This article is published by the Zamfara International Journal of Humanities.
Mamman Matthew Samuel
Department of
Sociology
Nasarawa State
University, Keffi
Nasarawa -Nigeria
matthewsamuel@nsuk.edu.ng,
Abdullahi Bashir
Idris
Department of
Sociology
Nasarawa State
University, Keffi
Nasarawa -Nigeria
abdullahibidris@nsuk.edu.ng
&
Salem
Igyundu-Iyorwuese
Institute of
Governance and Development Studies
Nasarawa State
University, Keffi
Nasarawa -Nigeria
sigyundu@gmail.com
Abstract
For adequate planning
at the national and regional levels, a nation requires detailed information
about the socio-demographic characteristics of her population. This paper
examines the implications of socio-demographic characteristics on death
registration in Lafia Metropolis of Nasarawa State, Nigeria. A survey design
was adopted. A sample of 384 respondents were drawn,
using the multi stage sampling techniques including simple random, systematic
sampling, clustered and purposive sampling techniques in the selection of
electoral wards, towns/villages, main streets, houses, households and
individuals. Primary data were utilized in the study. The primary data
were generated through the use of questionnaires. The questionnaires were
analyzed quantitatively using cross tabulation and chi-square. The study
discovered that demographic characteristics like educational level, age and
occupation of the respondents affect knowledge and awareness of death
registration in the study population. Therefore, the study recommends that
Government, donor agencies, and relevant stakeholders should be more proactive
in improving and strengthening the death registration system in the country and
there should be massive sensitization and awareness raising in the country on
the importance of death registration
Keywords: Socio-Demographic Characteristics, Death, Registration, Metropolis, Lafia
Introduction
For adequate planning
at the national and regional levels, a nation requires detailed information
about the socio-demographic characteristics of her population. In their quest
for social and economic development, developing countries often struggle with information
that is incomplete or is not available at the time it is needed. Death
registration is a vital event that is registered in most countries. While death
registration in developed countries is done well enough to be useful for
determining population changes and planning, the situation in most developing
countries is very poor. The importance of registration of deaths registration
for national and local planning has not received adequate attention in Nigeria.
In Nigeria death registration started from the colonial era and is currently
carried out by National Population Commission, which was inaugurated in 1989.
Deaths are required by national laws and international protocols to be
registered through the civil registration and vital statistics system (CRVS).
Death registration records are one of the most widely used national and
sub-national demographic data for identifying and addressing major public
health concerns (Brolan, Gouda, AbouZahr & Lopez, 2017).
Universally, each
year, about 38 million deaths, amounting to two-thirds of the 57 million annual
deaths go unregistered. Nevertheless, the usefulness of death records, in many
developing countries, including Nigeria, many deaths are not reported (UNICEF,
2020). Conceivably, one reason as to why they are not recorded could be that
many deaths occur at the community levels and outside health facilities, where
there are few trained physicians to assign the causes of death. Even when
relatives register death occurrences, available data suggest that registration
remains very low. For instance, the registration of deaths is codified in the
Births, Deaths, etc. (Compulsory Registration) Act of Nigeria since 1979, the
registration of deaths is still very low. The
completeness rate of death registration in Nigeria is at 17.5% as of 2020 (Zewoldi, 2019; United
Nations, 2021). Feasibly, to advance the capture the low registration of
deaths in the country, the National Bureau of Statistics in 2018 reported that
only 21 out of 36 States, including the Federal Capital Territory, submitted
records of deaths spanning between 2014 and 2016 (National
Bureau of Statistics, 2018). The reported deaths were without their
underlying causes, according to the agency. The low rate of death registration
in Nigeria is attributed to many factors. These factors could be summarized
into: citizen attitudinal problems and systemic failures on the part of the
government. On the part of the citizens, the negative attitudes towards death
registration that are often informed by cultural and religious practices and
poor funding, and the demand and use of mortality statistics on the part of
government are some of such reasons (Ukoji, Okoronkwo,
Imo & Mbah, 2019; Zewoldi, 2019).
Appropriate
registration and documentation of deaths confers on both the individual and the
country certain useful benefits. For the family of the deceased, a death
certificate ensures their right to inherit property, to access business and
financial entitlements, and to claim any available insurance benefits. It further
provides the country the data with which to compile accurate, complete, and
timely vital statistics that are central to estimating the burden of disease and the impact of
health-related interventions (United Nations, 2021). Consequently, every
government needs to know how many of its people die each year and the main
causes of their deaths, the requisite for having a well-functioning health
system. This evidence is collated and finally aggregated at the national level
to generate a national picture of the number of deaths per year with their
causes (Brolan, Gouda, AbouZahr & Lopez, 2017).
