Ayo Stephen Adebowale

Sexual hazards, life experiences and social circumstances among male sex workers in Nigeria.

The sexual health and rights needs of male sex workers in Nigeria remain poorly understood and served. Men who sell sex are at high risk of discrimination and violation because of laws criminalising same-sex activity and sex work. This paper examines the experiences, social circumstances, vulnerabilities and sexual hazards experienced by male sex workers in Nigeria. In-depth interviews were used to explore the experiences of six male sex workers who were selected by means of convenience sampling from among those who came for counselling. Findings reveal that economic disadvantage drives some men to engage in sex work and risky sexual behaviour. Subsequently, sex work may put their lives and health at risk as a result of violation by the police and clients, including ritual murder. Mens extreme vulnerability points to the need for appropriate interventions to improve well-being. Sexual health and rights programmes must identify ways of making male sex workers less vulnerable to abuse, and devise strategies for protecting their health and human rights, while empowering them economically to reduce their dependency on often risky sexual behaviour for livelihoods.

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 (nu2009=u200923,404), irrespective of the survival status of the child and the second part utilized all women aged 15–49 (Nu2009=u200933,385). 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 (pu2009<u20090.05). 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 (pu2009>u20090.05), but the difference was significant in the South (pu2009<u20090.05). 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.

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

INTRODUCTIONnSexually 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.nnnMETHODOLOGYnThe 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.nnnRESULTSnData 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).nnnCONCLUSIONSnThe 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.

Assessing full immunisation coverage using lot quality assurance sampling in urban and rural districts of southwest Nigeria.

BACKGROUNDnThis study was conducted to identify administrative wards (lots) with unacceptable levels of full child immunisation coverage, and to identify factors associated with achievement of a complete child immunisation schedule in Ibadan North East (IBNE) and Ido local government areas (LGAs) of Oyo State, Nigeria.nnnMETHODSnA cross-sectional survey involving 1178 mothers, 588 from IBNE LGAs and 590 from Ido LGAs, with children 12-23 months of age was conducted. Children were considered fully-immunised if they received all the vaccines included in the immunisation schedule. Lot quality assurance sampling was used to determine lots with acceptable and non-acceptable coverage. Samples were weighted based on the population by lot to estimate overall coverage in the two LGAs and a logistic regression model was used to identify factors associated with the fully immunised child.nnnRESULTSnMean age of the mothers was 28.5 ± 5.6 and 28.1± 6.0 years in IBNE and Ido LGAs, respectively. Eleven of 12 wards in IBNE and all the wards in Ido had unacceptable coverage. The proportion of fully immunised children was 40.2% in IBNE and 41.3% in Ido. Maternal age ≥30 years, retention of an immunisation card, completion of tertiary education, or secondary education, hospital birth and first-order birth were significant predictors of complete childhood immunisation.nnnCONCLUSIONnThe level of full immunisation coverage was unacceptable in almost all the wards. Educational intervention on the importance of completion of immunisation schedule should target young, uneducated mothers, mothers who delivered their babies at home and those with a high birth order.

Child survival dynamics in Nigeria: Is the 2006 child health policy target met?

Background: The childhood mortality rate in Nigeria continued to remain high. Unfortunately, information on the regional trajectories, progress, and sociodemographic determinants of childhood mortality in Nigeria are not readily available. The objectives of this study are to describe the childhood mortality trajectory in Nigeria, assess progress made toward achieving the 2006 child health policy targets, and determine the peculiar factors associated with childhood mortality in Nigeria regions. Materials and Methods: Birth history data from the Nigeria Demographic and Health Surveys for 1990, 2003, 2008 and 2013 were analysed. Childhood mortality levels were derived using indirect demographic techniques. Locally weighted scatterplot smoothing technique was employed to ascertain the childhood mortality trajectory. Weibull frailty models were fitted to determine the influence of unmeasured variables and factors associated with childhood death in each region. Results: Childhood mortality stagnated at 207/1000 live births until the year 2000, after which there was a linear decline to 137/1000 live births in 2010 at an annual rate of 4.91% (confidence interval: 4.52–5.29). The rate of decline was least in the South West (2.97%) and highest in the North Central (7.40%). Multivariate analysis revealed that unmeasured community factors played significant roles in North East and North West. Birth interval < 24 months, multiple births, and young maternal age were risk factors across all regions. Conclusions: Nigeria child survival dynamics differ between the Northern and Southern regions and rural and urban locations. Only the North Central and South-South regions are on course to achieve the 2006 targets for under-five mortality reduction. Multiple birth, short birth intervals, and young maternal age at childs birth were risk factors for childhood mortality in the six geo-political regions in Nigeria.

