The Rate And Causes Of Infant Mortality

Project and Seminar Material for Public Health

The Rate And Causes Of Infant Mortality


Abstract


This study investigated the rate and causes of infant mortality. The study was carried out in Irrua Teaching Hospital, Edo state, Nigeria. A reconnaissance survey was carried out in order to identify the various locations of hospitals in the LGAs. During the reconnaissance survey, oral interviews were carried out on women of child bearing age. Purposive sampling technique was used to select the study area, with up to date medical records of infant and child mortality. Stepwise Regression Analysis was used to model the spatial pattern of these changes in the mortality trend of Edo State. A total of 386 questionnaires were retrieved out of 400 questionnaires administered on 400 respondents (96.5%).

The major findings of the study reveal that major cause of morbidity in the study area is malaria (26.9%), major causes of death in the study area are malaria (30.1%) and it also showed that 39% of the children are within the ages of 0-1year. Mortality also varies with the marital status of the respondent, where the high rate of mortality was experienced by mothers who are married but not living with their husbands and widows. The major factors that determined mortality in the study area is distance to the health facility. Evidence from the hospital survey showed that the level of under-five mortality in Edo state has remained high since the past 10 years with an estimated U5MR of 163/1,000 live births even after considering a myriad of factors, including heterogeneity in study design. The study further recommended that Edo State Government should bring health services nearer to the communities especially in Irrua community so that mothers will have access to both during pregnancy and after. The impact of delivery a child with the help of a medical professional is enormous.


Table Of Contents


Preliminary Pages

  • Title page
  • Certification page
  • Dedication
  • Acknowledgement
  • Abstract
  • Table of content

Chapter One

Introduction

  • 1.1 Background Of The Study
  • 1.2 Problem Statement
  • 1.3 Study Objectives
  • 1.4 Significance Of The Study
  • 1.5 Study Questions/Hypotheses
  • 1.6 Scope And Limitation Of The Study
  • 1.7 Definition Of Terms

Chapter Two

Review Of Related And Relevant Literature

  • 2.1 Introduction
  • 2.2 Conceptual Clarifications
  • 2.3 Theoretical Studies
  • 2.4 Empirical Studies
  • 2.5 Related Literatures

Chapter Three

Research Methodology

  • 3.1 Research Design
  • 3.2 Study Area
  • 3.3 Sources Of Data
  • 3.4 Population Of The Study
  • 3.5 Sample Size Determination
  • 3.6 Instrumentation
  • 3.7 Reliability And Validity Of Instrument
  • 3.8 Method Of Data Analysis

Chapter Four

Data Presentation, Analysis And Interpretation

  • 4.1 Data Presentation
  • 4.2 Data Analysis
  • 4.3 Data Interpretation

Chapter Five

Summary, Conclusion And Recommendation

  • 5.1 Summary
  • 5.2 Conclusion
  • 5.3 Recommendation
  • References

Chapter One


Introduction

1.1 Background Of The Study

According to the medical dictionary, infant is a child during his or her first year of life till 5 years old of life. Then, infant mortality is the number of death which occurs among the young once. Infant mortality rate which is also known as (IMR) correlates very strongly with life expectancy t birth by region and is among the best predictors of state failure.

IMR is therefore also a very useful indicator of a country level of health development and is a component of the physical quality of life index.

Due to the improvement in the care and general management of diseases among the children and the prevention of this diseases which has lead to a better life for the infant, and some common challenges infancy is now the subject of this project. The diseases accounting for infant mortality is statistically analyzed carefully.

The study of infant mortality is of great economic, social, political and cultural importance for the determination of future population in humanity.

Also, this research gives the life expectancy at birth, which to a great extent helps in making population projection. The most important among the population policies are fundamentally related to those of health and mortality.

In Edo state Irrua comprises of towns and also with a great population. The entire infant mortality rate in this project covers both male and female.

