BackgroundHigh fertility and wide inequality in wealth distribution are phenomenal problems in sub-Saharan Africa. Modern Contraceptives (MC) are useful for limiting fertility, but are not always easily accessible in Malawi. This study examines the gap in MC use and fertility between women in the richest and poorest Wealth Quintile (WQ).MethodsThe study was cross-sectional in design and utilized Malawi DHS dataset, 2010. It focused on women of reproductive age. The dependent variables are ever and current use of MC. Chi-square and multinomial logistic regression were used for the analysis.ResultsMean children ever born by women in the poorest and richest WQs were 3.94 ± 2.7 and 2.82 ± 2.3 respectively (p < 0.001). The adjusted total fertility rate (Adj.TFR) was higher among women in the poorest (Adj.TFR = 7.60) WQ than the richest (Adj.TFR = 4.45). The prevalence of ever use of MC was higher among women in the richest WQ (82.4%) than the poorest (66.8%) (p < 0.001). Similar pattern exists for current use of MC; 58.5% and 45.9% for women in the richest and poorest WQs respectively (p < 0.001). Women in the richest WQ were more likely to ever use (OR = 2.36; C.I = 2.07-2.69, p < 0.001) and currently using (OR = 1.66; C.I = 1.40-1.97, p < 0.001) MC than their counterparts in the poorest WQ. Slight reduction in odd-ratio of MC use among women in richest WQ resulted when socio-demographic variables were used as control.ConclusionFertility was higher and the use of MC was lower among women in the poorest than their counterparts in the richest WQ. Ensuring availability of MC at little or no cost may bridge the gap in contraceptive use between women in the poorest and richest WQ in Malawi.

Abstract

BackgroundNigeria is among countries with high Under-Five Mortality (U5M) rates worldwide. Both maternal and childhood factors have been linked to U5M in the country. However, despite the growing global recognition of the association between housing and quality of life, the role of housing materials as predictors of U5M remain largely unexplored in Nigeria. This study, therefore, investigated the relationship between housing materials and U5M in Nigeria.MethodsThe study utilised the 2013 Nigeria Demographic and Health Survey data. A representative sample of 40,680 households was selected for the survey. The sample included 18,516 women of reproductive age who had given birth in the past 5 years prior the survey; with attention on the survival status of the index child (the most recent delivery). Data were analysed using descriptive statistics, Chi-square, Cox-proportional hazard and Brass 2-parameter models (α = 0.05).ResultsThe hazard ratio of U5M was 1.46 (C.I = 1.02–1.47, p < 0.001) and 1.23 (C.I = 1.24–1.71, p < 0.001) higher among children who lived in houses built with inadequate and moderate housing materials respectively than those in good housing materials. Under-five deaths show a downward trend (slope = −0.4871) relative to the housing materials assessment score. The refined U5M rate was 143.5, 127.0 and 90.8 per 1000 live birth among women who live in houses built with inadequate, moderate and adequate housing materials respectively. Other predictors of U5M were; the size of the child at birth, preceding birth interval, prenatal care provider, residence and education. Under-five death reduces with increasing maternal level of; education, wealth quintile, media exposure and housing material type and mostly experienced by Muslim women (6.0%), rural women (6.5%) and women residence in the North-West geopolitical zones (6.9%).ConclusionsLiving in houses built with poor housing materials promoted U5M in Nigeria. Provision of sustainable housing by the government and the maintenance of existing housing stock to healthful conditions will play a significant role in reducing the burden of U5M in Nigeria.

High fertility (HF) remains a public health problem and the intention to reduce fertility is a global

BackgroundSource of potable water has implication on the population health. Availability of Improved Drinking Water Sources (IDWS) is a problem in developing countries, but variation exists across segments of the population. This study therefore examined the relationship between wealth status, sex of household head and source of potable water.MethodsThe 2013 Nigeria Demographic and Health Survey data was used. A representative sample of 40,680 households was selected for the survey, with a minimum target of 943 completed interviews per state covering the entire population residing in non-institutional dwelling units in the country. Households where information on drinking water sources was not reported were excluded, thus reducing the sample to 38021. The dependent and key independent variables were IDWS and Wealth Index respectively. Data were analysed using Chi-square and binary logistic regression (α = .05).ResultsHouseholds that used IDWS were headed by females (66.7 %) than males (58.7 %). Highest proportion of households who used IDWS was found in the rich wealth index group (76.7 %). The likelihood of using IDWS was higher in household headed by females (OR = 1.41; C.I = 1.33–1.49, p <0.001). Households that belong to rich wealth index and middle class were 5.06(C.I = 4.81–5.32, p <0.001) and 2.62(C.I = 2.46–2.78, p <0.001) respectively times more likely to IDWS than the poor. This pattern was sustained when other confounding variables were introduced into the regression equation as control.ConclusionsHouseholds headed by women used improved drinking water sources than those headed by men. However, wealth index has strong influence on the strength of relationship between sex of household head and improved drinking water sources.

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The researcher assessed trends and patterns of marital timing and child marriage (CM) among women of reproductive age in Nigeria. Four rounds of Nigeria Demographic and Health Survey data-set were used (1990-2013). Data were analyzed using descriptive statistics and Cox-regression model with time-dependent covariates (α = 0.05). CM (<18 years) falls consistently from 63.8% in 1990 to 56.3% in 2013. The hazard ratio of CM was 1.24 (CI =1.19-1.28, p < .001), 1.24 (CI =1.19-1.29, p < .001), and 1.05 (CI =1.02-1.07, p < .001) times higher in 1990, 2003, and 2008, respectively than 2013. The region, education, religion, and ethnicity are common predictors of CM in all the survey rounds.