Background Nigeria, like many other countries, has been severely affected by the COVID-19 pandemic. While efforts have been devoted to curtailing the disease, a major concern has been its potential effects on the delivery and utilization of reproductive health care services in the country. The objective of the study was to investigate the extent to which the COVID-19 pandemic and related lockdowns had affected the provision of essential reproductive, maternal, child, and adolescent health (RMCAH) services in primary health care facilities across the Nigerian States. Methods This was a cross-sectional study of 307 primary health centres (PHCs) in 30 Local Government Areas in 10 States, representing the six geopolitical regions of the country. A semi-structured interviewer-administered questionnaire was used to obtain data on issues relating to access and provision of RMCAH services before, during and after COVID-19 lockdowns from the head nurses/midwives in the facilities. The questionnaire was entered into Open Data Kit mounted on smartphones. Data were analysed using frequency and percentage, summary statistics, and Kruskal–Wallis test. Results Between 76 and 97% of the PHCS offered RMCAH services before the lockdown. Except in antenatal, delivery and adolescent care, there was a decline of between 2 and 6% in all the services during the lockdown and up to 10% decline after the lockdown with variation across and within States. During the lockdown. Full-service delivery was reported by 75.2% whereas 24.8% delivered partial services. There was a significant reduction in clients’ utilization of the services during the lockdown, and the difference between States before the pandemic, during, and after the lockdown. Reported difficulties during the lockdown included stock-out of drugs (25.7%), stock-out of contraceptives (25.1%), harassment by the law enforcement agents (76.9%), and transportation difficulties (55.8%). Only 2% of the PHCs reported the availability of gowns, 18% had gloves, 90.1% had hand sanitizers, and a temperature checker was available in 94.1%. Slightly above 10% identified clients with symptoms of COVID-19. Conclusions The large proportion of PHCs who provided RMCAH services despite the lockdown demonstrates resilience. Considering the several difficulties reported, and the limited provision of primary protective equipment more effort by the government and non-governmental agencies is recommended to strengthen delivery of sexual and reproductive health in primary health centres in Nigeria during the pandemic.

BackgroundNigeria, like many other countries, has been severely affected by the COVID-19 pandemic. While efforts have been devoted to curtailing the disease, a major concern has been its potential effects on the delivery and utilization of reproductive health care services in the country. The objective of the study was to investigate the extent to which the COVID-19 pandemic and related lockdowns had affected the provision of essential reproductive health, maternal and child health, and adolescent health services in primary health care facilities across the Nigerian States.MethodsThis was a cross-sectional study of 307 primary health facilities in 30 Local Government Areas in 10 States, representing the six geopolitical regions of the country. A semi-structured interviewer-administered questionnaire was used to obtain data on issues relating to access and service provision before, during and after COVID-19 lockdowns from the head nurses/midwives in the facilities. The questionnaire was entered into Open Data Kit mounted on smartphones. Data were analysed using non-parametric statistics.ResultsThe results show that a large proportion of the primary health facilities in the selected states opened for the provision of essential sexual and reproductive health and rights services during the COVID-19 pandemic lockdown. However, there was a significant reduction in clients’ utilization of services due to challenges experienced in service implementation such as stock-outs, and low demand for services by clients. Although the health facilities reported identifying cases of COVID-19, there was limited provision for primary protective equipment and other special offers that would motivate the health workers to optimize services for clients. ConclusionsWe conclude that efforts made to address these challenges by governments, non-governmental agencies, the private sector, and donor agencies working in low resource settings would reduce the health and social burden posed by COVID-19 in Nigeria.

