Health effects of single motherhood on children in sub-Saharan Africa: a cross-sectional study.
BACKGROUND
Although progress has been made toward reducing child morbidity and mortality globally, a large proportion of children in sub-Saharan Africa still die before age five and many suffer chronic malnutrition. This study investigated the influence of single motherhood on stunting and under-5 mortality in Cameroon, Nigeria and Democratic Republic of the Congo (DRC). Particular attention was paid to the influence of mother's economic resources, parental care and health behaviour on the difference in children's health in single and two-parent families.


METHODS
Data were obtained from most recent Demographic and Health Surveys in Cameroon (2011), Nigeria (2008) and DRC (2007). The sample included women aged 15-49 years old and their under-5 children 11,748 in Cameroon, 28,100 in Nigeria, and 8,999 in DRC. Logistic regression and Cox proportional hazard analysis were used to estimate stunting and under-5 mortality, respectively.


RESULTS
The result showed that compared with children whose mothers were in union, children of single mothers who were not widows were more likely to be stunted (OR 1.79 p < 0.01 in Cameroon and 1.69 p < .01 in DRC). Economic resources and parental care significantly influenced the higher odds of stunting in single mother households in Cameroon and DRC. Relative to children of mothers in union, the risk of under-5 mortality in single mother families was higher in the three countries (HR 1.40 p < .05 in Cameroon, 1.27 p < 0.10 in DRC, 1.55 p < .01 in Nigeria). Economic resources, parental care and health behaviour accounted for the difference in Nigeria and Cameroon; in DRC, only economic resources had marginal influence.


CONCLUSIONS
Single motherhood is a risk factor for children's nutritional status and chances of survival before age 5 years in sub-Saharan Africa. To achieve improved reduction in children's exposure to stunting and under-5 mortality, there is the need for public health interventions targeted at single mother households in sub-Saharan Africa.
Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa. Lorretta.Ntoimo@wits.ac.za.
Lorretta F C
LF
Ntoimo
Clifford O
CO
Odimegwu
D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D002648:Child; D015362:Child Nutrition Disorders / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008875:Middle Aged; D009035:Mothers; D012307:Risk Factors; D015406:Single Parent