The Nigerian health information system policy review of 2014 : the need, content, expectations and progress.

BACKGROUND: Nigeria's national health information system (HIS) data sources are grouped into institutional and population based data that traverse many government institutions. Communication and collaboration between these institutions are limited, fraught with fragmentation and challenges national HIS functionality. OBJECTIVES: The objective of this paper was to share insights from and the implications of a recent review of Nigeria's HIS policy in 2014 that resulted in its substantial revision. We also highlight some subsequent enactments. REVIEW PROCESS AND OUTCOMES: In 2013, Nigeria's Federal Ministry of Health launched an inter-ministerial and multi-departmental review of the National Health Management Information System policy of 2006. The review was guided by World Health Organization's 'Framework and Standards for Country Health Information Systems'. The key finding was a lack of governance mechanisms in the execution of the policy, including an absent data management governance process. The review also found a multiplicity of duplicative, parallel reporting tools and platforms. CONCLUSION: Recommendations for HIS Policy revisions were proposed to and implemented by the Federal Government of Nigeria. The revised HIS policy now provides for a strong framework for the leadership and governance of the HIS with early results.

Use of insecticide treated nets in children under five and children of school age in Nigeria: Evidence from a secondary data analysis of demographic health survey.

BACKGROUND AND OBJECTIVE: Use of insecticide treated nets (ITN), one of the most cost-effective malaria interventions contributes to malaria cases averted and reduction in child mortality. We explored the use of ITN in children under five (CU5) and children of school age to understand factors contributing to ITN use. METHODS: A cross-sectional study analyzed 2018 Nigeria Demographic and Health Survey data. The outcome variable was CU5 or children of school age who slept under ITN the night before the survey. Independent variables include child sex, head of household's sex, place of residence, state, household owning radio and television, number of household members, wealth quintile, years since ITN was obtained and level of malaria endemicity. Multi-level logistic regression model was used to access factors associated with ITN use among children. RESULTS: In total, 32,087 CU5 and 54,692 children of school age were examined with 74.3% of CU5 and 57.8% of children of school age using ITN the night before the survey. While seven states had more than 80% of CU5 who used ITN, only one state had over 80% of school children who used ITN. ITN use in CU5 is associated with living in rural area (aOR = 1.20, 95% CI 1.14 to 1.26) and residing in meso endemic area (aOR = 3.1, 95% CI 2.89 to 3.54). While In children of school age, use of ITN was associated with female headed households (aOR = 1.14, 95% CI 1.09 to 1.19), meso (aOR = 3.17, 95% CI 2.89 to 3.47) and hyper (aOR = 14.9, 95% CI 12.99 to 17.07) endemic areas. Children residing in larger households were less likely to use ITN. CONCLUSIONS: This study demonstrated increased use of ITN in CU5 from poor households and children living in rural and malaria endemic areas. Findings provide some policy recommendations for increasing ITN use in school children.

Investigating the Spatial Patterns of Common Childhood Morbidity in Six Neighboring West African Countries.

Children in developing countries have continued to suffer morbidity and mortality arising from a few illnesses. This study was designed to examine the within and between spatial variations in childhood morbidity from cough, fever, and diarrhea among six West African countries in a manner that transcends geographical boundaries. Data from six countries including their geographical boundaries were obtained from Demographic and Health Surveys. The spatial modelling was through Bayesian models and appropriate prior distributions were assigned to the different parameters of the model. Parameter estimation was through integrated nested Laplace approximation. Results show similar significant spatial distributions for the three illnesses, and they demonstrate that children in Benin Republic and Mali are less likely to suffer from these illnesses, whereas higher likelihood were obtained in the case of Cote d'Ivoire, Burkina Faso, Togo, and some parts of Ghana. The nonlinear effects of child's age show that the risks of contracting the illnesses peak among children aged 10-14 months while, as the mothers advance in age, their children have reduced risks. Breastfeeding and a woman's working status and education are among the significant factors that either aggravate or prevent these illnesses in the West African countries. The results pinpointed regions of the West African countries with high and low risks of the illnesses, and this would enhance intervention strategies of policy makers and international donors in the subregion.

