Cultural, Maternal and Environmental Factors Contributing to High Under-Five Mortality in Identified Hotspots in Nigeria

Under-five mortality rate in Nigeria is among the world’s highest with northern Nigeria having the most appalling under-five health indicators. Despite the streams of studies, research on Nigeria, there is still a gap on the cultural, maternal, and environmental factors contributing to the high under-five mortality in the identified hotspots in Nigeria. The study utilized data from the 2013 Nigeria Demographic Health Survey (NDHS) reports. Results revealed that Spatial dependence across the study area was confirmed with Moran’s I testing positive (0.4689 and a P-value of 0.01), an indication of the presence of auto correlation. Six states namely Zamfara, Bauchi, Jigawa, Sokoto, Kebbi and Katsina, were identified as having the highest under-five mortality rates ranging from 162-221 deaths per 1000 live births from the spatial analysis. The variables identified as contributing to the high under-five mortalities in these states were maternal education, Age of the mother, religion, wealth index, antenatal visits, hospital delivery, post natal visit, age at first birth, Partner’s education, distance to the nearest health care facility and Sanitation (flush toilet), and piped water. However, the variable Age of the mother and, Age at first birth were relatively significant and consistent across the six states under examination. The six states were also observed to be part of the poorest states in the country. Therefore, Poverty and child marriage was observed to be common in the six states, hence the likely clustering pattern observed and positive autocorrelation. Awareness through the media and all available means need to be intensified on the practice of child marriages, while emphasis needs to be laid on effective programs, policies and amendments of laws especially the laws that affects children’s marriages and child rights, while unvarying age should be set for a child to marry in order to protect the rights of children in the country, to help eradicate/reduce the under-five mortality rate. Programs that will help alleviate poverty in these regions should also be of uttermost priority to stabilize the families financially, improve living standards, provide better health care, eradicate/ reduce child marriages/under-aged mothers who eventually will reduce under-five mortality in these regions.