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INCIDENCE AND CAUSES OF INFANTS MORTALITY IN OBI L.G.A, BENUE STATE
CHAPTER ONE INTRODUCTION
1.1 BACKGROUND OF THE STUDY
Health is a state of human well being which in 1948, the United Nations (UN) declared as a right (United Nations, 2008). Thus, striving for improvement in health is a moral obligation for policy-makers at all levels of governance (National and International). In addition to being a goal, scholars have posited the significance of health to human development. This represents a shift in development strategy; earlier, health has been viewed as an end of development, but now the general tenet is that improvement of health standards is a means to achieve other aspects of development (Mamman, 1992; Kumar and File, 2010; World Health Organization (WHO), 2013; Bello and Joseph, 2014). Death of children under five is a factor that defines the well- being of a population and it is usually taken as one of the development indicators of health and socioeconomic status which indicate the quality of life of a given population, as measured by life expectancy (Buwembo, 2010).
Infant mortality is defined as the death of a live born child between the day of birth and span of 12 months United Nation International Children Fund (UNICEF), 2008). The mortality rate among infants is the measure of probability of children dying before reaching the age of one year. Child mortality includes deaths that occur at ages 1 to 5 years. The reduction of infant and child mortality is a worldwide target and one of the most important key indices among Sustainable Development Goals (SDGs) of reducing infant and under-five child mortality rates by two-thirds from the 1990 levels by 2015 (Desta, 2011). As a result of this, in October 2008, the Nigerian government„s National Health Insurance Scheme (NHIS) launched a pilot health project, titled the NHIS/SDG Maternal and Child Health Project (Bello and Joseph, 2014). The Project
focuses on reducing maternal and child mortality and is assisted by the World Bank„s Heavily Indebted Poor Countries Initiative funds (HIPC).
Cases of infant and child mortality are largely under-reported and seldom documented in developing countries (Nigeria inclusive). Survival efforts can be effective only if they are based on accurate information of the cause of morbidity (Abhulimhen and Iyoha, 2012). The environment where the child is born and raised is increasingly becoming so unhealthy so that the life of the child is continually threatened by diseases (Chaudhari, Srirastava, Maitra and Desai, 2009). Another factor that is affecting the survival of infants and children has been identified to be the increasing devastating effect of Human Immunodeficiency Virus / Acquire Immune deficiency Syndrome (HIV/AIDS). This threat has become a major concern affecting the lives of families and thereby reducing the survival chances of the child (Baingana and Bos, 2009).
Many countries have shown considerable progress in tackling child mortality rate and it has been more than halved in Northern Africa, Eastern Asia, Western Asia, Latin America the Caribbean and Europe. It has placed them on track to achieving the (SDG) in contrast to many countries with unacceptably high rates of child mortality. Sub-Saharan Africa which accounts for 1/5th of the population of children under 5years, also accounts for half (8.8 million) of deaths in 2008 indicating insufficient progress to meet the SDG 2020 target world health organization (WHO, 2014).
Smith (2010), posited that infant and child mortality rate is high in Sub-Saharan Africa. Despite the region having only one fifth of the world‟s infants population, it habours half of childhood deaths globally. Worldwide, mortality in children younger than 5 years has dropped from 11.9 million deaths in 1990 to 7.7 million in 2010. About
33.0 percent of deaths of children younger than 5 years occur in South Asia and 49.6%
occur in Sub-Sahara Africa with less than one (1) percent of deaths occurring in high income countries (Rajaratnam, Tran, Lopez, and Murray, 2010).
In Nigeria, an examination of mortality levels across three successive five-year periods show that under-five mortality decreased from 199 deaths per 1,000 births during the middle to late 1990s (1993-1998) to 157 deaths per 1,000 births in the middle part of this decade (2003-2008) and 128 deaths per 1, 000 births in 2013 (NPC and ICF Macro, 2013). Infant mortality rates have remained steady at 75 deaths per 1,000 births for 1999 and 2008 while under-five mortality rates show increase between 1999 and 2008. Under-five mortality rates increased from 140 deaths per 1,000 live births in 1999 to 157 deaths in 2008 (Buwembo, 2010).
Socio-demographic and economic factors play important roles in determining child survival all over the world (Shawky and Milaat, 2011). For instance mothers‟ education has an implicit effect on the health of children (Abuqamar, Coomans and Louckx, 2011). Early marriage has also been identified in several studies to have affected both the socioeconomic condition and infant mortality (Othman and Saadat, 2009). A study conducted by Raj, Saggurti, Micheal, Alan, Michele, Decker, Balaiah and Jay (2010) in India showed that children born to mothers who were married before attaining the age of 18 were at a higher risk of stunting and underweight compared to children of women who had married at age 18 or older.