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Somefun OD, Olamijuwon E. Community structure and timing of sexual activity among adolescent girls in Nigeria. PLoS One 2022; 17:e0269168. [PMID: 35895697 PMCID: PMC9328553 DOI: 10.1371/journal.pone.0269168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 05/16/2022] [Indexed: 11/18/2022] Open
Abstract
Studies have linked the timing of sexual debut to unplanned pregnancies and sexually transmissible infections, including HIV. Current understandings of sexual debut among Nigerian adolescents focused on the roles of individual and familial characteristics. We leveraged the 2018 Nigeria Demographic and Health Survey data to examine how community features like affluence, ethnic diversity, and women empowerment may be associated with the timing of sexual debut among adolescent girls. The sample comprised 7449 adolescent girls who were usual residents in 6,505 households and 1,352 clusters or communities. Statistical associations between community characteristics and the onset of sexual debut were assessed using a two-level mixed-effects parametric survival model with Weibull distribution. We found that community affluence [aHR:0.43, 95%CI: 0.30–0.62] and community ethnic diversity [aHR: 0.63, 95%CI: 0.42–0.94] are associated with a lower hazard of sexual debut among adolescent girls. We also observed that women that married within the observation period had an earlier sexual initiation than those who were unmarried. The results disaggregated by marital status further shows that higher community level of women’s employment [aHR: 2.45, 95%CI: 1.38–4.38] and women’s education [aHR:1.85, 95%CI: 1.03–3.33] were associated with a higher hazard of sexual debut among unmarried adolescent girls but not married adolescent girls. Higher community affluence [aHR:0.40, 95%CI: 0.27–0.60] was also associated with a lower hazard of sexual debut among unmarried adolescent girls but not married adolescent girls. Our results illuminate the associated factors of the timing of sexual debut among adolescent girls that moves beyond individual characteristics to community characteristics.
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Affiliation(s)
- Oluwaseyi Dolapo Somefun
- UKRI GCRF Accelerating Achievement for Africa’s Adolescents, School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Emmanuel Olamijuwon
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, England, United Kingdom
- School of Geography and Sustainable Development, University of St Andrews, Scotland, United Kingdom
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, Faculties of Health Sciences and Humanities, University of the Witwatersrand, Witwatersrand, South Africa
- * E-mail:
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Simelane MS, Vermaak K, Zwane E, Masango S. Individual and community-level factors associated with lifetime number of sexual partners among women aged 15-49 in Eswatini. PLoS One 2021; 16:e0246100. [PMID: 33497398 PMCID: PMC7837491 DOI: 10.1371/journal.pone.0246100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 01/13/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Understanding the risk factors for behavioral patterns in sexual relationships play a significant role in the reduction of the transmission of HIV/AIDS and other sexually transmitted infections. OBJECTIVE To investigate individual and community level factors on the lifetime number of sexual partners of women in Eswatini. MATERIAL AND METHODS The study was a secondary cross-sectional analysis of the 2014 Eswatini Multiple Indicator Cluster Survey (MICS). A total of 2,832 women aged 15-49 years were asked in total, how many different people have you had sexual intercourse in your lifetime. The multilevel negative binomial regression model was used to analyze the data. RESULTS The overall mean number of lifetime sexual partners was 2.78 (95% CI: 2.66, 2.91) in 2014. Compared to women aged 15-19, those aged 20 years and older, formerly married or never married reported more lifetime sexual partners compared to currently married women. Those that were aged 15 years and older at sexual debut reported fewer lifetime sexual partners compared to those that were aged less than 15 years. Compared to women that used a condom at last sexual intercourse, those that did not use a condom at last sexual encounter reported fewer lifetime sexual partners. Relative to women that lived with their sons and daughters, those that did not live with their sons and daughters reported more lifetime sexual partners. Women that lived in the Shiselweni and Lubombo regions reported fewer lifetime sexual partners compared to those residents in the Hhohho region. CONCLUSION Overall, lifetime sexual partners in Eswatini was significantly associated with individual characteristics and is unique across regions. Programs that aim to elucidate the factors associated with incident HIV infections among women in Eswatini should focus on individual and community-level factors that are associated with multiple sexual partnerships, which in turn might increase the risk of HIV exposure.
