Adeniyi Francis Fagbamigbe

Barriers to antenatal care use in Nigeria: evidences from non-users and implications for maternal health programming

BackgroundIn Nigeria, over one third of pregnant women do not attend Antenatal Care (ANC) service during pregnancy. This study evaluated barriers to the use of ANC services in Nigeria from the perspective of non-users.MethodsRecords of the 2199 (34.9%) respondents who did not use ANC among the 6299 women of childbearing age who had at least one child within five years preceding the 2012 National HIV/AIDS and Reproductive Health Survey (NARHS Plus II), were used for this analysis. The barriers reported for not visiting any ANC provider were assessed vis-à-vis respondents’ social demographic characteristics, using multiple response data analysis techniques and Pearson chi-square test at 5% significance level.ResultsOf the mothers who did not use ANC during five years preceding the survey, rural dwellers were the majority (82.5%) and 57.3% had no formal education. Most non-users (96.5%) were employed while 93.0% were currently married. North East with 51.5% was the geographical zone with highest number of non-users compared with 14.3% from the South East. Some respondents with higher education (2.0%) and also in the wealthiest quintiles (4.2%) did not use ANC. The reasons for non-use of ANC varied significantly with respondents’ wealth status, educational attainment, residence, geographical locations, age and marital status. Over half (56.4%) of the non-users reported having a problem with getting money to use ANC services while 44.1% claimed they did not attend ANC due to unavailability of transport facilities. The three leading problems: “getting money to go”, “Farness of ANC service providers” and “unavailability of transport” constituted 44.3% of all barriers. Elimination of these three problems could increase ANC coverage in Nigeria by over 15%.ConclusionNon-use of ANC was commonest among the poor, rural, currently married, less educated respondents from Northern Nigeria especially the North East zone. Affordability, availability and accessibility of ANC providers are the hurdles to ANC utilization in Nigeria. Addressing financial and other barriers to ANC use, quality improvement of ANC services to increase women’s satisfaction and utilization and ensuring maximal contacts among women, society, and ANC providers are surest ways to increasing ANC coverage in Nigeria.

Survival probability and predictors for woman experience childhood death in Nigeria: "analysis of north-south differentials"

BackgroundChildhood mortality rate is high in Nigeria. There is dearth of information on the comparison of childhood mortality probability and its causal factors in the Northern and Southern Nigeria. This study was designed to fill these gaps.MethodsNigeria Demographic and Health Survey, 2008 data was used. The first part of this study focused on women aged 15–49 who ever given birth to a child (n = 23,404), irrespective of the survival status of the child and the second part utilized all women aged 15–49 (N = 33,385). The outcome variable was experienced childhood mortality. Data was analyzed using Chi-square, logistic regression and Brass logit model.ResultsResults showed that similar patterns of children’s death were observed in the two regions, but variation existed. Childhood mortality experienced was more pronounced in the North than the South, even when the potential confounding variables were used as control. Levels of education and wealth index showed an inverse relationship with childhood death in the regions (p < 0.05). The gap in childhood mortality experienced between the poorest and richest was wider in the North than the South. There was no significant difference in the risk of childhood mortality experienced by women in the urban and rural areas in the North (p > 0.05), but the difference was significant in the South (p < 0.05). The life-table mortality levels were lower in the North than the South, an indication of higher previous childhood mortality experience in the North than in the South. Across all childhood ages, the smoothed childhood mortality probabilities were consistently higher in the North than the South.ConclusionChildhood mortality is higher in the Northern than Southern Nigeria. Improving women’s education, particularly in the North will alleviate childhood mortality in Nigeria.

The Nigeria wealth distribution and health seeking behaviour: Evidence from the 2012 national HIV/AIDS and reproductive health survey

BackgroundRecently, Nigeria emerged as the largest economy in Africa and the 26th in the world. However, a pertinent question is how this new economic status has impacted on the wealth and health of her citizens. There is a dearth of empirical study on the wealth distribution in Nigeria which could be important in explaining the general disparities in their health seeking behavior. An adequate knowledge of Nigeria wealth distribution will no doubt inform policy makers in their decision making to improve the quality of life of Nigerians.MethodThis study is a retrospective analysis of the assets of household in Nigeria collected during the 2012 National HIV/AIDS and Reproductive Health Survey (NARHS Plus 2). We used the principal component analysis methods to construct wealth quintiles across households in Nigeria. At 5% significance level, we used ANOVA to determine differences in some health outcomes across the WQs and chi-square test to assess association between WQs and some reproductive health seeking behaviours.ResultThe wealth quintiles were found to be internally valid and coherent. However, there is a wide gap in the reproductive health seeking behavior of household members across the wealth quintiles with members of households in lower quintiles having lesser likelihood (33.0%) to receive antenatal care than among those in the highest quintiles (91.9%). While only 3% were currently using modern contraceptives in the lowest wealth quintile, it was 17.4% among the highest wealth quintile (p < 0.05).ConclusionThe wealth quintiles showed a great disparity in the standard of living of Nigerian households across geo-political zones, states and rural–urban locations which had greatly influenced household health seeking behavior.

