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Regional and socioeconomic inequalities in infant mortality in Nigeria

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Abstract

This study measures socioeconomic inequalities in infant mortality at the national and regional level in Nigeria based on secondary data from the 2003, 2008 and 2013 Nigeria demographic and health survey. Inequalities were assessed among groups defined by wealth, mother’s level of education and mother’s age using both simple range measures (Rate ratio and Rate difference) and more complex measures (Slope Index of Inequality, Concentration Index and Population Attributable Fraction). All measures identified significant inequalities in infant mortality amongst socioeconomic groups over space and time in Nigeria. Results showed that inequalities mostly favoured better-off groups. However, both relative and absolute inequalities between groups increased in some areas but generally narrowed to some degree or remained the same over time in most areas. Findings clearly show that a significant proportion of infant deaths could have been avoided in Nigeria over the 15 year period examined if socioeconomic inequalities in infant mortality rates had been eliminated/reduced by appropriate policy measures.

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References

  • Adebayo, S. B., Fahrmeir, L., & Klasen, S. (2004). Analyzing infant mortality with geoadditive categorical regression models: A case study of Nigeria. Economics and Human Biology,2(2), 229–244.

    Article  Google Scholar 

  • Adebowale, A. S. (2017). Intra-demographic birth risk assessment scheme and infant mortality in Nigeria. Global Health Action. https://doi.org/10.1080/16549716.1366135.

    Article  Google Scholar 

  • Adebowale, A. S., & Udjo, E. (2016). Maternal health care services access index and infant survival in Nigeria. Ethiopian Journal of Health Science,26(2), 131–144.

    Article  Google Scholar 

  • Adekanmbi, V. T., Kandala, N., Stranges, S., & Uthman, O. A. (2015). Contextual socioeconomic factors associated with childhood mortality in Nigeria: A multilevel analysis. Journal of Epidemiology and Community Health,69(11), 1102–1108.

    Article  Google Scholar 

  • Adetunji, J. A. (1995). Infant mortality and mother’s education in Ondo state Nigeria. Social Science and Medicine,40(2), 253–263.

    Article  Google Scholar 

  • Adewuyi, E. O., Zhao, Y., & Lamichhane, R. (2017). Risk factors for infant mortality in rural and urban Nigeria: Evidence from the national household survey. Scandinavian Journal of Public Health. https://doi.org/10.1177/1403494817696599.

    Article  Google Scholar 

  • Ahonsi, B. A. (1995). Age variations in the proximate determinants of child mortality in Southwest Nigeria. Journal of BioSocial Sciences,27(1), 19–30.

    Article  Google Scholar 

  • Aigbe, G. O., & Zannu, A. E. (2012). Differentials in infant and child mortality rates in Nigeria: Evidence from the six geopolitical zones. International Journal of Humanities and Social Sciences,2(6), 206–214.

    Google Scholar 

  • Alagi, M.A. and Dairo, D.M. (2014). Socioeconomic determinants of inequalities in under-5 mortality in Nigeria: analysis of NDHS. 20th IEA world congress of epidemiology, 17–21 August, 2014, Anchorage, Alaska USA.

  • Ayenigbara, G. O., & Olorunmaye, V. B. (2012). Investigating the causes of infant mortality in Akoko South West Local Government Area, Ondo, Nigeria. Public Health Research,2(6), 180–184.

    Article  Google Scholar 

  • Bado, A. R., & Susuman, A. S. (2016). Women’s education and health inequalities in under-five mortality in selected Sub-Saharan African countries, 1990–2015. PLoS ONE,11(7), e0159186.

    Article  Google Scholar 

  • Barros, F. C., Victoria, C. G., Scherpbier, R., & Gwatkin, D. (2010). Socioeconomic inequities in the health and nutrition of children in low/middle income countries. Revista de Saúde Pública. https://doi.org/10.1590/s0034-8910.

    Article  Google Scholar 

  • Caldwell, J. C. (1979). Education as a factor in mortality decline: An examination of Nigerian data. Population Studies,33(3), 395–413.

    Article  Google Scholar 

  • Castro, M.C. and Simoes, C.C.S. (2009). Spatio-temporal trends of infant mortality in Brazil. Paper presented at the xxvi international population conference, Marrakech, Morocco, September, 2009.

  • Congdon, P. (2001). Quantifying and explaining changes in geographical inequality of infant mortality in England and Wales since the 1890s. International Journal of Population Geography,7(1), 35–51.

