Despite reductions over the past 2 decades, childhood mortality remains high in low- and middle-i... more Despite reductions over the past 2 decades, childhood mortality remains high in low- and middle-income countries in sub-Saharan Africa and South Asia. In these settings, children often die at home, without contact with the health system, and are neither accounted for, nor attributed with a cause of death. In addition, when cause of death determinations occur, they often use nonspecific methods. Consequently, findings from models currently utilized to build national and global estimates of causes of death are associated with substantial uncertainty. Higher-quality data would enable stakeholders to effectively target interventions for the leading causes of childhood mortality, a critical component to achieving the Sustainable Development Goals by eliminating preventable perinatal and childhood deaths. The Child Health and Mortality Prevention Surveillance (CHAMPS) Network tracks the causes of under-5 mortality and stillbirths at sites in sub-Saharan Africa and South Asia through compr...
This study examined sexual practices in a Nigerian University community with a view to understand... more This study examined sexual practices in a Nigerian University community with a view to understanding the role of family structure and poverty on risky sexual behaviours. A representative sample of 1,301 undergraduate students was randomly selected from the various faculties that made up the University. Using a questionnaire instrument, information was obtained on sexual behaviours of interest such as sexual initiation, multi-partnered sexual activity and condom use. Findings showed a noticeable variation in the relationship between family structure and risky sexual behaviour. Contrary to expectations, students from single parent homes showed lower likelihood of having multiple sexual partners. Also poverty was found not to be a critical determinant of risky sexual behaviour. Given the unclear nature of the findings, future study should explore further understanding of the relationship between family characteristics, poverty rating and risky sexual behaviour among students.
SummaryThere are substantial regional disparities in under-five mortality in Nigeria, and evidenc... more SummaryThere are substantial regional disparities in under-five mortality in Nigeria, and evidence suggests that both individual- and community-level characteristics have an influence on health outcomes. Using 2008 Nigeria Demographic and Health Survey data, this study (1) examines the effects of individual- and community-level characteristics on infant/child mortality in Nigeria and (2) determines the extent to which characteristics at these levels influence regional variations in infant/child mortality in the country. Multilevel Cox proportional hazard analysis was performed on a nationally representative sample of 28,647 children nested within 18,028 mothers of reproductive age, who were also nested within 886 communities. The results indicate that community-level variables (such as region, place of residence, community infrastructure, community hospital delivery and community poverty level) and individual-level factors (including child's sex, birth order, birth interval, mat...
Background: West Africa historically has a high prevalence of girl-child marriage and requires su... more Background: West Africa historically has a high prevalence of girl-child marriage and requires substantial reduction to meet the United Nation’s Sustainable Development Goals (SDG) target of ending child marriage by 2030, but current data on progress is sparce. We aimed to determine the trend in child marriage in West Africa and assess the influence of selected socio-demographic factors. Methods: We analysed data on women aged 18-24 years from the two most recent Demographic and Health Surveys (conducted between 2006 and 2014) for 11 West African countries to determine the prevalence and trend of girl-child marriage. Multivariable logistic regression analysis was used to assess the relationship between girl-child marriage and selected socio-demographic factors. Results: The prevalence of child marriage in West Africa is 41.5%. An overall decrease of 4.6% (annual rate of 0.01%) was recorded over a seven-year inter-survey period. Three countries (Cote d’Ivoire, Nigeria, and Niger) rec...
Background: Family planning expansion has been identified as an impetus to harnessing Nigeria’s d... more Background: Family planning expansion has been identified as an impetus to harnessing Nigeria’s demo-graphic dividend. However, there is a need for data to address pockets of inequality and to better under-stand cultural and social factors affecting contraceptive use and health benefits. This paper contributes to addressing these needs by providing evidence on the trends and sub-national patterns of modern contraceptive prevalence in Nigeria and the association between contraceptive use and high-risk births in Nigeria. Design: The study utilised women’s data from the last three Demographic and Health Surveys (2003, 2008, and 2013) in Nigeria. The analysis involved descriptive, bivariate, and multivariate analyses. The multivariate analyses were performed to examine the relationship between high-risk births and contraceptive use. Associations were examined using Poisson regression. Results: Findings showed that respondents in avoidable high-risk birth categories were less likely to u...
