Browsing by Author "Idemudia, E. S."

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Assessment of quality of antenatal care services in Nigeria: evidence from a population-based survey
(BioMed Central, 2015) Fagbamigbe, A. F.; Idemudia, E. S.
Background: The aim of the newly introduced “focused Antenatal Care (ANC)” is not only to achieve a minimum number of 4 visits, but also the timeliness of the commencement of the visits as well as the quality and relevance of services offered during the visits. This study is therefore designed to assess the quality of ANC services in Nigeria. Methods: We used information supplied by the 13410 respondents who claimed to have used the ANC facilities at least once within five year preceding the 2013 Nigeria Demographic and Household Survey (NDHS). Ten components of ANC including: offer of HIV test, Tetanus Toxoid injection, receiving iron supplementation, intermittent preventive treatment (IPT), intestinal preventive drug (IPD), timely ANC enrollment and number of visits were assessed. Receipts of all the ten components were classified as desirable (good) quality of ANC services while receipt of eight critical components among the ten were assumed to be the minimum acceptable quality. Data was weighted and analyzed using descriptive statistics and logistic regression models at 5 % significance level. Results: Measurement of blood pressure and receiving iron supplementation were the most commonly offered ANC component in Nigeria with 91.0 % each while IPD and IPT were given to only 20.7 % and 37.6 % respectively. Less than two thirds were taught on PMTCT while 41.7 % had HIV test and obtained results. Only 4.6 % (95 % CI: 4.2–5.1) of women received good quality of ANC while nearly 1.0 % did not receive any of the components. About 11.3 % (95 % CI: 10.6–11.9 %) of the attendees had minimum acceptable quality of ANC. Receipt of good quality ANC services was higher among users who initiated ANC early, had at least 4 ANC visits, attended to by skilled health workers, attended government and private hospitals and clinics. Higher odds of receiving good quality of ANC were found among users who lives in urban areas, having higher educational attainment, belonging to households in upper wealth quintiles and attended to by skilled ANC provider. Conclusions: The levels of desirable and minimum acceptable quality of ANC services were poor in Nigeria thereby jeopardizing efforts to achieve the MDGs. There is need for intensified commitment by national and state governments in Nigeria as well as other stakeholders to ensure that main components of ANC are received by the users.
Barriers to antenatal care use in Nigeria: evidences from non-users and implications for maternal health programming
(BioMed Central, 2015) Fagbamigbe, A. F.; Idemudia, E. S.
Background: In Nigeria, over one third of pregnant women do not attend Antenatal Care (ANC) service during pregnancy. This study evaluated barriers to the use of ANC services in Nigeria from the perspective of non-users. Methods: Records of the 2199 (34.9%) respondents who did not use ANC among the 6299 women of childbearing age who had at least one child within five years preceding the 2012 National HIV/AIDS and Reproductive Health Survey (NARHS Plus II), were used for this analysis. The barriers reported for not visiting any ANC provider were assessed vis-à-vis respondents’ social demographic characteristics, using multiple response data analysis techniques and Pearson chi-square test at 5% significance level. Results: Of the mothers who did not use ANC during five years preceding the survey, rural dwellers were the majority (82.5%) and 57.3% had no formal education. Most non-users (96.5%) were employed while 93.0% were currently married. North East with 51.5% was the geographical zone with highest number of non-users compared with 14.3% from the South East. Some respondents with higher education (2.0%) and also in the wealthiest quintiles (4.2%) did not use ANC. The reasons for non-use of ANC varied significantly with respondents’ wealth status, educational attainment, residence, geographical locations, age and marital status. Over half (56.4%) of the non-users reported having a problem with getting money to use ANC services while 44.1% claimed they did not attend ANC due to unavailability of transport facilities. The three leading problems: “getting money to go”, “Farness of ANC service providers” and “unavailability of transport” constituted 44.3% of all barriers. Elimination of these three problems could increase ANC coverage in Nigeria by over 15%. Conclusion: Non-use of ANC was commonest among the poor, rural, currently married, less educated respondents from Northern Nigeria especially the North East zone. Affordability, availability and accessibility of ANC providers are the hurdles to ANC utilization in Nigeria. Addressing financial and other barriers to ANC use, quality improvement of ANC services to increase women’s satisfaction and utilization and ensuring maximal contacts among women, society, and ANC providers are surest ways to increasing ANC coverage in Nigeria.
Demand and unmet needs of contraception among sexually active in-union women in Nigeria: distribution, associated characteristics, barriers, and program implications
(Sage Publishing, 2018) Fagbamigbe, A. F.; Afolabi, R. F.; Idemudia, E. S.
