Skip to main content
Top
Published in: BMC Pediatrics 1/2015

Open Access 01-12-2015 | Research article

Trends in neonatal mortality in Nigeria and effects of bio-demographic and maternal characteristics

Authors: Joshua Odunayo Akinyemi, Elijah Afolabi Bamgboye, Olusola Ayeni

Published in: BMC Pediatrics | Issue 1/2015

Login to get access

Abstract

Background

Nigeria’s efforts to reduce under-five mortality has been biased in favour of childhood mortality to the neglect of neonates and as such the literature is short of adequate information on the determinants of neonatal mortality. Whereas studies have shown that about half of infant deaths occur in the neonatal period. Knowledge of the determinants of neonatal mortality are essential for the design of intervention programes that will enhance neonatal survival. Therefore, this study was conducted to investigate the trends and factors associated with neonatal mortality in Nigeria.

Methods

This was a retrospective analysis of the reproductive history data collected in the Nigeria Demographic and Health Surveys (NDHS) for 1990, 2003, 2008 and 2013. Neonatal mortality rates were estimated as the probability of dying before 28 completed days using synthetic cohort life table techniques. Univariate and multiple Cox proportional hazards regression models were used to explore the effects of selected maternal and bio-demographic variables on neonatal mortality. The Hazard Ratio (HR) and its 95% Confidence Interval (CI) were estimated to prioritize obtained significant factors.

Results

Nigeria neonatal mortality rate stagnated at 41 per 1000 live births between 1990 and 2013. There were rural-urban and regional differences with more deaths occurring in rural areas and northern regions. In 1990, antenatal care (HR = 0.76; CI = 0.61-0.95), facility delivery (HR = 0.69; CI = 0.53-0.90) and births interval less than 24 months (HR = 1.67; CI = 1.41-1.98) were significantly associated with neonatal deaths. Factors identified from the 2013 data were antenatal care (HR = 0.76; CI = 0.61-0.95), birth interval less than 24 months (HR = 1.67; CI = 1.41-1.98), delivery at health facility (HR = 0.69; CI = 0.53-0.90), and small birth size (HR = 1.72; CI = 1.39-2.14).

