Table 1
Distribution of and under-five mortality rate (U5MR) for each category of individual, household and community variables in Northwest geopolitical zone, Nigeria, 2008-2018.
| CHARACTERISTIC | 2008 | 2013 | 2018 | |||
|---|---|---|---|---|---|---|
| N (%) | U5MR (95% CI)* | N (%) | U5MR (95% CI)* | N (%) | U5MR (95% CI)* | |
| Residence type | ||||||
| Urban | 140 (12) | 167 (152—182) | 169 (13) | 148 (136—160) | 318 (19) | 169 (155—184) |
| Rural | 1050 (88) | 195 (184—206) | 1121 (87) | 186 (177—196) | 1345 (81) | 191 (178—204) |
| Northwest state | ||||||
| Jigawa | 129 (11) | 204 (189—219) | 214 (17) | 162 (145—178) | 217 (13) | 190 (175—205) |
| Kaduna | 139 (12) | 187 (164—210) | 65 (5) | 162 (143—181) | 364 (22) | 174 (158—191) |
| Kano | 396 (33) | 183 (165—200) | 307 (24) | 167 (153—182) | 319 (19) | 188 (173—203) |
| Katsina | 202 (17) | 191 (175—207) | 154 (12) | 160 (148—172) | 287 (17) | 185 (171—200) |
| Kebbi | 71 (6) | 205 (186—224) | 152 (12) | 161 (147—175) | 219 (13) | 187 (171—203) |
| Sokoto | 157 (13) | 199 (182—216) | 145 (11) | 159 (146—173) | 125 (8) | 193 (177—209) |
| Zamfara | 96 (8) | 199 (181—216) | 253 (20) | 152 (139—164) | 132 (8) | 191 (174—207) |
| Household wealth index+ | ||||||
| Rich | 151 (13) | 165 (150—181) | 171 (13) | 145 (135—154) | 253 (15) | 170 (155—185) |
| Middle | 457 (38) | 195 (181—209) | 536 (42) | 177 (161—193) | 772 (46) | 186 (170—201) |
| Poor | 582 (49) | 200 (187—212) | 583 (45) | 178 (166—191) | 637 (38) | 195 (182—207) |
| Mother’s education | ||||||
| Secondary or higher | 70 (6) | 170 (154—186) | 59 (5) | 142 (129—155) | 123 (7) | 176 (160—193) |
| Primary | 161 (13) | 188 (173—204) | 117 (9) | 158 (144—171) | 205 (12) | 183 (164—202) |
| No education | 959 (81) | 196 (185—207) | 1113 (86) | 187 (174—200) | 1335 (80) | 189 (177—201) |
| Mother’s literacy level~ | ||||||
| Able to read | 148 (12) | 166 (147—185) | 107 (8) | 147 (134—159) | 219 (13) | 172 (156—188) |
| Cannot read | 1025 (86) | 194 (181—206) | 1173 (91) | 186 (174—197) | 1444 (87) | 187 (177—199) |
| Mother’s age | ||||||
| < 20 | 86 (7) | 209 (190—229) | 95 (7) | 157 (142—172) | 106 (6) | 193 (175—211) |
| 20—29 | 534 (45) | 184 (171—195) | 586 (46) | 172 (159—185) | 817 (49) | 179 (166—193) |
| 30—39 | 411 (35) | 183 (171—195) | 430 (33) | 168 (155—180) | 540 (33) | 184 (172—197) |
| 40—49 | 159 (13) | 198 (182—214) | 178 (14) | 159 (145—173) | 201 (12) | 188 (175—201) |
| Mother’s body mass index~ | ||||||
| Normal | 790 (67) | 186 (174—198) | 984 (77) | 175 (164—186) | 427 (77) | 186 (173—199) |
| Underweight | 178 (15) | 196 (181—211) | 128 (10) | 156 (144—169) | 61 (11) | 186 (167—203) |
| Overweight | 148 (12) | 190 (173—206) | 119 (9) | 158 (143—172) | 54 (9) | 184 (166—202) |
| Obese | 65 (6) | 198 (178—218) | 49 (4) | 151 (138—164) | 13 (2) | 187 (172—201) |
| Wanted pregnancy~ | ||||||
| Wanted then | 1039 (87) | 180 (168—191) | 1225(95) | 177 (166—188) | 1604 (97) | 176 (165—187) |
| Wanted later | 39 (3) | 200 (183—218) | 13 (1) | 152 (139—166) | 45 (3) | 188 (170—206) |
| Wanted no more | 13 (1) | 204 (184—224) | 5 (0.4) | 152 (136—167) | 14 (1) | 189 (169—209) |
