Perceived health facility-related barriers and post-abortion care-seeking intention among women of reproductive age in Osun state, Nigeria.

BACKGROUND: Post-abortion care (PAC) prevents death and complications caused by unsafe abortion which is widespread in Nigeria. Yet, there is sparse community-based evidence on women's intention to seek PAC should they have an abortion. This study examined the influence of perceived health facility-related barriers (HFRB) on post-abortion care-seeking intention (PACSI) among women of reproductive ages in Osun state, Nigeria. METHODS: The study focused on women in a sexual relationship and who were residents of Osun state. A community-based survey was implemented using a multi-stage sampling technique. The calculated sample size (with attrition) was 1200 and data were collected from women aged 15-49 years, using open data kit (ODK). However, 1,065 complete responses were received on the ODK server, indicating an 88.8% response rate. Models were estimated using ordered logistic regression (Ologit) (α0.05) and data analysis was performed using Stata 14.0. RESULTS: Mean age of the women was 29.3±7.6 years and 34.01% had the intention to seek PAC in health facilities. Lack of service confidentiality and unavailability of equipment specific to abortion were the two most reported barriers that would prevent women from seeking PAC. The adjusted Ologit model showed that respondents with perceived low HFRB had higher odds (aOR=1.60; CI=1.12-2.11) of seeking PAC in the health facility. Also, women who were employed and skilled were more likely (aOR=1.51; CI=1.13-2.01) while women who had PAC support from spouses/partners had higher odds of healthy PACSI (aOR=2.03; CI=1.48-2.78). Other identified predictors of PAC seeking intention included level of education, employment status, and spousal/partner support. CONCLUSION: Perceived lack of trust in service provision and necessary equipment specific to abortion care had a negative influence on women's PACSI in Osun state. Reassuring health interventions that focus on improving the public perception of healthcare services and confidence to use the facility will likely improve the patronage of health facility for post-abortion care in Osun sate.

Dynamics of child marriage and marital timing in Nigeria: A retrogression or progression?

The researcher assessed trends and patterns of marital timing and child marriage (CM) among women of reproductive age in Nigeria. Four rounds of Nigeria Demographic and Health Survey data-set were used (1990-2013). Data were analyzed using descriptive statistics and Cox-regression model with time-dependent covariates (α = 0.05). CM (<18 years) falls consistently from 63.8% in 1990 to 56.3% in 2013. The hazard ratio of CM was 1.24 (CI =1.19-1.28, p < .001), 1.24 (CI =1.19-1.29, p < .001), and 1.05 (CI =1.02-1.07, p < .001) times higher in 1990, 2003, and 2008, respectively than 2013. The region, education, religion, and ethnicity are common predictors of CM in all the survey rounds.

Housing materials as predictors of under-five mortality in Nigeria: evidence from 2013 demographic and health survey.

BACKGROUND: Nigeria is among countries with high Under-Five Mortality (U5M) rates worldwide. Both maternal and childhood factors have been linked to U5M in the country. However, despite the growing global recognition of the association between housing and quality of life, the role of housing materials as predictors of U5M remain largely unexplored in Nigeria. This study, therefore, investigated the relationship between housing materials and U5M in Nigeria. METHODS: The study utilised the 2013 Nigeria Demographic and Health Survey data. A representative sample of 40,680 households was selected for the survey. The sample included 18,516 women of reproductive age who had given birth in the past 5 years prior the survey; with attention on the survival status of the index child (the most recent delivery). Data were analysed using descriptive statistics, Chi-square, Cox-proportional hazard and Brass 2-parameter models (α = 0.05). RESULTS: The hazard ratio of U5M was 1.46 (C.I = 1.02-1.47, p < 0.001) and 1.23 (C.I = 1.24-1.71, p < 0.001) higher among children who lived in houses built with inadequate and moderate housing materials respectively than those in good housing materials. Under-five deaths show a downward trend (slope = -0.4871) relative to the housing materials assessment score. The refined U5M rate was 143.5, 127.0 and 90.8 per 1000 live birth among women who live in houses built with inadequate, moderate and adequate housing materials respectively. Other predictors of U5M were; the size of the child at birth, preceding birth interval, prenatal care provider, residence and education. Under-five death reduces with increasing maternal level of; education, wealth quintile, media exposure and housing material type and mostly experienced by Muslim women (6.0%), rural women (6.5%) and women residence in the North-West geopolitical zones (6.9%). CONCLUSIONS: Living in houses built with poor housing materials promoted U5M in Nigeria. Provision of sustainable housing by the government and the maintenance of existing housing stock to healthful conditions will play a significant role in reducing the burden of U5M in Nigeria.

