Maternal Health and the Implications for Sustainable Transformation in Nigeria

Transformation is the major goal of the present democratic administration in Nigeria. No country ever achieves sustainable transformation without achieving maternal health. Maternal health is a major concern of all countries, especially in developing countries. This explains why Millennium Development Goals (MDGs) made maternal health one of the cardinal goals to be achieved by 2015. This paper examines the factors that brought about poor maternal health by critically identifying and discussing such factors as poverty, low level of education, inaccessibility of health care services, unbooked emergencies, hypertensive disorder of pregnancy, obstructed labour, anaemia, haemorrhage and infection. Guided by functionalist and political economy theories, the paper argued that the present maternal health is incapable of ensuring sustainable transformation in Nigeria owing to massive corruption, misplacement of priority, neo-liberal policies of government, leading to social and economic dislocation of families and widespread poverty. The paper concludes by arguing that, for there to be real sustainable transformation of Nigeria, the issue of maternal health should be accorded priority through reducing maternal mortality rate by government and other stakeholders. This could be achieved through massive enlightenment, sustainable education, poverty reduction, and adequate provision and funding of healthcare facilities in Nigeria. Keywords: Maternal health, MDGs, Maternal Mortality, Sustainable transformation, Povert

Women and Leadership in Nigeria: Challenges and Prospects

Women are a major stakeholder in the development project of any society. Globally, the issues of women marginalisation and low participation in political leadership and decision making have been attracting a lot of attention from scholars. Although women and men have different biological and physiological make-up, they may share common features with men in terms of educational qualifications, socio-economic status and occupation among others. Yet, they are marginalised in virtually all spheres of public life. In many African countries, such as Nigeria, obnoxious social norms, political exclusion and economic lopsidedness dictate the presence and voice of women in public life. According to 2006 Nigerian population census figure, women constituted 49% of the total population, but there has been a gross gender gap between men and women, especially in political representation, economic management and leadership. This paper, therefore, examines critically some factors that have brought about this wide political and socio-economic disparity. Using both historical and descriptive approaches and guided by patriarchy and liberal feminism theories, the paper argues that the various economic, political, social and systemic practices serve as obstacles to effective participation of women in politics, governance and decision making in Nigeria. The paper concludes that, for there to be greater participation of women in all spheres of Nigerian society, government and other stakeholders should engage in programmes and policies that would empower women politically, socially and economically. Keywords: Women, leadership, governance, marginalization, prospect, politic

Women development in agriculture as agency for fostering innovative agricultural financing in Nigeria

The significant contribution of women in agricultural development cannot be overemphasised. Women farmers are commonly side-lined and their  efforts under-valued in conventional agricultural and economic evaluations despite the substantial impact they have made in the sector. Globally,  women’s contributions to the agricultural sector have been appraised as the world’s major producers and organisers of food crops where half of the  world’s foods have been grown by them. In Africa, Nigeria included, women dominate and play major roles in producing subsistence crops and  livestock. Their contribution to agriculture is estimated to be 65% in Nigeria. However, their contributions are undermined largely because women  are often economically marginalised. Though women are food producers for most of the households in rural areas, their marginalisation has been  historical. Factors hindering women from accessing agricultural financing include patriarchy, an unfavourable land tenure system that deprives  women of access to collateral security in accessing bank loans and the vagueness of women’s limited self-agency. Anchored in patriarchal and  liberal feminism theories, this study examines how Nigerian women are marginalised in selected spheres of agrarian livelihoods in the south-  eastern parts of Nigeria. South-East Nigerian women farmers participate fully in all key stages of farming activities such as production, processing  and marketing of food crops. The Igbo men cultivate mainly cash crops. Similarly, in the Northern parts of Nigeria, women are only allowed to  participate in certain stages of cash crop growing but they are fully allowed to engage in subsistence farming as they are relegated to home front  activities. Patriarchy limits women's access and control over land resources in all forms. Patriarchal and liberal feminism denoted that the actions  and ideas of male farmers dominant over those of women has prevented female farmers the autonomy and freedom to become rational beings.  This paper recommends mainstreaming of gender in the design, implementation and monitoring of agricultural policies and programmes for  inclusive financing for food security and sustainable development.&nbsp

Demographic Transition and Rural Development in Nigeria

The discourse on population growth has generally given a picture that the increase in the population of any society will negatively affect the utilisation of resources and ultimately overall development. A school of thought gave the impression that the more the population increases, the greater is the poverty, leading to underdevelopment, especially for countries in transition. This argument led to various suggestions and attempts at population control and huge budgetary spending, neglecting positive aspects of population size, particularly in the period of demographic transition, and stressing that growth in population size, especially at certain periods, could not lead to and promote development. But can population growth not be a blessing to growth, especially for the rural areas? This paper was anchored in demographic dividend and labour force models. Utilising some theoretical expositions and drawing from the lessons of countries that have transformed from underdevelopment to developed nations, the paper argued that demographic dividend can be harnessed for the development of especially rural areas in transitional countries like Nigeria. The paper concluded with the submission that, in order to tackle the pervasive poverty in Nigeria, disjointed and inconsistent rural development policies should be jettisoned and the utilization of rural population for the supply of economic goods and services for the overall development of the country embraced. Keywords: Demographic dividend; rural poverty; labour force framework; rural areas; unemployment

