A Research Agenda on the Sexual and Reproductive Health Dimensions of the COVID-19 Pandemic in Africa

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Editorial: Scientific knowledge dissemination and reproductive health promotion in Africa: the case of AJRH

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Trend and Determinants of Unmet Need for Family Planning Services among Currently Married Women and Sexually Active Unmarried Women Aged 15-49 in Nigeria (2003—2013)

This study examines trend and determinants of unmet need for family planning (FP) among currently married women and sexually active unmarried women of reproductive age 15-49 in Nigeria over a period of 10 years (2003-2013). Data from three consecutive Nigeria Demographic and Health Surveys (2003, 2008 and 2013) were analyzed. The results show that the unmet need for FP declined between 2008 and 2013 to a level less comparable with the situation in 2003. The significant determinants of unmet need for FP included age, marital status, education, religion, current work status, decision-making on spending personal earnings, gender of household heads, household wealth status, number of living children (including current pregnancy), rural-urban residence, home visit by FP workers and recent exposure to FP messages via mass media. It is therefore necessary that FP programmers continue to develop specific responses that address the barriers to contraceptive use.

Factors affecting infant and child mortality in Ondo State, Nigeria.

Following the logic of the proximate determinants framework for child survival analysis, the study shows how the main socioeconomic inequalities in neonatal, post-neonatal, and child mortality observed in 1981-86 Ondo State were produced. Unlike most previous studies of early childhood mortality factors in Nigeria, the study explicitly investigates the linking mechanisms between key socio-economic factors and child survival. Local area infrastructural development is shown to be the main socioeconomic factor in neonatal mortality while household disposable income status along with local area infrastructural development showed the strongest impacts upon post-neonatal mortality. Household disposable income status emerged as the main socioeconomic factor affecting mortality during ages 1-4, with maternal education showing no strong effects even in this age segment where its impact may be expected to be most strongly felt. The integrated analysis demonstrates that much of the observed infant mortality advantage of residence in more developed local areas is due to easier physical and real access to modern health services and that most of the child mortality benefits conveyed by high household income status derive primarily from better home sanitary conditions and secondarily from better quality of curative and home care for very ill children

Contraceptive Use and Its Socio-economic Determinants among Women in North-East and North-West Regions of Nigeria: A Comparative Analysis

This study investigated the socio-economic factors associated with reported contraceptive use by women of reproductive age in northern Nigeria. Bivariate and logistic regression analysis was applied to successive Nigeria Demographic and Health Survey (NDHS: 1999-2013) data to examine the relationship between reported use of modern contraceptives (the dependent variable) and the socioeconomic status (age, rural-urban residence, education, religion, current work status, marital status, and number of living children) of these women in the north-east (NE) and north-west (NW) geo-political zones (GPZs). The results indicated that women’s socio-economic status were positively associated with use of modern contraceptives in the NW in 1999 (AOR=2.15; 95%CI=1.47, 3.14), 2003 (AOR=1.64; 95%CI=1.30, 2.08) and 2013 (AOR=1.30; 95%CI=1.12, 1.50) and also in the north-east in 2008 (AOR=0.74; 95%CI=0.64, 0.86). Contraceptive use could increase as FP programmes better respond to the socio-economic and cultural circumstances of women in northern Nigeria

HIV risk perception and risk behaviors among men who have sex with men in Nigeria