Irrua specialist teaching hospital comprises of several unit, which includes; the administrative unit the medical unit, the medical unit, and the general nursing unit.

For the study of infant mortality, we refer to infant (children between the ages of 0-5) years of life. The death that may occur between this early years receives more attention since infant mortality takes a relatively heavy toll on life, both a fair and low death rate implies a substantial number of infant death because infant contains large portion of total population.


1.2 Statement Of The Problem

This research work is being carried out to detect the rate of infant mortality (IMR)

In Edo state using Irrua specialist teaching hospital as a case study and to know the causes of this mortality and the most common killer diseases of infants that has taken place in Irrua specialist teaching hospital as a case study.


1.3 Research Hypothesis:

HO; There is a significant difference between the rate of male infant mortality and female infant.

HI; There is no significant difference between the rate of male infant mortality and female infant.


1.4 Significance Of The Study

The purpose of this study is to ascertain the total number of death that occurred from 2005-20010 in Irrua local government area.

Also, the study shows which among the male and female infant are mostly affected by this death.

The study also looks at the diagnosis of the diseases that constitutes to the infant mortality.


1.5 Scope Of The Study

Though the topic of this research is a wide topic (an analysis of infant mortality) as a result, it infant mortality will mainly be taken into account.

Therefore the scope of this study is restricted on Irrua west local government in Edo state. The decision to particularize the research in Irrua is due to the respect of infant. Mortality problem in this town with the statistical test that will be carried out on the effect will give the suggestion and valid inferences will be made to reduce this infant mortality rate.

This project is limited to Irrua specialist teaching hospital due to the data collected from it well organized recording department.


1.6 Limitation

Lack of finance which is the most common problem a researcher will encounter in carrying out a research constitutes the inability of getting more information from one place to another to collect this data.

The method adopted in collecting this data is secondary which may subject to no or little error.

Though, to collect the data is not an easy job but with all the effort put together, it was possible to achieve.


1.7 Definition Of Terms

Still birth:

Still birth is a situation was by a baby is born dead.

NEO Natal death:

This is the death of babies after birth.

Pre-Natal mortality:

This is the period of the early death that starts from Festus too late birth before birth takes place.

Exogenous death:

These are the death caused by external factors such as accident.

Endogenous death:

These are the death caused by physical factors such as illness of any sort.

Lactation:

This is the period in which mothers/nursing mothers breast feed their babies.

Live birth:

The world health organization (WHO) defines live birth as any born human being who demonstrate independent signs of life including breathing, heartbeat, umbilical cord pulsations


Chapter Five


Summary, Conclusion And Recommendations

5.1 Summary Of Findings

Evidence from the hospital survey showed that the level of under-five mortality in Edo state has remained high since the past ten (10) years with an estimated U5MR of 163/1,000 live births. The above U5M ratio may be higher than the average estimated for the north-West zone of Nigeria. The major findings of the study reveal that major cause of morbidity in the study area is malaria (26.9%), major causes of death in the study area are malaria (30.1%) and it also showed that 39% of the children are within the ages of 0-1year. Mortality also varies with the marital status of the respondent, where the high rate of mortality was experienced by mothers who are married but not living with their husbands and widows.

The major factors that determined mortality in the study area is distance to the health facility. These factors have influence on the levels of U5M. The result shows that the rates and levels of U5M vary with levels of mother‟s education, income, employment, access to and use of health facilities, attitude to immunization, breastfeeding and distance to health facilities. In specific terms the findings show that children mothers with no education have greater risk of dying before their fifth birthday than those born by educated mothers. This is because educated mothers have higher confidence in reaching out for medical attention for their children but have better income and more independence in tackling matters of ill health in the family. Therefore, it should be noted that the challenges we face today regarding the health of under-five Nigerian children cannot be put off, since they are not insurmountable. That is, we have the tools, resources, and knowledge to address our nation’s most critical child survival problems and build on the considerable achievements that have made since the World Summit for Children in 1990. In general, progress in reducing under-five mortality depends on the commitment by academics, governments, international agencies, health care professional associations, donors and nongovernmental organizations to work together towards achieving Sustainable Development Goals.

