Infant mortality and childhood nutrition in Ondo State, Nigeria : their correlates and socio-cultural explanations

Abstract

This thesis examines the factors associated with mortality among children under the age of 12 months (infant mortality) and nutritional status among children aged 6-36 months (childhood nutrition) in Ondo State, Nigeria. The primary purpose of the study was to identify the variables that were most important in explaining the level and pattern of infant mortality and childhood nutrition in the state. A secondary objective was to compare the pattern of association between the key variables for both infant mortality and childhood nutrition. Both quantitative and qualitative analysis has been used in the thesis. Bivariate and multivariate statistical methods were applied to the 1986-87 Ondo State Demographic and Health Survey (ODHS) to assess the effects of certain socio-economic variables and some of the Mosley and Chen's (1984) proximate determinants on infant mortality and childhood nutrition. Qualitative information from two phases of a micro-level study of an Ondo State town was also used to provide the context of infant mortality and childhood nutrition in a particular community. The findings on infant mortality showed that levels were lower in Ondo State than in Nigeria as a whole and that the level of infant mortality in the state was comparable to that observed in the southwest region in which it is located. In this study, the key variables associated with infant mortality were duration of breastfeeding, maternal age at childbirth and birth order. Among the three groups of proximate determinants for which data were available, only maternal factors had a significant effect on infant mortality. At the bivariate level, the pattern of association between infant mortality and mothers' education was not in the expected direction. However, when the effect of breastfeeding duration was controlled, the usually-observed inverse relationship between infant mortality and mothers' education emerged. This study appears to support the observation that demographic variables are more important than socio-economic factors in explaining infant mortality. Available qualitative data, on the other hand, suggested that economic disadvantage was at the root of many of the observed demographic effects, especially in relation to teenage childbearing. The economic disadvantage that resulted in high infant mortality among the children of mothers with secondary education also tended to result in stunting of their children. The findings on childhood nutrition showed about one-third of children in Ondo State had moderate to severe stunting, even though very few had moderate or severe wasting. The major predictors of stunting were source of drinking water, succeeding birth interval, maternal age at childbirth and diarrhoea. The major predictors of wasting were succeeding birth interval, toilet availability, and diarrhoea. This suggests that good child spacing coupled with environmental hygiene and the consequent reduction in exposure to disease pathogens enhances children's nutritional status. Economic resources can also ensure an adequate supply of food to the household. The study concludes that efforts to reduce infant mortality in Ondo State should include encouraging mothers to breastfeed their children, and improved economic well-being of mothers. Similarly, better environmental sanitation and general economic well-being will enhance the nutritional status of Ondo State children, and in turn bolster their survival prospects.