Rural-urban differences in the predictive influence of sex preference on marital dissolution in Nigeria

This study examined the influence of place of residence on sex preference as a predictor of marital dissolution in Nigeria. It also appraised the mediation of socio-demographic factors on the relationship between sex preference and marital dissolution. Data were sourced from the 2018 demographic and health survey of Nigeria. Analyses involved the use of descriptive statistics, Pearson chi-square test and binary logistic regression models. Generally, marital dissolution significantly occurred more in rural than in urban areas. While more respondents had no child sex preference, preference for boys was significantly more among the urban women compared to the rural women. Irrespective of place of residence, sex preference was not a significant predictor of marital dissolution in Nigeria as the unadjusted models of marital dissolution and sex preference indicated that preference for more boys significantly decreased the odds of marital dissolution in the rural (OR=0.84; p=0.05), urban (OR=0.67; p=0.001), and total population (OR=0.77; p=0.001). In addition, preference for more girls significantly decreased the likelihood of marital dissolution in the rural (OR=0.82; p=0.002) and total populations (OR=0.84; p=0.05). Moreover, in the full adjusted model of the total population, preference for more males (OR=0.57; p=0.002) was also significantly associated with decreased odds of marital dissolution. Conversely, other factors that significantly increased the odds of marital dissolution included educational attainment, intimate partner violence, religion, being employed, polygamous unions, and region of residence. Women should achieve higher levels of education and be engaged in income earning occupations as mitigation measures against marital dissolution. Antidissolution campaigns should be initiated, especially in rural areas with high levels of intimate partner violence and in regions with relatively high incidences of marital dissolution/p-/p-1. Keywords: Marital dissolution, Nigeria, place of residence, sex preference Cette étude a examiné l'influence du lieu de résidence sur la préférence sexuelle en tant que prédicteur de la dissolution du mariageau Nigéria. Il a également évalué la médiation des facteurs sociodémographiques sur la relation entre la préférence sexuelle et la dssolution du mariage. Les données proviennent de l'enquête démographique et sanitaire de 2018 au Nigéria. Les analyses  impliquaient l'utilisation de statistiques descriptives, du test du chi carré de Pearson et de modèles de régression logistique binaire.En général, la dissolution du mariage se produit beaucoup plus en milieu rural qu'en milieu urbain. Alors qu'un plus grand nombrede répondants n'avaient pas de préférence sexuelle pour les enfants, la préférence pour les garçons était significativement plus élevée chez les femmes urbaines que chez les femmes rurales. Quel que soit le lieu de résidence, la préférence sexuelle n'était pas un prédicteur significatif de la dissolution du mariage au Nigéria, car les modèles non ajustés de dissolution du mariage et de préférence sexuelle indiquaient que la préférence pour plus de garçons diminuait considérablement les chances de dissolution du mariage en milieu rural (OR = 0,84; p = 0,05), urbaine (OR = 0,67; p = 0,001) et population totale (OR = 0,77; p = 0,001). De plus, la préférence pour un plus grand nombre de filles réduisait considérablement la probabilité de dissolution du mariage dans les populations rurales (OR = 0,82; p = 0,002) et dans l'ensemble (OR = 0,84; p = 0,05). De plus, dans le modèle ajusté complet de la population totale, la préférence pour un plus grand nombre d'hommes (OR = 0,57; p = 0,002) était également associée de manière significative à une diminution des chances de dissolution du mariage. À l'inverse, d'autres facteurs qui augmentaient considérablement les probabilités de dissolution du mariage comprenaient le niveau de scolarité, la violence entre partenaires intimes, la religion, le fait d'avoir un emploi, les unions polygames et la région de résidence. Les femmes devraient atteindre des niveaux d'éducation plus élevés et être engagées dans des professions rémunératrices en tant que mesures d'atténuation contre la dissolution du mariage. Des campagnes anti-dissolution devraient être lancées, en particulier dans les zones rurales où la violence entre partenaires intimes est élevée et dans les régions où l'incidence de la dissolution du mariage est relativement élevée. Mots-clés: Dissolution conjugale, Nigéria, Lieu de résidence, Préférence sexuell

Review of Sexuality Studies in Africa: Setting a New Post-2015 Research Agenda

At the nexus between reproductive health, population and development is the subject of sexuality which has generated extensive discourse in the past two decades. In this paper, we review Africa sexuality studies published between 1994 and 2015 with the aim of synthesizing the available evidence and suggesting a new research agenda for post-2015. Review findings showed that previous studies covered the five components of sexuality – practices, partners, pleasure/pressure/pain, procreation and power to different extents. Risky sexual behaviour was prevalent from adolescence till older ages. Literature on pleasure, pain, procreation and power reflect the complex diversity driven by traditional norms, gender roles and attitudes across the continent. Knowledge gaps were highlighted and new agenda suggested for sexuality research.Keywords: sexual behaviour, sexual violence, sexual pleasure/satisfaction, gender roles, socio-cultural norms, sub-Saharan Africa