An analysis of the major characteristics of respondents revealed that majority of the women sampled are mostly young (35 years and below) as against their older counterparts. The background characteristics of the respondents reveal that majority (64.3%) are between the age group 25-34 years. This is observed to be a reflection of the rate of infant and child mortality in the study area. Infant and child mortality appeared to be rather on the high side. The level of infant and child mortality is rather too high compared to what is obtainable in the state. The rather high level of under-five mortality is a reflection of early age at marriage.

Marital status has been able to bring about differences in infant and child mortality in the study area. The results of the survey revealed that significant proportions (34.4%) were married and currently living with their husbands. Married women who are not currently living with their husbands and widows experience more under-five mortality compare to those living with their husbands.

The analysis by infant/child mortality and income per month shows that respondents who earned less than ₦30,000 per month had the highest mortality of five and above infants and children who are under five years, however, respondents without income per month do not experience neither infants nor child mortality. This is a sharp contrast with Mahfouz, Adil, David, Abdelrahim (2009) that low income affects the accessibility of medical services.
For infant/child mortality and children ever born, it was observed that those with few children ever born had more number of infants and children less than five year compared to those respondents with more children ever born. However, this high proportion with no infant mortality and child mortality among most respondents could be as a result of under reporting of death. This is consistent with United Nations (2010) findings that in certain culture, women appear to be more likely to state duration of marriage correctly than to give correct information about their age, so the estimation procedure based on data classified by duration of marriage may be preferred.

Evidence from the hospital survey showed that the level of under-five mortality in Edo state has remained high since the past 10 years with an estimated U5MR of 163/1,000 live births even after considering a myriad of factors, including heterogeneity in study design.

Considering the trends in under-five mortality in Edo State since 2005, there is no doubt that the trends has been on the decrease, although the decrease is small over the years up to 2014 in which 2011, 2012, 2013 and 2014 saw steady declined or no change in the trends of infant and child mortality. Six variables were found to be the most contributing factors of infant and child mortality in the study area and they are distance to health facilities, age at first marriage, age of the mother, marital status, educational attainment, and breast feeding.


5.2 Conclusion

The primary aim of this paper was not to calculate U5MR for Edo State but to see the trend in the progress made since 2005, which will serve as a wake -up call assessment towards achieving the 2020 SDGs target and to examine the under-five morality differentials and factors that contributes to infant and child mortality rate in the state. Any society wishing to make material and spiritual progress must assure that women are fully integrated into its productive, educational, cultural and political activities. The goals of development include improving standards of living minimizing poverty, increasing access to education and employment, and reduction in social inequality, and women as a group deserve special attention and consideration of their problems. Their low economic status, marrying at younger age and marital instability are some of the causes of high infant and child mortality. Involving women in the nation‟s development is essential to reducing fertility rates

Higher levels of education, employment outside the home, lower infant and child mortality and increased income are among the factors that can increase the level of economic development in the country. Perhaps, the most significant factor is improving in the status of women, which is important in its own right above and beyond any influence it has on mortality. This has to be given particular attention in the nation‟s population policy.

A child’s right to survival is fundamental. It is the building block towards the realization of a child„s potential and on it hinges other basic rights of the child. Yet, many children do not enjoy this right. In Edo state infant and child mortality ratio (163/1,000 live births) is extremely high representing one of the country‟s development challenges. National estimates of U5MR is 157/1,000 live births. As Nigeria intends to lower its underfive mortality to meet up the SDG by 2020 it is therefore a wake-up call for a more concerted effort to be made in order to bring down the observed high rate of infant and child mortality. If this be the situation in the state then government must double its effort at combating the challenge particularly in the rural areas where health facilities are totally absent and access to urban settlements is difficult due to distance to the location of the health facilities.


