Morakinyo Oyewale Mayowa, Fagbamigbe Adeniyi Francis
Department of Environmental Health Sciences, University of Ibadan, Ibadan, Nigeria.
Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria.
PLoS One. 2017 Aug 9;12(8):e0182990. doi: 10.1371/journal.pone.0182990. eCollection 2017.
Neonatal (NMR), infant (IMR) and under-five (U5M) mortality rates remain high in Nigeria. Evidence-based knowledge of trends and drivers of child mortality will aid proper interventions needed to combat the menace. Therefore, this study assessed the trends and drivers of NMR, IMR, and U5M over a decade in Nigeria. A nationally representative data from three consecutive Nigeria Demographic and Household Surveys (NDHS) was used. A total of 66,158 live births within the five years preceding the 2003 (6029), 2008 (28647) and 2013 (31482) NDHS were included in the analyses. NMR was computed using proportions while IMR and U5 were computed using life table techniques embedded in Stata version 12. Probit regression model and its associated marginal effects were used to identify the predisposing factors to NMR, IMR, and U5M. The NMR, IMR, and U5M per 1000 live births in 2003, 2008 and 2013 were 52, 41, 39; 100, 75, 69; and 201, 157, 128 respectively. The NMR, IMR, and U5M were consistently lower among children whose mothers were younger, living in rural areas and from richer households. Generally, the probability of neonate death in 2003, 2008 and 2013 were 0.049, 0.039 and 0.038 respectively, the probability of infant death was 0.093, 0.071 and 0.064 while the probability of under-five death was 0.140, 0.112 and 0.092 for the respective survey years. While adjusting for other variables, the likelihood of infant and under-five deaths was significantly reduced across the survey years. Maternal age, mothers' education, place of residence, child's sex, birth interval, weight at birth, skill of birth attendant, delivery by caesarean operation or not significantly influenced NMR, IMR, and U5M. The NMR, IMR, and U5M in Nigeria reduced over the studied period. Multi-sectoral interventions targeted towards the identified drivers should be instituted to improve child survival.
在尼日利亚，新生儿死亡率（NMR）、婴儿死亡率（IMR）和五岁以下儿童死亡率（U5M）仍然很高。基于证据了解儿童死亡率的趋势和驱动因素，将有助于采取适当干预措施来应对这一威胁。因此，本研究评估了尼日利亚十年来新生儿死亡率、婴儿死亡率和五岁以下儿童死亡率的趋势及驱动因素。研究使用了来自连续三次尼日利亚人口与健康调查（NDHS）的具有全国代表性的数据。分析纳入了2003年（6029例）、2008年（28647例）和2013年（31482例）NDHS之前五年内的66158例活产儿。新生儿死亡率采用比例计算，而婴儿死亡率和五岁以下儿童死亡率则使用Stata 12版本中嵌入的生命表技术计算。使用Probit回归模型及其相关边际效应来确定新生儿死亡率、婴儿死亡率和五岁以下儿童死亡率的诱发因素。2003年、2008年和2013年每1000例活产儿的新生儿死亡率、婴儿死亡率和五岁以下儿童死亡率分别为52、41、39；100、75、69；以及201、157、128。母亲年龄较小、居住在农村地区且家庭较富裕的儿童，其新生儿死亡率、婴儿死亡率和五岁以下儿童死亡率一直较低。总体而言，2003年、2008年和2013年新生儿死亡的概率分别为0.049、0.039和0.038，婴儿死亡的概率分别为0.093、0.071和0.064，五岁以下儿童死亡的概率分别为0.140、0.112和0.092。在对其他变量进行调整后，各调查年份婴儿和五岁以下儿童死亡的可能性显著降低。母亲年龄、母亲教育程度、居住地点、孩子性别、生育间隔、出生体重、接生人员技能、是否剖宫产等因素对新生儿死亡率、婴儿死亡率和五岁以下儿童死亡率有显著影响。在研究期间，尼日利亚的新生儿死亡率、婴儿死亡率和五岁以下儿童死亡率有所下降。应针对已确定的驱动因素采取多部门干预措施，以提高儿童存活率。
