Doctor Henry V
Mailman School of Public Health, Department of Population and Family Health, Columbia University, New York, USA.
Rural Remote Health. 2011;11(2):1635. Epub 2011 Apr 11.
The high infant and child morbidity and mortality in most sub-Saharan African countries, and Nigeria in particular, is a prominent global concern. The objective of this study was to assess factors influencing, and the prevalence of, the experience of child death among rural Nigerian mothers, with the specific aim to investigate whether household headship had an impact on child death.
Using data from the 2008 Nigeria Demographic and Health Survey, multivariate logistic regression methods were used to assess the influence of household headship and other associated variables among rural women who experienced child death (n=13 203) in the 5 years preceding the survey.
A total of 5632 women (43%) whose most recent birth occurred in the 5 years preceding the survey had reported the death of a child. Women who utilized health services were less likely to report child death than those who never utilized health services. Women who delivered their most recent child at home were more likely (46%; n=4565) to report child death compared with those who delivered in a health facility (32%; n=997). The women who resided in male-headed households had a significantly higher (43%; n=5143) prevalence of child death than women from female-headed households (37%; n=489). After controlling for all covariates in the multivariate logistic regression models, women from female-headed households were 17% less likely to experience child death (odds ratio=0.83; 95% confidence interval 0.71, 0.98) than women from male-headed households.
The occurrence of child death is not unusual in rural Nigeria. Multiple frameworks are needed to account for differentials in child mortality. After controlling for other explanatory variables such as age, wealth status, region and place of delivery of recent birth, this study found that household headship remained a strong predictor of child mortality. Recommendations are provided according to the complex interplay of socio-cultural, economic, and situational factors affecting the survival of children in rural Nigeria.
在撒哈拉以南非洲的大多数国家，尤其是尼日利亚，婴幼儿的高发病率和死亡率是一个突出的全球问题。本研究的目的是评估影响尼日利亚农村母亲儿童死亡经历的因素及其患病率，具体目标是调查户主身份是否对儿童死亡有影响。
利用2008年尼日利亚人口与健康调查的数据，采用多因素逻辑回归方法评估在调查前5年经历过儿童死亡的农村妇女（n = 13203）中户主身份及其他相关变量的影响。
共有5632名妇女（43%）报告其最近一次生育发生在调查前5年内且有孩子死亡。使用过卫生服务的妇女报告儿童死亡的可能性低于从未使用过卫生服务的妇女。与在医疗机构分娩的妇女（32%；n = 997）相比，最近一次在家分娩的妇女报告儿童死亡可能性更高（46%；n = 4565）。居住在男性为户主家庭的妇女儿童死亡患病率（43%；n = 5143）显著高于女性为户主家庭的妇女（37%；n = 489）。在多因素逻辑回归模型中控制所有协变量后，女性为户主家庭的妇女经历儿童死亡的可能性比男性为户主家庭的妇女低17%（比值比 = 0.83；95%置信区间0.71，0.98）。
在尼日利亚农村，儿童死亡的情况并不罕见。需要多个框架来解释儿童死亡率的差异。在控制了年龄、财富状况、地区和最近一次分娩地点等其他解释变量后，本研究发现户主身份仍然是儿童死亡率的有力预测因素。根据影响尼日利亚农村儿童生存的社会文化、经济和情境因素的复杂相互作用，提出了相关建议。