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Affiliation(s)
- Maswati S. Simelane
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni, Eswatini
| | - Kerry Vermaak
- The School of Built Environment and Development Studies, University of KwaZulu-Natal, Durban, South Africa
| | - Eugene Zwane
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni, Eswatini
| | - Sdumo Masango
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni, Eswatini
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Armstrong-Mensah E, Ebiringa DP, Whitfield K, Coldiron J. Genital Chlamydia Trachomatis Infection: Prevalence, Risk Factors and Adverse Pregnancy and Birth Outcomes in Children and Women in sub-Saharan Africa. Int J MCH AIDS 2021; 10:251-257. [PMID: 34900393 PMCID: PMC8647192 DOI: 10.21106/ijma.523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Genital Chlamydia trachomatis (CT) has adverse health outcomes for women and children. In pregnant women, the infection causes adverse obstetric outcomes including pelvic inflammation, ectopic pregnancy, and miscarriage. In children, it causes adverse birth outcomes such as skin rash, lesions, limb abnormalities, conjunctivitis, neurological damage, and even death. This article discusses genital CT prevalence, risk factors, and adverse pregnancy and birth outcomes among women and children in sub-Saharan Africa as well as challenges associated with the mitigation of the disease. A comprehensive search of databases including PubMed, ResearchGate, and Google Scholar was conducted using keywords such as genital chlamydia trachomatis, adverse pregnancy outcomes, adverse birth outcomes, and sub-Saharan African. We found that genital CT prevalence rates in some sub-Saharan Africa countries were higher than others and that risk factors such as the lack of condom use, having multiple sexual partners, and low educational levels contribute to the transmission of the infection. We also found that negative cultural practices, illiteracy among women, and the lack of access to screening services during pregnancy are some of the challenges associated with CT mitigation in sub-Saharan Africa. To reduce genital CT transmission in sub-Saharan Africa, efforts must be made by country governments to eliminate negative cultural practices, promote female literacy, and provide access to screening services for pregnant women.
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Affiliation(s)
| | | | - Kaleb Whitfield
- Georgia State University, School of Public Health, Atlanta, Georgia 30303, USA
| | - Jake Coldiron
- Georgia State University, School of Public Health, Atlanta, Georgia 30303, USA
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Fantay Gebru K, Mekonnen Haileselassie W, Haftom Temesgen A, Oumer Seid A, Afework Mulugeta B. Determinants of stunting among under-five children in Ethiopia: a multilevel mixed-effects analysis of 2016 Ethiopian demographic and health survey data. BMC Pediatr 2019; 19:176. [PMID: 31153381 PMCID: PMC6544992 DOI: 10.1186/s12887-019-1545-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 05/20/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Childhood stunting is the most widely prevalent among under-five children in Ethiopia. Despite the individual-level factors of childhood stunting are well documented, community-level factors have not been given much attention in the country. This study aimed to identify individual- and community-level factors associated with stunting among under-five children in Ethiopia. METHODS Cross-sectional data from the 2016 Ethiopian Demographic and Health Survey was used. A total of 8855 under-five children and 640 community clusters were included in the current analysis. A multilevel logistic regression model was used at 5% level of significance to determine the individual- and community-level factors associated with childhood stunting. RESULTS The prevalence of stunting was found to be 38.39% in Ethiopian under-five children. The study showed that the percentage change in variance of the full model accounted for about 53.6% in odds of childhood stunting across the communities. At individual-level, ages of the child above 12 months, male gender, small size of the child at birth, children from poor households, low maternal education, and being multiple birth had significantly increased the odds of childhood stunting. At community-level, children from communities of Amhara, Tigray, and Benishangul more suffer from childhood stunting as compared to Addis Ababa's community children. Similarly, children from Muslim, Orthodox and other traditional religion followers had higher log odds of stunting relative to children of the protestant community. CONCLUSIONS This study showed individual- and community-level factors determined childhood stunting in Ethiopian children. Promotion of girl education, improving the economic status of households, improving maternal nutrition, improving age-specific child feeding practices, nutritional care of low birth weight babies, promotion of context-specific child feeding practices and narrowing rural-urban disparities are recommended.
