Table 2. Individual- and community-level contextual factors associated with under-5 mortality by maternal ethnicity in Nigeria from multivariable multilevel logistic regression models± .
| Variables |
Model 0 (Empty model) |
Model 1 (Ethnicity) |
Model 2 (Child-level variables) |
Model 3 (Mother-level variables) |
Model 4a (Community-level variables) |
Model 4b (Community-level variables) |
| OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | |
| Fixed effects | ||||||
| Individual characteristics | ||||||
| Ethnicitya | ||||||
| Igbo | 0.60 (0.45–0.80) | 0.62 (0.47–0.83) | 0.64 (0.44–0.94) | 0.66 (0.45–0.97) | 0.78 (0.53–1.15) | |
| Yoruba | 0.43 (0.30–0.61) | 0.49 (0.34–0.69) | 0.88 (0.69–1.12) | 0.89 (0.70–1.13) | 0.82 (0.54–1.25) | |
| Others | 0.81 (0.68–0.98) | 0.85 (0.71–1.02) | 0.57 (0.39–0.84) | 0.60 (0.40–0.89) | 0.96 (0.75–1.23) | |
| Sex of the childb | ||||||
| Female | 0.92 (0.79–1.07) | 0.92 (0.79–1.07) | 0.92 (0.79–1.07) | 0.92 (0.79–1.07) | ||
| Birth order/birth interval in monthsc | ||||||
| First birth (order 1) | 1.36 (0.98–1.88) | 1.54 (1.19–1.99) | 1.55 (1.20–2.00) | 1.59 (1.19–2.00) | ||
| 2–4, <24 | 1.16 (0.87–1.53) | 1.17 (0.88–1.56) | 1.17 (0.88–1.55) | 1.17 (0.88–1.55) | ||
| 2–4, ≥48 | 0.76 (0.52–1.12) | 0.71 (0.48–1.05) | 0.71 (0.48–1.06) | 0.74 (0.50–1.09) | ||
| ≥5, <24 | 2.51 (1.92–3.27) | 2.05 (1.51–2.80) | 2.04 (1.49–2.78) | 2.04 (1.50–2.78) | ||
| ≥5, 24–47 | 1.23 (0.99–1.55) | 1.00 (0.76–1.33) | 1.00 (0.75–1.32) | 1.00 (0.75–1.32) | ||
| ≥5, ≥48 | 0.76 (0.53–1.10) | 0.58 (0.38–0.88) | 0.58 (0.38–0.88) | 0.59 (0.37–0.89) | ||
| Maternal age at birth, yearsd | ||||||
| 15–18 | 0.75 (0.48–1.16) | 0.74 (0.47–1.15) | 0.73 (0.47–1.13) | |||
| 19–23 | 0.98 (0.76–1.27) | 0.98 (0.76–1.26) | 0.96 (0.75–1.24) | |||
| 29–33 | 1.02 (0.80–1.31) | 1.03 (0.79–1.32) | 1.02 (0.80–1.31) | |||
| ≥34 | 1.31 (1.00–1.71) | 1.32 (1.01–1.73) | 1.33 (1.02–1.74) | |||
| Maternal age at first birthe | ||||||
| ≤18 years | 0.98 (0.81–1.18) | 0.98 (0.81–1.19) | 0.98 (0.81–1.19) | |||
| Religionf | ||||||
| Muslim | 0.89 (0.68–1.16) | 0.87 (0.67–1.14) | 0.84 (0.64–1.10) | |||
| Traditional indigenous religion | 1.70 (1.05–2.77) | 1.67 (1.02–2.72) | 1.57 (0.96–2.55) | |||
| Maternal educationg | ||||||
| None | 2.01 (1.53–2.64) | 1.87 (1.38–2.51) | 1.80 (1.34–2.41) | |||
| Primary | 1.76 (1.36–2.29) | 1.66 (1.25–2.19) | 1.63 (1.23–2.15) | |||
| Maternal occupationh | ||||||
| Not working | 1.00 (0.60–1.68) | 1.00 (0.60–1.68) | 1.01 (0.60–1.70) | |||
| Clerical, sales, services, skilled manual |
0.99 (0.59–1.64) | 0.99 (0.59–1.64) | 1.00 (0.60–1.67) | |||
| Agricultural self-employed or employee, household & domestic, unskilled manual |
1.00 (0.58–1.72) | 0.98 (0.51–1.69) | 0.96 (0.56–1.66) | |||
| Community characteristics | ||||||
| Community maternal educationi | ||||||
| Low | 1.18 (0.90–1.53) | 1.03 (0.79–1.34) | ||||
| Physician-provided community prenatal carej | ||||||
| Low | 1.06 (0.85–1.31) | |||||
| High | 0.58 (0.44–0.77) | |||||
| Random effects | Empty | Ethnicity | Child | Mother | Community | Community |
| Community-level | ||||||
| Variance (SE) | 0.253 (0.074) P = 0.001 | 0.202 (0.067) P = 0.003 | 0.196 (0.066) P = 0.010 | 0.160 (0.062) P = 0.010 | 0.137 (0.060) P = 0.009 | 0.137 (0.060) P = 0.022 |
| VPC (%) | 7 | 5.3 | 5.4 | 4.5 | 4.5 | 3.9 |
| Explained variation (PCV) (%) | Reference | 20.2 | 22.5 | 18.4 | −1.2 | 15.4 |
| Mother-level | ||||||
| Variance (SE) | 0.316 (0.137) P = 0.021 | 0.281 (0.132) P = 0.034 | 0.135 (0.126) P = 0.964 | 0.108 (0.123) P = 0.380 | 0.101 (0.122) P = 0.390 | 0.101 (0.122) P = 0.409 |
| VPC (%) | 8.2 | 7.4 | 3.7 | 3.0 | 3.0 | 2.9 |
| Explained variation (PCV) (%) | Reference | 11.1 | 57.3 | 20.0 | 1.8 | −84.7 |
| Model fit statistics | ||||||
| DIC | 4808 | 4792 | 4741 | 4714 | 4717 | 4702 |
Note: Model 0 contained no variables, Model 1 included ethnicity, Model 2 adjusted for birth order/birth interval, Model 3 additionally adjusted for maternal age at child birth and maternal education, Model 4a additionally adjusted for community maternal education, and Model 4b additionally adjusted for physician-provided community prenatal care.
Abbreviations: VPC, variance partition coefficient; DIC, deviance information criterion; SE, standard error; OR, odds ratio; CI, confidence interval.
aHausa/Fulani/Kanuri; bMale; cOrder 2–4, 24–47 months; d24–28 years; e19 years or more; fChristian; gSecondary or higher education; hProfessional/Technical/Management; iHigh; jMiddle.