Tukur Dahiru

Northern Nigeria Maternal, Newborn and Child Health Programme: Selected Analyses from Population-Based Baseline Survey

Maternal mortality in Northern Nigeria is among the highest in the world. To guide programme planning we in- terviewed 7,442 women in April and May 2009 in three northern states (Katsina, Yobe, and Zamfara) to understand pat- terns of antenatal care and delivery. Here, we present findings from a population-based survey conducted under the PRRINN-MNCH Programme to provide evidence-base programmatic interventions aimed at improving maternal and child health indicators. In the paper, we outline the health challenges facing northern Nigeria, describe the PRRINN- MNCH Programme, describe the baseline survey design, implementation, and subsequent data. We provide a series of maternal and child health indicators in order to address two key important policy issues: (1) the importance of visits to health care facilities to enable women get proper maternal care, and (2) the importance of having access to skilled person- nel at birth. We further describe how these data can be used to develop appropriate strategies for integrated programmes to increase awareness of pregnancy and delivery complications and to reduce the barriers to assessing risk and accessing the facilities in a timely manner. Appropriate strategies and interventions are necessary to address the existing health chal- lenges. To a large extent, these data also provide an opportunity to measure the impact of the programme in assisting Ni- geria attain the health Millennium Development Goals of maternal and child health.

Knowledge, Sources of information, and Risk Factors for Sexually Transmitted Infections among Secondary School Youth in Zaria, Northern Nigeria

Background: Sexually transmitted infections (STIs) are responsible for a variety of health problems especially among the youth who engage in risky sexual behavior. There are few studies that describe STIs among the youths in Northern Nigeria. The objective of the study was to assess knowledge of STIs and risk factors among secondary school youth. Materials and Methods: This was a cross-sectional study in which structured, self-administered questionnaire was used to collect data on socio-demographics, knowledge on STIs, and risk factors. Three senior secondary schools were purposively selected for the study. Results: A total of 1765 youths aged 10-30 years with mean age of 16.9 ± 2.0 years participated in the study. 1371 (77.7%) and 394 (22.3%) were respectively Muslim and Christian. Mean age at first sexual intercourse was 16.7 ± 2.0 years. A majority (67.6%) of them heard about STIs; sources of information of STIs were school lessons 23.6%, mass media 23.3%, and health magazines 19.2%, respectively. Generally, knowledge on STIs was good as 75.4% of respondents knew how the disease is transmitted. This knowledge was significantly associated with class of student, place of treatment, and religious teaching (χ2 = 9.6, P = 0.047, χ2 = 22.1, P = 0.035 and 42.6, P = 0.001, respectively). Mean knowledge score was 0.698 ± 0.01. A majority of respondents were engaged in risky sexual behavior as only 16.2% use condom as a preventive measure. Eleven percent reported ever having an STI in the past and majority (52.8%) go to government hospital for treatment of acquired STI. 56% of the youth had two or more boy/girl friends and 30% had sexual relationships. Conclusion: It was concluded that secondary school youth had good knowledge about STIs; however, the opposite is true when it comes to preventive practice (use of condom). Interventions such as periodic publicity awareness and school seminars focusing on STI preventions are needed to control the disease among the youth.

Predictors of delayed Antenatal Care (ANC) visits in Nigeria: secondary analysis of 2013 Nigeria Demographic and Health Survey (NDHS)

Introduction Antenatal Care (ANC) is an important component of maternal health and covers a wide range of activities with huge potential benefits for positive pregnancy out comes. However, large proportions of women do initiate ANC early resulting in adverse consequences. Methods The study utilized the nationally-representative sample of women of reproductive age interviewed during the 2013 Nigeria DHS. Analysis was restricted to 20, 467 women aged 15-49 years who had a live birth in the five-year period prior to the survey. Multinomial logistic regression was performed using Stata v13 to determine significant factors related to timing of initiation of ANC. Relative risk ratio (RRR) was used to assess the strength of association between independent and dependent variables. Results Overall, 27%, 62% and 12% of women initiated ANC in the first, second and third trimesters respectively. In both the two model, the findings reveal that maternal education, level of media exposure, region and place of residence are the uniform predictors of initiation of ANC; having health insurance is a significant predictor of third trimester ANC initiation relative to first to first trimester only. Within the categories of household wealth, levels of participation in household decision-making and region some categories are significant predictors while others are not. Conclusion Maternal education, level of media exposure, region and place of residence are the uniform and consistent predictors of delay in ANC initiation. This suggests that girl-child education, universal health coverage and universal health insurance could be the interventions required to improve service utilization and maternal health.

