scholarly journals Geopolitical zones differentials in intermittent preventive treatment in pregnancy (IPTp) and long lasting insecticidal nets (LLIN) utilization in Nigeria

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254475
Author(s):  
Chinedu Chukwu ◽  
Herbert Onuoha ◽  
Kwala Adline Katty Okorafor ◽  
Oluwaseun Ojomo ◽  
Olugbenga A. Mokuolu ◽  
...  
Keyword(s):  
Media Use ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Sub Saharan Africa ◽  
North Central ◽  
North West ◽  
North East ◽  
South West ◽  
Long Lasting Insecticidal Nets ◽  
In Pregnancy

Background The coverage of long lasting insecticidal nets (LLIN) and intermittent preventive treatment of malaria in pregnancy (IPTp) uptake for the prevention of malaria commonly vary by geography. Many sub-Saharan Africa (SSA) countries, including Nigeria are adopting the use of LLIN and IPTp to fight malaria. Albeit, the coverage of these interventions to prevent malaria across geographical divisions have been understudied in many countries. In this study, we aimed to explore the differentials in LLIN and IPTp uptake across Nigerian geopolitical zones. Methods We analyzed data from Nigeria Multiple Indicator Cluster Survey (MICS) 2016–17. The outcome variables were IPTp and LLIN uptake among women of childbearing age (15–49 years). A total sample of 24,344 women who had given birth were examined for IPTp use and 36,176 women for LLIN use. Percentages, Chi-square test and multivariable logit models plots were used to examine the geopolitical zones differentials in IPTp and LLIN utilization. Data was analyzed at 5% level of significance. Results The overall prevalence of IPTp was 76.0% in Nigeria. Moreover, there were differences across geopolitical zones: North Central (71.3%), North East (76.9%), North West (78.2%), South East (76.1%), South South (79.7%) and South West (72.4%) respectively. Furthermore, the prevalence of LLIN was 87.7%% in Nigeria. Also, there were differences across geopolitical zones: North Central (89.1%), North East (91.8%), North West (90.0%), South East (77.3%), South South (81.1%) and South West (69.8%) respectively. Women who have access to media use, married, educated and non-poor were more likely to uptake IPTp. On the other hand, rural dwellers and those with media use were more likely to use LLIN. Conversely, married, educated, non-poor and women aged 25–34 and 35+ were less likely to use LLIN. Conclusion Though the utilization of IPTp and LLIN was relatively high, full coverage are yet to be achieved. There was geopolitical zones differentials in the prevalence of IPTp and LLIN in Nigeria. Promoting the utilization of IPTp and LLINs across the six geopolitical zones through intensive health education and widespread mass media campaigns will help to achieve the full scale IPTp and LLIN utilization.

scholarly journals Regional Differences in Postnatal Care Service Utilisation and Child Morbidity in Nigeria: Evidence from 2018 Nigeria Demographic and Health Survey (NDHS)

2020 ◽  
Author(s):  
Endurance Uzobo ◽  
Aboluwaji D. Ayinmoro
Keyword(s):  
Socioeconomic Factors ◽  
Health Survey ◽  
Postnatal Care ◽  
Demographic And Health Survey ◽  
The South ◽  
North Central ◽  
North West ◽  
North East ◽  
South West ◽  
Child Morbidity

