Use of maternal health care as a predictor of postpartum contraception in Nigeria

This study examines the relationship between the utilisation of maternal health care and the postpartum use of contraception in Nigeria. The analysis was based on the data from the Women’s Questionnaire and the calendar data from the 2008 Nigeria Demographic and Health Survey (NDHS). Only women whose most recent birth was between January 2003 and one full year before the date of interview in 2008 were included. The use of maternal health care (ANC visits and timing of postnatal check-up) is significantly associated with the use of a modern method of contraception during the postpartum period. Other significant predictors of the postpartum use of a modern method include region, education, the household wealth index, exposure to family planning messages and religion. The findings suggest that contraceptive use among postpartum women will increase substantially if more women use maternal health care services, especially for antenatal care and postnatal care

Maternal Socioeconomic Status and Fertility Behaviour in Nigeria: Evidence from a Cross Sectional Nationally Representative Survey

Aims: Studies have linked individual factors such as education and household variables including wealth index as predictors of fertility behaviour. This study aims to examine the effect of socioeconomic characteristics on fertility behaviour when combined as a single proxy among women of reproductive ages in Nigeria. Methods: Data for this study was extracted from the Nigeria Demographic and Health Surveys (NDHS) of 2003, 2008, and 2013. The explanatory variable, “socioeconomic status”, was derived as a composite index from the combination of individual and household variables. The outcome variable “fertility behaviour” is measured by total children ever born (CEB). Pearson chi-square test was used to determine the association among variables. Ordinal logistic regression was used to assess the effect of the explanatory variable on the outcome variable. Level of significance was determined at 5% and 95% confidence interval. The analysis was carried out using Stata 14.0. Results: There is a statistically significant but inverse association between socioeconomic status and reported CEB. If women were to change their socioeconomic status from low to high, the CEB would reduce by -0.502 (p<.001) and by -1.038 (p<.000). This pattern remained consistent in the adjusted model and across all surveys. Conclusion: The study concludes that women’s socioeconomic status significantly predicts fertility behaviour. An improved socioeconomic status would reduce reported CEB. Efforts to reduce fertility in Nigeria must embrace a multi-dimensional approach that creates opportunities aimed at promoting women’s economic status

Religion as a Social Determinant of Maternal Health Care Service Utilisation in Nigeria

This study examines the relationship between religious affiliation and utilisation of maternal health care services using 2013 Nigeria Demographic and Health Survey data. The outcome variable is utilisation of maternal health care service measured by antenatal care and place of delivery. The explanatory variables were religion and three purposively selected social determinants of health, namely the social gradient, work condition and social exclusion. The chi-square test and multinomial logistic regression were applied. Result show that 50.7% had the recommended 4 or more antenatal care visits; 23.4% and 13.5% respectively utilise public and private sector facilities for their most recent child delivery. The relative risk of having 4 or more antenatal visits reduce by a factor of 0.7863 for Muslim women (p<0.05), and increase by a factor of 5.3806 for women in higher social ladder (p<0.01). Religion should be integrated into the social determinants of health framework.

Grandparenting in Selected West African Countries: Implications for Health and Hygiene Behaviours in the Household

This is a descriptive study of the health and hygiene behaviors of grandparents who are the primary caregivers of their grandchildren in four West African countries, Ghana, Liberia, Nigeria, and Sierra Leone. The article utilizes data from each country’s most recent Demographic and Health Survey (DHS). The study identified 20,841 households where grandparents were primary caregivers. As expected, most of these households are in Nigeria given their population exceeds the collective population of the other three West African countries. However, the number of grandfamilies in Ghana, Sierra Leone and Liberia is still worrisome for their population size. In each country, over half of the children in the care of their grandparents are preschool age or younger, suggesting the type of services in early child care that may be required. Regarding health and hygiene behaviors, over 60% of grandparent households have access to mosquito bed nets, but over 50% of the grandparents report not using, with Nigeria report the largest non- usage rate of 78.6%. Although the available of data is limited in scope, the descriptive analysis provides a foundation upon which more rigorous research can be built to address the health risks and needs confronting grandfamilies in African countries

