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Item Trend analysis of teenage pregnancy in Nigeria (1961-2013): how effective is the contraceptive use campaign?(Institute of Advanced Engineering and Science, 2019) Fagbamigbe, A. F.; Afolabi, R. F.; Yusuf, O. B.Teenage pregnancy (TP) is a recurrent global and public health problem. It poses both social and health challenges. Considering the massive campaign on the use of modern contraceptives to prevent TP in recent decades, we assessed trends in TP in Nigeria between 1961 and 2013. Pregnancy and contraception history of 70,811 women who were at least 20 years old when the Nigerian DHS was conducted in 1990, 2003, 2008, and 2013 respectively were used for the study, and descriptive statistics, time analysis techniques and multiple logistic regression were used to analyze the data at 5% significance level. The overall prevalence of TP between 1961 and 2013 was 49.5% which fluctuated insignificantly during the studied period. The TP prevalence among women who entered adulthood in 1961 was 39.2%; it peaked in 1978 at 58.9% before its unsteady decline to 39.6% in 2012, and then rose sharply to 55.6% in 2013. We predicted TP prevalence as 49.0%, 49.9% and 51.0% in 2014, 2015 and 2016 respectively. The odds of TP were over 4 times higher in the North East and 5 times higher in the North West than in the South West. Teenagers with no education had higher odds of TP and it was higher among teenagers from the poorest households (OR=5.64, 95% CI: 5.36-5.94). Rather than reducing with the worldwide acknowledged increase in contraceptive campaigns, TP increased over the years studied. As far as TP is concerned in Nigeria, the impact of the campaign on MC use is far from being effective. To achieve the objective of fewer TPs, fewer resources should be spent on access to contraception and instead diverted to areas more likely to achieve results such as improvements in educational achievement amongst girls.Item 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.Item Derivation and appraisal of maternal mortality estimates in Nigeria from the 2012 National HIV/AIDS and Reproductive Health Survey(College of Medicine, University of Ibadan, 2017) Akinyemi, J. O.; Yusuf, O. B.; Fagbamigbe, A. F.; Bamgboye, E. A.; Kawu, I. B.; Ngige, E.; Amida, P.; Bashorun, A.Background Despite the huge burden of in Nigeria, accurate and reliable data fur maternal mortality measurement arc locking The federal Ministry of Health in collaboration with development partners included questions that allow indirect estimation of maternal mortality m us 2012 National HIV/AIDS and Reproductive Health Survey (NARHS) The aim of this paper was to derive estimates of Maternal Mortality Ratio (MMR) and Lifetime Risk of maternal death (LTR) from the 2012 NARHS data Methods: This was a secondary analysis of data from the maternal mortality module of NARHS 2012. During the survey, respondents (men aged 15-59 years and women aged 15-49 years) were selected via a multi-stage cluster sampling technique and data collected by trained field workers. In this study, report on survival or otherwise of adult female siblings were analysed to derive estimates of life tune risk of maternal death using the indirect sisterhood method. Results: Data from 15,596 men and 15,639 women were analysed A total of 12.810 adult female siblings had been exposed to the risk of death out of which 377 (2.9*4) have died of the 377 adult female deaths. 70 (18 6%) were pregnancy related the estimates of LTR and MMR were I in 71 women and 256 (95% CT. 196 - 316) maternal deaths per 100,000 live births respectively. There were north-south and rural-urban differences. Conclusion: The high level of maternal mortality is worrisome, concerted efforts aimed at reduction and provision of routine data for its measurement should be intensified.Item Controlling malaria in pregnancy: how far from the Abuja targets?(Dutch Malaria Foundation, 2016) Yusuf, O. B.; Akinyemi, J. O.; Fagbamigbe, A. F.; Ajayi, I. O.; Bamgboye, E. A.; Ngige, E.; Issa, K.; Abatta, E.; Ezire, O.; Amida, P.; Bashorun, A.Background. The Roll Back Malaria (RBM) initiative recommended that all pregnant women receive Intermittent Preventive Treatment (IPTp) and that by 2010 at least 80% of people at risk of malaria (including pregnant women) use insecticide-treated bednets (ITN) in areas with stable transmission. We evaluated ITN/IPTp coverage, explored its associated factors, and estimated the number of pregnancies protected from malaria. Materials and methods. This analysis was based on data from the 2012 National HIV/AIDS and Reproductive Health Survey (NARHS Plus). To assess ITN coverage, we used the population of women that was pregnant (n=22,438) at the time of the survey. For IPTp coverage, we used women that had a live birth in the 5 years preceding the survey (n= 118,187) and extracted the population of pregnant women that, during their last pregnancy, received drugs for protection against malaria. We estimated the number of live births using the projected population of females in each state, population of women of child -bearing age and the total fertility rate. The estimated number of pregnancies covered/protected by ITN and IPTp was obtained from a product of the estimated live births and the reported coverage. Multivariate logistic regression was used to determine factors associated with ITN and IPTp use. Results. We estimated that there were 5,798,897 live births in Nigeria in 2012, of which 3,537,327 and 2,302,162 pregnancies were protected by ITN and IPTp, respectively. Four of 36 states achieved the 80% RBM target for ITN coverage. No state achieved the 100% target for IPTp. Education and socio-economic status were associated with IPTp use. Conclusion. ITN coverage was higher than in previous estimates even though it is still below the RBM targets. However, IPTp coverage remained low in 2012 and was not likely to increase to match the 2015 target coverage of 100%.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 A random effect logistic regression model of major depressive disorder among ageing Nigerians(Scientific & Academic Publishing, 2016) Idowu, O. P.; Yusuf, O. B.; Akpa, O. M.; Gureje, O.Major Depressive Disorder (MDD) is a major public health problem in Nigeria and has severely devastating effects on the elderly. Previous studies on MDD among elderly Nigerians have utilized cross sectional designs which are descriptive in nature and have not investigated differences in setting and time-occurrence of MDD. Therefore this study employed a random effect logistic regression model to determine the relative effects/contributions of individual and environmental factors in the occurrence of MDD. A secondary analysis of a four-year longitudinal data from the Ibadan Study of Ageing was conducted. A total of 2,149 elderly Nigerians participated in the study between 2003 and 2009. The Geriatric Depression Scale was used to assess MDD and consequently classified as “present” for scores ranging from 10 to 30 and “absent” for scores ranging from 0 to 9. A random effect logistic regression model was fitted to determine factors predicting MDD. Odds ratios (OR), 95% confidence intervals, and Intra-class Correlation Coefficients (ICC) for each random effect was estimated. The overall prevalence of MDD was 27.28%. Significant predictors of MDD included “no-contact with family members” (OR=2.9, 95%CI: 1.26-6.70), “no-contact with friends” (OR=1.32, 95%CI: 1.05-1.67)), non-participation in family activities (OR=2.07, 95%CI: 1.63-2.43), non-participation in community activities (OR=1.93, 95%CI: 1.54-2.43), and good quality of health (OR=0.25, 95%CI: 0.15-0.27). Disparities in the occurrence of MDD among the elderly were attributable to enumeration areas (6%) and the individuals (22%). Social isolation factors and self-reported quality of health are significant predictors of MDD among elderly Nigerians.