THE IMPACT OF WATER AND SANITATION ON CHILDHOOD MORTALITY IN NIGERIA
According to United Nations Development Programme (UNDP), nearly 41% and 48% of the Nigeria population lack access to improve water and sanitation respectively. We aimed to determine if singleton live born children, who reported unimproved drinking water sources and unimproved sanitation had increased risk of neonatal, infant and under-five deaths in Nigerian children.
The datasets from 1999, 2003 and 2008 Nigeria Demographic and Health Survey (NDHS) were pooled, to examine the impact of unimproved drinking water sources and unimproved sanitation on deaths of all singleton live born infants aged (0-30 days, 1-11 months and 1-4 years). The relationship between unimproved drinking water sources and unimproved sanitation and child deaths was estimated using Cox regression.
Survival information of 39,070 singleton live born infants was obtained which included 4,306 under-five child deaths. Of these deaths, 1,436 were neonatal (0-30 days), 1,268 infants (1-11 months) and 1,602 under-five (1-4 years). The risk for neonatal mortality increased significantly by 37% (unadjusted Hazard Ratios (HR) = 1.37, 95%CI = 1.18-1.67) and 24% (Adjusted Hazard Ratios (aHR) = 1.24, 95%CI = 1.01-1.51) for the combined effect of unimproved drinking water sources and unimproved sanitation. The risk effect for deaths on 1 month to 11 months of life for unimproved drinking water sources and unimproved sanitation were (HR = 1.86, 95%CI = 1.53-2.26) and (aHR = 1.50, 95%CI = 1.24-1.83) but it was also found that the risk for 1 year to 4 years increased by 68% (HR = 1.68, 95%CI = 1.38-2.04) and 14% (aHR = 1.14, 95%CI = 0.94-1.39) but the adjusted hazard ratios showed no significant effect.
As nearly half of the Nigeria population lacks improved water and sanitation, the findings of this study suggest that substantial public investments is needed to improve access to safe drinking water and improve sanitation in order to reduce preventable children’s death.