SOCIO ECONOMIC CONDITION OF MOTHERS AND INFANT MORTALITY RATE
CHAPTER ONE
Background of the Study
1.1 Introduction
Despite its human and
natural resources, Nigeria
with a population of over
170 million and GDP of
$235 billion (World Bank, 2012) and $500 billion when rebased in 2014, is ranked among the poorest countries in the
world; fifty five per cent live below the extreme poverty line of US$1 a day (World Bank, 2012). Less than one half of
the population has access to safe water (43% in rural areas) and only 41% have access to adequate sanitation (32%
in rural areas). Life expectancy at birth is 52 years. Overall, the adult literacy rate is 56 per cent, however the rate for
males (67%) is much higher than for females (47%). These facts adversely affect the survival of children and the
reproductive health of women in general.
Investing in the health of children and their mothers is not only a human rights imperative, it is a sound economic
decision and one of the surest ways for a country to set its course towards a better future (UNICEF, 2008). Simple,
reliable and affordable interventions with the potential to save and improve the lives of millions of children are readily Message us
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available. The challenge, particularly in developing countries, has been how to ensure that these remedies reach the
children and families who, so far, have been passed by.
In Nigeria, inadequate health facilities, lack of transportation to institutional care, inability to pay for services and
resistance among some populations to modern health care (such as immunization) are key factors behind the
country’s high rates of new-born and child mortality and morbidity (UNICEF, 2009). Cultural attitudes and practices
that discriminate against women and girls contribute, inadvertently to child morbidity and mortality. While poor service
delivery, parents who have low levels of education and lack of information about immunization are major reasons for
low coverage among children (UNICEF, 2012).
Childhood mortality has been at the centre of developmental discourse more importantly since the beginning of the
twentieth century. For instance, reduction of child mortality is the fourth of the United Nations’ Millennium
Development Goals (MDGs). The rationales for this special attention are not farfetched. One, although mortality is a
necessity of life and inevitable phenomenon, its untimely occurrence and varieties, especially under-5 mortality, bring
about diverse social, economic and psychological trauma not only to the members of bereaved family, but to their
immediate communities, various social and developmental organizations, the nation and entire world in general.
Two, in almost all cultures in the world, childbirth is an event that attracts celebration and children serve as symbols of
joy and success to their parents and the entire society, so, their sudden and untimely demise leaves behind sorrow
and confusion to the victims of such unfortunate occurrence. Three, child mortality negate the concepts of
reproduction and motherhood and if not properly stem it may lead to total extinction of entire humanity. Four,
childhood mortality remains disturbingly high in developing countries especially in sub-Saharan Africa despite the
significant decline in most parts of the developed world. The child mortality statistics reports of the World Health
Organization (2012) reveal staggering fact that about 7.6 million children under the age of five die every year and
more than half of these early child deaths are due to conditions that could be prevented or treated. More worrisome
than this is the child mortality statistics of the World Bank (2006) which reveals that the death toll among children
under-5 years has well reached some 11 million annually, with a clause that “more than 10 million of these occur in
the developing world and sub-Sahara Africa is the region most affected and accounts for more than one-third of
deaths of children under-5 years (World Bank, 2006).
This asymmetric geographical distribution and patterns persist even in the 2012 child mortality statistics. Thus, level
of child mortality is a significant indicator of level of development of a given country, region or continent which makes
child mortality to remains a major public health issue in developing countries where it is estimated that over 10 million
preventable child deaths occur yearly. In addition, progress in child mortality reduction remains unacceptable in SubSaharan Africa. With special reference to Nigeria, the giant of Africa, available statistics suggest that child mortality
levels continue to be high and exhibit wide geographic disparities (NPC, 1998; 2004; 2009). These factors and many
more reveal the needs for continuous and rigorous research in the areas of child mortality most especially in subSaharan Africa. Child mortality defined as the likelihood for a child born alive to die between its first and fifth birthday, is one of the
most sensitive and commonly used indicators of the social and economic development of a population. Thus, it is
frequently on the programme of public health and international development agencies and has received renewed
attention as a part of the United Nation’s Millennium Development Goals (MDG; Espo, 2002). The MDG target is to
reduce child mortality by two thirds in the year 2015. This is pertinent as the progress and future of any country
depends on how healthy the children are. This is reflected in their access to basic health care, nutritious food and a
protective environment, and if these are not available, the country’s mortality rates would increase and economic
potentials diminish (WHO, 2008). Globally, according to the UN Interagency Group on Child Mortality Estimation
(2011) a significant amount of progress has been made towards achieving the target of reducing mortality rate by two
thirds among children under five. For instance the number of under-five deaths worldwide has declined from more
than 12 million in 1990 to 7.6 million in 2010. However, the highest rates of child mortality are still in Sub-Saharan
Africa-where 1 in 8 children dies before the age of 5 years, more than 20 times the average for industrialized
countries (1 in 167) and South Asia (1in 15) despite action plans, interventions and broad approaches toward
improving child’s health in the region (WHO, 2005). Further, West African countries in particular experienced mortality
up to three times higher than neighbouring countries in Northern and Southern Africa (Balk et al., 2004) and of all the
under-five deaths which occur, five countries namely; India, Nigeria, Democratic Republic of the Congo, Pakistan and
China account for about 50% with India (22%) and Nigeria (11%) together accounting for a third of all under-five
deaths. Nigeria, despite its wealth of human and natural resources, the Federal Ministry of Health’s Integrated
Maternal, New-born and Child Health Strategy and the fact that it is one of the first African countries with an
integrated plan to look after mothers, new-borns and children right through from conception to the child’s fifth birthday,
is one of the least successful of African countries in achieving improvements in child survival in the past four decades
(Nigeria Health Journal, 2011).
Childhood deaths in Nigeria are usually caused by avoidable environmental threats to health which stem most often
than not from traditional problems that have long been resolved in the wealthier countries, such as a lack of clean
water, sanitation, adequate housing, and protection from mosquitoes, other insects and animal disease vectors and in
people’s beliefs and attitudes concerning childcare and behavioural practices into health strategies (Feyisetan &
Adedokun, 1992; Ogunjuyigbe, 2004). Though, common causes of child mortality and morbidity include diarrhoea,
malaria, measles and acute respiratory infections, studies have shown that in Nigeria, many children die mainly from
malaria, diarrhoea, whooping cough, tuberculosis and bronchopneumonia (Ogunlesi, 1961; Baxter-Grillo & Leshi,
1964; Morley, 1973; Animashaun, 1977; Ayeni, 1980). Ogunjuyigbe (2004) viewed morbidity and mortality of the child
to be influenced by the underlying factors of both biological and socio-economic that operates through proximate
determinants. Jinadu et al. (1991), in a study, found dirty feeding bottles and utensils, inadequate disposal of
household refuse and poor storage of drinking water to be significantly related to the high incidence of diarrhoea.
Children from poor households are more vulnerable to these attendant risks compared with children born to better off
families. They are usually more exposed to risks such as inadequate water and sanitation, indoor air pollution,
crowding and exposure to disease vectors and are more likely than not to be They are, therefore, at greater risk of severe disease, and are more likely to suffer from more than one disease when
ill. They are less likely to have access and use preventive and curative interventions, and those who do receive
treatment are less likely to receive appropriate quality services (Wagstaff et al., 2004). Thus, at the dawn of the
21st century, childhood mortality which is an indicator of health status of a country is very crucial and remains a
daunting issue for these developing countries and Nigeria in particular where poverty rates are disproportionately high.
SOCIO ECONOMIC CONDITION OF MOTHERS AND INFANT MORTALITY RATE