Mortality Among Children Aged <5 Years Living with HIV Who Are Receiving Antiretroviral Treatment - U.S. President's Emergency Plan for AIDS Relief, 28 Supported Countries and Regions, October 2020-September 2022.

Globally, children aged <5 years, including those living with HIV who are not receiving antiretroviral treatment (ART), experience disproportionately high mortality. Global mortality among children living with HIV aged <5 years receiving ART is not well described. This report compares mortality and related clinical measures among infants aged <1 year and children aged 1-4 years living with HIV with those among older persons aged 5-14, 15-49, and ≥50 years living with HIV receiving ART services at all clinical sites supported by the U.S. President's Emergency Plan for AIDS Relief. During October 2020-September 2022, an average of 11,980 infants aged <1 year and 105,510 children aged 1-4 years were receiving ART each quarter; among these infants and children receiving ART, 586 (4.9%) and 2,684 (2.5%), respectively, were reported to have died annually. These proportions of infants and children who died ranged from four to nine times higher in infants aged <1 year, and two to five times higher in children aged 1-4 years, than the proportions of older persons aged ≥5 years receiving ART. Compared with persons aged ≥5 years living with HIV, the proportions of children aged <5 years living with HIV who experienced interruptions in treatment were also higher, and the proportions who had a documented HIV viral load result or a suppressed viral load were lower. Prioritizing and optimizing HIV and general health services for children aged <5 years living with HIV receiving ART, including those recommended in the WHO STOP AIDS Package, might help address these disproportionately poorer outcomes.

Reproductive health challenges of male and female street beggars and use of reproductive health services by female street beggars in Ife-Ijesa, Nigeria.

OBJECTIVES: The aims of the study were to investigate the reproductive health challenges in Nigeria of male and female street beggars and the use of reproductive health services by female street beggars. METHODS: The study had a cross-sectional descriptive design. An interviewer-administered questionnaire, designed by the authors, was used to elicit information from 100 male and female street beggars recruited over a 4 week period in Ife-Ijesa zone, south-western Nigeria. Information was obtained about male and female participants' reproductive health challenges (symptoms and issues) and female participants' use of reproductive health services. RESULTS: More than a third of participants were aged ≥60 years (37%), 57% were men, 82% were from the Hausa tribe and 92% were Muslims. The main reasons given for street begging were poverty (30%) and physical handicap (66%). Although most of the street beggars were aware of the availability of reproductive health services (81%) and where to access them (89%), only a small proportion of female street beggars had given birth in hospital (9.3%) and family planning services (32.6%). CONCLUSION: Street beggars are a poor and vulnerable group with reproductive health challenges. They have difficulty accessing reproductive health services because of physical disabilities and related low socioeconomic status.

Lifting the veil on disrespect and abuse in facility-based child birth care: findings from South West Nigeria.

BACKGROUND: Eliminating disrespect and abuse in health care facilities during childbirth could be a contributory factor in improving pregnancy outcomes and avoiding preventable illnesses and deaths. This study aims to provide evidence of disrespect and abuse in this community in order to create awareness about its occurrence. METHODS: A cross-sectional survey was carried out on 384 recently delivered women who visited the postnatal and immunization clinics of a primary and tertiary health facility in Ile-Ife. Information was sought about awareness of disrespect and abuse, prevalence and forms of disrespect and abuse, and opinions on improvements which can be made in maternity services. Univariate analysis was used to summarise the data. RESULTS: About half of the respondents were in their fourth decade of life and had tertiary education. Overall, the majority (98.4%) of respondents agreed that it was their right to be treated with respect and dignity during childbirth while about one-fifth (19%) had ever experienced some form of disrespect and abuse. The commonly identified forms of disrespect and abuse were: non-dignified care (12.8%), discrimination (8.1%), a detention and abandonment (6%). However, the majority (81%) of the respondents did not have any suggestions for improvements in delivery services. CONCLUSIONS: Although most of the respondents knew it was their right to be treated with respect, some reported that they had experienced disrespect and abuse during childbirth in varying forms. The evidence from this survey draws attention to the need for interventions to address the health system factors hindering health service utilization.

The effect of mobile phone short message service on maternal health in south-west Nigeria.

BACKGROUND: The maternal mortality ratio in Nigeria is estimated to be about 814 per 100,000 live births, and deliveries taken outside a health facility have been implicated as a major factor for this high number. Mobile phones interventions are continually being explored in the health field but its usefulness in maternal health in Nigeria has not been widely explored. OBJECTIVE: To determine the impact of SMS (text messages) on maternal health behaviour in Ife-Ijesa zone of Osun State, Nigeria. METHODS: We conducted an experimental study involving 2 groups of pregnant women and sent text messages to both groups. The control group was sent general health messages while the intervention group was sent specific pregnancy related messages and both groups were followed up till 6 weeks after delivery. RESULTS: An increase in facility delivery rates among both groups, between the index pregnancy and their last pregnancies, were recorded for both groups with a higher percentage increase recorded in the intervention group (29%) compared with the control group 13%. Crude and adjusted linear regression coefficients were done to estimate the effect of the intervention on the change in proportion of deliveries in health facilities. After adjusting for other variables, the difference obtained was a significant value of 14% (regression coefficient = 0.14, 95% CI = 0.08-0.20, P value = .005). Most participants in the intervention group (96.6%) expressed support for the use of text message for maternal health promotion. CONCLUSION: The SMS-based intervention has a positive effect on facility delivery, and mothers welcome its use in pregnancy.