Rural-urban differentials in the rates and factors associated with post-neonatal mortality in Nigeria: Evidence from the 2013 national household survey.
The burden of post-neonatal mortality remains considerably high in Nigeria. This study examines the rural-urban differences in post-neonatal mortality rates (PNMR) and associated factors in Nigeria.
Dataset from the 2013 Nigeria demographic and health survey, disaggregated by rural-urban residence, was analyzed. PNMR was reported using frequency tabulation, whereas, factors associated were first evaluated using Chi-Square test and further examined using multivariable logistic regression analysis.
A total of 30384 singleton livebirths (20449 in rural and 9935 in urban residences) in the five years preceding the survey was included in this study. PNMR in rural and urban residences were 34 (95%CI: 31 - 38) and 22 (95%CI: 18 - 26) deaths per 1000 live births (P<0.001), respectively. In rural residence, living in the South-West region reduced the odds of post-neonatal mortality by 63% (Adjusted OR [AOR]: 0.372, 95%CI: 0.187 - 0.732)). In urban residence, poor wealth index (AOR: 1.660, 95%CI: 1.024 - 2.689), living in the South-East region (AOR: 2.902, 95%CI: 1.470 - 5.726), and home delivery (AOR: 1.539, 95%CI: 1.016 - 2.330) increased the odds of post-neonatal mortality. Regardless of residence, the use of solid cooking-fuels (Rural: AOR: 2.394, 95%CI: 1.211 - 4.734; Urban: AOR: 1.912, 95%CI: 1.206 - 3.030), birth interval < 24 months (Rural: AOR: 1.880, 95%CI: 1.557 - 2.270; Urban: AOR: 1.630, 95%CI: 1.042 - 2.550) and lack of breastfeeding (Rural: AOR: 2.547, 95%CI: 2.089 - 3.105; Urban: AOR: 2.152, 95%CI: 1.496 - 3.096) increased the odds of post-neonatal mortality.
PNMR and associated factors differ in rural and urban Nigeria. Post-neonates in urban areas had better survival chances. Intervention efforts would need to prioritize findings in this study. This article is protected by copyright. All rights reserved.
Adewuyi EO
,Adama SJ
,Adefemi K
,Akintunde OA
,Bulndi LB
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Rural versus urban variations of factors associated with early initiation of breastfeeding in Ethiopia.
Early initiation of breastfeeding is an important strategy to reduce under-five mortality. Nevertheless, it remains under-practiced in developing countries. In Ethiopia, there were studies done to identify determinants of early initiation of breastfeeding. However, the variation of factors among rural versus urban residents has not been investigated. Therefore, the main objective of this study is to investigate the variation of factors associated with early initiation of breastfeeding among rural versus urban residences.
The 2016 Ethiopian Demographic and Health Survey data was used to conduct the study. Mothers whose index child aged less than 24 months have participated in the study. We excluded mothers who had fetal death during birth and who didn't live with their child. Accordingly, a total of 3396 weighted samples of mothers from rural residences and 478 weighted samples of mothers from urban residences were included in the final analysis. A multivariable logistic regression analysis has been used to explore determinants of early initiation of breastfeeding. Finally, statistically significant associations have been declared by using AOR with a 95%CI at a p-value of <0.05.
In rural residences, age of mothers 15-24 years (AOR: 1.39, 95 % CI: 1.08, 1.79), mothers who are not currently working (AOR: 1.45, 95 % CI: 1.19, 1.78), large birth size (AOR: 1.49, 95 % CI: 1.17, 1.92), and giving birth at health facility (AOR: 1.25, 95 % CI: 1.01, 1.53) were factors associated with a higher odds of early initiation of breastfeeding. Whereas, in urban residences, being second to third birth order (AOR: 1.94, 95 % CI: 1.01, 3.75), skin-to-skin contact care (AOR: 2.58, 95 % CI: 1.44, 4.63) and antenatal care visit were factors associated with early initiation of breastfeeding. Regardless of residences, vaginal delivery (Rural AOR: 4.06, 95 % CI: 1.75, 9.44; Urban AOR: 2.52, 95 % CI: 1.15, 5.54) and involvement of mothers in health care decisions (Rural AOR: 1.52, 95 % CI: 1.25, 1.85; Urban AOR: 2.62, 95 % CI: 1.33, 5.17) were common determinants of early initiation of breastfeeding.
This study concludes that the factors associated with early initiation of breastfeeding are different among rural versus urban residences. Accordingly, maternal ages, maternal current working status, birth sizes, and place of delivery are identified as factors associated with early initiation of breastfeeding among rural residences. Whereas, antenatal care visits, skin-to-skin contact care, and birth order are identified as factors associated with early initiation of breastfeeding among urban residences. Regardless of residence, mode of delivery, and involvement of mothers in health care decisions are common determinants of early initiation of breastfeeding. Therefore, irrespective of the residence, special emphasis has to be given to newborns delivered by cesarean section to increase the rate of early initiation of breastfeeding.
Girma D
,Abita Z
《Heliyon》