Distance to health-care facilities: implication for under-five mortality in Nigeria

Sunday Adedini, University of the Witwatersrand
Clifford O. Odimegwu, University of the Witwatersrand
Olusina Bamiwuye, Obafemi Awolowo University
Opeyemi Fadeyibi, Obafemi Awolowo University
Sunday T. Omoyeni, Obafemi Awolowo University

Background: Health-care facilities are unevenly distributed in Nigeria as in several other sub-Saharan African countries. Meanwhile, accessibility to health facilities is crucial to the attainment of Millennium Development Goal 4 (reducing childhood mortality). This study, however aims at examining the implication of difficult access to health-care facilities (due to long distance) on childhood mortality in Nigeria. Methods: We analysed data from a nationally representative sample drawn from 18,028 women age 15-49 that had a total of 28,647 live births within the five years preceding the survey in the 2008 Nigeria Demographic and Health Survey. The risk of death in children below age five was estimated using logistic regression analysis and results are presented as odds ratio with 95% confidence intervals. In term of exposures, distance to health care-facility was used as the main explanatory variable; while controlling for the effect of other important socio-economic and demographic characteristics. Results: The study established a significant relationship between distance to health-care facility and under-five mortality (p<0.05). For instance, respondents who did not deliver in the health facility due to long distance were more likely to report higher under-five mortality compared to respondents who were living close to health facility (p<0.05). Conclusion: The findings of this study stressed the need for easy accessibility to health-care facilities in order to place Nigeria back on track towards the attainment of Millennium Development Goal 4.