Factors associated with utilization of LLINs among women of child-bearing age in Igabi, Kaduna State, Nigeria.

BACKGROUND: The long-lasting insecticidal nets (LLIN) are effective against prevention of malaria and its utilization has been proven to save lives. Despite the mass distribution of LLIN, Nigeria remains the country with the highest malaria burden in Africa. The awareness of LLIN in Nigeria is high, but the utilization is low. The aim of this work is to describe factors associated with the utilization of LLIN among women of child-bearing age (WCBA) in Igabi, Kaduna, Nigeria. METHODS: A cross-sectional survey was conducted among 630 WCBA selected using a multi-stage sampling at 63 randomly selected villages in Igabi Local Government Area of Kaduna State. Trained female data collectors administered pre-tested structured questionnaires adapted from the Malaria Indicator Survey. Information collected were demographic profile, knowledge of LLIN as a preventive strategy for malaria, and LLIN ownership and utilization. LLIN utilization was assessed by identifying household members that slept under the hanged LLIN the night before the survey. Questions on the awareness of LLIN, ability to define what it is, use of LLIN, what differentiates LLIN from other bed nets, and duration of use before replacement, were scored and categorized as good, average and poor knowledge of LLIN. RESULTS: A total of 629 WCBA was sampled, their mean age (± SD) was 29.3 (± 6.2) years, 22.0% were pregnant, 40.5% had no formal education, 41.1% were employed, and 47.7% lived in rural communities. Awareness and good knowledge about LLINs for the prevention of malaria was 96.0% and 24.0%, respectively. The proportion of women who slept under a LLIN the night before the survey (utilization) was 70.0% and slightly higher (74.0%) among pregnant WCBA. Women who lived in rural communities were more likely to utilize LLINs compared to their urban counterparts (OR 3.4; 95% CI 2.3-4.9). Younger women (aged < 30 years) were less likely to utilize LLINs compared to the older women (OR 0.7; 95% CI 0.5-0.9). CONCLUSIONS: The knowledge of LLIN among WCBA was poor, but LLIN utilization was moderate. Living in rural communities and older WCBA were significant characteristics associated with LLIN utilization. Strategies that will improve the utilization of LLIN among the young and urban WCBA should be the focus of the Malaria Elimination Programme (MEP).

A comparative study of factors influencing decisions on desired family size among married men and women in Bokkos, a rural local government area in Plateau state.

The total fertility rate of Nigerian women has remained high at 5.7. This is even higher for women in rural areas. Men and women in rural areas desire more children than those in urban areas. This study was aimed at describing and comparing the factors that influence family size decisions among men and women in Bokkos, a rural Local Government Area in Plateau state, Nigeria. A cross sectional descriptive comparative study was used. Data was collected using structured interviewer administered questionnaires. Seventy two percent of women and 83.6% of men who desire to have 1-4 children had at least a secondary school education. Close to seventy percent of both men and women would have fewer children if they are certain of their survival to adulthood. Over 50% of the respondents believe that the husbands should have the final say on family size decisions. Preference for male children influences decisions on family size among men and women in the study population.

Perception, and Experience of Domestic Violence among Women in a Rural Community in Kaduna State, Nigeria.

Background: Domestic violence (DV) occurs in all settings, transcending socio-cultural and demographic profiles. It is pervasive, insidious, carried out in private domain, and usually inflicted by family members. It continues over long period and limits avenues of escape for victims. The aim of this study was to assess the perception and experience of DV among rural women in Sabon Gari LGA of Kaduna State, Nigeria. Methodology: A cross-sectional descriptive study conducted in Tohu community, Sabon Gari LGA, Kaduna State. Sample size of 365 was determined using Fisher's formula, at p-value, reliability coefficient, confidence interval, degree of freedom, and possible attrition rate of 0.5, 1.96, 95%, 0.05, and 16% respectively. The study population comprised all women of reproductive age group in Tohu. Eligible respondents who had been in the community for at least one year were included in the study, while those who were ill were excluded. A semi-structured, interviewer-administered questionnaire was administered by female research assistants, and data collected was analyzed using SPSS version 21.0. Frequencies and percentages were reported for categorical data. Respondents' perception of DV was assessed using 19 questions across 5domains. Composite score of 0-19 was expected for each respondent. Scores of >10, and <10 were considered to be good, and poor perception of DV respectively. Relationships between variables were determined using appropriate test statistics at p-value <0.05. Results: Fifty-three percent of respondents have good perception of DV, with age, marital status, and occupation affecting respondents' perception. Seventeen percent of respondents had experienced physical and/or verbal abuse. Marital status and level of education were found to affect respondents' experience of DV. Conclusion: DV is still rife in rural parts of Nigeria. Civil rights groups should intensify efforts toward awareness creation so that victims can report to the appropriate authorities and the perpetrators prosecuted.

Moderating Effect of Husband's Controlling Attitudes on the Relation Between Women's Household Decision-Making Autonomy and Intimate Partner Violence Experience in Nigeria.

Existing studies show a consensus on the importance of women's household decision-making autonomy. However, the studies also show mixed findings of the association between the variable and intimate partner violence (IPV). In this study, moderating effects of husband's controlling and domineering attitudes on the association between women's household decision-making autonomy and husband-perpetrated physical, sexual, and emotional violence were investigated. Data used in the study were drawn from an existing database of a 2013 cross-sectional Demographic and Health Survey (DHS) of nationally representative sample (N = 19,360) of Nigerian married women. Participants were interviewed on measures of women's autonomy, husband's attitudes, and husband-perpetrated violence. Results revealed that women who exercised high household decision-making autonomy significantly experienced more physical (b = .31, t = 11.78, p < .001), sexual (b = .05, t = 3.59, p < .01), and emotional (b = .17, t = 9.76, p < .001) violence if they reported relationship with husbands who endorsed high controlling and domineering attitudes. The results represent an extension over existing research and have implications on how husband's attitudes could improve women's autonomy and reduce their IPV experience in various intervention settings.

Costs and Patterns of Financing Maternal Health Care Services in Rural Communities in Northern Nigeria: Evidence for Designing National Fee Exemption Policy.

BACKGROUND: As population and access to information increases, so does the demand for health services. Unfortunately, many people who genuinely require these services do not usually have access to them. To increase access, various financing options have been used. Despite this, maternal morbidity and mortality rates remain high and spending is still largely out of pocket. This study assesses maternal health problems, preferred sources of care and the pattern of financing in a semi-rural community in North Western part of Nigeria. METHODOLOGY: A cross-sectional descriptive study design was used. The study population consisted of women within the reproductive age group who had experienced childbirth 12 months or less prior to the study. A sample size of 240 was drawn using cluster and random sampling techniques. Interviewer administered questionnaires were used and the results were analyzed using Statistical Package for Social Sciences (SPSS). RESULTS: The mean age of the respondents was 29 years and 49% had no personal income. Fever was the commonest problem. Although majority received antenatal care, those who lacked antenatal care mostly cited financial difficulties. Nearly half of the women delivered at home as opposed to a health facility. On average, women spent between Nigerian Naira (N) N1, 350-N14, 850 (USD$9-99) for a total package of maternal health services. Out of pocket spending by the husbands or household heads and the women themselves accounted for 73.3% of expenses. CONCLUSION AND PUBLIC HEALTH IMPLICATIONS: In Nigeria, women are still vulnerable to common and preventable causes of maternal morbidity and mortality due to lack of access to antenatal health care. Out of pocket spending is still a popular method of financing. Harmonization of fee exemption policies can improve access to maternal healthcare.