Burn prevention and first aid knowledge: A focus on adolescents in Zaria

Background: Burns in developing countries accounts for significant morbidity and mortality. Despite the impressive advances in the science of injury-control and prevention, burns have remained the neglected disease of modern society and are still regarded by many as an act of fate and bad luck. The aim of this study was to determine the knowledge of burn prevention and first aid treatment in adolescents as baseline information to develop an effective burn prevention program. Materials and Methods: A survey to ascertain the knowledge of burns prevention and first aid was conducted in 10 junior secondary schools in Zaria. It was divided into three sections; demographic, knowledge of burn prevention practices and first aid treatment at home and a self-report of radio and television viewing habits. Descriptive frequencies were used to describe the student′s knowledge of burn prevention and first aid treatment. Chi-square analyses were conducted to identify any significant differences between students who had previous knowledge of burn prevention and those who did not. Results: A total of 335 students from 10 schools took part in the survey. Their age ranged from 10 to 17 years with a mean age of 14.8 years. There were 192 males (57%) and 143 females (43%). Seventy three students (21.5%) had previous knowledge of burn prevention and first aid, compared with 262 (77.3%) who had no previous knowledge of burn prevention. Those who had previous knowledge of burn prevention and first aid for burns were more likely to select the appropriate answers to burn prevention practices and first aid treatment at home (P < 0.0001). Majority of the students indicated that information on television (94.3%) or radio (90.7%) will be helpful in preventing burn injuries. Conclusion: Knowledge deficits exist in burn prevention and first aid knowledge among adolescents in Zaria. The use of the electronic media (television and radio) is suggested as an effective strategy to increase awareness.

Level and determinants of high fertility in two contrasting populations in Nigeria

This study examined levels and determinants of high fertility in the north-west and south-west zones in Nigeria. The study utilized 2013 nation-wide survey data on women aged 15-49 years (n=11,300). Data were analysed using ANOVA, logistic-regression, Brass P/F-ratio, Brass-relational Gompertz fertility and survival analysis models. About 44.4% of women in the north-west had high fertility (CEB≥5) compared to 26.9% in the south-west. The refined TFR, childbearing transition probabilities and progression rate were higher in the north-west (prr=0.2686) than south-west (prr=0.1709). The extent at which the age location of childbearing in the north-west (α=-0.003, StdE=0.083) differs from the standard was higher than south-west (α=-0.032, SE=0.95), but the fertility distribution across ages in the south-west was narrower. The odds of high fertility was higher in the north-west (OR= 2.18, C.I=1.99-2.37, p<0.001) than south-west. This odds barely changed when other factors such as age, age at first-sex, age at first-birth, modern contraceptive use, wealth quintile, education, religion, ethnicity, sex preference and ideal family size were controlled for. Fertility level was higher in the north-west than south-west. Improving women’s education in the north-west may facilitate low fertility in the region.

Digit preference in Nigerian censuses data of 1991 and 2006

Background: censuses in developing countries are prone to errors of age misreporting due to ignorance, low literacy levels and other social, economic and cultural factors. Ages are commonly rounded with great affinity for 0 or 5. This tendency to digit preference and/or avoidance results in age heaping or concentration of ages at certain digits. This study examined the extent of digit preference in the Nigerian census data of 1991 and 2006. Methods: this study utilized age data from the 1991 and 2006 Nigerian censuses reported in single years. The Whipple and Myers indices were used to determine the extent of digit preference. Results: both the 1991 and 2006 census data showed the expected pattern of errors, with Whipple and Myers indices being beyond acceptable levels. The Whipple index for 1991 and 2006 was 293 and 251 respectively, while the Myers index was 62.3 and 67.1 respectively. There was a strong preference for terminal digits 0 and 5, followed by 8 whereas terminal digits 1 and 9 were strongly avoided. Conclusions: the quality of age data in Nigerian census data is poor as a result of misreporting and no significant improvement or difference was observed between 1991 and 2006 censuses.