Female Autonomy, Use of Family Planning and Maternal Health in Nigeria

Abstract: Background There is growing evidence in many parts of the world that women’s autonomy and power within households influence couples’ childbearing decisions. For developing countries like Nigeria, the scientific base for this claim is weak and further research is needed on the specific conditions under which women’s status and childbearing patterns are related. While it is recognized, that family planning, prenatal health services and child health can improve the survival and quality of life for mothers and children in several societies, what vary are the specific determining factors of the levels of fertility to which any survival strategy is hinged. Level of fertility varies from one society to another, not just for differentials associated with biological or social mechanism but also strongly as a result of social pressures affecting individual decision-making in human reproduction. Such decision – making at the family and individual levels influences why pressures may also take the form of prescriptions on who can have children, time limits of commencement and end of childbearing as well as desirable intervals between children. Fertility behavior therefore reflects the values of a society. One of such values that is of interest to this research effort is the use of family planning method. Research Questions Researchers have examined the consequences of certain behavioral patterns on the reproductive health of women in many parts of Nigeria. These range from breast feeding patterns to family planning and attitude to the use of maternal and health services. The relationship between child-spacing patterns through family planning and woman’s status on the one hand and their implication for woman’s reproductive health has not been sufficiently documented in Nigeria. The study answers the following questions; What is the relationship between women autonomy and birth spacing through the use of family planning? Does the utilization of family planning affect desired family size? What implication does the utilization of family planning have on the maternal health? Hypotheses A major shift in the women autonomy may likely influence the use of family planning for birth spacing. There is a relationship between the utilization of family planning and desired family size There is a direct relationship between birth spacing pattern and women’s reproductive health The paper was based on 2008 Nigeria’s Demographic and Health Survey data (NDHS). Representative sampling of 33,385 women aged 15-59 years were interviewed. The data were collected from six geographical regions of the country with women drawn from different cultural backgrounds. Measures of women’s autonomy were based on two categories. The first category was based on direct autonomy indicators which are education, occupation and wealth index. The second category was based on the female participation in decision making. This was based on three questions: Who has the final say on your health? Who has the final say on household purchases? Who takes decision on the use of contraceptives? Those women who indicated that they can take decision were combined with those who indicated joint decision with their husbands. These women were considered as having autonomy. On the maternal health variables used for this study are; ever experienced pregnancy termination, miscarriages, abortion and still birth, experienced constant leaking of urine and stool. The data was analyzed using Statistical Package and Software Solutions (SPSS 16.0). Three levels of analysis were used in this paper, the univariate analysis is used to explain the socio-demographic variables and fertility behavior while bivariate and multivariate analysis were used to identify autonomy as a decisive factor for using family planning methods and maternal health among women in Nigeria Methodology: The paper was based on 2008 Nigeria’s Demographic and Health Survey data (NDHS). Representative sampling of 33,385 women aged 15-59 years were interviewed. The data were collected from six geographical regions of the country with women drawn from different cultural backgrounds. Measures of women’s autonomy were based on two categories. The first category was based on direct autonomy indicators which are education, occupation and wealth index. The second category was based on the female participation in decision making. This was based on three questions: Who has the final say on your health? Who has the final say on household purchases? Who takes decision on the use of contraceptives? Those women who indicated that they can take decision were combined with those who indicated joint decision with their husbands. These women were considered as having autonomy. On the maternal health variables used for this study are; ever experienced pregnancy termination, miscarriages, abortion and still birth, experienced constant leaking of urine and stool. The data was analyzed using Statistical Package and Software Solutions (SPSS 16.0). Three levels of analysis were used in this paper, the univariate analysis is used to explain the socio-demographic variables and fertility behavior while bivariate and multivariate analysis were used to identify autonomy as a decisive factor for using family planning methods and maternal health among women in Nigeria Results/key findings: From the study 37% and 36% of those who have experienced a constant leaking of urine and miscarriages or still births ever used any contraceptives methods respectively. The study reveals a significant relationship between the two categories of the autonomy measured and the use of family planning while the autonomy by the decision making shows an inverse relationship with the maternal health challenges. The result also indicates a negative relationship between the knowledge of the modern methods and maternal health. Spacing of births by apparent use of family planning is greater among women with education above secondary education than women without formal education who adopted contraception for limiting purposes at age 30 years and above. Women’s autonomy, use of modern methods, number of living children, knowledge of modern methods are the factors for the likelihood of having maternal health challenges in the study area. Knowledge contribution: Prioritize family planning, is one of the most cost-effective investments in reducing maternal death in Nigeria. Since the study has also confirmed the significant relationship between autonomy and contraceptive use, women should be educated up to secondary level. This will give them adequate knowledge about reproductive issues and will reduce maternal and child mortality

Household food Insecurity and Exclusive Breastfeeding: Implications for Child Survival in Osogbo, Osun State Nigeria.

