Deaths In Nigeria Research Articles

Traditional birth attendant-assisted versus unassisted births: a comparison of neonatal deaths in Nigeria, 2008–2018

to directly compare the risk of neonatal death between traditional birth attendant (TBA)-assisted and unassisted deliveries in Nigeria. Using data on live births from the 2008, 2013, and 2018 Nigeria Demographic and Health Surveys, this cross-sectional study compared risk of neonatal death for TBA-assisted versus unassisted births. We used survey-featured logistic regression to estimate the odds of neonatal death. Survey year-stratified and propensity score-matched (PSM) estimates were obtained. Multivariate imputation by chained equation (MICE) for missing data was conducted. A total of 28, 922 births were included. Regression and PSM analysis of pooled data showed that unassisted births had lower odds of neonatal death compared to TBA-assisted births, (aOR 0.81, 95% CI: 0.65,1.00) and (aOR 0.80, 95% CI: 0.64,1.00), respectively. Regression analysis by survey year yielded non-significant higher odds of neonatal death for TBA-assisted births. Pooled estimates from MICE showed non-significant higher odds of death for TBA-assisted births. These findings indicate that birth care by TBAs do not necessarily lead to better neonatal survival. Jurisdictions seeking to allow continued operation of TBAs need to consider measures such as training, supervision, and regulation to ensure the safety of newborns.

Social autopsy analysis of the determinants of neonatal and under-five mortalities in Nigeria, 2013-2018

Background Nigeria suffers from one of the world’s highest child mortality rates, with about 900,000 deaths in a single year, despite being classified as a middle-income country. Over the past few years, substantial efforts have been made to reduce child mortality, with under-five mortality declining by 31.6% between 1990 and 2018. However, this decline is slower than needed to reduce child mortality significantly. This study presents the social autopsy component of the 2019 verbal and social autopsy (VASA) survey to provide an in-depth understanding of the social determinants of under-five mortality in Nigeria. Methods The study was a cross-sectional inquiry into the social determinants of neonatal and 1-59 months child deaths from the 2018 Nigeria Demographic and Health Survey (NDHS) weighted to represent the Nigerian population. The social autopsy survey asked about maternal care for neonates and 1-59 months children during the final illness. Results Child mortality in Nigeria in children aged 1-59 months is strongly associated with levels of wealth, place of residence, and maternal education. The association of these same socio-economic factors with neonatal mortality is weaker. While there were significant associations with wealth quintiles and geopolitical zones, higher maternal education was not significantly associated with lower neonatal death rates. Maternal complications in pregnancy and/or labour and delivery were common and strongly associated with stillbirths and deaths in the first two days. Severity scores at the inception of the illnesses did not show differences between children who only received informal care versus those who went to formal care providers. The main barriers to care were distance, cost, transport, and the need to travel at night, and these barriers were interlinked. More distant facilities usually required vehicle transport, which was expensive for low-income families. Travelling for an emergency at night was even more difficult in terms of finding and paying for transport and involving problems with insecurity and bad roads. Conclusions The family, community, and health system factors related to neonatal and 1-59 months child deaths in Nigeria were highlighted in this study. Deaths were commonly associated with numerous factors, each of which could contribute to the sequence of events resulting in a preventable death.

Levels, Trends, and Causes of Adolescent and Young Adult Maternal Mortality in Nigeria During 1990–2017: Analysis of the 2017 Global Burden of Disease Study Database

