New trends in under-five mortality determinants and their effects on child survival in Nigeria: A review of childhood mortality data from 1990-2008

Under-five mortality in Nigeria has been reported to be on the decline, but the dynamics are yet to receive adequate attention. Thus the main objective of this study was to assess these factors and quantify their relative contributions to under-five mortality between 1990 and 2008. The Nigeria Demographic and Health Survey data for 1990, 2003 and 2008 were re-analysed to assess the trends in determinants of under-five mortality.Cox Regression model was applied to determine the relative contributions of each factor to the under-five mortality risk.The results showed there were improvements in maternal education (8.6%), childhood vaccination (17.7%), use of oral rehydration therapy (13.9%) and medical treatment of childhood illnesses(17.5%) over the 19-year period. There were declines in proportions with birth interval less than 24months (3.9%), access to improved sources of drinking water (24.2%), improved toilet facilities (9.0%) antenatal care (4.5%), skilled delivery (3.0%) while maternal age at childbirth remained unchanged. These factors increased the death hazards by 4.6% between 1990-2003 but decreased them by 12% between 2003 and 2008. It was concluded that Nigeria has recorded very minimal improvements in birth spacing and antenatal/delivery care. Poor access to potable drinking water and sewage disposal, and short birth intervals,are among the factors fueling childhood mortality risks. Further improvements in these environmental and health practices as well as other factors are recommended as strategies for promoting child survival in Nigeria

Physico-chemical and bacteriological assessments of shallow well water samples during the dry and rainy seasons

There is need to study the impact of seasonal variations on well water quality especially in Ado – Ekiti metropolis as this will assist in creating awareness on groundwater quality for domestic consumption. The quality of groundwater obtained during dry and rainy seasons from 60 privately utilized hand-dug closed wells in Ado Ekiti metropolis were assessed. Physicochemical and bacteriological investigations were carried out according to required standards. The temperature, colour, turbidity, pH, total solids, chlorides, sulphate, calcium, magnesium, nitrate, and iron, which are physico-chemical parameters of the well water samples ranged from 24.7 to 25.6 OC, 4.1 to 7.3 HU, 3.7 to 6.9 NTU, 7.3 to 7.5, 95.7 to 211.1 mg/L, 38.6 to 74.6 mg/L, 34.3 to 64.9 mg/L, 24.3 to 49.4 mg/L, 48.1 to 89.0 mg/L, 0.4 to 0.8 mg/L and 0.05 to 1.0 mg/L respectively. Despite the fact that the parameters were within the acceptable ranges, bacteriological studies showed the presence of E. coli (ranged from 19.5 to 81.6 CFU) throughout the seasons, thus, individuals who rely on groundwater for their health are exposed to disease-causing organisms. Deductions from the correlation matrix equally, demonstrated the relative dependence of the parameters on one another as they variate according to the change in weather. Mostly during the rainy seasons, higher concentrations of the physicochemical and bacteriological parameters were observed than during the dry seasons, proving that the rainy seasons aid anthropogenic activities from the surface to transmit dissolved harmful waste materials to the subsurface which eventually finds its paths into the groundwater. Improper disposal of faeces, faulty soak-pits, latrines, dumpsites and burial grounds are part of the factors that contribute to bacteriological pollutants in the groundwater source

Modelling time-to-discontinuation of exclusive breastfeeding: analysis of infants and under-2 survival in Nigeria

Background: Regardless of national and international strategies towards promoting exclusive breastfeeding, only 17% and 35% of infants were exclusively breastfed in 2015 in Nigeria and Worldwide respectively. Therefore, we aim to estimate average length of exclusive breastfeeding for infants and under-2, evaluate and predict maternal impact.Data Source and Methods: This retrospective cross-sectional study applied NARHS data collected via multistage-cluster random sampling. Count and proportion quantified maternal characteristics, Kaplan-Meier method estimated length of exclusive breastfeeding whereas Cox Proportional Hazard model and Wald-test determine and evaluate maternal effect.Results: Median duration of exclusive breastfeeding was 6.0 months. Locality {P < 0.05 (0.73 – 0.98)} and place-of-delivery {P < 0.01 (1.06 – 1.19)} were the determinant factors. Cox Proportional Hazard model fit the data and Wald-test identified main predictors.Conclusions: Average time at which exclusive breastfeeding was discontinued was six months, mothers’ locality and delivery-place of infants influence exclusive breastfeeding duration in Nigeria. Hence, exclusive breastfeeding interventions should target those factors

