The association between intimate partner violence and under 5- child mortality in Nigeria : A cross-sectional study based on Nigerian demographic health survey from 2018

Abstract: Background  Both Intimate partner violence and under 5- child mortality are alarmingly high in the world, Nigeria is one of the leading countries. The adverse health outcomes for both women and children as a result of living in a violent environment need to be addressed and combatted. This study aimed to investigate whether there was any association between maternal exposure of lifetime violence (Emotional, physical, sexual, and any violence) and under-5 child mortality.  Method  The study was a cross-sectional study based on secondary data from Nigerian demographic health surveys (DHS) from 2018. The study sample consisted of 8389 married and non-married women, aged 15-49 years who completed the domestic violence module, with a dead or alive first-born child. To assess the associations between maternal experience of lifetime exposure of different types of violence (Emotional, physical, sexual, and any violence) and under-5 child mortality Chi-squared tests were performed, followed by logistic regression. Result In this study, the prevalence of emotional violence was 33,6 %, physical violence 21,3 %, sexual violence 7,7 % and any violence 38,5 %. Moreover, 6,7 % of the children in the sample were dead. The results showed that emotional violence, physical violence, and any violence were not significantly associated with under-5 child mortality. However, sexual violence showed an association with under-5 child mortality (P-value: 0,002). In addition, logistic regression showed that religion was associated with under-5 child mortality (P-value: <0,001). Muslim women had increased odds of child death, compared with Christian women(aOR:0,63, CI:0,50-0,78). The oldest women aged 40-49 years were found to be associated with under-5 child mortality (P-value:< 0,001). High maternal age increased the odds for under-5 child mortality (aOR: 2,08, CI:1,58-2,75). Moreover, maternal working status was associated with under-5 child mortality (P-value: <0,001). Working women had increased odds for experiencing child death, compared with the non-working women (aOR: 7,04, CI: 4,99-9,92). Finally, wealth was negatively associated with the outcome of under-5 child mortality (P-value: 0,007). The richest women had the lower odds of under-5 mortality, compared with the poorest women (aOR: 0,62, CI: 0,44-0,88). Conclusion The study showed an association between sexual violence and under-5 child mortality. Both sexual IPV and under-5 child mortality must be addressed urgently because it has detrimental effects on both women’s and children’s health in Nigeria. The study also found that high maternal age increases the odds for under-5 child mortality, and adequate age for motherhood must be promoted, to save the lives of children. Moreover, belonging to a low wealth quintile increases the risk for child death, and therefore poverty must be relived in Nigeria, so SDG 3.2.1 can be reached: “End all preventable deaths under 5 years and not more than 25 child deaths per 1000 live births by 2030”.