Background: Some studies have shown that greater perceived vulnerability to HIV is associated with less involvement in risk taking. We evaluated prevalence and correlates of HIV risk perception among men who have sex with men (MSM) in Nigeria. Methods: A cross sectional study using respondent driven sampling (RDS) was conducted in six Nigerian states in 2010. Weighted HIV risk perceptions were calculated using an RDS analytic tool. Logistic regression was used to determine correlates of HIV risk perception, stratified by state. Results: The total number of MSM ranged from 217 in Abuja to 314 in Cross River state. Median age ranged from 22 years in Cross River state to 26 years in Kano. HIV risk perception ranged from 10% in Cross River state to 58% in Kaduna state and was 38%, 44%, 19% and 20% in Kano, Lagos, Abuja and Oyo states respectively. Factors associated with HIV risk perception include purchasing sex (AOR: 3.11, 95% CI: 1.09-8.88) and never being tested for HIV (AOR = 0.34, 95% CI: 0.14 - 0.85] in Cross River; no comprehensive knowledge of HIV (AOR = 0.21, 95% CI: 0.05 - 0.90) and receptive anal partners (AOR = 10.07, 95% CI: 2.07 - 49.02) in Abuja; being older than 25 years (AOR = 0.16, 95% CI: 0.03 - 0.98) in Kano; no exposure to peer education in Kaduna (AOR = 0.08, 95% CI: 0.01 - 0.89); never being tested for HIV in Lagos (AOR = 0.11, 95% CI: 0.03 - 0.40) and Oyo state (AOR = 0.21, 95% CI: 0.06 - 0.80) and selling sex (AOR = 3.24, 95% CI: 1.00 - 10.61) in Oyo state. Conclusion: This study shows that HIV risk perception and comprehensive HIV knowledge are very low among MSM in Nigeria. Heterogeneity in associated factors suggests that targeted interventions are needed to increase HIV risk perception in the different states. The role of HIV counseling and testing in increasing risk perception needs further evaluation

Providers\u27 and key opinion leaders\u27 attitudes, beliefs, and practices regarding emergency contraception in Nigeria: Key findings

This brief reports on a study in Nigeria to document provider attitudes, beliefs, and practices regarding emergency contraception (ECP), and to identify key opinion leaders’ opinions and insights pertaining to policy and programmatic issues in that country. Findings reveal that ECP is well known in urban Nigeria. Its provision is controlled mainly by the largely unregulated and unmonitored private sector. Government plays a distant role, thereby leaving family planning and ECP supply almost entirely in the hands of donor agencies. For wider availability and affordability of ECP products in both the private and public sectors, official policy action is required, along with increased education of potential users and providers

Providers\u27 and key opinion leaders\u27 attitudes, beliefs, and practices regarding emergency contraception in Nigeria

Despite significant progress in product development, procurement, and distribution in the past few decades, emergency contraception’s (EC) capacity to benefit many women in countries such as Nigeria is hampered by a number of potential barriers, that are not well understood. The Population Council, with support from the International Consortium for Emergency Contraception, documented EC-related knowledge, attitudes, and practices among providers in Nigeria as well as perceptions of key opinion leaders who help shape the policy environment for EC and family planning in general. Findings suggest significant gaps in Nigeria, potentially necessitating continuous training and re-training to help dispel misperceptions and negative attitudes. In Nigeria, where much of the health infrastructure, facilities, and human resources are controlled by the government, the public sector must play a greater role in providing EC-supportive policies and practices, and in monitoring their implementation

Providers\u27 and key opinion leaders\u27 attitudes, beliefs, and practices concerning emergency contraception: A multicountry study in India, Nigeria, and Senegal

The Population Council conducted a cross-sectional, descriptive, multicountry study in India, Nigeria, and Senegal aimed at understanding the attitudes, beliefs, and practices of providers and key opinion leaders (KOLs) regarding the provision and use of emergency contraception (ECP). The overarching goal of this study was to investigate and document providers’ attitudes, beliefs, and practices regarding ECP, and to capture the opinions and insights of providers and KOLs on a range of policy and program issues. Findings indicate that many provider-related barriers can be overcome through implementation of targeted interventions such as training and values clarification, whereas other barriers will require a broader strategy to address contextual and health systems-level factors that hinder women’s access to ECP. The brief includes a number of interventions that might prove useful in addressing these barriers

HIV/AIDS vulnerabilities, discrimination, and service accessibility among Africa\u27s youth: Insights from a multi-country study

This report contains information from a study implemented between August 2011 and July 2012 that sought to provide a comprehensive, evidence-based picture of the HIV-related issues facing young people across Africa, and the prevailing legal, policy, and programmatic responses. The study was designed to establish a basis for a sharper focus on youth within the response to HIV on the continent. Researchers conducted country-specific analytical reviews of the relevant literature on factors associated with HIV risk-taking and health-seeking behaviors among young people aged 15–24 in six countries across Africa—Egypt, Kenya, Nigeria, Senegal, South Africa, and Uganda. In addition, qualitative and quantitative analyses enabled an evaluation of the similarities and differences among countries regarding factors associated with young people’s sexual risk behavior, HIV-related health-seeking behavior, and the extent of policy and programmatic involvement