Insecurity in northern Nigeria: Implications for maternal and child health

Olarewaju, Obafemi Arinola

doi:10.1016/j.cegh.2021.100869

Cited by 15 publications

(12 citation statements)

References 10 publications

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“…Social support was the strongest predictor. This study confirms what is attainable in the general related literature (Aheto, 2019; Azuh et al, 2019; Mesike & Mojekwu, 2012; Olarewaju, 2021). This further demonstrates how the same causes that affect IDPs in AMAC and other IDP camps across the nation operate similarly.…”

Section: Discussionsupporting

confidence: 91%

“…Poor child survival has been due to preventable causes (Van Malderen et al, 2019) such as preterm birth, birth asphyxia, infections in the first 4 weeks of birth, and pneumonia, diarrheal diseases, and malaria in the post neonatal period, with malnutrition contributing substantially to these deaths (Abraha et al, 2020; WHO, 2023b). In SSA, child survival is associated with environmental factors such as sanitation and hygiene, access to potable water, access to quality healthcare, and socio‐economic factors such as maternal education, social support, household wealth index, and place of residence (Aheto, 2019; Mesike & Mojekwu, 2012; Olarewaju, 2021; Sokefun & Atulomah, 2020; Van Malderen et al, 2019; Wagner et al, 2018). In addition, factors such as the use of healthcare services, self‐efficacy, attitude, belief, knowledge, and practice of child survival strategies (CSS) also have great impacts on child survival (Abimbola et al, 2016; Etokidem & Johnson, 2016; Yaya et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

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Determinants of child survival practice among caregivers in internally displaced persons' camps in Abuja Municipal Area Council, Nigeria

Ajike,

Oloyede

2023

Child

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BackgroundChild survival remains a major public health challenge in the sub‐Saharan region of Africa, especially Nigeria. The Boko Haram crisis, which has aggravated this, has led to the displacement of many people in the north‐eastern region, including children under five. This study investigated the determinants of child survival practice among caregivers in internally displaced persons' (IDP) camps in Abuja Municipal Area Council (AMAC), Nigeria.MethodologyA cross‐sectional design was used to collect data on determinants of child survival practice from 312 caregivers in five purposively selected IDP camps in AMAC using the snowball sampling technique. Data were analysed using univariate, bivariate, and multivariate statistics at 5% level of significance.ResultsThe mean age of respondents was 29.6 ± 6.72 years. There was a significant (p < 0.05) relationship between the predisposing, reinforcing, enabling and environmental factors studied and child survival practice. Findings also indicated that all factors were significant (p < 0.05) predictors of child survival practice with the reinforcing factor being the major predictor (ß = 0.38; t = 6.08).ConclusionAttention needs to be paid to all factors, particularly the reinforcing factor of social support in order to promote optimal child survival practice among caregivers in AMAC IDP camps. Collaboration with social work professionals would be an added benefit to enhance social support.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Determinants of child survival practice among caregivers in internally displaced persons' camps in Abuja Municipal Area Council, Nigeria

Ajike,

Oloyede

2023

Child

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“…Our findings show that worsening security situation in Nigeria is among the top reasons the doctors are emigrating. This is in concordance with the negative consequences of insecurity on health workforce motivation and availability [36,37], which ultimately adversely affects health service delivery [38][39][40]. Over the years, insecurity in Nigeria has worsened [41]; in December 2021, majority (79%) of adult Nigerians opined that the country has not fared well in the area of security [42].…”

Section: Discussionmentioning

confidence: 80%

Physician emigration from Nigeria and the associated factors: the implications to safeguarding the Nigeria health system