Background: Despite the global progress made in reducing maternal mortality in the past two decades, the health of adolescents and young adult women (10-24 years) has been neglected based on the wrong assumption that they are healthy, especially in a developing country like Nigeria; this is despite the fact that adolescents and young adults (AYA) constitute over 16% of Nigeria’s population. Thus, this study aimed to determine the levels, trends, and causes of maternal mortality among AYA women aged 10-24 years in Nigeria. Methods: This was a cross-sectional study that utilized secondary data sets running from 1990 to 2017 from the Global Burden of Disease Study’s (GBD) online interactive tool downloaded from the Global Health Data Exchange (GHDx) platform. From the database, we extracted the numbers of maternal deaths (10-49 years), adolescent and young adults’ maternal deaths (10-24 years), the proportion of maternal deaths (10-24 years), and both maternal mortality ratio and rate for 15-49 years old and 10-24 years old in the form of Comma separated values (CSV) and converted into XLS file in Microsoft (MS) Excel format for the analysis. Frequencies, proportions, and charts were generated using MS Excel. Result: A total of 122,107 maternal deaths occurred among adolescents and young adults (AYA), which is 26% of all deaths occurring among 10-49 years old. Year-to-year changes in the absolute numbers of maternal deaths among AYA showed that it ranged from 3,866 (1990) to 4,451 (2017), showing a slight upward increase over the period; however, both AYA maternal mortality ratio and rate show consistent declines over the period. AYA maternal mortality ratio (MMR) for adolescents aged 15-19 years was 17% higher than for young adults aged 20-24 years. Sepsis was the leading cause of adolescent maternal death (MMR of 168), followed by maternal hypertensive disorder, obstructed labor, maternal hemorrhage, ectopic pregnancy, and abortion. A total of 460,155 maternal deaths occurred in women aged 10-49 years during the study period. Maternal deaths in the age group 10-24 years ranged from 3,866 (29.8%) in 1990 to 4,451 (25.1%) in 2017. The maternal mortality ratio in women aged 10-49 years declined by about 30% for the 1990 – 2017 period. Conclusion and Implications for Translation: The study showed that adolescents and young adults are at increased risk of maternal deaths in Nigeria. Therefore, multi-faceted maternal health programs in the country need to target this age group to prevent maternal deaths. Copyright © 2022 Dahiru et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

Modeling Covid-19 Deaths in Nigeria Using Exponential-Gamma Distribution

This work examines the performance of Exponential-Gamma distribution and the existing Exponetial and Gamma in relative to the distribution that will best fit the data on Covid-19 death in Nigeria from March 2020 to April 2021. The parameters of the distribution were estimated using the method of maximum likelihood estimates. The newly developed Exponential-Gamma distribution was compared with the exiting Exponential and Gamma distributions using the log-likelihood function, Akaike information criterion (AIC), and Bayesian information criterion (BIC) as the criteria for selecting the best fit model. The results show that the newly developed Exponential-Gamma distribution performed better than the existing Exponential and Gamma distributions in contrast in terms of model fit, this showed that the newly developed Exponential-Gamma distribution is more flexible and precise in analyzing the Covid-19 data other than the existing Exponential and Gamma distributions.

Comparative Study of the Error Trend and Seasonal Exponential Smoothing and ARIMA Model using COVID-19 Death Rate in Nigeria

In the last two years, COVID-19 had claimed millions of life in Nigeria and the world at large. It is an established global health emergency of our time and an ongoing threat faced by the world up till now. This study aims to determine the trend, fit an appropriate Error Trend and Seasonal (ETS) exponential smoothing and ARIMA model to the COVID-19 daily deaths in Nigeria. Dataset on the daily COVID-19 confirmed death cases were utilized in the study. The data was extracted from the Nigerian Centre for Disease Control (NCDC) online database from 10th July 2020 to 2nd December 2021. Autoregressive Integrated Moving Average (ARIMA) and twelve (12) (ETS) exponential smoothing techniques were compared based on the dataset. The performance of the ARIMA and ETS exponential smoothing methods was investigated using the Akaike Information Criterion (AIC), Bayesian Information Criterion (BIC), Hannan Quinn Information Criterion (HQC), and AMSE selection criteria. The best time series modeling for the coronavirus (COVID-19) epidemic in Nigeria was the ARIMA (0,1,0) because its model selection criteria showed that it had the lowest value of; AIC=2863.51, BIC= 2866.90, HQ = 2866.90, and AMSE = 0.55471. ARIMA (0,1,0) model is preferred among the thirteen (13) competing models based on daily confirmed deaths due to COVID-19 in Nigeria.

