In order to reduce or eradicating the effect of birth interval and wealth effect, there is burning need to control the economic inequality and birth interval.

Maternal Education and Child Mortality in Nigeria

Reports have shown that child mortality is still pervasive in Nigeria despite several intervention programmes. While most authors have been preoccupied with searching for long-lasting solutions to the syndrome, this article argues that the relationship that subsists between maternal education and child mortality in Nigeria cannot be fully understood without examining certain background variables of the mothers such as familial, economic and religious factors among others. Data were sourced from the Nigerian Demographic Health Survey of 2013 and were analyzed with both descriptive and inferential statistics. The study found that child mortality is particularly high among mothers without formal education and relatively lower among those with other levels of education although factors such as family size, religious affiliation, wealth index and sex of household head had strong influence on these women.

Application of Count Models on Infant and Child Mortality in Nigeria: A Comparative Study

Application of Count Models on Infant and Child Mortality in Nigeria: A Comparative Study

Determinants of Maternal Care Services Utilization within Conjugal Context in Lagos State

Antenatal care attendance is an essential component of maternal health and critical to reducing high maternal and child mortality in Nigeria. This study focused on factors that influence maternal healthcare services utilization at the conjugal level. The study was carried out among ever-married men and women in Shomolu, Lagos State, between March and June, 2017. Both quantitative and qualitative approaches were adopted to implement the study. At the quantitative level, cross-sectional survey was adopted while In-Depth Interview (IDI) was used at the qualitative level. The probability sampling technique was adopted to select a sample size of 480 respondents for the quantitative aspect of the study, while 36 participants were purposively selected for the qualitative aspect. The study examined the relationship between men's perception of the influence of antenatal clinic attendance on pregnancy outcome and their approval of wives' antenatal clinic attendance. It equally investigated the relationship between educational attainment and perception of non-attendance of antenatal clinic among women, and the relationship between requirement to obtain husband's permission and number of antenatal care attendance among women. Results showed that no relationships exist between men's perception of antenatal care attendance and their approval for wives' attendance of antenatal care facility. However, educational attainment among men was found to be positively related to their perception of antenatal clinic attendance. Similarly, test result showed a relationship between women's perception of antenatal care attendance and number of attendance, with t(83.395) = 7.718, p<0.001.

The Relationship between Health Facility-based Delivery and Child Mortality in Nigeria: Insights from 2013 Nigeria Demographic and Health Survey

Background: Health facility-based delivery has been considered to be an important factor in reducing maternal and child deaths. Evidence suggests that 63 per cent of women aged 15-49 years deliver at home. This study seeks to examine the effect of health facility-based delivery on child mortality in Nigeria. Methods: Secondary data from the 2013 Nigeria Demographic and Health Survey was used. Variables on place of delivery as well as demographic and socio-economic characteristics of the study sample were analysed. Data analysis was carried out using STATA 12. Univariate, bivariate and multivariate analyses were conducted. Results: Results showed that health facility-based delivery was not significantly associated with child mortality. However, being a child of women aged 25-34 years, being a child of women aged 35 years or older, being a child of a woman with secondary or higher education, being a child of a woman living in rural area, being a child of a woman living in North West region, being a child of a woman living in South East region, being a child of a married woman, being a child of a woman with more than five members, being a child of a woman with 2-4 birth order, being a child of a woman with five or more birth order, being a child of a woman with 3 and 4 children and being a child of a woman with five or more children were significantly associated with child mortality. Conclusions: Our study concludes that health facility-based delivery is not a significant predictor of child mortality in Nigeria. However, demographic and socio-economic factors were significantly associated with child mortality. Therefore, policy makers need to target these factors in their effort to reduce child mortality.

Beyond causes of death: The social determinants of mortality among children aged 1-59 months in Nigeria from 2009 to 2013.

