Evidence for the variation and decline of mortality in Nigeria

Distr, LT.^ITF^

i /C,'/1'./VOV/152

UNITED NATIONS

ECONOMIC AND SOCIAL COUNCIL

JXOi'IOalC LOiIJir.SION i'OR AFRICA-

Expert Group lieetinp- on Fertility and .' Levels, Patterns anc Trends in Africa And their Policy Implications

, 26 NovemLer tc 1 December 197>

CI. FOS T^TE VARlATIOiT ^:

OF MORTALITY IN NIREI1IA

P.O. OLUSA'TA

79-3152

Information on mortality in Tiseria is very scanty. In fact, if ve exclude the Federal Office of Statistics (FOS) survey of 1965/00 vhic-i ol tained this information from the rural sector of the country, it tt.cs not until the past tvo three years that mortility information was oit?.ine.l which went beyond tie crude death rate. This is unfortunate because unless raorc infornation- on rjortnlity is made available urgently, it will be difficult to know if and to uimt extent it is declining and its relative levels in the various peowapuical rerions and socio-economic groups in the couittry. liore importantly, in tnese <mys of increasing concern about the improvement of the health ;md jreneral vellbeinf* of Nigerians, it will be difficult to knov vhet, or or not the various he-ilth

reasures *• -ire achieving their objectives.

What follows is an attempt to exraine tue available data for any evidence on . mortality trend and differentials.

SOUTXES AIC MATURE OF KORTALITY DATA

In Iliperia there is very little information on mortality representative of substantial numbers of people and ir the absence of a vital registration system, reliance has been heavily placet1, o?, small-scale surveys and indirect estinatin?

procedures for the derivation of vital rates. Although the registration of births and deaths has been in existence iii parts of ni<-eria since the early

years of the present cantury, its history has been one of failure. Consequently, the material emanating from the vitr.1 registration activities In various parts of the country is of very poor quality so that for analytical purposes it is utterly useless. In the first place, the coverage in the few centres of

registration is very limited. Secondly, ir spite of the fact that registration is compulsory, the Fachinery for its enforcement is either very weak or non

existent.

Figures from the past annual reports of the departments and T-inistries of health of the old Regions illustrate the worthlessness of the results that can be expected from vital registration activities which ore not orientcJ towards any specified objective and for which the masses were ill-prenared. These results show for various dates that apart fron one or tro accidental cases in which the birth rate was about 40 per 1000 or ttore, Trost of the birth rates fiven vary from as-low as 12 to 30 per 1G3U, while death rates between 1 inc! 10 per 1C;);

are found in several cases,2 While the absurdity of these rates ray-be

attributed in part to tb£ uncertainty of the base population, it is certainly due largely to the inefficiency of the registration nachinery. The basic problem of population analysis in ili^erl?* is thus connected uitr. the absence of a vital registration system and an acceptable population census.

In recent years, a number of surveys have been undertaken in parts of the country. These surveys, with the exception of tlie FOS survey, were one-round surveys designed to measure fertility, child survival an^ the socio-econonic variables associated with them. Fxaiaple»of these studies are those hii&frA. in the Nigerian Institute of Social and Economic Research and carried out in the 1960's3 - and the H&tional Fertility, Family ana Fvrily Planning T'AF study

(FFFF-KAP) based in the University ofIfe's former Institute of Population and Manpower Studies and carried out in three phases O'estern conprisin? the former Hestern, Lagos, Kid-West and T.wara States, all in the Southwest of Nigeria, Eastern, enlracinf* the former last-Central, F,ivers and South-!asterr States, all east of the River Miper, and Northern covering the whole area north of

the Si£er and the i.enue) between r;71 and 1973^ Fron these as well as from the

age structures of the populations from the country's censuses estimtes of

Pa; e 2\W/..

rortUity i:ave bear, directly in' indirectly derive 1. rsti?v?tes of rv-rtality

i--ve also teev recently nice frort data on t'o profit!"" cf 61.; chil-^r drawn frori the sieUcal census of l,\3.»-32.- Tiiesp are oome of the sources

used in t^is paper.

The FOE uerxrrapMc sample survey needs special rentioi.. It was deoi^r^

as a ]\ulti-rGund study specifically to measure fertility, uort.ility in,:

ni'^tio:;. Tie survey however, ran into difficulties p-irtly owin*"ro the

political disturbances of t?.e ti*e wiiic\ prevented the urban pW-se of t.x,

study, u Aiiu partly lecause of technical ^ir; artvr.iiaatiou^.l "ror^rn-s v!ic~- affected t;;e results. TUe ncthoc of L.-ryiir,- tae i^teriil also contril'ute:-

in Yio sr.ill v.iy to tUe unreliability of sore of tl;e results. For ezinplc, in estincitiurs t^fi rates, a population no,; el of l->: -,'k ; persons vas use: -i-i aivide^. by re",ions it, proportions of tlie :.i~eri.-in rural popul-ition is of

1963 census. ;;ei^iita used in corq-utinr vitrl r.itos T^ere the si.:e of tie

rural populstior. in each region Mccor.Ua- to the l-\3 census. Ircidciit^lly,

tiie l:-o3 census was controversial mul tlie difficulty of eetahlisliif In ,1 satisfactory mi.ner tUe rur^l-urb.in conpoiiei.t of tUe populatioi^. tra1:es nons — s^

of these ueip.ats./ Infant deaths vere corrected ^ecrmse, accor-'i.-- to tic

renort, they v.ere rrossly iu error, but ..ou r^eou^te the procedure ras cit-not

be determined, - .