Abstract Introduction: Modern Postnatal Care Services (PNC) in Nigeria is vital tool for providing quality health for mothers and newborns. Nonetheless, many regions in Nigeria are still struggling to achieve optimum utilisation of modern PNC services due to variation in associated socioeconomic factors of mothers based on their regions. This study aims at assessing regional socioeconomic factors associated with PNC services utilisation and its relationship with child morbidity in Nigeria. Methods Data for this study was extracted from the Nigeria Demographic and Health Survey (NDHS) 2018 birth recoded file dataset, with a sample size of 30713 women (aged 15–49). Data were analysed using descriptive statistics, Chi-Square Test and logistic regression. The main predictor variable was the region, while others included the type of PNC service utilised and various demographic variables of the respondents – age, education, type of residence, religion, ethnicity among others. Results The average age of the respondents was 29.5 ± 6.8. The use of modern PNC services ranged from South-West (20.3%), South-South (10.9%), South-East (23.0%), North-Central (22.0%), North-East (13.0%) to North-West (10.9%). The prevalence of child morbidity ranged from South-West (8.5%), South-South (9.8%), South-East (11.4%), North-Central (15.3%), North-East (26.3%) to North-West (28.7%). Child morbidity is significantly higher in the South-South (OR = 1.46), South-East (OR = 1.50), North-Central (OR = 1.13), North-East (OR = 2.31) and North-West (OR = 1.35) compared to the South-West. Conclusion Majority of women in Nigeria are not using modern PNC services. Regional variations in the use of PNC services and socio-demographic characteristics of mothers influence child morbidity in Nigeria. There is need for regional-specific context sensitisation for mothers in the use of modern PNC services.

scholarly journals Malaria health seeking practices for children, and intermittent preventive treatment in pregnancy in Wakiso District, Uganda

2021 ◽  
Vol 21 (4) ◽  
pp. 1722-32
Author(s):  
David Musoke ◽  
Rawlance Ndejjo ◽  
Solomon Tsebeni Wafula ◽  
Simon Kasasa ◽  
Jessica Nakiyingi-Miiro ◽  
...  
Keyword(s):  
Household Head ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Education Level ◽  
Sub Saharan Africa ◽  
Health Seeking ◽  
Chi Square ◽  
Adult Age ◽  
Malaria Burden ◽  
In Pregnancy

Background: Timely health care among children with suspected malaria, and intermittent preventive treatment (IPTp) in pregnancy avert related morbidity and mortality in endemic regions especially in sub-Saharan Africa. Malaria burden has steadily been declining in endemic countries due to progress made in scaling up of such important interventions. Objectives: The study assessed malaria health seeking practices for children under five years of age, and IPTp in Wakiso district, Uganda. Methods: A structured questionnaire was used to collect data from 727 households. Chi-square and Fisher’s exact tests were performed in STATA to ascertain factors associated with the place where treatment for children with suspected malaria was first sought (government versus private facility) and uptake of IPTp. Results: Among caretakers of children with suspected malaria, 69.8% sought care on the day of onset of symptoms. The place where treatment was first sought for the children (government versus private) was associated with participants’ (household head or other adult) age (p < 0.001), education level (p < 0.001) and household income (p = 0.011). Among women who had a child in the five years preceding the study, 179 (63.0%) had obtained two or more IPTp doses during their last pregnancy. Uptake of two or more IPTp doses was associated with the women’s education level (p = 0.006), having heard messages about malaria through mass media (p = 0.008), knowing the recommended number of IPTp doses (p < 0.001), and knowing the drug used in IPTp (p < 0.001).  Conclusion: There is need to improve malaria health seeking practices among children and pregnant women particularly IPTp through programmes aimed at increasing awareness among the population. Keywords: Health seeking behaviour; intermittent preventive treatment; malaria; children; pregnancy; Uganda.

scholarly journals Impact of Health Systems on the Implementation of Intermittent Preventive Treatment for Malaria in Pregnancy in Sub-Saharan Africa: A Narrative Synthesis

2020 ◽  
Vol 5 (3) ◽  
pp. 134
Author(s):  
Atinuke O. Olaleye ◽  
Oladapo Walker
Keyword(s):  
Health System ◽  
Data Extraction ◽  
Supply And Demand ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Malaria In Pregnancy ◽  
Sub Saharan Africa ◽  
Cochrane Library ◽  
Narrative Synthesis ◽  
In Pregnancy

