Determinants of under-five mortality clustering in a health and demographic surveillance system in Zamfara State, northern Nigeria

Despite global reduction, under-5 mortality remains high in most developing countries and tends to cluster among certain individuals, households and communities. We assess levels and factors influencing under-5 mortality clustering in a rural setting in northern Nigeria. Data were collected from January 2011 to December 2013 at Nahuche Health and Demographic Surveillance System. Binomial distribution and Poisson regression model were used to assess family level clustering and factors associated with under-5 mortality clustering. Results show that there was under-5 mortality clustering, with 5% of the compounds accounting for 35% of all deaths. Surviving beyond infancy was associated with reduced incidence rate of under-5 mortality clustering (p<0.05). Child’s age, source of drinking water and type of provider at delivery during the most recent birth (p<0.05) influenced under-5 mortality clustering. Findings call for evidence-based policies to reduce under-5 mortality.