An Evaluation of Environmental and Cultural Factors Affecting Under-Five Mortality in Kebbi State, Nigeria

J. B. Azaki, R. Mundi, S. Dakyes
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Abstract

Over the years, Nigeria at all levels of government has formulated and implemented health policies and programmes to reduce under-five mortality; and despite that, it is still among Sub-Saharan Africa countries with high under-five mortality rate. This study aimed at evaluating environmental and cultural factors affecting under-five mortality in Kebbi State, Nigeria. Multi-stage sampling technique was used to sample respondents. Structured questionnaires were administered to 625 women aged 15-49 years and 603 were retrieved, giving the response rate of 96.5%. Descriptive statistics such as frequencies and percentages were employed to analyse the characteristics of the respondents and distribution of under-five mortality experienced by women based on the environmental and cultural factors. Logistic regression analysis was applied to determine the environmental and cultural factors affecting under-five mortality in the study area. The results of the Logistic regression analysis revealed that at P-value <0.05, source of water, frequency of washing water container, water treatment, method of disposing waste water, type of toilet, shared toilet, frequency of washing toilet, method of disposing child’s stool, type of cooling appliance, number of persons per room, use of mosquito net, refuse disposal method and type of cooking fuel were found to be the environmental factors significantly affecting under-five mortality; while ethnicity, religion, practice of food taboo, belief in traditional medicine, belief about disease causation, mother’s autonomy on child’s health and family’s decision on child’s health were found to be the cultural factors significantly affecting under-five mortality in the study area. The study therefore concluded that environmental and cultural factors affect under-five mortality in Kebbi state. To reduce under-five mortality rate, it was recommended that government at all levels should step up efforts in providing adequate infrastructure for public use. Government and cultural organizations should mount advocacy programmes aimed at improving women’s participation in child’s health decision-making in the family.
对影响尼日利亚凯比州五岁以下儿童死亡率的环境和文化因素的评估
多年来,尼日利亚各级政府制定并实施了降低五岁以下儿童死亡率的卫生政策和方案;尽管如此,它仍然是撒哈拉以南非洲国家中五岁以下儿童死亡率很高的国家之一。这项研究旨在评估影响尼日利亚凯比州五岁以下儿童死亡率的环境和文化因素。采用多阶段抽样技术对受访者进行抽样。对625名15-49岁的女性进行结构化问卷调查,回收603份,回复率为96.5%。采用频率和百分比等描述性统计数据,根据环境和文化因素分析受访者的特征和妇女五岁以下死亡率的分布。采用Logistic回归分析确定影响研究区5岁以下儿童死亡率的环境和文化因素。Logistic回归分析结果显示,在p值<0.05时,水源、洗涤水容器使用频率、水处理方式、废水处理方式、厕所类型、共用厕所、洗涤厕所使用频率、儿童粪便处理方式、制冷器具类型、房间人数、蚊帐使用情况、垃圾处理方式和烹饪燃料类型是影响5岁以下儿童死亡率的环境因素;而种族、宗教、食物禁忌的实践、对传统医学的信仰、对疾病起因的信仰、母亲对儿童健康的自主权和家庭对儿童健康的决定被认为是影响研究地区五岁以下儿童死亡率的重要文化因素。因此,研究得出的结论是,环境和文化因素影响凯比州五岁以下儿童的死亡率。为了降低五岁以下儿童死亡率,建议各级政府加紧努力,为公众提供适当的基础设施。政府和文化组织应开展宣传方案,提高妇女在家庭中参与儿童保健决策的程度。
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