African Population Studies (UAPS) / Etude de la Population Africaine (UEPA)
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Nurses’ International Migration and the Crystallizing ‘Culture of Exile’ in Nigeria: Historical Trends, Dynamics and Consequences
Get PDFThis paper examines an oft-neglected feature of international migration: social changes (disruptions and/or dislocations of their normal ways of living) in source societies in response to the exigencies of these migrations, and their eventual consequences. It demonstrates how policies in developed economies inadvertently impact on developing societies by creating new social conditions. An exploratory case of Nigerian nurses’ international migration, the paper takes the hypothetical perspective that the socioeconomic effects of migration have engendered a crystallizing ‘culture of exile’ among significant youth populations. It examines the lures/motivation of nurse training and establishes a new dominant drive – the urge to migrate to developed, high-income economies. This development is a direct result of the long-term ‘progressive impact’ of migrated nurses’ remittances in local societies. The paper shows how locals’ belief in the high probability of nurses to attract ‘overseas’ suitors/spouses also feeds into the narrative. The development dire consequences were also highlighted
Application of mHealth to improve service delivery and health outcomes: Opportunities and challenges
Get PDFThe use of mobile technologies for health related activities (mHealth) is a new but rapidly progressing activity with global penetration. However, few programs have been implemented at scale. The objective of this paper is to review the background and evidence on mHealth, particularly with respect to the benefits and challenges of scale-up. A comprehensive review of literature on mHealth, aspects of eHealth and the related regulatory environment was undertaken in August 2014. mHealth innovations vary broadly in purpose, delivery channel and target population. As a result of its broad applicability and geographic reach, the benefits of successfully, safely and widely implemented mHealth are numerous and promising. However, these benefits can only be realized if the associated risks are minimized and the barriers are purposefully overcome. Government stewardship and leadership is crucial in overcoming these barriers and scaling up mHealth
Projecting population, numbers of households and dwelling units in South Africa 2011-2021
Get PDFFuture trends in population, number of households and dwelling units are critical components in strategic planning for future service delivery in South Africa. To aid planning therefore, this study analysed provincial trends in fertility, mortality and net migration as well as trends in the number of households and dwelling units. On the basis of the trends and assumptions about the future, households and dwelling units were projected for the period 2011-2021 using component functional models and ratio method. The results suggest that the size of the population aged 15 years and over in South Africa may increase from 36.4 million in mid-2011 to 42.5 million in mid-2021. Gauteng province is projected to have the largest number of persons in this age group. The number of households nationally is projected to increase from 15 million in mid-2011 to 20 million by mid- 2021 with Gauteng having the highest number of households
Gender and HIV-related discrimination in the health sector in Nigeria
Get PDFThis study explored the influence of gender on HIV-related discrimination in health care facilities in Lagos state from the perspectives of people living with HIV/AIDS. It hypothesized that women were more vulnerable to discrimination in the healthcare settings than men. Anchoring the analysis on Radical Feminism, the study argued that gender discrimination exacerbated HIV-related discrimination against female PLWHA in the health sector and that women's vulnerability to discrimination was based on the assumption that women were promiscuous. A purposive sample of 80 PLWHA was interviewed from September 2005 to April 2006. The results revealed that female PLWHA were more vulnerable to discrimination than the males. There were statistically significant differences between men and women's experiences in the following areas: mandatory HIV testing, unfair treatment, restricted movements, segregation and isolation from other patients. Rural female PLWHA; those aged 30 - 39 years, married, divorced, separated and widowed female PLWHA, those in paid employment and low income ones experienced discrimination more than the other categories of women. Gender mainstreaming, empowerment of women, formulation and enforcement of anti-discrimination laws, enforcement of CEDAW and education of health workers are recommended
Contraceptive Use and Its Socio-economic Determinants among Women in North-East and North-West Regions of Nigeria: A Comparative Analysis
Get PDFThis study investigated the socio-economic factors associated with reported contraceptive use by women of reproductive age in northern Nigeria. Bivariate and logistic regression analysis was applied to successive Nigeria Demographic and Health Survey (NDHS: 1999-2013) data to examine the relationship between reported use of modern contraceptives (the dependent variable) and the socioeconomic status (age, rural-urban residence, education, religion, current work status, marital status, and number of living children) of these women in the north-east (NE) and north-west (NW) geo-political zones (GPZs). The results indicated that women’s socio-economic status were positively associated with use of modern contraceptives in the NW in 1999 (AOR=2.15; 95%CI=1.47, 3.14), 2003 (AOR=1.64; 95%CI=1.30, 2.08) and 2013 (AOR=1.30; 95%CI=1.12, 1.50) and also in the north-east in 2008 (AOR=0.74; 95%CI=0.64, 0.86). Contraceptive use could increase as FP programmes better respond to the socio-economic and cultural circumstances of women in northern Nigeria
Status of Maternal Mortality in Zambia: Use of Routine Data
Get PDFMaternal mortality constitutes a major public health problem in developing countries. Although Zambia has been experiencing a decline in maternal mortality ratio (MMR) at a minimal rate, MMR still remains high, at 483 maternal deaths per 100 000 live births. Data from HMIS between 2011 and 2013 was used to analyze levels and trends of maternal mortality at national and subnational level. By yearly variation, MMR records 257/100,000 live births in 2011, (146/100,000) in 2012 and (171/100,000) in 2013. The major delivery complication was abortion which accounted for 57.4%, 55.6% and 52.6% in 2011, 2012 and 2013 respectively. Obtaining data on the magnitude of the health problem and its causes at the subnational level is vital for effective policy and program implementation and sustainability. However, improvement in skilled birth attendant and prompt efficient and enhancement routine data reporting will assist in the fight to reduce maternal mortality in Zambi
Maternal health care in Nigeria: Do community factors moderate the effects of individual-level Education and Ethnic origin?
