Prevalence and determinants of childhood mortality in Nigeria

BACKGROUND Childhood 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. METHOD Data 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). RESULTS The 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. CONCLUSION The 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.