Health risk of inhalation exposure to sub-10 µm particulate matter and gaseous pollutants in an urban-industrial area in South Africa: an ecological study

Objective To assess the health risks associated with exposure to particulate matter (PM10), sulphur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO) and ozone (O3). Design The study is an ecological study that used the year 2014 hourly ambient pollution data. Setting The study was conducted in an industrial area located in Pretoria West, South Africa. The area accommodates a coal-fired power station, metallurgical industries such as a coke plant and a manganese smelter. Data and method Estimate of possible health risks from exposure to airborne PM10, SO2, NO2, CO and O3 was performed using the US Environmental Protection Agency human health risk assessment framework. A scenario-assessment approach where normal (average exposure) and worst-case (continuous exposure) scenarios were developed for intermediate (24-hour) and chronic (annual) exposure periods for different exposure groups (infants, children, adults). The normal acute (1-hour) exposure to these pollutants was also determined. Outcome measures Presence or absence of adverse health effects from exposure to airborne pollutants. Results Average annual ambient concentration of PM10, NO2 and SO2 recorded was 48.3±43.4, 11.50±11.6 and 18.68±25.4u2005µg/m3, respectively, whereas the South African National Ambient Air Quality recommended 40, 40 and 50u2005µg/m3 for PM10, NO2 and SO2, respectively. Exposure to an hours concentration of NO2, SO2, CO and O3, an 8-hour concentration of CO and O3, and a 24-hour concentration of PM10, NO2 and SO2 will not likely produce adverse effects to sensitive exposed groups. However, infants and children, rather than adults, are more likely to be affected. Moreover, for chronic annual exposure, PM10, NO2 and SO2 posed a health risk to sensitive individuals, with the severity of risk varying across exposed groups. Conclusions Long-term chronic exposure to airborne PM10, NO2 and SO2 pollutants may result in health risks among the study population.

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 33u2005223 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 4u2005years in never-married and 14u2005years 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.

Childbearing dynamics among married women of reproductive age in Nigeria: re-affirming the role of education

Nigeria ranks among the high-fertility countries in sub-Saharan Africa. Studies that examine relationshipxa0between fertility dynamics and education are important to improving maternal and child health. This study uses 2008 NDHS dataset on births history of married women of childbearing age. Data were analysed using ANOVA, Kaplan-Meier and Cox-proportional hazard models. Mean CEB were 6.72 and 4.31 among women with no formal education and higher education respectively. Majority (38.6%) of the women left 24-35 months births-interval. Women with lower education exhibited shorter births-interval and higher completed fertility than more educated women. The Births Progression Hazard Rate from marriage to 1 birth was higher among highly educated women than those with no education, but reverse pattern was observed at higher order births. This pattern barely changes after controlling for other socio-demographic variables. Education remains an important factor in fertility dynamics in Nigeria; therefore, existing policies addressing female education should be sustained.

School absenteeism among orphans and vulnerable children in Lagos State, Nigeria: a situational analysis

ABSTRACT Knowledge of factors associated with school absenteeism among orphans and vulnerable children (OVC) who are at greater risk could facilitate effective policies to mitigate school dropouts. This study assessed the level of school absenteeism and its associated factors among OVC in five local government areas (LGAs) in Lagos State, Nigeria. A cross-sectional study of OVC households in purposively selected five LGAs in Lagos State was conducted. Enrolled vulnerable households were based on the National Household Vulnerability Assessment criteria. School absenteeism was measured by whether the OVC missed any school day, for any reason in the last school week. Data were collected by personal interview using a semi-structured questionnaire. IBM SPSS Statistics, version 20, was used for all analysis of data collected on schooling of OVC aged 10–17 years. Chi-square test and logistic regression model were used to determine significance of associations at 5% level. The 757 OVC participants were aged 13.1±2.2 years and their caregivers were aged 43.1±13.9 years from 1300 households. There was high proportion of school enrolment (85.7%) as well as absenteeism (20%). The rate of absenteeism among OVC was significantly higher among those who involved in household chores (31.2%) and who often sleep at night without food (40.0%). The odds of absenteeism were almost twice higher among OVC who involved in household chores (odds ratio [OR]: 1.93, 95% confidence interval [CI]: 1.14–3.27), whose guardian could not pay unexpected expenses (OR: 1.78, 95% CI: 1.05–3.02) and those from households where there was often no food (OR: 1.84, 95% CI: 1.04–3.27). A high rate of OVC school enrolment might not translate to regular school attendance. Also, a high proportion of school absenteeism can be attributed to OVC engagement in house chores, poor economy and food insecurity. Economic empowerment of OVC caregivers may improve school attendance.