Bolaji Samson Aregbeshola

Factors affecting the uptake of malaria prevention strategies among pregnant women in Nigeria: evidence from 2013 Nigeria demographic and health survey

AimThis study aims to examine the factors affecting the uptake of malaria prevention strategies among pregnant women in Nigeria.MethodsSecondary data from the 2013 Nigeria Demographic and Health Survey were used to examine the factors affecting the uptake of malaria prevention strategies among pregnant women (n = 4493) in Nigeria. Variables on demographic and socio-economic characteristics of pregnant women were analysed. Data analysis was carried out using STATA version 12 software and univariate, bivariate and multivariate analyses were conducted.ResultsWe found that only 10.3% of pregnant women received intermittent preventive treatment of malaria in pregnancy, while 17.4% used insecticide-treated bed nets. Multivariate analysis indicated that maternal age (p < 0.05), geo-political zone (p < 0.05), socio-economic status (p < 0.05), religion (p < 0.05), women’s autonomy (p < 0.05) and number of antenatal care visits (p < 0.05) were significant predictors of the uptake of intermittent preventive treatment of malaria in pregnancy. The use of insecticide-treated bed nets was influenced by socio-economic status (p < 0.05) and women’s occupation (p < 0.05).ConclusionOur study shows that there is poor uptake of malaria prevention strategies among pregnant women in Nigeria. In addition, demographic and socio-economic factors affect the uptake of malaria prevention strategies. The design of new policies and improvement in the current malaria prevention programs should target demographic and socio-economic factors which are important in increasing the uptake of malaria prevention strategies among pregnant women. We also recommend economic empowerment of women.

Out-of-Pocket Payments, Catastrophic Health Expenditure and Poverty Among Households in Nigeria 2010

Background: There is high reliance on out-of-pocket (OOP) health payments as a means of financing health system in Nigeria. OOP health payments can make households face catastrophe and become impoverished. The study aims to examine the financial burden of OOP health payments among households in Nigeria. Methods: Secondary data from the Harmonized Nigeria Living Standard Survey (HNLSS) of 2009/2010 was utilized to assess the catastrophic and impoverishing effects of OOP health payments on households in Nigeria. Data analysis was carried out using ADePT 6.0 and STATA 12. Results: We found that a total of 16.4% of households incurred catastrophic health payments at 10% threshold of total consumption expenditure while 13.7% of households incurred catastrophic health payments at 40% threshold of nonfood expenditure. Using the

Predictors of Enrolment in the National Health Insurance Scheme Among Women of Reproductive Age in Nigeria

1.25 a day poverty line, poverty headcount was 97.9% gross of health payments. OOP health payments led to a 0.8% rise in poverty headcount and this means that about 1.3 million Nigerians are being pushed below the poverty line. Better-off households were more likely to incur catastrophic health payments than poor households. Conclusion: Our study shows the urgency with which policy makers need to increase public healthcare funding and provide social health protection plan against informal OOP health payments in order to provide financial risk protection which is currently absent among high percentage of households in Nigeria

Primary Health Care in Nigeria: 24 Years after Olikoye Ransome-Kuti’s Leadership

Background: Despite the implementation of the National Health Insurance Scheme (NHIS) since 2005 in Nigeria, the level of health insurance coverage remains low. The study aims to examine the predictors of enrolment in the NHIS among women of reproductive age in Nigeria. Methods: Secondary data from the 2013 Nigeria Demographic and Health Survey (NDHS) were utilized to examine factors influencing enrolment in the NHIS among women of reproductive age (n=38 948) in Nigeria. Demographic and socio-economic characteristics of women were determined using univariate, bivariate and multivariate analyses. Data analysis was performed using STATA version 12 software. Results: We found that 97.9% of women were not covered by health insurance. Multivariate analysis indicated that factors such as age, education, geo-political zone, socio-economic status (SES), and employment status were significant predictors of enrolment in the NHIS among women of reproductive age. Conclusion: This study concludes that health insurance coverage among women of reproductive age in Nigeria is very low. Additionally, demographic and socio-economic factors were associated with enrolment in the NHIS among women. Therefore, policy-makers need to establish a tax-based health financing mechanism targeted at women who are young, uneducated, from poorest households, unemployed and working in the informal sector of the economy. Extending health insurance coverage to women from poor households and those who work in the informal sector through a tax-financed non-contributory health insurance scheme would accelerate progress towards universal health coverage (UHC).

Out-of-pocket payments in Nigeria

Policy makers need to strengthen and revitalize primary health care (PHC) in Nigeria. This opinion aims to inform policy decisions and actions by examining the evolution of PHC in Nigeria, the role of Professor Olikoye Ransome-Kuti in the implementation of Alma Ata Declaration, the present state of PHC, the challenges and opportunities in implementing PHC in Nigeria, as well as ways to maximize the opportunities. In 1960, there was no strong focus on health systems development. Policy makers and political actors made efforts to establish and expand health-care infrastructures with more emphasis placed on curative medicine rather than preventive medicine (1). From 1975 to 1980, health system development was initiated with PHC as the cornerstone (1). The National Basic Health Services Scheme (NBHSS) was developed based on a PHC approach (1). Unfortunately, the NBHSS program could not achieve its goals due to implementation challenges; hence, PHC services were not delivered across Nigeria (2). In 1985, Professor Olikoye Ransome-Kuti was appointed the Minister of Health. Professor Ransome-Kuti adopted PHC in 52 local government areas as models based on Alma Ata Declaration of 1978 (3). Furthermore, Nigerias first comprehensive national health policy based on PHC was launched in 1988 (3). From 1986 to 1990, Professor Olikoye Ransome-Kuti expanded PHC to all local governments, achieved universal child immunization of over 80%, and devolved responsibility for PHC to local government areas (3). Professor Olikoye Ransome-Kuti worked assiduously between 1985 and 1992 to implement PHC policy based on the Alma Ata Declaration for the benefit of the Nigerian population. Professor Olikoye Ransome-Kuti introduced a comprehensive national health policy with a focus on PHC, placed emphasis on preventive medicine and health-care services at the grass root, ensured exclusive breast feeding practice, introduced free immunization to children, encouraged the use of oral rehydration therapy by nursing mothers, made compulsory the recording of maternal deaths, and encouraged continuous nationwide vaccination and pioneered effective HIV/AIDS campaign. In 1992, the National Primary Health Care Development Agency (NPHCDA) was established to ensure that the PHC agenda is continued and sustained (1, 3). The military takeover of government that occurred in 1993 brought to an end the giant strides recorded under the leadership of Professor Olikoye Ransome-Kuti from 1985 to 1992. Twenty-four years after the leadership of Professor Olikoye Ransome-Kuti, the need to strengthen the PHC in Nigeria is relevant as ever before. The current state of PHC system in Nigeria is …