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This study was carried out to investigate family dynamics and parenting problems of secondary school students in Uyo Metropolis of Akwa Ibom State. Three research questions and three null hypotheses were formulated to guide the study. The survey design was adopted for the study. The population of 7412 students (2016/2017 academic session) with a sample of 200 students selected from 4 public secondary schools within the study area. A researcher -- made questionnaire called "Family Dynamics and Parenting Problems of Secondary School Students Questionnaire (FDPPSSQ)" was used to elicit data from respondents. The research instrument has a 4-point rating scale. The Pearson Product Moment (PPM) Correlation Coefficient of 0.87 ascertained the reliability of instrument for use in the study. After the administration, scoring and collation of the instrument, the data obtained were subjected to Independent t-test. All the null hypotheses were tested at 0.05 level of significance. Based on the result of this study, it is concluded that Secondary School students' in Uyo Metropolis Area differ significantly in terms of parenting problem based on parent-child relationship, parent level of education and family size of students. It is recommended that Seminars, workshops, and symposia on family size should be organized for parents. This will make them aware of family size as it influences secondary school students, thus parents will also control the family size through birth control mechanisms.

Education is viewed as a tool for change. Globally, efforts are geared toward enhancing the educational process of students' academic achievement in secondary schools. However, there is gap associated with differences in the students' attributes, and the desire for parents to provide better educational opportunities to their children. To achieve the goal of this research, students from Katsina State Science and Technical Education Board (STEB) were purposively selected for the study. Random sampling technique was used to select 300 students from six secondary schools. Primary data were collected using a structured questionnaire designed to address the specific objectives of the study. Cramer's V and stepwise regression model were used as tool of analyses to achieve the stated objectives of the study. Age of students was found statistically related to students' academic achievement using Cramer's V. The regression model has an R2 (0.915) implying that 92% of the total variations in students' academic achievement was accounted for by the independent variables. The F statistic was also reliably fit and statistically significant at p = 0.001 confidence level. Of the nineteen variables, nine were statistically significant and show effect on students' academic achievement. The significant variables that were positively related to academic achievement are: parent education, parent occupation, family feeding, provision of resource materials, visits to schools, provision of pocket money, and residential type. Family type and age category of parents had negative effects on students' academic achievement. We recommend for an intensified public enlightenment and awareness campaign on family planning and child spacing as well as dilution of family resources to counter the effect of family type being a risk factor.

Recently, politics of education in Nigeria have shifted from urban to rural literacy, which led to the development of programmes such as the nomadic women's adult education programme. The primary objective of this study was to evaluate the efficacy of the programme's implementation strategies, and the extent to which the health educational objectives have been achieved and practised by the Fulani pastoral women. A qualitative narrative research design was used to collect social data from the participants. The choice of design considered the cultural interactive patterns and gender socialization process of the women's ethnic group. The data collection process involved focus-group interviews and participant observations, while data analysis included translation and transcription of the oral to text data, followed by categorization and coding processes which resulted in major expected and "ordinary" themes. Triangulation as a validity procedure was used to corroborate the stories of the women study participants. The study major findings revealed that the objectives of the programme have been achieved in the area of personal health empowerment, knowledge and practices that minimized reproductive morbidities, fostered better family planning practices, healthier food and nutritional practices, improved hygienic and sanitation practices, and child healthcare first-aid therapies. Excerpts from the women's "voices" are cited to support their health transformational claims. The paper concludes by elucidating major learner challenges, as well as suggesting administrative remedies that will minimize these, serve as a guide for future policy reforms and research and help sustain the transformational health practices of the women.

Clark and Murray examine the six Critical Performance Factors for Mega planning in an example drawn from the five-year history of the population program of a major west coast philanthropy. In this article, the authors describe the salience and scope of the population issue as it is relates to other global trends; the steps the foundation took to "scope" the program and establish measurable impacts. It rates performance against the critical factors, then looks at some specific country impacts five years later. This analysis will be incorporated into the plan revision. (Contains 2 figures and 4 notes.)

