National and subnational variations in gender relations and the utilization of maternal healthcare services in Nigeria.

Introduction: poor maternal health outcomes remain a major public health issue in Nigeria. These have been shown to be affected by the low level of utilization of maternal healthcare services. This study investigates the levels of gender relations (GR) among Nigerian women and how these influence their utilization of maternal healthcare services. The relations are conceptualized as feminine (FGR), masculine (MGR) and egalitarian. Methods: data on household decision-making, antenatal care (ANC) visits, health facility delivery, and associated sociodemographic variables, were extracted from the 2018 Nigeria Demographic and Health Survey for 29,992 parous women aged 15-49 for a cross-sectional study. Associations were investigated using Chi-Square and regression analyses. Results: women with FGR constituted 5.7% of the population at the national level, while subnational variations ranged from 1.8% in the North-East to 12.8% in the South-South regions. The prevalence rates of the recommended minimum ANC visits (RMANC) and health facility delivery were 42.1% and 30.0% at the national level and were lowest in the northern regions. At both the unadjusted and adjusted levels, FGR was not significantly associated with RMANC and health facility delivery at the national level and in all the regions except the South-West. MGR was however significantly associated with increased odds of RMANC (OR: 2.235, CI: 2.043-2.444) and health facility delivery (OR: 2.571, CI: 2.369-2.791) at national level. Significant subnational variations in the association between gender relations and the utilization of maternal healthcare services were also recorded. Conclusion: sub-national variations in GR and their varying impacts on the utilization of maternal healthcare services in Nigeria suggest that gender-related policies to improve maternal health outcomes should be location-specific, rather than general. As FGR did not affect maternal healthcare services utilization, educating men on the benefits of supporting their wives to scale-up utilization is recommended.

Heavy Metals and Health Risks Associated with Consumption of Herbal Plants Sold in a Major Urban Market in Southwest, Nigeria.

BACKGROUND: Although herbal medicines play an important role as a source of medicine, concerns have been raised about the risks posed by consumption of these plants, especially if consumed above permissible levels. OBJECTIVES: This study was undertaken to assess the level of exposure, toxicity and health risk associated with the consumption of herbal plants in Ado Ekiti urban market, Nigeria. METHODS: Ten commonly consumed herbal plants sold in Ado Ekiti urban market were subjected to heavy metal analysis. Health risk assessment was carried out to determine the estimated daily intake (EDI) of heavy metals, health risk index (HRI), target hazard quotient for non-carcinogenic risk and estimation of cancer risk (ECR). RESULTS: The EDIs for lead (Pb), nickel (Ni), chromium (Cr), copper (Cu) and magnesium (Mn) were above the upper tolerable daily intake reference for all studied plant species in both children and adults, an indication that herbal use poses a short-term to long-term health risk to consumers of these herbal products. The EDI for children was significantly lower compared to that of adults, indicating higher risks for adult consumers of these herbal products. The HRI in children for Pb (Alstonia congensis, Terminalia avicennioides, Aframomum melegueta, Cymbopogon citratus and Napoleona vogelii) were greater than 1; HRI in Cu and Mn also showed an unusually high concentration, an indication that long term exposure to the consumption of these herbal plants poses a serious health risk. The HRI in children and adults follows the order Mn > Cu > Ni > Pb > Cr; cadmium (Cd) was not detected in any of the herbal plants. The ECR for Pb, Ni and Cr present in the herbal plants for children ranged between 10-6 (low) to 10-3 (high), while the ECR for Pb, Ni and Cr for herbal plants for adults ranged between 10-5 (acceptable) to 10-2 (unacceptable). For both children and adults, there is a call for concern due to ECRs above the acceptable range; the consumption of these herbal plants poses a long-term cancer risk. CONCLUSIONS: In both children and adults, ECRs for some of the herbal plants in the present study above the acceptable range present a risk to human health. The consumption of such herbal plants poses a long-term cancer risk. COMPETING INTERESTS: The authors declare no competing financial interests.