et al. 2022

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Background Adequate Human Resources for Health is indispensable to achieving Universal Health Coverage and physicians play a leading role. Nigeria with low physician–population ratio, is experiencing massive exodus of physicians. This study investigated emigration intention of physicians, the factors influencing it and discussed the implications to guide policy formulation and reforms, curtail the trend and safeguard the country’s health system. Methods Through cross-sectional survey, 913 physicians from 37 States were interviewed with semi-structured questionnaire using Google form shared via WhatsApp and Telegram forums of Nigeria Medical Association. Data were analysed with IBM-SPSS version-25 and charts were created with Microsoft-Excel. Chi-square and multiple regression tests were done with p-value set at 0.05. Results The mean age of respondents is 37.6 ± 7.9 years; majority of them are males (63.2%), married (75.5%) with postgraduate qualifications (54.1%) and working in public health facilities (85.4%). Whereas 13% and 19.3% are, respectively, satisfied with their work and willing to continue practice in Nigeria, 43.9% want to emigrate and 36.8% are undecided about future location of their practice. The commonest reasons for emigration are poor remuneration (91.3%), rising insecurity (79.8%) and inadequate diagnostic facilities (61.8%). Physicians working in public health facilities are 2.5 times less satisfied than their counterparts in non-public sector (AOR = 0.4; 95% CI = 0.3–0.8). Physicians in their thirties, forties and fifties are 3.5 (95% CI = 1.5–8.0), 5.5 (95% CI = 2.1–14.5) and 13.8 (95% CI = 3.9–49.3) times, respectively, more willing to retain practice in Nigeria than those younger and those satisfied with their work are 4.7 (AOR = 4.7, 95% CI = 2.9–7.4) times more willing to practice in Nigeria than those not satisfied. Conclusion Majority of Nigerian physicians want to emigrate for professional practice and top among the push factors are poor remuneration, rising insecurity and inadequate diagnostic facilities. The observed trend portends danger to the country’s health system due to the foreseeable negative consequences of physician deficit to the system. We recommend upward review of physician remuneration, a root cause analysis of insecurity to determine workable preventive measures and increased funding of the health sector to improve the diagnostic infrastructure, retain physicians and save the health system from imminent collapse.

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“…Furthermore, the upsurge of conflicts and terrorism in the country might be associated with the poor coverage of RMNCH services, specifically in Northern Nigeria. 99 This study could not assess the level of coverage by geographical regions in the equity gap analysis due to limited data. The analysis could offer an insight into the coverage of RMNCH services in Northern Nigeria.…”

Section: Discussionmentioning

confidence: 98%

Insight into Nigeria’s progress towards the universal coverage of reproductive, maternal, newborn and child health services: a secondary data analysis

Mafiana

Shen

et al. 2022

BMJ Open

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ObjectiveThis study investigated the progress towards the universal coverage of reproductive, maternal, newborn and child health (RMNCH) services in Nigeria after universal health coverage (UHC) adoption.DesignA descriptive observational approach was used based on secondary data analysis. Representative data generated from publicly accessible databases and reports were used to describe the coverage trend and estimate the absolute inequality. Analysis was conducted using Excel and the WHO’s Health Equity Assessment Toolkit software.SettingThe study setting is Nigeria.ParticipantsAggregated health service coverage data of women aged 15–49 years and children under 5 years of age.Outcome measuresThe outcome of interest is the level of coverage of RMNCH services in Nigeria and the difference in equity gaps among subgroups before and after UHC adoption.ResultsThe RMNCH index increased by 6.4% points with a difference of 33.7% points to attain the minimum 80.0% target. The widest inequality was by economic status with the difference ranging from 21.9% points (95% CI 10.1% to 33.8%) to 56.3% points (95% CI 51.5% to 61.2%), Absolute Concentration Index from 3.5% points (95% CI 1.6% to 5.5%) to 11.3% points (95% CI 10.4% to 12.2%), Slope Index of Inequality from 23.1% points (95% CI 11.9% to 34.2%) to 65.5% points (95% CI 62.6% to 68.5%) and population attributable risk from 9.3% points (95% CI 7.3% to 11.4%) to 31.2% points (95% CI 29.0% to 33.3%). Among the indicators, three doses of diphtheria–tetanus–toxoid–pertussis immunisation had the widest absolute inequality across the subgroups.ConclusionThe poor coverage of RMNCH services in Nigeria and persistent inequalities pinpoint the need to investigate further the country-level determinant of RMNCH service coverage. In addition, it emphasises the need to formulate effective policies focusing on marginalised groups and improving resource allocation to ensure sustainable service coverage.

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Insecurity in northern Nigeria: Implications for maternal and child health

Cited by 15 publications

References 10 publications

Determinants of child survival practice among caregivers in internally displaced persons' camps in Abuja Municipal Area Council, Nigeria

Determinants of child survival practice among caregivers in internally displaced persons' camps in Abuja Municipal Area Council, Nigeria

Physician emigration from Nigeria and the associated factors: the implications to safeguarding the Nigeria health system

Insight into Nigeria’s progress towards the universal coverage of reproductive, maternal, newborn and child health services: a secondary data analysis

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