Outlines some of the population-related factors and effects upon the family and child. Because of their vested interests and wealth of experience in family life, home economists are challenged to take the lead in planning and providing curriculum materials, and to promote population education in the schools. (Author)

In Bauchi State, northern Nigeria, communities recognise short birth interval (kunika in the Hausa language) as harmful, but family planning is a sensitive topic. This paper describes the development of a culturally safe way to communicate about kunika in a conservative Muslim setting. The objective was to co-design culturally safe communication material, based on local knowledge about short birth interval, to share with women and men in households. Six community co-design groups of women and six of men (total 96 participants) reviewed summaries of their previously created maps of perceived local causes of kunika, categorised as frequent sex, family dynamics and non-use of contraception. They advised how these causes could be discussed effectively and acceptably with women and their husbands in households and suggested storylines for three short video docudramas about the prevention of kunika. The research team created the docudramas with a local producer and fieldworkers piloted their use in households. The design groups advised that communication materials should focus on child spacing rather than on limitation of family size. Even sensitive issues could be covered. People would not change their sexual behaviour but could be advised to use contraceptives to prevent kunika. The groups approved the final videos and six focus groups of visited women and men reported they were acceptable and helpful. Community co-design of communication about kunika was feasible and led to videos about a sensitive topic that were acceptable to ordinary men and women in communities in Bauchi. [ABSTRACT FROM AUTHOR]

Desired fertility measures are routinely collected and used by researchers and policy makers, but their self-reported nature raises the possibility of reporting bias. In this paper, we test for the presence of such bias by comparing responses to direct survey questions with indirect questions offering a varying, randomized, degree of confidentiality to respondents in a socioeconomically diverse sample of Nigerian women (N = 6,256). We find that women report higher fertility preferences when asked indirectly, but only when their responses afford them complete confidentiality, not when their responses are simply blind to the enumerator. Our results suggest that there may be fewer unintended pregnancies than currently thought and that the effectiveness of family planning policy targeting may be weakened by the bias we uncover. We conclude with suggestions for future work on how to mitigate reporting bias. [ABSTRACT FROM AUTHOR]

This document is a correction notice for an article on the demand for family planning in Nigeria. It includes a corrected version of Figure 1 and Table 3, which had missing information and formatting errors. The corrected Table 3 provides results for model Dsa, including independent variables, adjusted odds ratios, standard errors, and p-values. The correction aims to provide accurate and complete information for researchers studying family planning in Nigeria. The given text appears to be a statistical analysis of various factors related to family planning in Nigeria, including community-level variables and their effects. The publisher acknowledges errors in the text and apologizes for them. [Extracted from the article]

Introduction: The United Nations established the Sustainable Development Goals (SDGs) in 2015 to enhance global development. In this study, we examine an SDG indicator: the percentage of women aged 15–49 whose family planning needs are met by modern contraception (mDFPS). We evaluate both the factors influencing its coverage and its progress since 2015. Methods: We used nationally representative surveys data (Demographic and Health Surveys (DHS) and Performance Monitoring for Action (PMA)) from Ethiopia, Kenya, and Nigeria. We assessed predictors of mDFPS. We also computed mDFPS coverage across countries and subnational areas, assessing coverage changes from the SDGs onset to the most recent period, using a Bayesian model-based geostatistical approach. We assessed whether the subnational areas exceeded the minimum recommended WHO mDFPS coverage of 75%. Results: Varied individual and community-level determinants emerged, highlighting the countries' uniqueness. Factors such as being part of a female-headed household, and low household wealth, lowered the odds of mDFPS, while rural-residence had low odds only in Ethiopia and Nigeria. The results indicate mDFPS stagnation in most administrative areas across the three countries. Geographic disparities persisted over time, favouring affluent regions. The predicted posterior proportion of mDFPS and exceedance probability (EP) for WHO target for Ethiopia was 39.85% (95% CI: [4.51, 83.01], EP = 0.08) in 2016 and 46.28% (95% CI: [7.15, 85.99], EP = 0.13) in 2019. In Kenya, the adjusted predicted proportion for 2014 was 30.19% (95% CI: [2.59, 80.24], EP = 0.06) and 44.16% (95%CI: [9.35, 80.24], EP = 0.13) in 2022. In Nigeria, the predicted posterior proportion of mDFPS was 17.91% (95% CI: [1.24, 61.29], EP = 0.00) in 2013, and it was 23.08% (95% CI: [1.80, 56.24], EP = 0.00) in 2018. None of the sub-national areas in Ethiopia and Nigeria exceeded the WHO target. While 9 out of 47 counties in Kenya in 2022 exceeded the WHO mDFPS target. Conclusion: The study unveils demographic, geographic, and socioeconomic mDFPS disparities, signalling progress and stagnation across administrative areas. The findings offer policymakers and governments insights into targeting interventions for enhanced mDFPS coverage. Context-specific strategies can address local needs, aiding SDG attainment. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study delves into the intricate connection between educational achievement and decisions regarding family planning, alongside the escalating prevalence of single parenting. Existing literature suggests that children raised in single-parent households, particularly those led by mothers, may develop positive attributes. However, conversely, this scenario can also give rise to negative traits, contributing to societal issues. Moreover, choices related to engaging in unprotected sex, initial pregnancies, and assuming the role of a single parent may be influenced by one's educational attainment. Nevertheless, the study acknowledges the contradictory conclusions within the literature regarding the correlation between education and single parenting for unmarried women. This necessitates a thorough examination. Employing a mixed research methodology that is non-experimental, incorporating both quantitative and qualitative techniques, the study conducted an online survey via Facebook with the Nigerian Single Parent Lounge group due to the constraints imposed by the COVID-19 pandemic. The findings indicate that among highly educated women, education is linked to reduced fertility rates and delayed childbirth. The study identifies several contributing factors to single parenting, including heightened independence, delayed marriage, and the financial autonomy of educated women. Consequently, the paper proposes targeted family planning awareness initiatives, enhanced accessibility to contraceptives, and policy adjustments to assist women in managing their personal and professional lives. To address the complexities involved, the study recommends the introduction of programs aimed at aiding women in navigating family planning decisions in tandem with their employment. Additionally, cultural attitudes hindering highly educated women from entering into marriage should be addressed, fostering a more inclusive societal perspective. [ABSTRACT FROM AUTHOR]

