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

Factors associated with infant mortality in Nigeria: A scoping review

BACKGROUND

Infant mortality persists as a global public health concern, particularly in lower-middle-income countries (LIMCs) such as Nigeria. The risk of an infant dying before one year of age is estimated to be six times higher in Africa than in Europe. Nigeria recorded an infant mortality rate of 72.2 deaths per 1,000 live births in 2020, in contrast to the global estimate of 27.4 per 1,000 live births. Several studies have been undertaken to determine the factors influencing infant mortality.

OBJECTIVE

This scoping review sought to identify and summarise the breadth of evidence available on factors associated with infant mortality in Nigeria.

METHODS

This review followed the five-stage principles of Arksey and O'Malley's framework. Four electronic databases were searched with no limit to publication date or study type: Ovid MEDLINE, PubMed, CINAHL Complete, and Web of Science. Selected studies were imported into Endnote software and then exported to Rayyan software where duplicates were removed. Included articles were thematically analysed and synthesised using the socioecological model.

RESULTS

A total of 8,139 references were compiled and screened. Forty-eight articles were included in the final review. At the individual level, maternal- and child-related factors were revealed to influence infant mortality; socioeconomic and sociocultural factors at the interpersonal level; provision and utilisation of health services, health workforce, hospital resources and access to health services at the organisational level; housing/neighbourhood and environmental factors at the community level; and lastly, governmental factors were found to affect infant mortality at the public policy level.

CONCLUSION

Factors related to the individual, interpersonal, organisational, community and public policy levels were associated with infant mortality in Nigeria.

Preventable multiple high-risk birth behaviour and infant survival in Nigeria

BACKGROUND

Globally, infant mortality has declined considerably but has remained unacceptably high in sub-Saharan Africa, especially Nigeria where infant mortality rate is 67/1000 live births. To facilitate infant mortality reduction in Nigeria, an understanding of the synergistic effect of bio-demographic characteristics of mothers known as High Risk Birth Behaviours (HrBBs) is important. We therefore investigated the influence of HrBBs on infant survival in Nigeria.

METHODS

This cross-sectional study design utilized data from the 2018 round of Nigerian Demographic Health Survey. The study participants were a representative sample of women of reproductive age (n = 21,350) who had given birth within the 5 years preceding the survey. HrBBs was measured through integration of information on maternal age at child's birth, parity, and preceding birth interval with respect to the most recent child. The HrBBs was categorized as none, single and multiple. Data were analysed using descriptive statistics, Log-rank test and Cox proportional hazard model (α =0.05).

RESULTS

The mean age of the women was 29.7 ± 7.2 and 4.1% had experienced infant death. Infant mortality was highest among women with multiple HrBBs (5.1%). Being a male, having small size at birth, failure to receive tetanus injection, non-use of contraceptives and living in the core-north (North West and North East) predisposed children to higher risk of dying before 12 months of age. The hazard ratio of infant mortality was significantly higher among infants of mothers in multiple HrBBs category (aHR = 1.66; CI: 1.33-2.06) compared to their counterparts with no HrBBs.

CONCLUSION

Multiple HrBBs increase the chances of dying among infants in Nigeria. Screening women for HrBBs for special health attention during pregnancy, birth and postnatal period will alleviate infant death in Nigeria.

The comparing of infant mortality rate in different World Health Organization regions during 1990–2017

Background

Infant mortality rate is an important index of community health status and mortality rate. It is also one of the most prominent indexes showing the development of various societies. Regarding the importance of infant mortality rate (IMR), the purpose of current study was to compare and trend analysis of IMR in different areas of the WHO during 1990–2017. In current ecological study, IMR per 1000 live births in different WHO regions from 1990 to 2017 data were derived from the WHO website. The required information included the data about IMR per 1000 live births in different WHO regions from 1990 to 2017. The analysis was performed by using descriptive and analytical methods.

Results

The IMR during the study period had a significant decreasing trend in all the regions (p < 0.001) but the slope of decrease was greater in Africa than in other regions. The African and European regions had the highest (55.7%) and lowest (17.2%) annual decrease in the infant mortality rate (from 106.3 cases in 1990 to 50.6 in 2017, and from 24.9 in 1990 to 7.7 in 2017), respectively.

Conclusion

Our results showed that the trend of IMR had a decreasing trend in all WHO regions. It can be due to improving the public health situation in different areas. But the identification of effective factors on IMR needs individuals based studies.

Spatio-temporal patterns of under 5 mortality in Nigeria

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Under 5 mortality rates in Nigeria are very high.

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There are significant variations in under 5 mortality rates across states over time.

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There is evidence of statistically significant spatial autocorrelation over time.

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Significant reductions are achievable with both state and region specific measures.