Maternal socio-demographic factors vs antenatal care utilization and under-five mortality in Nigeria

Abstract

Despite the 28% decline in under-five mortality (U5M) between 1990 and 2017 in sub-Saharan Africa, U5M remain considerably high in Nigeria as a result of poor progress in child survival practices. This persistence high rate of U5M has necessitated this study by examining the interaction influence of maternal sociodemographic factors and ANC utilisation on under-five mortality in Nigeria. Data on a weighted nationally representative sample of 127,202 birth history from the 2018 Nigeria Demographic and Health Survey were analysed to estimate the risks of U5M using Cox proportional regression. The study established that the risks of U5M were significantly lower for children whose mothers had 4 or more ANC visits (HR: 0.65, CI: 0.50-0.85), but increased for children whose mothers delivered in a private health facility (HR: 1.44, CI: 1.01-1.88). With respect to socio-demographic factors, the risks of U5M significantly reduced for children of mothers with secondary or tertiary education (HR: 0.68, CI: 0.55-0.86) and children of mothers found in the highest wealth quintile households (HR: 0.64, CI: 0.51-0.81) relative to those in the reference categories. Though not significant, the risks of U5M varied across place and region of residence. The study established that the risks of U5M are associated with poor maternal socio-demographic factors and incomplete or inadequate ANC utilisation during pregnancy in Nigeria. Hence, the need to re-strategise women empowerment plans and further re-training of private healthcare providers/workers on the importance of complete and adequate ANC  utilisation towards achieving SDG 3 target of reducing maternal and child mortality in Nigeria.

Keywords: Maternal socio-demographic factors, ANC utilisation, under-five mortality, Nigeria