Migration and child health inequities in Nigeria: a multilevel analysis of contextual- and individual-level factors

Objective: To assess the role of rural–urban migration in the risks of under-five death; to identify possible mechanisms through which migration may influence mortality; and to determine individual- and community-level relationships between migration status and under-five death. Method: Multilevel Cox regression analysis was used on a nationally representative sample of 6029 children from 2735 mothers aged 15–49 years and nested within 365 communities from the 2003 Nigeria Demographic and Health Survey. Hazard ratios with 95% confidence intervals were used to express the measures of association between the characteristics, and intra-class coefficients were used to express the measures of variation. Results: Children of rural non-migrant mothers had significantly lower risks of under-five death than children of rural–urban migrant mothers. The disruption of family and community ties, low socio-economic position and vulnerability, and the difficulties migrants face in adapting into the new urban environment, may predispose the children of rural–urban migrants to higher mortality. Conclusion: Our results stress the need for community-level and socio-economic interventions targeted at migrant groups within urban areas to improve their access to health care services, maternal education, as well as the general socio-economic situation of women

Alcohol Drinking Patterns and Differences in Alcohol-Related Harm: A Population-Based Study of the United States

Alcohol use and associated alcohol-related harm (ARH) are a prevalent and important public health problem, with alcohol representing about 4% of the global burden of disease. A discussion of ARH secondary to alcohol consumption necessitates a consideration of the amount of alcohol consumed and the drinking pattern. This study examined the association between alcohol drinking patterns and self-reported ARH. Pearson chi-square test χ2 and logistic regression analyses were used on data from the National Comorbidity Survey Replication (NCS-R). The NCS-R is a cross-sectional nationally representative sample. Data was obtained by face-to-face interviews from 9282 adults aged ≥18 years in the full sample, and 5,692 respondents in a subsample of the full sample. Results presented as odds ratio (OR) and 95% confidence intervals (95% CI). Alcohol drinking patterns (frequency of drinking, and drinks per occasion) were associated with increased risks of self-reported ARH; binge or “risky” drinking was strongly predictive of ARH than other categories of drinks per occasion or frequency of drinking; and men had significantly higher likelihood of ARH in relation to frequency of drinking and drinks per occasion. Findings provide evidence for public health practitioners to target alcohol prevention strategies at the entire population of drinkers

Correlates of Complete Childhood Vaccination in East African Countries.

Despite the benefits of childhood vaccinations, vaccination rates in low-income countries (LICs) vary widely. Increasing coverage of vaccines to 90% in the poorest countries over the next 10 years has been estimated to prevent 426 million cases of illness and avert nearly 6.4 million childhood deaths worldwide. Consequently, we sought to provide a comprehensive examination of contemporary vaccination patterns in East Africa and to identify common and country-specific barriers to complete childhood vaccination. Using data from the Demographic and Health Surveys (DHS) for Burundi, Ethiopia, Kenya, Rwanda, Tanzania, and Uganda, we looked at the prevalence of complete vaccination for polio, measles, Bacillus Calmette-Guérin (BCG) and DTwPHibHep (DTP) as recommended by the WHO among children ages 12 to 23 months. We conducted multivariable logistic regression within each country to estimate associations between complete vaccination status and health care access and sociodemographic variables using backwards stepwise regression. Vaccination varied significantly by country. In all countries, the majority of children received at least one dose of a WHO recommended vaccine; however, in Ethiopia, Tanzania, and Uganda less than 50% of children received a complete schedule of recommended vaccines. Being delivered in a public or private institution compared with being delivered at home was associated with increased odds of complete vaccination status. Sociodemographic covariates were not consistently associated with complete vaccination status across countries. Although no consistent set of predictors accounted for complete vaccination status, we observed differences based on region and the location of delivery. These differences point to the need to examine the historical, political, and economic context of each country in order to maximize vaccination coverage. Vaccination against these childhood diseases is a critical step towards reaching the Millennium Development Goal of reducing under-five mortality by two-thirds by 2015 and thus should be a global priority

Effect of maternal exposure to intimate partner violence on under-five mortality in Nigeria

Background: The under-5 mortality rate in many developing countries has shown little or no improvement over the years. Ravaged by war and poverty, violence which is now a norm in most African countries (including Nigeria) is on the increase and has condensed into most families with women and children bearing the major brunt of this violence.Aim: Effect of maternal exposure to intimate partner violence on under-5 mortality in Nigeria.Methods: Data from nationally representative sample of mothers (aged 15-49 years) was obtained from the 2008 Nigeria Demoraphic and Health Survey. Cox regression and multiple logistic regressions were used to identify and examine the association between maternal exposure to intimate partner violence and under-5 death and use of maternal and child health services after controlling for potential confounding factors.Results: The prevalence of intimate partner violence (IPV) in Nigeria is 34.9%. This may be lower than the actual prevalence due to under reporting of cases of IPV in most developing countries. Women not exposed to intimate partner violence were 0.77 times less likely to lose a child under-5 compared to women exposed to intimate partner violence (HR=0.77 95%CI 0.64-0.81). Decision making autonomy in family activities significantly affected loss of a child under-5 in the face of IPV. Similarly women not exposed to IPV were 1.74 times more likely to use maternal and child health services compared to exposed mothers (OR=1.74 95% CI 1.65-1.83). Age of mother, educational status of mothers, social class, occupation, marital status, access to media and decision making autonomy were retained as important maternal predictors of use of maternal and child health services when exposed to IPV in multivariate analysis (p<0.05).Conclusion: Intimate Partner Violence has a significant effect on under-5 mortality. Therefore tackling this social menace will not only reduce the effect on child mortality but also address the ill societal effect that results from family collapse following IPV