Prevalence, risk-inducing lifestyle, and perceived susceptibility to kidney diseases by gender among Nigerians residents in South Western Nigeria

Background: Kidney disease (KD) is increasingly recognized as a major public health problem worldwide with rising incidence and prevalence. Early identification of KD risk factors will slow down progression to kidney failure and death. Objective: To determine the prevalence, risk-inducing lifestyle and perceived susceptibility among Nigerians in South-western Nigeria. Methods: A pretested structured questionnaire was employed to draw information on socio-demographic, knowledge, risk-inducing lifestyle and perceived susceptibility to conventional risk factors of KD from 1757 residents aged 6515 years. Results: The mean age of the respondents was 47.61\ub113.0 years with a male-female ratio of 1.13:1. Knowledge of KD was low (mean score 2.29; 95% CI: 2.18, 2.32). The prevalence of some established KD risk factors was regular use of herbal medications, 26.8% and physical inactivity, 70.0%. Females with factors such as use of herbal drink [RRR: 1.56; CI=1.06-2.30; p=0.02] and smoking [RRR: 2.72; CI=1.37-5.37; p=0.00] predicted increased odds of perceived susceptibility to KD than their male counterparts. Conclusion: The prevalence of KD risk-inducing lifestyles was high. More emphasis should be placed on effective public health programmes towards behavioural change in order to adopt lifestyle modification as well as to reduce the tendency to develop KD

Multilevel Analysis of Urban–Rural Variations of Body Weights and Individual-Level Factors among Women of Childbearing Age in Nigeria and South Africa: A Cross-Sectional Survey

Background: An unhealthy body weight is an adverse effect of malnutrition associated with morbidity among women of childbearing age. While there is increasing attention being paid to the body weights of children and adolescents in Nigeria and South Africa, a major surge of unhealthy body weight in women has received less attention in both countries despite its predominance. The purpose of this study was to explore the prevalence of body weights (underweight, normal, overweight, and obese) and individual-level factors among women of childbearing age by urban–rural variations in Nigeria and South Africa. Methods: This study used the 2018 Nigeria Demographic Health Survey data (n = 41,821) and 2016 South Africa Demographic Health Survey (n = 8514). Bivariate, multilevel, and intracluster correlation coefficient analyses were used to determine individual-level factors associated with body weights across urban–rural variations. Results: The prevalence of being overweight or obese among women was 28.2% and 44.9%, respectively, in South Africa and 20.2% and 11.4% in Nigeria. A majority, 6.8%, of underweight women were rural residents in Nigeria compared to 0.8% in South Africa. The odds of being underweight were higher among women in Nigeria who were unemployed, with regional differences and according to breastfeeding status, while higher odds of being underweight were found among women from poorer households, with differences between provinces and according to cigarette smoking status in South Africa. On the other hand, significant odds of being overweight or obese among women in both Nigeria and South Africa were associated with increasing age, higher education, higher wealth index, weight above average, and traditional/modern contraceptive use. Unhealthy body weights were higher among women in clustering areas in Nigeria who were underweight (intracluster correlation coefficient (ICC = 0.0127), overweight (ICC = 0.0289), and obese (ICC = 0.1040). Similarly, women of childbearing age in clustering areas in South Africa had a lower risk of experiencing underweight (ICC = 0.0102), overweight (ICC = 0.0127), and obesity (ICC = 0.0819). Conclusions: These findings offer a deeper understanding of the close connection between body weights variations and individual factors. Addressing unhealthy body weights among women of childbearing age in Nigeria and South Africa is important in preventing disease burdens associated with body weights in promoting Sustainable Development Goal 3. Strategies for developing preventive sensitization interventions are imperative to extend the perspectives of the clustering effect of body weights on a country level when establishing social and behavioral modifications for body weight concerns in both countries

A Comparative Cross-Sectional Study of the Prevalence and Determinants of Health Insurance Coverage in Nigeria and South Africa: A Multi-Country Analysis of Demographic Health Surveys