Epidemiology of measles in Southwest Nigeria: an analysis of measles case-based surveillance data from 2007 to 2012

BACKGROUND In Nigeria, a system of measles case-based surveillance with laboratory confirmation of suspected cases was introduced in 2005 as one of the strategies for the control of measles morbidity and mortality. In this report, we provide an epidemiological distribution of confirmed cases of measles reported from the southwest of the country between 2007 and 2012, and predict the expected number of cases for the ensuing years. METHODS A descriptive analysis of persons and place and time of confirmed measles cases (laboratory and epidemiological link) reported in the case-based surveillance data was carried out. Using an additive time series model, we predicted the expected number of cases to the year 2015, assuming that current interventional efforts were sustained. RESULTS From the 10 187 suspected cases investigated during the time period, 1631 (16.0%) cases of measles were confirmed. The annual incidence rose from <1 case per million in 2007 to 23 cases per million in 2011. Cases were confirmed from all six states within the zone and most (97.4%) were in individuals aged less than 20 years. Seasonal variation existed with peaks of infection in the first and second quarters of the year. There was an increasing trend in the number of expected cases based on projections. CONCLUSIONS Case-based surveillance provided an insight into understanding the epidemiology of measles infection in Southwest Nigeria. There is a need to work out alternate strategies for control of measles and to strengthen the surveillance system.

Statistical modelling of social risk factors for sexually transmitted diseases among female youths in Nigeria

INTRODUCTION Sexually Transmitted Diseases (STDs) are avertable, but the social risks factors connected to these infections are often unnoticed by many, particularly female youths. Previous studies on STDs among youths in Nigeria only focused on its risk factors but failed to model these risk factors as evidenced in this study. METHODOLOGY The study is retrospective cross-sectional in design which utilized Nigeria Demographic and Health Survey, 2008. It focused on female youths aged 15-24 (n=8093) who ever had sexual intercourse (vaginal, oral and anal). Data analysis was done using Chi-square and logistic regression models. The logistic regression on the data was performed at two stages. These stages generated three and eight different models respectively. RESULTS Data analyses revealed that the mean age of the respondents was 20.2 ± 2.5. Female youths who were aged between 20-24 years contacted STDs in the last 12 months (2.5%) than those between the ages of 15-19 months (1.4%). A year prevalence of STDs among female youths in Nigeria was 2.1%. Socio-demographic factors such as age, educational status, wealth index, marital status, toilet shared, place of residence, contraceptive use and total life-time number of sexual partners were found to be associated significant risk factors for contacting STDs (P<0.05). CONCLUSIONS The data confirmed the considerable impact of wealth index and contraceptive use as important predictors of STDs acquisition. Constant use of condoms, abstinence and having one uninfected sexual partner can help reduce the risk of STDs transmission.

Wealth and antenatal care utilization in Nigeria: Policy implications

ABSTRACT Antenatal care (ANC) utilization is lower in Nigeria than the African average. We investigated the relationship between wealth and utilization of ANC and also assessed other determinants associated with ANC utilization in Nigeria. Using data of the most recent births within 5 years prior to a 2012 nationally representative survey, we modeled predictors of ANC utilization. Respondents in the wealthiest quintile were over five times (aOR = 5.5 (95% CI: 4.2–7.2) more likely to adequately use ANC. The odds of ANC use were generally lower among the poor and the least educated women living in rural areas who need ANC the most.

Geostatistical analysis of trace elements PXRF dataset of near-surface semi-arid soils from Central Botswana

Geospatial dataset of trace elements including manganese (Mn), iron (Fe), titanium (Ti), rubidium (Rb), strontium (Sr), thorium (Th), Vanadium (V) and Zirconium (Zr) of near-surface soils in a Cu–Ni prospecting field at Airstrip North, Central Botswana were statistically analysed. Grid sampling method was used in the field data collection. The relatively new portable X-ray fluorescence spectrometer (Delta Premium, 510890, USA) technology in a “soil” mode was used to measure the concentrations of trace elements in the soils. The data presented was obtained from the average reading of two soil samples collected from same point but passed through sieves. Sequel to DOI: 10.1016/j.dib.2016.08.026 (P.N. Eze, V.S. Mokosomani, T.K. Udeigwe, O.F. Oyedele, 2016) [1].