Similarly, the civil
registration and vital statistics system (CRVS), which supplies the most
reliable data on births, deaths, and other population dynamics is not adequately
funded. This results in incomplete, unreliable, and untimely vital statistics
for national epidemiological surveillance and public health policy formulation
(Brolan, Gouda, AbouZahr & Lopez, 2017).
Just like across the length and breadth of Nigeria, in Lafia Metropolis,
there is a pervasive and widespread misconception about the relevance of death
registration. Hitherto diminutive inquiry has been fixated on socio-demographic
characteristics driving this misconception and the resultant low level of death
registration among citizens in the metropolis. Level of educational attainment,
income levels, age of the deceased and occupation are characteristics or
variables in consideration to underreporting registration of deaths. Based on
the foregoing, the paper examines the implications of socio-demographic
characteristic on death registration in Lafia Metropolis of Nasarawa State,
Nigeria
Statement
of the Problem
In Africa countries
like Egypt, Mauritius, Seychelles, and South Africa, maintain a properly functioning,
compulsory, and universal Civil Registration and Vital Statistics System (CRVS)
system that meets international standards (UNECA, 2014). There are increased
efforts by national governments, international development partners, and other
numerous philanthropic organizations to scale up the registration of vital
events, including deaths, in many developing countries with weak CRVS systems (World Health Organization, 2019). The World Health
Organization, World Bank, and other partners have developed a Ten-year plan,
"the Global Civil Registration and Vital Statistics Scaling up plan
(2015-2024)", in the hope of providing the needed guidance to support
governments towards the achievement of this goal (World Bank, 2020). Other
charities and recognized individuals have also made financial commitments to
support the improvement of the CRVS in developing countries (Lopez & Setel, 2015). When deaths go unaccounted for and the causes
of death are not documented, both national and local governments cannot design
effective public health policies or measure their impact (Alarcon,
2007). Furthermore, having mere records of deaths and their underlying
causes is not only enough. This information needs to be universal, compulsory,
timely, and complete to have the desired effect in the public policy
decision-making process and good governance. Hence, data from death records
need to be timely, accurate, reliable, and complete to provide actionable
information on the economic burden of disease, understanding of disease
etiology, and their patterns. Nigeria's CRVS data, including death statistics,
are grossly incomplete and untimely. Therefore, they play little or no role in
driving evidence-based decision-making process, as major policies are anchored
on political correctness in the absence of reliable and timely population
data.
Population statistics
are a significant data source in the measurement of a population’s health
status, by providing the denominator data for calculating development
indicators. They are also the indicators used to measure the quality of health
care in a country and the level of access to health care in the population
(Alarcon, 2007). Poor data on these parameters can be misleading and could
drive suboptimal investments in the health system. For instance, countries with
well-functioning Civil Registration and Vital Statistics System (CRVS) systems
that produce complete and timely population data are noted to have better
health outcomes than countries with weaker systems. This is irrespective of other
factors that are likely to influence the health status of the population (UNECA, 2014). For instance, in Africa, countries with
well-functioning CRVS systems and quality population data ranked highest in
good governance. However, despite the opportunities from complete and reliable
death registration data, in Nigeria, only a small proportion of these events
are registered (Lopez & Setel, 2015).
In Nigeria, death
registration has not received the adequate attention it merits despite its
wide-ranging benefits. The last published data on a
national scale on death registration was in 2007, amounting to 14 years of no
national death registration data. Hence, little is known about the systemic,
political, cultural, religious, and socioeconomic contexts in death
registration. This lack of current knowledge about the underlying factors in
death registration and the consequent paucity of death statistics militates
against the drive towards meeting the Sustainable Development Goals, effective
public health interventions, and good governance (Makinde, Odimegwu, Udoh, Adedini, Akinyemi, Atobatele,
Fadeyibi, Sule, Babalola & Orobaton 2020).
In other to improve the quality of death records in Nigeria and with the
hope of driving Nigeria's public policy-making process with timely, accurate,
and reliable population data, there are ongoing efforts to scale up Nigeria's
Civil Registration and Vital Statistics System (CRV) system. One way to achieve
this is by digitizing Nigeria CRVS ecosystem. Notwithstanding this laudable
effort, there seems to be no well thought strategy to motivate or compel
citizens to duly register their vital events, including the death of relatives.
