Socio-Economic and Cultural Determinants of Use of Modern Healthcare Facilities for Delivery by Mothers in Nigeria

This study examined the socio-economic and cultural determinants of use of modern healthcare facilities for delivery by mothers in Nigeria. The objectives of the study are to identify the socio-economic, demographic and cultural factors (referred to as background factors or variables), that are influencing mothers to deliver in modern healthcare facilities, and to identify those more direct factors (called proximate determinants) through which the background factors are operating to influence mothers’ delivery in modern healthcare facilities. The study used quantitative data from the 2008 Nigeria Demographic and Health Surveys (NDHS). Data on 17,635 women aged 15-49 years who had a live birth within the five years preceding the survey were extracted from the 33,385 women sampled in the survey. Using STATA 12 computer software, data analyses were done and presented in three stages, that is, Univariate, Bivariate and Multivariate analyses. In the study, 36.6% of all the deliveries took place in modern healthcare facilities while the remaining 63.4% deliveries took place outside of healthcare facilities. Data analysis at the bivariate level showed that all the selected background variables were significantly related to healthcare facility delivery. The variables are current age, marital status, children ever born, educational attainment, occupation, wealth index, rural/urban residence, region, ethnic group and religion. At the multivariate level, some of the background variables (i.e., mothers’ education, children ever born, region, marital status, and wealth status of the woman) still maintained significant relationship with the outcome variable (i.e., delivery in healthcare facilities). Increase in mother’s level of education and wealth status corresponds to increased use of modern healthcare facilities for delivery. Also, there is significant variation in the use of modern healthcare facilities for delivery among mothers in different geopolitical zones of the country. More mothers in the Southern zones were delivering their babies in healthcare facilities than the mothers in the Northern zones. Five proximate determinants were proposed to be examined in the study but only two could be fully used due to limited data on the other three. The two used were antenatal clinic attendance and decision-making autonomy of the woman. The other three that could not be fully utilized were cost of service, accessibility to service and trust of healthcare system. The two proximate determinants used significantly helped to explain the indirect effects of the background variables on modern healthcare facility delivery. Mothers who had adequate antenatal clinic attendance delivered their babies in healthcare facilities more than those mothers who did not attend or whose attendance were inadequate. Also, mothers who had autonomy in decision-making on their use of healthcare services delivered in healthcare facilities more than those mothers who did not have such autonomy. We therefore conclude that antenatal clinic attendance and women’s decision-making autonomy are important proximate factors through which the socioeconomic, demographic and cultural factors influence mothers to deliver their babies in modern healthcare facilities. Hence, policies that are targeted to ensure adequate antenatal clinic attendance by pregnant women and those that also encourage women’s autonomy in decision-making on their healthcare services utilization would go a long way in increasing the level of utilization of healthcare facilities for delivery in Nigeria

BIRTH ORDER AS A CORRELATE OF EDUCATION PERFORMANCE AMONG SECONDARY SCHOOL STUDENTS IN AKURE, SOUTHWESTERN NIGERIA

This study examines the effect of birth order on a child’s educational performance. The main objective of the study was to examine the effect and relationship between birth order and students' academic performance. A survey design using random sampling technique was employed in administering 240 well structured questionnaires among secondary school students in Akure South Local Government Area in Akure, Ondo State. Data were analyzed with the aid of the SPSS 15.0. Statistical techniques used include percentage distribution, cross tabulation and regression analysis (ANOVA). In this study, it was observed that being first-born confers an important educational advantage that persists when considering earnings while on the other hand being last born confers none. The ANOVA regressions analysis show that perception of favoritism for education/schooling, sex, and average score in school performance are significant predictors of Birth order among secondary school students. The recommendation for this study is that parent should help by playing an important role in strengthening their education and take proper care of each and every birth order

The Role of Parents in Early Childhood Education: A case Study of Ikeja, Lagos State