Background: Given the health and economic benefits of family planning (FP), Nigeria's very low demand for FP satisfied by modern methods (mDFPS) of less than 50% is therefore a major public health concern, especially considering the global target aimed at achieving an mDFPS of at least 75% by year 2030 for all countries. In view of this, together with recognising the possible contextual nature of health outcomes, this study aimed to empirically analyse the mDFPS among married or in-union women of reproductive age (WRA) in Nigeria. Materials and methods: A multilevel binomial logistic model with two levels of analysis was used: individual and community levels. Secondary cross-sectional data were obtained from the 2018 Nigeria Demographic and Health Survey, and analyses were performed using Stata 15.0. The analytical sample size was 9,122 WRA nested in a total of 1,072 communities. Results: The mDFPS was approximately 31.0%. The median odds ratio (MOR) estimated from the final multilevel model was 2.245, which was greater than the adjusted odds ratio (aOR) for most of the individual-level variables, suggesting that the unexplained/residual between-community variation in terms of the odds of women having their mDFPS was more relevant than the regression effect of most of the individual-level variables. This was with the exception of the regression effects of the following individual-level variables: women's husbands that had higher education level in comparison to their counterparts who had husbands with no formal education (aOR = 2.539; 95% CI = 1.896 to 3.399; p<0.001); and women from the Yoruba ethnic group in comparison to their counterparts from the Hausa/Fulani/Kanuri ethnic group (aOR = 2.484; 95% CI = 1.654 to 3.731; p value<0.001). However, other individual-level variables with positive statistically significant regression effects on mDFPS were: women who mentioned that money for accessing health care was not a problem; women's empowerment in relation to the visitation of family and relatives; and women being exposed to FP messages through various media sources, all in comparison to their respective counterparts. On the other hand, at the community level, women in communities where a high percentage of them had at least a secondary education had statistically significant greater odds of having mDFPS than women in communities with lower education levels (aOR = 1.584; 95% CI = 1.259 to 1.991; p<0.001). We found similar findings regarding women residing in communities with exposure to FP messages through various media sources. However, using the 80% interval ORs (80% IORs) as a supplemental statistical measure for further understanding the regression effects of community-level variables showed that all of the 80% IORs had a value of '1', signifying considerable uncertainty in the regression effects of all community-level variables due to the substantial residual variation existing between communities. Conclusions: Our study showed that to achieve the dire increase in mDFPS in Nigeria, policy interventions aimed at improving the education level of both females and males, especially beyond the secondary school level, should be implemented. Additionally, all of the various media sources should be extensively utilised, both at the individual and the community level, by the Nigerian government to spread information on the importance of women having their mDFPS. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Globally, women with disabilities are less likely to have access to family planning services compared to their peers without disabilities. However, evidence of effective interventions for promoting their sexual and reproductive health and rights remains limited, particularly in low- and middle-income settings. To help address disparities, an inclusive sexual and reproductive health project was developed to increase access to modern contraceptive methods and reduce unmet need for family planning for women of reproductive age with disabilities in Kaduna city, Nigeria. The project uses demand-side, supply-side and contextual interventions, with an adaptive management approach. This protocol presents a study to evaluate the project's impact. Methods: A pragmatic cluster-randomized controlled trial design with surveys at baseline and endline will be used to evaluate interventions delivered for at least 1 year at health facility and community levels in comparison to 'standard' state provision of family planning services, in the context of state-wide and national broadcast media and advocacy. Randomization will be conducted based on the health facility catchment area, with 19 clusters in the intervention arm and 18 in the control arm. The primary outcome measure will be access to family planning. It was calculated that at least 950 women aged 18 to 49 years with disabilities (475 in each arm) will be recruited to detect a 50% increase in access compared to the control arm. For each woman with disabilities enrolled, a neighbouring woman without disabilities in the same cluster and age group will be recruited to assess whether the intervention has a specific effect amongst women with disabilities. The trial will be complemented by an integrated process evaluation. Ethical approval for the study has been given by the National Health Research Ethics Committee of Nigeria and London School of Hygiene & Tropical Medicine. Discussion: Defining access to services is complex, as it is not a single variable that can be measured directly and need for family planning is subjectively defined. Consequently, we have conceptualized 'access to family planning' based on a composite of beliefs about using services if needed. Trial registration: ISRCTN registry ISRCTN12671153. Retrospectively registered on 17/04/2023. [ABSTRACT FROM AUTHOR]