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Affiliation(s)
- K Fantay Gebru
- Tigray National Regional State, Bureau of Science and Technology, Mekelle, Tigray, Ethiopia
| | - W Mekonnen Haileselassie
- Tigray National Regional State, Bureau of Science and Technology, Mekelle, Tigray, Ethiopia. .,School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
| | - A Haftom Temesgen
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - A Oumer Seid
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - B Afework Mulugeta
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Okigbo CC, Speizer IS, Domino ME, Curtis SL, Halpern CT, Fotso JC. Gender norms and modern contraceptive use in urban Nigeria: a multilevel longitudinal study. BMC WOMENS HEALTH 2018; 18:178. [PMID: 30373570 PMCID: PMC6206649 DOI: 10.1186/s12905-018-0664-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 10/11/2018] [Indexed: 11/23/2022]
Abstract
Background Evidence suggests that gender equality positively influences family planning. However, the evidence from urban Africa is sparse. This study aimed to examine the association between changes in gender norms and modern contraceptive use over time among women in urban Nigeria. Methods Data were collected in 2010/2011 from 16,118 women aged 15–49 living in six cities in Nigeria (Abuja, Benin, Ibadan, Ilorin, Kaduna, and Zaria) and again in 2014 from 10,672 of the same women (34% attrition rate). The analytical sample included 9933 women living in 480 neighborhoods. A four-category outcome variable measured their change in modern contraceptive use within the study period. The exposure variables measured the changes in the level of gender-equitable attitudes towards: a) wife beating; b) household decision-making; c) couples’ family planning decisions; and d) family planning self-efficacy. Multilevel multinomial logistic regression models estimated the associations between the exposure variables at the individual and neighborhood levels and modern contraceptive use controlling for the women’s age, education, marital status, religion, parity, household wealth, and city of residence. Results The proportion of women who reported current use of modern contraceptive methods increased from 21 to 32% during the four-year study period. At both surveys, 58% of the women did not report using modern contraceptives while 11% reported using modern contraceptives; 21% did not use in 2010/2011 but started using by 2014 while 10% used in 2010/2011 but discontinued use by 2014. A positive change in the gender-equitable attitudes towards household decision-making, couples’ family planning decisions, and family planning self-efficacy at the individual and neighborhood levels were associated with increased relative probability of modern contraceptive use (adoption and continued use) and decreased relative probability of modern contraceptive discontinuation by 2014. No such associations were found between the individual and neighborhood attitudes towards wife beating and modern contraceptive use. Accounting for the individual and neighborhood gender-equitable attitudes and controlling for the women’s demographic characteristics accounted for 55–61% of the variation between neighborhoods in the change in modern contraceptive use during the study period. Conclusion Interventions that promote gender equality have the potential to increase modern contraceptive use in Nigerian cities. Electronic supplementary material The online version of this article (10.1186/s12905-018-0664-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chinelo C Okigbo
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. .,Measurement, Learning & Evaluation Project, Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
| | - Ilene S Speizer
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Measurement, Learning & Evaluation Project, Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marisa E Domino
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sian L Curtis
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Carolyn T Halpern
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jean C Fotso
- Innovations for Maternal, Newborn & Child Health, Concern Worldwide USA, New York, USA
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Akpa O. Multilevel analysis of psychosocial functioning of Adolescents in families affected by HIV/AIDS in Benue state, Nigeria. AFRICAN JOURNAL OF BIOMEDICAL RESEARCH : AJBR 2018; 21:123-131. [PMID: 30190652 PMCID: PMC6122853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Psychosocial functioning is increasing a public health priority issue among young people. Previous reports have focused on the effect of personal health conditions on the psychosocial well-being of children but contextual analysis of environmental or social factors could provide relevant information for interventions. In the context of HIV/AIDS, the present study examined the personal- and contextual-level predictors of Psychosocial Functioning Index (PFI) among adolescents in Benue state, Nigeria. Data on 2,276 adolescents was extracted from a cross-sectional study in Benue State for secondary analysis. The PFI was obtained using the final score of an existing scale (Adolescents Psychosocial Functioning Inventory). Participant's characteristics were summarized using descriptive statistics and compared using Chi-square test. Multilevel logit models were used to assess the individual- and contextual-level predictors of the PFI of adolescents. A nominal p-value ≤0.05 was considered significant in all analyses. Participants were 14.77±2.04 years old and mostly female (53.9%). About 19% of the participants have single parents while 62.1% have self-employed mothers. Proportion with elevated PFI was significantly higher among adolescents who have self-employed mothers (84.4%) and alcohol/substance users (82.7%). In adjusted analysis, adolescents who reported alcohol/substance use (OR=1.65; 95%CI: 1.14 to 2.38) were twice more likely to have elevated psychosocial functioning index compared to non-users. The psychosocial functioning index is high among study participants and differs contextually. Adolescent's psychosocial functioning depends on their life styles and parents' marital and economic situations. Family empowerments and other family level intervention programmes will benefit adolescents in these categories.