Conclusion

There was little improvement in neonatal survival in Nigeria between 1990 and 2013. Bio-demographic and health care related characteristics are significant determinants of neonatal survival. Family planning should be intensified while government should improve the quality of maternal and child health services to enhance the survival of neonates.
Literature
1.
go back to reference UNICEF, WHO, World Bank, United Nations. Levels and Trends in Child Mortality: Report 2014. In: Levels and Trends in Child Mortality: Report 2014. New York, 10017 USA: United Nations Children’s Fund; 2014. UNICEF, WHO, World Bank, United Nations. Levels and Trends in Child Mortality: Report 2014. In: Levels and Trends in Child Mortality: Report 2014. New York, 10017 USA: United Nations Children’s Fund; 2014.
2.
go back to reference Lawn JE, Kinney MV, Black RE, Pitt C, Cousens S, Kerber K, et al. Newborn survival: a multi-country analysis of a decade of change. Health Policy Plan. 2012;27:iii6–28.CrossRefPubMed Lawn JE, Kinney MV, Black RE, Pitt C, Cousens S, Kerber K, et al. Newborn survival: a multi-country analysis of a decade of change. Health Policy Plan. 2012;27:iii6–28.CrossRefPubMed
3.
go back to reference Lawn JE, Cousens S, Zupan J. 4 million neonatal deaths: when? where? why? Lancet. 2005;365:891–900.CrossRefPubMed Lawn JE, Cousens S, Zupan J. 4 million neonatal deaths: when? where? why? Lancet. 2005;365:891–900.CrossRefPubMed
4.
go back to reference Oesterggaard MZ, Inoue M, Yoshida S, Mahanani WR, Gore FM, Cousens S, et al. Neonatal mortality levels for 193 countries in 2009 with trends since 1990: A systematic analysis of progress, projections, and priorities. PLoS Med. 2011; 8. doi:10.1371/journal.pmed.1001080. Oesterggaard MZ, Inoue M, Yoshida S, Mahanani WR, Gore FM, Cousens S, et al. Neonatal mortality levels for 193 countries in 2009 with trends since 1990: A systematic analysis of progress, projections, and priorities. PLoS Med. 2011; 8. doi:10.1371/journal.pmed.1001080.
5.
go back to reference National Population Commission [Nigeria]. Nigeria Demographic and Health Survey 2013. Calverton MD: National Population Commission and ORC Macro International; 2014. National Population Commission [Nigeria]. Nigeria Demographic and Health Survey 2013. Calverton MD: National Population Commission and ORC Macro International; 2014.
6.
go back to reference Ahonsi BA. Age variations in the proximate determinants of child mortality in south-west Nigeria. J Biosoc Sci. 1995;27:19–30.CrossRefPubMed Ahonsi BA. Age variations in the proximate determinants of child mortality in south-west Nigeria. J Biosoc Sci. 1995;27:19–30.CrossRefPubMed
7.
go back to reference Manda SOM. Birth intervals, breastfeeding and determinants of childhood mortality in Malawi. Soc Sci Med. 1999;48:301–12.CrossRefPubMed Manda SOM. Birth intervals, breastfeeding and determinants of childhood mortality in Malawi. Soc Sci Med. 1999;48:301–12.CrossRefPubMed
8.
go back to reference Titaley CT, Dibley MJ, Agho K, Roberts CL, Hall J. Determinants of neonatal mortality in Indonesia. BMC Public Health. 2008; 8. doi:10.1186/1471-2458-1188-1232. Titaley CT, Dibley MJ, Agho K, Roberts CL, Hall J. Determinants of neonatal mortality in Indonesia. BMC Public Health. 2008; 8. doi:10.1186/1471-2458-1188-1232.
9.
go back to reference Kamal SMM. Maternal education as a determinant of neonatal mortality in Bangladesh. J Health Manag. 2012;14:269–81.CrossRef Kamal SMM. Maternal education as a determinant of neonatal mortality in Bangladesh. J Health Manag. 2012;14:269–81.CrossRef
10.
go back to reference Mekonnen Y, Tensou B, Telake DS, Degefie T, Bekele A. Neonatal mortality in Ethiopia: trends and determinants. BMC Public Health. 2013;13:1–14.CrossRef Mekonnen Y, Tensou B, Telake DS, Degefie T, Bekele A. Neonatal mortality in Ethiopia: trends and determinants. BMC Public Health. 2013;13:1–14.CrossRef
11.
go back to reference Mosley W, Chen LC. An analytical framework for the study of child survival in developing countries. Population Dev Rev. 1984;10:25–45.CrossRef Mosley W, Chen LC. An analytical framework for the study of child survival in developing countries. Population Dev Rev. 1984;10:25–45.CrossRef