/'lso "the xiuir.'er of s.^isple units, ifter tie exclusioi;. of units ir v/Mc1,,

quality vas. in ;Joult, was iii t^e southern regions too swiJl for reliaMe estimates for each re-.ior. separately."'-" T)ie reiectioi. of s-vipliiv ui:its vis, aowever, basea on ti.e ma^nitule of tUe rates derive! from t~.it; ori<;ir.a! tVati. Very low rates led to the rejection of tire units ir. vhic:i they occurr^": vi.ile t!:.e urxits whicl; showed unusually Uiph rates (fispp.cin.lly in the cn.se of

itortality) v;ere retailed for the final analysis. /.lie unusually lov"birth

r.-.tes t-.ay Le s.ifely rejects! on t^e reasonable assui'.ption ti;at Lirt:> rates vouia normally vary very little fror. year to year, particularly ii, a very lar?e population, the rejection of lur.usu^lly hi--, or lo*- Ocath'rjitea ia net easy to -jefencT especially when lase^ on the experience of a single year it. wj.icl, uortality ii. a rn^uically w/-ckr7;arf! society nay *luctu*te very vilely aepencizi'*

oi- ciiance variratior.s ia the virulence of sore iirportarct causes of

In spite of t-.e flavs in t!^e :"':S sturTy, nore of sucr stiulies, particularly ir. nortality, should have been done in "ireria siuce t'"? prcisler of * cwnic.iion of deaths due to recall lapse-' is roicn nore controlled t.var- in sinrle-round surveys of mortality.-- lTnfcrtui:ately, the financial iiiplicatior.s of ::;u?.ti- rounci surveys place t»en beyoi^ tlie reach of aca-le-.ic -epw»rapliers v-»cse nea<;re resources can only cope with one-rouiv? retrospective surveys, aur;

Goveriineut-Gponooreo surveys like the Ffj£ ont are a rarity in ";i:eria. One

other factor responsible for the dearth of. mortality ,Iat:i'probably .derives fro'"

the fact that people neeJ. very little ^crsuatior. to use the nost effective available radical aids arJ. the fact tuat Mortality will .-.ecliue i^ ti.esc aids

are proviciev.;, uuch nore emphasis has, therefore, \oeu or;, fertility u'^ich is . far more difficult to influence.

As already stated, available data 01. wrtality are to Te found.ir smll-

scale studies carried out in parts of the country i.y Jifferei-.t reseircliWE

Pa-e 3

using different methods. Strictly speaking therefore, the results n:iy :ict be comparable since errors and biases of various types and decrees which n.re unknown are likely to be involved. IjevertheXess, they ire used here i;

exploring the possibility of variations in mortality.

Tables 5, 7 and 14 are an atteupt to illustrate sex differentials iu mortality. Table 5 shows ape-specific mortality (a q x) by sex for tvo sub

divisions of Nigeria. In the southwest, no sex differential is noticeable and, probably none exists. In the east, the figures ire rather erratic, vTitli

higher male mortality in some ages and lower male -mortality-in some ares and

lower male mortality in others in a more or less inconsistent rxinner which suggests errors in the data. JevertUeless, it seems that sex differentials, are clearer here and are of two types: (a) generally lower female mortality at ages below 15 years and (L) generally ivi.r.her fertile uortality fror about the a£e of 15 years. If the data can be accepted at their face value, it

would appear that the effect of physiological impairment occasioned, inter alia, by the frequency of childbearing from very early apes has continued to have a pronounced influence on the incidence of mortality of the eastern females far beyond the a<;e of reproduction. If data were available separately for urban and rural areas, they would probably s,.ov more substantial mortality differentials between male and female in the apes of reproduction.

Table 5 does not present the mortality situation in ITiferia ac a whole because the source does not ,*?ive such data. Up till now, only the western aati eastern phases of the Ife FFFP-KAP survey have been analyse;! in sufficient detail while the northern phase .is only partly analysed. Table 7, tiowever, shows the life axpectancy at birth, by age for Nigeria as a rhole.

The life expectancy at birth for male or female in the FOE 1565-66 study seera

to be rather low compared with other independent estimates for Nigeria."■» ^

The probable e:<planatioa for this has already been mentioned. In fact, the authors of the report from which the information is t'arivec! call attention to this inadequacy: "The mortality was fount1, to be r it her hipher than bad generally been expected and as a result the population growth rite somewhat more moderate than is often assured,,.. "However, since particularly the f'.ecttv rate is likely to fluctuate fron year to year, it is not suro that the

observation period was a typical one. Furtberriorti, the towns whicu conprise 10-% of the povmi.ition of the country were not included iv, this survey and the national rates Bight therefore be somewhat different from the rural ratan of

the study."

The figures rcir^it, therefore, be adjusted upwards by at least two years in both cases in the.li-yiit of this comment and since towns made up 2£% of

the population of Ili^eria in 1963, not 10? as. stated i.i, the report. . Towever, none of the two sets of data shows any clear or consistent differential

between the sexes although in the FOE stuCy there is a tendency for fenalc

life expectancy to be sli;-htly lover than that of the male from are y.i downwards.

Perhaps the difference between the FOf, and tiie FFFP-KAP studies is due to the fact that the former excludes the urban centres viiile the latter includes them.

In other words, it is possible that the slight Jifference in nortality between males and females shown in the FOS study woulo. riisappear if the urban centres had been included. Tne central ueatii rates (Kx) «ivew in Table 14 also show this tendency; that is, slightly hi?aer feiwle mortality up to.a?e 3'> years, the difference being somewhat more pronounced at are 15-29 years. ,

E/CN.U/POP/152 - Faj;e 4

In short, for Nigeria as a whole, no sex differential is discernible. Only in the east (and possibly in the ■north if <?ata wore available) is tV-ere-n tendency for female mortality to be Iti^.iei iu -Jne reproductive a^s ai;d beyond. The

inadequacies in the data and the magnitude of the observed differer.ti.il, however, make any categorical statement alout ser, differentials difficult to justify.

Mortality differentials between sub-divisions of the country are examined

in Table l^C, Table 1 .presents cruuc deatU rates. Zone initial"observations on

the accuracy cf the figures are pertinent. Two sets of data (a) and (t) rrm-m from the same source (Ife FFFP-KAT survey) tut presented -t two-different tines (1976 and 1979) are shown here. It will be observed that the two sets ~ive, in the majority of cases, crude death rates that are different for tne pane" State.