Get PDFMaternal mortality ratio in Nigeria is still high despite the initiation of the safe motherhood initiative. The poor maternal health situation has been attributed to inadequate use of maternal health care services. This study examines whether community factors moderated the association between individual factors and the use of skilled ANC. Data on 17560 women aged 15-49 years drawn from 2008 Nigeria Demographic and Health Survey were used. Multilevel logistic regression models were used for analysis. Results reveal variations in the use of skilled ANC across the Northern and Southern regions. Residence in communities with a high proportion of women that delivered in a health facility increased the odds of skilled ANC utilization. Community education and poverty moderated the association between individual factors and the utilization of skilled ANC. To improve the use of ANC and increase the pace towards achieving the sustainable Development Goal-improved maternal health in the post 2015 era, increasing health facility delivery, women’s education and targeting poverty alleviation programs in disadvantaged communities should be taken into consideration
Improving care-seeking for facility-based health services in a rural, resource-limited setting: Effects and potential of an mHealth project
Get PDFThe aim of this paper was to investigate the impact of a toll-free hotline and mobile messaging service on care-seeking behaviors. Due to the low uptake of the services, the treatment on the treated estimate is used. For maternal health, the intervention had a strong, positive impact on antenatal care initiation and skilled birth attendance. No effect was observed for postnatal check-ups, receiving the recommended four antenatal care visits and vitamin A uptake. A negative effect was observed on tetanus toxoid coverage. For child health, no change was seen in child immunization, and a significant decrease was observed for care-seeking for children with fever. Different factors are associated with care-seeking, which may explain in part the variations seen across care-seeking behaviors and possible influence of exogenous factors. Introduction of mHealth services for demand generation require attention to local health systems to ensure adequate supply and quality are available
Religion as a Social Determinant of Maternal Health Care Service Utilisation in Nigeria
Get PDFThis study examines the relationship between religious affiliation and utilisation of maternal health care services using 2013 Nigeria Demographic and Health Survey data. The outcome variable is utilisation of maternal health care service measured by antenatal care and place of delivery. The explanatory variables were religion and three purposively selected social determinants of health, namely the social gradient, work condition and social exclusion. The chi-square test and multinomial logistic regression were applied. Result show that 50.7% had the recommended 4 or more antenatal care visits; 23.4% and 13.5% respectively utilise public and private sector facilities for their most recent child delivery. The relative risk of having 4 or more antenatal visits reduce by a factor of 0.7863 for Muslim women (p<0.05), and increase by a factor of 5.3806 for women in higher social ladder (p<0.01). Religion should be integrated into the social determinants of health framework.
Male involvement in utilization of emergency obstetric care and averting of deaths for maternal near misses in Rakai district in Central Uganda
Get PDFAlthough studies have assessed male involvement in birth preparedness and complication readiness, little is known about their involvement after the onset of maternal near miss complications. This information is important in developing appropriate strategies for male involvement in accessing emergency obstetric care (EmOC) in order to reduce Uganda’s high maternal mortality ratio. The study examined the roles played by men after the onset of maternal near miss complications in Uganda. A qualitative study using narratives of 40 purposively selected maternal near misses and in-depth interviews of 10 randomly selected men was conducted. Results showed that men were involved in postpartum uptake of long term contraceptive methods, management of obstetric complications, decision making, social support, transport arrangements and provision of financial support to access EmOC. Therefore, men should be sensitized on the recommended haemorrhage medication during home births, the need for supervised deliveries and prompt referral of their wives to health facilities