Given the underperformance of death registration across Nigeria, despite the
law requesting that every death should be registered, this paper examines the
implications of socio-demographic characteristics on mortality registration in
Lafia Metropolis of Nasarawa State, Nigeria.
Research
Hypotheses
The following hypotheses were formulated for the study.
1. There is
no significant relationship between death registration and education levels in
Lafia Metropolis of Nasarawa State, Nigeria
2. There is
no significant relationship between death registration and ages in Lafia
Metropolis of Nasarawa State, Nigeria
3. There is
no significant relationship between death registration and occupation in Lafia
Metropolis of Nasarawa State, Nigeria
Methodology
Lafia Metropolis of
Nasarawa State, Nigeria is the study location. Descriptive cross-sectional
survey design was utilized to elicit empirical data from respondents. This study will not cover everyone in the
total population of residents of Lafia Metropolis of Nasarawa State,
Nigeria which is 361,321 as at 2021,
(National Bureau of Statistics, 2022). The target population of the study
comprises of heads of households that have experienced death of love-ones and
or family members in the past five years (2016-2020). To determine the sample
size for the study, population proportion formula was adopted as the
target study population is unknown. The formula for the single population
proportion formula is showed below:
n = Z2pq
/ d2
The above formula is propounded by Susan
Rose, Nigel Spinks and Ana Isabel Canhoto (2015)
Where:
n = Sample size
Z = the standard normal deviate usually set
at 1.96 (which corresponds to the 95% confidence level).
p = the Proportion in the target population
to have a specific characteristic. If no estimate available set at 50% (or
0.5).
q = 1-p
d = the degree of precision, which the margin
of error is (0.05)
Calculation:
n = (1.96)2 (0.5) (0.5)
(0.05)2
n = 384
Therefore, the sample size for the study was 384 respondents. The study utilized using multi-stage sampling techniques including simple random, systematic sampling, clustered and purposive sampling techniques in the selection of electoral wards, towns/villages, main streets, houses, households and individuals. The data were retrieved through the questionnaire to elicit quantitative data. Bivariate analysis was utilized in the analyses of data collected from the field using cross-tabulation and the chi-square statistics. The bivariate statistics is used to test associations between variables
Results and Analysis
Table 1: The
Relationship between the awareness of death registration and Educational
level of the respondents |
||||||
Respondents view on whether they heard of
death registration previously |
Level of Education of the
Respondents |
Total |
||||
No Formal Education |
Primary |
Secondary |
Tertiary |
|||
|
Yes |
8 (20.00) |
21(46.6) |
80 (67.9) |
126 (72.4) |
235 (62.3) |
No |
32(80.00) |
24 (53.4) |
38 (32.1) |
48 (27.6) |
142 (37.7) |
|
Total |
40(100) |
45(100) |
118(100) |
174(100) |
377(100) |
Chi-Square value= 44.267a; df =3, Asymp. Sig. (2-sided) = .000 and Critical value =7.815
Table 1 indicates the cross tabulation result of death
registration and educational level of the respondent. Data in the table shows
that a larger proportion of the total respondent acknowledged that respondents
educational level greatly affect their knowledge about death registration. This
affirmed that respondents in the sampled population of the study educational
level determine their awareness about death registration. The chi-square test
shows that the calculated value is 44.267 with the degree of freedom df. 3 and
at .05 level of confidence and the critical or table value is 7.815 at the
degree of freedom of 3 and.05 level of confidence. Given that the calculated
chi-square value is greater than the critical value, it is therefore concluded
that there is a significant relationship between death registration and
educational level of the respondent.
Table
2: The Relationship between the awareness of death registration and Age of
the respondents |
|||||
Respondents view on whether they heard of
death registration previously |
Age of the Respondents |
Total |
|||
18-27 |
28-37 |
38 and above |
|||
|
Yes |
38 (48.1) |
142 (69.6) |
55 (58.5) |
235(62.3) |
No |
41(51.90 |
62 (30.4) |
39 (41.5) |
142 (37.7) |
|
Total |
79(100) |
204(100) |
94(100) |
377(100) |
Chi-Square value= 11.998a; df =2, Asymp. Sig. (2-sided)
= .002 and Critical value =5.991
Table 2 shows the
cross-tabulation result of death registration and age of the respondents. The
findings revealed that the age of the respondent has a strong influence on the
death registration with a large proportion of the
respondents acknowledging the influence. The chi-square test indicates a
calculated value of 11.998 with a degree of freedom df. 2 and at .05 level of
confidence while the critical or table value is 5.991 at a degree of freedom of
2 and.05 level of confidence. Given that the calculated chi-square value is
greater than the critical value, it is therefore concluded that there is a
significant relationship between the death registration and age of the respondents.
