Adolescents and HIV-related behaviour in Nigeria: does knowledge of HIV/AIDS promote protective sexual behaviour among sexually active adolescents?

HIV/AIDS prevalence among Nigerian youth remains one of the highest in the world. Although studies confirmed a high knowledge of HIV among Nigerian youth, there is a lag in linking HIV/AIDS knowledge with protective sexual behaviour. The study utilized data from the Nigeria 2007 National HIV/AIDS and Reproductive Health Survey (NARHS). Analysis was on 865 sexually active adolescents. About 75% of adolescents had good knowledge of HIV/AIDS. Logistic regression models showed that HIV knowledge was significant predictor of non-use of condom (OR=2.34; p=0.041) and accepting gifts for sex (OR=2.02 p=0.043) among male, and predictor of multiple sexual partners (OR=1.30; p=0.023) among females. Regardless of HIV knowledge, higher education, older age at first sex, higher wealth index and urban residency are significant predictors of engagement in non-protective sexual behaviour. The study concludes that high knowledge of HIV/AIDS is not statistically significant in HIV protective attitudes among adolescents

Quality of Spousal Relationship on Procurement of Abortion in Peri-Urban Nigeria

The quality of spousal relationship may influence the acceptance of the status of pregnancies and the decision to procure abortion; however, this relationship has largely been unexplored. The objective of this paper is to assess the influence of specific dimensions of relationship quality on abortion procurement. Data from the 2010 Family Health and Wealth Survey site were used to assess the association between relationship quality and induced abortion among 763 ever-pregnant married or cohabiting women in Ipetumodu, South-west Nigeria. Abortion question though not directly related to current time, however, it provides a proxy for the analysis in such context where abortion is highly restrictive with high possibility of underestimation. The association between relationship quality and abortion risk was analyzed using bivariate and multivariate (logistic regression) methods. Only 7.9% of women 15-49 years reported ever having induced abortion. Communication was the only dimension of relationship quality that showed significant association with history of induced abortion (aOR=0.42; 95% C.I. =0.24-0.77). The paper concludes that spousal communication is a significant issue that deserves high consideration in efforts to improve maternal health in Nigeria.Keywords: Induced abortion, Spousal communication, Nigeria, relationship-qualit

Household use of solid fuel for cooking and under-five mortality in Nigeria

Background:Exposure to harmful smoke from household use of solid fuel had continuously contributed to childhood deaths in Nigeria. Objective:This study examined the effects of cooking fuels used by households on childhood mortality in Nigeria. The study derives its relevance from the United Nations Sustainable Development Goals 1, 3 and 7, which focused on issues of poverty, good health, affordable and clean energy. Methods:The 2013 Nigeria Demographic and Health Survey dataset was used for analysis with a selection of 10,983 households. Results:The results show that level of education, wealth-status, place of residence and regional locations are factors influencing the use of solid fuel, and under-five mortality (P<0.01). Conclusion:Therefore, improved level of education, economic conditions, availability and provision of cheap and clean fuel will assist the poor to reduce usage of solid fuel, minimize exposure of young children to dangerous smoke and reduce childhood mortality in Nigeria

