Socioeconomic inequalities and family planning utilization among female adolescents in urban slums in Nigeria

Background/statement of problem: Family planning (FP) utilization is important for preventing unwanted pregnancy and achieving optimal reproductive health. However, the modern contraceptive prevalence rate (mCPR) among women of childbearing age is still low in many low- and middle-income countries (LMIC), particularly in Nigeria, despite interventions to increase access and utilization. The low mCPR has been associated with a high prevalence of unwanted pregnancy, unsafe abortion, sexually transmitted infections such as HIV/AIDS, and high maternal and infant mortality in LMIC. Despite existing studies associating high family planning utilization to urban settings relative to the rural areas, the socioeconomic inequality in urban settings, especially among adolescents in urban slums has been given less research attention. This study examines the role of socioeconomic inequality on family planning utilization among female adolescents of various ethnic backgrounds in urban slums in Nigeria. Methods: The study utilized data from the Adolescent Childbearing Survey (2019). A total sample of 2,035 female adolescents of ages 14-19 years who were not pregnant at the time of the study and were resident in selected slums. Associations between socioeconomic inequalities-measured by wealth index, social status, and education-and modern contraceptive use were examined using relative and slope inequality indices, and logistic regression models. Results: The results show that only 15% of the female adolescents in the North, and 19% in the South reported modern contraceptive use. While wealth index and education were important predictors of FP use among adolescents in southern urban slums, only education was important in the North. However, the relative and slope inequality indices further indicate that adolescents with no education and those in the lowest social status group use much fewer contraceptives compared to their counterparts with higher wealth and social statuses. Those with secondary/higher education and the highest social status group, respectively, were more disadvantaged in terms of FP utilization (Education: RII = 1.86, p < 0.05; 95% C.I. = 1.02-2.71; Social Status: RII = 1.97, p < 0.05; 95% C.I. = 1.26-2.68) with results showing a more marked level of disparity when disaggregated by North and South. Conclusion: The persistent socioeconomic inequalities among female adolescents in Nigeria, especially those in the urban slums, have continued to limit their utilization. Policy measure in education, communication and subsidized contraceptives should be intensified for vulnerable female adolescents in the slums

Non-mental health workers’ attitudes and social distance towards people with mental illness in a Nigerian teaching hospital

Background: Studies on attitudes towards mental health in Nigeria have been mainly community-based surveys. Objective: To determine the knowledge and attitudes towards mental illness (MI) of health workers in a Nigerian Teaching Hospital. Methods: A stratified sample of 256 health workers completed an Attitude to Mental Illness Questionnaire (AMIQ) designed for this study. Results: Most participants (62.1% to 80.9%) identified scientific factors such as genetic inheritance as causes of MI; 24.8% identified spiritual factors as potential causes. Effective methods of treatment identified by respondents include orthodox methods (84.6%) and a combination of traditional and orthodox management (37.8%). There were varying shades of negative attitudes towards mentally ill persons (MIPs). Conclusion: The health workers showed some degree of social distance to MIPs, and there is need for psycho-education to improve their knowledge in mental health

Detection of mental disorders with the Patient Health Questionnaire in primary care settings in Nigeria

Mental disorders lead to difficulties in social, occupational and marital relations. Failure to detect mental disorder denies patients potentially effective treatment. This study aimed to assess the prevalence and nature of mental disorders at the primary care settings and the recognition of these disorders by the attending physicians. Over a period of eight weeks, consecutive and consenting patients who attended three randomly selected primary health care facilities in Sagamu Local Government Area of Ogun state were recruited and administered a questionnaire that included a socio-demographic section and Patient Health Questionnaire (PHQ). A total of 412 subjects took part in the study. Subject age ranged from 18-90 years with a mean age of 52.50±21.08 years. One hundred and seventy- six (42.7%) of the subjects were males. A total of 120 (29.1%) of the subjects had depressive disorder, 100 (24.3%) had anxiety disorder, 196 (47.6%) somatoform disorder and 104 (25.2%) met the criteria for an alcohol related problem. The PHC physicians were only able to diagnose disorders relating to mental health in 52 (12.6%) of the subjects. Health and work situations accounted for more than three-quarters of the causes of stress experienced by the subjects. We conclude that there is a high prevalence of mental disorders among patients seen in primary care settings and that a significant proportion of them are not recognized by the primary care physicians. Stress relating to health, work and financial problems is common among primary health care attendees. Physicians in primary health care should be alert to the possibility and the impact of undetected psychiatric morbidity