Marital status and HIV prevalence among women in Nigeria: Ingredients for evidence-based programming.

OBJECTIVE: To assess the influence of marital status and other correlates on HIV infection among women in Nigeria. METHODS: Data were extracted from the 2012 Nigerian population-based HIV/AIDS and reproductive health survey. The survey determined the HIV status of consenting women using standard procedures. Data were weighted and analyzed using descriptive statistics and logistic regression at the 5% significance level. RESULTS: HIV prevalence among currently married and never married women was 3.4%, but was 5.9% among formerly married women. The odds of HIV infection were found to be 1.8 times higher among formerly married women compared with currently married women (odds ratio (OR) 1.8, 95% confidence interval (CI) 1.3-2.5) and never married women (OR 1.8, 95% CI 1.2-2.6). Also, the odds of HIV infection were 1.5 times higher among women who had made their sexual debut before the age of 15 years (adjusted OR 1.5, 95% CI 1.1-2.1) compared with women who delayed it. The odds of HIV infection were 1.4 times higher among women who had recently had transactional sex (adjusted OR 1.4, 95% CI 1.1-2.0) compared with others. CONCLUSION: Being formerly married, under 15 years of age at first sex, and having engaged in transactional sex were found to be the strongest HIV risk factors among women. Besides empowering formerly married women and providing better social security, these women should be targeted in HIV programming and policies.

Understanding self-appraisal of HIV-infection risk among young adults in Nigeria: evidence from a national survey.

A major component of HIV prevention is to encourage individuals to appreciate their personal risk of contracting the virus with the aim of encouraging them to take steps to reduce the risks. This article addresses the accuracy of an individual's risk assessment by matching this with individual's reported risk behaviours in order to assess possible congruence. Although the relationship between risk perception and risk behaviours has been studied by previous authors using cross-sectional studies, this has not been extensively studied using a large nationally representative data set, such as in Nigeria. In our attempt to address this, we classified HIV-risk behaviour into low-risk and high-risk behaviour. We considered both descriptive and inferential approaches in our analyses. The findings were triangulated with qualitative studies using focus group discussions conducted among members of the target group in Nigeria. Dependence of risk perception on some selected background characteristics, HIV/AIDS-knowledge indicators, experience of sexually transmitted infections (STIs), as well as exposure to the Society for Family Health (SFH) radio campaigns in Nigeria were investigated through multiple logistic regression models. Among the respondents with risk behaviours, being single, Christian, male, and listening to the SFH radio campaigns were associated with a higher perception of risk of contracting HIV.

Understanding self-appraisal of HIV-infection risk among young adults in Nigeria: Evidence from a National Survey

A major component of HIV prevention is to encourage individuals to appreciate their personal risk of contracting the virus with the aim of encouraging them to take steps to reduce the risks. This article addresses the accuracy of an individual's risk assessment by matching this with individual's reported risk behaviours in order to assess possible congruence. Although the relationship between risk perception and risk behaviours has been studied by previous authors using cross-sectional studies; this has not been extensively studied using a large nationally representative data set; such as in Nigeria. In our attempt to address this; we classified HIV-risk behaviour into low-risk and high-risk behaviour. We considered both descriptive and inferential approaches in our analyses. The findings were triangulated with qualitative studies using focus group discussions conducted among members of the target group in Nigeria. Dependence of risk perception on some selected background characteristics; HIV/AIDS-knowledge indicators; experience of sexually transmitted infections (STIs); as well as exposure to the Society for Family Health (SFH) radio campaigns in Nigeria were investigated through multiple logistic regression models. Among the respondents with risk behaviours; being single; Christian; male; and listening to the SFH radio campaigns were associated with a higher perception of risk of contracting HIV