Pregnancy Outcomes Among The Ibani Of Rivers State, Nigeria: Findings From Case-Studies

The prevalence of high maternal and infant morbidity/mortality among the Ibani of Rivers State, Nigeria, is linked to socio-cultural factors that influence perceptions, attitudes and practices of the people with regard to pregnancy. This study investigates the factors affecting pregnancy outcomes among the Ibani by examining 19 cases identified through Exit-interviews (EIs). Findings indicate that pregnancy outcomes depend on the interaction of complex variables such as male role, socioeconomic status of women, child spacing, access and use of maternal health facilities, among others. The results show that there are 4 principal types of pregnancy outcomes among the Ibani, which include: Type-1 representing maternal and infant survival; Type-2 which is synonymous with maternal survival but infant mortality; Type-3 or spontaneous abortion; and Type-4 which represents maternal mortality but infant survival. The findings suggest that multiple social, cultural and ideological factors condition behaviours among the Ibani and that pregnancy outcomes are only comprehensively understood in the context they occur

Gender Inequality and Contradictions In West African Development: The Need For Centriarchy

The convergence and almost absolute uniformity among communities in West Africa on the issue of gender inequity remains one of the central challenges of globalisation. The centrality of this phenomenon is given that women constitute almost 50% of the population in most of these societies. Hence, any policy or convention or culture that inflicts poverty on women, unwittingly overburdens their men counterparts to the extent society “crashes”. The feminization of poverty in a patriarchal structure has led to over-arching consequences impinging negatively on the education of women, their access to credit facilities and other resources and their general involvement in the process of decision making in the family. In some communities women only achieve status and recognition through children, especially males, making some of them engage in child bearing even in conditions that threaten their lives. In addition, although the practice of Female Genital Mutilation [FGM) is widely discouraged as harmful, some cultures in the sub-region still attach great significance to it. These translate into poverty, which in West Africa is conceived as gender-biased. This paper argues that interventions should focus on the role of policymakers and social policy in effecting necessary attitudinal and behavioral change. This study by not only suggesting how “commonizaton” of knowledge of the factors that heighten vulnerability of women to poverty can be achieved, but also how social policies within the diversity of these societies can succeed sets out to provoke meaningful dialogue among scholars towards ideological, theoretical and policy consensus to meet the immediate challenge of enthroning gender equality in the sub-region through centriarchy. African Journal for the Psychological Study of Social Issues Vol.7(1) 2004: 30-4

Revisiting gender and reproductive health analysis in a global age

This paper examines the extent that scholars are analysing gender and reproductive health issues in a global era. The examination is necessitated by existing data which indicate that African researchers are investigating these phenomena as static and monolithic. Their approach fails to view the concepts as embedded in complexity and as such require careful decomposition. It has, therefore, become necessary to deviate gender and reproductive health studies from traditional disciplinary insulation that secludes academic fields from other areas of knowledge. The present paper argues that a holistic analysis of gender and reproductive health issues is only achievable with interdisciplinary collaboration and in the context they are reviewed. Transdisciplinary analysis in this study involves understanding gender relations as a way of investigating whether household decisions are both democratic and all inclusive. By emphasising the inseparability of gender and reproductive health discourse, the paper makes important contributions to the theoretical and methodological interests of social research and advances insight on how scholars can adjust, analytically, to changing societies without at the same time infringing on the norms of the academic community. Keywords: globalization, gender, reproductive health and interdisciplinary collaborationAfrican Journal for Psychological Study of Social Issues Vol. 8(2) 2005: 175-18

Maternal Crises and the Role of African Men: The Case of a Nigerian Community

Studies have consistently shown that maternal processes in Africa are prone to crises as a result of multiple socio-economic and religious factors. A combination of male-domination, low status of women, poverty, cultural beliefs and practices and high fertility affects pregnancy outcomes in most societies in the continent and especially in sub-Saharan Africa. With very few exceptions, African communities are patriarchal and as such norms, values and expectations are defined and sustained by men in virtually all spheres of life. This paper, which focuses on the Ibani of Rivers State, Nigeria, examines the role of African men during maternal periods to establish that pregnancy outcomes will improve significantly when women are supported by their spouses at different stages of maternity. The study reveals that men do not play roles during pregnancy-postpartum processes that are significantly different from their normal activities because pregnancy is perceived as a normal condition, which does not require special attention. The results also indicate that pregnancy outcomes among the Ibani do not necessarily derive from spousal communication and gender discourse because 87.7 percent of women whose husbands were solely responsible for decisions on child spacing recorded more Type-1 outcome (mother and child survival) than those whose husbands did not. By adapting the present investigation to the systemic approach, a holistic analysis of a complex phenomenon like maternal outcomes was undertaken

