Hearing the silences: adult Nigerian women’s accounts of ‘early marriages’

‘Early marriage’ is a relatively common, but under-researched global phenomenon, associated with poor health, mental health, educational and occupational outcomes, particularly for young girls. In this article, we draw on qualitative interviews with 6 Nigerian women from Sokoto State, who were married between the ages of 8 and 15. The interviews explored young women’s experiences of the transition to marriage, being married, pregnancy and their understanding of the marital and parental role. Using Interpretive Phenomenological Analysis, we explore women’s constrained articulations of their experiences of early marriage, as they are constituted within a social context where the identity of ‘woman’ is bound up in values and practices around marriage and motherhood. We explore the complexity of ‘hearing’ women’s experiences when their identities are bound up in culturally overdetermined ideas of femininity that function explicitly to silence and constrain the spaces in which women can speak

Prevalence and factors associated with non-utilization of healthcare facility for childbirth in rural and urban Nigeria: Analysis of a national population-based survey

Aim: The aim of this study was to assess the rural–urban differences in the prevalence and factors associated with non-utilization of healthcare facility for childbirth (home delivery) in Nigeria. Methods: Dataset from the Nigeria demographic and health survey, 2013, disaggregated by rural–urban residence were analyzed with appropriate adjustment for the cluster sampling design of the survey. Factors associated with home delivery were identified using multivariable logistic regression analysis. Results: In rural and urban residence, the prevalence of home delivery were 78.3% and 38.1%, respectively (p < 0.001). The lowest prevalence of home delivery occurred in the South-East region for rural residence (18.6%) and the South-West region for urban residence (17.9%). The North-West region had the highest prevalence of home delivery, 93.6% and 70.5% in rural and urban residence, respectively. Low maternal as well as paternal education, low antenatal attendance, being less wealthy, the practice of Islam, and living in the North-East, North-West and the South-South regions increased the likelihood of home delivery in both rural and urban residences. Whether in rural or urban residence, birth order of one decreased the likelihood of home delivery. In rural residence only, living in the North-Central region increased the chances of home delivery. In urban residence only, maternal age ⩾ 36 years decreased the likelihood of home delivery, while ‘Traditionalist/other’ religion and maternal age < 20 years increased it. Conclusion: The prevalence of home delivery was much higher in rural than urban Nigeria and the associated factors differ to varying degrees in the two residences. Future intervention efforts would need to prioritize findings in this study

Determinants of exclusive breastfeeding in Nigeria

<p>Abstract</p> <p>Background</p> <p>Exclusive breast feeding (EBF) has important protective effects on the survival of infants and decreases risk for many early-life diseases. The purpose of this study was to assess the factors associated with EBF in Nigeria.</p> <p>Methods</p> <p>Data on 658 children less than 6 months of age were obtained from the Nigeria Demographic and Health Survey (NDHS) 2003. The 2003 NDHS was a multi-stage cluster sample survey of 7864 households. EBF rates were examined against a set of individual, household and community level variables using a backward stepwise multilevel logistic regression method.</p> <p>Results</p> <p>The average EBF rate among infants younger than 6 months of age was 16.4% (95%CI: 12.6%-21.1%) but was only 7.1% in infants in their fifth month of age. After adjusting for potential confounders, multivariate analyses revealed that the odds of EBF were higher in rich (Adjusted Odds Ratios (AOR) = 1.15, CI = 0.28-6.69) and middle level (AOR = 2.45, CI = 1.06-5.68) households than poor households. Increasing infant age was associated with significantly less EBF (AOR = 0.65, 95%CI: 0.51-0.82). Mothers who had four or more antenatal visits were significantly more likely to engage in EBF (AOR = 2.70, 95%CI = 1.04-7.01). Female infants were more likely to be exclusively breastfed than male infants (AOR = 2.13, 95%CI = 1.03-4.39). Mothers who lived in the North Central geopolitical region were significantly more likely to exclusively breastfeed their babies than those mothers who lived in other geopolitical regions.</p> <p>Conclusions</p> <p>The EBF rate in Nigeria is low and falls well short of the expected levels needed to achieve a substantial reduction in child mortality. Antenatal care was strongly associated with an increased rate of EBF. Appropriate infant feeding practises are needed if Nigeria is to reach the child survival Millennium Development Goal of reducing infant mortality from about 100 deaths per 1000 live births to a target of 35 deaths per 1000 live births by the year 2015.</p