It is not clear whether the 16% unmet need for contraceptives in Nigeria indicates a success story. This study assessed the contraceptive prevalence rate (CPR), total contraceptive demand, and unmet needs and determined the distribution, determinants, and barriers to contraceptive demands and unmet needs in Nigeria. The fertility, breastfeeding, and contraceptive use information provided by 27,829 women who were either currently married or in a sexual union in the 2013 Nigeria Demographic and Health Survey (NDHS) were extracted. Associations between having unmet needs and the demographic, socioeconomic, and reproductive profiles of the respondents were assessed using bivariate and multiple logistic regression at 5% significance level. Multiple response data analysis techniques were used to assess barriers to nonuse of contraceptives. Data were weighted to reflect differentials in the population of in-union women in each geographical state. The modern CPR was 9.8% while total demand for contraception was 31.2%, consisting of unmet need at 16.1% and met needs at 15.1%. Unmet need for family planning was higher among rural women compared with urban women (16.8% vs. 14.9%); younger women (adjusted odds ratio [aOR] = 4.29; confidence interval [CI] = [3.03, 6.07]), women belonging to poorer economic status (aOR = 2.27, CI = [1.92, 2.68]), and women with no education (aOR = 3.23, CI = [2.60, 4.02]) had higher odds of unmet needs. The low unmet need should not be mistaken for a good progress in family planning programming in Nigeria; the success is better measured using the level of total demand for contraceptives and CPR. Interventions to improve the socioeconomic status of women, increase the knowledge of modern contraceptives, and improve women’s decision-making power should be prioritized.
Does gender and age at sexual initiation affect modern contraceptive use among teenagers and young adults in Nigeria?
(Ife Centre for Psychological Studies/Services, 2015) Fagbamigbe, A. F.; Idemudia, E. S.
This study was designed to assess use of Modern Contraceptive Use (MCP) among Sexually Active Teenagers and Young Adults (SATYA) as well as its determinants. We used a secondary data collected during the 2012 National HIV&AIDS and Reproductive Health Survey (NARHS Plus II 2012) in Nigeria. The cross-sectional and nationally representative survey adopted four-stage cluster sampling design. Bivariate and multiple binary logistic regression were used for data analysis at 5% level of significance. Females SATYA living in urban areas had higher odds of current use of MCP than those living in rural areas (OR=1.62(1.32-1.99)). The odds of current use of MCP among males that had sexual initiation between age 15 and 19 years and those that had it after age 20 years reduced by 21% and 36% respectively compared to males that were initiated before attaining age 15 years. The odds of using MCP currently among both males and females SATYA increased with higher economic status and educational attainment but more pronounced among females. Current use of contraceptive is general low among the youths but much lower among females than males who need it most. Although total abstinence from all sexual contact remains the surest way to avoid sexually related diseases and early child bearing as well as unwanted pregnancies, stakeholders should reenergize efforts towards use of contraception among sexually active teenagers and young adults.
Gender differences in responsible sexual behaviour of in-school adolescents
(Gender & Behaviour,, 2013) Olapegba, P. O.; Idemudia, E. S.; Onuoha, U.C.
There are indications that gender influences involvement in risky activities including sexually risky behaviour. The present study therefore sought to explore gender differences in responsible sexual behaviour among in-school adolescents. Using a cross-sectional survey design, two hundred and fifty In-School adolescents drawn from Secondary Schools in Ondo State, South West Nigeria participated in the study. Participants were made up of 97 (38.8%) males and 153 (61.2%) females, with ages ranging from 11 to 23 years with a mean of 15.5 and standard deviation of 2.7. A structured questionnaire containing two sections was utilized for data collection. Section A tapped demographical information such as age, sex, and religion while Section B is the sexual behaviour scale developed by Oluwatelure, (2011). The Cronbach alpha of the scale in the present study was .90. T-test of independent means was used to test the hypothesis. Result revealed significant gender difference in responsible sexual behaviour ( t (246) = -4.08; p<.05). Female adolescents were found to show significantly higher positive disposition to responsible sexual behaviour than male adolescents. It is thus recommended that intervention be put in place to infuse the virtue and values of responsible sexual behaviour in males while effort should be made to sustain and improve on responsible sexual behaviour among females.
Modelling self-assessed vulnerability to HIV and its associated factors in a HIV-burdened country
(Taylor & Francis Group, 2017) Fagbamigbe, A. F.; Lawal, A. M.; Idemudia, E. S.