For example, for Yvnra State the first set of data fives 25.3 per thousand while the second set ?ives 24.9 per thousand. For Western State the figures

are 17.6 per thousand and 18.5 per thousand and for Rivers State 21.1 per thousand and 27.5 per thousand (the largest discrepancy). These discrepancies in death rates for the same State and the same data are certainly due to earless handling of the data by the authors concerned. Consequently, it ie not clear which set of crude death rates is the more accurate. The discrepancies in all the

States but one are small and may be overlooked for the purpose of tUis analysis, though admittedly they destroy the credibility of these data.

On the assumption that the more recent presentation of t-:e data is the more reliable, the crude death rate for Nigeria in 1971-73 was 20.6per thousand which looks plausible. With the execution of Kano and North-Central States which have unusually low rates that are not consistent with the rates for other

northern states, 15 the nigher death rates can be said to be concentrated in

the north while the lower rates are in the east and the southwest especially if we transfer froK the southwest group Xwara State which politically and, to some extent, culturally belongs to the croup of northern States with which it shares similar socio-econocic characteristics.

Estimates of the denth rats fron other sources are presented in Table 2 for the four pre-lV67 political sub-divisior, of the country. Tha first set of death rates (,i) are those from the FOS survey while the second set (b) are based on the aj>e structure of the 1963 census population. Considering the estimates presented in Table 1, it would appear that the first (oririnal) FOS estimates of the death rate for the four regions separately, in spite of the:

authors's reservations, Improbably represent more accurately the mortality

situation in these four regions vita the exception of the lid-west region whose rate seems too low. If comparison is based on these (excluding of course, the Kid-west region) we have evidence which shows that the northern Region has the highest mortality (22.:)) followed by the Eastern kepioi) (20.4) and finally by the Western Region (13.G).

Combining the Eastern, Western and ?-id-west T.*e?ions into one f:,ro,up (south) and further adjustment of the data by the FOS yielded for the two broad sub-, divisions of the country (North and South) death rates.of 25.(> per thousand arid 20.4 per thousand respectively and 23.4 for iliperia as a whole. :Furhter adjustment of the data, which as hac, been pointed out was overdone,, resulted . in an overall Nigerian rate of 26.;,' which is markedly different from estimates . made for Nigeria arounjl the same period and may therefore be disregarded. :

In other words, vdth further adjustraer.t, the /forth still shows i hinner incidence

r/O?\14/POP/152 Pare 5.

"of mortality which Is about 25% above that of the South.

The second■■ «'et of death rates (b) in'Table 2, shows rates that are similar to, the FOS adjusted rates for Norfh; and South. It will be

observed that the overall Nigerian rate is 23.0 which is different from the FOS adju-sted rate by only G .4. If adjusted estimates were available from the FOS study for the southern regions separately, they would

probably be close to the second set of death rates (b). Fere apain, the north-south mortality differential persists and can therefore he

regarded as real. ;

The age-specific death rates commuted directly from retrospective

information on deaths in the household in the previous twelve months are shown in Table 3, They are so erratic, especially from about the age of 20 years, that they suggest the presence of gross errors attri butable in the main to memory lapse and age misstatements. In some

cases, the rates are so incredibly high as to suggest a life expe ctancy ?t birth as low as 20 years and fn other cases, they are so low as to suggest an unusually high expectation of life at birth

of 65-years. In terms of accuracy or.plausibility, the Southwest phase of the FFFP-KAP survey from which the data were derived yielded the best results (assuming, of course, the appropriateness of the-method of

appraisal). The northern phase, understandably, yielded the poorest

results. '

, Although it seems from the crude data that the southwest has the

lowest mortality level, followed by the east and lastly the north, age by age comparisons are rendered difficult because of these irregularities and it is obvious that for proper comparison the data have to be adju

sted somehow. Even though the method of adjustment itself is liable to errors, the results would be nuch better than and are certainly to be preferred to the erratic rates of the original table.

The adjusted rates are shown in Table 4. For the purpose of the adjustment a number of assumptions had to be made. These are:

i) that the figures are not totally useless and that at least some of them, especially in the younger ages, reflect some-

. what the level of mortality in the population;

ii) that the expectation of life at birth for the populations in ; 1971-73 could not have been higher than 50 years or lower

than 35 years. This automatically restricts the range of

selection, and the mortality level of a repion is determined

on the basis of the frequency of occurrence of a level of mortality following age by ape comparisons of the rates with Coale and Demeny "North'1 model life tables. 1S

It seems from this table that, the pattern of regional variation of mortality observed above persists. This is true also of the implied expectations of life at birth presented below the table and the info

rmation presented in Tables 5 and 6,

e Ther? ;S indent literary evidencein support of the north-south ferential in-mortality. It would appear that this differential is a reflection,of differences in the level of education,

in the prevalence of important causes *

E/CN.14/P0P/152 ■

Page 6 " .

of death (yaws, leprosy, cerebro-spinal meningitis, syphilis, influenza, smallpox, etc.). in -the provision and use of medical facilities,,, in the supply? of medical practitioners and para-medical personnel, which is linked with the level of educational development since the more edu cationally advanced, areas are able' to produce more indigenous medical personnel in a situation of general shortage.

In addition to diseases prevalent in all parts of Nigeria and hence also in the southwest where no special diseases were singled out for report - small-pox, intestinal infections, malaria and. tuberculosis the Northern Region was particularly noted for annual epidemics, of

cerebro-spinal meningitis which usually occurred in the dry cold season.

Mortality arising from reported cases of this disease was excessively

high. .