Pattern and determinants of BCG immunisation delays in a sub-Saharan African community

<p>Abstract</p> <p>Background</p> <p>Childhood immunisation is recognised worldwide as an essential component of health systems and an indispensable indicator of quality of care for vaccine-preventable diseases. While performance of immunisation programmes is more commonly measured by coverage, ensuring that every child is immunised at the earliest/appropriate age is an important public health goal. This study therefore set out to determine the pattern and predictors of Bacille de Calmette-Guérin (BCG) immunisation delays in the first three months of life in a Sub-Saharan African community where BCG is scheduled at birth in order to facilitate necessary changes in current policy and practices for improved services.</p> <p>Methods</p> <p>A cross-sectional study in which immunisation delays among infants aged 0-3 months attending community-based BCG clinics in Lagos, Nigeria over a 2-year period from July 2005 to June 2007 were assessed by survival analysis and associated factors determined by multivariable logistic regression. Population attributable risk (PAR) was computed for the predictors of delays.</p> <p>Results</p> <p>BCG was delayed beyond three months in 31.6% of all eligible infants. Of 5171 infants enrolled, 3380 (65.4%) were immunised within two weeks and a further 1265 (24.5%) by six weeks. A significantly higher proportion of infants born in hospitals were vaccinated in the first six weeks compared to those born outside hospitals. Undernourishment was predictive of delays beyond 2 and 6 weeks while treated hyperbilirubinaemia was associated with decreased odds for any delays. Lack of antenatal care and multiple gestations were also predictive of delays beyond 6 weeks. Undernourishment was associated with the highest PAR for delays beyond 2 weeks (18.7%) and 6 weeks (20.8%).</p> <p>Conclusions</p> <p>BCG immunisation is associated with significant delays in this setting and infants at increased risk of delays can be identified and supported early possibly through improved maternal uptake of antenatal care. Combining BCG with subsequent immunisation(s) at 6 weeks for infants who missed the BCG may be considered.</p

Impact of mothers’ socio-demographic factors and antenatal clinic attendance on neonatal mortality in Nigeria

Neonatal death is often referred to maternal complications during pregnancy, and other exogenous factors that exist around the time of birth or shortly after birth. The United Nations Sustainable Development Goals (UNSDG)-Goal 3, Targets 3.2 aimed at ending preventable deaths of newborns by demanding that all countries should reduce neonatal mortality to 12 per 1000 live births by 2030. The objective of the study was to examine the relationship between mothers’ socioeconomic and demographic factors on neonatal deaths in Nigeria. The study used quantitative data from the 2013 Nigeria Demographic and Health Surveys (NDHS). The data analyzed consisted of 26,826 women aged 15–49 years who had a live or dead birth within the 5 years preceding the survey. STATA 12 computer software was used to carry out data analyses. Data analyses were at univariate (frequency distribution), bivariate (chi-square) and due to the dichotomous nature of the outcome variable (i.e., whether a child was born alive or dead during the delivery; coded as (1, 0), a binary logistic regression was carried out to examine the relationships between various socio-demographic factors, antenatal clinic attendance and neonatal mortality in Nigeria. The results, among others, revealed that background factors of the women such as age, region, residence, education, and wealth status have a significant association with neonatal mortality (P < 0.05). The study also found that adequate antenatal clinic attendance helps to reduce neonatal deaths. The study recommended that women should be encouraged to observe regular antenatal clinic visits during pregnancy and also go for institutional delivery for possible reduction of neonates and infant deaths in Nigeria