Browsing by Author "Oyedele, O. K."

Now showing 1 - 3 of 3

Coverage-level and predictors of maternity continuum of care in Nigeria: implications for maternal, newborn and child health programming
(BioMed Central, 2023) Oyedele, O. K.; Fagbamigbe, A. F.; Akinyemi, O. J.; Adebowale, A. S.
Background Completing maternity continuum of care from pregnancy to postpartum is a core strategy to reduce the burden of maternal and neonatal mortality dominant in sub-Saharan Africa, particularly Nigeria. Thus, we evaluated the level of completion, dropout and predictors of women uptake of optimal antenatal care (ANC) in pregnancy, continuation to use of skilled birth attendants (SBA) at childbirth and postnatal care (PNC) utilization at postpartum in Nigeria. Methods A cross-sectional analysis of nationally representative 21,447 pregnancies that resulted to births within five years preceding the 2018 Nigerian Demographic Health Survey. Maternity continuum of care model pathway based on WHO recommendation was the outcome measure while explanatory variables were classified as; socio-demographic, maternal and birth characteristics, pregnancy care quality, economic and autonomous factors. Descriptive statistics describes the factors, backward stepwise regression initially assessed association (p<0.10), multivariable binary logistic regression and complementary-log–log model quantifies association at a 95% confidence interval (α=0.05). Results Coverage decrease from 75.1% (turn-up at ANC) to 56.7% (optimal ANC) and to 37.4% (optimal ANC and SBA) while only 6.5% completed the essential continuum of care. Dropout in the model pathway however increase from 17.5% at ANC to 20.2% at SBA and 30.9% at PNC. Continuation and completion of maternity care are positively drive by women; with at least primary education (AOR=1.27, 95%CI=1.01–1.62), average wealth index (AOR=1.83, 95%CI=1.48 –2.25), southern geopolitical zone (AOR=1.61, 95%CI=1.29–2.01), making health decision alone (AOR=1.39, 95%CI=1.16–1.66), having nurse as ANC provider (AOR=3.53, 95%CI=2.01–6.17) and taking at least two dose of tetanus toxoid vaccine (AOR=1.25, 95%CI=1.06–1.62) while women in rural residence (AOR=0.78, 95%CI=0.68–0.90) and initiation of ANC as late as third trimester (AOR=0.44, 95%CI=0.34–0.58) negatively influenced continuation and completion. Conclusions 6.5% coverage in maternity continuum of care completion is very low and far below the WHO recommended level in Nigeria. Women dropout more at postnatal care than at skilled delivery and antenatal. Education, wealth, women health decision power and tetanus toxoid vaccination drives continuation and completion of maternity care. Strategies optimizing these factors in maternity packages will be supreme to strengthen maternal, newborn and child health.
Modelling time-to-discontinuation of exclusive breastfeeding: analysis of infants and under-2 survival in Nigeria
(Union for African Population Studies, 2020) Oyedele, O. K.; Fagbamigbe, A. F.; Ayeni, O.
Background: Regardless of national and international strategies towards promoting exclusive breastfeeding, only 17% and 35% of infants were exclusively breastfed in 2015 in Nigeria and Worldwide respectively. Therefore, we aim to estimate average length of exclusive breastfeeding for infants and under-2, evaluate and predict maternal impact. Data Source and Methods: This retrospective cross-sectional study applied NARHS data collected via multistage-cluster random sampling. Count and proportion quantified maternal characteristics, Kaplan- Meier method estimated length of exclusive breastfeeding whereas Cox Proportional Hazard model and Wald-test determine and evaluate maternal effect. Results: Median duration of exclusive breastfeeding was 6.0 months. Locality (P < 0.05 (0.73 -0.98)} and place-of-delivery (P < 0.01 (1.06-1.19)} were the determinant factors. Cox Proportional Hazard model fit the data and Wald-test identified main predictors. Conclusions: Average time at which exclusive breastfeeding was discontinued was six months, mothers' locality and delivery-place of infants influence exclusive breastfeeding duration in Nigeria. Hence, exclusive breastfeeding interventions should target those factors.
Multivariate decomposition of trends, inequalities and predictors of skilled birth attendants’ utilisation in Nigeria (1990–2018): a cross-sectional analysis of change drivers
(BMJ Publishing Group Ltd, 2022) Fagbamigbe, A. F.; Oyedele, O. K.
Objectives Literature has assessed skilled birth attendants (SBAs) utilisation, but little is known about what contributes to the changes in SBA use. Multivariate decomposition analysis was thus applied in this study to examine; levels, trends, inequalities and drivers of changes in SBA utilisation. Design and setting A cross-sectional analysis of five waves of NDHS-data (1990, 2003, 2008, 2013, and 2018), collected through similar multistage sampling across the 36 states and the federal-capital-territory of Nigeria. Participants Women of reproductive age (15–49 years), and with at least one birth in the last 5 years preceding each of the surveys .Main outcome measure SBA use is the response variable while explanatory variables were classified into; Demographics, Health, Economic and Corporal factors. Methods Chi-square test for trends of proportions across the ordered survey years assessed trends in SBA use. MDA that quantifies and partition predictors effect into endowment and coefficient components evaluated contributors to changes in SBA use. Statistical analysis was carried out at a 95% confidence interval in Stata 16. Results SBA use increased with significant (p<0.05) linear trends by 12% between 2003 and 2018. The decomposition analysis showed that differences in characteristics (endowment) accounted for 11.5% of the changes while the remaining 88.5% were due to differences in effects (coefficient). SBA utilisation rises by 61% when respondents decided on her health compared to when such decisions were made by the spouse. Utilisation of SBA, however, fell by 88% among women who reside in the states with high rural populations percentage. Conclusions SBA use remained low in Nigeria, and slowly increase at the rate of <1% yearly. Women health decision-making power contributed most to positive changes. Residing in states with high rural populations has a negative impact on SBA use. Maternal health programmes that strengthen women’s health autonomy and capacity building in rural communities should be encouraged.