5.3 Recommendations

The critical correlates of infant and child mortality therefore are age of the mother, age at first marriage, level of education, type of occupation and type of accommodation. This analysis suggests the need for more research to determine the additional variable needed to further reduce the observed infant and child mortality levels, since only 95% of their variance can be ascribed to the selected socio-economic indicators considered here.

Providing more basic health facilities within the urban and in rural communities and raising the level of girl-child education hold the key to our rapid advance to meeting the millennium development goals.

  1. Edo State Government should bring health services nearer to the communities especially in Irrua community so that mothers will have access to both during pregnancy and after. The impact of delivery a child with the help of a medical professional is enormous.
  2. Government of Edo state is called upon to sincerely encourage girl-child education through focused advocacy by religious leaders and traditional rulers. More girls‟ secondary Schools should be established in all the Local Government Areas.
  3. Increase the availability and accessibility of life saving services in health facilities in all the three Local Government Areas. This can be done through increasing coverage and quality of existing new born health programmers and packages, by strengthen the continuum of care and by honoring its previous commitments to more funding resources and accountability.
  4. Edo State Government should develop integrated approach to child health tackling under-five mortality will need an integrated approach to child health. These essential interventions can be implemented through a mix of delivery channels that are already in wide use, including outreach and community and facility-based services, while also taking advantage of longer-term opportunities such as community capacity to deliver integrated services. This will help address neonatal causes of under-five mortality and diseases that still have high mortality rates, most notably malaria, pneumonia and diarrhea.
  5. Girls in Irrua community, Edo state areas should be encouraged to go to school up to at least secondary level. This will first of all increase age at first birth and therefore reduce child deaths at first birth order. It will also increase the survival of their children since child survival is found to increase with maternal age and level of education in the study area.
  6. State Government should embark on enduring process of institutionalizing PHC in the state with the provision of necessary skills, management techniques, and capacity building through the active involvement, participation, and sense of ownership by communities at village and districts levels.
  7. If SDG to be achieved and needless loss of under-five child death prevented, it is essential that national governments, international agencies and civil societies increase attention to systematically preventing and tracking under-five deaths. Partners must work together now to increase their efforts and resources, focusing not just on one intervention or cause but on developing a functional continuum of basic services that save lives and improve health for millions of newborns and children.
  8. Government should collaborate with ministry of health to develop strategies to improve adequate breast feeding, vaccinations, zinc and vitamin A supplementation, insecticide-treated mosquito nets, oral rehydration therapy, antibiotic treatment of infection and treatment of malaria across the state. ix. Community leaders (spiritual and temporal) in the state are called upon to engage in advocacy for the sensitization of mothers with no education who are locked away from modern practices by cultural practices such as the puda system. Focus should be on antenatal care, intra-partum cares, post-natal care, extra care for sick new born and referral systems.
  9. Political consideration and regional pride in the state should be set aside when issues of data collection storage and release for academic use research purposes especially in Edo South Local Government Area.
  10. Government at all levels should support the Midwifes Service Scheme (MSS) to recruit and deploy midwives, with emphasis in all the Local Government Areas in the state.
5.3.1 Recommendation(s) for Further Research
  1. As a future work, determinants of mortality risk among children between the ages 1-5 in Edo State in addition to the determinants of infant mortality risk can be analyzed. Factors associated with child mortality risk might be different than those associated with infant mortality. Therefore explanatory variables other than the ones used in this study can be included to the model.
  2. A further study may examine the impact of public health provision, income, inequality, and female education on under-five mortality within different areas in the state. In addition, a question also arises if public spending on health could effectively reduce under-five mortality when health care is profit-oriented. How commercialized health care system influence public sector performance should be carefully considered.
  3. Further studies on other contextual factors such as socio-cultural factors influencing infant and child mortality are needed in Nigeria.
  4. The influences of contextual determinants on infant and child mortality need to be further explored with the use of qualitative data.

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