12.
go back to reference Bamgboye EA, Familusi JB. Mortality pattern at a children’s emergency ward, University College Hospital, Ibadan, Nigeria. Afr J Med Med Sci. 1990;19:127–32.PubMed Bamgboye EA, Familusi JB. Mortality pattern at a children’s emergency ward, University College Hospital, Ibadan, Nigeria. Afr J Med Med Sci. 1990;19:127–32.PubMed
13.
go back to reference Aikhionbare HA, Yakubu AM, Naida AM. Mortality pattern in the Emergency Paediatric Unit of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Cent Afr J Med. 1989;35:393–6.PubMed Aikhionbare HA, Yakubu AM, Naida AM. Mortality pattern in the Emergency Paediatric Unit of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Cent Afr J Med. 1989;35:393–6.PubMed
14.
go back to reference Njokanma OF, Sule-Odu AO, Akesode FA. Perinatal mortality at the Ogun State University Teaching Hospital, Sagamu, Nigeria. J Trop Paediatr. 1994;40:78–81.CrossRef Njokanma OF, Sule-Odu AO, Akesode FA. Perinatal mortality at the Ogun State University Teaching Hospital, Sagamu, Nigeria. J Trop Paediatr. 1994;40:78–81.CrossRef
15.
go back to reference Njokanma OF, Olanrewaju DM. A study of neonatal deaths at the Ogun State University Teaching Hospital, Sagamu, Nigeria. J Trop Med Hyg. 1995;98:155–60.PubMed Njokanma OF, Olanrewaju DM. A study of neonatal deaths at the Ogun State University Teaching Hospital, Sagamu, Nigeria. J Trop Med Hyg. 1995;98:155–60.PubMed
16.
go back to reference Adimora GN, Odetunde IO. Perinatal mortality in University of Nigeria Teaching Hospital (UNTH) Enugu at the end of the last millennium. Niger J Clin Pract. 2007;10:19–23.PubMed Adimora GN, Odetunde IO. Perinatal mortality in University of Nigeria Teaching Hospital (UNTH) Enugu at the end of the last millennium. Niger J Clin Pract. 2007;10:19–23.PubMed
17.
go back to reference Udo JJ, Anah MU, Ochigbo SO, Etuk IS, Ekanem AD. Neonatal morbidity and mortality in Calabar, Nigeria: a hospital-based study. Niger J Clin Pract. 2008;11:285–9.PubMed Udo JJ, Anah MU, Ochigbo SO, Etuk IS, Ekanem AD. Neonatal morbidity and mortality in Calabar, Nigeria: a hospital-based study. Niger J Clin Pract. 2008;11:285–9.PubMed
18.
go back to reference Omoigberale AI, Sadoh WE, Nwaneri DU. A 4 year review of neonatal outcome at the University of Benin Teaching Hospital, Benin City. Niger J Clin Pract. 2010;13:321–5.PubMed Omoigberale AI, Sadoh WE, Nwaneri DU. A 4 year review of neonatal outcome at the University of Benin Teaching Hospital, Benin City. Niger J Clin Pract. 2010;13:321–5.PubMed
19.
go back to reference National Population Commission. National and State Population Housing Tables: Priority Tables Volume I. 2006 Population and Housing Census of the Federal Republic of Nigeria. Abuja: National Population Commission; 2009. National Population Commission. National and State Population Housing Tables: Priority Tables Volume I. 2006 Population and Housing Census of the Federal Republic of Nigeria. Abuja: National Population Commission; 2009.
20.
go back to reference Library of Congress. Nigeria Country Profile. Nigeria Country Profile Library of Congress - Federal Research Division. 2008. Library of Congress. Nigeria Country Profile. Nigeria Country Profile Library of Congress - Federal Research Division. 2008.
21.
go back to reference National Population Commission [Nigeria. Nigeria Demographic and Health Survey 2008. Calverton MD: National Population Commission and ORC Macro International; 2009. National Population Commission [Nigeria. Nigeria Demographic and Health Survey 2008. Calverton MD: National Population Commission and ORC Macro International; 2009.
22.
go back to reference Akinyemi JO, Bamgboye EA, Ayeni O. New trends in under-five mortality determinants and their effects on child survival in Nigeria: A review of childhood mortality data from 1990-2008. Afr Popul Stud. 2013;27:25–42. Akinyemi JO, Bamgboye EA, Ayeni O. New trends in under-five mortality determinants and their effects on child survival in Nigeria: A review of childhood mortality data from 1990-2008. Afr Popul Stud. 2013;27:25–42.
23.