Modeling Covid-19 Deaths in Nigeria Using Exponential-Gamma Distribution

Modeling Covid-19 Deaths in Nigeria Using Exponential-Gamma Distribution

Causes of deaths in neonates and children aged 1–59 months in Nigeria: verbal autopsy findings of 2019 Verbal and Social Autopsy study

BackgroundNigeria has one of the highest under-five mortality rates in the world. Identifying the causes of these deaths is crucial to inform changes in policy documents, design and implementation of appropriate interventions to reduce these deaths. This study aimed to provide national and zonal-level estimates of the causes of under-five death in Nigeria in the 2013–2018 periods.MethodsWe conducted retrospective inquiries into the cause of deaths of 948 neonates and 2,127 children aged 1–59 months as identified in the 2018 Nigeria Demographic and Health Survey (NDHS). The verbal autopsy asked about signs and symptoms during the final illness. The Physician Coded Verbal Autopsy (PCVA) and Expert Algorithm Verbal Autopsy (EAVA) methods were employed to assign the immediate and underlying cause of deaths to all cases.ResultFor the analysis, sampling weights were applied to accommodate non-proportional allocation. Boys accounted for 56 percent of neonatal deaths and 51.5 percent of the 1–59-months old deaths. About one-quarter of under-5 mortality was attributed to neonatal deaths, and 50 percent of these neonatal deaths were recorded within 48 h of delivery. Overall, 84 percent of the under-5 deaths were in the northern geopolitical zones. Based on the two methods for case analysis, neonatal infections (sepsis, pneumonia, and meningitis) were responsible for 44 percent of the neonatal deaths, followed by intrapartum injury (PCVA: 21 percent vs. EAVA: 29 percent). The three main causes of death in children aged 1–59 months were malaria (PCVA: 23 percent vs. EAVA: 35 percent), diarrhoea (PCVA: 17 percent vs. EAVA: 23 percent), and pneumonia (PCVA: 10 percent vs. EAVA: 12 percent). In the North West, where the majority of under-5 (1–59 months) deaths were recorded, diarrhoea was the main cause of death (PCVA: 24.3 percent vs. EAVA: 30 percent).ConclusionThe causes of neonatal and children aged 1–59 months deaths vary across the northern and southern regions. By homing on the specific causes of mortality by region, the study provides crucial information that may be useful in planning appropriately tailored interventions to significantly reduce under-five deaths in Nigeria.

Evaluating the Effectiveness of a Hybrid Model for Mobilization of Women for Cervical Cancer Screening; A Preliminary Report of a Pilot Project in Lagos, Nigeria. A Case Study of the Blue-Pink Center for Women's Health, Nigeria

PURPOSE Cervical cancer is the second commonest cancer in Nigeria, accounting for 14.8% of all cancer-related deaths in Nigeria. Studies have demonstrated poor knowledge and attitude of women toward cervical cancer, with screening rates as low as 0.7% among Nigerian women. Besides poor awareness and poverty, lack of easy access to cancer education and screening is among the biggest barriers to its effective prevention and control. Our project aimed to increase access to cervical cancer education and screening among rural and suburban women in Lagos, Nigeria. METHODS We introduced an integrated approach to mobilize women for cervical cancer screening (using Visual Inspection with Acetic Acid [VIA]) in four local councils in Lagos. This model involved a hybrid of a facility- and community-based provision of screening services. Daily, skilled nurses and community health extension workers actively mobilize community women for screening through a purpose-built screening center and regular community outreaches to mirror organized and opportunistic screening. Extensive community stakeholders engagement was used to mobilize women groups. Women were charged up to $2.92 to identify if putting a price deters willingness to screen and to evaluate the model's sustainability. Project evaluation was conducted by a mixed method of quantitative and qualitative assessments. RESULTS Within nine months of the pilot, 13,892 women received cancer education, 1,250 women had VIA, and 181 had cryotherapy. Knowledge about cervical cancer rose from an average of 13.7% in our pre-participation survey to 80% in the post-participation surveys. Increased trust in the screening was the commonest theme in the qualitative survey which increased service uptake. CONCLUSION Our preliminary findings show that this hybrid model increased access to, and uptake of, cervical cancer screening, even when a cost was attached. Provision of screening services in an organized and strategic people-oriented manner may yield better and sustained outcomes in resource-poor settings than either opportunistic screening or screening offered only as part of routine hospital services.

Serum Iron Status of Pregnant Women in Central Hospital Sapele, South-South Nigeria

Background: Low iron status and Iron deficiency anemia are major prenatal complications predisposing pregnant women to preventable causes of premature delivery, intrauterine growth retardation and neonatal and prenatal death in Nigeria. Therefore, this study aims to evaluate and compare serum iron status in pregnant and non-pregnant women in Sapele South-South Nigeria. Materials and methods: A total of three hundred and sixty (360) subjects were enrolled for this study comprising of 78 non-pregnant women and 282 pregnant women. 5ml of venous blood were collected from participant into EDTA and plan containers respectively. The serum obtain from clotted sample was used for serum iron estimation using iron reduction method while EDTA blood was used for PCV and hemoglobin estimation.

