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Item 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.Item A comparative analysis of fertility differentials in Ghana and Nigeria(Women's Health and Action Research Centre, 2014) Olatoregun, O.; Fagbamigbe, A. F.; Akinyemi, O. J.; Yusuf, O. B.; Bamgboye, E. A.Nigeria and Ghana are the most densely populated countries in the West African sub-region with fertility levels above world average. Our study compared the two countries’ fertility levels and their determinants as well as the differentials in the effect of these factors across the two countries. We carried out a retrospective analysis of data from the Nigeria and Ghana Demographic Health Surveys, 2008. The sample of 33,385 and 4,916 women aged 15-49 years obtained in Nigeria and Ghana respectively was stratified into low, medium and high fertility using reported children ever born. Data was summarized using appropriate descriptive statistics. Factors influencing fertility were identified using ordinal logistic regression at 5% significance level. While unemployment significantly lowers fertility in Nigeria, it wasn’t significant in Ghana. In both countries, education, age at first marriage, marital status, urban-rural residence, wealth index and use of oral contraception were the main factors influencing high fertility levels.Item Statistical modeling of social risk factors for sexually transmitted diseases among female youths in Nigeria(Open Learning on Enteric Pathogens, 2013) Adebowale, A. S.; Titiloye, M.; Fagbamigbe, A. F.; Akinyemi, O. J.Introduction: Sexually transmitted diseases (STDs) are preventable, but the social risks factors connected to them are often not understood, particularly by female youths. There has been a dearth of information on the identification of social risk factors influencing STDs among female youths in Nigeria, hence we conducted this study. Methodology: This retrospective cross-sectional study utilized the Nigeria Demographic and Health Survey, 2008. It focused on female youths aged 15-24 (n=7,736) who ever had sexual intercourse. Data was analyzed using Chi-square and logistic regression models. Results: The mean age of the respondents was 20.2±2.5years. More female youths aged between 20 and 24 years contracted STDs in the last 12 months (2.5%) than those between the ages of 15 and 19 months (1.4%). A year prevalence of STDs among female youths in Nigeria was 2.1%. Socio-demographic factors such as age, education, wealth index, marital status, shared toilet, residence, contraceptive use, and total life-time number of sexual partners were found to be associated risk factors for contracting STDs (p<0.05). Controlling for potential confounding variables at the fifth iteration, the identified predictors of contracting STDs were wealth index, total lifetime number of sexual partners, awareness of HIV/AIDS, and shared toilet facility (p<0.05). Conclusions: The data confirmed the considerable impact of wealth index and awareness of HIV/AIDS as important predictors of STDs acquisition. Providing free condoms, along with teaching the importance of abstinence and improving knowledge of HIV/AIDS, can help to reduce the risk of STDs transmission.