Understanding the Socioeconomic Determinants of Childhood Illness in Nigeria: A Narrative Review of Health Inequities and Policy Implications

Abstract

Background: The burden of childhood illnesses and under-five mortality remains high in Nigeria. The situation is driven significantly by both biological factors and socioeconomic inequalities and realities. These factors combined include poverty, limited healthcare access, a poor educational level of the carer, food insecurity, inadequate water and sanitation, and harmful socio-cultural practices. Objectives: This narrative review seeks to define the spectrum of socioeconomic determinants influencing childhood illness across Nigeria and proposes actionable policy recommendations to mitigate these effects. Methods: A comprehensive review using the Scale for the Assessment of Narrative Review Articles (SANRA) framework was employed. Literature retrieved include peer-reviewed articles, national surveys, and health-related reports from WHO, UNICEF, and NDHS ranging from 2005 to 2024. This review also integrates insights according to WHO Commission on Social Determinants of Health (CSDH) framework, this is to enable contextualization of the findings within policy-relevant domains Findings: The most prevailing determinants of childhood illness in Nigeria include poverty, wealth inequality, food insecurity, lack of access to healthcare services, maternal illiteracy, environmental exposures, and sociocultural practices. Furthermore, the rural-urban disparities worsen the challenge, with Northern Nigeria bearing the highest disease burden. Despite various national health frameworks and child survival strategies, implementation gaps persist. Conclusion: This review is among the few who utilizes both WHO-CSDH framework and SANRA-guided methodology to explore determinants of childhood illness in Nigeria. Addressing childhood illness in Nigeria requires multisectoral strategies targeting root socioeconomic factors, aligned with health equity and SDG 3. Strengthening PHCs system, improve health education and behavioural change communication, social safety nets and multisectoral collaboration will be key to improving health outcomes in Nigeria.