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. 2010 Jun;118(6):877-83.
doi: 10.1289/ehp.0901306. Epub 2010 Feb 10.

Urban area disadvantage and under-5 mortality in Nigeria: the effect of rapid urbanization

Diddy Antai  1 , Tahereh Moradi
Affiliations

Urban area disadvantage and under-5 mortality in Nigeria: the effect of rapid urbanization

Diddy Antai et al. Environ Health Perspect. 2010 Jun.

Erratum in

  • Environ Health Perspect. 2010 Jun;118(6):882

Abstract

Background: Living in socioeconomically disadvantaged areas is associated with increased -childhood mortality risks. As city living becomes the predominant social context in low- and middle-income countries, the resulting rapid urbanization together with the poor economic circumstances of these countries greatly increases the risks of mortality for children < 5 years of age (under-5 mortality).

Objective: In this study we examined the trends in urban population growth and urban under-5 mortality between 1983 and 2003 in Nigeria. We assessed whether urban area socioeconomic dis-advantage has an impact on under-5 mortality.

Methods: Urban under-5 mortality rates were directly estimated from the 1990, 1999, and 2003 Nigeria Demographic and Health Surveys. Multilevel logistic regression analysis was performed on data for 2,118 children nested within data for 1,350 mothers, who were in turn nested within data for 165 communities.

Results: Urban under-5 mortality increased as urban population steadily increased between 1983 and 2003. Urban area disadvantage was significantly associated with under-5 mortality after adjusting for individual child- and mother-level demographic and socioeconomic characteristics.

Conclusions: Significant relative risks of under-5 deaths at both individual and community levels underscore the need for interventions tailored toward community- and individual-level interventions. We stress the need for further studies on community-level determinants of under-5 mortality in disadvantaged urban areas.

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Figures

Figure 1
Figure 1
Trends in urban under-5 mortality rates (U5MR) and urban population in Nigeria, 1986–2003. Urban under-5 mortality rates (per 1,000) were directly estimated from the 1990, 1999, and 2003 Nigeria DHS birth history data. Urban population data were from United Nations Department of Economics and Social Affairs (2004).
Figure 2
Figure 2
Distribution of under-5 mortality rate (U5MR) according to UADI among participants in the Nigeria Demographic and Health Survey (2003).
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