Effects of Women's Education on Postpartum Practices and Fertility in Urban Nigeria

This study examines the influence of women's education on postpartum practices and fertility in Ilorin, a Nigerian urban community. Using life-table survival analysis to estimate breastfeeding and abstinence durations and the Cox Proportional Hazards Model to estimate relative risk of weaning and terminating abstinence, women's education was found to have a strong negative relationship with breastfeeding and postpartum abstinence. The use of contraception was low in this community and marital fertility for educated women was higher than for illiterate women. Policy implications of the findings and recommendations are discusse

IS ANTENATAL CLINIC ATTENDANCE A PROXIMATE DETERMINANT OF USE OF MODERN HEALTHCARE FACILITY FOR DELIVERY BY NIGERIAN WOMEN

A proximate determinant of an outcome (or event) is a variable (or factor) that produces a direct effect on that outcome. It can act as an intermediary variable through which other variables (or factors) which have indirect effects on the same outcome variable operate to exhibit their effects. Socioeconomic, demographic and cultural factors (also called background or underlying factors) are known to have indirect effects on whether or not a pregnant woman would choose to deliver her baby in a healthcare facility. The background or underlying factors of the women can also determine if they will attend or not attend antenatal clinic during pregnancy. However, antenatal clinic attendance also has direct effect on a woman’s use of healthcare facility to deliver her baby. In this study we examined whether or not antenatal clinic attendance is a major proximate determinant of use of healthcare facility for delivery by Nigerian women. The study used quantitative data from the 2008 Nigeria Demographic and Health Surveys (NDHS). Mothers were asked to indicate where they delivered their last babies (i.e., in Healthcare Facility or outside the healthcare facility) and also the number of antenatal visits they attended during the pregnancy. A mother that had four or more visits during the pregnancy was considered to have had adequate number of visits and those who did not attend at all or attended for less than four times were considered not to have had adequate attendance. Information was also collected on the socio-economic and demographic characteristics of the women. Information was also collected on the socio-economic and demographic characteristics of the women. The data analyzed consisted of 17,635 women aged 15-49 years who had a live birth within the five years preceding the survey STATA 12 computer software was used to carry out data analyses. Data analyses were at univariate, bivariate and multivariate levels. Due to the dichotomous nature of the outcome variable (i.e., whether a child was delivered in a healthcare facility or not; coded as (1, 0)), the multivariate analyses technique used is Binary Logistic Regression, and Likelihood Ratio (LR) statistical test of significance was applied. Results from bivariate analysis indicated that the background (underlying) factors of the women (i.e., age, children ever born, region of residence, educational level, wealth index status, and religion) all have significant association with the number of antenatal visits made by mothers during their last pregnancy (P < 0.001). Similarly, antenatal clinic attendance has significant relationship with delivery in healthcare facility (P < 0.001). The binary logistic regression which includes all the six background variables and antennal clinic attendance (i.e., the proximate determinant) indicated a highly significant contribution to the model chi-square statistic. Women who had adequate number of antenatal clinic visits were about four times more likely to deliver their babies in healthcare facility than were those mothers who did not (OR = 4.4, P < 0.001). The likelihood Ratio (LR) test to determine the extent to which antenatal clinic attendance helped to explain the effect of the background variables on delivery in healthcare facilities also gave a highly significant result (chi-square = 891 on 1 degree of freedom, P < 0.001). This means that antenatal clinic attendance is an important proximate determinant through which socioeconomic, demographic and cultural factors influence Nigerian women delivery in healthcare facilities. We conclude therefore that policies and programs targeted at encouraging Nigerian pregnant women to attend adequately antenatal clinics will also increase the prevalence of their delivery in healthcare facilities, thereby reducing the risk of maternal and infant mortality. KEYWORDS: Underlying Factors, Antenatal Clinic Attendance, Proximate Determinants, Healthcare Facility Delivery, Nigeri