In'a report on health.in the year 1952-53, ttie following: remarks were made: "It is a saddening reflection on the present inadequacies of our medical services that the state of health of the African popu lation can only be assessed from year to year in;terms of.the presence or absence of natural disasters like famine or plague* Considered in these terms, 1952-53 was a better than average year,.. The great . - : endemic diseases, however, continued to take their toll of life and limb,,,. Narrow advance were made in certain sections, notably in

leprosy: control and the elucidation of blindness due to onchocerciasist but the decisive battle remains as yet unjoiried."19

In another section of . the , report, .the following remarks were: made on the high incidence of syphilis: "The venereal diseases constitute perhaps the most serious, certainly the most refractory, disease

problem confronting the Region at the present time. In 1952*53, the combined hospitals of the Region treated 25,015 cases of syphilis, alone with thirty-nine deaths, 'and m-any more thousands of cases were treated at the Native. Administration dispensaries... Given the present social organization^, characterised as it is by polygamy, purdah and widespread prostitution, re-infection after successful treatment' is almost

inevitable, and the prospects of controlling the disease are slight.

Certain Native Authorities have made valiant, attempts to tackle the problem of prostitution by edicts banishing prostitutes from towns or forcing them; into marriage, but the results, as might be expected,

have been very transient • *'2O : . . ..

The.Eastern Region was noted for leprosy and yaws. In fact, a leprosy.-service was initiated in the Region in , 1927 by the Church of Scotland Mission at Itu, Uyo Province. This was followed by the

establishment of the Uzuakoli Settlement in Umuahia Province by the Church Missionary Society and the Oji.River : Settlement in Enugu Pro vince by the'same Mission in 1932 and 1936 respectively. The gove rnment leprosy service which was established in 1945 absorbed the Uzuakoli and 0ji River settlements and became responsible for leprosy control work in the former Ortitsha, Owerri and Rivers Provinces.

Early in 1957, a network of treatment centres similar to those in the

government control ,areas was gradually being extended through the , ,", provinces. Anti-leprosy drugs for mass treatment were supplied by

WHO and UNICEF in 1953, By 1958 there were about 500 leprosy units in

the Eastern Region.21 Although the virulence of these diseases has been

considerably reduced, they are probably responsible for present patterns of variation in mortality in Nigeria.

No mortality indices separately for urban and rural areas are available

17CIT. 14/POP/152 Pat-2 7

for the Uorth. The discussion of rural-urban dif fere-Titials in nor tali ty will therefore concern the southwest and the east. In terms of the cru<la death rate there is a distinct difference between the urban aud the rural area. Althourwi soraa of this difference can be attributed to saraplinf variability, the

differences (except in Lagos State where it is understandably small av.6 in Ewara.State.where urban is surprisingly higher than rural rnte) ere so lar^e that they can-be-accepted as valid* They are due to the concentration of medical facilities in.the urban centres, especially the. capitals, to the virtual neglect of the rural areas. This is what the basic health services scheme proposed in the 1975-'.O development plan seeks to correct.

This fact is also reflected in the data in T-iblrf 5 for south-west Nigeria only. It is, however, not possible to say if the distinct differentials by age observed here would have characterised also the east and the north if the relevant data were available.

In a study of chilJ mortality in the old Uestern State -and Lapos State, Caldwell found that the schooling of irothers hrd a significant effect on child mortality. In fact, maternal education was foun:? to be tue single most significant determinant of the marked differences in child mortality. Fven where medical facilities are grossly inadequate, as in rural communities, mother's schooling has a decidedly beneficial effect on chile mortality

(Table 0. as Caldwell himself puts it, "These differentials are also affected by a range of other socio-economic factors, but iio other factor has the impact of maternal education So important is it that it «oes far towar.-s raiti- 3ating the child mortality impact of the presence or absence of nerjical facilities in the area of residence."z'-

A fact that further stress the importance of mother's education is that where the fatlier has never been to school but the mother has had some secondary

school education, child mortality expressed as s. percentage of the highest child mortality in each group is 15% whereas if the father L.is had at least sovae

schooling but the mother has had no schooling, the ratio junps to 73/ - ->r.

indication of relatively high child mortality.2 Table )t presents further

evidence on tlie close association between mother's education and chile mortality

by a:;.e.

As already metuioned, the availability of medical facilities is an

important determinant of mortality level. T.ut even where there are no hospital facilities, there is, as was found in another study in some rural communities in the old Uestern State, a marked difference between educated and uneducated parents in t-ie application of drugs sold by pb.armactutical stores or hawkers and this different is clearly reflected in child ^ort^lity."'

EVIDUXL FOI: I-'OUfciLITY DECLINE

It is not easy to piece together tue available mortality dstr-. in ° clear and consistent r-anner in or<;er to show i tre:i'. Aii attempt io, Uovravcr, r,ade in Table 10 to explore the possibility of nortnlity decline in Ilirreria. If the rates for the three yaars 1932-53, 13C3 and 1.71-73 are comparable, then it may be said that mortality as measured by the crude death rate declined by about one-fifth in the first decade and by about a thirv. turouphout the whole perioj

under consideration.

Paje G . . , . :

Although vital"; registration data in Ki^erln are unreliable "Lec/*.us'e of the problem of grossly incomplete registration anA very livdtoc" "cover-ire, ih' t'e various .area where registration was'done, the infant mortality rates 'derived were (probably up to the 1*5: fs) usually in tue rai^e 20 ^3-^ per thousandlive births. The estir-c.ted rates in TaMe 11 for IS 31 lend sor.e credibility to the vit.-.l re-iatration figures. In terrs of decline iii iE.f.tnt p.ortalitv

it would' appear that all ,ireas of rijreria L.ive ei^>erienced v. ^eclir.e to varyinp letween ly-31 and 1^71-73.

Life expectan-ey at birth seems to hnve incren.se;} over the period 1"?31-1^71- 73; so also ins life expectancy ^ener-liy as B-iovn in fct les' 12' and 13. Put differently, mortality by a?e seems to h.ave declined (Table 14). ;'on mich of this apparent decline c;iu te attriljutcd to in<adequanci*is in the r.ethorolory used aiiJ how much to improvement in health coalitions is difficult to a*.y.

The consistency-of the differentials, however, inclines one to the belief ti*at mortality Las indeed declined.