Child’s risk attributes at birth and infant mortality disparities in Nigeria

Births in avoidable high-risk contexts defined by the interplay of sub-optimal childbearing age, short spacing, and first and high birth order incur elevated risks of childhood death. However, the extent of disparities in risks of dying in infancy vis-à-vis the continuum of non-high-risk and (un)avoidable high-risk attributes at birth as determined by mother‘s age at childbirth, child spacing, and birth order characteristics is yet to be adequately explored in Nigeria as elsewhere. To fill this gap, chi-square association test and Cox‘s proportional hazards regression were used to analyze data of 31,260 nationally representative children aged 0-59 months drawn from 2013 Nigeria Demographic and Health Survey. Disparities in infant mortality risks were mainly examined across the spectrum of birth-related risk attributes at birth broadly categorized as no extra high-risk, unavoidable firstorder risk and combined avoidable high-risk. The risks of dying in infancy differed significantly by risk attributes to the extent dictated by other confounders. Also, infant mortality risks varied significantly by all moderating factors excluding religion, water source, toilet type and place of delivery. Interventions targeted at reducing avoidable high-risk fertility rate and strengthening health system to provide life-saving care to most-at-risk children would engender rapid improvement in infant survival.Les naissances dans des contextes à risque élevé évitables, définies par l'interaction d'un âge de procréation sous-optimal, d'un espacement réduit, et du premier rang de naissance élevé, entraînaient des risques élevés de mortalité infantile. Toutefois, l'ampleur des disparités en matière de risque de décès dans la petite enfance par rapport au continuum d'attributs à haut risque non haut risque et (in) évitables haut risques à la naissance, déterminée par l'âge de la mère à la naissance, l'espacement des naissances et le rang de naissance les caractéristiques n‘a pas encore été explorée de manière adéquate au Nigeria comme ailleurs. Pour combler cette lacune, le test d‘association du khi-deux et la régression des hasards proportionnels de Cox ont été utilisés pour analyser les données de 31 260 enfants représentatifs au niveau national, âgés de 0 à 59 mois tirés de l‘enquête démographique et de santé réalisée en 2013 au Nigéria. Les disparités dans les risques de mortalité infantile ont été principalement examinées à travers le spectre d'attributs de risque liés à la naissance, généralement classées dans la catégorie comme pas de haut risque supplémentaire, à très haut risque, risque inévitable de premier ordre et le haut évitable combiné. Les risques de mourir dans la petite enfance différaient considérablement par les attributs de risque dans la mesure dictée par d'autres facteurs de confusion. En outre, les risques de mortalité infantile variaient de manière significative en fonction de tous les facteurs modérateurs, à l'exclusion de la religion, de la source d'eau, du type de toilette et du lieu de livraison. Les interventions visant à réduire le taux de fécondité évitable à haut risque et à renforcer le système de santé afin de fournir des soins vitaux aux enfants les plus exposés, engendreraient une amélioration rapide de la survie des nourrissons.Keywords: Infant Mortality, High-Risk Birth, Fertility Behaviour, Disparities, NigeriaAfr J Reprod Health 2019; 23[3]:120-13

Demand and supply of adolescent and young adult’s sexual and reproductive health services during COVID-19 in sub-Saharan Africa : a scoping review

The COVID-19 pandemic and its associated containment strategies have significantly impacted the logistics of supplying sexual and reproductive health (SRH) services to adolescents and young adults (AYA) in sub-Saharan Africa (SSA). Studies conducted in the region indicate an increase in sexual activity, particularly among young people, during the pandemic. However, the impact of these changes on their utilization of SRH services remains unclear. This scoping review aims to synthesize the available evidence on the impact of COVID-19 on the SRH behavior and service utilization of AYA. This review focuses on examining the demand and supply of SRH for AYA during the COVID-19 lockdown period (January 2020 – December 2021). Following the Arksey & O’Malley (2005) procedure and the Joanna Briggs Institute (JBI) Reviewer’s Manual (2020), the review encompasses comprehensive search strategies, analysis, and reporting of results. The search for relevant articles was conducted across various databases, including Medline Complete, Africa-Wide, SocINDEX, Academic Search Complete (all through EBSCOhost), Public Health, Social Science & Sociology databases, the Middle East & Africa Database (all through ProQuest), and Web of Science. Articles published between January 2020 and December 2021 were included in this review. The studies discussed in this review shed light on the discrepancies in the demand for and supply of SRH services during the COVID-19 pandemic, exposing a substantial gap in addressing the specific SRH needs of AYA. This review also examines the strategies adopted by countries in SSA to mitigate these effects. Several countries in SSA demonstrated resilience as health providers fulfilled their role, while AYA sought alternatives to mitigate the shortage in the supply chain for SRH services and commodities, often resorting to alternative medicine. The findings underscore the urgency of further research to address the risks imposed by COVID-19 on the utilization of SRH services by AYA in SSA. The evidence presented in this review can inform strategic efforts to ensure the availability and accessibility of SRH services for AYA during any unforeseen emergency or future pandemic