Knowledge and Perceptions of Marital Rape among Women in Oyo State, Nigeria

Marital rape is a serious public health problem affecting many women worldwide. In Nigeria, there is dearth of evidence-based information on issues relating to knowledge and perceptions of marital rape among women. This study was therefore designed to assess the knowledge and perceptions about marital rape among married women in Oyo State, Nigeria. The cross-sectional survey was conducted among 1200 women aged 18-60 years who were ever-married. Participants were recruited using a multi-stage random sampling technique. A validated semi-structured questionnaire which contained a-8 point knowledge of health consequences of marital rape and a-20 point marital rape perception scales was used for data collection. Data were analyzed using descriptive statistics and Chi-square test. Respondents’ mean age was 36.6 ± 9.6 years, while their husbands’ mean age was 42.1 ± 10.3 years. Mean knowledge score was 3.9±2.2 and 23.4% had poor knowledge of marital rape. Respondents who had poor knowledge who were aged ≤24 years, 25–49 years and ≥50 years were 31.6%, 25.3% and 9.6%, respectively (P≤0.05). Mean perception score was 8.9 ± 3.6, and 69.8% had supportive perceptions relating to marital rape. A higher proportion of respondents with marriage duration of >20 years (84.6%) had marital rape supportive perception compared with those with marriage duration of 0-10 years (64.9%) (P≤0.05). Knowledge of marital rape remains inadequate, especially among younger women. Furthermore, many women had supportive perceptions for marital rape, a situation which can adversely hinder adopting appropriate preventive behaviours. Multiple community-based health educational interventions have potentials for addressing the phenomenon

Attitude and willingness of infertile persons towards the uptake of assisted reproductive technologies in Ibadan, Nigeria

Introduction: In most developing countries, the joy of every married man and woman is to procreate and raise children of their own. However, this desire does not always find fulfilment among some couples because of primary or secondary infertility. The majority who experience this condition live in developing countries where fertility services including Assisted Reproductive Technologies (ARTs) are not always available. This study, therefore, investigated the attitude and willingness of infertile persons to uptake ARTs.Methods: The study was a descriptive cross-sectional survey; a three-stage multi-stage sampling technique was adopted to select 202 married persons receiving fertility services at a gynaecological clinic in Ibadan, Nigeria. A validated interviewer-administered semi-structured questionnaire was used for data collection. Data were analysed using SPSS with descriptive and inferential statistics with the level of the significant set at ⩽0.05.Results: Respondents’ age was 34.3 years (SD ± 6.5); 88.6% were female; 55.5% had tertiary education; 54.5% reported a history of primary infertility. The negative attitude towards ARTs was observed among many of the respondents; however, some were willing to use ART services. In vitro fertilization (IVF) was the most preferred method; only 15.0% were optimistic of noncomplications. The cost was the most mentioned barrier to use of ART. Positive association existed between attitude and willingness to use ART. Females are three times more likely than males to have a positive attitude toward the uptake of ART.Conclusion: Public enlightenment and advocacy are recommended to influence negative attitude towards ARTs.Keywords: Infertility, Couples, Assisted reproductive technologies, Attitude, Willingnes

Involvement of pastors’ wives in educating nursing mothers on childcare practices in Ibadan North local government area, Nigeria

Poor childcare practices among nursing mothers have been implicated as one of the factors influencing high child morbidity and mortality in many developing countries including Nigeria. Many health promotion and education approaches have been used in previous studies to improve childcare practices but very few have considered the inherent potentials of using faith-based strategy as one of the acceptable means of health promotion in many developing countries. This descriptive cross-sectional study was aimed at investigating the involvement of Pastors’ wives as change agents in educating nursing mothers on childcare practices in Ibadan North Local Government Area. Multi-stage sampling technique was used to select pastors’ wives from all the registered churches in the Local Government Area. A pre-tested interviewer-administered questionnaire was used for data collection. Data were analysed using descriptive and inferential statistics. One hundred and twenty-eight (N=128) pastors’ wives with age of 46.1±9.3 years were interviewed. Overall, 9.4% had never taught or preached on childcare practices or other health-related matters to mothers/women in the church before. Analysis showed that 42.2%, 26.6% and 31.3% of Pastor’s wives had good, fair and poor level of basic communication techniques, respectively. Age and educational status of Pastors’ wives significantly affect the level of communication between Pastors’ wives and mothers in the church (p<0.05). Involvement of Pastors’ wives with the mothers on childcare practices was through counselling (90.6%), teaching (53.1%), preaching (29.7%) and phone calls (18.8%). Counselling was the most preferred method (68.0%) of communication. This study establishes the fact that Pastors’ wives and nursing mothers have been communicating health matters through counselling, which can be used as an opportunity for improving child care through faith-based setting.Keywords: Child health care practices, Pastors’ wife involvement, Faith-based approach, Nursing mothersAfr. J. Biomed. Res. Vol. 22 (May, 2019); 145- 15

Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018

Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations.Peer reviewe

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4 (62.3 (55.1�70.8) million) to 6.4 (58.3 (47.6�70.7) million), but is predicted to remain above the World Health Organization�s Global Nutrition Target of <5 in over half of LMICs by 2025. Prevalence of overweight increased from 5.2 (30 (22.8�38.5) million) in 2000 to 6.0 (55.5 (44.8�67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic. © 2020, The Author(s)

Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017 (Nature Medicine, (2020), 26, 5, (750-759), 10.1038/s41591-020-0807-6)

An amendment to this paper has been published and can be accessed via a link at the top of the paper. © 2020, The Author(s)

Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017 (Nature Medicine, (2020), 26, 5, (750-759), 10.1038/s41591-020-0807-6)

An amendment to this paper has been published and can be accessed via a link at the top of the paper. © 2020, The Author(s)

Mapping routine measles vaccination in low- and middle-income countries

The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs)(1-4). Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19)(5-8). Here we generated annual estimates of routine childhood MCV1 coverage at 5 x 5-km(2) pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations; strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children.Peer reviewe

Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019

Background Human resources for health (HRH) include a range of occupations that aim to promote or improve human health. The UN Sustainable Development Goals (SDGs) and the WHO Health Workforce 2030 strategy have drawn attention to the importance of HRH for achieving policy priorities such as universal health coverage (UHC). Although previous research has found substantial global disparities in HRH, the absence of comparable cross-national estimates of existing workforces has hindered efforts to quantify workforce requirements to meet health system goals. We aimed to use comparable and standardised data sources to estimate HRH densities globally, and to examine the relationship between a subset of HRH cadres and UHC effective coverage performance. Methods Through the International Labour Organization and Global Health Data Exchange databases, we identified 1404 country-years of data from labour force surveys and 69 country-years of census data, with detailed microdata on health-related employment. From the WHO National Health Workforce Accounts, we identified 2950 country-years of data. We mapped data from all occupational coding systems to the International Standard Classification of Occupations 1988 (ISCO-88), allowing for standardised estimation of densities for 16 categories of health workers across the full time series. Using data from 1990 to 2019 for 196 of 204 countries and territories, covering seven Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) super-regions and 21 regions, we applied spatiotemporal Gaussian process regression (ST-GPR) to model HRH densities from 1990 to 2019 for all countries and territories. We used stochastic frontier meta-regression to model the relationship between the UHC effective coverage index and densities for the four categories of health workers enumerated in SDG indicator 3.c.1 pertaining to HRH: physicians, nurses and midwives, dentistry personnel, and pharmaceutical personnel. We identified minimum workforce density thresholds required to meet a specified target of 80 out of 100 on the UHC effective coverage index, and quantified national shortages with respect to those minimum thresholds. Findings We estimated that, in 2019, the world had 104·0 million (95% uncertainty interval 83·5–128·0) health workers, including 12·8 million (9·7–16·6) physicians, 29·8 million (23·3–37·7) nurses and midwives, 4·6 million (3·6–6·0) dentistry personnel, and 5·2 million (4·0–6·7) pharmaceutical personnel. We calculated a global physician density of 16·7 (12·6–21·6) per 10 000 population, and a nurse and midwife density of 38·6 (30·1–48·8) per 10 000 population. We found the GBD super-regions of sub-Saharan Africa, south Asia, and north Africa and the Middle East had the lowest HRH densities. To reach 80 out of 100 on the UHC effective coverage index, we estimated that, per 10 000 population, at least 20·7 physicians, 70·6 nurses and midwives, 8·2 dentistry personnel, and 9·4 pharmaceutical personnel would be needed. In total, the 2019 national health workforces fell short of these minimum thresholds by 6·4 million physicians, 30·6 million nurses and midwives, 3·3 million dentistry personnel, and 2·9 million pharmaceutical personnel. Interpretation Considerable expansion of the world's health workforce is needed to achieve high levels of UHC effective coverage. The largest shortages are in low-income settings, highlighting the need for increased financing and coordination to train, employ, and retain human resources in the health sector. Actual HRH shortages might be larger than estimated because minimum thresholds for each cadre of health workers are benchmarked on health systems that most efficiently translate human resources into UHC attainment. Funding Bill & Melinda Gates Foundation