go back to reference Uthman OA, Uthman MB, Yahaya I. A population-based study of effect of multiple birth on infant mortality in Nigeria. BMC Pregnancy Childbirth. 2008;8:41.CrossRefPubMedPubMedCentral Uthman OA, Uthman MB, Yahaya I. A population-based study of effect of multiple birth on infant mortality in Nigeria. BMC Pregnancy Childbirth. 2008;8:41.CrossRefPubMedPubMedCentral
24.
go back to reference National Population Commission [Nigeria]. Nigeria Demographic and Health Survey. National Population Commission and ORC Macro International, 2000. Maryland: Calverton; 1999. National Population Commission [Nigeria]. Nigeria Demographic and Health Survey. National Population Commission and ORC Macro International, 2000. Maryland: Calverton; 1999.
25.
go back to reference National Population Commission [Nigeria]. Population and the quality of life in Nigeria. Abuja: National Population Commission; 2003. National Population Commission [Nigeria]. Population and the quality of life in Nigeria. Abuja: National Population Commission; 2003.
26.
go back to reference Hall S. Neonatal mortality in developing countries: what can we learn from DHS data? Applications and Policy Working Paper A05/02. Southampton: University of Southampton; 2005. Hall S. Neonatal mortality in developing countries: what can we learn from DHS data? Applications and Policy Working Paper A05/02. Southampton: University of Southampton; 2005.
27.
go back to reference Hill K, Choi Y. Neonatal mortality in the developing world. Demogr Res. 2006;14:429–52.CrossRef Hill K, Choi Y. Neonatal mortality in the developing world. Demogr Res. 2006;14:429–52.CrossRef
28.
go back to reference Hong R, Ayad M, Rutstein S, Ren R. Childhood mortality in Rwanda: Levels, trends and differentials. Further analysis of the Rwanda Demographic Health Surveys 1992-2007/8. Calverton, Maryland, USA: ICF Macro; 2009. Hong R, Ayad M, Rutstein S, Ren R. Childhood mortality in Rwanda: Levels, trends and differentials. Further analysis of the Rwanda Demographic Health Surveys 1992-2007/8. Calverton, Maryland, USA: ICF Macro; 2009.
29.
go back to reference Bicego GT, Bicego GT, Ahmad OB. Infant and child mortality. Calverton, Maryland: DHS Comparative Studies No 20. Macro International Inc; 1996. Bicego GT, Bicego GT, Ahmad OB. Infant and child mortality. Calverton, Maryland: DHS Comparative Studies No 20. Macro International Inc; 1996.
30.
go back to reference Fayehun O, Omololu O. Ethnicity and child survival in Nigeria. Afr Popul Stud. 2011;25:92–112. Fayehun O, Omololu O. Ethnicity and child survival in Nigeria. Afr Popul Stud. 2011;25:92–112.
31.
go back to reference Ogunjuyigbe PO. Under-five mortality in Nigeria: perception and attitudes of the Yorubas towards the existence of “Abiku”. Demogr Res. 2004;11:41–56.CrossRef Ogunjuyigbe PO. Under-five mortality in Nigeria: perception and attitudes of the Yorubas towards the existence of “Abiku”. Demogr Res. 2004;11:41–56.CrossRef
32.
go back to reference Adedini SA, Odimegwu C, Bamiwuye O, Fadeyibi O, De Wet N. Barriers to accessing health care in Nigeria: implications for child survival. Glob Health Action. 2014;7:23499.PubMed Adedini SA, Odimegwu C, Bamiwuye O, Fadeyibi O, De Wet N. Barriers to accessing health care in Nigeria: implications for child survival. Glob Health Action. 2014;7:23499.PubMed
33.
go back to reference Antai D. Regional inequalities in under-5 mortality in Nigeria: a population-based analysis of individual- and community-level determinants. Popul Health Metrics. 2011;9:6.CrossRef Antai D. Regional inequalities in under-5 mortality in Nigeria: a population-based analysis of individual- and community-level determinants. Popul Health Metrics. 2011;9:6.CrossRef
34.
go back to reference Adebowale AS, Yusuf BO, Fagbamigbe AF. Survival probability and predictors for woman experience childhood death in Nigeria: “analysis of North-South differentials”. BMC Public Health. 2012;12:430.CrossRefPubMedPubMedCentral Adebowale AS, Yusuf BO, Fagbamigbe AF. Survival probability and predictors for woman experience childhood death in Nigeria: “analysis of North-South differentials”. BMC Public Health. 2012;12:430.CrossRefPubMedPubMedCentral