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Affiliation(s)
- O.M. Akpa
- Author for correspondence: , Tel: +2348073732015
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Ward-Peterson M, Fennie K, Mauck D, Shakir M, Cosner C, Bhoite P, Trepka MJ, Madhivanan P. Using multilevel models to evaluate the influence of contextual factors on HIV/AIDS, sexually transmitted infections, and risky sexual behavior in sub-Saharan Africa: a systematic review. Ann Epidemiol 2017; 28:119-134. [PMID: 29439782 DOI: 10.1016/j.annepidem.2017.11.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 11/04/2017] [Accepted: 11/20/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To describe the use of multilevel models (MLMs) in evaluating the influence of contextual factors on HIV/AIDS, sexually transmitted infections (STIs), and risky sexual behavior (RSB) in sub-Saharan Africa. METHODS Ten databases were searched through May 29, 2016. Two reviewers completed screening and full-text review. Studies examining the influence of contextual factors on HIV/AIDS, STIs, and RSB and using MLMs for analysis were included. The Quality Assessment Tool for Quantitative Studies was used to evaluate study quality. RESULTS A total of 118 studies met inclusion criteria. Seventy-four studies focused on HIV/AIDS-related topics; 46 focused on RSB. No studies related to STIs other than HIV/AIDS met the eligibility criteria. Of five studies examining HIV serostatus and community socioeconomic factors, three found an association between poverty and measures of inequality and increased HIV prevalence. Among studies examining RSB, associations were found with numerous contextual factors, including poverty, education, and gender norms. CONCLUSIONS Studies using MLMs indicate that several contextual factors, including community measures of socioeconomic status and educational attainment, are associated with a number of outcomes related to HIV/AIDS and RSB. Future studies using MLMs should focus on contextual-level interventions to strengthen the evidence base for causality.
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Affiliation(s)
- Melissa Ward-Peterson
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL.
| | - Kristopher Fennie
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
| | - Daniel Mauck
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
| | - Maryam Shakir
- Office of Medical Education, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Chelsea Cosner
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Prasad Bhoite
- Department of Health, Humanities, and Society, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Mary Jo Trepka
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
| | - Purnima Madhivanan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
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Abstract
OBJECTIVES South Africa has a large adolescent population (approximately 20% of the total population). The survival and development of these individuals are a priority among parents and the government. In an effort to better understand the factors contributing to adolescent mortality in South Africa, this study examined the effect of household and community factors on adolescent death. METHODS The study used data from Census 2001. Multilevel modelling was used to study the impact of community and household factors on adolescent mortality. A multivariate binary logistic 2-level model was developed. Odds ratios were produced and, statistically significant values (p<0.05) were discussed. There were 41,261 reported adolescent deaths from census data. RESULTS This study found that having a few household assets, six or more people living in a residence, and high racial diversity is associated with increased odds of adolescent mortality in South Africa in 2001. CONCLUSIONS Socio-economic status of the household and racial diversity within communities is likely to increase adolescent mortality in South Africa. However, there is need to examine the role of other community characteristics, such as number of schools, health facilities and employment opportunities in order to create a holistic profile of the contextual determinants of adolescent mortality in the country.
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Affiliation(s)
- Nicole De Wet
- Demography and Population Studies, University of the Witwatersrand
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N WC, A S. Associated Risk Factors of STIs and Multiple Sexual Relationships among Youths in Malawi. PLoS One 2015; 10:e0134286. [PMID: 26248328 PMCID: PMC4527764 DOI: 10.1371/journal.pone.0134286] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 07/07/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Having unprotected sex with multiple sexual partners (MSP) is the greatest risk factor for human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) among youths. Young people with MSPs are less likely to use a condom and the greater the risk for STIs. This study examines the associated risk factors of STIs and multiple sexual partnerships among youths aged 15-24 years. DATA AND METHODS The Malawi Demographic Health Survey 2010 data was used. Out of a sample of 2,987 males and 9,559 females aged 15-24 years, 2,026 males and 6,470 females were considered in the study. Chi square test and logistic regression techniques were performed. Analysis was performed using Statistical Package for Social Sciences (SPSS) version 22. FINDINGS The results indicate that 1,399 (69.0%) males and 2,290 (35.4%) females reported multiple sexual partnerships (MSP). Within the rural area, females (n = 1779) were more likely to report MSP than males (n = 1082) and within the urban areas, a higher proportion of females (n = 511) still reported MSP, with males (n = 316). About 78% rural females aged 20-24 years, and about 79% rural males aged 15-19 years reported MSP. The likelihood of MSP was higher among females in the poorest households (OR = 1.31), being married (OR = 5.71) and Catholic males (OR = 1.63), who were married (OR = 1.59). Catholic males (OR = 1.82) in the rural areas, who were married (OR = 1.80) and rural females in the northern region (OR = 1.26) were more likely to have MSP. The odds ratios were higher among urban females in the poorest (OR = 3.45) households who were married (OR = 4.22). CONCLUSIONS Having more than one sexual partner increases the risk of STIs and sexuality education programs should be introduced that emphasize the danger that surrounds MSP.
