Beyond causes of death: The social determinants of mortality among children aged 1-59 months in Nigeria from 2009 to 2013

Alain K Koffi, Henry D. Kalter, Ezenwa N. Loveth, John Quinley, Joseph Monehin, Robert E Black

Research output: Contribution to journalArticle

Abstract

Background Millions of children worldwide suffer and die from conditions for which effective interventions exist. While there is ample evidence regarding these diseases, there is a dearth of information on the social factors associated with child mortality. Methods The 2014 Verbal and Social Autopsy Study was conducted based on a nationally representative sample of 3,254 deaths that occurred in children under the age of five and were reported on the birth history component of the 2013 Nigerian Demographic and Health Survey. We conducted a descriptive analysis of the preventive and curative care sought and obtained for the 2,057 children aged 1-59 months who died in Nigeria and performed regional (North vs. South) comparisons. Results A total of 1,616 children died in the northern region, while 441 children died in the South. The majority (72.5%) of deceased children in the northern region were born to mothers who had no education, married at a young age, and lived in the poorest two quintiles of households. When caregivers first noticed that their child was ill, a median of 2 days passed before they sought or attempted to seek healthcare for their children. The proportion of children who reached and departed from their first formal healthcare provider alive was greater in the North (30.6%) than in the South (17.9%) (p<0.001). A total of 548 children were moderately or severely sick at discharge from the first healthcare provider, yet only 3.9%-18.1% were referred to a second healthcare provider. Cost, lack of transportation, and distance from healthcare facilities were the most commonly reported barriers to formal care-seeking behavior. Conclusions Maternal, household, and healthcare system factors contributed to child mortality in Nigeria. Information regarding modifiable social factors may be useful in planning intervention programs to promote child survival in Nigeria and other low-income countries in sub-Saharan Africa.

Original languageEnglish (US)
Article numbere0177025
JournalPLoS One
Volume12
Issue number5
DOIs
StatePublished - May 1 2017

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Child Mortality
Nigeria
Cause of Death
Education
death
Planning
Mortality
Costs
health services
Health Personnel
Delivery of Health Care
Health Surveys
Mothers
households
Reproductive History
Preventive Medicine
Africa South of the Sahara
Caregivers
health care workers
Sub-Saharan Africa

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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Beyond causes of death : The social determinants of mortality among children aged 1-59 months in Nigeria from 2009 to 2013. / Koffi, Alain K; Kalter, Henry D.; Loveth, Ezenwa N.; Quinley, John; Monehin, Joseph; Black, Robert E.

In: PLoS One, Vol. 12, No. 5, e0177025, 01.05.2017.

Research output: Contribution to journalArticle

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