Assessing the Impact of Poverty on Maternal and Infant Mortality
Chapter One
Research Objectives
General Objectives
The general objective was to establish how impact of poverty influence infant mortality in Jos North L.G.A.
Specific Objectives
- To establish whether poverty level of a family influenced infant mortality in Jos North L.G.A.?
- To determine whether maternal education influenced infant mortality in Jos North L.G.A.?
- To find out whether income level affects infant mortality in Jos North L.G.A.?
CHAPTER TWO
LITERATURE REVIEW
Theoretical background
According to Mosley and Chen (1984), all social and economic determinants of child mortality necessarily operate through a common set of biological mechanisms, or proximate determinants (intermediate variables) to directly influence the risk of mortality. This study adopts this approach to compare how socio-economic factors contribute to infant mortality in Jos North L.G.A.
Figure 1 below illustrates the path to a healthy child or a sick child and eventual death. The socioeconomic factors operate through maternal, biological, environmental, nutritional and health seeking behaviour factors leading to a healthy child or sick child.
This framework assumes that in an optimal setting, over ninety-seven per cent of newborn infants can be expected to survive through the first five years of life, and that reduction in this survival probability in any society is due to the operation of social, economic, biological and environmental forces. It further assumes that impact of poverty (independent variables) must operate through more basic proximate determinants that in turn influence the risk of disease and the outcome of disease processes.
And that specific diseases and nutrient deficiencies observed in a surviving population may be viewed as biological indicators of the operations of the proximate determinants.
Growth faltering and ultimately mortality too in children (the dependent variable) are the cumulative consequences of multiple disease processes (including their biosocial interactions). Only infrequently is a child‘s death the result of a single isolated episode (Ibid).
Adapted from Mosley and Chen (1984)
The framework identifies a set of proximate determinants, or intermediate variables that directly influence the risk of morbidity and mortality. And that all social and economic determinants must operate through these variables to affect child survival. The four groups of the proximate determinants operate on the health dynamics of a population. They influence the rate of shift of healthy individuals toward sickness. Specific states of sickness (infection or nutrient deficiency) are basically transitory: ultimately there is either complete recovery or irreversible consequences manifested by increasing degrees of permanent growth faltering (or other disability among the survivors) and/or death.
The maternal factors such as age, parity and birth interval have been shown to exert an independent influence on pregnancy outcome and infant survival through its effects on maternal health. Environmental contamination that refers to the transmission of infectious agents to children (and mothers) can be seen in the light of the following four categories: One, where infectious agents are transmitted to the human host through air- the route of spread for the respiratory and many ―contact‖ transmitted diseases. Second, through food, water and fingers- the principal routes of spread for diarrheas and other intestinal diseases. Third, skin, soil and inanimate objects- the routes for skin infections, and lastly, insect vectors which transmit parasitic and viral diseases (Ibid).
Depending on where a child is born and to the family it is born, these factors influence their survival rates; children born in environments where conditions of the environment is good and well taken care of survive more than those born in deplorable environments like slum areas of urban centres where contamination of the environment, lack of quality water for domestic use and limited toilet facilities are a characteristic. For example, air contamination and risk of contact-acquired respiratory infections can be inferred from the intensity of household crowding (persons per room); water contamination can be scaled by source of supply (ditch, pond, open well, protected well, hand-pump, piped supply); household contamination, by cleaning, cooking, and storage practices; and potential feacal contamination, by the presence of latrines or toilets, or the use of soap and water. Nutrient deficiency relates to the intake of the three major classes of nutrients- calories, protein and the micronutrients which are essential to the survival of children and the mother alike.
CHAPTER THREE
STUDY DESIGN AND METHODOLOGY
Research Design
Aaker et al (2002) defines a research design as the detailed blue print used to guide a research study towards its objectives. Method design, sample design and analysis design was used. Cross section studies were used during data collection. According to Saunders et al (2004) a cross sectional design allows data to be collected at a single point in time without repetitions from a sample selected to represent some large population and therefore using minimum time and resources. In this study, the design was favorable because of limited resources like time, labor (personnel) and transport.
Sampling Procedure
The study population involved all Primary Schools in Jos North Local Government Area of Plateau State. The main target groups of sampling were the head of school, teachers and pupils. The sampling methods that were used to get the required sample included systematic random sampling and purposive sampling techniques.
CHAPTER FOUR
DATA ANALYSIS AND RESULT PRESENTATION
Distribution of births by the study variables
Table 1 below summarizes the frequencies and percentages of the variables used in the study of the area.
Table1 Combined frequencies and percentages of variables for the cities
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATIONS
Summary of findings
This project attempted to examine the effects of impact of poverty on infant mortality in North Jos. The study used a combined data for the area to achieve this objective.
The study found out that the type of birth, whether single or multiple, was negatively associated with infant mortality in the area under the study. An indication that infant children born to mothers through multiple births were less likely to experience mortality before their fifth birth day. This is a unique outcome from what many research studies have found out, but it is possible from the researcher‘s findings that despite the small number of multiple births reported for the area, it can occur that such births when they occur in towns tend to receive maximum attention from their mothers and relatives to the extent that all the twins or the triplets are able to survive to their fifth birthday. Alternatively, when such births occur in families with high socio-economic status, then the children who are products of such births tend to live long to surpass their fifth birthday since their mothers can adequately provide for their needs just having one child.
In addition, the study also revealed that the age of the mother at birth was an important factor in determining infant mortality in the cities under study. This finding that infant children born to mothers in ages less than 20 years were more likely to experience high mortality compared to those who were born to mothers whose ages were between 20-34 years.
Nevertheless, this study found out that mothers whose ages were 35 years and above were less likely to contribute to infant mortality in the area than those whose ages were in the middle at 20- 34 years of age. At the bivariate analysis level, women whose ages ranged between 20 to 34 years were significant at p=0.025, while when the socio-economic factors were fitted in the model, this level was insignificant in predicting the outcome. At multivariate analysis, the third category of women whose ages were 35 years and above was statistically significant thus indicating that the age of the mother has an important influence in the infant mortality experienced in the area.
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