This research aims at providing solutions to role of parents in early childhood education in Nigeria. It will serve as an eye opener to parents and the society in helping to modify or re-adjust their mode of parental involvement towards achieving a better future for themselves and their children notwithstanding their busy schedules and in some cases, inadequacy of resources. A survey approach was used through self- administered questionnaires, and analysis was done using Analysis of Variance (ANOVA) to test the hypotheses. Based on the findings of this work, parental involvement, that is emotional care and support has a very big influence on early childhood education, particularly the academic performance of the child. More so, it was observed that the extent of parental educational attainment has a significant influence on the age which the child is being sent to school. This implies that the extent or level of the parental educational attainment and exposure determines the age at which the child is being enrolled to school. It was also discovered that, the residential setting of the parents (respondents) has nothing to do with the educational performance of the child. On the whole, parental involvement is very essential in early childhood education and this helps to broaden the child’s horizon, enhance social relationships, and promote a sense of self-esteem and self-efficacy

Couples’ Socio-Economic Characteristics: Determinants of Children’s Nutritional Status in Akure South Local Government Area of Ondo State, Nigeria

The aim of the study is to examine the socio-economic characteristics of couples as they affect the nutritional status of children ≤5 years of age in Akure South Local Government area of Ondo State, Nigeria. Multistage sampling technique was used to select 200 couples whose last two children were not more than 5 years of age at the time of the interview. The mean age of the fathers was found to be 39years while that of the mothers was found to be 32years; more than half of the fathers (53.5%) had up to a tertiary education, whereas about half of the mothers (47.5%) had up to secondary education. The result of the bivariate analysis revealed a significant relationship between fathers’ income and children’s nutritional status (p<0.05); so also a significant relationship was found between mothers’ age and children’s nutritional status. Further analysis using the logistic regression coupled with the forward stepwise regression further found fathers’ income as the best predictor of children’s nutritional status, while mothers’ age at first marriage was found to be the best predictor of children’s nutritional status

Household Sanitation and Child Morbidity: Impact on Child Survival

The Issues of Households Sanitation and Child morbidity cannot be over emphasized; as it relates to the understanding of how these factors influences the health of children. Therefore, the research tends to examine Household Sanitation and Child Morbidity as its impact on Child’s Health survival. The objective of the study basically aims at examining the effect of Household conditions on the child’s health, assessing the relative importance of Distal determinants on household sanitation, and also to ascertain the influence of Home safety precaution on the health of children in Nigeria. The study sets out to empirically investigate the relationship between Household Sanitation and child morbidity in Nigeria using 2008 NDHS data for women inNigeria. A univariate and multivariate analysis was carried to analyze the effects of the predictors, making use of the Two way analysis of variance to determine the effect of household condition on child morbidity, a linear regression to determine the effect of Home safety precaution on child morbidity, and finally a Binary regression to show the influence of Distal determinant on child morbidity. In Nigeria today, the present situation of sanitation calls for a very serious reflection on her errors of judgment or neglect, and a determination to take the necessary and bold remedial steps clearly focused on adequate investment on proper sanitation. The study recommends that there is the need to devote more attention to helping the individuals of each household in Nigeria to ensure proper sanitation and ensure good health. Keyword: household sanitation, child morbidity, child mortality, Water and diarrhe

PREVALENCE AND DETERMINANTS OF USE OF MODERN HEALTH FACILITIES FOR DELIVERY BY NIGERIAN WOMEN

Delivery is potentially a hazardous process as most maternal mortality occurs during delivery. Utilization of maternal health services offered by institutional or modern health facilities is known to be associated with decrease in maternal, neonatal and infant mortality rates because health facility delivery affords the woman the attendance of skilled or professional health personnel at childbirth. Yet many women in the developing countries including Nigeria still deliver outside health facilities, particularly at home without professional attendance, risking survival of both the mother and the baby. Nigeria is one of the countries of the world that have the highest maternal, infant and child mortality rates. It is also one of the countries with low use of health facilities for delivery. In 1999, only 37.3% of mothers in the country delivered in health facilities (NDHS, 1999), and in 2003 only 32.6% delivered in health facilities (NDHS 2003). Identifying the factors affecting the use of modern health facilities for delivery is essential for appropriate policies and programs that can help to increase health facility utilization for delivery and thereby decrease maternal and infant mortality in Nigeria. This study aimed to establish the prevalence (i.e., levels) of use of modern health facilities (public and private), for delivery in Nigeria. It also aimed at identifying the socioeconomic and demographic determinants of use of health facility delivery in the country. The study was a cross sectional analyses of the data from the Nigeria Demographic and Health Survey (NDHS) conducted in 2008. The NDHS covers a nationally representative sample of more than 36,000 households based on 2006 Population and Housing Census of the Federal Republic of Nigeria, 2006. The NDHS interviewed 33,385 women aged 15 to 49 years, and 15,486 men aged 15 to 59 years. This study analysed responses from the 17,635 women aged 15-49, who had at least one live birth in the five years preceding the survey. The univariate, bivariate and multivariate analytical techniques were adopted. To estimate the effects of socioeconomic and demographic factors on delivery in health facilities, binary logistic regression analysis was adopted as the multivariate technique. Results show that only 36.7% of deliveries took place in health facilities. Using binary logistic regression analysis, the following variables were significant predictors of use of health facilities for delivery: mother’s age, children ever born, education, region of residence, religion and wealth status. In order to significantly increase the level of use of health facilities for delivery by Nigerian women, and thereby reduce maternal and infant mortality, policies and programs should be well targeted to those identified groups with low utilization of health facilitie

