title: Inequalities in under-5 mortality in Nigeria: do ethnicity and socioeconomic position matter?
abstract: BACKGROUND
  Each ethnic group has its own cultural values and practices that widen inequalities in child health and survival among ethnic groups. This study seeks to examine the mediatory effects of ethnicity and socioeconomic position on under-5 mortality in Nigeria.
  
  
  METHODS
  Using multilevel logistic regression analysis of a nationally representative sample drawn from 7620 females age 15 to 49 years in the 2003 Nigeria Demographic and Health Survey, the risk of death in children younger than 5 years (under-5 deaths) was estimated using odds ratios with 95% confidence intervals for 6029 children nested within 2735 mothers who were in turn nested within 365 communities.
  
  
  RESULTS
  The prevalence of under-5 death was highest among children of Hausa/Fulani/Kanuri mothers and lowest among children of Yoruba mothers. The risk of under-5 death was significantly lower among children of mothers from the Igbo and other ethnic groups, as compared with children of Hausa/Fulani/Kanuri mothers, after adjustment for individual- and community-level factors. Much of the disparity in under-5 mortality with respect to maternal ethnicity was explained by differences in physician-provided community prenatal care.
  
  
  CONCLUSIONS
  Ethnic differences in the risk of under-5 death were attributed to differences among ethnic groups in socioeconomic characteristics (maternal education and to differences in the maternal childbearing age and short birth-spacing practices. These findings emphasize the need for community-based initiatives aimed at increasing maternal education and maternal health care services within communities.
authors.affiliation: Division of Social Medicine, Department of Public Health, Karolinska Institute, Stockholm, Sweden. Diddy.Antai@ki.se
authors.forename: Diddy
authors.initials: D
authors.lastname: Antai
mesh_terms: D000293:Adolescent; D000328:Adult; D046688:Child Mortality / Q000208:ethnology*; D002675:Child, Preschool; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000208:ethnology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D011247:Pregnancy; D011295:Prenatal Care; D012307:Risk Factors; D012923:Social Class; D012959:Socioeconomic Factors; D055815:Young Adult