The study comprehensively analyzed the nexus between economic growth, health expenditures, education, and the environment in Nigeria, using data obtained from Central bank of Nigeria and World Bank. By utilizing a robust dataset spanning from 1981 to 2021, the study employed autoregressive distributed lag (ARDL) approach to uncover intricate relationships. Results, both short-run and long-run analyses, reveal that health and education spending, and gross fixed capital formation positively correlated with economic growth. Conversely, the findings demonstrated that population growth and carbon dioxide emissions (CO2) exerted detrimental effects on economic growth due to the negative impact on the health of the working population. Additionally, the inverted U-shaped relationship between the macroeconomic footprint and income confirms the validity of Nigeria's Environmental Kuznets Curve (EKC) phenomenon. Lastly, the findings of this study hold important policy implications, emphasizing the need for technological advancements and innovative solutions to address the challenges associated with economic growth, health expenditures, education, and the environment in Nigeria. Policy measures promoting birth control through contraception and family planning should be embraced to effectively manage the country's rapidly growing population. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although interest in patient-centered family planning measures is growing, little is known about women's preferences for contraceptive methods and whether these preferences influence contraceptive behaviors. OBJECTIVE: We assessed whether the fulfillment of contraceptive preferences affected women's decisions to continue, switch, or stop using contraception. METHODS: Data came from a panel of urban Kenyan, Nigerian, and Senegalese women collected between 2010-2015. Women who were not using contraception at baseline and intended to use reported their preferred contraceptive method, and then at the second round reported their contraceptive use, which permits us to measure whether they fulfilled their baseline preference. We then examined whether fulfilling their contraceptive preference was associated with the decision to continue, switch, or stop using contraception by the third round by estimating a set of probit and bivariate probit models. RESULTS: After controlling for individual, household, and health system characteristics, women with fulfilled contraceptive preferences were 25 percentage points less likely to stop or switch contraceptive methods than women with unfulfilled contraceptive preferences. CONCLUSIONS: Fulfilling contraceptive preferences is associated with later contraceptive behavior, which demonstrates the importance of these preferences for achieving family planning goals. CONTRIBUTION: This study is important because it is the first research looking at the relationship between the fulfillment of contraceptive method preferences and contraceptive continuation in low- and middle-income countries. Women have a high probability of adhering to their contraceptive method when using a method that satisfies their contraceptive preferences. [ABSTRACT FROM AUTHOR]