Objectives: The significant improvement in the contraceptive prevalence rate in Kaduna State, Nigeria, from 8.4% in 2008 to 18.5% in 2013 is a notable achievement. This article analyses the role of midwives as drivers of reproductive health commodity security (RHCS) and their impact on contraceptive use in Kaduna State. Methods: The United Nations Population Fund (UNFPA) supported the bimonthly review resupply meetings facilitated by midwives at State and local government area (LGA) levels. The midwives deliver contraception to the LGAs for onward distribution to 6974 of the 25,000 health facilities across the country according to usage data from the previous 2 months. They also collect requisition, issue and resupply form data from the previous 2 months. Results: The active participation of midwives at the bimonthly meetings improved data timeliness by 23% and data completeness by 50% in 1 year. Only one health facility ran out of intrauterine devices and only 17% reported running out of female condoms. The total number of contraceptives issued increased from 31,866 in 2012 to 177,828 in 2013, resulting in a couple–year protection increase from 3408 in 2012 to 102,207 in 2013. Conclusions: Creation of increased demand and engagement of midwives in providing family planning services, especially long-acting contraceptive methods, coupled with the removal of cost to the user and the strengthening of the supply chain have been major factors in more than doubling the contraceptive prevalence rate.

Background: In 2015, the United Nations Development Programme (UNDP) noted that countries will need to meet the increasing demand for contraceptives by the over 600 million 15- to 19-year-olds around the world. Although the unmet need for contraception for Women of Child Bearing Age (WCBA) in Nigeria is 12.7%, the value is higher (35.3%) among adolescents aged 15 – 19 years. Additionally, the unmet need for family planning (FP) among WCBA in Kaduna state is 5.8%, with 33.3% of women aged 20-24 years in Kaduna reported to have had a live birth before the age of 18 years. This study sought to evaluate adolescent contraceptive use in three referral health facilities of Kaduna metropolis. Methods: This is a descriptive cross-sectional desk review of 5543 FP clients that attended three referral centers between 2014 and 2016. Data on their age, parity and the use of contraceptives were collected from the clinic registers and analyzed using SPSS 22. Results: The FP client age ranged from 12 to 57 years, of which only 3.6% were adolescent. The annual proportion of adolescent contraceptive users ranged from 3.1 – 4.1%. More than 96% of the adolescents had given birth to at least one child. Around 62% of the adolescents used injectable contraceptives but there was no IUD use reported by any adolescent. Conclusions: The low proportion of adolescent contraceptive users and their limited choice of contraceptive methods, emanating from multiplicity of client and provider bias, calls for innovative interventions to meet the contraceptive needs of adolescents.

Background: Globally, women and their unborn babies continue to die from preventable causes. This study aims to highlight the causes of maternal and perinatal deaths and bring to the fore areas that need to be improved in order to improve maternal and perinatal health indices in Gombe State. Methodology: Information for this report was obtained from Maternal and Perinatal Deaths Surveillance and Response (MPDSR) desk officers and chairmen across MPDSR supported health facilities in the state. Secondary data abstraction from registers was conducted using an electronic questionnaire and was analysed using SPSS version 23. Findings: The Maternal Mortality Ratio (MMR) was 1,092/100,000 livebirths in 2019 and 993/100,000 live births in 2020. Majority of the women (84.3% and 86.7% in 2019 and 2020 respectively) were severely ill at presentation, while most maternal deaths were as a result of eclampsia/pre-eclampsia and Post Partum Haemorrhage (PPH). Only 15.9% and 14.4% of maternal deaths in 2019 and 2020 respectively were reviewed. Perinatal asphyxia accounted for 36.4% and 31.8% of perinatal deaths in 2019 and 2020 respectively, while prematurity resulted in 24.7% and 35.6% of deaths in 2019 and 2020 respectively. The Perinatal Mortality Rates (PMR) were 78.3/1000 births in 2019 and 76.1/1000 births in 2020. Conclusion: Although MMR and PMR have been on a decline in Gombe state from 2018 till date, these figures are still far from achieving the SDG 2030 target. There is therefore the need to revive MPDSR activities in the state and improve emergency obstetric health care services.

