Social determinants of morbidity among under fives in a rural community of North-Western Nigeria

The United States Centers for Disease Control defines social determinants of health as life-enhancing resources, such as food supply, housing, education, and health care, whose distribution across populations effectively determines length and quality of life. Every community has social determinants of Health which can affect health either positively (wellbeing) or negatively (morbidity). Understanding the determinants will aid in policy formulation and design of appropriate interventions. This community-based cross-sectional descriptive study was conducted to assess social factors that determine morbidity of under fives in Gimba village, a rural community of Kaduna State, Nigeria. It was conducted during Community Diagnosis field practical posting of trained final year medical students of Ahmadu Bello University, Nigeria, in July 2012. An interviewer-administered questionnaire was used to collect data from all household heads in the community (total population study). Multivariate analysis was done using SPSS (Version 19). Children of uneducated fathers were more likely to have been ill compared to those of educaated fathers (RR = 1.20; 95% C.I = 0.78 – 1.91). Children who were weaned abruptly and transferred to their aunties or grandmothers (geographic weaning) were more likely to have been ill compared to those weaned normally (RR = 1.71; 95% C. I= 0.97 – 2.03). The result indicated that several factors like paternal education and geographic weaning are social determinants of health of under-fives in the study area. Improved access to formal education; Health education on effects of harmful cultural practices; community-based health insurance scheme and rural development are recommended.