A systematic literature review to evaluate the effect of maternal education on under-five mortalities in Nigeria, with recommendations for sustainable development.

Abstract Introduction The second target of the SDG3 hopes to reduce under-5 mortalities (U5M) to at least as low as 25 per 1000 live births by 2030. However, U5M remain high in Nigeria and maternal education has been recognized as a predicting factor. This systematic literature review aims to evaluate the relationship between maternal education and under-five mortalities in Nigeria and make recommendations. Methods A systematic search of PubMed, CINAHL, EMBASE and Maternity and Infant Care databases was conducted between 1st August 2021 and 31 st July 2022. Included articles were appraised using Critical Appraisal Tool for Analytical Cross-sectional Studies developed by the Joanna Briggs Institute (JBI), 2017. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA, 2009) guidelines was used for data extraction. Result A total of 215 articles were retrieved out of which 33 were removed due to duplications. After screening, 27 were assessed out of which 14 were finally included. The result indicates that there was less odd of U5M among children whose mothers had at least primary education and suggests that the risk of dying further reduces with higher levels of maternal education. This result corroborates that of earlier studies. Conclusion Reduction in U5M depends on understanding of the impact of maternal education. Therefore, policies should strive to bridge the gaps in female literacy by creating better access to education for Nigerian women. Key message U5M remains high in Nigeria despite an improving global figure. Aside the direct causes, maternal education has been identified as one remote predictor of child deaths before the age of 5. Although some isolated studies have tried to prove this, there is still need for more evidence to support this thinking, given the potential of such findings to influence policies related to child health. Therefore, this SLR hopes to synthesize evidence based on what is already known with the goal to influence local policies on child survival.