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Related Experiment Video

Updated: May 31, 2026

Establishing a Competing Risk Regression Nomogram Model for Survival Data

Establishing a Competing Risk Regression Nomogram Model for Survival Data

Published on: October 23, 2020

Exploring variations in under-5 mortality in Nigeria using league table, control chart and spatial analysis.

Olalekan A Uthman¹, Victor Aiyedun, Ismail Yahaya

¹West Midlands Health Technology Assessment Collaboration, Department of Public Health and Biostatistics, University of Birmingham, Birmingham, UK. uthlekan@yahoo.com

Journal of Public Health (Oxford, England)

|July 19, 2011

Summary

Under-5 mortality rate (U5MR) in Nigeria is high, with significant state-level variations. While most states show common-cause variation, 27% exhibit special-cause variation requiring further investigation.

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Last Updated: May 31, 2026

Establishing a Competing Risk Regression Nomogram Model for Survival Data

Establishing a Competing Risk Regression Nomogram Model for Survival Data

Published on: October 23, 2020

Area of Science:

Public Health
Demography
Biostatistics

Background:

Nigeria faces a high under-5 mortality rate (U5MR), contributing significantly to sub-Saharan Africa's burden.
Variations in health practices and government priorities across Nigerian states necessitate localized U5MR analysis.
Understanding U5MR disparities is crucial for targeted interventions and improved child survival strategies.

Purpose of the Study:

To investigate and quantify the variation in under-5 mortality rates (U5MR) across Nigeria's 37 states.
To identify states with significantly high or low U5MR, distinguishing between common-cause and special-cause variations.
To provide data-driven insights for public health planning and resource allocation to reduce child mortality.

Main Methods:

Utilized data from the 2008 Nigerian Demographic and Health Survey (NDHS) birth histories.
Estimated U5MR using synthetic cohort life table methods.
Applied Shewhart's theory of variation, plotting control charts and Local Indicators of Spatial Association (LISA) to analyze state-level U5MR.

Main Results:

The national average U5MR is 159 deaths per 1000 live births, indicating over 1 in 10 children do not survive to age 5.
Kwara and Osun states reported the lowest U5MR (<60 per 1000), while Jigawa, Kano, Sokoto, Niger, and Adamawa states had the highest (>200 per 1000).
Control charts revealed 27% of states exhibited special-cause variation (4 above upper control limit, 6 below lower control limit), suggesting unique contributing factors.

Conclusions:

Nigeria's U5MR remains critically high, with substantial inter-state disparities.
A significant proportion (27%) of states display special-cause variation in U5MR, warranting in-depth investigation into specific risk factors.
The majority of states (73%) demonstrated common-cause variation, indicating systemic factors influencing child mortality across the country.