GENDER DISCRIMINATION AND DEVELOPMENT IN NIGERIA: ISSUES AND PERSPECTIVE

Women, today, have come to be accepted as the pillars of the smallest economic unit, the family and from them all great people, both male and female, have been birthed. This goes to show that women are forces to be reckoned with in terms of nation building and economic development. However, the special qualities possessed by women have been toned down and played to a minor key due to ignorance on the part of most and lack of concern or appreciation by others. The establishment of structures of inequality against women, as opposed to men, has come to generate the phenomenon of gender discrimination. This study is carried out to emphasize the need for the empowerment of Nigerian women today so as to eradicate gender discrimination. Questionnaires were administered to gather information from respondents concerning their opinions about the phenomenon. Using the SPSS Package, Chi-square method was used to analyze the data that was obtained. It was observed that gender discrimination, as a result of cultural factors, plays a significant role in the employment process of Nigerian organizations. Also, educational acquisition plays an important role in eradicating gender discrimination. The basic recommendation is for development of alternative rules, norms and procedures that provide the avenue for structural transformation to protect what rights women have and increase the comprehensiveness of the rights to which they are entitled

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

Toward Nigeria’s Vision 20:2020: Public Investment in Human Capital and Outcomes

The paper examines Nigeria’s public investment in relation to human capital development outcomes between 2009 and 2012. The aim is to analyse the extent to which human capital development responds to the smart initiative by the Nigerian Government in its drive towards achieving Nigeria’s vision 20:2020. The paper adopted a comparative approach. Human capital in Nigeria was compared with those of Belgium, Poland, Saudi Arabia and Sweden that have been in contention for the 20th largest economy since 2009. The paper found out that the huge investment in education and health in 2011 and 2012 has produced mixed results in human capital development. Some of the challenges identified as hindrances to the achievement of the set targets include; inadequate funding, corruption and child labour. Therefore, the paper concludes that a new law - the Project Implementation Continuity Act which was initiated should be fully implemented. This will ensure that all projects started must be completed before new ones are initiated. This will go a long way in ensuring that the required level of human capital that will engender sustainable economic growth and development are established. Keywords: Public Sector Investment, Human Capital, Sustainable Economic Growth

Toward Nigeria's Vision 20:2020:Public Investment in Human Capital and Outcomes

The paper examines Nigeria’s public investment in relation to human capital development outcomes between 2009 and 2012. The aim is to analyse the extent to which human capital development responds to the smart initiative by the Nigerian Government in its drive towards achieving Nigeria’s vision 20:2020. The paper adopted a comparative approach. Human capital in Nigeria was compared with those of Belgium, Poland, Saudi Arabia and Sweden that have been in contention for the 20th largest economy since 2009. The paper found out that the huge investment in education and health in 2011 and 2012 has produced mixed results in human capital development. Some of the challenges identified as hindrances to the achievement of the set targets include; inadequate funding, corruption and child labour. Therefore, the paper concludes that a new law - the Project Implementation Continuity Act which was initiated should be fully implemented. This will ensure that all projects started must be completed before new ones are initiated. This will go a long way in ensuring that the required level of human capital that will engender sustainable economic growth and development are established