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RISK FACTORS AND A PREDICTIVE MODEL FOR UNDER-FIVE MORTALITY IN NIGERIA

Thursday, 16th of August 2012

 

• RISK FACTORS AND A PREDICTIVE MODEL FOR UNDER-FIVE MORTALITY IN NIGERIA: EVIDENCE FROM NIGERIA DEMOGRAPHIC AND HEALTH SURVEY

‘[T]he following factors reduced odds of U5M: health seeking behaviour, breastfeeding children for > 18 months, use of contraception, small family size, having one wife, low birth order, normal birth weight, child spacing, living in urban areas, and good sanitation.’

BMC Pregnancy Childbirth. 2012; 12: 10.

Published online 2012 February 29.

Gbenga A Kayode, 1,2 Victor T Adekanmbi,1,2 and Olalekan A Uthman1,2

1Department of Public Health & Biostatistics, University of Birmingham, Birmingham, UK

2Centre for Evidence-Based Global Health, Ilorin, Kwara State, Nigeria

Corresponding author.

Gbenga A Kayode: gakayode@yahoo.co.uk; Victor T Adekanmbi: vkanmbi@yahoo.com; Olalekan A Uthman: uthlekan@yahoo.com

Abstract below; full text is at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3313900/?tool=pubmed

Background

Under-5 mortality is a major public health challenge in developing countries. It is essential to identify determinants of under-five mortality (U5M) childhood mortality because these will assist in formulating appropriate health programmes and policies in order to meet the United Nations MDG goal. The objective of this study was to develop a predictive model and identify maternal, child, family and other risk factors associated U5M in Nigeria.

Methods

Population-based cross-sectional study which explored 2008 demographic and health survey of Nigeria (NDHS) with multivariable logistic regression. Likelihood Ratio Test, Hosmer-Lemeshow Goodness-of-Fit and Variance Inflation Factor were used to check the fit of the model and the predictive power of the model was assessed with Receiver Operating Curve (ROC curve).

Results

This study yielded an excellent predictive model which revealed that the likelihood of U5M among the children of mothers that had their first marriage at age 20-24 years and ≥ 25 years declined by 20% and 30% respectively compared to children of those that married before the age of 15 years. Also, the following factors reduced odds of U5M: health seeking behaviour, breastfeeding children for > 18 months, use of contraception, small family size, having one wife, low birth order, normal birth weight, child spacing, living in urban areas, and good sanitation.

Conclusions

This study has revealed that maternal, child, family and other factors were important risk factors of U5M in Nigeria. This study has identified important risk factors that will assist in formulating policies that will improve child survival.

• CAN UNIVERSAL INSECTICIDE-TREATED NET CAMPAIGNS ACHIEVE EQUITY IN COVERAGE AND USE: THE CASE OF NORTHERN NIGERIA

Malar J. 2012 Feb 1;11:32.

Ye Y, Patton E, Kilian A, Dovey S, Eckert E.

Source

ICF International, 11785 Beltsville Drive, Suite 300, Calverton, MD 20705, USA. yye2@icfi.com

Abstract below; full text is at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312823/?tool=pubmed

BACKGROUND:

Insecticide-treated nets (ITNs) are effective tools for malaria prevention and can significantly reduce severe disease and mortality due to malaria, especially among children under five in endemic areas. However, ITN coverage and use remain low and inequitable among different socio-economic groups in sub-Saharan Africa, particularly in Nigeria. Several strategies have been proposed to increase coverage and use and reduce inequity in Nigeria, including free distribution campaigns recently conducted by the Nigerian federal government. Using data from the first post-campaign survey, the authors investigated the effect of the mass free distribution campaigns in achieving equity in household ownership and use of ITNs.

METHODS:

A post-campaign survey was undertaken in November 2009 in northern Nigeria to assess the effect of the campaigns in addressing equity across different socio-economic groups. The survey included 987 households randomly selected from 60 clusters in Kano state. Using logistic regression and the Lorenz concentration curve and index, the authors assessed equity in ITN coverage and use.

RESULTS:

ITN ownership coverage increased from 10% before the campaigns to 70%-a more than fivefold increase. The campaigns reduced the ownership coverage gap by 75%, effectively reaching parity among wealth quintiles (Concentration index 0.02, 95% CI (-0.02 ; 0.05) versus 0.21 95%CI (0.08 ; 0.34) before the campaigns). ITN use (individuals reporting having slept under an ITN the night before the survey visit) among individuals from households owning at least one ITN, was 53.1% with no statistically significant difference between the lowest, second, third and fourth wealth quintiles and the highest wealth quintile (lowest: odds ratio (OR) 0.87, 95% confidence interval (CI) (0.67 ; 1.13); second: OR 0.85, 95% CI (0.66 ; 1.24); third: OR 1.10 95% CI (0.86 ; 1.4) and fourth OR 0.91 95% CI (0.72 ; 1.15).

CONCLUSION:

The campaign had a significant impact by increasing ITN coverage and reducing inequity in ownership and use. Free ITN distribution campaigns should be sustained to increase equitable coverage. These campaigns should be supplemented with other ITN distribution strategies to cover newborns and replace aging nets.