Suchergebnisse

BACKGROUND: Contraceptive use in Nigeria has been consistently low despite its many benefits and several efforts by government and development partners to increase its uptake. According to the Nigeria Demographic and Health Survey, the use of any modern method staggeringly increased from 4 to 12% over 28 years (1990–2018). Studies have identified factors at the individual, household, and societal levels that affect contraceptive use. While studies have also shown that decisions such as contraceptive behavior and acquisition of family skills may vary according to the individual or societal factors, there is a dearth of knowledge on how household structure and composition influence contraceptive use in Nigeria. This article seeks to contribute to the body of knowledge by exploring contraceptive use within the household context. METHOD: We used data from the 2018 Nigeria Demographic and Health Survey to examine the relationship between household structure and contraceptive use. We excluded pregnant and non-married women at the time of the survey from the sample and used multinomial regression analysis to examine the likelihood of using traditional or modern methods of contraception. RESULTS: Results show that having a large household size, and the presence of multiple wives in the household significantly reduces the likelihood of using any method of contraceptive. The result further shows a significant association between household wealth index and contraceptive use as the use of any method increases with household wealth index, with those from richest households being twice as likely as their counterparts in the poorest households to use traditional methods (OR:2.02, p < 0.05). Also, women living in households headed by older men (25 and above), households with under 5 children, and those living in rural areas have significantly reduced likelihood of using any method. CONCLUSION: This study highlights the dynamics of contraceptive use among married women considering household composition. While our study serves ...

Within the last two decades, the Nigerian government has committed to strengthening its primary health care system, through reforms addressing institutional restructuring, deepening decentralized governance, and the incorporation of an alternative health care financing strategy. One of these reforms prescribed the establishment of state primary health care agencies/boards (SPHCDBs) as an integral part of the national health system, with the principal responsibility "for the coordination of planning, budgeting, provision and monitoring of all primary health care services that affect residents of the state." Central to this reform is the integration of primary health care (PHC) governance and management, popularly called primary health care under one roof. Another reform, piloting results-based financing, has been implemented since 2011 in three states under the Nigeria State Health Investment Project. This study assesses the implementation of the Primary Health Care Under One Roof (PHCUOR) policy as part of the broader PHC reforms, with a specific focus on how this policy has been strengthened through the Nigeria State Health Investment Project (NSHIP) in Adamawa, Nasarawa, and Ondo states, documenting the evolution of SPHCDB and PHC service delivery, with a focus on management, accountability, and incentives. The study shows that, in the above-mentioned states, significant milestones were achieved in the establishment of the SPHCDB, the strengthening of PHC systems, the improvement of accountability linkages, and an increase in service utilization. The authors therefore argue that integrated PHC systems through SPHCDBs, as enshrined in the PHCUOR guidelines, are a panacea for effective provision of primary health care and a potential game changer for health outcomes, especially when reinforced with a results-based financing approach.

Death registration provides an opportunity for the legal documentation of death of persons. Documentation of deaths has several implications including its use in the recovery of inheritance and insurance benefits. It is also an important input for construction of life tables which are crucial for national planning. However, the registration of deaths is poor in several countries including Nigeria. This paper describes the performance of death registration in Nigeria and factors that may affect its performance. We conducted a systematic literature review of death registration completeness in Nigeria to identify, characterize issues as well as challenges associated with realizing completeness in death registration. Only 13.5% of deaths in Nigeria were registered in 2007 which regressed to 10% in 2017. There was no data reported for Nigeria in the World Health Organization database between 2008 and 2017. The country scored less than 0.1 (out of a maximum of 1) on the Vital Statistics Performance Index. There are multiple institutions with parallel constitutional and legal responsibilities for death registration in Nigeria including the National Population Commission, National Identity Management Commission and Local Government Authorities, which may be contributing to its overall poor performance.