Incidence And Causes Of Infants Mortality In Nigeria.A Study of Obi L.G.A, Benue State
ABSTRACT
Despite modest improvements in child health outcomes during the 20th century, infant and child mortality rates remain unacceptably high in Nigeria. Infant and child mortality rate in Benue State is a major concern as the State recorded 88 deaths per 1,000 live births and 179 deaths per 1,000 live births in 2010. The aimed of this study is to analyze causes of infant and child mortality trends and differentials in Benue State and Obi LGA in particular. The objectives were to determine the level and examine the trend of infant and child mortality rate from 2005- 2014; examine the socio-economic and demographic differentials in infant and child mortality and the factors that determine infant and child mortality rate in the study area. Data from the hospitals in the Local Government Areas were analyzed to assess the trends of infant and child mortality. A total of four hundred (400) copies of semi structured questionnaire were administered using purposive sampling technique, of which 386 were found useful for analysis. The data were analyzed using descriptive statistics, ANOVA and regression analysis using SPSS 20.0 version. The descriptive statistics showed that 66.3% of the respondents are between the ages of 20 and 34 years, 36.8% are Hausa/Fulani, 28.8% have attended secondary school, and most of the respondents (21.8%) have monthly income between ₦ 30,001-₦ 40,000. Malaria is the major cause of under-five deaths with 30.1%. Experience of under-five (U5) mortality was found to differ by education, income, and occupation. The result also shows that under-five mortality is higher between women within 15-24 than 25-34 years. Women that got married early (15-24 years) experience more under-five mortality than the adult (25-34 years). Women with no formal education were found to experience more under-five mortality than those with formal education. The level of under-five mortality in Benue State has remained high since the past 10 years with an estimated under-five mortality rate of
163/1,000 live births. The trends in under-five mortality in Benue State since 2005 has been on the decrease, although the decrease is small over the years in which 2011, 2012, 2013 and 2014 witnessed steady decline or no change in the trends of infant and child mortality. Six factors were significantly associated with under-5 mortality, namely, distance to health facility, age at first marriage, age of mothers, current marital status, level of education, and length of breast feeding. Logistic regression revealed that distance from the health facility had the most significant correlation (0.379), followed by age at first marriage (0.138), age of mother (0.118), marital status (0.064), level of education (0.064) and length of breast feeding contribute (0.054). On the basis of the findings, the study recommends that programme interventions need to focus on mothers with low socioeconomic status. Also, the adolescent girls should be encouraged to go to school to acquire at least secondary education. This will increase age at first birth and reduce child death at first birth. Health services should be brought nearer to the communities so that mothers can have access to health facilities during pregnancy postpartum services to reduce infant and child mortality in the State.
 TABLE OF CONTENTS
Title page – – – – – – – – – – i
Declaration – – – – – – – – – – – ii
Certification – – – – – – – – – – – iii
Dedication – – – – – – – – – – – v
Acknowledgements – – – – – – – – – – v
Abstract – – – – – – – – – – – viii
Table of Contents – – – – – – – – – – x
List of Tables – – – – – – – – – xv
List of Figures – – – – – – – – – – xvii
CHAPTER ONE: BACKGROUND TO THE STUDY
Introduction – – – – – – – – – – 1
Statement of the Research Problem – – – – – – – 5
Aim and Objectives of the Study – – – – – – – 11
Research Hypothesis – – – – – – – – 11
Scope of the Study- – – – – – – – – 11
Justification of the Study – – – – – – – – 11
CHAPTER TWO: CONCEPTUAL, THEORETICAL FRAMEWORK AND LITERATURE REVIEW
2.1 Introduction- – – – – – – – – – 13
