6 research outputs found
Analyzing Maternal Mortality in Nigeria: A Qualitative Study Approach using the Three Phases of Delay
Get PDFBackground:Â Nigeria has a Maternal Mortality Ratio of 814 per 100,000 births. Only 30% of births in Nigeria occur in health facilities. A proven method to prevent maternal deaths is to provide emergency obstetric care and promote hospital birth. Application of the Three Phases of Delay Model to hospital births in Nigeria directed a community needs assessment and may influence local and regional health promotion efforts with the goal of preventing maternal deaths. This study aimed to analyze maternal deaths in Nigeria, employing a qualitative approach with the Three Phases of Delay model.Subjects and Method: This was a qualitative study grounded in theory research that employed focus groups and key informant interviews in Cross River State, Nigeria. A stratified random sampling of local government areas was followed by a random selection of wards and a purposive selection of key informants and focus group participants. In total 26 key informants and 100 focus group, discussion participants were selected across the wards in accordance with local customs. All responses were recorded digitally and transcribed verbatim. All key informant interviews and all but two focus groups were conducted in English. Data were collected in December 2016, over a four-week period. The transcripts were analyzed using Atlas TI to designate codes and to compile quotes by theme.Results:Â Application of the Three Phases of Delay Model to hospital births in Cross River State, Nigeria found significant points of delay at all levels of the Delay Model. The most prevalent of the delays described by the focus groups and key informants were delays in reaching the point of care and delay in receiving quality care at the health facility.Conclusion:Â Identifying the influences on delay can be employed to develop and plan local and regional health promotion efforts with the goal of preventing maternal death.Keywords:Â maternal mortality, childbirths, pregnancy, delay model, health facility.Correspondence:Precious Chidozie Azubuike. Department of Public Health, College of Medical Sciences, University of Calabar, PMB 1115, Calabar, Nigeria. Email: [email protected]. Phone: +234810- 6353021.Journal of Health Promotion and Behavior (2023), 08(01): 22-33DOI: https://doi.org/10.26911/thejhpb.2023.08.01.0
Analyzing Maternal Mortality in Nigeria: A Qualitative Study Approach using the Three Phases of Delay
Get PDFBackground:Â Nigeria has a Maternal Mortality Ratio of 814 per 100,000 births. Only 30% of births in Nigeria occur in health facilities. A proven method to prevent maternal deaths is to provide emergency obstetric care and promote hospital birth. Application of the Three Phases of Delay Model to hospital births in Nigeria directed a community needs assessment and may influence local and regional health promotion efforts with the goal of preventing maternal deaths. This study aimed to analyze maternal deaths in Nigeria, employing a qualitative approach with the Three Phases of Delay model.
Subjects and Method: This was a qualitative study grounded in theory research that employed focus groups and key informant interviews in Cross River State, Nigeria. A stratified random sampling of local government areas was followed by a random selection of wards and a purposive selection of key informants and focus group participants. In total 26 key informants and 100 focus group, discussion participants were selected across the wards in accordance with local customs. All responses were recorded digitally and transcribed verbatim. All key informant interviews and all but two focus groups were conducted in English. Data were collected in December 2016, over a four-week period. The transcripts were analyzed using Atlas TI to designate codes and to compile quotes by theme.
Results:Â Application of the Three Phases of Delay Model to hospital births in Cross River State, Nigeria found significant points of delay at all levels of the Delay Model. The most prevalent of the delays described by the focus groups and key informants were delays in reaching the point of care and delay in receiving quality care at the health facility.
Conclusion:Â Identifying the influences on delay can be employed to develop and plan local and regional health promotion efforts with the goal of preventing maternal death.
Keywords:Â maternal mortality, childbirths, pregnancy, delay model, health facility.
Correspondence:
Precious Chidozie Azubuike. Department of Public Health, College of Medical Sciences, University of Calabar, PMB 1115, Calabar, Nigeria. Email: [email protected]. Phone: +234810- 6353021.