BackgroundMillions of children worldwide suffer and die from conditions for which effective interventions exist. While there is ample evidence regarding these diseases, there is a dearth of information on the social factors associated with child mortality.MethodsThe 2014 Verbal and Social Autopsy Study was conducted based on a nationally representative sample of 3,254 deaths that occurred in children under the age of five and were reported on the birth history component of the 2013 Nigerian Demographic and Health Survey. We conducted a descriptive analysis of the preventive and curative care sought and obtained for the 2,057 children aged 1–59 months who died in Nigeria and performed regional (North vs. South) comparisons.ResultsA total of 1,616 children died in the northern region, while 441 children died in the South. The majority (72.5%) of deceased children in the northern region were born to mothers who had no education, married at a young age, and lived in the poorest two quintiles of households. When caregivers first noticed that their child was ill, a median of 2 days passed before they sought or attempted to seek healthcare for their children. The proportion of children who reached and departed from their first formal healthcare provider alive was greater in the North (30.6%) than in the South (17.9%) (p<0.001). A total of 548 children were moderately or severely sick at discharge from the first healthcare provider, yet only 3.9%-18.1% were referred to a second healthcare provider. Cost, lack of transportation, and distance from healthcare facilities were the most commonly reported barriers to formal care-seeking behavior.ConclusionsMaternal, household, and healthcare system factors contributed to child mortality in Nigeria. Information regarding modifiable social factors may be useful in planning intervention programs to promote child survival in Nigeria and other low-income countries in sub-Saharan Africa.

Prevalence and determinants of childhood mortality in Nigeria

BackgroundChildhood mortality has remained a major challenge to public health amongst families in Nigeria and other developing countries. The menace of incessant childhood mortality has been a major concern and this calls for studies to generate new scientific evidence to determine its prevalence and explore predisposing factors associated with it in Nigeria.MethodData was obtained from Nigeria DHS, 2013. The study outcome variable was the total number of children lost by male partners and female partners respectively who were married. The difference between the numbers of child births and the number of living children was used to determine the number of children lost. Study variables were obtained for 8658 couples captured in the data set. Descriptive statistics were computed to examine the presence of over-dispersion and zero occurrences. Data were analysed using STATA Software version 12.0. Zero-inflated negative binomial (ZINB) regression analysis was carried out to determine the factors associated with childhood mortality. Results of ZINB were reported in terms of IRR and 95% confidence interval (CI).ResultsThe age (mean ± std.) of male and female participants were 36.88 ± 7.37 and 28.59 ± 7.30 respectively. The data showed that 30.8% women reported loss of children and 37.3% men reported the same problem. The study revealed age (years), region, residence, education, wealth index, age at first birth and religion of father and mother as factors associated with childhood mortality. In terms of education, secondary and tertiary educated fathers exhibited 3.8% and 12.1% lower risk of childhood mortality respectively than non-educated fathers. The results showed that the risk of childhood mortality are 26.7%, 39.7 and 45.9% lower among the mothers having primary, secondary and tertiary education respectively than those with no formal education. The mothers living in rural areas experienced 28.3% increase in childhood mortality than those in urban areas, while the fathers in rural areas experienced 33.5% increase in childhood mortality than the urban areas. The risk of childhood mortality was significantly lower in middle, richer and richest (11.1%, 37.5 and 49%) economic quintiles respectively when compared to the risk of childhood mortality with female spouse who are poorest. Similar results were obtained for the fathers, with reduction in the incidence-rate ratio of 3.3%, 20.2 and 28.7% for middle, richer and richest economic quintiles respectively, compared to the poorest status. Furthermore, region and religion were found to be significant factors associated with childhood mortality in Nigeria.ConclusionThe findings suggested that age, region, residence, education, wealth index, age at first birth and religion of fathers and mothers are key determinants associated with childhood mortality. The correlation between childhood mortality and fathers’ and mothers’ ages were found to increase the incidence of the outcome for every unit increase in age. The converse was however, true for age at first birth which was also statistically significant. The implication of this study is that policy makers and stakeholders in health care should provide for improved living standards to achieve good life expectancy meeting SDG3.