Malaria in pregnancy is a public health challenge with serious negative maternal and newborn consequences. Intermittent preventive treatment (IPTp) with sulphadoxine-pyrimethamine is recommended for the control of malaria during pregnancy within endemic areas, but coverage for the recommended ≥3 doses IPTp regimen has remained suboptimal. We searched PubMed, Cochrane library, and HINARI database from 1 January 2010 to 23 May 2020, for studies investigating the effect of the health system on IPTp implementation. Data extraction was independently performed by two investigators and evaluated for quality and content. Health system barriers and facilitators were explored using thematic analysis and narrative synthesis. Thirty-four out of 1032 screened articles were included. Key health system issues affecting the provision and uptake of IPTp were the ambiguity of policy and guidelines for IPTp administration, human resource shortages, drug stock-outs, conflicting policy implementation on free IPTp provision, hidden costs, unclear data recording and reporting guidelines, and poor quality of care. Factors affecting the supply and demand for IPTp services involve all pillars of the health system across different countries. The success of health programs such as IPTp will thus depend on how well the different pillars of the health system are articulated towards the success of each program.

scholarly journals Intermittent screening and treatment with dihydroartemisinin-piperaquine for the prevention of malaria in pregnancy: implementation feasibility in a routine healthcare system setting in western Kenya

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Jenny Hill ◽  
Peter Ouma ◽  
Seth Oluoch ◽  
Jane Bruce ◽  
Simon Kariuki ◽  
...  
Keyword(s):  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Standard Of Care ◽  
Health Facilities ◽  
Malaria In Pregnancy ◽  
Sub Saharan Africa ◽  
Directly Observed Therapy ◽  
Western Kenya ◽  
Sub Saharan ◽  
In Pregnancy

Abstract Background Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is recommended for preventing malaria in pregnancy in areas of moderate-to-high transmission in sub-Saharan Africa. However, due to increasing parasite resistance to SP, research on alternative strategies is a priority. The study assessed the implementation feasibility of intermittent screening and treatment (ISTp) in the second and third trimester at antenatal care (ANC) with malaria rapid diagnostic tests (RDTs) and treatment of positive cases with dihydroartemisinin-piperaquine (DP) compared to IPTp-SP in western Kenya. Methods A 10-month implementation study was conducted in 12 government health facilities in four sub-counties. Six health facilities were assigned to either ISTp-DP or IPTp-SP. Evaluation comprised of facility audits, ANC observations, and exit interviews. Intermediate and cumulative effectiveness analyses were performed on all processes involved in delivery of ISTp-DP including RDT proficiency and IPTp-SP ± directly observed therapy (DOT, standard of care). Logistic regression was used to identify predictors of receiving each intervention. Results A total of 388 and 389 women were recruited in the ISTp-DP and IPTp-SP arms, respectively. For ISTp-DP, 90% (289/320) of eligible women received an RDT. Of 11% (32/289) who tested positive, 71% received the correct dose of DP and 31% the first dose by DOT, and only 6% were counselled on subsequent doses. Women making a sick visit and being tested in a facility with a resident microscopist were more likely to receive ISTp-DP (AOR 1.78, 95% CI 1.31, 2.41; and AOR 3.75, 95% CI 1.31, 2.40, respectively). For IPTp-SP, only 57% received a dose of SP by DOT. Payment for a laboratory test was independently associated with receipt of SP by DOT (AOR 6.43, 95% CI 2.07, 19.98). Conclusions The findings indicate that the systems effectiveness of ANC clinics to deliver ISTp-DP under routine conditions was poor in comparison to IPTp-SP. Several challenges to integration of ISTp with ANC were identified that may need to be considered by countries that have introduced screening at first ANC visit and, potentially, for future adoption of ISTp with more sensitive RDTs. Understanding the effectiveness of ISTp-DP will require additional research on pregnant women’s adherence to ACT.

