1.1 Introduction
Mortality rate, or death rate, is a measure of the number of deaths in a particular population, scaled to the size of that population, per unit of time. In Nigeria, as in all parts of Africa, women experience unplanned pregnancy. Some of these women seek to terminate their pregnancies by safe medical methods or by other unorthodox methods available. Child mortality rate also known as under-five mortality rate is defined as the possibility that in every 1000 live births one baby will die before reaching age five: Whereas, the death of a child before his/her first birth day is termed infant death or infant mortality. Therefore, infant mortality rate is the number of chil-dren dying under a year of age by 1000 live births. Infant mortality rate is an important marker to measure the health and wellbeing of a population (Centre for disease control and prevention, 2014). This is because it is often linked to several factors such as maternal health, quality and access to medical care, socioeconomic conditions, and public health practices (Definition of Mortality, Infant, 2012).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.
1.2 Background of Study
Globally 2.5 million children die in the first month of life, almost 7,000 newborn deaths occur every day with 1 million dying on the first day of life, while nearly 1 million died within 6 days of life in 2017. Also, a child’s risk of dying is extremely high in the first 28 days of life, during the neonatal period (WHO, 2018). The number of neonatal deaths dropped from 5.0 million in 1990 to 2.5 million in 2017 globally, even though, the reduction in neonatal mortality from 1990 to 2017 has not been meaningfully low, compared to post-neonatal under-5 mortality (WHO, 2018). Mortality among under-five was higher than neonatal mortality, even though there was decreased mortality in all regions globally. Generally, all over the world, the neonatal mortality rate fell by 51 per cent from 37 deaths per 1,000 live births in 1990 to 18 in 2017, a slighter reduction in mortality than among children aged 1-59 months (63 per cent). With the exclusion of the highly developed countries, neonatal mortality has fallen more rapidly since year 2000 than between years 1990-2000.
In urban areas of Africa, Americas and Asia, statistics show that the poorest 20% population is twice as likely to die before their first birthday (Infant mortal-ity, WHO, 2013). In 2013, an estimated 6.3 million children under the age of five died (Children: Reducing Mortality, 2014). Child mortality is important as it is a pointer of the usage, accessibility, and availability of the health system by the inhabitants especially children. It is also a sign of the extent in which a society exercises the most basic human right: the right to life and health (GOAL 4: Reduce the under-five child mortality rate, 2010).
In 2013, an estimated 6.3 million children under five years of age depart this life. An estimated 44% of these deaths occurred during the neonatal period. Neonatal period, which is the first 28 days of life, is considered to be the time where in a child is at the highest risk of dying. In addition, about 45% of all the under-five death has a connection with malnutrition. Although a child born in an already developed or a developing country can die before five years of age, he/she is, however, more likely to die if living in sub-Saharan Africa and Southern Asia compared to his/her counterparts in a developed country. About 50% of all under-five deaths occur in only five developing countries namely China, Democratic Republic of the Congo, India, Nigeria and Pakistan (Children: Reducing Mortality, WHO, 2014). A large proportion of these deaths are caused by infectious yet preventable diseases (Niño-Zarazúa, 2013).
According to WHO, Nigeria, in the past few years has experienced some worsening of child mortality (WHO, 2014). In 2003, the infant mortality rate was estimated at 100 per 1000 births while it was 87 in 1990 and two third of the births in Nigeria still occurred at home. This was identified to be as a result of persisting low numbers of births occurring in health facilities and the low number of births attended by trained healthcare service providers. Likewise, only little more than one-third of births are attended to by doctors, nurses, or midwives (WHO, 2014). Significant reduction in the global burden of neonatal mortality was achieved through the millennium development goals, but in Nigeria, only a marginal reduction was realized. Postnatal care is an aspect of child survival that has received limited attention in the country (FMOH, 2012).
Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Nurses' Role in Prevention of Infant and Under-Five Child Mortality in Africa.
1.3 Statement of Problems
Investigation revealed that the considerable gains achieved in reducing childhood deaths globally, the recorded progress was insufficient in meeting the MDG 4 target. The recommended SDG target for child mortality signifies a renewed commitment to the world’s children. Achieving this renewed commitment is dependent on monitoring the drivers of preventable deaths among children. In spite of the significant progress made in recent years to reduce under-five mortality, significant inequities between and within countries continue to exist.
These are not only driven by poverty, but are intrinsically linked to social exclusion and de jure and de facto discrimination. The outcome of this study would serve as a bedrock for planning suitable interventions for halting preventable deaths of newborns and under-fives. Therefore, this study tends to identify the role of nurses in reducing and or preventing infant and child mortality.
1.4 Aim and Objectives of Study
The aim of the study is to examine and identify the Nurses' Role in Prevention of Infant and Under-Five Child Mortality in Africa. In achieving this aim, the following specific objectives were laid out as follows:
- To examine what nurses are doing to prevent infant and under-five mortality in Africa;
- To determine the position of nurses in consideration to childhood deaths;
- To examine the challenges nurses face in dealing with child mortality; and
- To examine the relationship between nurse and prevention of infant and under-five mortality;
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What are nurses' doing to prevent infant and under-five mortality in Africa?
- What is the position of nurses in consideration to childhood deaths?
- What challenges do nurses face in dealing with child mortality?
- What is the relationship between nurse and prevention of infant and under-five mortality?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no relationship between nurse and prevention of infant and under-five mortality.
- H1: There is a relationship between nurse and prevention of infant and under-five mortality.
1.7 Significance of Study
The findings of this study can be used by health care professionals especially nurses in developing countries. Research on the solutions needed to overcome the challenges faced as well as a study that focuses entirely on the nurses’ position is needed. This study will also be of immense benefit to researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.
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