Background: Globally, individuals’ self-assessment of vulnerability to HIV infection is important to maintain safer sexual behaviour and reduce risky behaviours. However, determinants of self-perceived risk of HIV infection are not well documented and differ. We assessed the level of self-perceived vulnerability to HIV infection in Nigeria and also identified its risk factors. Methods: We explored a recent nationally representative data with self-reported vulnerability (‘high’, ‘low’ and ‘no risk at all’) to HIV infection as the outcome of interest. Data were weighted and association between the outcomes and the risk factors determined. We used simple ordered logit regression to model relationship between the outcome variable and risk factors, and controlled for the significant variables in multiple ordered logistic regression at 5% significance level. Results: About 74% had good knowledge of HIV transmission and 6% had experienced STI recently. The likelihood of assessing oneself as having ‘no risk at all’ was 50% and for ‘high chances’ was 1.6%. Self-perceived high risk of HIV was higher among those who recently experienced STI (5.6%) than those who did not (1.7%), and also higher among those who recently engaged in transactional sex and had multiple sexual partners. The odds of good knowledge of HIV transmission on high self-perceived vulnerability to HIV was 19% higher than poor knowledge (OR ¼ 1.19, 95% CI: 1.12–1.27). Also, respondents who recently had multiple sexual partners were 72% (OR ¼ 1.72, 95% CI: 1.60–1.86) more likely to report self as having high risk. Younger respondents aged 14–19 years had higher odds of 41% (OR ¼ 1.41, 95% CI: 1.29–1.55) to perceive self as having high vulnerability to HIV than older respondents. Conclusion: High vulnerability to HIV infection was reported among younger respondents, those with history of STIS and those who engage in multiple sexual relations. Despite high level of risky sexual behaviour and good knowledge of HIV transmission and prevention found in this study, self-perceived vulnerability to HIV generally is low. For the low perception found in this study to translate to low chance of HIV infection, there is need for all stakeholders to embark on risk reduction initiatives through sexual education that would minimise risky sexual practices and ensuring availability and affordability of HIV prevention methods.
The need for counselling parents with special needs children and their families in adjusting to life situations
(Glory-Land Publishing Company, Ibadan, 2010-06) Idemudia, E. S.; Lazarus, K. U.
Psychological predictors of perceived quality of life among people living with HIV and AIDS in South West Nigeria
(Journal of social development in Africa, 2013) Olapegba, P. O.; Idemudia, E. S.
This study examined the dynamics of perceived social support and self-esteem in predicting perception of quality of life among People Living with HIV/AIDS (PLWHA) in South West Nigeria. One hundred and fifty nine (159) PLWHA selected using the purposive sampling technique participated in the study; the sample was made up of 46 males and 113females, aged between 19 and 72 years. Data were collected using a structured questionnaire. The result of the multiple regression analysis showed that perceived social support and self-esteem significantly jointly predicted perceived quality of life among PLWHA (p< .05). Self-esteem significantly independently predicted perceived quality of life(p< .05) while perceived social support did not significantly predict perceived quality of life. A t-test indicated no gender differences in perception of quality of life. The study therefore concluded that psychological interventions are required to shore-up the self-esteem of PLWHA alongside social support to enable them to cope better and be more optimistic and positive in their perception of quality of life
Survival analysis and determinants of timing of first birth after marriage in Nigeria
(Union for African Population Studies, 2016) Fagbamigbe, A. F.; Idemudia, E. S.
This study assessed the dynamics of First Birth Interval (FBI) after marriage, its determinants as well as relationship between fertility and FBI among women of reproductive age in Nigeria. We right-censored FBI of women aged 15-49 years using 201 3 Nigeria DHS data, used Kaplan Meier survival function to monitor the timings and Cox Proportional Hazard (CPH) and Generalized Gamma (GG) regression to model factors affecting FBI. The median FBI in Nigeria was 1.75 years and decreased with delayed age at marriage. Women with higher education have shorter FBI (TR=0.86(95% Cl: 0.85-0.88)). Urban women were more likely to have earlier FBI (HR= 1.28 95% C l: 1.24-1.32)). Fertility was significantly associated with FBI. The longer the FBI the lower the fertility level and vice versa except for women aged 15-19 years. Age at marriage, educational attainment, wealth status and residence were the main determinants of timing of first birth after marriage in Nigeria.
Survival analysis and prognostic factors of timing of first childbirth among women in Nigeria
(BioMed Central, 2016) Fagbamigbe, A. F.; Idemudia, E. S.
