Background Uptake of iron–folate supplementation for at least 90 days during pregnancy is recommended as a cost-effective way of reducing iron deficiency anemia, the commonest form of anemia among women of childbearing ages. The paper examines the level of compliance in Nigeria. Methods We analysed a sample of 14 740 married women aged 15–49 years from the 2018 Nigerian Demographic and Health Survey with available data on hemoglobin and anemia. Multinomial logistic regression models were used to establish associations between socio-demographic characteristics, compliance with recommended uptake of micronutrients and anemia status of the mothers. Results A number of socio-demographic factors, namely maternal age, type of residence, education, wealth, among others correlated with incidence of maternal anemia as well as compliance with recommended uptake of micronutrient to protect against anemia. For instance, whereas 46.3% of mothers from rural backgrounds were not anemic, 39.0% of those with urban background were not anemic (P < 0.001). More than half (56.2%) of mothers in the richest households were anemic compared with about a third (34.6%) of mothers in the poorest household who were not anemic (P < 0.001). The urban dwellers, richer and more educated mothers complied more with the uptake of iron–folate supplements to protect against anemia during pregnancy (P < 0.001). The younger mothers (15–29 years) were more likely to comply with iron intake (odds ratio: 1.150 (1.060–1.247)).

BackgroundAnaemia during pregnancy continues to constitute significant challenge to maternal health in Nigeria and contributes substantially to the worsening maternal mortality ratio (MMR) in Nigeria despite a global reduction in MMR in response to effort to improve safe motherhood. The incidence of anaemia during pregnancy is still high (>40 %) in Nigeria, and attitudes and management practices are yet unclear as the peoples’ understanding of the phenomenon remains unclear. This study explored the perceptions/attitudes on anaemia during pregnancy and practices to prevent and/or manage it in Anambra State.MethodsIn-depth interview and focus group discussion data were collected from health workers and mothers who delivered within 6 months preceding the study and from mothers and husbands of women who delivered within 6 months preceding the study, respectively.ResultsThe people expressed some knowledge of anaemia, being common in pregnancies. However, some expressed the view that anaemia being a typical sign of pregnancy cannot be prevented. Some mothers expressed desire for focused antenatal care services to control anaemia but lamented the attitude of the health workers, who make access to these interventions difficult.ConclusionsControl of anaemia in pregnancy should start with providing health education to pregnant women and their partners, who reinforce what the women are told during antenatal care, and with training health workers for friendlier attitudes to clients.

Background: The risk for importation and reintroduction wild poliovirus in areas that have been cleared of the wild poliovirus in the Horn of Africa will remain if the surveillance systems are weak and porous. Methods: Consequently, the Horn of Africa Polio Coordinating Office in Nairobi, together with partners conducted surveillance reviews for some of the countries in the Horn of Africa, especially Ethiopia, Kenya and Somalia to identify gaps in the polio surveillance and provided recommendations for improved surveillance. Structured questionnaires collected information about acute flaccid paralysis (AFP) surveillance resources, training, data monitoring, and supervision at provincial, district, and health facility levels. Other information collected included resource availability, management and monitoring of AFP surveillance.Results: The result revealed that although AFP surveillance systems were well established in these countries, a number of gaps and constraints existed. Widespread deficiencies and inefficient resource flow systems were observed and reported at all levels. There were also deficiencies related to provider knowledge, funding, training, and supervision, and were particularly evident at the health facility level. These weaknesses were corroborated with the sustained transmission of polioviruses in the region, where the surveillance systems were not sensitive enough to pick the viruses. Conclusion: The review teams made useful recommendations that led to strengthening of the surveillance systems in these countries, including the formation and use of village polio volunteers in the south and central zones of Somalia, where security was heavily compromised and surveillance officers lacked regular access to the communities.

Background: One of the four key strategies of the Global Polio Eradication Initiative (GPEI) is high immunization coverage, with oral polio vaccine as part of routine immunization schedules. However, given the weak routine immunization structures in the African Region, coverage is enhanced with supplemental immunization activities (SIAs), and mop-up immunizations. Unfortunately, anecdotal information show that vaccination teams sometimes omit some catchments areas without immunization. This paper thus describes the use of “Call Centers” in detecting missed populations and taking prompt corrective action. Method: The study was based on review of call records during polio supplemental immunization campaigns in Bol Districts in Chad from February to May 2018. The immunization coverage resulting from these campaigns was compared with that of February 2018. A compilation of data – details on communities, community leaders, and their phone numbers was performed. On the eve of the campaign, community leaders were alerted on the vaccinators’ visitThe community leaders were called on the eve of the campaign to alert them on the visit of the vaccinators. At the end of each day, activities (visits as well) were reviewed at the coordination centres Vaccinators were asked to return to any community where community leaders did not confirm visits). Result: Telephone calls allowed the verification and confirmation of the vaccinators visits in 92% of cases. Villages where vaccination was planned but which were not reached were revisited. More than 1,011 children were caught up through this approach in 10 villages in the Bol district. Conclusion: In conclusion, call centers played significantly higher role in generating covering more children with immunization during immunization campaign.

We explored management and prevention practices concerning anemia in pregnancy (AIP) in Anambra State, Nigeria from a cross-sectional survey of 600 women of child-bearing age through a multistage random selection process. The objective is to identify factors that influence recognition and management of AIP. A knowledge index of 45 points was developed with the mean score of 5.9 points (5.9 ± 6.1 SD). Furthermore, 49.3% of the respondents had good knowledge. The urban respondents had good knowledge (66.7%) compared with their rural counterparts (32%). There were misconceptions on the causes, management, and prevention of AIP during pregnancy. Multiple regression analyses revealed that variables such as religious affiliation, education, and residence influenced the knowledge about AIP. A unit increase in the educational level of the women will bring about 0.644 units of increase in the knowledge of AIP ( p = .003). A unit change from urban to rural locality would lead to 1.536 units increase in correct practices to prevent AIP ( p < .001). A unit change to being married would lead to 0.936 unit increase in correct practices to prevent AIP ( p = .025). Knowledge about the management and prevention of AIP was poor. Anemia-related education to improve knowledge and practice should be provided during antenatal care. Living in an urban community was associated with the odds ratio of 4.3 (95% CI [3.07, 6.07]) and 7.42 (95% CI [2.0, 27.6]) for knowledge and prevention of AIP, respectively.