Patterns of Anemia in Married Women and Their Children in Cambodia: A Synthetic Cohort Analysis.

AIM: To explore the prevalence of anemia in three cohorts of women, namely, married yet to be mothers, married and are mothers, and currently pregnant, to ascertain the patterns in anemia in women. METHODS: We analyzed a sample of 130,965 married women from four Demographic Health Surveys: 2000, 2005, 2009 and 2015. The primary focus for the analysis was married women aged 15 to 49 years. In the absence of a longitudinal data that followed the same women over the periods, a synthetic cohort of the women of that age-group was constructed to get women aged 15 to 64 years over the four surveys. Women who were aged 15 to 19 years in 2000 were the same as those 30 to 34 years in 2015, while those aged 45 to 49 years in 2000 were the same as 60 to 64 years in 2015. RESULTS: Logistic regression revealed that young mothers were significantly more infected (p < .001). Pregnancy affected anemia in the women (p < .001). Being younger and richer were associated with odds ratios of 0.599 (95% confidence interval, CI: [0.560, 0.640]) and 0.765 (95% CI: [0.726, 0.807]) for anemia, respectively. Being pregnant had odds ratio of 1.642 (95% CI: [1.439, 1.872]) for anemia. CONCLUSION: Public health strategies should target social deprivation at the household level while addressing maternal health issues. An analysis of data on unmarried women and their children is recommended.

Factors associated with compliance to recommended micronutrients uptake for prevention of anemia during pregnancy in urban, peri-urban, and rural communities in Southeast Nigeria.

BACKGROUND: The study investigated the factors associated with compliance to the recommended ≥90-day uptake of micronutrients for prevention of iron-deficiency anemia during pregnancy in Nigeria. METHODS: A cross-sectional study of 1500 women who had babies within 6 months prior to the survey, drawn from six urban, peri-urban, and rural local government areas in Enugu and Imo States of Nigeria, was conducted, using a structured questionnaire. A focus group discussion was held with grandmothers and fathers of the new baby. In-depth interviews were held with health workers. RESULTS: There were six demographic factors in the bivariate analysis: living in an urban center and close to health facility, and being wealthy, with post-secondary education as well as older and engaged in civil service showed significant association with compliance. The urban residents complied more than the peri-urban and rural residents (χ 2 = 12.749; p = 0.002). Those living close to the health facilities complied more than those living far away (χ 2 = 24.638; p < 0.001). Those in higher wealth quintile complied more (χ 2 = 13.216; p < 0.010). Utilization of antenatal clinics during pregnancy showed statistically significant association with compliance. Those who used the ANC services complied more than those that did not (χ 2 = 6.324; p = 0.010) and the more frequent the use of ANC services the more the compliance (χ 2 = 14.771; p < 0.001). These results were confirmed when the opinions expressed in the urban, peri-urban, and rural communities are compared. However, the multivariate binary logistic regression highlighted only urban residence, closeness to health facilities, and utilization of ANC services as positively associated with compliance. CONCLUSION: These findings could help in targeting health education program to increase compliance to the recommended uptake of micronutrients in prevention of anemia during pregnancy.

Compliance with regimens of existing vaccines in Orumba North local government area of Anambra state, Nigeria.

The factors associated with third dose of diphtheria, pertussis and tetanus (DPT3) uptake, a true indicator of compliance with required regimen of vaccines, in Anambra state, Nigeria, were investigated in a cross-sectional survey of 600 mothers (15-49). Being an older mother showed a positive association with compliance. Compliance was more among those who used the government health facilities for their health needs (χ(2 )= 12.286, p < .001). Satisfactory experiences with health service influenced compliance (χ(2 )= 8.542, p = .002). Those with good perception (30.1%) complied more (χ(2 )= 42.572, p < .001). Those who were aware that immunization protects the children against vaccine preventable diseases complied more (χ(2 )= 8.735, p = .002). In conclusion, the action-hesitancy model strengthens the Health Belief Model in explaining parents' attitude to childhood immunization, as experience and perception of the health service influenced uptake more. Health education and campaigns should be directed at factors that would encourage mothers to adopt required behaviours.

Prospects of using Community Directed Intervention strategy in delivering health services among Fulani Nomads in Enugu State, Nigeria.

BACKGROUND: The Community Directed Interventions (CDI) strategy has proven effective in increasing access to health services in sedentary populations. It remains to be seen if CDI strategy is feasible among nomads given the dearth of demographic and medical data on the nomads. This study thus characterized the nomadic populations in Enugu State, Nigeria and outlined the potentials of implementing CDI among nomads. STUDY DESIGN AND METHODS: This exploratory study adopted qualitative methods. Forty focus group discussions (FGD) were held with members of 10 nomadic camps in 2 LGAs in Enugu State, as well as their host communities. Thirty in-depth interviews (IDIs) were held with leaders of nomadic camps and sedentary populations. Ten IDIs with traditional healers in the nomadic camps and 14 key informant interviews with health workers and programme officers were also conducted. Documents and maps were reviewed to ascertain the grazing routes of the nomads as well as existing health interventions in the area. RESULTS: Like sedentary populations, nomads have definable community structures with leaders and followers, which is amenable to implementation of CDI. Nomads move their cattle, in a definite pattern, in search of grass and water. In this movement, the old and vulnerable are left in the camps. The nomads suffer from immunization preventable health problems as their host communities. The priority health problems in relation to CDI include malaria, measles, anemia, and other vaccine preventable infections. However, unlike the sedentary populations, the nomads lack access to health interventions, due to the mutual avoidance between the nomads and the sedentary populations in terms of health services. The later consider the services as mainly theirs. The nomads, however, are desirous of the modern health services and often task themselves to access these modern health services in private for profit health facilities when the need arises. CONCLUSION: Given the definable organizational structure of the nomads in Enugu State and their desire for modern health intervention, it is feasible to test the CDI strategy for equitable healthcare delivery among nomads. They are willing and capable to participate actively in their own health programmes with minimal support from professional health workers.

The place of autochthonous disease aetiology in mental health-seeking behaviors in a globalizing Nigerian community.

This study aimed at ascertaining the connection between disease aetiology of the autochthonous psychiatric health system and the current mental health-seeking behaviors of the Nsukka people. Structured participant observation was the principal method of collecting data. In-depth interview sessions were also held with elders in the communities. It was found that although there has been social contact and change among the Nsukka, the personalistic elements in the aetiology of their traditional psychiatric system still largely determined their mental health-seeking behaviors. Thus, they were found to be more at home with traditional healers and syncretic churches than orthodox mental healthcare. To be successful, any mental healthcare program in Nsukka ought to consider how orthodox mental health practitioners, traditional healers, and those who run prayer houses could be incorporated in a comprehensive community mental healthcare program.