Background: First childbirth in a woman’s life is one of the most important events in her life. It marks a turnaround when she might have to drop roles of career building and education, for motherhood and parenthood. The timing of the commencement of these roles affects the child bearing behavior of women as they progress in their reproductive ages. Prevalent early first childbirth in Nigeria has been reported as the main cause of high population growth and high fertility, mortality and morbidity among women, but little has been documented on the progression into first birth as well as factors affecting it in Nigeria. This paper modelled timing of first birth among women in Nigeria and determined socio-demographic and other factors affecting its timing. Methods: We hypothesized that background characteristics of a woman will influence her progression into having first birth. We developed and fitted a survival analysis model to understand the timing of first birth among women in Nigeria using a national representative 2013 NDHS data. Women with no children were right censored as of the date of the survey. The Kaplan Meier survival function was used to estimate the probabilities of first birth not occurring until certain ages of women while Cox proportional hazard regression was used to model the timing of first births at 5 % significance level. Results: About 75.7 % of the respondents had given birth in the Northern region of Nigerian compared with 63.8 % in the South. Half (50.1 %) of the first childbirth occurred within the 15–19 years age bracket and 38.1 % within 20–29 years. The overall median survival time to first birth was 20 years (North 19, South 22), 27 years among women with higher education and 18 years for those with no formal education. The adjusted hazard of first birth was higher in the Northern region of Nigeria than in the South (aHR = 1.24, 95 % CI: 1.20-1.27), and higher in rural areas than in urban areas (aHR = 1. 15, 95 % CI: 1.12-1.19). Also, hazard of earlier first birth tripled among women with no education (aHR = 3.36, 95 % CI: 3. 17-3.55) compared to women with higher education. The significant factors affecting age at first birth are education, place and zone of residence, age at first marriage, religion, ethnicity and use of contraceptives. Conclusions: This study showed that progression into early first birth is most affected by the education standing of women as well as age at first marriage. Delay of first childbirths as a strategy for fertility reduction and maternal health improvement can be achieved if women are empowered early in life with quality education. Stakeholders should therefore, give adequate attention to educating the girl child. Adverse socio-cultural norms of betrothing and marrying young girls should be abrogated, while health education and promotion of need to delay child bearing must be intensified especially among rural dwellers and also in Northern Nigeria.
Trends and drivers of skilled birth attendant use in Nigeria (1990–2013): policy implications for child and maternal health
(Dove Medical Press, 2017) Fagbamigbe, A. F.; Hurricane-Ike, E. O.; Yusuf, O. B.; Idemudia, E. S.
Introduction: While Nigeria accounts for only 2% of the world population, it regrettably shares 14% of global maternal death burden. Whether its reported increase in antenatal care utilization is accompanied by increased use of skilled birth attendants (SBAs) is not known. This study assessed trends in utilization of SBAs in Nigeria between 1990 and 2013 and identified its determinants. Methods: Data from four consecutive Nigerian Demographic and Health Survey reports between 1990 and 2013 were pooled. We used basic descriptive statistics, test of association, and logistic regression to assess the prevalence, relative change, and determinants of SBA use at 5% significance level. Sample weights were applied, and adjustment was made for survey design and sampling errors. Results: Nearly half (46.7%) of the respondents were aged 25–34 years, while half (50.3%) of the respondents had no formal education. The prevalence of SBA use increased only marginally across the years and characteristics studied, from 32.4% in 1990 to 38.5% in 2013, an insignificant 6% increase. Educated women used SBA more than women with no education (92.4% vs 13.1%), and their odds ratio of using SBA were thrice that of uneducated women (odds ratio =3.09, 95% confidence interval =2.17–4.38). Women involved in decisions regarding their use of health facility were 12% more likely to use SBAs than others who do not. Educational attainment, religion, tribe, rural/urban residence, and zone of residence were significant to the use of SBA. Conclusion: The use of SBA was very low throughout the study period, barely at one third usage with insignificant changes over the studied period. Women empowerment, including decision-making power and residence, were the strongest determinants of SBA use. To overturn poor child and maternal health outcomes in Nigeria through SBA use, efforts should be targeted at educating girls, sexual and reproductive health education, and accessible and improved health care facility services.
Wealth and antenatal care utilization in Nigeria: Policy implications
(Taylor & Francis, 2017) Fagbamigbe, A. F.; Idemudia, E. S.
Antenatal care (ANC) utilization is lower in Nigeria than the African average. We investigated the relationship between wealth and utilization of ANC and also assessed other determinants associated with ANC utilization in Nigeria. Using data of the most recent births within 5 years prior to a 2012 nationally representative survey, we modeled predictors of ANC utilization. Respondents in the wealthiest quintile were over five times (aOR D 5.5 (95% CI: 4.2–7.2) more likely to adequately use ANC. The odds of ANC use were generally lower among the poor and the least educated women living in rural areas who need ANC the most.