Determinants of Maternal Utilization of Health Services and Nutritional Status in a Rural Community in South-West Nigeria.

Poor Maternal Health (MH) remains an issue of public health concern in Nigeria. This study identified the determinants of maternal utilization of health services and nutritional status in a rural community in south-west Nigeria. It was a cross-sectional house-hold survey of women aged 15-49 years. Data were analysed using Chi-square, logistic regression and generalized linear models (α=.05). Respondents' mean age was 29.9±7.8 years and about 9.0% were underweight, 76.7% attended ≥4 ANC visits and 65.7% were provided with ANC by skilled health workers. Sixty-two percent delivered in modern health facility, 67.5% were assisted by skilled health worker and 29.1% sought post-natal care within the first 3 days after delivery. The likelihood of delivery in health facility was 1.48(C.I=1.10-1.99, p<0.05) higher among women in monogamous than those in polygamy family. The estimated maternal mortality ratio was 448 deaths/100,000 live-births. The findings emphasize the need to scale-up MH improvement strategies in the study area.

Wealth status and sex differential of household head: implication for source of drinking water in Nigeria.

BACKGROUND: Source of potable water has implication on the population health. Availability of Improved Drinking Water Sources (IDWS) is a problem in developing countries, but variation exists across segments of the population. This study therefore examined the relationship between wealth status, sex of household head and source of potable water. METHODS: The 2013 Nigeria Demographic and Health Survey data was used. A representative sample of 40,680 households was selected for the survey, with a minimum target of 943 completed interviews per state covering the entire population residing in non-institutional dwelling units in the country. Households where information on drinking water sources was not reported were excluded, thus reducing the sample to 38021. The dependent and key independent variables were IDWS and Wealth Index respectively. Data were analysed using Chi-square and binary logistic regression (α = .05). RESULTS: Households that used IDWS were headed by females (66.7 %) than males (58.7 %). Highest proportion of households who used IDWS was found in the rich wealth index group (76.7 %). The likelihood of using IDWS was higher in household headed by females (OR = 1.41; C.I = 1.33-1.49, p <0.001). Households that belong to rich wealth index and middle class were 5.06(C.I = 4.81-5.32, p <0.001) and 2.62(C.I = 2.46-2.78, p <0.001) respectively times more likely to IDWS than the poor. This pattern was sustained when other confounding variables were introduced into the regression equation as control. CONCLUSIONS: Households headed by women used improved drinking water sources than those headed by men. However, wealth index has strong influence on the strength of relationship between sex of household head and improved drinking water sources.

Influence of gender preference and sex composition of surviving children on childbearing intention among high fertility married women in stable union in Malawi.

BACKGROUND: Child's gender preference (GP) frequently leads to high fertility which has adverse effect on family health. The link between women's fertility intention, GP and Living Children's Sex Composition (LCSC) as found in this study is less explored in Malawi. OBJECTIVES: We examined the relationship between GP, LCSC and fertility intention. METHODS: This study utilized 2010 MDHS dataset and focused on married women aged 15-49 years (n=1739) in stable unions who currently have at least 5 living children. Data was analyzed at bivariate and multivariate levels (α=0.05). RESULTS: About 39.7% of the women have GP and higher proportion (23.3%) has preference for females. Age, region, wealth-quintile, religion, residence and family planning programmes were significantly associated with fertility intention. Women who have GP and same LCSC were 1.35 and 2.4 times significantly more likely to have intention to bear more children than those who have no GP and different sexes composition respectively. These odd ratios changed to 1.38 for GP and 2.44 for LCSC after adjusting for other socio-demographic variables. CONCLUSIONS: We find that GP and LCSC significantly influence women's intention to bear more children. Women should stop childbearing after attaining their desired number irrespective of the LCSC.