Clustering of infant deaths among Nigerian women: investigation of temporal patterns using dynamic random effects model

Abstract

Abstract This study was conducted to estimate the magnitude of infant death clustering as well as the mortality risk associated with death of a preceding child and investigate how these have changed over three decades (1980–2013) in Nigeria. Birth history data from the Nigeria Demographic and Health Survey for 1990, 2003, 2008 and 2013 were analysed using dynamic random effects models. The effect of death of an immediate preceding child (sibling mortality correlation) was estimated by controlling for background characteristics and unobserved heterogeneity. A total of 232,090 single births to 56,123 women were analysed. Results showed that 13.2% in the oldest maternal cohort (≤ 1969) experienced death of at least two infants and they accounted for 40.2% of all infant deaths. Among the 1970–1979 maternal cohort, it was 8.6% and 31.6% respectively. In the youngest maternal cohort (≥ 1980), 3.3% had recorded multiple infant deaths but accounted for 20.3%. Model results revealed that sibling mortality correlation increased the probability of infant death by 0.080 and 0.061 in the 1980–1989 and 2010 birth cohorts respectively. There is a substantial level of infant death clustering in Nigeria, and this is closely driven by sibling mortality correlation both of which have declined very slowly over time. To achieve desired progress in child survival, death clustering should be addressed alongside other barriers to child survival.

Keywords

• Infant mortality
• Death clustering
• Death concentration
• Preceding child
• Sibling mortality correlation
• Dynamic models