What the data reveals about our health, population and life choices

Courtesy of UNICEF and the Federal Ministry of Information, I was part of a significant discussion of a study that should receive more attention than it is getting. It is the Nigerian Demographic and Health Survey that reports on various areas of our lives and the choices citizens make. The 2018 edition was the focus of the two-day workshop, “Media Dialogue on the NDHS, SDGs, Data and Solution Journalism”.


It was held at the Bayview Hotel, Port Harcourt. The NDHS 2018 is the sixth since the survey commenced.

NDHS regularly provides information and estimates on fertility levels, marriage, sexual activity, family planning, breastfeeding practices, nutrition childhood and maternal mortality. It also provides data and information on maternal and child health, malaria, domestic violence, disability, and female genital mutilation.


Headlines from our practical session captured the trends. 97 percent of Nigerians have no health insurance, though only 29 percent of children under 6 months in Nigeria exclusively breastfeed, or only 31 percent of Nigerian children complete immunization to Nigeria ranks fifth in under-5 deaths globally. Others include why one Million Nigerian children die before their fifth birthday to Kebbi leads, Ogun lowest in under-5 mortality and How doctors and hospitals make women lose care in the first three months of pregnancy without meaning to do so.


Maureen Zubie-Okolo led with a breakdown of the significant trends the report captures. According to this extensive survey of Nigeria’s 36 states and FCT, women head 18 percent of households in the land. Households in Nigeria have an average of five members (4.7) and 46 per cent of the population is under 15 years.


Sanitation and water practices are improving across the land. It is one of those data trends that raise an eyebrow as it reports that up to 66 per cent of households have access to improved water compared to previous studies. It is, of course, better in the urban areas with only 28 percent unimproved versus 42 percent in rural areas.


The NDHS discloses that 59 percent of Nigerian households access electricity; it is 83 percent in urban areas and 39 percent in rural areas. Mobile phones are available to 88 percent of Nigerians, with 95 percent urban and 82 percent rural. Television is present in 49 per cent of households, with a skew of 71 percent urban and 30 percent rural.

Mortality in children remains a challenge. It speaks to the quality of life including nutrition and healthcare. Childhood mortality in Nigeria remains high. Every year, an estimated one million Nigerian children die before their fifth birthday

Secondary education is the most common among Nigerians with 48 per cent of men and 40 percent of women. Those with “more than secondary education” are 17 percent men and 11 percent women. The number of those with no formal education is still a disturbingly high 35 percent of women and 22 percent of men aged 15-49.


NDHS 2018 then reports a literacy rate of 72 percent for men and 53 percent for women. The majority are in the urban areas as 86 percent men and 74 percent women. This is significant because most sources attribute to Nigeria a literacy rate of 63 per cent.


Exposure to media is challenging. More than half (51 percent men and 56 percent of women) have no exposure to media of any kind. Thirty-nine per cent of men listen to radio versus 30 percent of women while 34 and 33 per cent each watch television. Only five per cent of women and 15 percent of women read newspapers. Internet usage is at 35 percent for men and 16 per cent for women.


Nigeria follows the trend of post-industrial societies where sales and services occupations predominate. It accounts for 62 percent of the jobs women 15-49 did in the last 12 months before the survey and 26 percent of the men. Men were more in agriculture (42 percent) with women at 22 percent. Thirteen percent of men are in professional/technical/managerial positions as against nine percent of women.


Mortality in children remains a challenge. It speaks to the quality of life including nutrition and healthcare. “Childhood mortality in Nigeria remains high. Every year, an estimated one million Nigerian children die before their fifth birthday. Nigeria is one of five countries in the world with the highest number of under-five deaths.

The infant mortality rate was 67 deaths per 1,000 live births for the 5 years preceding the survey, while under-5 mortality was 132 deaths per 1,000 live births. This implies that more than 1 in 8 children in Nigeria dies before their 5th birthday. The under-5 mortality rate has decreased since 2008, from 157 deaths per 1,000 live births to 132 deaths per 1,000 live births. Similarly, there has been a slight reduction in infant mortality, from 75 to 67 deaths per 1,000 live births. However, there has been no noticeable change in the neonatal mortality rate over the same period.”


Health insurance remains out of reach to the majority of Nigerians. Ninety-seven per cent of both men and women have no health insurance. With the mandatory recapitalisation of the insurance industry, one hopes that a few players would check to confirm if there is a market in this wide gap and develop it.


The National Population Commission in collaboration with the National Malaria Elimination Programme of the Federal Ministry of Health implemented the 2018 Nigeria Demographic and Health Survey (NDHS). USAID. Funding came from a host of international agencies. They include USAID, Global Fund, Bill and Melinda Gates Foundation, the United Nations Population Fund and the World Health Organisation. Dataset available at


Chido Nwakanma


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