Table
3: The Relationship between the knowledge of death registration and
Occupation of the respondents |
||||||
Respondents view on whether they heard of
death registration previously |
Occupation of the
Respondents |
Total |
||||
Civil servant |
Business |
Artisan |
Farmer |
|||
|
Yes |
72 (73.5) |
111 (63.1) |
41 (58.6) |
11 (33.3) |
235 (62.3) |
No |
26 (26.5) |
65 (36.9) |
29
(41.4) |
22 (66,7) |
142 (37.7) |
|
Total |
98(100) |
176(100) |
70(100) |
33(100) |
377(100) |
Chi-Square value= 17.459a; df =3, Asymp. Sig. (2-sided)
= .001 and Critical value =7.815
Table 3 demonstrates
the cross-tabulation result of death registration and occupation of the
respondents. The findings showed that death
registration is significantly affected by the occupation of the respondents.
This denotes that larger percentage of the respondents affirmed to the
statement in the sampled population of the study. The calculated chi-square
value of 17.459 with the degree of freedom df. 3 and at .05 level of confidence
while the critical or table value is 7.815 at the degree of freedom of 3 and.05
level of confidence. Given that the calculated chi-square value is more than
the critical value, it is therefore concluded that there is a significant
relationship between death registration and occupation of the respondents.
Discussion
of the Findings
Study findings
unraveled that socio-demographic characteristics like educational level, age
and occupation of the respondents affect knowledge and awareness of death
registration in the study population. The findings were in agreement with the
submission of Brolan, Gouda, AbouZahr and Lopez (2017) that level of education,
age, occupation, income levels, age of the deceased and educational attainment
are variables in consideration to underreporting registration of deaths in the
world. There is a widespread misconception about the relevance of death registration.
Yet little research has been focused on factors driving this misconception and
the consequent low level of death registration among citizens. Income levels,
age of the deceased and educational attainment are variables in consideration
to underreporting registration of deaths. The onus is entirely on the family to
register vital events such as deaths. Assuming the family of the deceased is
aware of this obligation, it often requires substantial effort and can take
several weeks. This scenario in part further explains why so many deaths go
unrecorded. Similarly, the Civil Registration and Vital Statistics System
(CRVS) system, which supplies the most reliable data on births, deaths, and
other population dynamics is not adequately funded. This results in incomplete,
unreliable, and untimely vital statistics for national epidemiological
surveillance and public health policy formulation.
Conclusion
and Recommendations
A gross proportion of
deaths were unregistered in Lafia Metropolis of Nasarawa State, Nigeria, which
has created a huge gap in fertility and mortality data. Under reporting of
deaths may have severe consequences for policy formulation, health planning,
research and resource allocation at all levels. A more proactive approach
should be adopted in improving and strengthening the vital registration system
in the country. There is the need for proper registration and documentation of
deaths discusses on both the individual and the country certain useful
benefits. For the family of the deceased, a death certificate ensures their
right to inherit property, to access business and financial entitlements, and
to claim any available insurance benefits. It further provides the country the data with which to compile accurate,
complete, and timely vital statistics that are central to estimating the burden of disease and the impact of
health-related interventions. Therefore, every country in the world needs
to know how many of its people die each year and the main causes of their
deaths, the indispensable for having a well-functioning health system. This
evidence is organized and in conclusion accumulated at the national level to
generate a national picture of the number of deaths per year with their causes.
When deaths go unaccounted for and the causes of death are not documented,
equally national and local governments cannot plan effective public health
policies or measure their impact. The paper makes the following recommendations
1. There
should be priorities for interventions, with specific benchmarks to monitor
progress, recognized that political will is an essential component, and the
need to revitalize death registration and statistics must be placed high on the
development agenda. Therefore, the experiences and capabilities of other
countries that have accomplished complete coverage of death registration should
be scrutinized for possible replication.
2.
Government, donor agencies and relevant
stakeholders should be more practical and proactive in improving and
consolidating the death registration system in the country. Practical and
proactive strategies to advance the systems should be developed by ascertaining
the problems that are resolvable and the level of funding required in
addressing them.
3. The
ultimate aim should be the development of a high quality and worth death
registration system, and death registration completeness should be frequently
reviewed. It is therefore important to conduct advance studies to recognise
ways of improving death registration in Nigeria.
4.
There should be massive sensitization and
awareness raising in the country on the importance of death registration. The
commission should collaborate and explore the network.
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