Ethnic disparities in parity and child mortality in Nigeria: a multiple indicator cluster survey

Introduction
Women’s reproductive or fertility behaviour and overall maternal and child health outcomes are greatly influenced by various biological and psychosocial factors, which themselves seem to vary substantially among different ethnic backgrounds. This study was undertaken on a representative sample of Nigerian women to assess whether: 1) the ethnic disparities in fertility and child mortality rates are significant even after controlling for potential confounders, 2) women who experience higher child mortality have higher fertility rates.

Material and methods
Cross-sectional data on 34,139 women aged between 15 and 49 years were extracted from a multiple indicator cluster survey conducted in 2017. The total number of children ever born and self-reported events of child health were used as outcome variables. Ethnic differences in parity and child mortality were analysed using multivariable regression techniques.

Results
Significant ethnic variation was found across fertility and under-five mortality rates. These variations persisted even after adjusting for several potential risk factors. There was an inverse relationship between under-five mortality and fertility. The prevalence of having > 6 children was highest among women who reported > 2 child deaths. In the regression analysis, high-parity women were found to have experienced higher child mortalities.

Conclusions
Significant ethnic differences exist in fertility and under-five mortality, which might be indicative of ethnic inequalities in health determinants and access to healthcare resources. The findings also support the view that women who experience child death are more likely to have higher fertilities than those who do not. Future studies should explore the underlying disparities in child mortality and fertility rates in Nigeria.