Widowers' accounts of maternal mortality among women of low socioeconomic status in Nigeria

The research is based on information collected on 50 deceased Nigerian women of low socioeconomic status in different locations of the country including Lagos, Ibadan, Kaduna, Zaria, Minna, Enugu, and Port-Harcourt among others. They had some common characteristics such as low levels of education, involvement in petty trading and were clients of a microfinance bank as small loan receivers. Primary data were generated mainly through verbal autopsy with widowers employing In-depth Interviews and Key Informant Interviews. In addition, unobtrusive observation was carried out in these locations to ascertain in some instances the distance between the deceased homes and health facilities patronised by the women. Secondary data were specific to death certificates of the deceased supplied by the widowers. Both ethnographic summaries and content analysis were employed in data analysis to account for contextual differences, especially in a multicultural society like Nigeria. The findings implicated several issues that are taken for granted at the micro-family and macro-society levels. It specifically revealed that small loans alone are not sufficient to empower poor women to make meaningful contributions to their own reproductive health in a patriarchal society like Nigeria. Results also indicated that cultural differences as well as rural-urban dichotomy were not proximate determinants of maternal behaviour; the latter rather finds expression in low socioeconomic status. Consequently, policy relevant recommendations that could contribute to significant maternal mortality reduction were proffered. (Afr J Reprod Health 2012; 16[3]: 101-117).La recherche est basée sur des informations recueillies sur les 50 femmes nigérianes décédées venant d'un milieu socioéconomique faible dans différents endroits du pays tels que Lagos, Ibadan, Kaduna, Zaria, Minna, Enugu et Port-Harcourt, entre autres. Ils avaient des caractéristiques communes telles que de niveaux bas d'éducation, la participation dans le petit commerce et elles étaient des clients d'une banque de micro finance en tant que récepteurs de petits prêts. Les données primaires ont été générées principalement par le biais d'autopsie verbale avec les veufs qui emploient des interviews en profondeur et des interviews avec des informateurs clé. En outre, l'observation discrète a été réalisée dans ces endroits afin de déterminer dans certains cas, la distance entre les domiciles des décédés et les établissements de santé fréquentés par les femmes. Les données secondaires sont spécifiques à des certificats de décès de la personne décédée fournies par les veufs. Les deux résumés ethnographiques et l'analyse de contenu ont été employés dans l'analyse des données pour tenir compte des différences contextuelles, surtout dans une société multiculturelle comme le Nigéria. Les résultats ont mis en cause plusieurs problèmes qui sont pris pour acquis aux niveaux micro-et macro-famille de la société. Il a surtout révélé que de petits prêts à eux seuls ne suffisent pas à renforcer la capacité des femmes pauvres, de faire des contributions significatives à leur propre santé de la reproduction dans une société patriarcale comme le Nigéria. Les résultats indiquent également que les différences culturelles ainsi que la dichotomie rurale-urbaine ne sont pas des déterminants immédiats du comportement maternel; celui- ci trouve plutôt son expression dans une situation socioéconomique faible. Par conséquent, les recommandations politiques pertinentes qui pourraient contribuer de manière significative à la réduction de la mortalité maternelle ont été proposées (Afr J Reprod Health 2012; 16[3]: 101-117)

Dying along the Ladder of Stratification: A view of Rural – Urban Dichotomy in Malaria Treatment among Pregnant Women in Ondo State

Studies on malaria related maternal mortality in Nigeria have focused largely on preventive behaviours and healthcare providers‘ knowledge of treatment regimen. However, negligible attention has been paid to rural – urban differentials and treatment patterns adopted by care seekers in relevant contexts. This study, therefore, investigated the factors that influenced pregnant women‘s disposition to malaria treatment in rural and urban areas of Ondo state. The Health Belief Model, Theory of Planned Behaviour and Health Utilization Model were used as the theoretical framework. The study employed descriptive survey research design using both quantitative and qualitative data collection techniques. Quantitative data were collected from 927 respondents selected through a multistage sampling technique in 10 Local Government Areas of the state. Qualitative data were elicited from six Key Informant Interviews (KIIs) conducted with Modern and Traditional health providers selected from the list of care providers in each LGA. The quantitative data were analysed employing descriptive statistics, chi-square, T- test and Ordinal Regression, while content analysis was used for the qualitative data. Mild malaria were treated at home while severe cases were referred to formal health care, however moderate difference existed in rural (X=1.52, SD=0.49) and urban (X=1.29, SD=0.45) respondents‘ choice of treatment options. More urban men than their rural counterparts provided respondents first treatment for malaria. Rural respondents (20.9%) than their urban counterparts (19.7%) reported drug failure in their first treatment regimen. Malaria treatment was influenced by socioeconomic and demographic factors both at rural and urban areas of the state. Policy and national programmes aimed at reduction in maternal mortality should recognise the cultural milieu given its linkage with the aetiology of disease. Without a deliberate intervention, malaria induced maternal morbidity and mortality will remain high not only in Ondo State but Nigeria in general.Keywords: Rural-urban Dichotomy, malaria treatment, maternal mortality, Ondo StateGender & Behaviour, 10(2), December 201

