Communication and agreement between spouses has been found to be an important factor in terms of acceptance and use of family planning services and supplies. Therefore, it is likely that agreement between spouses may play an important role in other aspects of family health, including care of childhood illness. This study, based in a rural and an urban community in Osun State, Nigeria, set out to determine the agreement between mothers and fathers on the illness experience and care provided to their preschool age children. Among the 550 couples studied, most mothers (98%) and fathers (94%) reported that they "did something" to help during their child's recent illness. The illness was recognized first by the mothers according to 83% of respondents. Overall, 81% of couples concurred that the mother was the first to discover the illness. Concurrence was greater in urban areas and where fathers read a newspaper frequently. Only 45% concurred on who took the decision for first action to address the illness, which again was greater in the urban area and in families where the father read a newspaper frequently. Parents also were not in full agreement about the name of the child's illness, but concurrence was greater in the case of malaria/fever. Finally, concurrence on the actual first form of treatment care reached only 36%. Most concurrent couples and non-concurrent mothers mentioned drug shops/chemists as the first source of care, while non-concurrent fathers placed government clinics first. While mothers are likely to be the main caregivers, fathers do have decision making and financial roles. Not only should health education for appropriate and prompt care of child illnesses be aimed equally are both parents, it should also recognize that fathers may have different perceptions from mothers. Education should also encourage better couple communication.
Remote training of interviewers in low-resource settings can be an effective approach during the COVID-19 pandemic when data are critically needed and in-person learning is not possible. We demonstrate that remote interviewer training is possible when interviewers: have at least an intermittent Internet connection, have select physical materials available, and are experienced and part of a cohesive team.
Introduction
Adolescent pregnancy contributes significantly to the high maternal mortality in Nigeria. Research evidence from developing countries consistently underscores Antenatal Care (ANC) among childbearing adolescents as important to reducing high maternal mortality. However, more than half of pregnant adolescents in Nigeria do not attend ANC. A major gap in literature is on the influence of family context in pregnant adolescent patronage of ANC services.
Methods
The study utilized a cross-sectional survey with data collected among adolescent mothers in urban slums in three Nigerian states namely, Kaduna, Lagos, and Oyo. The survey used a multi-stage sampling design. The survey covered a sample of 1,015, 1,009 and 1,088 childbearing adolescents from each of Kaduna, Lagos, and Oyo states respectively. Data were analyzed at the three levels: univariate, bivariate and multivariate.
Results
Overall, about 70 percent of female adolescents in our sample compared with 75 percent in the Demographic and Health Survey (DHS) had any antenatal care (ANC) visit. About 62 percent in our sample compared with 70 percent in the DHS had at least 4 ANC visits, and, about 55 percent in our sample compared with 41 percent of the DHS that had 4 ANC visits in a health facility with skilled attendant (4ANC+). Those who have both parents alive and the mother with post-primary education have higher odds of attending 4ANC+ visits. The odds of attending 4ANC+ for those who have lost both parents is almost 60% less than those whose parents are alive, and, about 40% less than those whose mothers are alive. The influence of mother’s education on 4ANC+ attendance is more significant with large disparity when both parents are dead.
Conclusion
The study concludes that identifying the role of parents and community in expanding access to ANC services among adolescent mothers is important in improving maternal health in developing countries.
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