The estimated benefits of increasing cigarette prices through taxation on the burden of disease and economic burden of smoking in Nigeria: A modeling study.

Globally, tobacco consumption continues to cause a considerable burden of preventable diseases. Although the smoking prevalence in Nigeria may be declining over the last years, the absolute number of active smokers remains one of the highest in Africa. Little is known about the disease burden and economic costs of cigarette smoking in Nigeria. Consequently, there is an evidence gap to inform the design and implementation of an effective policy for tobacco control. We applied a microsimulation model to estimate the burden attributable to smoking in terms of morbidity, mortality, disability-adjusted life-years (DALYs), and direct medical costs and indirect costs (e.g., productivity loss costs, informal caregivers' costs). We also modeled the health and economic impact of different scenarios of tobacco price increases through taxes. We estimated that smoking is responsible for approximately 29,000 annual deaths in Nigeria. This burden corresponds to 816,230 DALYs per year. In 2019, the total economic burden attributable to tobacco was estimated at ₦ 634 billion annually (approximately U$D 2.07 billion). If tobacco cigarettes' prices were to be raised by 50% through taxes, more than 30,000 deaths from smoking-attributable diseases would be averted in 10 years, with subsequent savings on direct and indirect costs of ₦597 billion and increased tax revenue collection of ₦369 billion. In Nigeria, tobacco is responsible for substantial health and economic burden. Increasing tobacco taxes could reduce this burden and produce net economic benefits.

Predictors of utilization of facility-based ante-natal care and delivery services in a Nigerian Rural Community.

With maternal mortality ratio of 2,000/100,000 live births and perinatal mortality rate of 40/1,000 total births, Cross River State is one of the states with the highest maternal and perinatal deaths in Nigeria. One of the causes of these poor health indices is low utilization of facility-based maternal and child healthcare services during pregnancy and childbirth. The objective of this study was to assess the predictors of utilization of antenatal care and delivery services in Akpabuyo, a rural community in Cross River State of Nigeria. This was an analytical cross-sectional survey. Data were collected from 370 pregnant women between June and July, 2013 and analyzed using SPSS version 25. Binary logistic regression showed that compared with women with tertiary education, women with non-formal education were less likely to attend antenatal clinic (AOR=0.510, 95% CI=0.219-1.188) although the difference was not statistically significant. Also, compared with farmers, full-time housewives were less likely to deliver in a health facility (AOR=0.650, 95% CI=0.305-1.389) while civil servants were nearly five times more likely to deliver in the health facility (AOR=4.750, 95%CI=1.616-13.962). The predictors of antenatal care and facility delivery services utilization identified by the study were educational status and occupation. This raises the need for policies and programmes to ensure girl child education and the economic empowerment of women.

Modeling and Forecasting the Third wave of Covid-19 Incidence Rate in Nigeria Using Vector Autoregressive Model Approach

Modeling the onset of a pandemic is important for forming inferences and putting measures in place. In this study, we used the Vector autoregressive model to model and forecast the number of confirmed covid-19 cases and deaths in Nigeria, taking into account the relationship that exists between both multivariate variables. Before using the Vector Autoregressive model, a co-integration test was performed. An autocorrelation test and a heteroscedasticity test were also performed, and it was discovered that there is no autocorrelation at lags 3 and 4, as well as no heteroscedasticity. According to the findings of the study, the number of covid-19 cases and deaths is on the rise. To forecast the number of cases and deaths, a Vector Autoregressive model with lag 4 was used. The projection likewise shows a steady increase in the number of deaths over time, but a minor drop in the number of confirmed Covid-19 cases.