| Father’s education~ | ||||||
| No education | 767 (65) | 200 (186—213) | 893 (69) | 188 (177—199) | 1063 (64) | 191 (180—203) |
| Primary | 186 (16) | 195 (181—209) | 186 (14) | 160 (150—171) | 227 (14) | 186 (172—200) |
| Secondary or higher | 206 (17) | 164 (149—179) | 182 (14) | 146 (134—157) | 291 (18) | 172 (157—187) |
| Mother’s perceived baby size~ | ||||||
| Average or larger | 875 (74) | 172 (160—183) | 926 (72) | 169 (159—179) | 1268 (76) | 171 (160—183) |
| Small or very small | 222 (19) | 213 (199—228) | 300 (24) | 173 (158—187) | 389 (23) | 196 (182—209) |
| Sex | ||||||
| Female | 551 (46) | 183 (167—199) | 588 (46) | 173 (157—189) | 831 (50) | 178 (164—191) |
| Male | 640 (54) | 187 (174—200) | 702 (54) | 172 (161—183) | 832 (50) | 188 (172—204) |
| Birth order/birth interval | ||||||
| First | 193 (16) | 202 (184—221) | 235 (18) | 167 (151—183) | 308 (19) | 189 (171—207) |
| 2nd or 3rd rank, interval ≤ 2 yrs | 136 (11) | 202 (186—217) | 120 (9) | 164 (148—180) | 201 (12) | 192 (177—207) |
| 2nd or 3rd rank, interval > 2 yrs | 180 (15) | 177 (163—191) | 195 (15) | 149 (136—161) | 212 (13) | 175 (161—190) |
| 4th or higher rank, interval ≤ 2 yrs | 420 (35) | 174 (162—186) | 415 (32) | 159 (147—172) | 521 (31) | 174 (162—187) |
| 4th or higher rank, interval > 2 yrs | 262 (22) | 215 (200—229) | 321 (25) | 178 (163—194) | 406 (24) | 203 (187—219) |
| Place of birth~ | ||||||
| Home | 1047 (88) | 184 (174—194) | 1139(88) | 180 (169—190) | 1417 (85) | 181 (169—192) |
| Health facility | 79 (7) | 184 (167—201) | 99 (8) | 151 (138—165) | 246 (15) | 179 (161—196) |
| Mode of delivery | ||||||
| Non-caesarean | 1178 (99) | 180 (169—191) | 1268(98) | 179 (169—190) | 1646 (99) | 180 (169—191) |
| Caesarean‴ | 8 (1) | 203 (184—223) | 9 (1) | 152 (138—166) | 17 (1) | 190 (175—204) |
| Delivery assistance~ | ||||||
| Health professional | 95 (8) | 182 (164—199) | 109 (9) | 151 (137—165) | 276 (17) | 178 (160—197) |
| Non-health professional^ | 1019 (86) | 188 (176—201) | 780 (61) | 180 (169—192) | 1362 (82) | 183 (169—197) |
[i] n (%) Weighted number, and proportion of children < 5 years old who died during the under-five period (0–59 months); * All U5MR estimates with 95% confidence interval (CI) were rounded to a whole number; + Wealth was assessed based on household assets (radio, television, fridge, bicycle, motorcycle, car, telephone, electricity, and type of floor material used in rooms) that were consistent across the combined NDHS data sets; ^ Traditional birth attendant, relative or friend; ‴ Caesarean section is a combination of both elective and emergency caesarean; ~ Proportion varies between groups due to missing values; yrs Years.
Figure 1
a Trends in singleton under-5 mortality rate (U5MR), with 95% confidence interval (lower-class limit [LCL] and upper-class limit [UCL]) in Northwest geopolitical zone (NWGZ) by year of Nigeria Demographic and Health Surveys (NDHS), 2008-2018. b Trends in U5MR in NWGZ states by year of NDHS survey.
Table 2
Under-5 mortality model, and distribution of characteristics reported in three demographic and health surveys in the northwest geopolitical zone, Nigeria, 2008–2018.