Context Considering the persistent poor maternal and child health outcomes in sub-Saharan Africa ... more Context Considering the persistent poor maternal and child health outcomes in sub-Saharan Africa (SSA), this study undertook a comparative analysis of the timing and adequacy of antenatal care uptake between women (aged 20–24 years) who married before age 18 and those who married at age 18 or above. Method Data came from Demographic and Health Surveys of 20 SSA countries. We performed binary logistic regression analysis on pooled data of women aged 20–24 (n = 33,630). Results Overall, the percentage of child brides in selected countries was 57.1%, with the lowest prevalence found in Rwanda (19.1%) and the highest rate in Chad (80.9%). Central and West African countries had the highest prevalence of child marriage compared to other sub-regions. Bivariate results indicate that a lower proportion of child brides (50.0%) had 4+ ANC visits compared to the adult brides (60.9%) and a lower percentage of them (34.0%) initiated ANC visits early compared to the adult brides (37.5%). After con...
What role has gender equality played in fertility transitions in Africa? This article addresses t... more What role has gender equality played in fertility transitions in Africa? This article addresses this and other questions with a focus on the fertility levels of two selected countries in Africa. Using Demographic and Health Surveys datasets of Nigeria (2008) and Kenya (2008-09), the article examines the relationship between the current level of gender systems and fertility transitions in Africa. The prospects for future decline in fertility levels in the selected countries are also discussed.
Background . Improving access to quality healthcare can contribute to reducing childhood mortalit... more Background . Improving access to quality healthcare can contribute to reducing childhood mortality. Therefore, understanding the patterns of healthcare utilisation for common childhood conditions as well as barriers to healthcare use is important in planning appropriate public health programmes and interventions. Objective . The objective of the present study was to examine patterns of child healthcare uptake and barriers that affect access to healthcare in two South African (SA) low-income urban settings. Methods . A healthcare utilisation survey was conducted between April and September 2015, using a cross-sectional study design. Data were analysed using descriptive and inferential statistics. Information was collected on 531 children and their caregivers from 503 randomly selected households. Results . Our findings revealed that 81.9% of respondents preferred clinics as their first choice, and 84.2% preferred hospitals as their second point of call. About 5% of caregivers preferr...
Poor maternity care uptake (MCU) persists in Nigeria. Evidence shows that this is partly responsi... more Poor maternity care uptake (MCU) persists in Nigeria. Evidence shows that this is partly responsible for the country’s high maternal mortality ratio of 560 deaths per 100,000 live births and under-five mortality rate of 128 deaths per 1,000 live births. Also, wide gap in partners' age difference (PAD) coupled with lack of control over own health and that of their children persist among women in patriarchal societies, especially Nigeria. Given this situation, this study examined the influence of PAD on MCU in Nigeria. Binary logistic regression analysis was performed on 7023 couples in 2013 Nigeria Demographic and Health Survey data. Results indicated significantly lower odds of utilizing maternal and child health care [i.e. antenatal care (ANC), skilled delivery (SD) and postnatal care (PNC)] among women that were far younger than their partners, relative to much older women. For instance, PAD of 10 years or higher was significantly associated with lower odds of utilizing ANC ...
Background. The burden of under-five mortality in sub-Saharan Africa (SSA) is highest during the ... more Background. The burden of under-five mortality in sub-Saharan Africa (SSA) is highest during the neonatal period, with over 40% of cases occurring during the first month of life. There is a paucity of evidence on the influence of women’s household position on neonatal survival in SSA. Objective. To assess the influence of women’s household position on neonatal survival in SSA. Methods. We analysed pooled data ( N =191 514) from the demographic and health surveys of 18 countries in SSA. Cox proportional hazards regression analysis was used to explore statistically significant relationships. Results. Findings support the hypothesis that a low position of a woman in the household is significantly associated with high neonatal mortality, as children of women who experienced a high position in the household had a significantly lower risk of neonatal mortality (hazard ratio 0.85, confidence interval 0.76 - 0.95; p <0.05) than those whose mothers experienced a low household position....