Effect of Perception and Free Maternal Health Services on Antenatal Care Facilities Utilization in Selected Rural and Semi-Urban Communities of Ondo State,Nigeria

Aims: We aimed at assessing perception and effect of free maternal health services on the utilization of ANC services among women of child bearing age. Study Design: A cross-sectional study involving 460 women aged 15 -49 years who were currently pregnant or had their most recent birth within the previous five years prior the survey was conducted using a two-stage sampling technique. Place ofStudy:Rural and semi-urban communities in Ondo State, Nigeria. Methodology: We administered semi-structured interviewer questionnaire. Knowledge

Survival analysis of time to uptake of modern contraceptives among sexually active women of reproductive age in Nigeria.

Objective To assess the timing of modern contraceptive uptake among married and never-married women in Nigeria. Design A retrospective cross-sectional study. Data and method We used nationally representative 2013 Demographic and Health Survey data in Nigeria. Modern contraceptive uptake time was measured as the period between first sexual intercourse and first use of a modern contraceptive. Non-users of modern contraceptives were censored on the date of the survey. Kaplan–Meier survival curves were used to determine the rate of uptake. A Cox proportional-hazards model was used to determine variables influencing the uptake at 5% significance level. Participants A total of 33 223 sexually active women of reproductive age. Outcome measure Time of uptake of a modern contraceptive after first sexual intercourse. Results The median modern contraceptive uptake time was 4 years in never-married and 14 years among ever-married women. Significant differences in modern contraceptive uptake existed in respondents’ age, location, education and wealth status. Never-married women were about three times more likely to use a modern contraceptive than ever-married women (aHR=3.24 (95% CI 2.82 to 3.65)). Women with higher education were six times more likely to use a modern contraceptive than those without education (aHR=6.18 (95% CI 5.15 to 7.42)). Conclusions The rate of modern contraceptive uptake is low, and timing of contraceptive uptake during or after first sexual intercourse differed according to marital status. Age and number of children ever born influenced modern contraceptive uptake among the never-married women, but religion and place of residence were associated with the probability of modern contraceptive uptake among ever-married women.

Modelling self-assessed vulnerability to HIV and its associated factors in a HIV-burdened country

Abstract Background: Globally, individuals’ self-assessment of vulnerability to HIV infection is important to maintain safer sexual behaviour and reduce risky behaviours. However, determinants of self-perceived risk of HIV infection are not well documented and differ. We assessed the level of self-perceived vulnerability to HIV infection in Nigeria and also identified its risk factors. Methods: We explored a recent nationally representative data with self-reported vulnerability (‘high’, ‘low’ and ‘no risk at all’) to HIV infection as the outcome of interest. Data were weighted and association between the outcomes and the risk factors determined. We used simple ordered logit regression to model relationship between the outcome variable and risk factors, and controlled for the significant variables in multiple ordered logistic regression at 5% significance level. Results: About 74% had good knowledge of HIV transmission and 6% had experienced STI recently. The likelihood of assessing oneself as having ‘no risk at all’ was 50% and for ‘high chances’ was 1.6%. Self-perceived high risk of HIV was higher among those who recently experienced STI (5.6%) than those who did not (1.7%), and also higher among those who recently engaged in transactional sex and had multiple sexual partners. The odds of good knowledge of HIV transmission on high self-perceived vulnerability to HIV was 19% higher than poor knowledge (OR = 1.19, 95% CI: 1.12–1.27). Also, respondents who recently had multiple sexual partners were 72% (OR = 1.72, 95% CI: 1.60–1.86) more likely to report self as having high risk. Younger respondents aged 14–19 years had higher odds of 41% (OR = 1.41, 95% CI: 1.29–1.55) to perceive self as having high vulnerability to HIV than older respondents. Conclusion: High vulnerability to HIV infection was reported among younger respondents, those with history of STIS and those who engage in multiple sexual relations. Despite high level of risky sexual behaviour and good knowledge of HIV transmission and prevention found in this study, self-perceived vulnerability to HIV generally is low. For the low perception found in this study to translate to low chance of HIV infection, there is need for all stakeholders to embark on risk reduction initiatives through sexual education that would minimise risky sexual practices and ensuring availability and affordability of HIV prevention methods.