| VARIABLE | N* | N%Ψ | CRUDE MODEL†§ | ADJUSTED MODEL†§ |
|---|---|---|---|---|
| Year of Survey | ||||
| 2008 | 8529 | 1096 (29) | Ref | Ref |
| 2013 | 11442 | 1181 (32) | 0.74 (0.63—0.87) | 0.76 (0.65—0.87) |
| 2018 | 12045 | 1468 (39) | 0.96 (0.84—1.10) | 1.00 (0.89—1.13) |
| Residence type | ||||
| Urban | 7044 | 580 (15) | Ref | Ref |
| Rural | 24971 | 3165 (85) | 1.56 (1.31—1.86) | 1.28 (1.10—1.50) |
| North West state | ||||
| Jigawa | 4006 | 505 (14) | Ref | Ref |
| Kaduna | 4872 | 485 (13) | 0.84 (0.64—1.10) | 1.00 (0.81—1.25) |
| Kano | 7950 | 942 (25) | 1.00 (0.84—1.19) | 1.19 (1.00—1.41) |
| Katsina | 5500 | 578 (15) | 0.85 (0.71—1.01) | 0.92 (0.78—1.09) |
| Kebbi | 3054 | 395 (11) | 1.19 (0.97—1.46) | 1.21 (0.99—1.47) |
| Sokoto | 3005 | 385 (10) | 1.15 (0.95—1.38) | 1.25 (1.03—1.51) |
| Zamfara | 3628 | 454 (12) | 0.93 (0.78—1.12) | 1.04 (0.86—1.25) |
| Household wealth index+ | ||||
| Rich | 6662 | 521 (14) | Ref | |
| Middle | 12789 | 1589 (42) | 1.73 (1.48—2.02) | |
| Poor | 12564 | 1635 (44) | 1.74 (1.47—2.04) | |
| Mother’s education | ||||
| Secondary or higher | 3791 | 227 (6) | Ref | Ref |
| Primary | 3942 | 405 (11) | 1.72 (1.32—2.24) | 1.53 (1.17—2.01) |
| No education | 24282 | 3113 (83) | 2.21 (174—2.81) | 1.80 (1.40—2.33) |
| Mother’s literacy level | ||||
| Able to read | 5697 | 393 (11) | Ref | |
| Cannot read | 26229 | 3330 (89) | 1.88 (1.58—2.22) | |
| Mother’s age | ||||
| < 20 | 2085 | 277 (7) | 1.61 (1.34—1.94) | 1.35 (1.08—1.68) |
| 20—29 | 15693 | 1784 (48) | 1.03 (0.93—1.13) | 0.99 (0.88—1.12) |
| 30—39 | 10689 | 1210 (32) | Ref | Ref |
| 40—49 | 3548 | 474 (13) | 1.20 (1.04—1.39) | 1.20 (1.04—1.40) |
| Mother’s body mass index | ||||
| Normal | 16733 | 2010 (73) | Ref | |
| Underweight | 3076 | 338 (12) | 0.89 (0.78—1.02) | |
| Overweight | 2765 | 294 (11) | 0.84 (0.70—1.00) | |
| Obese | 1102 | 115 (4) | 0.73 (0.54—1.00) | |
| Wanted pregnancy | ||||
| Wanted then | 30424 | 3494 (96) | Ref | |
| Wanted later | 898 | 97 (3) | 0.95 (0.72—1.25) | |
| Wanted no more | 284 | 31 (1) | 0.88 (0.55—1.41) | |
| Father’s education | ||||
| No education | 18943 | 2464 (68) | 1.67 (1.45—1.92) | |
| Primary | 4552 | 519 (14) | 1.48 (1.25—1.74) | |
| Secondary or higher | 7584 | 624 (17) | Ref | |
| Mother’s perceived baby size | ||||
| Average or larger | 26469 | 2855 (79) | Ref | Ref |
| Small or very small | 5031 | 753 (21) | 1.46 (1.30—1.65) | 1.43 (1.28—1.61) |
| Sex | ||||
| Female | 15876 | 1769 (47) | Ref | |
| Male | 16139 | 1976 (53) | 1.10 (1.01—1.21) | |
| Birth order/birth interval | ||||
| First | 5257 | 719 (19) | 1.57 (1.37—1.81) | 1.47 (1.27—1.71) |
| 2nd or 3rd rank, interval ≤ 2yrs | 2657 | 441 (12) | 1.90 (1.57—2.30) | 1.90 (1.58—2.28) |
| 2nd or 3rd rank, interval > 2 yrs | 6470 | 561 (15) | Ref | Ref |
| 4th or higher rank, interval ≤ 2yrs | 12755 | 1158 (31) | 1.12 (0.99—1.27) | 1.05 (0.90—1.22) |
| 4th or higher rank, interval > 2 yrs | 4877 | 866 (23) | 1.98 (1.72—2.29) | 1.86 (1.58—2.19) |
| Contraceptive use | ||||
| Yes | 1525 | 103 (3) | Ref | |
| No | 30490 | 3642 (97) | 2.07 (1.59— 2.71) | |
| Place of birth | ||||
| Home | 27980 | 3311 (91) | 1.42 (1.18—1.72) | |
| Health facility | 3801 | 337 (9) | Ref | |
| Mode of delivery‡ | ||||
| Non-caesarean | 31762 | 3701 (99) | Ref | |
| Caesarean‴ | 170 | 27 (1) | 1.31 (0.63—2.72) | |
| Delivery assistance | ||||
| Health professional | 4290 | 376 (11) | Ref | |
| Non-health professional^ | 24398 | 2911 (89) | 1.39 (1.17—1.66) |
[i] * Combined total weighted live births (singleton) across each of the variable groups between 2008 and 2018; Ψ Weighted number, and proportion of children < 5 years old who died during the under-five period (0–59 months); † logistic regression model was used to estimate the odds ratio with 95% confidence interval; § Missing values were not included in the model; ‡ Mode of birth was excluded from the adjusted model because only 1% had caesarean section during the study period; ‴ Caesarean section is a combination of both elective and emergency caesarean; ^ Traditional birth attendant, relative or friend; Ref Reference category; yrs Years; + Wealth was assessed based on household assets (radio, television, fridge, bicycle, motorcycle, car, telephone, electricity, and type of floor material used in rooms) that was consistent across the combined NDHS data sets.