Human Immune Virus (HIV) Infection among Children, Treatment and Under-5 Deaths in Nigeria: An Empirical Analysis

Purpose: This study investigates the impact of Human Immune Virus (HIV) infections among children and under-5 deaths in Nigeria. Since the prevalence of HIV infection, Nigeria health care and the government has experienced many challenges towards achieving healthy outlook among the citizens and this struggle has continued over the years, with the consideration of the thunderous increase of the under-5 deaths caused by HIV infections in Nigeria. Therefore, this study investigates HIV infections, its treatment and under-5 deaths in Nigeria and contributes a way forward towards recuperation in achieving a healthy society among Nigerians. Design/Methodology/Approach: This study used the Ordinary Least Square (OLS) method to investigate the impact of HIV infections among children on under-5 deaths in Nigeria. Being an empirical study, the data used for its analysis were annual secondary data and they were obtained from World Bank indicators which is a reliable source. Findings: The findings from the result of the OLS method of analysis prove that HIV infections increase under-5 deaths at 1% significant level in Nigeria. The result also proved that treatment of HIV victims definitely reduces under-5 deaths in Nigeria at 1% significant level.

Vector Autoregressive Modeling of COVID-19 Incidence Rate in Nigeria

With the outbreak of COVID-19, a lot of studies have been carried out in various science disciplines to either reduce the spread or control the increasing trend of the disease. Modeling the outbreak of a pandemic is pertinent for inference making and implementation of policies. In this study, we adopted the Vector autoregressive model which takes into account the dependence that exists between both multivariate variables in modeling and forecasting the number of confirmed COVID-19 cases and deaths in Nigeria. A co-integration test was carried out prior to the application of the Vector Autoregressive model. An autocorrelation test and a test for heteroscedasticity were further carried out where it was observed that there exists no autocorrelation at lag 3 and 4 and there exists no heteroscedasticity respectively. It was observed from the study that there is a growing trend in the number of COVID-19 cases and deaths. A Vector Autoregressive model of lag 4 was adopted to make a forecast of the number of cases and death. The forecast also reveals a rising trend in the number of infections and deaths. The government therefore needs to put further measures in place to curtail the spread of the virus and aim towards flattening the curve.

Assessing the Application of the Principles of Non-discrimination and Gender Equality in Relation to Devolution of Land upon Death in Nigeria

Assessing the Application of the Principles of Non-discrimination and Gender Equality in Relation to Devolution of Land upon Death in Nigeria

Decapitation strategies and the significance of Abubakar Shekau's death in Nigeria's Boko Haram crisis

Abstract Decapitation strategies have often been linked to counterterrorism. The existing literature suggests the results of these strategies are mixed. Previous studies suggest that the death of a prominent leader may not necessarily end the crisis; it all depends on the group's infrastructure, ideology, leadership traditions, and extent of its penetration in society. This article takes a critical look at the impact of a recent leadership decapitation in Nigeria. Abubakar Shekau, the leader of the Boko Haram movement in the Lake Chad Basin countries, was killed on 19 May 2021 by a faction of the movement known as the Islamic State of West African Province (ISWAP). This article argues that Shekau's case has paradoxically helped to strengthen ISWAP's position, giving it new recruits and other resources and perhaps most importantly reinforced its position with local communities. This has implications for the Nigerian state, its neighbours and, because of Boko Haram's links to ISIS, the wider war on terrorism.

Does Stock Market Respond to Disease Pandemic? A Case of COVID-19 in Nigeria

Abstract This paper investigates whether stock markets respond to disease pandemic referencing the case of COVID-19 in Nigeria. The paper employs three cointegrating regression models: Fully Modified Ordinary Least Squares, Dynamic Ordinary Least Squares, and Canonical Cointegrating Regression to analyse the effect of growth in total COVID-19 confirmed cases and related deaths in Nigeria and across the globe from 27 February 2020 to 4 September 2020 on the stock market performance. Key findings support the presence of long-run association between stock market returns and COVID-19 in Nigeria. The stock market is found to respond negatively to both domestic and global growths in total confirmed cases and deaths of COVID-19. Consequently, affected businesses in Nigeria should be assisted and bailed out by the government through practices such as tax filing, subsidies, targeted spending, and credit.

