Factors associated with under-5 mortality in the south-south region of Nigeria

Under-5 mortality rates (U5MR) have declined drastically globally. However, it remains high in Nigeria, with variations across the Country’s six geo-political zones. Understanding the factors associated with under-5 mortality (U5M) among lesser-explored subpopulations will inform strategies to curtail U5M. We investigated the factors associated with U5M in the south-south geopolitical zone (SSGZ) of Nigeria and population attributable risk percent (PAR%).

We analyzed population-based data from the Nigeria Demographic and Health Survey (NDHS) for 2013 and 2018. Logistic regression analysis was used in SPSS version 26.0 to calculate the Odds Ratios (OR) with 95% Confidence Intervals (CI) for U5M associated with various factors, while the PAR% was computed using Levine's formula.

The adjusted logistic regression analysis model showed maternal overweight (OR = 1.39, 95% CI 1.12–1.72, p < 0.05), primary education (OR = 2.18, 95%CI 1.18–4.04 p < 0.05) and secondary education (2.05, 95%CI 1.13–3.72, p < 0.05) levels, male gender (OR=1.22, 95%CI 1.01–1.47, p < 0.05), birth interval of less than two years (OR = 2.93, 95%CI 2.10–4.10, p < 0.001), and small birth size (OR = 2.54, 95% CI 1.94–3.31, P < 0.001) significantly increased U5M risk, while having seven or more household members (OR = 0.73, 95%CI 0.59–0.89, p < 0.05) and 2 under-five children in the household (OR = 0.66, 95% CI 0.52–0.83, p < 0.001) were protective factors, with PAR% for the factor significantly associated with U5M ranging from 4.5% to 47.1%.

Increased interventions on maternal weight, maternal education, low birth size, and child spacing could reduce U5M in the SSGZ of Nigeria.