Increase in the prices of food commodities in the last seven years has resulted to food crisis and food intake. Consequently, these effects impact the health and nutritional status of households especially among lactating mothers, infants, and pregnant women. The study therefore examines the impact of household food insecurity on the exclusive breast-feeding and its implications for child survival. The study was carried out in Osogbo, Osun State south-western Nigeria. A multi-stage random sampling procedure was employed in the administration of 230 questionnaires to lactating mothers. For qualitative data, four focus group discussions (FGD) were conducted to collect information from married women within the study population. The data collected were subjected to basic demographic analytical techniques. From the study it was revealed that less that 40% practice exclusive breastfeeding while majority of the respondents (65%) start introducing complementary feeding from four months. Reasons given for the complimentary feeding include inadequate milk in the breast, insufficient food for the mother and child’s illness. Two thirds of the respondents explained that their children had illnesses in the last two weeks preceding the survey. There is a significant relationship between ever-experienced food shortage, exclusive breastfeeding and child illness. Level of income, education, number of children, place of delivery and meal skipping habits on the likelihood of practicing exclusive breastfeeding is established in the study. The study concludes that for Nigeria to achieve reduction in infant mortality, food production must be given adequate priority

A Statistical Analysis of Child Mortality: Evidence from Nigeria

Despite the global decline in under-five mortality rate from 90 deaths per 1,000 live births in 1990 to 48 in 2012, Nigeria has failed to record any substantial improvement. Under-five mortality in Nigeria increased from 138 per 1,000 live births in 2007 to 158 per 1,000 live births in 2011 against the Millennium development Goal target of 71 per 1,000 live births. The study used data from the Nigeria Demographic and Health Survey (NDHS) 2008 to investigate the predictors of child (aged 0-4 years) mortality in Nigeria. Only data for the currently married women were extracted and filtered by the experience of child mortality (n = 6,256) and those who do not have such experience (n = 9,809). Overall, 16,065 women were covered. Cross-tabulation and binary logistic regression techniques were employed in the statistical analysis. The cross-tabulation analysis shows that that mortality rate was highest (49.14%) for children of illiterate mothers and lowest (13.29%) among mothers with higher education. In the logistic regression analysis, education of both parents and occupation of mothers were found statistically significant to reduction in child mortality rate. The result also revealed that mothers’ wealth index, age at first birth and usual of place of residence have substantial impact on child mortality in Nigeria. The authors suggested that increase in women education could increase age at first birth and mitigate the risk of poor child health outcomes. Key words: Child mortality, predictors, wealth inde

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

Influence of socio-cultural factors on child's upbringing in Oshodi/Isolo Local Government Area of Lagos State, Nigeria

This paper investigated the influence of socio-cultural factors on child's upbringing in Oshodi/Isolo Local Government Area of Lagos State, Nigeria. Precisely, 250 parents having children that are 0-12 years were interviewed with the aid of questionnaire schedule. The study tested only two hypotheses. Frequency table, Chi-square and binary logistic regression analysis were employed to analyze the data obtained from the survey. The major findings are: firstly, that the socio-cultural factors identified in this study include; the influence of residential environment, family, culture and social institutions. Secondly, that the socio-cultural factors such as; the influence of family, social institutions and residential environment are significantly related to child's upbringing through authoritarian parenting style.Thus, the paper recommends the following: firstly, that the native culture of every parent should reflect in their choice of authoritarian parenting style. Lastly, the family involvement, social institution and residential environment should form the bedrock in child's upbringing in every Nigerian society

Undergraduates Perspectives on Sex Education and Teenage Pregnancy in Covenant University, Ota, Ogun State, Nigeria

This study examines undergraduates' perspective on sex education and teenage pregnancy in Covenant University, Ota, Ogun State, Nigeria. The study population was 250 undergraduates of Covenant University. Frequency tables, linear regression analysis and analysis of variance were used to analyze the data collected via self-administered questionnaires. Two hypotheses were tested in this study. The results derived from this study are: firstly, that the level of awareness on sex education is significantly related to teenage pregnancy .. Secondly, the t statistics at p=O.OOO shows that there is a high significant relationship between the use of contraceptive and teenage pregnancy. Also, the Analysis of Variance (ANOVA) indicated that at p= 0.000, there is a high significant relationship between sex education and teenage pregnancy. Thus, the paper recommends the following: Firstly, that there should be, as a matter of urgency, the establishment of functional youth-friendly services that will enable teenagers to express their opinions on sexual activity. Secondly, teenagers should be exposed to basic sex education in both primary and secondary schools so that contraceptive methods and their usage will not be strange to them. Thirdly, training of teenagers by healthcare service providers should be made available to the teenagers so that they would be able to open up on matters relating to their sexual life