Journal of Health Promotion and Behavior (2023), 08(01): 22-33
DOI: https://doi.org/10.26911/thejhpb.2023.08.01.0
Prevalence and determinants of skilled birth attendance among young women aged 15–24 years in Northern Nigeria: evidence from multiple indicator cluster survey 2011 to 2021
No full textAbstract Background Childbirth among adolescents and young mothers has been linked to various complications, including perinatal mortality, preterm births, low birth weight, and infections, which collectively contribute to the high burden of neonatal and maternal mortality. Despite some progress, the prevalence of skilled birth attendance, proven to improve maternal and newborn health outcomes, remains consistently low in Northern Nigeria. This study assessed the prevalence and determinants of Skilled Birth Attendance (SBA) among young women ages 15–24 years in Northern Nigeria. Methods This pooled cross-sectional study included 6,461 young women aged 15–24 years from 2011, 2016 and 2021 multiple indicator cluster surveys in Nigeria. We used a binary logistic regression model to assess the factors associated with skilled birth attendance at 95% confidence intervals (CIs) with computed adjusted odds ratios (aORs). Results The prevalence of skilled birth attendance among young women in Northern Nigeria increased from 25.6% in 2011 to 33.1% in 2021. Women who were atleast 18 years of age at first marriage had 2.48 higher odds of SBA (aOR 2.48, 95% CI = 1.54–4.00) compared those less than 18 years of age at first marriage after controlling for confounders. Young women from rich household wealth quintile were more likely to utilize SBA (aOR 1.84, 95% CI = 1.11–3.14) compared to young women from poor household wealth quintile. In terms of education, those women who had secondary (aOR = 2.52, 95% CI = 1.77–3.56) and higher education (aOR = 10.01, 95% CI = 2.21–49.31) had higher odds of SBA compared to those with no education. Individual women with media exposure had 59% higher likelihood (aOR = 1.59, 95% CI = 1.16–2.19), women who attended 4 or more antenatal care visits during their last pregnancy demonstrated 2.28 times higher odds (aOR = 2.28, 95% CI = 1.67–3.09), while those who reported no intention for their last pregnancy were 37% less likely (aOR = 0.63, 95% CI = 0.42–0.96) to utilize SBA. Conclusion A slight increase in the prevalence of skilled birth attendance was observed over the 10-year period. For a significant boost in skilled birth attendance among young women in Northern Nigeria, particular attention needs to be paid to girls’ child education, delay in marriage, economic empowerment of young women, and strategic ways of leveraging trained community health workers (CHIPs) to bring reproductive healthcare close to young women living in rural areas
Addressing stigma to achieve healthcare equity and universal health coverage in Nigeria
No full textAbstract Stigma remains a strong barrier to achieving the Sustainable Development Goals (SDGs) and Universal Health Coverage (UHC) in Nigeria’s healthcare system. Stigma is deeply embedded in cultures and historical contexts and has marginalized entire populations affected by HIV/AIDS, mental health disorders, disabilities, and ethnic minorities. It is propagated through social exclusion that aggravates health inequities with aversive expected social reactions, discouraging healthcare-seeking behaviors in time, compromising treatment adherence, and continuing to increase social exclusion for people from stigmatized groups. What has equally remained elusive is the implementation of legislative reforms, with targeted interventions by agencies like the National Agency for Control of AIDS, having policies such as the Mental Health Act. This has created discriminatory attitudes to healthcare settings and limited access to key services for these groups, affecting reproductive health and maternal care, including mental health services. There has been a double burden of communicable diseases and non-communicable diseases in Nigeria, exacerbating the current condition of limited resources and infrastructure gaps in health care. Combating stigma requires a multifaceted approach targeting individual, interpersonal, organizational, community, and societal levels if the country is to effectively meet the challenge. This involves hard-hitting education campaigns, enhanced training in cultural competence among healthcare providers, ensuring confidentiality, and creating an inclusive healthcare environment. Indeed, societal perceptions can be changed through community-driven efforts and advocacy for fair access to health care and further, realize equitable quality health access toward full coverage and sustainable development in Nigeria
Harnessing religion in the pursuit of sustainable development in Nigeria
No full textAbstract Religious institutions in Nigeria wield significant influence as moral authority hubs, fostering societal cohesion. This influence presents a unique opportunity for advancing the Sustainable Development Goals (SDGs). However, their potential remains underutilized, as religious leaders are often overlooked in efforts to address key national challenges such as poverty, inequality, and environmental degradation. This is a perspective on how religious leaders can transcend their spiritual roles to engage in social justice, education, and ethical governance initiatives that align with the SDGs. We employed a pseudo-content analysis that assessed various texts, including sermons, press releases, religious teachings, and other materials produced by religious institutions, with a focus on their discussions and contributions to sustainable development. We further explored case studies of specific faith-based organizations and their partnerships with governmental and non-governmental bodies working on SDG-related projects. We found that while religious leaders have begun engaging with sustainable development initiatives, their contributions are limited by structural barriers within religious organizations and minimal collaboration with government and civil society. Nonetheless, efforts such as the Kaduna Peace Declaration highlight the potential of interfaith collaboration in promoting social cohesion and ethical governance. By leveraging their moral authority and extensive community networks, religious leaders can significantly contribute to addressing Nigeria’s development challenges and advancing the SDGs
Experiences and unmet needs among caregivers of children living with autism spectrum disorder in Nigeria: a qualitative study using the socio-ecological model
Get PDFAbstract Introduction This study examines the experiences and unmet needs of caregivers of children with autism spectrum disorder in Nigeria. With a high prevalence in Nigeria, autism spectrum disorder poses a heavy economic burden on society and the patients’ families, with limited social interactions and stigma. Despite this, the unmet needs and psychosocial burdens of autism spectrum disorder on caregivers have been understudied in Nigeria. The study contributes evidence and raises interest in this area of research. Methods This qualitative study was conducted among twenty-three purposively selected caregivers. Questions from the PREPARE and Zarit Burden Interview tools were adapted for the interview and discussion guides. Data were collected among caregivers of pupils in selected special needs schools in Cross River State, Nigeria. Inductive and deductive approaches were used for the analysis using NVivo 20 pro. The socio-ecological model was used to generate the themes and quotes. Results The study generated four themes and eleven sub-themes across four levels of the socio-ecological model. Findings from our study showed that caregivers of children undergo significant emotional distress, disbelief, and fear at the early stage of diagnosis. Furthermore, families and friends had difficulty comprehending or accepting their children’s diagnosis, which further created tension and misunderstanding. Socio-cultural contexts such as stigma and isolation were not uncommon in the society. Conclusion Given the burden of the psychological demand and stigma attached to caregivers and children with autism, there is an urgent need for a tailor-made intervention with the key interplay of individual, interpersonal, societal/institutional, and policy in Nigeria. Advocacy efforts and awareness chaired by caregivers should be strengthened across all levels of the society in Nigeria