Background: The core Universal Health Coverage (UHC) objectives are to ensure universal access to healthcare services by reducing all forms of inequalities. However, financial constraints are major barriers to accessing healthcare, especially in countries such as Nigeria and South Africa. The findings of this study may aid in informing and communicating health policy to increase financial access to healthcare and its utilization in South Africa and Nigeria. Nigeria-South Africa bilateral relations in terms of politics, economics and trade are demonstrated in the justification of the study setting selection. The objectives were to estimate the prevalence of health insurance coverage, and to explore the socio-demographic factors associated with health insurance in South Africa and Nigeria. Methods: This was a cross-sectional study using the 2018 Nigeria Demographic Health Survey and the 2016 South Africa Demographic Health Survey. The 2018 Nigeria Demographic Health Survey data on 55,132 individuals and the 2016 South Africa Demographic Health Survey on 12,142 individuals were used to investigate the prevalence of health insurance associated with socio-demographic factors. Percentages, frequencies, Chi-square and multivariate logistic regression were e mployed, with a significance level of p < 0.05. Results: About 2.8% of the Nigerian population and 13.3% of the South African population were insured (Nigeria: males—3.4%, females—2.7% vs. South Africa: males—13.9%, females—12.8%). The multivariate logistic regression analyses showed that higher education was significantly more likely to be associated with health insurance, independent of other socio-demographic factors in Nigeria (Model I: OR: 1.43; 95% CI: 0.34–1.54, p < 0.05; Model II: OR: 1.34; 95% CI: 0.28–1.42, p < 0.05) and in South Africa (Model I: OR: 1.33; 95% CI: 0.16–1.66, p < 0.05; Model II: OR: 1.76; 95% CI: 0.34–1.82, p < 0.05). Respondents with a higher wealth index and who were employed were independently associated with health insurance uptake in Nigeria and South Africa (p < 0.001). Females were more likely to be insured (p < 0.001) than males in both countries, and education had a significant impact on the likelihood of health insurance uptake in high wealth index households among both male and females in Nigeria and South Africa. Conclusion: Health insurance coverage was low in both countries and independently associated with socio-demographic factors such as education, wealth and employment. There is a need for continuous sensitization, educational health interventions and employment opportunities for citizens of both countries to participate in the uptake of wide health insurance coverage

Human Trafficking For Sexual Exploitation: Evaluating The Health Consequences Of Victims

Sexually transmissible diseases linked to binding or coerced prostitution activities, especially HIV, have attracted considerable attention. Other health issues are sometimes glossed over, both in the academic literature and by rehabilitation organizations working with trafficked individuals. Based on field research conducted in Lagos and Oyo States, the study focuses on health issues such as noncommunicable disease ailments experienced by trafficking victims and rehabilitated individuals. The paper documents the physical, psychological effects of trafficking as well as non-communicable diseases such as hypertension and diabetes resulting from the living conditions of victims. It also investigates the (self)-medication practices among trafficked individuals

Conceptualising afrocentric-feminism and social constructivism through Alma Ata declaration (Primary Health Care, PHC) in rural Nigeria

Christian and Islamic scriptures reduced women to a second class in any society. They are subjected to helper and relegated to house chores. In some societies, roles of  ritual-making and administration are accorded them, but they would be regulated with the power of men. The Eurocentric system of administration introduced to Africa  appears to have been reducing Afrocentrism, as Western education has found new roles for women. With more female enrolment in schools, from primary to higher institutions, it is expected that the old system would pave way for equal opportunity to address  sustainable development holistically in Africa. Poverty, unemployment, ignorance,  religion and culture are the major obstacles to women empowerment. These social  issues have an effect upon health development; they aggravate mortality rate despite government focus on primary health care (PHC) as agreed through the Alma Ata  Declaration in Kazakhstan. In addressing these plights, free education and ability to  accommodate neglected rural dwellers to quality education would serve as stimuli for service delivery that is eluding the state.Keywords: Afrocentric-Feminism, Constructivism, Rural Women, Nigeria, PHC  Sustainable Developmen

Prevalence and association of HIV and tuberculosis status in older adults in South Africa: an urgent need to escalate the scientific and political attention to aging and health

ObjectivesThis study examined the prevalence and sociodemographic factors among older adults with HIV and TB status in South Africa.MethodsThis data was cross-sectional and obtained from the 2019 General Household Surveys in South Africa. Adults 50 years and over with reported HIV and TB status were included (N = 9,180,047). We reported statistical analyses of the descriptive, Chi-square and Fisher’s exact tests, and binary logistic regression.ResultsThe study has found a prevalence rate of HIV to be 5.3% and TB to be 2.9% among older adults aged 50 years and above in South Africa. However, the study found HIV and TB to be highest among older adults residing in Gauteng, KwaZulu-Natal and Eastern Cape provinces. For HIV status, the female gender [AOR = 0.80*, CI 95% = 0.80–0.80] and secondary education [AOR = 0.57, CI 95% = 0.56–0.58] have lower odds of association among older adults with HIV. Regarding TB status, primary education [AOR = 1.08*, CI 95% = 1.06–1.10] and diabetes [AOR = 1.87*, CI 95% = 1.82–1.91] have lower likelihoods of associations among older adults with TB.ConclusionThere is an urgent need to escalate scientific and political attention to address the HIV/TB burden in older adults and, public health policymakers need to take cognizance of the interdependence of inequality, mobility, and behavioural modification among this high-risk population