F/C^.14/POP/152 Vare '.'-

COKCLUSIOIv*-- -

The data presented in this paper give sone evidence of mortality differentials in, Siberia - differentials betveep. the north and. the south, between tlie urban and the rural'area and between those who have had formal education riud those who have had none. T.;.;r;re is also some in.lic*tion of ,?

decline in mortality between l?3v (-* year vhich way be regarded as virUti? the end of a period, of very, high aud fluctuating nortality in I.i^eria and the

bepinnin? of a period of gradual decline) anc. 1970. The nature of t4ie available data, however, makes a categorical statement on this point a little difficult.

All one can say is that there is ;\ hirh probability tlvit overall mortality has declined and continues to decline with progressive improvements In the general, standard of living.

There is hardly any doubt that the sta«e is set for rapid mortality declines in the next decade considering the fact that more nedical and health facilities are being provided and are now more evenly distributed■especially•

since, tike creation of States in rx>7 and 197C. If the basic health services scheme takes off as expected, mortality uill certainly decline nore rapidly than it Uas ever done in the past fifty years. ;7hat is not so sure is whether or not the mchinery for assessing the impact of the various health measures will for some time to come be adequate for that purpose in spite of the

inauguration on September 1, 1979 of a compulsory national vital registration

system.

1./CN.14/PGP/152 1'age 10

'■foxrr /Ti f:rnr.;.,c-.,r

X. The Federal Government's allocation for its proper \ asic henit cervice scheme Jurir.? the current plan ;;erio 1 (1: 7!)-> ) is N51jn.r<e sc/c^n ic aimed at erailicitinp coiraMiricibla .--r^5 parasitic ^isp^sea with orp' -sis c the rural areas. See Third ■ National *)cv3lopnent M«a 1^-75-^. Vol. 1, ??

2.0,. Oiusanya, "Operational problem of - vitil r^ ?str-t;ioi> yy-t ^ i~

li^eria," ITlserlfti,-Opiate*, Vol. 5, ,os. 5-7, lu , p-.^CWkI1^. ' See, for exanple, P.O. ciusanya, "Minl-UrL™ futility aiffercntialn i

western iiiferia," Popul itiop. Studies, Vol. .■/:, f.'o.3, 1:;CS.

Gyor&y Ascudi, A.A. I-un *nd Gwendolyv. :'. Johnso-.\t purveys of Fertility

Family aud Fanily Flmminr in Nigeria, l/aiversity of Ife, differi^ • T^*-

Publication 'Jo. ;;, 1:72.

0. Ayeni, "retrospective estimates of mortality from the ^"i^-riar :'eiic.il

censuses of 1-J3O-1932: A research note," Tha ::if-ori^n Jourual of Fccniwaic and Social Studies. Vol. 1^, .Jo. 3, 1V7C. ^~~

Federal Office of Statistics, Kural JJepo^rapliic^gmple Survey l"C5-l'<f'

Laros, l;06,i, pp.1-2. " . ■ : ' : *"

Ibid., pp. 12-16 Ibid. , p.22

l^y £om» Recall Lapse iu "enorrapbic rr.quiries, /si- Tublishii-- "ouse, rop

10. Pierre Crmtrelle, "I^ortglity Levels, patterns ?:v' trenrla," in J.C. Cil^wel

(ed) Fopulatlon Growt'-. .-ino rocio-econoniic Chanpo ir. Vest Africa, "ew Vori.:

Columbia University Press, 1^75, pp. lui-11.

11. P.O. Olusauya, "Population Growth ?.nr itn Coripontntc: The natur

diti of population c?».inpe" in J.C. CalJwcll (gj..) op.cit. ^{e i;:}

12. 0. Ayeni, jtemoprapiilc Characteristics of iii-eria: /ir. Analysis of

Population Data from I<J31 to 1965. Ur.publiaiieJ Ph.D. (London) thesis, r-74

13. FOS, Op. cit, p. 31

14. F.O. Olus^nya, "Population growth :m/. its coaporonts " in J.C. C;ild«ell

(ed.) op.cit, p. ?t:0

15. AccorJ.inj-: to a report on medical servicec in t:«fc lortaern Keciou of Liberia,

death registration in V^no City vvis 5'*;^ complete «i«i the estir-iteu CPU

for 1V52-53 wis ,?3.:j per lC-:n on c;,e basis of wirc'^er of burlilr. Ceo, Northern Re«ior^.l Government, Annual Keport or. the Lepartcient of ; eclicil Services of tiie ilortlicrr. -aPion of :Tij^eri.i, 1. ;:2-53, p.22. Alt'jourl. consi derable inprovenents 1l. v.ealth have l.eeu achieve-!, the death rste"for

E/CN.14/POP/152 Page 11

16

18

19

22

23

24

Kano State cannot possibly be as low as for Lagos.

Ekanera and conclusion

shows CDR's

Farooq think is, however, of 20,2and and ("Suncrrtnrastv - See I. I of pplLul.atj.pjj, change in

of Economic and Social Studies, Vol. 18., No. 1 rates from the second set are respectively M.O. Wogugu and I.I. Ekanem, "Mortality and

that there is a differe based on the fiicL set 13.9 per 1000 respectiv

Ekanem and G;M.- Farooq southern Nigeria'% The

\ce. Their of data which ely for East

, "The dynamics Nigerian Journal

The See

planning in Nigeria:

University of' Ife, C

A regional perspective", 1979, p. 25.

, 1976, p.55, 19.3 and 18.9.

basic health (memeographed)

17. FOSj op. cit. , p. 22

A.J. Coale and Paul Deraeny, Regional Model Life Tables and.

Stable Populations, Princeton: Princeton University Press, 196-6 • Comparison with Brass one-par an eter model life tables alsp gives similar results: Level 50 or e° = 45 for the

southwest, level 40-45 or eg = 4C.0-42.5 for the North, Level 45-50 or eg = 42.5-45.0 for the Fast, and Level 45 or

e°, = 42.5 for Nigeria. See N. Carrier and J. Hobcraft, Demographic Estimation for Developing Societies, Population Investigation Committee, London School of Economic, 1971. , The central death rates shown in Table 4 were obtained by interpolation- between two levels of mortality.