Adolescent mortality in South Africa: An analysis of unnatural causes of deaths by sex, 2000-2009

Despite South Africa being a peaceful democracy for the past 18 years, mortality due to unnatural and violent causes still occur among the youth, who are aged between 15 and 34 years old (Presidency of the Republic of South Africa 2009). However, this is not specific to South Africa; with developed countries experiencing the same trend. In developed countries, Christoffe (1994) found that death due to unnatural causes, specifically related to violence, had increased especially among the youth. South Africa is now moving towards the same transition that is currently experienced by developed nations in the world: violent deaths as a major cause of death amongst the youth which includes some adolescents (10-19 years old) (Norman, et al, 2007). With this in mind, this paper aims to examine the different levels of male and female adolescent mortality due to five unnatural causes of death. Data from South African Death Notification Forms is analysed for the years 2000-2009. Cause-specific mortality rates and proportional mortality ratios are produced. Results show adolescents are dying from events of undetermined intent, transport accidents’ and self- harm, especially males. The selected causes of death are contributing up to 27% of all adolescent male mortality and almost 12% of all female mortality in 2009. The results of this paper allude to crime, violence and safety issues in South Africa

Does female autonomy affect contraceptive use among women in northern Nigeria?

Literature identified female empowerment as a predictor of positive health behaviour. However, in the context of conservative and traditional society, this is yet to be explored. This paper explores the role of female autonomy in contraceptive use among currently married women in northern Nigeria. Nationally representative Nigeria Demographic and Health Survey (NDHS, 2013) data for 18,534 currently married women in northern Nigeria was analysed. Complimentary log-logistic regression (cloglog) was used to analyse the data. Current use of modern contraceptive was 6.6% among currently married women in northern Nigeria. Results show that female autonomy was significantly associated with modern contraceptive use. Respondents‘ education, wealth status and desire for no more children were associated with higher contraceptive use. Despite the conservative and religious context of northern Nigeria, female autonomy significantly predicts modern contraceptive use. Thus, empowering women in northern Nigeria, especially by education, will enable them to participate in healthy contraceptive decision making.Keywords: Female autonomy; Contraceptive; Reproductive health; northern Nigeria; Sustainable Development Goa

Determinants of condom use among selected migrant commercial farm workers in South Africa

Previous studies have shown that HIV prevalence rates are relatively high while condom use is low in migrant communities in South Africa. Using data from the Integrated Biological and Behavioural Surveillance Survey implemented by the International Organisation for Migration in 2010 among farm workers, this study seeks to investigate factors associated with condom use among migrant men and women in selected commercial farms in two provinces of South Africa. The study analysed 943 sexually active non-South Africans working in selected farms. Data analysis was undertaken at univariate, bivariate and multivariate levels using logistic regression producing odds ratios to examine the associations at 5% level of significance. The results showed that access to free condoms, financial stability and staying away from spouse increased the odds of condom use among migrant farm workers in Limpopo and Mpumalanga. Amongst men being financially stable and having access to free condoms significantly increased the odds of using condoms. Amongst women being married reduced the odds of using condoms while access to free condoms and living away from spouse significantly increased condom use. Determinants of condom use vary between male and female migrants. HIV prevention policies and programmes targeting migrant farm workers should be gender sensitive. (Afr J Reprod Health 2016; 20[2]: 13-26).Keywords: HIV prevention, migrant labour, risky behaviour, vulnerabilitie

Covariates of high-risk sexual behaviour of men aged 50 years and above in sub-Saharan Africa

Since the advent of HIV/AIDS, sexuality studies in sub-Saharan Africa (SSA) have focused mainly on the sexual behaviour of the younger generation (15–49 years) and little has been done to understand the sexual behaviour of those a 50 years and above. The objective of this study is therefore to examine the covariates of high-risk sexual behaviour among men aged 50 years plus within the SSA region. Data from Demographic and Health Surveys of 10 SSA countries were pooled together and a sample of 5394 men aged 50 years plus who have ever had sex was analysed. Findings show that in SSA, a large proportion of men aged 50 years plus (74%) were sexually active and a substantial proportion of these men engaged in unsafe sexual behaviours, such as having multiple sexual partners and unprotected sex. The multivariate logistic regression analysis showed that involvement with multiple sexual partners was significantly associated with older age, urban residence, religion, having primary or secondary education, and ever taken an HIV test. Condom use at last sex was significantly associated with age at first sex, multiple sexual partners, level of education and ever been tested for HIV. These results suggest that HIV prevention and intervention programmes should also target older men as they are also sexually active and at risk of being infected because of unsafe sexual practices

Disease Surveillance by Private Health Providers in Nigeria: A Research Proposal

A large proportion of Nigerians access healthcare services in private health facilities (PHFs) but the compliance of these PHFs to the mandatory disease surveillance and reporting - a means of implementing the international health regulation of 1969 - has not been established. The recent Ebola outbreak spread to Nigeria and revealed challenges in the efficiency of the surveillance system after a suspicious case presented at a PHF. The impact of an inefficient disease surveillance system can be far reaching. Thus, we propose a study to investigate and understand factors affecting compliance of these PHFs to the country disease surveillance and response system