Despite reductions over the past 2 decades, childhood mortality remains high in low- and middle-i... more Despite reductions over the past 2 decades, childhood mortality remains high in low- and middle-income countries in sub-Saharan Africa and South Asia. In these settings, children often die at home, without contact with the health system, and are neither accounted for, nor attributed with a cause of death. In addition, when cause of death determinations occur, they often use nonspecific methods. Consequently, findings from models currently utilized to build national and global estimates of causes of death are associated with substantial uncertainty. Higher-quality data would enable stakeholders to effectively target interventions for the leading causes of childhood mortality, a critical component to achieving the Sustainable Development Goals by eliminating preventable perinatal and childhood deaths. The Child Health and Mortality Prevention Surveillance (CHAMPS) Network tracks the causes of under-5 mortality and stillbirths at sites in sub-Saharan Africa and South Asia through compr...
This study examined sexual practices in a Nigerian University community with a view to understand... more This study examined sexual practices in a Nigerian University community with a view to understanding the role of family structure and poverty on risky sexual behaviours. A representative sample of 1,301 undergraduate students was randomly selected from the various faculties that made up the University. Using a questionnaire instrument, information was obtained on sexual behaviours of interest such as sexual initiation, multi-partnered sexual activity and condom use. Findings showed a noticeable variation in the relationship between family structure and risky sexual behaviour. Contrary to expectations, students from single parent homes showed lower likelihood of having multiple sexual partners. Also poverty was found not to be a critical determinant of risky sexual behaviour. Given the unclear nature of the findings, future study should explore further understanding of the relationship between family characteristics, poverty rating and risky sexual behaviour among students.
SummaryThere are substantial regional disparities in under-five mortality in Nigeria, and evidenc... more SummaryThere are substantial regional disparities in under-five mortality in Nigeria, and evidence suggests that both individual- and community-level characteristics have an influence on health outcomes. Using 2008 Nigeria Demographic and Health Survey data, this study (1) examines the effects of individual- and community-level characteristics on infant/child mortality in Nigeria and (2) determines the extent to which characteristics at these levels influence regional variations in infant/child mortality in the country. Multilevel Cox proportional hazard analysis was performed on a nationally representative sample of 28,647 children nested within 18,028 mothers of reproductive age, who were also nested within 886 communities. The results indicate that community-level variables (such as region, place of residence, community infrastructure, community hospital delivery and community poverty level) and individual-level factors (including child's sex, birth order, birth interval, mat...
Background: West Africa historically has a high prevalence of girl-child marriage and requires su... more Background: West Africa historically has a high prevalence of girl-child marriage and requires substantial reduction to meet the United Nation’s Sustainable Development Goals (SDG) target of ending child marriage by 2030, but current data on progress is sparce. We aimed to determine the trend in child marriage in West Africa and assess the influence of selected socio-demographic factors. Methods: We analysed data on women aged 18-24 years from the two most recent Demographic and Health Surveys (conducted between 2006 and 2014) for 11 West African countries to determine the prevalence and trend of girl-child marriage. Multivariable logistic regression analysis was used to assess the relationship between girl-child marriage and selected socio-demographic factors. Results: The prevalence of child marriage in West Africa is 41.5%. An overall decrease of 4.6% (annual rate of 0.01%) was recorded over a seven-year inter-survey period. Three countries (Cote d’Ivoire, Nigeria, and Niger) rec...
Background: Family planning expansion has been identified as an impetus to harnessing Nigeria’s d... more Background: Family planning expansion has been identified as an impetus to harnessing Nigeria’s demo-graphic dividend. However, there is a need for data to address pockets of inequality and to better under-stand cultural and social factors affecting contraceptive use and health benefits. This paper contributes to addressing these needs by providing evidence on the trends and sub-national patterns of modern contraceptive prevalence in Nigeria and the association between contraceptive use and high-risk births in Nigeria. Design: The study utilised women’s data from the last three Demographic and Health Surveys (2003, 2008, and 2013) in Nigeria. The analysis involved descriptive, bivariate, and multivariate analyses. The multivariate analyses were performed to examine the relationship between high-risk births and contraceptive use. Associations were examined using Poisson regression. Results: Findings showed that respondents in avoidable high-risk birth categories were less likely to u...