For more details of the health situation, see Government, op.cit., 1952-3, 1953-54, 1954-55 1957-59 and 1961.

Northern . 1955-56

Regional

20. Ibid.Y 1952-3, p"p.l"6V31.

21, Governient'oF "EasTern "Nigeria, Progress' Series on! Medical

Services <1) , C. 1960, pp. 6-3.

J.C. Caldwell, "Education as a factor in mortality decline: An examination of Nigerian data," Changing African Family Project University of Ibadan, 1973, "p.28. '

Ibid., p. 19.

1.0. Ourbuloye and J.C. Caldwell, "The impact of public health services on mortality: A study of mortality differentials in a rural area' of Nigeria." Population Studies, Vol. 29, No. 2, 1975, pp.264-267.

E/CN.14/POP/I52 Page 12

Table 1. Crude death rates per 1000 population by Region/State

and rural-urban dwell inn, 1:171-73

-

Region/State NORTH.

fcenu Plateau Kane

Morth Central North East North West

LAST

East Central Rivers

South F.ast

SOUTH WEST Lagos West Kwara Mid-West

NIGERIA

Crude death ratea

Urban

5.3 IB.7 .

9.9

16.2 9.0 15.7 30.1 16.1

-

i

Rurnl

■

22.9 21.2 • 33.A 13.4

21.1 11.5 20.5 23.7 21.4

-

■

Total

20.2 ICG

31.1 \

17. .V

13.9 y.o 17.3

?5.3

-

Crude deatl rate

22.7

ic;

15.0 32.5 31.1

19,3 10.0 27.5.

16.9

i:.9 9.6 13.5 24.9 2~,.«

20.6

Source: (a)

(t)

I.I.Ekanem and G.M. Farooa, "The dynamics" of population change in Southern Nigeria", "The T^ir-erian Journal of Economic & Social Studies, Vol. 1£, l-To. 1, 197C, p.69.

At the time of writing this article, &Af\ fror: the northern ph.ise of the 1971-73 n3tion.il KAP survey oa which the article was based were not yet available.

M.O. Wo^u«u and I.I. Tkanem, "Mortality and basic health planning in Nigeria: A regional'perspective"

Unpublished manuscript, Department of

Social Statistics, University of Ife, ^iperia.C 1970,

p. 25. ' r

F/C17.14/PCP/152 Pare 13

Table 2. Crude death r^ites per 1000 population (Estimates from, other source's) ,"1963-1066, by Reflion

Repion

Horth

E;ist

West

Hid-West

Nigeria

CDR(g)

20.4)

18.6) (20.4)

14.2)

(c)

26.9(d)(23.4)(c)

era

25.4

20.7

21.?:

25.6

23.0

Source: (a) Federal Office of Statistics, Rur-^1 Demographic Sample Survey 1965-66, La^os: 1968 p.7.

(b) F.O. Olusanya, "Population growth and its components:

" The nature and direction of population chance" in J.C.

daldwell (ed) Population Growth and Socio-econor,iic Change in West Africa, Uo.w York: Columbia University Press, 1975, p. 272.

These are existing political sub-divisions of A before the creation of 12 States and subsequently 19 States.

(c) Rates obtained after weighting original results with the proportion of the rural population in each region.

See p. 12.

(d) Obtained after wei^htinf and rejection of sample

units rmd adjustment for possible incomplete recordinp of vital events.

14

l'J.\ le 3. A;.e -Specific ;.'ej*,th .'rates, (per IK'O) by rciprs of ::irdri^, X:?71-3'Uotl?.se3-^-3)

/re

i 5 r.

li,

*;•

3;;

35

45 5;

55

■, j

-reap

x 1 - 4 - i.

- 14

_ i ■'.

- 3'i - 3'-

I H

- 54 - 5..' - 64

Couthx-est l^l.f^

U.7 9.4 3.5 5.2 7.-J

4.6 6,9

7.1 12..- 15.4

•'..'■. "^

(t)

/ll -i-eria^'^

117..

13.3 7.1

7;

11.2 47.-:

11,.3

11.1 5.u C.'' l(:.i

2. -

y.3 ,>.i

.*.'•■

■, r

2j.7

r -

i: ..6

— .'•■'

ii.o 5.":

7.7

0.4

10.7

ic;

Source: (m) L./., ACsokur. (fid) 1.71-75-I'-ation:,! Survey of Fertility Family -int i'arlly Planrtirif^ gu_astJ I: fouthvest "ineri

.£'?. *.ono7r-iph i!o. I, liriversity of Ifc, :3iperiAf

(L) :..O. ':o- u^u fvA I. I. :=I,«ritiw, op.cit., p. 2^

:./c;ma/pop/152 P.i-p IS

Table 4. Age - Specific death rates (1000 ix) by

region (?oth sexes), 1971-3 - Adjusted rates.

i - 5.- 10 - 15 - 20 - 25 - 30 - 35 - 40 - 45 - 50 - 55 - GO - 65 - 7C -

7S "

3 Of

>_ ~

t

■ 4

■ 9

• 14 ' .19

• 24

■ 2)

■ 34 35

, 44

■ 4'J

■54 - 59

• 04

■ 'o) 74

■ 79

- ■ ■

Southwest

. 149.1C 2d.24 9.21' 4/6.

5,42 7..06 7.75 3.51 9.32 11.41 13.23 10.75 22.5o 32.03 47.:^

74.1C 112.12 .. 225.53

:■ ortL

165.46

'■' 32.a-

17.17 5.52

7. -7

9.64 11. IV.

l;:.72 14.70 10.44.' 24.52 35.14 ,52.04 SO. 33 l<>0.53 2.32.74

. ^s.t

3i.^

14.73 5.41 5.96 7.73 H.50 9.46 li».^0 12.5 ■ 14.45 lii.13 24.14 34,69 51.33 7':\27 119.10 231.59

All Ti."eria

..K.1,4!) 31.7;

1^.37 5.3v ...