Regional variations in seasonality of births in Nigeria, 1990-2007: A trigonometric regression model approach

Background: Seasonality of births in Nigeria has been previously addressed in a small number of studies. This study was designed to explore and describe the regional variations in the seasonality of births in Nigeria.Data Source and Methods: A total of 82,827 births history data collected in the Nigerian Demographic Survey 2008 were analyzed. It covered periods between January 1990 and December 2007. Seasonal variation by month of birth was explored with the aid of correlogram. A classical time series trigonometric regression model was fitted to describe the pattern of seasonality.Findings: The reported monthly distribution for number of births showed a significant seasonal pattern with a peak in May and corresponding minima in November. Birth patterns differ across the regions, but in every region, births are concentrated in the first half of the year.Conclusion: Though, birth seasonality is more pronounced in the northern part of the country, there has been significant shift in the magnitude of variation in the 18 year period of study

Trends and transition times in parity progression among women of reproductive age in Nigeria between 1998 and 2012

Context: This study assessed the trends and transition times in parity progression among women of reproductive age in Nigeria between 1998 and 2012. Data Source & Method: This is a descriptive, cross-sectional study which utilized data from the 2003, 2008 and 2013 Nigeria Demographic and Health Survey. Data were analysed using Descriptive statistics, Brass P/F Ratio, Pandey and Suchrinder Parity Progression Method and Feeney and Yu Method of Period parity Progression. Findings: Our findings show that the proportion of women progressing to next parity was fairly equal for periods 1998-2002 and 2003-2007 with a slight decrease for period 2008-2012. There was a relatively consistent reduction in the speed of progression to high order parities from 1998 – 2012. Conclusion: In conclusion, not much progress has been made with respect to fertility reduction in the country. However, a reduction in the pace of progression to high order parities suggests Nigeria is experiencing a consistent but slow total fertility decline

Improving access to HIV testing for pregnant women in community birth centres in Nigeria: an evaluation of the Prevention of Mother-to-Child Transmission program

Background: The elimination of mother-to-child HIV transmission requires access to HIV testing services (HTS) for pregnant women. In Akwa Ibom, Nigeria, 76% of pregnant women receive antenatal care from traditional birth attendants and may not have access to HIV testing. Objectives: This study examines the contribution of traditional birth attendants and other healthcare workers in community birth centres in improving access to HTS among pregnant women and their HIV-exposed infants. Design: A retrospective cross-sectional study of previously collected programme data at two points in time to evaluate the prevention of mother-to-child transmission (PMTCT) programme. Methods: We assessed programme records before and after introducing an intervention that engaged traditional birth attendants and other healthcare workers in community birth centres to expand access to HTS among pregnant women and their HIV-exposed infants in Akwa Ibom State, Nigeria. Data were abstracted from the programme database for the preintervention period (April 2019 to September 2020) and the intervention period (October 2020 to March 2022). Data abstracted include the number of pregnant women tested for HIV, those diagnosed with HIV, the number of HIV-exposed infants who had samples collected for early infant diagnosis and those diagnosed with HIV. The data were analysed descriptively and inferentially. Results: Before the intervention, 39,305 pregnant women and 2248 HIV-exposed infants were tested for HIV. After the intervention, the number of pregnant women tested increased to 127,005 and the number of HIV-exposed infants tested increased to 2490. Among pregnant women, the postintervention testing increased by 3.2-fold, with community birth centres reporting 63% of all tests. The intervention also resulted in an 11% increase in HIV-exposed infants benefitting from early infant diagnosis with community birth centres reporting 5% of all tests. Of those diagnosed with HIV, 24% of pregnant women and 12% of infants were diagnosed at community birth centres. Conclusion: Community-based HIV testing for pregnant women can reduce mother-to-child transmission and improve early diagnosis and treatment of exposed infants. Collaboration with birth attendants is crucial to ensure testing opportunities are not missed. Prospective research is needed to understand the clinical outcomes of intervention programmes in the community