    Article  Google Scholar 

  • Ezeh, O. K., Agho, K. E., Dibley, M. J., Hall, J., & Page, A. N. (2015). Risk factors for post neonatal, infant, child and under-5 mortality in Nigeria: A pooled cross-sectional analysis. BMJ Open. https://doi.org/10.1136/bmjopen-2014-006779.

    Article  Google Scholar 

  • Fagbamigbe, A. F., & Alabi, O. (2014). Differentials and correlates of infant mortality in Nigeria: A comparative survival analysis between Northeast and Southwest Nigeria. Internaional Journal of Tropical Disease,4(8), 869–886.

    Article  Google Scholar 

  • Finlay, J. E., Norton, M. K., & Meiji-Guevara, I. (2017). Adolescent fertility and child health: The interaction of maternal age, parity and birth intervals in determining child health outcomes. International Journal of Child Health and Nutrition,6(1), 16–33.

    Article  Google Scholar 

  • Grady, S. C., et al. (2017). Neonatal mortality in East Africa and West Africa: A geographic analysis of district-level demographic and health survey data. Geospatial Health. https://doi.org/10.4081/gh.2017.501.

    Article  Google Scholar 

  • Hajizadeh, M., Nandi, A., & Heymann, J. (2014). Social inequality in infant mortality: What explains variations across low and middle income countries? Social Science and Medicine,101, 36–46. https://doi.org/10.1016/j.socscimed.2013.11.019.

    Article  Google Scholar 

  • Hinman, S. E. (2017). Comparing spatial distributions of infant mortality over time: Investigating the urban environment of Baltimore, Maryland in 1880 and 1920. Applied Geography,86, 1–7. https://doi.org/10.1016/j.apgeog.2017.06.015.

    Article  Google Scholar 

  • Iyun, B. F. (1992). Women’s status and childhood mortality in two contrasting areas in Southwestern Nigeria: A preliminary analysis. GeoJournal,26(1), 43–52.

    Article  Google Scholar 

  • Jacdonmi, I., Suhainizam, M. S., & Jacdonmi, G. R. (2016). Breastfeeding, a child survival strategy against infant mortality in Nigeria. Current Science,110(7), 1282–1287.

    Google Scholar 

  • Kotsadam, A., Østby, G., Rustad, S. A., Tollefsen, A. F., & Urdal, H. (2018). Development aid and infant mortality: Micro-level evidence from Nigeria. World Development,105, 59–69. https://doi.org/10.1016/j.worlddev.2017.12.022.

    Article  Google Scholar 

  • Lee, H., Van Do, D., Choi, S., Trinh, O. H., & Gia To, K. (2016). Trends and determinants of infant and under-five childhood mortality in Vietnam, 1986–2011. Global health Action, 9(1). https://doi.org/10.3402/gha.V9.29312.

  • Low, A., & Low, A. (2004). Measuring the gap: Quantifying and comparing local health inequalities. Journal of Public Health,26(4), 388–395.

    Article  Google Scholar 

  • Marmot, M. (2005). Social determinants of health inequalities. The Lancet,365(9464), 1099–1104.

    Article  Google Scholar 

  • Morakinyo, O. M., & Fagbamigbe, A. F. (2017). Neonatal, infant and under-five mortalities in Nigeria: An examination of trends and drivers (2003–2013). PLoS ONE,12(8), e0182990.

    Article  Google Scholar 

  • Mosley, W.H. and Chen, L.C. (1984). An analytical framework for the study of child survival in developing countries. Bulletin of the WHO, 2003: 81(2) (extracted from the Population and Development Review 10 Suppl: 25-45).

  • Mujica, O. J., Vasquez, E., Duarte, E. C., Cortez-Escalante, J. J., Molina, J., & Barbosa da Silva Junior, J. (2014). Socioeconomic inequalities and mortality trends in BRICS, 1990–2010. Bulletin of the WHO,92(6), 405–412.

    Google Scholar 

  • Naugle, D. A., & Hornik, R. C. (2014). Systematic review of the effectiveness of mass media interventions for child survival in low and middle income countries. Journal of Health Communication,19(1), 190–215. https://doi.org/10.1080/10810730.2014.918217.

    Article  Google Scholar 

  • Nwaokoro, J. C., Ibe Sally, N. O., Ihenachor, C. A., Emerole, C. O., Nwufo, R. C., Ebiriekwe, S. C., et al. (2015). Risk factors associated with infant mortality in Owerri metropolis, Imo state, Southeastern Nigeria. Science Journal of Public Health,3(5–1), 64–71.