5..=5 . . 7,>7 . D.^ .■

%^3 1 .77 . ■ 12.4u , . . .14.41

10.13 . 24.0* . . Vi. G2

51.22 7?>.1P .

■■■•'- ■• ■•.

231.41

Implied

44.89 41.92 A2..A1!

E/CK.14/POP/152 16

Table 5: Mortality (gx) per 1000 by a<*e, region, sex and rur^l-urVar residence, 1371-73

A G SCUT17 TST. "IGFRIA

Urlari Rural Tot^il

V

VASTTK1 NIGERIA

1 5 10 15 20 25 30 35 40 45 5o 55 oC 65 70 75

74.

32.

13.

22.

31.

32.

34.

3L-.

47.

60.

■;i.

111.

162.

22-;.

335.

473.

631.

,4

,3

i -j

2 7

6 5 8

4 4 3 7

4

>'■>«

74.

. 32.

- 13.

. 22.

. 30.

- 32.

. 34.

- 3D.

■ 47.

6u.

• U.

110.

161.

•22,1.

335.

473.

631.

,6 .4 .4 2 6

^

5 4 4 2 li 4

';

3

4

?■>

3 1

oq t

IS 3ti.

15, 26, 36.

31.

4ti.

45.

54.

c*.

:1.

i.r*.

177.

k44.

350, 4E4.

636.

■1

■V o

■■>

7

i.

?.

V

5 1 9 7 1 4 4

>";

7

9.1.1 'J 2.2 39.^

IG.fJ 27.1 3G.r

A0.4 46.2 54.7 6y.4 ,■2.4 i?.4.i;

177.4 245.*;

351.1 4;;5.o 636.1

90.?

UJll:

■ 36.2 14.7 25.0 34.3

■ 35.7 37.7 43.1 - 51.4

■■ 65.'I - S7.6 ii;;.2

■170.5 '■23.-U:

344.U 479.;:

634..?

51,7 33-X 36.4 14..

't i: i

34.4 3C.fi 37.^

43.3 51.5 f-5.--,

■!j". .0 ir;.7 171.5

?.?>*..*>

--342-1 4'. 2.5 634.2

119.

112, 25,

20.

43.

45.

32, 57.

. "■ 3.

1 ■/■

139.

r.7o.

- 3^.- 51?.

C63.

r

,(:

.i

4 3 5 4

j

^_

2 i C

4

r.

-

9 3

He

121 ::■':

5 A"

*? ^

45 47 5/, f.5 -,2

!'.'■

I'.u 2-7.

25;, 4-2-0, 32?, 519.

.2 .7 .7 .e

.5

, ^

* -

.f .5 ,f

.3 .5

r-

> c

.1 .5 Source: Derived from I.I. rkp.nen and G.::. IVirooq, op.cit., pp.70-72

I/CH.14/POP/152 P.T-ii 17

Table 0: Life expectancy hy ap,e and regions of

'■'• ■ :-ii?.eria Gotir sexas), 1^71/73

':*. T 0 A G ]■■

Torth.Tost

1 5 10 15 2) 25 30 35 4u 45 5'5 53 C.i 65

3£.l 41.7

43.9 40.4 37.3 33.3 2a. 9 24. v, 20.:

17.C 12.3 10.7 6.2 4.4

/:7.3 51.1

44.:- 4... 4

4:-.v 44.2

:7. ■) 40.3

33.1 3-?. 3

lV.v.5 32.3

li.'. . 2-,.G

14.5 10.3

11.4 12.2

7.7 O.1:

4.^> 4.6

Source: Ii.O. •,"o«u,tu end I.I. nkanem, op.cit., p

V./CS>.Uf£OP/152

Table 7: Life expectancy ly .apo and sex, :ii^eria 1965/uc. ant1. lf>71/73

■ g r,

0 1

10 15 tvi 25- 30- 35- AC 45 50- 55 (X 65- 70 75

37.?

4^.5 4^,3 4C.G 42. j 39,2 35.5 31.6 27.3 24.1 20.8 1-M 15.3 12.5 10.2

< .1 J.Z

?C.7

• 43.2 47.3 44.7

• 41.2 31: .1 34.6

■ 31.1 27.j 24.1

■ 20.7 17..v

■ 15.2

■ 17.4

■1G.(-.

n.5 7,-;

■ r;71-73(b)

T

4( -,C 44.6 4C.6 45.9 42.3 3'J. 5 36.7 32.9 2n.j

24. ^>

21.1 16."

13.0 ' .5 4.<

F

4A.0 4f- ■ 3 50.2 AC.

43.'.

39.:;

36.1 31.5 27.3 :3.5 19.7 15. r 13.4

4.''

lource: (a) Federal Office of Statisticy, op.cit., p.2\

(b) lr.O. V'Ofugu and I.I. rk-ineir, op.cit., p.2£;<

E/CIM4/POP/152

Table 3

Child mortality incites by typ-:: of community and nother's

education, IP/3 ~ "™

Type of Coioraunity

City Town Village

Mother's Education

.Prti&iry

Schooling only At least none Secondary schooling 37

74 51

25 43 46

Source: J.C. Caldwell, "Education -is * factor in mortality ,'cclinc: Ar.

exanmation of ili^erian data", Chas^lns African r^mllv Froiect, University of Ibadan, 1973, p.?jT. " ~~ * i

TabXe 9: Pr°Portion of children dead by ape and education of not1'

Ibadan City, tiifreria,. 11*73 " "

AGE

No

Mother's Education Primary At least some

Sci-oolinf only Secondary Schoolinrr

.030

others

Source: As in Table '<

E/CN.14/PCP/152 Page 20

Table 10: Crude death rates per l.yOO i^eria 1052-1973

Date Cruffe death rate

1952-53 2o.4(a)

1063 7.3.0(b)

1905-66 ?.6.9(c)

1971-73 2O.G(d)

Source: (a) P.O. Olusahya, Socioecbnonic Aspects of Rural-urban Miration in ties tern Nigeria-, Ibadan: NISER1 1969, p.153.