Family Planning Knowledge, Attitudes and Practices of Males in Ilorin, Nigeria

A household survey conducted between September 1988 and January 1989 in Ilorin, Nigeria, yielded data on the contra- ceptive knowledge, attitudes and practices of 1,022 men. Although the sample is not representative of the city, the data provide comparative information by level of educa- tion and area of residence, which serves as a proxy for socioeconomic status. Contraceptive knowledge is virtually uni- versal among these men, with the condom and oral contraceptives the most com- monly known methods. The condom is also the most commonly used method, yet less than half of men from the most educated and highest socioeconomic groups have ever used it. The majority of men at all education and residence levels have positive attitudes toward family planning, and contraceptive use is associated with communication about family planning between husbands and wives. Among men who say they have had such discussions, 22-60 percent re- port that their wives use a method, com- pared with 4-10 percent of those who say they have not discussed family planning with their wives

Use of Contraceptives for Birth Spacing in a Nigerian City

This paper examines the use of contraceptives among women aged 15-35 in the urban area of Ilorin, Nigeria, with particular focus on use for the purpose of spacing births. Approximately 19 percent of ever-married women in the sample had used contraceptives at some time and approximately 6 percent were using at the time of the survey. Results suggest that some women have used or are using contraceptives as a substitute for prolonged periods of postpartum sexual abstinence. Whereas all groups of women in the study prefer to maintain an interval of two years between births, less traditional women no longer prefer to observe long periods of postpartum sexual abstinence. For some women, therefore, there is a wide gap between the length of preferred birth interval and the length of preferred abstinence. The magnitude of this gap is significantly associated with both ever use and current use of contraceptives. Other variables found to have a significant independent effect on contraceptive use were total number of children desired, maternal age, and maternal educatio

Changing Levels and Patterns of Under-five Mortality: Empirical Evidence from Nigeria Demographic and Health Survey (Changing Levels and Under-five Mortality)

This study examined the levels and patterns of under-five mortality in Nigeria within 2003-2013 using the Nigeria Demographic and Health Survey datasets for this period. In the study the mortality trends was related to some socioeconomic and health variables to explain factors that could have contributed to mortality changes. The descriptive approach through the use of tables and charts was adopted in the analysis. Results show that under-five mortality rate had declined from 187 in 2003 to 128 in 2013 (i.e., a decline of 32 percent). Under-five mortality declined with increase in mothers’ education especially among mothers with less than secondary education. During the ten-year period, children who had DPT3 increased from 10.4 percent to 22 percent. Households who drank water from safer sources increased from 14.4 percent to 49.7 percent for urban areas and 2.3 percent to 32.7 percent in rural areas. Childhood diarrhea incidence declined by 45.2 percent. The study concluded that decline in under-five mortality may be attributed to improved immunization, safer water sources, and reduced incidence of childhood diarrhea. This study, therefore, recommended that both the national and state governments of Nigeria should intensify efforts to increase childhood immunization coverage, provide more communities and households with safe drinkable water in order to drastically reduce diarrhea diseases – a major cause of deaths in children. This will help to accelerate the decline in under-five mortality rate in the country

Diarrhoeal Disease Morbidity, Risk Factors and Treatments in a Low Socioeconomic Area of Ilorin, Kwara State, Nigeria

A 12-month diarrhoeal disease surveillance was carried out in a sample of 351 child-en under 3 years of age in a low - income traditional area of llorín, Nigeria to determine whether sociodemographic characteristics, including age of the child, sex, parity, mother's education, occupation, mother's age and household kitchen, were associated with the incidence of acute diarrhoea. Bivariate and multivariate analyses were used to determine association. Results indicated that only the age of the child and the type of kitchen used by the household had a significant association with diarrhoea. Diarrhoeal incidence decreases with the child's age while households with a private kitchen had a significantly lower incidence rate than those without a kitchen. This finding emphasises the importance of good hygiene in reducing the risk of having diarrhoea. Three common treatments applied by mothers are ORS (used in 14.8% of diarrhoea days), antibiotics (54.5%) and local herbs (27.7%). The younger a child is the more likely that ORS and antibiotics will be administered during diarrhoea. About 53% of the antibiotic use was by self medication while 40% were prescribed by the clinics. The need for educational campaigns to discourage the inappropriate use of antibiotics was emphasised. Key words'. Diarrhoea, Infantile; Risk factors; Diarrhoea morbidity; Diarrhoea mortality; Socioeconomic factors

Gender-Based Violence and Pregnancy Outcomes among Couples and Cohabiting Partners in Nigeria.

