Spatio‐temporal patterns and determinants of infant mortality in Nigeria

Infant mortality remains a major problem world-wide. This is particularly so for developing countries and regions that are continually faced with problems of political unrest, poverty and economic crisis, corruption, poor infrastructure, low food security, weak health-care delivery systems and the devastating impact of HIV/AIDS and infectious diseases (Aggrey 2015; Alemu 2017; Anyanwu and Erhijakpor 2007; Becher et al. 2004; Carvalho et al. 2015; Gemperli et al. 2004; Lindskog 2016; Macassa et al. 2003; UNDP 2013; WHO 2015). According to reports (Black et al. 2010; Garenne and Gakusi 2006; Liu et al. 2015; 2016; WHO, 2015), some progress has been made in reducing deaths occurring among children during their first year of life, especially in the last decade. World-wide, infant mortality rates (IMRs) have fallen by 52 per cent from 65 deaths per 1,000 live births in 1990 to 31 deaths per 1,000 live births in 2016, while in absolute terms the number of infant deaths dropped from 8.8 million in 1990 (i.e., 24,000 infant deaths every day) to 4.2 million (i.e., 12,000 infant deaths every day) in 2016 (UN-IGME 2017). However, infant mortality remains shockingly high in many places with large disparities across and within regions and countries. At the regional level, sub-Saharan Africa has consistently had the highest rate of infant deaths. In 2016, 1.9 million infant deaths (54 deaths per 1000 live births) occurred in this region alone with most (53 per cent) of these deaths occurring in the neonatal period (i.e., the first 28 days of life)(UN-IGME 2017). At the country level, developing countries have the highest IMRs. Nigeria, in particular, has the second highest absolute number of infant deaths worldwide (476,000) after India (867,000) and one of the highest infant mortality rates (67 deaths per 1000 live births) after Mali (68), the Democratic Republic of Congo (72), Lesotho (72), Chad (75), Sierra Leone (83) and the Central African Republic (89)(2017). Nevertheless, significant reduction in infant mortality is possible in countries like Nigeria with a good understanding of the levels, patterns and root causes of infant mortality over time, particularly at sub-national levels. This is crucial to assessing/evaluating the effectiveness of past and ongoing child interventions and programmes and in identifying high priority areas for future health planning.