Intimate partner violence against women in Maputo city

Abstract Background: There is limited research about IPV against women and associated factors in Sub-Saharan Africa, not least Mozambique. The objective of this study was to examine the occurrence, severity, chronicity and "predictors" of IPV against women in Maputo City (Mozambique)

Spatial-temporal Dynamics of Urban Expansion and Land Cover Transformation in Uyo Capital City, Akwa Ibom State, Nigeria

This study examined the spatial-temporal dynamics of urban expansion in Uyo Capital City, Akwa Ibom State, Nigeria. Landsat satellite imageries from 1986, 2005, and 2024 with 30-meter resolution were analyzed using supervised and unsupervised classification techniques in ERDAS Imagine 10.5. The research employed Remote Sensing and GIS-based spatial analysis to assess land use and land cover (LULC) transformations, urban growth patterns, and environmental impacts. The results revealed notable LULC transitions during the study period. Forest cover declined from 31.05% in 1986 to 16.43% in 2024, while built-up areas expanded from 23.44% to 44.80%, signifying rapid urbanization and infrastructure development. Agricultural land increased slightly by 2005 but later decreased to 22.83% in 2024, indicating urban encroachment. Water bodies steadily declined, highlighting potential hydrological stress. Between 1986 and 2024, forest and farmland decreased by 4,923.6 and 1,525.4 hectares respectively, while built-up areas increased by 7,192.74 hectares. Urban growth showed a concentric pattern outward from Ibom Plaza, influenced largely by road infrastructure. NDVI analysis showed vegetation degradation, especially between 2005 and 2024, attributed to economic changes. Population and economic growth were identified as the primary drivers of urban expansion, followed by infrastructure, housing demand, and policy influences. Farmland loss and land use transformation emerged as the most critical consequence, along with livelihood disruption, environmental degradation, and economic impact. Projections using the MOLLUSC model in QGIS indicate a 79% rise in built-up areas by 2050. The study recommends sustainable urban planning, land use regulation, reforestation, and predictive modeling to mitigate ecological damage and enhance urban resilience in Uyo

Intimate partner violence against women in Maputo city, Mozambique

Intimate partner violence against women in Maputo city, Mozambique. Abstract Background: There is limited research about IPV against women and associated factors in Sub-Saharan Africa, not least Mozambique. The objective of this study was to examine the occurrence, severity, chronicity and "predictors" of IPV against women in Maputo City (Mozambique). BMC International Health and Huma

Regional inequalities in under-5 mortality in Nigeria: a population-based analysis of individual- and community-level determinants

<p>Abstract</p> <p>Background</p> <p>Regions with geographically diverse ecology and socioeconomic circumstances may have different disease exposures and child health outcomes. This study assessed variations in the risks of death in children under age 5 across regions of Nigeria and determined characteristics at the individual and community levels that explain possible variations among regions.</p> <p>Methods</p> <p>Multilevel Cox proportional hazards analysis was performed using a nationally representative sample of 6,029 children from 2,735 mothers aged 15-49 years and nested within 365 communities from the 2003 Nigeria Demographic and Health Survey. Hazard ratios (HR) with 95% confidence intervals (CI) were used to express measures of association among the characteristics. Variance partition coefficients and Wald statistic were used to express measures of variation.</p> <p>Results</p> <p>Patterns of under-5 mortality cluster within families and communities. The risks of under-5 deaths were significantly higher for children of mothers residing in the South South (Niger Delta) region (HR: 1.30; 95% CI: 1.76-2.20) and children of mothers residing in communities with a low proportion of mothers attending prenatal care by a doctor (HR: 1.36; 95% CI: 1.15-1.86). In addition, the cross-level interaction between mothers' education and community prenatal care by a doctor was associated with a more than 40% higher risk of dying (HR: 1.41; 95% CI: 1.21-1.78).</p> <p>Conclusion</p> <p>The findings suggest the need to differentially focus on community-level interventions aimed at increasing maternal and child health care utilization and improving the socioeconomic position of mothers, especially in disadvantaged regions such as the South South (Niger Delta) region. Further studies on community-levels determinants of under-5 mortality are needed.</p