Women's household decision-making autonomy and safer sex negotiation in Nigeria: An analysis of the Nigeria Demographic and Health Survey.

Although married women's safer sex negotiation with their husbands is critical in reducing new HIV infections in Nigeria, its linkage to women's household decision-making autonomy is less explored in Nigeria. Drawing data from the 2013 Nigeria Demographic and Health Survey and using the logistic regression technique, we examined the associations between women's household decision-making autonomy and two indicators of the ability to engage in safer sex including whether married women 1) can refuse sex and 2) ask for condom use during sexual intercourse with husbands. Findings indicate that 64% and 41% of married women can refuse sex and ask for condom use, respectively. While the impact of women's household decision-making autonomy on the ability to refuse sex remained statistically significant after controlling for theoretically relevant variables (OR = 1.15; p < 0.001), its impact on the ability to ask for condom use became weakly significant once socioeconomic variables were controlled (OR = 1.03; p < 0.1). Based on these results, we have two suggestions. First, it may be important that marital-based policies and counselling promote environments in which married women can establish equal power relations with their husbands. Second, it is also important to eliminate structural barriers that hinder married women's economic opportunities in Nigeria.

Nourishing the Nexus: A Feminist Analysis of Gender, Nutrition and Agri-food Development Policies and Practices.

This article applies feminist critiques to investigate how agri-food and nutritional development policy and interventions address gender inequality. Based on the analysis presented of global policies and examples of project experiences from Haiti, Benin, Ghana, and Tanzania, we find that the widespread emphasis on gender equality in policy and practice generally ascribes to a gender narrative that includes static, homogenized conceptualizations of food provisioning and marketing. These narratives tend to translate to interventions that instrumentalize women's labor by funding their income generating activities and care responsibilities for other benefits like household food and nutrition security without addressing underlying structures that cause their vulnerability, such as disproportionate work burdens, land access challenges, among many others. We argue that policy and interventions must prioritize locally contextualized social norms and environmental conditions, and consider further the way wider policies and development assistance shape social dynamics to address the structural causes of gender and intersecting inequalities.

Cet article se sert des critiques féministes pour étudier la façon dont les politiques et les interventions de développement agroalimentaire et nutritionnel traitent l'inégalité entre les sexes. Sur la base de l'analyse présentée des politiques mondiales et des exemples d'expériences de projets en Haïti, au Bénin, au Ghana et en Tanzanie, nous constatons que l'accent généralisé sur l'égalité des sexes dans les politiques et les pratiques attribue généralement à un récit de genre qui comprend des conceptualisations statiques et homogénéisées de l'approvisionnement et de la commercialisation des denrées alimentaires. Ces récits ont tendance à se traduire par des interventions qui instrumentalisent le travail des femmes en finançant leurs activités génératrices de revenus et leurs responsabilités de soins à fins telles que la sécurité alimentaire et nutritionnelle des ménages, sans pour autant s'attaquer aux structures sous-jacentes qui causent leur vulnérabilité, telles que les charges de travail disproportionnées, les difficultés d'accès à la terre, parmi tant d'autres. Nous soutenons que les politiques et les interventions doivent donner la priorité aux normes sociales et aux conditions environnementales contextualisées localement, et mieux prendre en compte la manière dont les politiques publiques en général et l'aide au développement façonnent la dynamique sociale pour s'attaquer aux causes structurelles des inégalités de genre et croisées.

How is gender investigated in African climate change research? A systematic review of the literature.

This systematic review analyzes all 260 studies published in the Web of Science on gender and climate change in Africa. While there is no strong methodological bias, comparative case studies and sex disaggregated analyses predominate from a limited set of countries. Many articles covered the agrarian sector by comparing women's and men's on-farm vulnerability to a changing climate based on their adaptation behaviours. Though this literature recognizes women's important conservation, farming, and food responsibilities, it oftentimes generalized these contributions without providing evidence. A number of themes were covered by a very limited number of articles, including coastal areas, conflict, education, energy, migration, urban areas, and water. Overall, more justice-oriented research is needed into the socioeconomic structures that intersect with social identities to make certain people, places, and institutions more vulnerable. Investigations into the power dynamics between (social) scientists and African institutions are also needed as most articles reviewed stem from North America and Europe and are locked beyond paywalls.

Debated agronomy: public discourse and the future of biotechnology policy in Ghana.