COVID-19 pandemic: Experience in Calabar and Implication on the Economic Status of the People

The COVID-19 caused by the SARS-CoV-2, which originated from the Wuhan Province of China during the last days of 2019, has become a global health issue unprecedented since the Spanish influenza of 1918. As of December 30th, there were 86,576 recorded cases of Covid-19 and 1278 confirmed deaths in Nigeria. While the impact of the pandemic varies across societies, for most countries, available evidence reveals that it has increased poverty and inequalities. This study assessed the effect of the Covid-19 pandemic on the economic status of people in Calabar. The survey research method was used in collecting data from a sample of 400 from Calabar, Cross River State, Nigeria. The instrument of data collection was a self-developed unstructured questionnaire. Data were collected within eight days with the aid of five (5) research assistants. Out of the 400-instrument distributed, only 386 was returned and was used for the analysis. Data collected were coded and analyzed using descriptive statistics such as frequency distribution, tables and figures. The result from the descriptive statistics was then subjected to parametric statistics at the 0.05 confidence level. The result from the analysis revealed a significant impact of the covid-19 pandemic on the economic status of people in Calabar, Cross River, Nigeria. Based on the findings, the study recommends, among others, that the government at every level prioritize the distribution of stimulus packages equitably

Incidence Rate of COVID-19 Mortality and its Associated Factors During the First and Second Waves in Nigeria: A Retrospective Cohort Study

Background: COVID-19 mortality rate has not been formally assessed in Nigeria. We therefore aimed to address this gap and identify associated mortality risk factors during the first and second waves in Nigeria.Methods: We conducted a retrospective cohort study using the national surveillance database between February 27, 2020, and April 3, 2021. The outcome was deaths amongst persons with a laboratory diagnosis of COVID-19. Incidence rates of COVID-19 death per 100,000 person-days were estimated. Adjusted negative binomial regression was used to identify factors associated with COVID-19 death, and presented as adjusted Incidence Rate Ratios (aIRR) with 95% confidence intervals (CI). Results: The first wave included 65,790 COVID-19 patients, of whom 994 (1∙51%) died; the second wave included 91,089 patients, of whom 513 (0∙56%) died. The incidence rate of deaths related to COVID-19 was higher in the first wave [54∙25 (95% CI: 50∙98-57∙73)] than in the second wave [19∙19 (17∙60-20∙93)]. Factors independently associated with increased risk of death in both waves were: age ≥45 years, male gender [first wave aIRR 1∙65 (1∙35-2∙02) and second wave 1∙52 (1∙11-2∙06)], being symptomatic [aIRR 3∙17 (2∙59-3∙89) and 3∙04 (2∙20-4∙21)], and being hospitalised [aIRR 4∙19 (3∙26-5∙39) and 7∙84 (4∙90-12∙54)].Interpretation: The incidence rate of COVID-19 death in Nigeria was higher in the first wave, suggesting improved public health response and care during the second wave. Regional mortality differences suggest that policy makers focus on regional equity in access to testing and quality of care to mitigate the impact of another COVID-19 wave in Nigeria.Funding: None to declare. Declaration of Interest: None to declare. Ethical Approval: Ethical approval for the study was given by the Nigeria National Health Research Ethics Committee (NHREC/01/01/2007-22/06/2020).

Approximation of the Cox survival regression model by MCMC Bayesian Hierarchical Poisson modelling of factors associated with childhood mortality in Nigeria

The need for more pragmatic approaches to achieve sustainable development goal on childhood mortality reduction necessitated this study. Simultaneous study of the influence of where the children live and the censoring nature of children survival data is scarce. We identified the compositional and contextual factors associated with under-five (U5M) and infant (INM) mortality in Nigeria from 5 MCMC Bayesian hierarchical Poisson regression models as approximations of the Cox survival regression model. The 2018 DHS data of 33,924 under-five children were used. Life table techniques and the Mlwin 3.05 module for the analysis of hierarchical data were implemented in Stata Version 16. The overall INM rate (INMR) was 70 per 1000 livebirths compared with U5M rate (U5MR) of 131 per 1000 livebirth. The INMR was lowest in Ogun (17 per 1000 live births) and highest in Kaduna (106), Gombe (112) and Kebbi (116) while the lowest U5MR was found in Ogun (29) and highest in Jigawa (212) and Kebbi (248). The risks of INM and U5M were highest among children with none/low maternal education, multiple births, low birthweight, short birth interval, poorer households, when spouses decide on healthcare access, having a big problem getting to a healthcare facility, high community illiteracy level, and from states with a high proportion of the rural population in the fully adjusted model. Compared with the null model, 81% vs 13% and 59% vs 35% of the total variation in INM and U5M were explained by the state- and neighbourhood-level factors respectively. Infant- and under-five mortality in Nigeria is influenced by compositional and contextual factors. The Bayesian hierarchical Poisson regression model used in estimating the factors associated with childhood deaths in Nigeria fitted the survival data.