Prevalence and Determinants of Unintended Pregnancies in Malawi

Available statistics indicate high levels of unintended pregnancies in Africa. This study examines the prevalence and determinants of unintended pregnancies in Malawi based on 2,144 pregnant women extracted from the 2010 Malawi Demographic and Health Survey. Data were analyzed using univariate, bivariate and multinomial logistic regression models. Nearly 43% of the pregnancies were unintended of which 25% were mistimed. Multivariate analysis indicated that mistimed pregnancies are significantly influenced by the age of the respondent, fertility preference and number of children ever born. Among the variables that significantly increased the likelihood of unwanted pregnancies are age of respondent, wealth status, fertility preference, and region of residence even though potential confounding factors were used as control. The study recommends the strengthening of family planning services in order to reduce the level of unintended pregnancies. Focus should be on couples in Central Region and those having large number of childre

Relationship between household wealth and childhood immunization in core-North Nigeria

Background: Childhood immunization rate is lowest in the core-North Nigeria. We examined the relationship between inequal- ity in household wealth and complete childhood immunization in that part of the country.   Methods: A cross-sectional survey was conducted among 4079 mothers with children 12-23 months of age. Children were considered ‘fully-immunized’ if they received all the vaccines included in the immunization schedule. Data were analyzed using descriptive statistics and  logistic regression models (α=5.0%).Results: About 39% and 5.0% children of the rich and poor received complete immunization respectively. Also, 64.2% and 49.6% children of the rich women received BCG and DPT 3 compared to 15.9% and 8.7% observed among the children of the poor. Higher proportion of children from poor households (40.6%) received no immunization than 20.8% found from the rich households. The likelihood of receiving complete immunization was 1.95(C.I=1.35-2.80, p<0.001) times higher among the children of the rich than the poor. Other important predictors of childhood immunization were age, religion, media access, working status, husband’s education, prenatal attendants and delivery place.Conclusion: Disparities existed in childhood immunization between the poor and rich in the core-North part of Nigeria. Policy makers should institute effective interventions that will assist children from poor households to improve their immunization access.Keywords: Household wealth, immunization, child health, Nigeria

Ethnic disparities in fertility and its determinants in Nigeria

Background High fertility rate has been consistently reported in Nigeria. The three major ethnic groups in Nigeria, Hausa/Fulani, Igbo, and Yoruba have different socio-cultural identities particularly those that relate to fertility but fertility index is often reported at the national level. This paper examined ethnic differences in fertility and identified its determinants in Nigeria. Method This cross-sectional design study focused on 23,140 women aged 15–49 years. Fertility was measured from information on the full birth history of women of reproductive age. Fertility was assessed using descriptive statistics, parity progression ratio(PPR) and negative binomial model (α = 0.05). Results The total fertility rate was 8.02, 4.91 and 4.43 among women in Hausa/Fulani, Igbo and Yoruba ethnic group respectively. The proportion of women with ≥5 children was highest among the Hausa/Fulani (40%), followed by Igbo (21.6%) and Yoruba (17.5%). For women aged 45–49 years; the PPR was highest among Hausa/Fulani while Igbo and Yoruba exhibited a similar pattern. The mean fertility was 1.725(C.I = 1.661–1.792, p < 0.001) times higher among Hausa/Fulani than Yoruba women, but Igbo and Yoruba women exhibited a similar pattern. Controlling for other factors barely changes this pattern. Conclusion Variation existed in fertility across the main ethnic groups in Nigeria, but highest among Hausa/Fulani. Fertility reduction strategies that target improvement in women’s education will reduce the fertility rate in Nigeria, particularly among Hausa/Fulani women. Ethnicity is important in fertility reduction strategies in Nigeria

Study on mineral, antinutrient and blood parameters of goats fed molasses treated rice husk

