Maternal health services utilisation and survival of under 5 children in Nigeria

Abstract Background Nigeria’s under-five mortality rate exceeds the Sustainable Development Goal (SDG) target 3.2. Preventable child deaths can be reduced through the utilisation of maternal health services. Objective This study aims to assess the extent to which maternal health service utilisation and maternal factors affect child survival. Methods A retrospective analysis was conducted using data from the 2018 Nigeria Demographic and Health Survey. The study population included 16,311 children under the age of five and their mothers aged 15 to 49 years. Kaplan-Meier survival curves, and a log-normal accelerated failure time model were conducted to assess survival times based on maternal health service utilisation. Results Mortality rate for children under the age of five was approximately 60 per 1000 live births. Female children have a 35% longer survival time than males (95% CI 9.4–65.0%, p = 0.005). Late initiation of antenatal care in the third trimester was associated with a 36% reduction in survival time (95% CI 55.5% − 7.7%, p = 0.017). Children from the richest wealth quintile had a 216% longer survival time compared to those in the poorest category (95% CI 96.0–406.2%, p = 0.001), while those whose mother had secondary school education had 58% longer survival time than those with no formal education (95% CI 16.2% -114.0%, p = 0.003). Conclusion Maternal health services and biological factors influence child survival in Nigeria; therefore, stakeholders should strengthen these services and promote other positive determinants of child health.