Women's empowerment status and exposure to maternal mortality risks in Nigeria

The statistics on maternal mortality clearly show that Nigeria is lagging in the struggle to significantly improve maternal health. Annually, an estimated 50,000 to 59,000 Nigeria women of reproductive age die because of pregnancy and childbirth. One of the main reasons for this high rate has been the low level of involvement of women in decision-making process. Men generally view some of reproductive health issues as their prerogative, issues in which the compliance of their wives is taken for granted. The study employed the women’s data from the 2008 NDHS to examine the relationship between women’s decision-making autonomy and exposure to mortality risks. Given that the study was interested in the risks of maternal mortality in the country, the analysis was restricted to only the women who had at least a birth in the last five years (preceding the survey). A total of 17635 women out of the 33385 women interviewed nationwide in the 2008 NDHS, met the inclusion criteria. The analysis was done at univariate and bivariate levels. Also, using logistic regression models, multivariate analyses were performed to estimate the odds ratios for each of the predictor variables in the models. The study shows that 36% of the women did not make a single antenatal visit to a hospital during the duration of their last pregnancy; as many as 63% did not deliver in a health facility (government or privately owned); and about 60% did not deliver with the assistance of a skilled provider. After controlling for the confounding influence of some other independent variables, the study suggests that the “strong authority” of women in household decision-making gives them a voice that is heard in the house and ability to initiate moves to obtain healthcare without necessarily waiting for “administrative clearance” from adult males within the husband’s family.Keywords: Women Empowerment, Maternal Mortality Risks, Antenatal Visits, Skilled Birth Attendants, Nigeri

Differentials in unmet need for modern contraceptives among currently married women in Nigeria: analysis of Nigerian Demographic and Health Survey, 2013

Of the many causes of high fertility, unmet needs for family planning methods remain at forefront. In Nigeria, current contraceptive prevalence rate is approximately 10% and about one in every five women have unmet need for contraception. This study will examine socio economic and demographic characteristics of currently married women and explore how it contributes to differentials in unmet need across the regions of the country. A cross-sectional secondary data of the NDHS, 2013 was used in the study. Data of women who are currently married was extracted for the study. Data was analysed at both univariate and bivariate levels using STATA 14. Within age groups, the analysis showed women aged 25-29 years had the highest unmet need for modern contraception while unmet need to space and to limit was found highest among women who had their first birth before age 24. Findings showed different background factors of women such as level of education, religion, residence, household wealth, age at first and CEB significantly contribute to differentials in unmet need for modern contraception either to limit or to space births. The study hereby concludes by advocating the integration of family planning services into communities to increase accessibility to and availability of modern contraceptives.Keywords: Unmet need, Family Planning, Fertility, Differentials, Modern Contraceptive

Contraceptive use and distribution of high-risk births in Nigeria: a sub-national analysis

Background: Family planning expansion has been identified as an impetus to harnessing Nigeria’s demographic dividend. However, there is a need for data to address pockets of inequality and to better understand cultural and social factors affecting contraceptive use and health benefits. This paper contributes to addressing these needs by providing evidence on the trends and sub-national patterns of modern contraceptive prevalence in Nigeria and the association between contraceptive use and high-risk births in Nigeria. Design: The study utilised women’s data from the last three Demographic and Health Surveys (2003, 2008, and 2013) in Nigeria. The analysis involved descriptive, bivariate, and multivariate analyses. The multivariate analyses were performed to examine the relationship between high-risk births and contraceptive use. Associations were examined using Poisson regression. Results: Findings showed that respondents in avoidable high-risk birth categories were less likely to use contraceptives compared to those at no risk [rate ratio 0.82, confidence interval: 0.76_0.89, pB0.001]. Education and wealth index consistently predicted significant differences in contraceptive use across the models. Conclusions: The results of this study suggest that women in the high-risk birth categories were significantly less likely to use a modern method of contraception relative to those categorised as having no risk. However, there are huge sub-national variations at regional and state levels in contraceptive prevalence and subsequent high-risk births. These results further strengthen evidence-based justification for increased investments in family planning programmes at the state and regional levels, particularly regions and states with high unmet needs for family plannin