A study on the nutritional potential of rice husk treated with or without molasses was carried out using 25 West African Dwarf (WAD) bucks. Five experimental diets were formulated such that; 0, 1, 2 3 and 4% molasses were incorporated in goat diets and were fermented for 5days before being fed to 25 WAD bucks of 5 replicates per treatment in a Completely Randomized Design experiment for 84 days. Results showed that, dietary treatments had significant (P&lt;0.05) influences in all the parameters observed. Diet 5 had the highest crude protein (11.29%CP) and least crude fibre (26.51% CF). However, the dietary ash varied from 11.29% (Diet 5) to 19.84% (Diet 1). The mineral contents (Ca, P, Mg, K) of the diets progressively increased with increased inclusion of molasses and were adequate to support the growth of goats. The highest values were recorded in Diet 5 except for sodium which declined across the treatment. The anti-nutrients contents observed in this study were least in Diet 5 with exception of phenol which had the highest value (23.66%). Dry matter intake (DMI) varied from 466.86g/day (Diet 5) to 452.47g/day (Diet 1). Meanwhile, CPI increased with increased molasses in the diet. Bucks fed Diet 5 had the best mineral retention values and best daily weight gain (68.00g/day) as (6.86) feed gain ratio was the least. Consequently, treatment of rice husk with molasses at 4% inclusion level could improve the general performance of WAD bucks without any adverse effect on their health status

Factors Influencing Satisfaction with Service Delivery Among National Health Insurance Scheme Enrollees in Ibadan, Southwest Nigeria.

Perceived quality of care is a determinant of uptake of health services. This study aimed to assess the determinants of quality of care of enrollees in the National Health Insurance Scheme (NHIS) in Nigeria. The outcome was satisfaction with health care services, which was used as a proxy for quality. Findings will assist in the intervention to enhance enrollment in the scheme and for universal health coverage attainment. This was a descriptive cross-sectional study conducted among enrollees in selected NHIS facilities in Ibadan, Nigeria. Data on satisfaction with health care were collected among selected 432 enrollees with the aid of an adapted semi-structured WHO-USAID interviewer-administered questionnaire. Data were analyzed using chi-square and multiple logistic regression models (α = 0.05). Among predictors of satisfaction with health services were younger age (OR = 1.85, 95% CI = 1.05-3.25, p = .024), working in the private sector (OR = 1.84, 95% CI = 1.03-3.28, p = .022), and seeking information about quality of services prior enrollment (OR = 1.63, 95% CI = 1.04-2.53, p = .013). Targeted intervention based on the findings of this study should be implemented to improve satisfaction with the services offered

Geospatial distribution and bypassing health facilities among National Health Insurance Scheme enrollees: implications for universal health coverage in Nigeria.

BACKGROUND: This study was carried out to enable an assessment of geospatial distribution and access to healthcare facilities under the National Health Insurance Scheme (NHIS) of Nigeria. The findings will be useful for efficient planning and equitable distribution of healthcare resources. METHODS: Data, including the distribution of selected health facilities, were collected in Ibadan, Nigeria. The location of all facilities was recorded using Global Positioning System and was subsequently mapped using ArcGIS software to produce spider-web diagrams displaying the spatial distribution of all health facilities. RESULTS: The result of clustering analysis of health facilities shows that there is a statistically significant hotspot of health facility at 99% confidence located around the urban areas of Ibadan. The significant hotspot result is dominated by a feature with a high value and is surrounded by other features also with high values. Away from the urban built-up area of Ibadan, health facility clustering is not statistically significant. There was also a high level (94%) of bypassing of NHIS-accredited facilities among the enrollees. CONCLUSIONS: Lopsided distribution of health facilities in the study area should be corrected as this may result in inequity of access to available health services

Relationship between household wealth and childhood immunization in core-North Nigeria

Background: Childhood immunization rate is lowest in the core-North Nigeria. We examined the relationship between inequality in household wealth and complete childhood immunization in that part of the country. Methods: A cross-sectional survey was conducted among 4079 mothers with children 12-23 months of age. Children were considered \u2018fully-immunized\u2019 if they received all the vaccines included in the immunization schedule. Data were analyzed using descriptive statistics and logistic regression models (\u3b1=5.0%). Results: About 39% and 5.0% children of the rich and poor received complete immunization respectively. Also, 64.2% and 49.6% children of the rich women received BCG and DPT 3 compared to 15.9% and 8.7% observed among the children of the poor. Higher proportion of children from poor households (40.6%) received no immunization than 20.8% found from the rich households. The likelihood of receiving complete immunization was 1.95(C.I=1.35-2.80, p&lt;0.001) times higher among the children of the rich than the poor. Other important predictors of childhood immunization were age, religion, media access, working status, husband\u2019s education, prenatal attendants and delivery place. Conclusion: Disparities existed in childhood immunization between the poor and rich in the core-North part of Nigeria. Policy makers should institute effective interventions that will assist children from poor households to improve their immunization access. DOI: https://dx.doi.org/10.4314/ahs.v19i1.33 Cite as: Adebowale A, Obembe T, E B. Relationship between household wealth and childhood immunization in core-North Nigeria. Afri Health Sci. 2019;19(1). 1582-1593. https://dx.doi.org/10.4314/ahs.v19i1.3

Shifts in age pattern, timing of childbearing and trend in fertility level across six regions of Nigeria: Nigeria Demographic and Health Surveys from 2003-2018.

