Environmental Factors as Predictors of Childhood Mortality Experience in Nigeria

Child Mortality (CM) remains a problem in Nigeria. Despite the high prevalence of under-five mortality in Nigeria, the role of environmental factors as predictors of U5 mortality has not been adequately explored. We explored factors influencing CM in Nigeria against the backdrop of limited research on the survival chances of under-five children (UFC). This cross-sectional study used the 2013 Nigerian Demographic and Health Survey. The survey was a nationally representative sample of females of reproductive age (15-49 years). A total n=31,828 births were reported among the 38,522 participants within five years preceding the survey among which 2879 died. We censored children who were alive at the day of survey. Data were analysed using descriptive statistics, Chi-square and Cox-Proportional hazard models (á=.05). Mean age of the women was 29.5± 7.0 years and 65% were living in the rural areas, 9.0% of UFC died before attaining age five. The hazard of child mortality was 28% higher among children who had no access to safe water (aHR=1.277, 95% CI:1.174-1.390) and 31% higher for no access to improved toilet facilities (aHR=1.312, 95% CI: 1.205-1.429). Children of mothers with no education were about 33%times likely to die before age 5 than children whose mothers had secondary education (aHR=1.327, 95% CI:1.065-1.653). The richer the household from which a child comes, the lower the likelihood of death before age 5. The hazard of child mortality was significantly higher among those who lived in houses made of unimproved roofs and walls, used unimproved cooking fuel, used mosquito nets regularly and shared toilet facilities. Childhood mortality is still high in Nigeria and children from poor homes in rural areas, with limited access to improved sanitation, housing materials and safe water were the most affected. Child health programming should focus on infrastructural development as a tool of improving the living conditions of under-five children in Nigeria.