This paper examines the highly contested and ongoing biotechnology (Bt) policy-making process in Ghana. We analyse media content on how Bt is viewed in the context of Ghana's parliamentary debate on the Plant Breeders Bill and within the broader public policy-making literature. This paper does not seek to take a position on Bt or the Bill, but to understand how policy actors influence the debate with political and scientific rhetoric in Ghana. The study reveals that in the midst of scientific uncertainties of Bt's potential for sustainable agriculture production and food security, policy decisions that encourage its future adoption are heavily influenced by health, scientific, economic, environmental and political factors dictated by different ideologies, values and norms. While locally pioneered plant breeding is visible and common in the Ghanaian food chain, plant breeding/GMOs/Bt from international corporations is strongly resisted by anti-GMO coalitions. Understanding the complex and messy nature of Bt policy-making is critical for future development of agricultural technology in Ghana and elsewhere.

Timing and utilisation of antenatal care service in Nigeria and Malawi.

As the world draws curtains on the implementation of Millennium Development Goals (MDGs), there is increasing interest in evaluating the performance of countries on the goals and assessing related challenges and opportunities to inform the upcoming Sustainable Development Goals (SDGs). This study examined changes in the timing and utilisation of maternal health care services in Nigeria and Malawi; using multivariate negative log-log and logistic regression models fitted to demographic and health survey data sets. Predicted probabilities were also computed to observe the net differences in the likelihood of both the first and the required number of antenatal care (ANC) visits for each of the three analysis years. Women in Nigeria were 7% less likely in 2008 compared to 2003, and in Malawi, 32% more likely in 2013 compared to 2000, to utilise ANC in the first trimester of pregnancy. Timing of first ANC visit was strongly influenced by wealth in Nigeria but not in Malawi. The findings in our case studies show how various contextual factors may enable or inhibit policy performance. Maternal and child health, SDGs should incorporate both wealth and degrees of urbanicity into country level implementation strategies.

Utilisation of skilled birth attendants over time in Nigeria and Malawi.

Despite recent modest progress in reducing maternal and infant mortality rates in sub-Saharan Africa, Nigeria and Malawi were still in the top 20 countries with highest rates of mortalities globally in 2015. Utilisation of professional services at delivery - one of the indictors of MDG 5 - has been suggested to reduce maternal mortality by 50%. Yet, contextual, socio-cultural and economic factors have served as barriers to uptake of such critical service. In this paper, we examined the impact of residential wealth index on utilisation of Skilled Birth Attendant in Nigeria (2003, 2008 and 2013), and Malawi (2000, 2004 and 2010) using Demographic and Health Survey data sets. The findings from multivariate logistic regressions show that women in Nigeria were 23% less likely to utilise skilled delivery services in 2013 compared to 2003. In Malawi, women were 75% more likely to utilise skilled delivery services in 2010 than in 2000. Residential wealth index was a significant predictor of utilisation of skilled delivery services over time in both Nigeria and Malawi. These findings illuminate progress made - based on which we make recommendations for achievement of SDG-3: ensure healthy lives and promote well-being for all at all ages in Nigeria and Malawi, and similar context.

Financial sustainability versus access and quality in a challenged health system: an examination of the capitation policy debate in Ghana.

Policy makers in low and middle-income countries are frequently confronted with challenges of increasing health access for poor populations in a sustainable manner. After several years of trying out different health financing mechanisms, health insurance has recently emerged as a pro-poor health financing policy. Capitation, a fixed fee periodically paid to health service providers for anticipated services, is one of the payment policies in health insurance. This article examines claims and counter-claims made by coalitions and individual stakeholders in a capitation payment policy debate within Ghana's National Health Insurance Scheme. Using content analysis of public and parliamentary proceedings, we situate the debate within policy making and health insurance literature. We found that the ongoing capitation payment debate stems from challenges in implementation of earlier health insurance claims payment systems, which reflect broader systemic challenges facing the health insurance scheme in Ghana. The study illustrates the extent to which various sub-systems in the policy debate advance arguments to legitimize their claims about the contested capitation payment system. In addition, we found that the health of poor communities, women and children are being used as surrogates for political and individual arguments in the policy debate. The article recommends a more holistic and participatory approach through persuasion and negotiation to join interests and core evidence together in the capitation policy making in Ghana and elsewhere with similar contexts.