The Brides of Boko Haram: Economic Shocks, Marriage Practices, and Insurgency in Nigeria

Marriage markets in rural Nigeria are characterised by bride price and polygamy. These customs may diminish marriage prospects for young men, causing them to join militant groups. Using an instrumental variables strategy, I find that marriage inequality increases civil conflict in the Boko Haram insurgency. To generate exogenous shocks to the marriage market, I exploit the fact that young women delay marriage in response to favourable pre-marital economic conditions, which increases marriage inequality primarily in polygamous villages. The same shocks that increase marriage inequality and extremist violence also lead women to marry fewer and richer husbands, generate higher average marriage expenditures, and increase insurgent abductions. The results shed light on the marriage market as an important driver of violent extremism.

Hepatitis e prevalence, knowledge, and practice of preventive measures among secondary school adolescents in rural Nigeria: a cross-sectional study

Background Currently, there is a paucity of data on the knowledge and practice of preventive measures for Hepatitis E infection in Nigerian populations. This study provided data on the prevalence, knowledge and practices of prevention in an adolescent population from Nigeria. Methods This cross-sectional study was conducted over 3 months among rural Nigerian secondary school adolescents. An interviewer-based questionnaire was used to collect data on sociodemographic profile, knowledge, and practice of preventive measures for Hepatitis E infection. Blood samples collected from participants were analysed for Hepatitis E IgG using Elisa Kits (Sigma Diagnostics, USA). Data were analysed using SPSS software version 20.0. Tests of association were done with a level of significance set at 5%. Results A total of 9 out of the 414 participants tested positive for Hepatitis E IgG antibodies giving a prevalence of 2.2%. Significant factors for Hepatitis E infection were male gender {P = 0.004} and school {P < 0.001, however logistic regression gave infinite value. Most participants (98.6%) had poor knowledge of Hepatitis E infection, 239(57.7%) had good preventive practices, while 175(42.3%) had average preventive practices. Conclusion A low prevalence of HEV infection was recorded among study participants. There was poor knowledge of Hepatitis E, and association could not be established between HEV infection and individual preventive practices.

Only two subscales of the Coping Strategies Questionnaire are culturally relevant for people with chronic low back pain in Nigerian Igbo populations: a cross-cultural adaptation and validation study

Background Pain coping strategies are important in the chronicity of low back pain and the associated disability. However, their exact influence is unknown in many African contexts such as rural Nigeria due to lack of outcome instruments with which to measure them. This study aimed to cross-culturally adapt and psychometrically test the Coping Strategies Questionnaire (CSQ) in Igbo populations in Nigeria. Methods The CSQ was forward and back translated by clinical and non-clinical translators; evaluated by an expert review committee. The translated measure was piloted amongst twelve rural Nigerian dwellers with chronic low back pain (CLBP) using the think-aloud cognitive interviewing style. Internal consistency (Cronbach’s alpha), test–retest reliability (intra-class correlation coefficient—ICC and Bland–Altman plot), and minimal detectable change were examined amongst 50 people with CLBP in rural and urban Nigerian populations. Construct validity was determined by assessing the correlations between the adapted CSQ and measures of disability, pain intensity, fear avoidance beliefs, and illness perceptions using Spearman’s correlation analyses with 200 adults with CLBP in rural Nigeria. Exploratory factor analyses using Kaiser criterion (eigenvalue) and parallel analysis as methods for determining dimensionality were conducted with the same sample. Results Fourteen out of 42 items were routinely adopted in this population including all items of catastrophising subscale, and all but one item of praying and hoping subscale. Catastrophising and praying and hoping subscales had the highest Cronbach’s alpha. All subscales had high ICCs with Bland–Altman plots that showed good agreement. All coping strategies were positively correlated with self-reported disability and pain intensity with catastrophising subscale having the highest values. Seven-factor and three-factor structures were produced with the Kaiser criterion and parallel analysis, with different items from the original CSQ, except for catastrophising. Conclusions Catastrophising and praying and hoping may be the relevant coping strategies in this population. More culturally relevant measures of pain coping strategies that include adaptive coping strategies may need to be developed for African contexts such as rural Nigeria.

“We have either obsolete knowledge, obsolete equipment or obsolete skills”: policy-makers and clinical managers’ views on maternal health delivery in rural Nigeria

ObjectiveThe objective of this paper is to explore policy-makers and clinical managers’ views on maternal health service delivery in rural Nigeria.DesignThis is a qualitative study using key informant interviews. Participants’ responses were audio recorded and reflective field notes supplemented the transcripts. Data were further analysed with a deductive approach whereby themes were organised based on existing literature and theories on service delivery.SettingThe study was set in Esan South East (ESE) and Etsako East (ETE), two mainly rural local government areas of Edo state, Nigeria.ParticipantsThe study participants consisted of 13 key informants who are policy-makers and clinical managers in ESE and ETE in Edo state. Key informants were chosen using a purposeful criterion sampling technique whereby participants were identified because they meet or exceed a specific criterion related to the subject matter.ResultsRespondents generally depicted maternal care services in primary healthcare centres as inaccessible due to undue barriers of cost and geographic location but deemed it acceptable to women. Respondents’ notion of quality of service delivery encompassed factors such as patient-provider relationships, hygienic conditions of primary healthcare centres, availability of skilled healthcare staff and infrastructural constraints.ConclusionThis study revealed that while some key aspects of service delivery are inadequate in rural primary healthcare centres, there are promising policy reforms underway to address some of the issues. It is important that health officials advocate for strong policies and implementation strategies.

Prevalence and correlates of food insecurity in rural Nigeria: A panel analysis

The study assessed dynamics of food insecurity among households in rural Nigeria using the Living Standard Measurement Survey-Integrated Survey on Agriculture (LSMSISA) collected in 2010/2011 and 2015/2016. Food insecurity status of the households was constructed using Household Food Insecurity Access Scale and analysed with descriptive statistics and random effect ordered probit model. Overall, 63.10%, 26.24%, 9.53% and 1.13% of households were food secure, mildly food insecure, moderately food insecure andseverely food insecure, respectively in the first panel; while 46.53%, 31.63%, 19.39% and 2.45% were food secure, mildly food insecure, moderately food insecure and severely food insecure, respectively in the second panel. Food insecurity status increased with large household size, dependency ratio, being female-headed and aging household heads. Households in south-eastern Nigeria had a higher food insecurity incidence than elsewhere. Age, age squared, female to male adult ratio, primary and tertiary education, occupation, marital status, household size, access to credit and living in North East, North West, South West, South East and South zones were the correlates of food insecurity in rural Nigeria. Based on the findings, the study recommended an increased awareness on the use of family planning methods and improved access to family planning services. Also, severely food insecure households should be identified and specifically targeted by the government for appropriate safety net interventions.