Status of Legislation and Factors affecting Disease Surveillance in Nigeria: A qualitative inquiry

ObjectiveAssess the legal framework establishing disease surveillance in Nigeria and identify major factors affecting the performance of the surveillance system.IntroductionThe outbreak of infectious diseases with a propensity to spread across international boundaries is on an upward rise. Such outbreaks can be devastating with significant associated morbidity and mortality. The recent Ebola Virus Disease outbreak in West Africa which spread to Nigeria is an example.(1) Nigeria like several other African countries implements the Integrated Disease Surveillance and Response (IDSR) system as its method for achieving the International Health Regulations (IHR). Yet, compliance to the IDSR is questioned. This study seeks to investigate the legal instruments in place and the factors affecting performance of the disease surveillance in the country.MethodsThe study reports the first objective of a larger study to investigate compliance to disease surveillance by private health providers.(2) An investigative search of the literature for legal instruments on disease surveillance in Nigeria was carried out. In addition, key informants were identified and interviewed at the national level and in selected states. The six states in the South-West were identified for an in-depth study. The IHR focal person and the National Health Management Information System officer were interviewed at the national level. The state epidemiologists and the state health management information system (HMIS) officers across the six states were interviewed. Each state has only one state epidemiologist and one HMIS officer as such it was a total sample. In all, 14 key informants were interviewed.ResultsSix legal instruments were identified as seen in table 1. The most recent comprehensive legal instrument on infectious disease control in Nigeria is a 2005 policy on IDSR. This is further supported by the National Health Act of 2014. However, the National Health Act is not detailed for infectious disease control. The substantive law which governs infectious diseases in Nigeria, the Quarantine Act was enacted almost a century ago during the colonial era in 1926. None of the states studied has an active law on infectious disease surveillance as noted by key informants. While all states refer to the IDSR policy, none has formally ratified the document. There are two independent overlapping data collection systems on infectious diseases: the IDSR and the National Health Management Information System (NHMIS). Data on malaria, HIV and tuberculosis are among data collected across the two systems. This was identified by key informants as a problem since the data collection forms differed across systems and almost always result in differing statistics. In addition, this duplication causes overburdening of frontline workers expected to fill the parallel data collection tools and results in inefficiency of the system. Funding of the surveillance system was identified to be inadequate with significant reliance on international partners.ConclusionsA review of the national law on disease surveillance to address emerging global health security challenges is necessary. State legislators need to enact or ratify national laws on infectious disease monitoring and control in their states. The duplication across the NHMIS and the IDSR surveillance system requires harmonization to improve efficiency. Government needs to invest more resources in disease surveillance.References. Makinde OA. As Ebola winds down, Lassa Fever reemerges yet again in West Africa. J Infect Dev Ctries [Internet]. 2016 Feb 28;10(02):199–200. Available from: http://www.jidc.org/index.php/journal/article/view/81482. Makinde OA, Odimegwu CO. Disease Surveillance by Private Health Providers in Nigeria: A Research Proposal. Online J Public Health Inform [Internet]. 2016 Mar 24;8(1). Available from: http://ojphi.org/ojs/index.php/ojphi/article/view/655

The proximate determinants of fertility in Eswatini

Accelerating downwards the fertility rate remains a priority issue for developmental planning of any country. Fertility transition for most African countries has been slow since attaining their independence. In a period of almost four decades Eswatini experienced high fertility above replacement level fertility of 2.1; total fertility rate has declined from 6 to 4 children per woman from 1968 to 2007. This paper examines the impact of each proximate factor (contraception, postpartum infecundability, abortion and sexual activity) on fertility. Using the cross-sectional data from the 2006-7 Eswatini Demographic and Health Survey (DHS), the revised Bongaarts proximate determinants model of fertility was applied at national level and the analysis was extended to observe educational variation among women aged 15-49. The analysis showed that contraception had the greatest impact of fertility reduction, then sexual activity, postpartum infecundability and induced abortion. Women‘s educational level had huge negative influence on fertility and positive implication on reproductive choice of using contraception, delaying sexual activity/marriage and childbearing. The results guide on selection of potential social variables amenable to policy aimed at improving women‘s reproductive behaviour  in Eswatini through better educational attainment.Keywords: Abortion, contraception, postpartum infecundability, sexual activity, educatio

Disease Surveillance by Private Health Providers in Nigeria: A Research Proposal

A large proportion of Nigerians access healthcare services in private health facilities (PHFs) but the compliance of these PHFs to the mandatory disease surveillance and reporting - a means of implementing the international health regulation of 1969 - has not been established. The recent Ebola outbreak spread to Nigeria and revealed challenges in the efficiency of the surveillance system after a suspicious case presented at a PHF. The impact of an inefficient disease surveillance system can be far reaching. Thus, we propose a study to investigate and understand factors affecting compliance of these PHFs to the country disease surveillance and response system