Unmet need for family planning and barriers to contraceptive use in Kaduna, Nigeria: culture, myths and perceptions.

In 2017, just one-fifth of all married women of reproductive age reported using contraception in Kaduna state, Nigeria, while many more experienced unmet need for contraception. These realities drive risky fertility behaviours and compromise reproductive rights. This study explored the determinants of low modern contraceptive uptake and persistent unmet need among women in the state. Nine focus group discussions were conducted with married women who met study criteria for unmet need, and who had different levels of access to contraception. Discussions confirmed that many women in Kaduna do not feel empowered to make contraceptive decisions. Yet there is a growing preference for smaller families and decreased stigmatisation of contracepting women. Barriers at home, in the community and in health facilities impose a ceiling on the extent to which women's fertility desires may be achieved. These include cultural, normative, social and financial factors, such as the need for husband's permission to access services, service providers' insistence on spousal consent, subtle and overt pressures to use folkloric approaches by religious leaders, and high real, or perceived, out-of-pocket costs. These findings suggest that Kaduna is on the cusp of social change and study findings can be translated into programmatic interventions to improve voluntary uptake of contraception.

Predictors of tuberculosis knowledge among mothers of under-fives, seen at Bingham University Teaching Hospital, Jos Nigeria.

INTRODUCTION: Globally, tuberculosis still remains a disease of public health concern and accounts for high morbidity and mortality particularly in developing countries, where it is fuelled by a number of factors. METHODOLOGY: Through a cross-sectional descriptive study, this study aims to determine the predictors of knowledge about TB among 261 mothers of children under 5 years of age attending Child Welfare Clinic, Bingham University Teaching Hospital, Jos, Plateau State, Nigeria. RESULTS: The mean age of the mothers was 31.54 ± 5.28 years, and 249 (98.4%) aware of TB. About two-third having sufficient knowledge and positive attitude regarding TB. Significant statistical association was found between knowledge and attainment of post-secondary education (OR 4.0; 95% CI 12.09, 7.63; p Ë‚ 0.001), monthly income ≤ 25,000 naira (OR 2.18; 95% CI 1.02, 4.65; p = 0.042), monthly income > 51,000 naira (OR 3.24; 95% CI 1.43, 7.31; p = 0.005), women engaged in business (OR 0.43; 95% CI 0.22, 0.83; p = 0.012) and possessing positive attitude (OR 3.87; 95% CI 2.16, 6.93; p ˂ 0.001) in the univariate analysis. However, in the multivariate logistic regression, it was only attitude that was found to be a predictor of TB knowledge of mothers. CONCLUSIONS: TB knowledge among the mothers was high, only attitude regarding thoughts and beliefs about TB was found as an independent predictor of TB knowledge. With the positive influence of attitude on knowledge among the mothers, it is recommended that this be strengthened for sustenance to prevent further infection.

Women's experience with group prenatal care in a rural community in northern Nigeria.

OBJECTIVE: To assess women's experience of group prenatal care in a rural Nigerian community. METHODS: In an observational study, consenting pregnant women were enrolled in a group prenatal care program based on the CenteringPregnancy model from July 1, 2010, to June 30, 2011, in Tsibiri, Nigeria. Women were interviewed before joining the group and postnatally. A predesigned pro forma was used to assess group behavior during sessions. Descriptive and inferential statistics were applied to data. RESULTS: In total, 161 women enrolled, and 54 of 72 scheduled prenatal sessions took place. The average number of visits was three per woman, with good group interaction and cohesion. Mothers who could mention at least five out of eight danger signs of pregnancy increased from 1.4% (2) to 13.3% (14) (P<0.001, 95% CI 4.28-19.52), while mean knowledge score for danger signs increased from 31% to 47.8% (P<0.001, 95% CI 0.86-2.16). Commitment to birth preparedness plans was impressive. The mothers enjoyed the group sessions and shared the lessons they learned with others. CONCLUSION: Group prenatal care was feasible and acceptable to women in the present study setting. Comparative trials would be helpful to demonstrate the benefits of the tested model in low-income settings.

A cross-sectional study of traditional practices affecting maternal and newborn health in rural Nigeria.

INTRODUCTION: Certain traditional practices which have negative effects on maternal and child health continue to be practiced in sub-Saharan African countries. A survey was carried out in a rural village in Nigeria to understand the scale and range of these practices. METHODS: This was a cross-sectional study in which trained interviewers administered pre-tested questionnaires on child-bearing women using questionnaires embedded on android devices. RESULTS: The median age of marriage and pregnancy were 15 and 16 years respectively. Home births were high (90.4%) while non-skilled birth attendant was 87.4%. The community had a son preference index ratio of 1:4.1. Up to 81.5% of mothers responded that one form of unhygienic traditional procedure or the other was performed on their children. Time to initiation of breast feeding was in hours in the majority (76.3%) of mothers, with a high rate of use of prelacteal feeds (85.2%). Being an adolescent mother (AOR 0.403, 95%CI 0.203, 0,797) and utilizing a skilled provider at birth (AOR 0.245, 95%CI 0.088, 0.683) were associated with less likelihood of having an unhygienic procedure performed on children. CONCLUSION: The findings of our study suggest that traditional practices which could have negative effects on maternal and child health are still ongoing in the study community. Child protection laws and safeguarding principles could help to reduce these practices and would need to be developed and implemented in these settings where these practices are still prevalent.

Prevalence and sociodemographic determinants of developmental delay: a cross-sectional study of under-five Nigerian children

Background: developmental problems or delays are preventable and others may be ameliorated by interventions. Developmental delay and factors associated with it therefore need to be identified in order for early and appropriate interventions to be instituted. This study therefore aimed to determine the prevalence of developmental delay among under-fives and identify the sociodemographic factors associated with the delay.Methods: Four hundred and fifteen Nigerian children, aged 6- 59 months were assessed for development using the Schedule of Growing Skills II tool. Developmental quotient below threshold point of 85% in a developmental domain was used to define developmental delay. Results: Of the 415 children assessed, 147 (35.4%) had delay in the various developmental domains. The highest prevalence was in the manipulative domain (25.8%) followed by visual (17.1%), cognitive skill (13.5%), hearing and language (6.3%), interactive social (5.8%), self-care social (4.4%) and speech and language (4.1%). Low maternal education was significantly associated with delay in locomotive domain (4.3%; OR=5.00; 95% CI=1.04-23.84), manipulative domain (32.4%; OR=1.89; Most 95% CI=1.21-2.95), visual domain (22.9%; OR=2.11; 95% CI=1.25-3.55), speech and language (6.4%; OR=3.03; 95% CI=1.05-8.75), interactive social (8%; OR=3.05; 95% CI=1.32-7.04), self-care social (6.9%; OR=3.30; 95% CI=1.15-9.43), cognitive (17.6%; OR=1.89; 95% CI= 1.07-3.35). Birth order and household size also had significant association with delay in various domains. There was no significant association between socioeconomic class and developmental delay in any of the domains.Conclusion: The study showed that developmental delay was relatively common among under-five children in North-West Nigeria; and has a strong association with some socio demographic factors. There is need to screen children for developmental delay for early intervention