scholarly journals Entrepreneurship and Self-Sustainability in Nigeria

2017 ◽  
Vol 7 (2) ◽  
pp. 258
Author(s):  
Timothy T. Alabar ◽  
Mtswenem Paul Shima
Keyword(s):  
Survey Design ◽  
Chi Square ◽  
North Central ◽  
North West ◽  
North East ◽  
South West ◽  
High Level ◽  
Entrepreneurial Activities ◽  
Purposive Sample ◽  
West North Central

<div><p><em>The need for this study arose from the worrisome state of unemployment in the country and the obvious neglect of the direct effect of entrepreneurship to entrepreneurs. The study therefore, attempts to ascertain the possible relationship between entrepreneurship and self sustainability in Nigeria. The study adopted a survey design and the six Geo-political zones of the country; south-east, south-south, south-west, north central, north east and north west constituted the population for the study from which a purposive sample of ten (10) entrepreneurs from each zone was taken with particular reference to those that have survived the five (5) years of existence and the total was 60. Data so collected was presented in tabular form and analyzed. The Friedman’s Chi-square was instrumental in the test of the hypothesis formulated and the result showed a significant positive relationship between entrepreneurship and self-sustainability in Nigeria. The study therefore, recommended that considering the pivotal role that entrepreneurship plays in enhancing self-sustainability in the economy, all hands must be on desk to encourage and support entrepreneurial activities in order to curb the high level menace of unemployment rate as well as provide  a supporting ground for economic sustainability of the country.</em></p></div>

scholarly journals Regional Differences in Postnatal Care Service Utilisation and Child Morbidity in Nigeria: Evidence from 2018 Nigeria Demographic and Health Survey (NDHS)

2021 ◽  
Vol 4 (1) ◽  
pp. 68-81
Author(s):  
Endurance Uzobo ◽  
Aboluwaji D. Ayinmoro
Keyword(s):  
Health Survey ◽  
Postnatal Care ◽  
Economic Factors ◽  
North Central ◽  
North West ◽  
Care Services ◽  
North East ◽  
South West ◽  
Child Morbidity ◽  
Socio Economic Factors

Modern Postnatal Care (PNC) Services in Nigeria is a vital tool for providing quality health for mothers and newborns. Nonetheless, many Nigeria regions are still struggling to achieve optimum utilisation of Postnatal Care Services due to variations in mothers' associated socio-economic factors based on their specific locations. This study aims at assessing regional socio-economic factors associated with Postnatal Care Services utilisation and its relationship with child morbidity in Nigeria. Data for this study was extracted from the Nigeria Demographic and Health Survey (NDHS) 2018 birth recoded file dataset, with a sample size of 30,713 women (aged 15-49). Data were analysed using descriptive statistics, Chi-Square Test, and logistic regression reporting the result in odds-ratios (OR). The primary predictor variable was the region, while others included the type of Postnatal Care Services utilised and various demographic variables of the respondents – age, education, type of residence, religion, and ethnicity. The average age of the respondents was 29.5±6.8. The use of modern Postnatal Care Services ranged from South-West (20.3%), South-South (10.9%), South-East (23.0%), North-Central (22.0%), North-East (13.0%) to North-West (10.9%). The prevalence of child morbidity ranged from South-West (8.5%), South-South (9.8%), South-East (11.4%), North-Central (15.3%), North-East (26.3%) to North-West (28.7%). Child morbidity is significantly higher in the South-South (OR=1.46, 95% Confidence Interval [CI] = 1.316 – 1.611; p =0.01), South-East (OR=1.50), North-Central (OR=1.13), North-East (OR=2.31) and North-West (OR=1.35) compared to the South-West. The majority of women in Nigeria are not using modern PNC services. Regional variations in the use of PNC services and mothers' socio-demographic characteristics influence child morbidity in Nigeria. There should be region-specific sensitisation of women on the need for the benefit of modern health care for both antenatal care and postnatal care services.

scholarly journals Managing intermittent preventive treatment of malaria in pregnancy challenges: an ethnographic study of two Ghanaian administrative regions

