Trends and Regional Disparities in Under-Five Mortality in Nigeria: A Three-Round Review of the Nigeria Demographic and Health Survey Data (2013, 2018 and 2024)

Felix Olaniyi Sanni; Abike Elizabeth Sanni

doi:10.25159/2957-3645/21161

Authors

Felix Olaniyi Sanni Fescosof Data Solutions https://orcid.org/0000-0001-7761-3604
Abike Elizabeth Sanni Fescosof Data Solutions https://orcid.org/0000-0002-3572-6640

DOI:

https://doi.org/10.25159/2957-3645/21161

Keywords:

under-five mortality, neonatal mortality, regional disparities, health inequalities, geopolitical zones, Nigeria, Demographic and Health Survey

Abstract

Nigeria has one of the highest under-five mortality rates globally. Using three rounds of the Nigeria Demographic and Health Survey (NDHS) conducted in 2013, 2018 and 2024, this study examined temporal trends and regional disparities in neonatal and under-five mortality across Nigeria’s six geopolitical zones (North Central, North East, North West, South East, South South, South West). We analysed birth-history data from the three NDHS rounds, which comprised a pooled sample of 93 189 children born within the five years preceding each of the three surveys. Survey-weighted neonatal mortality rates (NMR), infant mortality rates (IMR), and under-five mortality rates (U5MR) with 95% confidence intervals (CIs) were estimated, and linear regression was used to test temporal trends. Regional disparities were examined, and survey-weighted logistic regression models, adjusted for each zone, identified independent predictors of mortality. Nationally, NMR rose from 37.1 to 40.9 per 1 000 live births between 2013 and 2024, while U5MR fell from 90.4 to 85.0 per 1 000 live births; neither trend was statistically significant. Regional disparities were substantial: the North West (112.4 per 1 000) had nearly double that in the South West (57.6 per 1 000). Urban–rural gaps were widest in the northern zones. In the multivariable model, the North West showed higher odds, while the South South showed lower odds. Persistent North South and urban–rural gradients indicate the need for zone-specific multisectoral interventions rather than uniform national programmes, and sustained investment in the quality of maternal and newborn care.

Author Biography

Felix Olaniyi Sanni, Fescosof Data Solutions

PhD

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