Nigeria has about 3.8 million people living with HIV, the second largest globally. Stigma and discrimination are major barriers to testing, treatment uptake, and adherence. In this review, we synthesized information on research studies, policies, and programmes related to HIV-stigma in Nigeria. This was with a view to identify critical areas that research and programmes must address in order to accelerate the progress towards zero (new infections, discrimination, and death) target by year 2030. Existing studies were mostly devoted to stigma assessment using varieties of measures. Research, policies, and programmes in the past two decades have made very useful contributions to stigma reduction. We identified the need for a consistent, valid, and objective measure of stigma at different levels of the HIV response. Nigeria does not lack relevant policies; what needs to be strengthened are design, planning, implementation, monitoring, and evaluation of context-specific stigma reduction programmes.
The aim of this study was to estimate: (1) the lifetime risk (LTR) of maternal death; and (2) the maternal mortality ratio (MMR) in the Zamfara State of northern Nigeria. Data from the Nahuche Health and Demographic Surveillance System were utilized using the 'sisterhood method' for estimating maternal mortality. Female respondents (15-49 years) from six districts in the surveillance area were interviewed, creating a retrospective cohort of their sisters who had reached the reproductive age of 15 years. Based on population and fertility estimates, we calculated the LTR of maternal death and the MMR. A total of 17,087 respondents reported 38,761 maternal sisters of whom 3592 had died and of whom 1261 were maternal-related deaths. This corresponded to an LTR of maternal death of 8% (referring to a period of about 10.5 years prior to the survey) and an MMR of 1049 deaths per 100,000 live births (95% confidence interval, 1021-1136). The study provides documented evidence of high maternal mortality in the study area and the state as a whole. Thus, there is a need to improve the health system with an emphasis on interventions that will accelerate reduction in MMR such as the availability of skilled birth attendants and emergency obstetric care, promotion of facility delivery and antenatal care attendance. This can be achieved through a holistic approach and is critical in order to accelerate progress in meeting the Millennium Development Goal of maternal mortality reduction.
BackgroundStigma and discrimination remains a barrier to uptake of HIV/AIDS counselling and treatment as well as effective HIV reduction programmes. Despite ethnic diversity of Nigeria, studies on determinants of HIV stigma incorporating the ethnic dimension are very few. This paper provides empirical explanation of the ethnic dimension of determinant of HIV stigma and discrimination in Nigeria.MethodsNationally representative data from Nigerian Demographic and Health Survey 2013 (Individual recode) was analysed to explore ethnic differentials and homogeneity in the determinants of HIV/AIDS stigma and discrimination among women in multi-ethnic Nigeria.ResultsResult shows that determinants of HIV stigma and discrimination varies by ethnicity in Nigeria. Significant ethnic differentials in HIV/AIDS stigma and discrimination by Secondary school education exist among Hausa and Igbo respectively (OR = 0.79; CI: 1.49-2.28 and OR=1.62; CI: 1.18-2.23, p<0.05). Wealth status significantly influenced HIIV/AIDS stigma and discrimination among Hausa, Igbo and Yoruba ethnic groups (p<0.05). Knowledge of HIV/AIDS was significantly associated with lower odds of discriminating attitudes among the Hausa and Fulani ethnic groups (OR = 0.45; CI: 0.30-0.67 and OR=0.36; CI: 0.16-0.83, p<0.05).ConclusionsIdentifying ethnic differential and homogeneity in predictors of HIV/AIDS stigma is key to reducing HIV/AIDS prevalence in Nigeria and countries with similar settings.
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