Background: In Nigeria, in-service trainings for new family planning (FP) methods have typically been conducted using a combination of classroom-based learning, skills labs, and supervised practicums. This mixed-methods study evaluated the feasibility, acceptability, provider competency, and costs associated with a hybrid digital and in-person training model for the hormonal intrauterine device (IUD). Methods: The study was conducted in Enugu, Kano, and Oyo states, Nigeria, and enrolled FP providers previously trained on non-hormonal IUDs. Participants completed a digital didactic training, an in-person model-based practicum with an Objective Structured Clinical Examination (OSCE), followed by supervised provision of service to clients. Provider knowledge gains and clinical competency were assessed and described descriptively. Data on the feasibility, acceptability, and scalability of the approach were gathered from participating providers, clinical supervisors, and key stakeholders. Training costs were captured using an activity-based approach and used to calculate a cost per provider trained. All analyses were descriptive. Results: Sixty-two providers took the hybrid digital training, of whom 60 (91%) were included in the study (n = 36 from public sector, n = 15 from private sector, and n = 9 both public/private). The average knowledge score increased from 62 to 86% pre- and post-training. Clinical competency was overall very high (mean: 94%), and all providers achieved certification. Providers liked that the digital training could be done at the time/place of their choosing (84%), was self-paced (79%), and reduced risk of COVID-19 exposure (75%). Clinical supervisors and Ministry of Health stakeholders also had positive impressions of the training and its scalability. The hybrid training package cost $316 per provider trained. Conclusions: We found that a hybrid digital training approach to hormonal IUD service provision in Nigeria was acceptable and feasible. Providers demonstrated increases in knowledge following the training and achieved high levels of clinical competency. Both providers and clinical supervisors felt that the digital training content was of high quality and an acceptable (sometimes preferable) alternative to classroom-based, in-person training. This study provided insights into a hybrid digital training model for a long-acting contraceptive, relevant to scale-up in Nigeria and similar settings. [ABSTRACT FROM AUTHOR]

Background: The availability of contraceptives, family planning guidelines, and Information, Education, and Communication (IEC) materials can increase access to family planning services. This study assessed the availability of commodities and readiness of primary health care (PHC) facilities in Delta State to offer family planning services. Methods: A cross-sectional design with an explanatory mixed-method approach was used i.e., the authors first collected the quantitative data, and after preliminary analysis of quantitative information, the qualitative approach was utilised to gather data on the perspectives of 32 PHC facility managers and 6 reproductive health supervisors on factors affecting family planning service availability and readiness. Results: Twenty-one (65.6%) of the PHC facilities surveyed offered at least five modern methods of family planning. Stock-outs of emergency contraceptives, implants, intra-uterine contraceptive device (IUCD), oral contraceptive pills (OCP), condoms, and injectables were observed in 31 (96.9%), 17 (53.1%), 13 (40.6%), 4 (12.5%), 2 (6.3%), and 1 (3.1%) of the facilities respectively. Eleven (34.4%) and 8 (25.0%) of the facilities had IEC materials and family planning guidelines, and contraceptive commodity checklists respectively. Seventeen (53.1%) of the facilities did not have complete records of family planning activities. Conclusion: This study shows that a significant proportion of PHC facilities had stock-outs of contraceptive commodities, no complete records of contraceptive activities, no IEC materials and no family planning checklists. Continuous training of health providers and increased government commitment can help to improve contraceptive services. [ABSTRACT FROM AUTHOR]

The objectives of the study were to examine the influence of timing of first marriage on women's ability to negotiate safer sex, and to identify other drivers of women's ability to negotiate safer sex. Women's data of 2018 Nigeria Demographic and Health Survey were analysed. Three binary logistic regression models were fitted. Findings showed that 58.5% of the women had high ability to negotiate safer sex. The fitted models showed that the odds of high ability to negotiate safer sex were higher among women who delayed marriage compared to women who married early. A number of socio-demographic and relational characteristics also significantly drive high ability to negotiate safer sex. Early marriage hinders women from gaining total control of their sexual lives. The development of more sexual health promotion strategies is imperative in Nigeria. [ABSTRACT FROM AUTHOR]