2.2 Conceptual Framework- – – – – – – – 13
2.2.1 Neonatal Mortality- – – – – – – – – 13
2.2.2 Post-neonatal Mortality- – – – – – – – 14
2.2.3 Infant and Child Mortality- – – – – – – – 15
2.2.4 Under-five Mortality- – – – – – – – – 15
Theoretical Framework – – – – – – – 16
Literature Review- – – – – – – – – 19
Labour Market Status of the Mother – – – – – 19
Biological and Maternal Determinants of Child Survival – – – 19
Socioeconomic Determinants of Child Survival – – – – 19
Parent‟s Education – – – – – – – – 21
Place of Residence – – – – – – – – 23
Labour Market Status of the Mother- – – – – – 24
Demographic Differences and Infant and Child Mortality- – – – 25
2.4.8 Birth Order – – – – – – – – – 27
Birth Interval- – – – – – – – – 27
Age of the Mother- – – – – – – – – 29
Sex of the Child- – – – – – – – – 31
Environmental Health Determinants of Child Survival – – – – 33
Nutrient Deficiency as a Determinant of Child Survival – – – – 36
Healthy Seeking Behaviour as a Determinant of Child Survival – – – 37
2.4.15 Income – – – – – – – – – – 38
2.4.16 Breastfeeding and Immunization- – – – – – – 39
2.4.17 Mortality – – – – – – – – – – 40
Culture and Norms – – – – – – – – – 41
Overview of Malnutrition- – – – – – – – 41
Protein-Energy Malnutrition in Children Under Five Years- – – – 42
Marasmus and Kwashiorkor Among Children in the Urban Slums- – – 43
Hunger and Realities of Under Nourishment- – – – – 44
Anthropometric Indicators of Child Malnutrition- – – – – 45
Relevant to the Reviewed Materials to the Study- – – – – 46
CHAPTER THREE: THE STUDY AREA AND METHODOLOGY
THE STUDY AREA- – – – – – – – 47
Location and Size – – – – – – – – 47
Physical Setting- – – – – – – – – 47
3.1.3 Climate – – – – – – – – – 48
Geology and Relief- – – – – – – – – 50
Soil and Vegetation- – – – – – – – – 51
Historical Development – – – – – – – 52
Population and Growth Distribution- – – – – – – 53
The Economic Activities- – – – – – – – 53
Basic Infrastructure and facilities- – – – – – – 56
METHODOLOGY – – – – – – – – 58
3.2.1 Reconnaissance Survey- – – – – – – – 58
3.2.2 Types of Data– – – – – – – – – 58
3.2.3 Sources of Data- – – – – – – – – 58
3.2.4 Sample Frame- – – – – – – – – 60
3.2.5 Sampling Size and Sampling Technique – – – – – 60
3.2.6 Data Analysis– – – – – – – – – 63
CHAPTER FOUR: RESULTS AND DISCURSSION
4.1 Introduction- – – – – – – – – – 64
4.2 Demographic and Socio-economic Characteristics of the Respondents- – 64
4.2.1 Age and Ethnicity- – – – – – – – – 64
4 .2.2 Religion of the Respondents- – – – – – – – 65
Education, Occupation and Income of the respondents- – – – 66
Marital Status of the Respondents- – – – – – – 69
Age at Marriage- – – – – – – – – 74
Age at First Birth- – – – – – – – – 71
Type of Marital Union– – – – – – – – 72
Household Size of the Respondents – – – – – – 72
Number of Children in the Household – – – – – 74
Number of Surviving Children- – – – – – – 75
Sex Preference- – – – – – – – – 75
Type and Ownership of Accommodation- – – – – – 76
Health Facility- – – – – – – – – 78
ANC Visitation and Health Care Centre Patronage – – – – 78
Postnatal Care Visitation and Reason for Health Care Centers Patronage- – 80
Distance to and Means of Mobility to Health care Facilities – – – 82
Water Supply and Type of Toilet Facilities- – – – – – 84
4.5 Nutrition- – – – – – – – – 85
Breast Feeding Practices – – – – – – – – 85
Introduction of Solid Food – – – – – – – – 87
Supplementary Feeding- – – – – – – – 88
Under-five Feeding Food- – – – – – – – 89
INFANT, CHILD MORBIDITY AND MORTALITY
4.5.1 Introduction- – – – – – – – – – 91
4.5.2 Type of Morbidity- – – – – – – – – 91
4.5.3 Immunization– – – – – – – – – 95
Use of Mosquitoes Nets- – – – – – – – 93
Causes of Infant and Child Mortality – – – – – – 93
Levels Trends and Differentials in Infant and Child Mortality- – – 96
Test of Hypothesis – – – – – – – – – 127
CHAPTER FIVE: SUMMARY, CONCLUSION AND RECOMMENDATIONS
51 Summary of the Findings- – – – – – – – 129
5.2 Conclusion- – – – – – – – – – 132
5.3 Recommendations- – – – – – – – – 133
5.3.1 Recommendation(s) for Further Research- – – – – – 136
REFERENCES- – – – – – – – – – 140
Contents