Poor Maternal Health (MH) remains an issue of public health concern in Nigeria. This study identified the determinants of maternal utilization of health services and nutritional status in a rural community in south-west Nigeria. It was a cross-sectional house-hold survey of women aged 15-49 years. Data were analysed using Chi-square, logistic regression and generalized linear models (α=.05). Respondents' mean age was 29.9±7.8 years and about 9.0% were underweight, 76.7% attended ≥4 ANC visits and 65.7% were provided with ANC by skilled health workers. Sixty-two percent delivered in modern health facility, 67.5% were assisted by skilled health worker and 29.1% sought post-natal care within the first 3 days after delivery. The likelihood of delivery in health facility was 1.48(C.I=1.10-1.99, p<0.05) higher among women in monogamous than those in polygamy family. The estimated maternal mortality ratio was 448 deaths/100,000 live-births. The findings emphasize the need to scale-up MH improvement strategies in the study area.

BackgroundPresumptive diagnosis and prescription of anti-malarial medicines to malaria rapid diagnostic test (RDT)-negative patients is a common practice among health care workers (HCWs) in Nigeria. There is paucity of data on HCWs adherence to RDT result in Sokoto metropolis, Nigeria. The study was conducted to determine HCWs adherence to malaria test result and the influencing factors.MethodsA cross-sectional study was conducted among 262 HCWs selected by multistage sampling technique from primary and secondary health facilities in Sokoto metropolis. Data on demographic characteristics, adherence to RDT result and its influencing factors were collected from the HCWs. Adherence was categorized into good if adherence score is ≥ 4 and poor if otherwise. Chi-squared test was used to test association between adherence to test results and patients’ fever presentation, expectation to be given anti-malarials, prior HCWs’ case management training, among others. Independent predictors of adherence to RDT results were ascertained.ResultsRespondents’ mean age was 33.5 ± 7.9 years, 190 (72.5%) worked in Primary Health Care facilities, 112 (42.8%) were Community Health Workers, 178 (67.9%) had National Diploma Certificate. The median years of practice was 5.0 (IQR: 3–10) years, while 118 (45.0%) had at most 4 years of practice. Overall, 211 (80.5%) had good adherence to RDT results. About 108 (89.3%) of HCWs who had training on malaria case management and 35 (89.7%) certificate holders had good adherence to RDT results. Predictors of adherence to test results were presence of fever in the patient [adjusted odds ratio (aOR): 2.53, 95% confidence interval (CI) 1.18–5.43], patients’ expectation to be given anti-malarial medicines by the HCW (aOR: 3.06, 95% CI 1.42–6.58) and having been trained on malaria case management (aOR: 2.63; 95% CI 1.26–5.44).ConclusionHigh level of adherence to RDT results among HCWs in Sokoto metropolis could be attributed to prior malaria case management training and HCWs’ confidence in the national treatment guidelines. Continual training and supportive supervision of HCWs on malaria case management might optimize the current level of adherence to RDT results in Sokoto metropolis, Nigeria. Similarly, patients/caregivers’ health education could aid better understanding of the need for anti-malarials thus reducing unnecessary demand.

The study aimed at examining the independent and joint influence of three cultural factors; religion, sex preference (SP) and ethnicity on fertility in Nigeria. Cross-sectional population-based cluster design approach was used for the study. The investigated population group was women of reproductive age (n=19,348). Probability of bearing &ge;5 children, refined Total Fertility Rate and mean fertility were used to assess fertility. Data were analyzed using demographic and Zero-Inflated Poisson models. Fertility indices were higher among the Hausa/Fulani ethnic group than Igbo and Yoruba and also among Muslim women than Christians. Interaction shows that the probability of bearing at least five children was highest among women who; have no SP, belong to Islamic religious denomination, and of Hausa/Fulani ethnic group. The fertility incident rate ratio (IRR) was higher among women with no SP than women who have SP and also higher among Hausa/Fulani than Yoruba but lower among Christians than Muslims. Fertility differentials persists by ethnicity, religion and SP after controlling for other important variables. Difference exists in fertility among religious, ethnic groups and by SP in Nigeria. Fertility reduction strategies should be intensified in Nigeria, but more attention should be given to Muslims and Hausa/Fulani women.

The study aimed at examining the independent and joint influence of three cultural factors; religion, sex preference (SP) and ethnicity on fertility in Nigeria. Cross-sectional population-based cluster design approach was used for the study. The investigated population group was women of reproductive age (n=19,348). Probability of bearing &ge;5 children, refined Total Fertility Rate and mean fertility were used to assess fertility. Data were analyzed using demographic and Zero-Inflated Poisson models. Fertility indices were higher among the Hausa/Fulani ethnic group than Igbo and Yoruba and also among Muslim women than Christians. Interaction shows that the probability of bearing at least five children was highest among women who; have no SP, belong to Islamic religious denomination, and of Hausa/Fulani ethnic group. The fertility incident rate ratio (IRR) was higher among women with no SP than women who have SP and also higher among Hausa/Fulani than Yoruba but lower among Christians than Muslims. Fertility differentials persists by ethnicity, religion and SP after controlling for other important variables. Difference exists in fertility among religious, ethnic groups and by SP in Nigeria. Fertility reduction strategies should be intensified in Nigeria, but more attention should be given to Muslims and Hausa/Fulani women.

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