Context Considering the persistent poor maternal and child health outcomes in sub-Saharan Africa ... more Context Considering the persistent poor maternal and child health outcomes in sub-Saharan Africa (SSA), this study undertook a comparative analysis of the timing and adequacy of antenatal care uptake between women (aged 20–24 years) who married before age 18 and those who married at age 18 or above. Method Data came from Demographic and Health Surveys of 20 SSA countries. We performed binary logistic regression analysis on pooled data of women aged 20–24 (n = 33,630). Results Overall, the percentage of child brides in selected countries was 57.1%, with the lowest prevalence found in Rwanda (19.1%) and the highest rate in Chad (80.9%). Central and West African countries had the highest prevalence of child marriage compared to other sub-regions. Bivariate results indicate that a lower proportion of child brides (50.0%) had 4+ ANC visits compared to the adult brides (60.9%) and a lower percentage of them (34.0%) initiated ANC visits early compared to the adult brides (37.5%). After con...
What role has gender equality played in fertility transitions in Africa? This article addresses t... more What role has gender equality played in fertility transitions in Africa? This article addresses this and other questions with a focus on the fertility levels of two selected countries in Africa. Using Demographic and Health Surveys datasets of Nigeria (2008) and Kenya (2008-09), the article examines the relationship between the current level of gender systems and fertility transitions in Africa. The prospects for future decline in fertility levels in the selected countries are also discussed.
Background . Improving access to quality healthcare can contribute to reducing childhood mortalit... more Background . Improving access to quality healthcare can contribute to reducing childhood mortality. Therefore, understanding the patterns of healthcare utilisation for common childhood conditions as well as barriers to healthcare use is important in planning appropriate public health programmes and interventions. Objective . The objective of the present study was to examine patterns of child healthcare uptake and barriers that affect access to healthcare in two South African (SA) low-income urban settings. Methods . A healthcare utilisation survey was conducted between April and September 2015, using a cross-sectional study design. Data were analysed using descriptive and inferential statistics. Information was collected on 531 children and their caregivers from 503 randomly selected households. Results . Our findings revealed that 81.9% of respondents preferred clinics as their first choice, and 84.2% preferred hospitals as their second point of call. About 5% of caregivers preferr...
Poor maternity care uptake (MCU) persists in Nigeria. Evidence shows that this is partly responsi... more Poor maternity care uptake (MCU) persists in Nigeria. Evidence shows that this is partly responsible for the country’s high maternal mortality ratio of 560 deaths per 100,000 live births and under-five mortality rate of 128 deaths per 1,000 live births. Also, wide gap in partners' age difference (PAD) coupled with lack of control over own health and that of their children persist among women in patriarchal societies, especially Nigeria. Given this situation, this study examined the influence of PAD on MCU in Nigeria. Binary logistic regression analysis was performed on 7023 couples in 2013 Nigeria Demographic and Health Survey data. Results indicated significantly lower odds of utilizing maternal and child health care [i.e. antenatal care (ANC), skilled delivery (SD) and postnatal care (PNC)] among women that were far younger than their partners, relative to much older women. For instance, PAD of 10 years or higher was significantly associated with lower odds of utilizing ANC ...
Background. The burden of under-five mortality in sub-Saharan Africa (SSA) is highest during the ... more Background. The burden of under-five mortality in sub-Saharan Africa (SSA) is highest during the neonatal period, with over 40% of cases occurring during the first month of life. There is a paucity of evidence on the influence of women’s household position on neonatal survival in SSA. Objective. To assess the influence of women’s household position on neonatal survival in SSA. Methods. We analysed pooled data ( N =191 514) from the demographic and health surveys of 18 countries in SSA. Cox proportional hazards regression analysis was used to explore statistically significant relationships. Results. Findings support the hypothesis that a low position of a woman in the household is significantly associated with high neonatal mortality, as children of women who experienced a high position in the household had a significantly lower risk of neonatal mortality (hazard ratio 0.85, confidence interval 0.76 - 0.95; p <0.05) than those whose mothers experienced a low household position....
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