Perceptions of child death in Jigawa State, Nigeria: a mixed-methods study on how sociocultural nuances shape paediatric mortality reporting

Kristen Nicole Andersen; Funmilayo Shittu; Abdullahi Magama; Tahlil Ahmed; Damola Bakare; Julius Salako; Rochelle Ann Burgess; Carina King; INSPIRING Consortium

doi:10.1080/16549716.2022.2120251

Perceptions of child death in Jigawa State, Nigeria: a mixed-methods study on how sociocultural nuances shape paediatric mortality reporting

Glob Health Action. 2022 Dec 31;15(1):2120251. doi: 10.1080/16549716.2022.2120251.

Authors

Kristen Nicole Andersen¹, Funmilayo Shittu², Abdullahi Magama³, Tahlil Ahmed⁴, Damola Bakare², Julius Salako², Rochelle Ann Burgess⁵, Carina King^{1

5}; INSPIRING Consortium

Affiliations

¹ Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
² Department of Pediatrics, University of Ibadan, Ibadan, Nigeria and University College Hospital, Ibadan, Nigeria.
³ Save the Children International, Jigawa, Nigeria.
⁴ Save the Children UK, London, UK.
⁵ Institute for Global Health, University College London, London, UK.

Abstract

Background: Vital statistics are critical for effective public health and monitoring progress towards child survival. Nigeria has the highest global under-five mortality rate; however, deaths are often under- or misreported.

Objective: We explored perceptions of child deaths and socio-cultural factors influencing the reporting of child deaths in Jigawa State, Nigeria.

Methods: We conducted a triangulation mixed-methods study in Kiyawa local government area, Jigawa, including: four focus group discussions (FGDs) with 8-12 women, six key informant interviews (KII) with Imams, and process data from 42 verbal autopsies (VAs) conducted with caregivers of deceased children. Data was collected between November 2019-April 2021. Purposive sampling was used to recruit FDG and KII participants and two-stage systematic and simple random sampling was employed to recruit VA participants. Qualitative data was analysed using content analysis; VA data was described with proportions.

Results: Five categories emerged from FGDs: culturally grounded perceptions of child death, etiquette in mourning and offering condolence, formal procedures surrounding child death, the improving relationship between hospital and community, and reporting practices. Women expressed that talking or crying about a death was not culturally accepted, and that prayer is the most acceptable form of coping and offering condolence. Many women expressed that death was God's will. These findings correlated with VAs, in which visible signs of emotional distress were recorded in 31% of the interviews. Three categories emerged from KIIs: religion as part of formal procedures surrounding child death, communities support the bereaved, and multilayered reasons for unreported deaths. Imams serve a key role as community leaders, involved in both the logistical and religious aspects of their community, though they are not involved in mortality reporting.

Conclusion: Religion plays a central role in burial practices, community mourning rituals, and expression of grief, but does not extend to reporting of child deaths. Imams could provide an opportunity for improving vital registration.

Keywords: Nigeria; Qualitative; religion; verbal autopsy; vital statistics.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Autopsy / methods
Caregivers*
Cause of Death
Child
Female
Focus Groups
Humans
Nigeria / epidemiology

Grants and funding

This work was funded through the GlaxoSmithKline (GSK)-Save the Children Partnership [grant reference: 82603743]. Employees of both GSK and Save the Children contributed to the design and oversight of the study as part of a co-design process. Any views or opinions presented are solely those of the authors/publisher and do not necessarily represent those of Save the Children or GSK, unless otherwise specifically state.