尼日利亚东北部与五岁以下儿童死亡率相关的风险因素；对国家人口与健康调查数据的回顾性分析。

College of Medical Sciences, ATBU, Bauchi, Nigeria. Email:

Department of Pediatrics, College of Medical Sciences, ATBU, Bauchi, Nigeria.

West Afr J Med. 2024 Jun 28;41(6):651-658.

BACKGROUND

Under-five children mortality rate (U5MR) remains a crucial indicator of a nation's child healthcare and socioeconomic development. This study aims to identify and quantify significant maternal, child, family, and environmental risk factors contributing to under-five mortalities in the Northeast geopolitical zone of Nigeria.

METHODS

Retrospective analysis of secondary data from the 2018 National Demographic and Health Survey (NDHS) in six northeastern Nigerian states. Maternal factors (age, education, health-seeking behavior), child variables (weight, sex, vaccination status), family factors, and environmental factors (water source, residence, wealth index) were analyzed to determine their association with the under-five mortality rate (U5MR). Logistic regression models and population-attributable risk estimates were used to identify key contributors to U5MR in the region.

RESULTS

A total of 26,293 mothers were surveyed, of which the majority (93.6%) were married, employed (70.7%), and had no insurance (99%). Most of the mothers were above 35 years of age, uneducated and with first birth between ages 15-19. Adjusted odds ratios show unmarried mothers 1.67 (P=0.015), small birth size 1.37 (P=0.022), never breastfeeding 1.83 (P=0.000), short birth intervals 1.50 (0.005), higher parity 1.5 (P=0.005), lack of any family planning method 1.43(P=0.040), twin siblings 3.95 (P=0.000) and place of residence 1.21 (P=0.000) were associated with higher U5MR odds ratios. Maternal age 21-25 years showed a protective effect AOR 0.59 (95% CI: 0.36-0.98, P=0.040) and age > 31 years AOR 0.44 (95% CI: 0.24-0.81, P=0.009).

CONCLUSION

This study provides crucial insights into the multifaceted determinants of under-5 mortality in Northeast Nigeria. The findings underscore the importance of tailored interventions addressing maternal, child, and family factors to improve child health outcomes in the region.

背景

五岁以下儿童死亡率（U5MR）仍然是衡量一个国家儿童保健和社会经济发展的关键指标。本研究旨在确定并量化导致尼日利亚东北部地缘政治区域五岁以下儿童死亡的重要产妇、儿童、家庭和环境风险因素。

方法

对尼日利亚东北部六个州 2018 年全国人口与健康调查（NDHS）的二次数据进行回顾性分析。分析了产妇因素（年龄、教育、寻求医疗保健行为）、儿童变量（体重、性别、疫苗接种状况）、家庭因素和环境因素（水源、住所、财富指数），以确定它们与五岁以下儿童死亡率（U5MR）的关联。使用逻辑回归模型和人群归因风险估计来确定该地区 U5MR 的主要贡献因素。

结果

共有 26293 名母亲接受了调查，其中大多数（93.6%）已婚、就业（70.7%）且无保险（99%）。大多数母亲年龄在 35 岁以上，未受过教育，初产妇年龄在 15-19 岁之间。调整后的优势比显示，未婚母亲 1.67（P=0.015）、出生体重小 1.37（P=0.022）、从未母乳喂养 1.83（P=0.000）、生育间隔短 1.50（0.005）、多胎 1.5（P=0.005）、缺乏任何计划生育方法 1.43（P=0.040）、双胞胎 3.95（P=0.000）和居住地 1.21（P=0.000）与更高的 U5MR 优势比相关。21-25 岁的母亲年龄表现出保护作用 AOR 0.59（95%CI：0.36-0.98，P=0.040），31 岁以上的母亲年龄 AOR 0.44（95%CI：0.24-0.81，P=0.009）。