Environmental threats to child health

Despite the global decline in childhood mortality, under-5 mortality remains high in Nigeria. With about 1 in 6 children dying before the age of 5, Nigeria is not on track to achieve the Millennium Development Goal 4. While many studies on childhood mortality in Nigeria have established individual level factors as important predictors of infant and child mortality, similar studies on the effects of neighborhood contexts have been minimal. Hence, this study examines the effects of neighborhood contexts on under-5 mortality in Nigeria. The study utilized 2003 and 2008 Nigeria Demographic and Health Survey data. Cox regression analysis was performed on a nationally representative sample of 6028 (2003) and 28,647 (2008) children, (α=0.05). Results established region of residence, place of residence, ethnic diversity, neighborhood infrastructures, community education and health care contexts as important determinants of infant and child mortality in Nigeria. For instance, findings showed that being born or raised in poor neighborhoods (HR:1.54,P<0.05), rural communities (HR:1.25,p<0.05), North-east (HR:1.56), was associated with elevated hazards of dying before age 5. Policies to achieve under-5 mortality reduction in Nigeria must involve community-level interventions aimed at improving child survival in the deprived neighborhoods.

Health-care facilities are unevenly distributed in Nigeria while under-five mortality rate stood at 157 per 1000 live births in the country. Considering the importance of adequate health care on improved child health outcomes, this study examines the implication of difficult access to health-care facilities on childhood mortality in Nigeria. The study utilizes 2008 Nigeria Demographic and Health Survey. Cox proportional regression analysis was performed on a nationally representative sample of 28,647 children. Findings indicate that risk of death was about 10% significantly lower for children whose mothers had no problem accessing a health facility compared to those whose mothers had problem accessing a health facility (Hazard ratio – HR:0.92, 95%CI: 0.86-0.99,p<0.05). This result was consistent even after adjusting for the effects of other important covariates. The findings of this study stressed the need for easy accessibility to health-care facilities if Nigeria’s quest for attainment of Millennium Development Goal 4 will be a reality.

Most deaths of children under age five in India and other developing countries are linked to the household environment. This study, therefore, hypothesized that variations in household environments could affect children’s survival chances. Using secondary data from National Family Health Surveys (NFHS) round 3, the study broadly categorized the eight selected states into low and high under-five mortality groups. Uttar Pradesh, Madhya Pradesh, Bihar and Rajasthan are selected as high under five mortality group and Maharashtra, Karnataka, Kerala and Tamil Nadu are selected as low under-five mortality group. The household environmental variables include sources of drinking water, time to water source, types of toilet facilities, main flooring material and type of cooking fuel. The study found that high-mortality states are at a relative disadvantage on basic household environmental variables. Differences found in childhood morbidity and mortality between low and high under-five mortality states can be explained by levels of household environmental health hazards and by mother’s socioeconomic status. In order to meet Millennium Development Goal 4—to reduce under-five mortality by two-thirds between 1990 and 2015—attention should be given to the high mortality states to distribute of resources and facilities for better tomorrow.

Millions of people around the world are suffering from food shortages and hunger. Children and pregnant women are at risk of becoming permanently malnourished. It is therefore, imperative to provide adequate information about the dynamics of food insecurity at the household level as well as the nutrient intake of nursing mothers and their children as it affects their health. Both quantitative and qualitative methods were used to collect information. From the study, it was revealed that only 10% can afford appropriate nutrition for their children based on the nutritional chart provided during the survey. Thirteen percent of the respondents indicated that their children had anaemia four weeks preceding the survey. The logistic regression shows that women’s socio-economic status and nutritional intake are the predisposing factors for likelihood of having illness among infants in the study area. The study concludes that households should be encouraged to practise irrigated farming

Although immigrant women are less likely to smoke compared to Non-hispanic whites and U.S. natives born of same ethnic origin, previous studies indicate that acculturation is positively associated with maternal smoking during pregnancy. The increase in maternal smoking during pregnancy with acculturation is often attributed to the downward trajectory within the segmented assimilation framework. However, theoretical frameworks (e.g., acculturation) that emphasize cultural explanations have used a “zero-sum game” approach which does not provide a comprehensive understanding of complex acculturative processes of the immigrant experience. To incorporate the structural factors in the context of reception in understanding maternal smoking during pregnancy of Mexican-origin women in the United States, we draw from the emerging scholarship on how residential segregation affects health. Our preliminary results support the protective effect of immigrant enclaves for Mexican foreign-born women. On the other hand, interaction with non-Hispanic white at the contextual level is associated with the increased odd of maternal smoking during pregnancy.

Today, malnutrition is the underlying cause of approximately one-third of child deaths. It is therefore necessary to have a good understanding of the risk factors for malnutrition to improve interventions. This study aimed to illustrate the effect of the quality of drinking water and sanitation facilities on the nutritional status of children. This is a cross-sectional study using data from the MICS3 survey realized in 2006 in Cameroon. We used z-scores for the weight-for-age and height-for-age indices as indicators of children’s nutritional status. We used two dummy variables to indicate whether or not households had satisfactory drinking water and sanitation facilities. Control variables related to child, mother and household were included and we used a multiple linear regression model. Using an improved drinking water source and improved sanitation facilities has a positive impact on children's health in Cameroon (higher z-scores). The effect on underweight is greater than it is on growth retardation. Drinking water of good quality and satisfactory sanitation seem to be protective factors with respect to child malnutrition in Cameroon. In addition to actions usually taken (eg. educating mothers), improving hygiene conditions in households is an important issue to be considered by stakeholders involved in children’s health.

The consequences of environmental tobacco smoke (especially maternal smoking) on child respiratory health are very severe. Moreover, high fertility rates in Africa mean rising rates of female smoking in Africa translate into increase of maternal smoking, with devastating consequences for fetus and child health. Besides, underlying sex differentials often are critical to better understanding of child health. Thus the research question: Does maternal smoking in Africa engender sex differentials among children as far as their respiratory health is concerned? The study addresses issues like determination of the net impact of maternal smoking on child respiratory health among several confounding factors and identification of tobacco products with severest impact on child respiratory health. The following hypothesis is tested: “there is no health risk variation between boys and girls as far as respiratory infections are concerned, unless the mother of the child is smoking”. The analysis uses a sample of 37 274 children less than 5 years of age from the most recent DHS surveys in Cameroon, Senegal and Malawi, including 328 born to 226 smoking mothers. The Poisson regression is used to model the number of symptoms suffered by children during survey period.