Nigeria's population is projected to increase from 200 million in 2019 to 450 million in 2050 if the fertility level remains at the current level. Thus, we examined the shifts in the age pattern of fertility, timing of childbearing and trend in fertility levels from 2003 and 2018 across six regions of Nigeria. This study utilised the 2003, 2008, 2013, and 2018 Nigeria Demographic and Health Survey datasets. Each survey was a cross-sectional population-based design, and a two-stage cluster sampling technique was used to select women aged 15-49 years. The changes in the timing of childbearing were examined by calculating the corresponding mean ages at the birth of different birth orders for each birth order separately to adjust the Quantum effect for births. The Gompertz Relational Model was used to examine the age pattern of fertility and refined fertility level. In Nigeria, it was observed that there was a minimal decline in mean children ever born (CEB) between 2003 and 2018 across all maternal age groups except aged 20-24 years. The pattern of mean CEB by the age of mothers was the same across the Nigeria regions except in North West. Nigeria's mean number of CEB to women aged 40-49 in 2003, 2008, 2013 and 2018 surveys was 6.7, 6.6, 6.3 and 6.1, respectively. The mean age (years) at first birth marginally increased from 21.3 in 2003 to 22.5 in 2018. In 2003, the mean age at first birth was highest in South East (24.3) and lowest in North East (19.4); while South West had the highest (24.4) and both North East and North West had the lowest (20.2) in 2018. Similar age patterns of fertility existed between 2003 and 2018 across the regions. Nigeria's estimated total fertility level for 2003, 2008, 2013 and 2018 was 6.1, 6.1, 5.9 and 5.7, respectively. The findings showed a reducing but slow fertility declines in Nigeria. The decline varied substantially across the regions. For a downward change in the level of fertility, policies that will constrict the spread of fertility distribution across the region in Nigeria must urgently be put in place. [Abstract copyright: Copyright: © 2023 Olowolafe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Spatio-temporal analysis of childhood vaccine uptake in Nigeria : a hierarchical Bayesian Zero-inflated Poisson approach

Funding Information: The authors are grateful to ICF Macro, USA, for granting the authors the request to use the Demographic and Health Survey data. Publisher Copyright: © 2023, BioMed Central Ltd., part of Springer Nature.Peer reviewedPublisher PD

University community-based survey on the knowledge, attitude and perception about COVID-19 pandemic: the Federal University of Agriculture, Abeokuta, Nigeria as a case study

Objectives Coronavirus disease (COVID-19) is impacting social, economic and political patterns globally. To contain its spread, Nigeria like many other countries, imposed drastic measures such as lockdown/curfew. This study assessed the knowledge, attitude and perception (KAP) about COVID-19 pandemic among members of staff of a university community in Nigeria. Methods A cross-sectional survey using an anonymous, self-designed, online KAP questionnaire was conducted from April 18 to May 31, 2020. The questionnaire consisted of ten knowledge questions regarding the transmission and prevention of COVID-19. The questions on attitude (15) and perception (10) assessed respondents’ behaviour towards adherence to government policies and views on government efforts to contain &nbsp;the infection respectively. Results A total of 125 (teaching) and 102 (non-teaching) staff responded. Approximately 59.1 % of the respondents were males. The mean knowledge and positive attitude levels were 70.8 % (SD ± 9.6 %) and 83.1 % (SD ± 13.07 %) respectively. Significant differences in the knowledge mean scores were observed for demographic categories such as educational qualification (p = 0.0006), staff work category (p = &lt;0.0001), work background (p = &lt;0.0001), and type of lockdown (p = 0.0271). Most of the respondents (85.3 %) opined that COVID-19 was a biological weapon and viewed the lockdown as necessary (81.5 %). However, they thought that the Nigerian government was not doing enough to mitigate COVID-19 spread. Conclusions The perception of COVID-19 in the university community bear implications across public health initiatives, compliance with precautionary behaviour and bilateral relations with foreign nations. &nbsp