Background: For Nigeria to attain a Contraceptive Prevalence Rate (CPR) of 36% in 2018 as committed by the Federal Government at the London 2012 summit, Family Planning (FP) services must be provided to all eligible couples at every contact with the health system, including the Obstetric fistula (OF) units. In Nigeria, about 20,000 women develop OF annually for which access to FP services will prevent recurrence of OF and increase the FP utilization. This study therefore assessed the prevalence of missed opportunities for FP, its trend amongst repaired OF clients, the possible causes and suggested recommendations. Methods: This cross-sectional descriptive study was conducted in two OF and FP units of hospitals in Zaria and Sokoto. Records of FP for the 1,015 OF clients admitted from 2011-2015 were extracted and analyzed on SPSS version 20. Also questionnaire survey were applied and analyzed on excel for all the 8 health workers and 18 repaired OF clients available in the units during the study period. Results: Seventy percent of the 1,015 OF repaired by the two units did not take a FP method post repair.. The main reasons given by OF service providers for these missed opportunities were the desire for more children by OF client having lost the index one, inadequate FP training for OF staff and client ignorance. Suggestions by the OF service providers for improvement include improved client counselling, quality FP services and information, client sensitization, training of staff on FP services and balanced counselling. Conclusion: The implementation of the above suggestions by stakeholders, reinforced with appropriate IEC strategy will reverse these missed opportunities.

Background: Available data from South Asia and sub-Saharan Africa indicates that 12% and 34% of girls were married at age 15years and 18years respectively. This practice of child marriage may debar countries from achieving the Sustainable Development Goals. Objective: To extract and present disaggregated indices in the 2013 Nigeria Demographic and Health Survey (NDHS) on the effect of child marriage on health. Method: This desk review study extracted disaggregated maternal and child health indices on married females aged 15-19 years from the 2013 NDHS. Results: The result showed that married females aged 15-19 years were short, thin, and least likely to receive prophylactic Vitamin A dose postpartum and deworming medication at last pregnancy. Also, while awareness for Family Planning (FP) was high, its utilization was poor at only 1.2%. Their Antenatal clinic attendance, facility delivery, skilled birth attendance at delivery and post natal service utilization were lowest. Similarly, mortality of children under 5 was highest amongst these mothers. Although violence during pregnancy was highest amongst this group, nevertheless more than 20% of them agreed that the practice of female circumcision should be continued. Conclusion: These findings depict some of the negative outcomes of child marriage on maternal and child survival which require integrated multisectoral interventions to ensure that all girls have access to timely sexual reproductive health services and information.</P>

Background: Adolescents are exposed to several reproductive health challenges including early marriage, unwanted pregnancies, unsafe abortions and sexually transmitted infections. An estimated 14 million adolescents give birth annually of which more than 90% of these occurs in developing countries. Adolescents in the Sub-Saharan Africa have low family planning utilization rates, limited knowledge of reproductive health services and very high pregnancy rates which is not unrelated to the negative attitude of some health care providers towards the provision of Sexual and Reproductive Health (SRH) services and information to adolescents. Objective: The aim of the study was to explore the health workers attitude, practice and its socio-demographic correlates on the provision of contraceptives to adolescents. Methodology: The cross-sectional descriptive study was conducted in Kaduna, Nigeria among Health care workers from public health facilities attending a regional child-spacing conference. The data was collected using a structured self-administered questionnaire which yielded 77% response rate. It was entered and analyzed with SPSS20. Result: The respondents were mostly females (93.9%), Muslims (72.5%) with an average age of 42 years. Those respondents older than 40 years (67.7%), married (82.9%), of Muslims faith (72.4%) and with more than 5 years of working experience (84.4%) agreed to provide contraceptive counseling to adolescents. Also the majority of health workers that were females (91.4%), above 40 years of age (69.4%), married (84.8%), Muslims (70.1%) and had more than 5 years working experience (85.6%) agreed to provide contraceptives to unmarried adolescents. However none of the respondents wanted to provide IUD to unmarried adolescents. Conclusion:The majority (83%) of public health workers in Northern Nigeria are willing to provide early contraceptive counseling and services to both married and unmarried adolescents. This findings will further guide the drive to ensure universal access to sexual and reproductive health-care services, including for family planning, information and education