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Affiliation(s)
- Wilson Chialepeh N
- Department of Statistics and Population Studies, University of the Western Cape, Cape Town, South Africa
| | - Sathiyasusuman A
- Department of Statistics and Population Studies, University of the Western Cape, Cape Town, South Africa
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Adedini SA, Odimegwu C, Imasiku EN, Ononokpono DN. Unmet need for family planning: implication for under-five mortality in Nigeria. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2015; 33:187-206. [PMID: 25995735 PMCID: PMC4438662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
There are gaps in evidence on whether unmet need for family planning has any implication for under-five mortality in Nigeria. This study utilized 2008 Nigeria Demographic and Health Survey data to examine the effect of unmet need on under-five mortality. Cox regression analysis was performed on 28,647 children born by a nationally-representative sample of 18,028 women within the five years preceding the survey. Findings indicated elevated risks of under-five death for children whose mothers had unmet need for spacing [Hazard ratio (HR): 1.60, confidence interval (CI) 1.37-1.86, p<0.001] and children whose mothers had unmet need for limiting (HR: 1.78, CI 1.48-2.15, p<0.001) compared to children whose mothers had met need. These findings were consistent after adjusting for the effects of factors that could confound the association. Findings of this study underscore the need to address the present level of unmet need for family planning in Nigeria, if the country would achieve meaningful reduction in under-five mortality.
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Affiliation(s)
- Sunday Adepoju Adedini
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Demography and Social Statistics Department, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Clifford Odimegwu
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Eunice Ntwala Imasiku
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Geography, University of Zambia, Lusaka, Zambia
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Adedini SA, Odimegwu C, Imasiku EN, Ononokpono DN. Ethnic differentials in under-five mortality in Nigeria. ETHNICITY & HEALTH 2014; 20:145-62. [PMID: 24593689 PMCID: PMC4337727 DOI: 10.1080/13557858.2014.890599] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 12/23/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE There are huge regional disparities in under-five mortality in Nigeria. While a region within the country has as high as 222 under-five deaths per 1000 live births, the rate is as low as 89 per 1000 live births in another region. Nigeria is culturally diverse as there are more than 250 identifiable ethnic groups in the country; and various ethnic groups have different sociocultural values and practices which could influence child health outcome. Thus, the main objective of this study was to examine the ethnic differentials in under-five mortality in Nigeria. DESIGN The study utilized 2008 Nigeria Demographic and Health Survey (NDHS) data. We analyzed data from a nationally representative sample drawn from 33,385 women aged 15-49 that had a total of 104,808 live births within 1993-2008. In order to examine ethnic differentials in under-five mortality over a sufficiently long period of time, our analysis considered live births within 15 years preceding the 2008 NDHS. The risks of death in children below age five were estimated using Cox proportional regression analysis. Results were presented as hazard ratios (HR) with 95% confidence intervals (CI). RESULTS The study found substantial differentials in under-five mortality by ethnic affiliations. For instance, risks of death were significantly lower for children of the Yoruba tribes (HR: 0.39, CI: 0.37-0.42, p < 0.001), children of Igbo tribes (HR: 0.58, CI: 0.55-0.61, p < 0.001) and children of the minority ethnic groups (HR: 0.66, CI: 0.64-0.68, p < 0.001), compared to children of the Hausa/Fulani/Kanuri tribes. Besides, practices such as plural marriage, having higher-order births and too close births showed statistical significance for increased risks of under-five mortality (p < 0.05). CONCLUSION The findings of this study stress the need to address the ethnic norms and practices that negatively impact on child health and survival among some ethnic groups in Nigeria.
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Affiliation(s)
- Sunday A. Adedini
- Programme in Demography and Population Studies, University of the Witwatersrand, Johannesburg, South Africa
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Clifford Odimegwu
- Programme in Demography and Population Studies, University of the Witwatersrand, Johannesburg, South Africa
| | - Eunice N.S. Imasiku
- Programme in Demography and Population Studies, University of the Witwatersrand, Johannesburg, South Africa
- Department of Geography, University of Zambia, Lusaka, Zambia
| | - Dorothy N. Ononokpono
- Programme in Demography and Population Studies, University of the Witwatersrand, Johannesburg, South Africa
- Department of Sociology and Anthropology, University of Uyo, Uyo, Nigeria
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Does it Really Matter Where Women Live? A Multilevel Analysis of the Determinants of Postnatal Care in Nigeria. Matern Child Health J 2013; 18:950-9. [DOI: 10.1007/s10995-013-1323-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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A Bayesian semiparametric multilevel survival modelling of age at first birth in Nigeria. DEMOGRAPHIC RESEARCH 2013. [DOI: 10.4054/demres.2013.28.45] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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