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Implications of Socio-Demographic Characteristics on Death Registration in Lafia Metropolis of Nasarawa State, Nigeria

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.


 

References

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