Use of non-emergency contraceptive pills and concoctions as emergency contraception among Nigerian University students: results of a qualitative study

Abstract Background Emergency contraception (EC) can significantly reduce the rate of unintended pregnancies and unsafe abortions especially in sub-Saharan Africa. Despite the increasing awareness of EC among educated young women in Nigeria, the rate of utilisation remains low. This study therefore explores the main barriers to the use of EC among female university students by analysing their knowledge of emergency contraception, methods ever used, perceived efficacy, and its acceptability. Methods This paper brings together the findings from several focus groups (N = 5) and in-depth interviews (N = 20) conducted amongst unmarried female undergraduate students in two Nigerian universities. Results Participants considered the use of condom and abstinence as the most effective methods of preventing unplanned pregnancy. However, many participants were misinformed about emergency contraception. Generally, participants relied on unconventional and unproven ECs; Ampiclox, “Alabukun”, salt water solution, and lime and potash and perceived them to be effective in preventing unplanned pregnancies. Furthermore, respondents’ narratives about methods of preventing unwanted pregnancies revealed that inadequate information on emergency contraception, reliance on unproven crude contraceptive methods, and misconception about modern contraception constitute barriers to the use of emergency contraception. Conclusions The findings suggested that female university students are misinformed about emergency contraception and their reliance on unproven ECs constitutes a barrier to the use of approved EC methods. These barriers have serious implications for prevention of unplanned pregnancies in the cohort. Behavioural interventions targeting the use of unproven emergency contraceptive methods and misperceptions about ECs would be crucial for this cohort in Nigeria

“It's Sweet Without Condom”: Understanding Risky Sexual Behaviour Among Nigerian Female University Students

Background: Over a million people globally acquire sexually transmitted infections (STI) every day mainly through unprotected sexual contact. While the consequences of risky sexual behaviour are well documented, the literature on young educated women's perceptions of, and narratives about risky sexual behaviour is limited, and thus, it is difficult to fathom from available sources why such behaviour persists. This study examined the prevalence of sexual risk-taking and assessed female University students' knowledge of the consequences of unprotected sex and reasons why such behaviour persists. Paradoxes between their narratives and risky sexual behaviour were discussed. Methods: The study adopted a mixed study design involving a survey of 420 students selected using cluster random sampling, 20 in-depth interviews and 5 focus group discussions. The analysis of the quantitative data involves the use of descriptive and inferential statistics, while thematic content analysis was used to analyse the qualitative data. Results: High prevalence of unprotected sexual intercourse was reported and was not associated with age, year of study, place of residence and religion. The narratives of participants indicate that female university students were aware of the risks associated with unprotected sex. Participants generally condemned sexual risk-taking and asserted that freedom, peer influence, poverty, ignorance, lack of sex education, civilisation, promiscuity, and satisfying sexual urge were the reasons for the persistent risky sexual behaviour among female university students. Also, perceived reduced fun associated with condom use, nourishment of marital expectations, and equivalence of unprotected sex with trust are among the reasons for persistent sexual risk-taking among female university students. Conclusion: Our findings show that female students practice risky sexual behaviour despite having knowledge of its consequences. Change in sexual behaviour of this cohort will require multi-faceted strategies targeting socio-cultural norms and empowerment of women to develop skills in negotiating safe sex

Towards Risk-Sensitive and Transformative Urban Development in Sub Saharan Africa

Risk-sensitive urban development is required to reduce accumulated risk and to better consider risk when planning new developments. To deliver a sustainable city for all requires a more frank and comprehensive focus on procedure: On who makes decisions, under which frameworks, based upon what kind of data or knowledge, and with what degree and direction of accountability? Acting on these procedural questions is the promise of transformative urban development. This paper explores the status of risk sensitive and transformative urban development and the scope for transition towards these components of sustainability in urban sub-Saharan Africa through the lens of diverse city cases: Karonga (Malawi), Ibadan (Nigeria), Niamey (Niger) and Nairobi (Kenya). The paper draws from a 3-year research and capacity building programme called Urban Africa: Risk Knowledge that aims to address gaps in data, understandings and capacity to break cycles of risk accumulation. A common analytical framework is presented to help identify blockages and opportunities for transition towards a risk-sensitive and transformative urban development. This framework is then illustrated through each city in turn and a concluding discussion reflects on city observations to draw out recommendations for city level and wider action and research partnerships