Over the last two decades, the international community has expressed concerns on the increasing occurrence of gender-based violence and related consequences, particularly in African and many low-and middle-income countries. The 2006 United Nations General Assembly declaration on elimination of violence against women has been applauded across many settings. Intimate partner violence is a typical example of genderbased violence that occurs among males and females who have intimate relationships either as husbands and wives, or are in cohabiting relationship. This paper examines factors likely to influence gender-based violence and effects on pregnancy outcomes in Nigeria. The study used the 2013 Nigeria Demographic and Health Survey (NDHS) couple data set of 8658 couples aged 15-49 for women and 15-59 for men. 6,961 were interviewed for domestic violence. Analysis employed univariate, bivariate and multivariate techniques i.e. binary logistic regression. Pregnancy outcome, measured as either live birth or stillbirth is the ultimate dependent variable. Explanatory factors are of two types (1) intervening factors are, physical, and emotional violence, and (2) background factors including age, residence, education, employment status, and religion among others. The results showed that residence, employment status, religion and partner’s age were significant factors explaining emotional, and physical violence among couples (p<0.05) While physical violence and emotional violence were significant associated with pregnancy outcome of either a live birth or still birth (P<0.05). The study also showed that respondents whose husband takes alcohol have a higher odds of experiencing violence while those who are working and educated beyond primary school also have higher odds of experiencing violence. These findings have significant implications for policy and programmes geared to improve on gender equity, and reproductive health of women in Nigeria

Multitasking, but for what benefit? The dilemma facing Nigerian university students regarding part-time working.

Students working part-time while studying for a full-time university degree are commonplace in many Western countries. This paper however, examines the historically uncommon part-time working activities and career aspirations among Nigerian university students. In particular, how working is perceived to contribute to developing employability skills, and whether it is influenced by their self-efficacy. Survey data from 324 questionnaires was collected from a federal university, although the data analysis used a mixed-method. The findings indicate that despite low levels of part-time working generally among students, older, more experienced, higher level and female students, place a premium on the skills that part-time work can develop. Moreover, self-efficacy and being female, is a significant predictor in understanding part-time work and career aspirations. This study offers originality by focusing on students’ part-time work, the value working provides, and its link with career aspirations, within a relatively unexplored context of Nigeria

Child mortality in a Nigerian City: Its levels and socioeconomic differentials

Using the ‘indirect’ demographic estimation technique, levels of child mortality for some selected socioeconomic characteristics of mothers in Ilorin, an urban community in Nigeria, were derived. The adjusted effects of these variables on child mortality were assessed. The variables found to exert significant independent effects on child mortality included the husbands education, area of residence in the town, the parity of the mother, her use of modern contraception, availability of indoor pipe-borne water and the use of a refrigerator by the household. Reliable or useful information on child mortality in this part of Nigeria is hard to come by, hence, the estimates provided here can serve as useful baseline data for evaluating the impacts of child survival activities that are currently going on in that part of the countr

Child mortality in a Nigerian City: Its levels and socioeconomic differentials

Using the 'indirect' demographic estimation technique, levels of child mortality for some selected socioeconomic characteristics of mothers in Ilorin, an urban community in Nigeria, were derived. The adjusted effects of these variables on child mortality were assessed. The variables found to exert significant independent effects on child mortality included the husbands education, area of residence in the town, the parity of the mother, her use of modern contraception, availability of indoor pipe-borne water and the use of a refrigerator by the household. Reliable or useful information on child mortality in this part of Nigeria is hard to come by, hence, the estimates provided here can serve as useful baseline data for evaluating the impacts of child survival activities that are currently going on in that part of the country.child mortality education Nigeria socioeconomic differentials