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Antai D. Regional inequalities in under-5 mortality in Nigeria: a population-based analysis of individual- and community-level determinants. Popul Health Metr. 2011;9:6doi: 10.1186/1478-7954-9-6.
Antai, D. (2011). Regional inequalities in under-5 mortality in Nigeria: a population-based analysis of individual- and community-level determinants. Population health metrics, 96. https://doi.org/10.1186/1478-7954-9-6
Antai, Diddy. "Regional inequalities in under-5 mortality in Nigeria: a population-based analysis of individual- and community-level determinants." Population health metrics vol. 9 (2011): 6. doi: https://doi.org/10.1186/1478-7954-9-6
Antai D. Regional inequalities in under-5 mortality in Nigeria: a population-based analysis of individual- and community-level determinants. Popul Health Metr. 2011 Mar 09;9:6. doi: 10.1186/1478-7954-9-6. PMID: 21388522; PMCID: PMC3065413.
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Popul Health Metr. 2011 Mar 09;9:6. doi: 10.1186/1478-7954-9-6.

Regional inequalities in under-5 mortality in Nigeria: a population-based analysis of individual- and community-level determinants.

Population health metrics

Diddy Antai

Affiliations

  1. Division of Global Health & Inequalities, The Angels Trust - Nigeria, Abuja, Nigeria. [email protected].

PMID: 21388522 PMCID: PMC3065413 DOI: 10.1186/1478-7954-9-6

Abstract

BACKGROUND: Regions with geographically diverse ecology and socioeconomic circumstances may have different disease exposures and child health outcomes. This study assessed variations in the risks of death in children under age 5 across regions of Nigeria and determined characteristics at the individual and community levels that explain possible variations among regions.

METHODS: Multilevel Cox proportional hazards analysis was performed using a nationally representative sample of 6,029 children from 2,735 mothers aged 15-49 years and nested within 365 communities from the 2003 Nigeria Demographic and Health Survey. Hazard ratios (HR) with 95% confidence intervals (CI) were used to express measures of association among the characteristics. Variance partition coefficients and Wald statistic were used to express measures of variation.

RESULTS: Patterns of under-5 mortality cluster within families and communities. The risks of under-5 deaths were significantly higher for children of mothers residing in the South South (Niger Delta) region (HR: 1.30; 95% CI: 1.76-2.20) and children of mothers residing in communities with a low proportion of mothers attending prenatal care by a doctor (HR: 1.36; 95% CI: 1.15-1.86). In addition, the cross-level interaction between mothers' education and community prenatal care by a doctor was associated with a more than 40% higher risk of dying (HR: 1.41; 95% CI: 1.21-1.78).

CONCLUSION: The findings suggest the need to differentially focus on community-level interventions aimed at increasing maternal and child health care utilization and improving the socioeconomic position of mothers, especially in disadvantaged regions such as the South South (Niger Delta) region. Further studies on community-levels determinants of under-5 mortality are needed.

References

  1. Soc Sci Med. 2000 Apr;50(7-8):965-83 - PubMed
  2. Afr J Reprod Health. 1997 Mar;1(1):7-13 - PubMed
  3. Demography. 2000 May;37(2):155-74 - PubMed
  4. PLoS Med. 2007 Jan;4(1):e7 - PubMed
  5. Am J Epidemiol. 1996 Nov 15;144(10):934-42 - PubMed
  6. BMC Int Health Hum Rights. 2009 Jun 09;9:12 - PubMed
  7. Int J Equity Health. 2006 Jul 11;5:9 - PubMed
  8. Demography. 2001 Feb;38(1):115-32 - PubMed
  9. Am J Trop Med Hyg. 2007 Oct;77(4):770-9 - PubMed
  10. Lancet. 2003 Jul 19;362(9379):233-41 - PubMed
  11. Nutrition. 2003 Feb;19(2):179-81 - PubMed
  12. J Relig Health. 2009 Sep;48(3):290-304 - PubMed
  13. J Epidemiol Community Health. 2005 Jun;59(6):443-9 - PubMed
  14. J Biosoc Sci. 1993 Jul;25(3):311-8 - PubMed
  15. Am J Public Health. 2001 Nov;91(11):1808-14 - PubMed
  16. J Biosoc Sci. 2009 Jan;41(1):57-76 - PubMed
  17. Lancet. 2006 Apr 1;367(9516):1066-1074 - PubMed
  18. Soc Sci Med. 2002 Apr;54(7):1051-64 - PubMed
  19. J Int Dev. 1995 Jan-Feb;7(1):135-44 - PubMed
  20. Bull World Health Organ. 2003;81(7):539-45 - PubMed

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