35.
go back to reference Obono O. Cultural diversity and population policy in Nigeria. Popul Dev Rev. 2003;29:103–11.CrossRef Obono O. Cultural diversity and population policy in Nigeria. Popul Dev Rev. 2003;29:103–11.CrossRef
36.
go back to reference Sastry N. Urbanization, development and under-five mortality differentials by place of residence in Sap Paulo, Brazil, 1970-1991. Demogr Res Spec Collect. 2004;2:354–86. Sastry N. Urbanization, development and under-five mortality differentials by place of residence in Sap Paulo, Brazil, 1970-1991. Demogr Res Spec Collect. 2004;2:354–86.
37.
go back to reference Fotso J. Urban-Rural differentials in child malnutrition: trends and socio-economic correlates in Sub-Saharan Africa. Health Place. 2006;13:205–23.CrossRefPubMed Fotso J. Urban-Rural differentials in child malnutrition: trends and socio-economic correlates in Sub-Saharan Africa. Health Place. 2006;13:205–23.CrossRefPubMed
38.
go back to reference Gakidou E, Cowling K, Lozano R, Murray CJ. Increased educational attainment and its effect on child mortality in 175 countries between 1970 and 2009: a systematic analysis. Lancet. 2010;376:959–74.CrossRefPubMed Gakidou E, Cowling K, Lozano R, Murray CJ. Increased educational attainment and its effect on child mortality in 175 countries between 1970 and 2009: a systematic analysis. Lancet. 2010;376:959–74.CrossRefPubMed
39.
go back to reference Caldwell JC. Cultural and social factors influencing mortality levels in developing countries. Ann Am Acad Pol Soc Sci. 1990;510:44–59.CrossRef Caldwell JC. Cultural and social factors influencing mortality levels in developing countries. Ann Am Acad Pol Soc Sci. 1990;510:44–59.CrossRef
40.
go back to reference Brockerhoff N, Derose LF. Child survival in East Africa: the impact of preventive health care. World Dev. 1996;24:1841–57.CrossRef Brockerhoff N, Derose LF. Child survival in East Africa: the impact of preventive health care. World Dev. 1996;24:1841–57.CrossRef
41.
go back to reference Fayehun O. Household environmental health hazards and child survival in Sub-Saharan Africa. DHS Working Papers No 74. Calverton, Maryland, USA: ICF Macro; 2010. Fayehun O. Household environmental health hazards and child survival in Sub-Saharan Africa. DHS Working Papers No 74. Calverton, Maryland, USA: ICF Macro; 2010.
43.
go back to reference Titaley CT, Dibley MJ, Roberts CL. Type of delivery attendant, place of delivery and risk of early neonatal mortality: analyses of the 1994-2007 indonesian Demographic and Health Surveys. Health Policy Plan. 2012;27:405–16.CrossRefPubMed Titaley CT, Dibley MJ, Roberts CL. Type of delivery attendant, place of delivery and risk of early neonatal mortality: analyses of the 1994-2007 indonesian Demographic and Health Surveys. Health Policy Plan. 2012;27:405–16.CrossRefPubMed
44.
go back to reference Rutstein S. Effects of preceding birth intervals on neonatal, infant and under-five years mortality and nutritional status in developing countries: evidence from the demographic and health surveys. Int J Gynecol Obstet. 2005;89:7–24.CrossRef Rutstein S. Effects of preceding birth intervals on neonatal, infant and under-five years mortality and nutritional status in developing countries: evidence from the demographic and health surveys. Int J Gynecol Obstet. 2005;89:7–24.CrossRef
45.
go back to reference Curtis SL. Assessment of the quality of data used for direct estimation of infant and child mortality in DHS-II surveys. Occasional Papers No 3. Calverton, Maryland: Macro International Inc; 1995. Curtis SL. Assessment of the quality of data used for direct estimation of infant and child mortality in DHS-II surveys. Occasional Papers No 3. Calverton, Maryland: Macro International Inc; 1995.
Metadata
Title
Trends in neonatal mortality in Nigeria and effects of bio-demographic and maternal characteristics
Authors
Joshua Odunayo Akinyemi
Elijah Afolabi Bamgboye
Olusola Ayeni
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2015
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-015-0349-0

Other articles of this Issue 1/2015

BMC Pediatrics 1/2015 Go to the issue