    Google Scholar 

  • Olakunle, A., & Peters, D. H. (2015). Utility and limitations of measures of health inequities: A theoretical perspective. Global Health Action, 8(1). https://doi.org/10.3402/gha.v8.27591.

    Article  Google Scholar 

  • Quentin, W., Abosede, O., Aka, J., Akweongo, P., Dinard, K., Ezeh, A., et al. (2014). Inequalities in child mortality in ten major African cities. BMC Medicine, 12(95). https://doi.org/10.1186/1741-7015-12-95.

  • Rasanathan, K., et al. (2015). Ensuring multisectoral action on the determinants of reproductive, maternal, newborn, child and adolescent health in the post-2015 era. BMJ 351. https://doi.org/10.1136/bmj.h4213..

    Article  Google Scholar 

  • Rutherford, M. E., Mulholland, K., & Hill, P. C. (2010). How access to health care relates to under-five mortality in Sub-Saharan Africa: Systematic review. Journal of Medicine and International Health,15(5), 508–519.

    Google Scholar 

  • Sartorius, K. D., & Sartorius, K. (2014). Global infant mortality trends and attributable determinants – an ecological study using data from 192 countries for the period 1990–2011. Population Health Metrics, 12(29). https://doi.org/10.1186/s12963-014-0029-6.

  • Schneider, M. C., Castillo-Salgado, S., Bacallo, J., Loyola, E., Mujica, O. J., Vidaurre, M., et al. (2005). Methods for measuring health inequalities II. Epidemiological Bulletin/PAHO,26(1), 5–10.

    Google Scholar 

  • Schneider, M. C., Castillo-Salgado, C., Loyola-Elizondo, E., Bacallao, J., Mujica, O. J., Vidaurre, M., et al. (2002). Trends in infant mortality inequalities in the Americas: 1955–1995. Journal of Epidemiology and Community Health,56(7), 538–541.

    Article  Google Scholar 

  • Shen, C. E., & Williamson, J. B. (2001). Accounting for cross-national differences in infant mortality decline (1965–1991) among less developed countries: Effects of women’s status, economic dependency, and state strength. Social Indicators Research,53(3), 257–288.

    Article  Google Scholar 

  • Smith-Greenaway, E. (2013). Maternal reading skills and child mortality in Nigeria: Reassessment of why education matters. Demography,50(5), 1551–1561. https://doi.org/10.1007/s13524-013-0209-1.

    Article  Google Scholar 

  • Storegard, A., et al. (2008). The global distribution of infant mortality: A subnational spatial view. Population, Space and Place. https://doi.org/10.1002/psp.484.

    Article  Google Scholar 

  • UN-IGME. (2017). Levels and trends in child mortality. Estimates developed by the United Nations Inter-agency group for child mortality estimation (UNICEF, WHO, World Bank and the United Nations Population Division).

  • Victora, C. G., Wagstaff, A., Schellenberg, J. A., Gwatkin, D., Claeson, M., & Habicht, J. (2003). Applying an equity lens to child health and mortality: More of the same is not enough. The Lancet,362(9379), 233–341.

    Article  Google Scholar 

  • Wagstaff, A. (2000). Socioeconomic inequalities in child mortality: Comparisons across 9 developing countries. Bulletin of the WHO,78(1), 19–29.

    Google Scholar 

  • Wagstaff, A., Pierella, P., & Doorslaer, E. (1991). On the measurement of inequalities in health. Social Science and Medicine,33(5), 545–557.

    Article  Google Scholar 

  • WHO. (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Geneva: Final Report of the Commission on Social Determinants of Health.

    Google Scholar 

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Acknowledgements

The Author is grateful to ICF Macro, Calverton, USA for providing access to the 2003, 2008 and 2013 demographic and health survey data for Nigeria.

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  1. Department of Geography, University of Ibadan, 22325, Ibadan, 200005, Oyo State, Nigeria

    Modupe Alake Ayoade

  2. Ibadan, Nigeria

    Modupe Alake Ayoade

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Correspondence to Modupe Alake Ayoade.

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Ethical approval was granted for the secondary analysis of existing demographic and health survey data after the removal of all identifying information of the respondents by the Institutional Review Board (IRB) of the ICF Macro at Calverton, USA in conjunction with the National Health Research Ethics Committee (NHREC) of the Federal Ministry of Health, Abuja, Nigeria.

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Ayoade, M.A. Regional and socioeconomic inequalities in infant mortality in Nigeria. GeoJournal 85, 515–533 (2020). https://doi.org/10.1007/s10708-019-09978-0

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