(b) P.C Olusanya, (As for TaMe 2 above)

(c) Federal Office of Statistics, op.cit., p.22.

(d) Worugu & Bkanen, op.-.-^,, p.25.

NOTE: Rates marked (i) and (b) are estimates b«ed respcctivoly on the age structure of the 1952-3 and the IOC3 census populations,

Table-11 r■ Infant mortality rates per 1,0'JO live births, by Fenior, 1931-;

Region mt(a) IIiR('b) IIT.(c)

West 223 149.16

Ilorth -215 1C5.40

East " 214 161.91

215 173 ' 1C1.45

NOTE: (a) Estimates for 1931.0. Ayeni, "Retrospective estimates o.

fiortalityfrom tVie Hi»eriav ,-edical Censuses of 11J3O-IV32:^

A research note", The Uir>erian Journal of Economic and Social

Studies, Vol. 1',, Ho. 3, 1976, p.463

(b) Federal office of Statistics, op.cit., p. 20. Estimates for

(c) Author's estimates for 1971-73 based on data fro-; Voru-u and

Ekanem (op.cit.)

Table 12: Expectation of life at birth by Region,

i/ai.H/POP/152 r.i«e 21

ia, 1931-1C73

Repion

e o(a) e°o(b)

(1^31) (1953-3) ^{e o(c)}(1963) (1CC5)

e o(e) (1971-3) Nigeria

North

East

West

ilid-Uest

31.87

31.S7

31.95

30.55).

35.0

37.3

42.2

3S.4)

41.3)

42.3 3--.1

.39,5

Source:' (a) 0. Ayeni, op.cit., p.4i*3

(b) P.O. Olusanya (As for I$Me 10, note (a).

. (c) P.O..Olusanya (As for Table 2, note (b)

(d) 0. Ayeni, Demographic Characteristics of . ireria: An Analysis of Population Data from 1931 to 1965.

Unpublished Ph.D. (London) thesis, 1974.

. (e) VJogugu .1- EUanem, op.cit., p.2C. ■

E/CN.14/POP/152

Fage 22

Table 13: Life expectancy by age and Re; ion (roth Sexes), Nigeria, 1931

and 1971-73 ;- ■■-■ " : '~~i

A£e Life Expectancy(1921)a) Life Expectancy l"71-73(b) ' North- liast flitter ia J! West North "East Nigeria fc) 0

1 2 3 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75

30 3U 41 42 43 41 37 34 32 29.

26.

23.

20.

17.

14.

11.

>- 7.

2.

Source:

.6 .5 .6

■ c

.U

.5 7 6 0 1 1 1

1 4 9 7 7

*.*

(a) .31. 5

39.5 42.4 43.5 .43.7 41.5 3C.1 33.7 29.G -tf.7 25.6 22,5

w:r~

16.3 13.4 10. G ii.O 5.3 2.1

32 3:

42 43 43 41

in->■-■

35 32

"29

26 23

17.

14.

11.

y.

7.

5.

Conputed .0 .5 .5 .5 .7 .9

•1 _ .0 .2 3 3 1

X

4 7 5 3 5

from 31

42.

43.

43.

41.

..3S- 35.

32.

23.

26.

,23'

.20, 17.

14.

11.

9.

7.

5.

0.

9 5 4 5 7 9 J.

0 2 3 2 1 1 1 3 7 4 3 3

i ii ii

ii ii

!i ii ti . i i

1

it ii

'

■i

1

i

■■

ii

■!

i I i

ii

ii

i i i1:

■ i

iiti

■ i11

ii

Ayeni 44

i

-

51.

'rO.

-44.

fiO._' 3".

32.

24.■

20.

16.

12.

r

4.

» op

0 3

1 4

*>

3 3 3 6 5 6 3

■i

0 6

.cit 3.«3 41

45 43 M) 37 33

24 20 17 12 10

4 .1 .7

-

-

.9 .9 .4 ,3- .3

p

.0 .9 .7 .?

.4

pp

3T.

43.

—

A7.

44.

40.

37.

35.

30.

26.

23.

V6.

14.

11.

7.

4.

5 ' C

3 3

o

0 1 5

Q

r

5 4 7 5

.467-46:.

42 4-'

_

49 LI

■43 39 36 32 22 - 24 20 16 13

4

.3 :

.5

.4 .0 .1 .7 .4

.2

.2 .4

* /.

.2 .4 .6

(b) I-'ogugu & Ekanem, op.cit., p.29.

(c) Average of male anr fcnale life expectancy,

'7CN.14/PCF/152 Pace 23

Table 14: Age-specific mortality rates per 1,000, Nigeria 1965-66

Age

-1 1 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75*

la) - 4 - 9 -14 - IS - 24 - 29 - 34 - 39 - 44 - 49 - 54 - 59 - G4 - 69 - 74

and 1971-73

FOS Survey, 19G5-66(a)

K 11,4.3

53.2 9.5 5,6 6.4 6.9 6.6 8.G 9.7 15.5 23.8 26.1 31-1 47.7 63.1

129.3

F 172.4

50.1 10.3 7.3 9.7 3.3 9.0 9.4 12.3 13.7 22.5 23.5 32.5 54.3 61.2 69.2 126.9

IJ *■

178 51 9 6

7 7 9 11 14 23 21 31 51 52,

94 121'.

Federal Office of Statistics, .4 .7 .9 .3 .1 .6 .3 .0 .3 .6 .2 .3 .8 .0 .2 .2 .4

op.cit.

FFFP-KAP 1971-73(b)

IT & F 161.5 31.«

14.4 5.4 CO 7.9 8.5 9.4 10. C 12.5 14.4 l?.l 24.1 34.6 51.2 79.1

, p. 25.

(b) Figures are taken from the last column of Table 4 + Average of V, - F rates