Effects of Adolescents Exposure to Sexual Contents on Social Media in Nigeria

The study examined the effects of adolescents’ exposure to sexual contents as available in the social media. Data was gathered among 305 literates adolescents using quantitative structured face-to-face interviews. They were distributed using Nigerian age-sex ratio of 51 and 49 between male and female respectively. The study locations consist of densely populated urban areas in Lagos metropolis, Nigeria. The locations were chosen due to high proportion of adolescents in the areas according to the country’s census results. Data were analysed using univariate and multivariate analyses. Common social media identified among the respondents includes Facebook, Twitter, YouTube, Flickr, Instagram and LinkedIn. The result also revealed that users of social media in age group 10-14 years are 4.614 times more likely to be exposed to sexual activity at P-value = 0.000. Adolescent users of social media with primary education are 26.953 times more likely to be involved in sexual activity (P-value = 0.000). Those who use social media like Twitter, Facebook, YouTube and Instagram are 6.932, 4.630, 3.566 and 2.682 times (respectively) more likely to be exposed to sexual activity compared to their counterparts that use other forms of media. The paper posits that it is inimical not to monitor adolescents’ exposure to sexual contents and censor the scenes available on social media gadgets. The study recommends that sexuality education must be popularised in order to stem the risk of HIV/AIDS among the group studied

Levels and Trends in Household Source of Cooking Fuel in Nigeria: Implications on Under-Five Mortality

Background: Studies have shown that characteristics present in the neighbourhood where children are raised might likely influence the mortality risks of such children. Cooking fuel can be regarded as one of the environmental factors determined by the socioeconomic background of the household, but the nexus between this and the health outcome of under-five children had received little attention. Objective: This study seeks to examine the levels and trends of source of cooking fuels among households in Nigeria as implied on under-five mortality. Methods: The data used was the Nigeria Demographic and Health Survey (NDHS)-Child Recode file of 2003, 2008 and 2013. The method of analysis used was the descriptive approach which includes cross tabulation, charts and tables. The chi-square statistic was used to show the significance of the association between the variables of interest in the study. Results: The percentage of U-5 children who lived in homes where wood was used as cooking fuel was about 80 percent. The findings from this study show that there was a highly significant relationship between type of cooking fuel and under-five mortality in Nigeria (P<0.001). The poorest and the poorer represented the highest percentage among the households that used wood and agric. crop/dung for cooking. Environmental factor such as type of cooking fuel is significantly associated to socioeconomic characteristics of the household where the child lives, some of which includes wealth status and place of residence as discussed in the result. Recommendation and conclusion: The study found that, there has not been a major improvement in the source of cooking fuel in households where under-five children are raised and this contribute in determining their health outcomes. Therefore, the government of Nigeria needs to provide reliable power supply (electricity) for household consumption. Also, gas fuel must be made available and affordable for household consumption

SEXUAL BEHAVIOUR IN NIGERIAN CONTEXT, VULNERABILITY TO CERVICAL CANCER AND HEALTH PROMOTION

The study examined the extent to which Nigerian women are vulnerable to cervical cancer in the context of their cultural characteristics of sexual behaviour. The data were extracted from 2015 Regional Breast and Cervical Cancers Survey that targeted women in age 15-49 years using structured face-to-face interviews. The geo-political zones constituted the strata, out of which two geo-political zones (South West and North Central) were randomly selected and only two states (one from each zone) were randomly picked. The data were analysed using univariate and multivariate techniques. The study revealed the proportion of respondents with identified risk factors that could increase vulnerability to cervical cancer including STIs such as vagina discharge (15.4%) experience heavy or long menstruation (13.9%), discomfort during sexual intercourse (13.1%), pelvic pain (9.5%) and bleeding in-between menstrual periods (5.6%). Multiple sexual partnership practice was not perceived as a risk factor to cervical cancer. The study concludes that the traditional passivity on women sexual relationship could aggravate the vulnerability to cervical cancer. Counselling also would be necessary to address women perception and understanding of various implications of their sexual behaviour in order to reduce the spread of not only cervical cancer but also other reproductive health challenges