Infant and maternal deaths in rural south west Nigeria: a prospective study.

Baseline data on neonatal, infant and maternal deaths including factors associated with infant mortality in a rural community are needed to assess the progress being made towards achieving lower rates in Nigeria. In this community-based prospective study, baseline data on births and deaths were collected as they occurred for 6 consecutive years and perinatal risk factors associated with these deaths identified. There were 972 live births in the study period. Maternal mortality ratio (MMR) for the period was 2160 per 100,000 and infant and neonatal mortality rates of 65.8 and 32.9 per 1000 live births were obtained. MMR was highest in mothers aged 40 years and above and lower in mothers 15-34 years. Of infants deaths, 18.8% occurred on the first day of life and 32.8% of deaths occurred within one week of birth. Malaria/fever (23.4%), LBW (17.2%), and Vaccine preventable diseases (neonatal tetanus and measles) (12.5%) were the commonest known causes of infant deaths. Perinatal risk factors for infant deaths included being first birth order (RR = 3.1, 2.1-4.7), birth outside the health care facility (RR = 2.5, 1.4-4.3), no attendant at delivery (RR = 2.5, 1.4-4.4); low weight at birth (RR = 2.46 1.01-5.9) and traditional birth attendants at delivery (RR = 1.7, 1.2-2.6). Babies born to fathers who were between the ages of 25-34 years had borderline protection (RR = 0.76, 0.6-1.01). Delivery and perinatal events have a significant impact on infant survival and more needs to be done to integrate infant survival with maternal survival strategies and this should be done at the primary care level. The community must also be educated and empowered to use the facilities for promotive, preventive and curative care.