mortality

Child mortality reflects a country’s level of
socio-economic development, the country’s health care system as well as the
quality of life particularly of the mothers (Bello and Joseph, 2014). In recent
time, the reduction of child mortality has become a common agenda of
international development agencies and of public health (Bello and Joseph,
2014). According to Espo (2002),
there are approximately 10 million children under the age of five who die each
year with large variation across regions and countries. Globally, the mortality rate of under-fives has decreased by 56%,
from an estimated rate of 93 deaths per 1000 live births in 1990 to 41 in 2016
(World Health Organization, 2018), majorly due to interventions targeted at
communicable diseases such as diarrhoea, measles, malaria, respiratory
infections and other childhood infections children could be immunised for which
have been major causes of child mortality.
However, it should be noted that these health gains only lasted a short
time especially in sub-Sahara Africa because disease-oriented vertical program
alone was ineffective (Bello and Joseph, 2014). Socio-economic, environmental and maternal factors were acknowledged
as additional important determinants of the survival of a child (Espo, 2002).

Despite sub-Saharan Africa having only one-fifth of
the world’s children population ((UNICEF
The State of the World’s Children 2016, 2016), the mortality rates of
children remain unacceptably high as half
of the deaths occur in the region ((UNICEF The State of the World’s Children
2016, 2016). For instance, according to UNICEF (2017), in sub-Saharan Africa,
approximately 1 in 13 children die before their fifth birthday which is nearly
twenty times the average of 1 in 189 in the developed parts of the world. Among
new-borns in sub-Saharan Africa, 1 in 36 children dies in the first month,
while 1 in 333 children dies in countries of a higher income. Similarly, the
world children’s report noted that in 2016, an estimate of 5.6 million children
across the world died before reaching their fifth birthday from a preventable disease
(UNICEF, 2017). It also noted that, about 80 per cent of under-five deaths occurred
in the sub-Saharan Africa (38%) and Southern Asia region (39%). Half of these
deaths occurred in five countries namely with namely Ethiopia (3%), India (24%),
Nigeria (9%), Pakistan (10%) and the Democratic Republic of the Congo (4%) (UNICEF,
2017).

Nigeria is Africa’s most
populous country, with 193 million people in 2017 and 33 million of them under
the age of five. REFERENCE Having a fertility
rate of 2.61%, its population continues to grow rapidly. In addition to its
population, Nigeria is known for its immense oil wealth however, the
distribution of wealth is unequal, and the overall economic situation of the
country remains unsatisfactory. REFERENCE
According to the World Development Indicators (2016), majority of Nigeria’s
population still lives in extreme poverty as more than 64% live on less than $1
(£0.74) per day, impeding their ability to afford health care. Demographic pressures, poverty and insufficient
investment in public health care increases the levels and ratios of neonatal
and maternal mortality (UNICEF, 2018).

According to the Nigerian
Demographic Health Survey (2013), infant and under-five mortality rates in the
five-year period before the survey are 69 and 128 per 1000 live births
respectively. With this mortality level, 1 in 15 Nigerian children dies before
their first birthday and 1 in 8 does not survive before their fifth birthday (Nigeria Demographic and Health Survey, 2013). Mortality
rates vary by location. Children who lived in rural areas had a lower survival
rate to children in urban areas with under-five mortality at 100 per 1,000 live
births in urban areas, compared with 167 per 1,000 live births in rural areas (Nigeria Demographic and Health Survey, 2013). Childhood mortality generally decreases as the wealth of a household
increases. In poor households, under-five mortality rates were 190 deaths per
1,000 live births compared to 73 deaths per 1,000 live births in the wealthiest
households (Unicef.org, 2018).

Maternal mortality ration
in Nigeria contributes a major part of these deaths at 576 per 1000 live births
and the neonatal mortality is 37 per 100,000 live births (National Population Policy, 2004). The mortality rate
of children born to mothers with no education was 180 deaths per 1,000 live
births which is almost twice the number born to mothers with a secondary
education (91 deaths per 1,000 live births) and three times children born to
mothers with more than a secondary education (62 deaths per 1,000 live births)
(Nigeria Demographic and Health Survey, 2013). Maternal
health is intricately linked to a child’s survival. So therefore, this high
maternal mortality rate is a sign of grave implications for the survival of a
child.

Numerous factors have
been acclaimed to be accountable for this ugly trend of high infant and child
mortality. According to Ogunjuyigbe (2004), studies have shown that in Nigeria,
childhood illnesses such as malaria (30%), vaccine preventable diseases most
especially measles (22%), diarrhoea (19%), acute respiratory infections (16%) and
malnutrition (60%) contribute substantially to morbidity and mortality among
children under the age of five. According to Lambo (2006), mortality in a neonate
contributes to approximately half of infant mortality rates and represents
a quarter of the total number of deaths of children
under-fives in Nigeria. Majority of these deaths occur within the first week of
life, mostly due to complications that occur during pregnancy and delivery
showing the close link between the survival of a new-born and the quality of
maternal care (Unicef.org, 2018). For neonates, the major conditions that cause
death are low birth weight, neonatal jaundice, neonatal tetanus, asphyxia and
sepsis. Also, they cause morbidity and in some cases long-term disability. In
addition, the present HIV seroprevalence rates of 5% further threatens the
survival of the child through mother-to-child transmission of infection (Lambo,
2006).

Likewise, the possibility
of a woman dying from pregnancy and childbirth in Nigeria is 1 in 13
(Unicef.org, 2018). Although many of these deaths are avoidable, the quality of
health care and coverage continues to fail women and children as there are
currently less than 20% of health facilities that offer emergency obstetric
care and only 35% of deliveries are attended by skilled birth attendants. This
shows the close relationship between the welfare of a mother and her child, and
justifies the need to integrate maternal, neonatal and interventions for child
health (Unicef.org, 2018).

Asides the
health-related factors mentioned earlier, there are non-health related factors
that can affect a child’s survival. They include access to adequate and safe
sanitation, cultural and gender bias, poverty, waste disposal, and air pollution. Others include inadequate
health facilities, inability to pay for services, lack of transportation to
institutional care, exposure to industrial chemical and wastes, the literacy
level of the mother and her status regarding the level of participation she has
in the household’s decision making (Lambo, 2006).

 Death
might be common but when child mortality rate is on the high side, it becomes disturbing
and catastrophic as this shows and places emphasis on a gradual human
extinction. This study aims to
reduce infant mortality rates in Nigeria and improve the health care outcome of
neonates.