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Matilda Aberese-Ako ◽  
Pascal Magnussen ◽  
Margaret Gyapong ◽  
Gifty D. Ampofo ◽  
Harry Tagbor
Keyword(s):  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Ethnographic Study ◽  
Health Facilities ◽  
Malaria In Pregnancy ◽  
Sub Saharan Africa ◽  
Bed Nets ◽  
Maternal Healthcare ◽  
Sub Saharan ◽  
In Pregnancy

Abstract Background Malaria in pregnancy (MiP) is an important public health problem across sub-Saharan Africa. The package of measures for its control in Ghana in the last 20 years include regular use of long-lasting insecticide-treated bed nets (LLINs), directly-observed administration (DOT) of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) and prompt and effective case management of MiP. Unfortunately, Ghana like other sub-Saharan African countries did not achieve the reset Abuja targets of 100% of pregnant women having access to IPTp and 100% using LLINs by 2015. Methods This ethnographic study explored how healthcare managers dealt with existing MiP policy implementation challenges and the consequences on IPTp-SP uptake and access to maternal healthcare. The study collected date using non-participant observations, conversations, in-depth interviews and case studies in eight health facilities and 12 communities for 12 months in two Administrative regions in Ghana. Results Healthcare managers addressed frequent stock-outs of malaria programme drugs and supplies from the National Malaria Control Programme and delayed reimbursement from the NHIS, by instituting co-payment, rationing and prescribing drugs for women to buy from private pharmacies. This ensured that facilities had funds to pay creditors, purchase drugs and supplies for health service delivery. However, it affected their ability to enforce DOT and to monitor adherence to treatment. Women who could afford maternal healthcare and MiP services and those who had previously benefitted from such services were happy to access uninterrupted services. Women who could not maternal healthcare services resorted to visiting other sources of health care, delaying ANC and skipping scheduled ANC visits. Consequently, some clients did not receive the recommended 5 + doses of SP, others did not obtain LLINs early and some did not obtain treatment for MiP. Healthcare providers felt frustrated whenever they could not provide comprehensive care to women who could not afford comprehensive maternal and MiP care. Conclusion For Ghana to achieve her goal of controlling MiP, the Ministry of Health and other supporting institutions need to ensure prompt reimbursement of funds, regular supply of programme drugs and medical supplies to public, faith-based and private health facilities.

scholarly journals Safety Challenges in Transportation in Nigeria – A Relative Risk Approach

2020 ◽  
Vol 7 (2) ◽  
pp. 39
Author(s):  
Suleiman G. Purokayo ◽  
James Zira Stephen
Keyword(s):  
Risk Factors ◽  
Relative Risk ◽  
Multinomial Logistic Regression ◽  
Significant Risk ◽  
Main Concern ◽  
North Central ◽  
North West ◽  
North East ◽  
South West ◽  
West North Central

This study investigates safety challenges in transportation in Nigeria across the six geopolitical zones of the country comprising South-South, South-East, North-West, North-Central, North-East and South-West geopolitical Zones. Both primary and secondary data were employed, and the Multinomial Logistic Regression Model, with specific adoption of the Relative Risk Ratio approach, is the method of analysis. The main concern is examination of exposed and unexposed commuters in the various locations to determine the degrees of exposure to risks associated with ‘basket’ of modes, state of infrastructures and specific risk factors, which account for the fatalities observed on the different roads under consideration. It is found that the six geopolitical zones have various degrees of risks exposure while North-West, North-Central and South-West zones showed significant risk difference between the exposed and the unexposed groups due to risk factors such as bad roads, road blockage/obstruction, kidnaping, unmaintained vehicles, overloading, over speeding and other forms of reckless use of the roads etc. The study recommends risk avoidance education to commuters as new strategies in vulnerable zones and increased deployment of well-trained community road marshals and other relevant security personnel to monitor situations and provide safety for road users. Also, a working transportation policy must be evolve to mitigate the risk factors highlighted above.

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