Background: This research investigated the determinants of the number of family planning consumers in Kenya, Nigeria and Uganda, with a focus on outlet's and provider's characteristics which are important factors influencing the choice of using contraceptive methods but largely unexplored in previous literature. Methods: We utilized a unique panel survey on outlet's in Kenya (n = 1,321), Nigeria (n = 1,255) and Uganda (n = 842), which is part of the Consumer Market for Family Planning conducted in between 2019 and 2020, for the analysis of the pooled data (n = 3,418) and individual country. Random effects Poisson regressions were performed. Results: The pooled data results showed that the expected number of consumers were significantly lower in Nigeria and Uganda than in Kenya, and that working experience (provider's characteristics), types of stores, duration of providing family planning services, participations in community outreach and host community events, and sign of family planning services (outlet's characteristics) were significant determinants of the number of customers. The results for each country revealed interesting similarities and differences in the determinants across the three countries. Conclusions: This study sheds light on the relationship between the number of family planning customers and outlet's and provider's characteristics, thus providing informative evidence-based to on-going debates on the coverage of family planning services, which is still insufficient in developing countries. As a result, the government's family planning expenditures should instead prioritize small, private enterprises such as pharmacies or drug stores. Furthermore, it is critical to focus on several critical tasks to improve the qualities of outlets and providers to attract customers, such as ensuring that they are eye-catching, advertising FP services, have professional credentials, fulfil providers' obligations to counsel contraceptive users, provide long-term services and community care, and have female providers. [ABSTRACT FROM AUTHOR]

Background: The unmet need for limiting childbearing (UNLC) remains a problem in Nigeria. Conception after four pregnancies is considered a high-risk pregnancy. We examined the level, reasons for non-use of contraception, and predictors of UNLC among high parity (≥ 4 live birth) women in Nigeria. Methods: This cross-sectional design study was based on the analysis of nationally representative weighted data (2018 Nigeria Demographic Health Survey). The study focused on high-parity women of reproductive age (n = 4260) who do not want to have any more children irrespective of the number of their surviving children. Multi-stage cluster sampling approach was used for sample selection. Data were analyzed using logistic regression (α0.05). Results: Mean age of the respondents and children ever born was 38.92 ± 5.7 and 6.54 ± 2.3 respectively. The prevalence of UNLC was 40.9%, higher in the rural (48.8%) than urban (32.8%) areas, highest among women with no formal education (52.0%), higher among Muslims (48.4%) than Christians (34.8%), highest in the North-West (51.7%) and least in the South-East (26.1%). The most reported reasons for non-use of family planning (FP) were; respondents opposed (25.0%), infrequent sex (15.0%), fatalistic (13.2%), husband/partner opposed (11.2%), fear of side effects/health (8.5%), and religious prohibition (3.3%). The odds of UNLC was 100% higher among women aged 40–49 years compared to the younger women in age group 20–29 years. Living in the rural area predisposes high parity women of reproductive age to higher risks of UNLC (OR = 1.35, 95% C.I = 1.14–1.59, p < 0.001). Lack of access to family planning information through health workers (OR = 1.94, 95% C.I = 1.63–2.30, p < 0.001) increased the risks of UNLC. Being an Igbo or a Yoruba ethnic group was protective for UNLC compared to Fulani/Hausa women. Conclusions: A high level of UNLC was found among high-parity women in Nigeria. Access to FP information reduces the risk of UNLC. Expanding FP services would help respond to the expressed desires for contraception among high-parity Nigerian women who want to stop childbearing. [ABSTRACT FROM AUTHOR]

Introduction: the decision of men is pertinent to contraceptive uptake in a patriarchal society like Nigeria. Earlier studies on contraception in Nigeria have focused majorly on women. In this paper, we identified factors influencing contraceptive use, and non-users' perceptions about family planning among Nigerian men. Methods: using data from the 2018 Nigeria Demographic and Health Survey, this retrospective cross-sectional study focused on men aged 15-59 years. Three outcome variables were analysed: modern contraceptive use categorised as non-users or users; perception about contraception captured using two statements- "contraception is woman's business"; "women who use contraception may become promiscuous". Data were analyzed using multivariable logit model with robust standard errors (α = 0.05). Results: mean age of the men was 37.3 years (SD=10.2). Out of 9622 study participants, 71.0% do not use any modern contraceptive method; 19.9% believed that contraception is woman's business while 38.1% believed that women who used contraceptives may become promiscuous. Significant predictors of non-use of contraceptives and perceptions about family planning were older age, low education, Islamic religion, exposure to family planning messages, desire for more children and residence in Northern part of Nigeria. Conclusion: large proportion of contraceptive non-users had negative perceptions. Educational intervention and advocacy among Nigerian men are essential to increase contraceptive uptake. [ABSTRACT FROM AUTHOR]

This study analyses the use of multimodal semiotic resources in the Family Planning campaign materials of the Nigerian Urban Reproductive Health Initiative's (NURHI) 'Get It Together' (GIT) campaign which aims to persuade individuals and families, families to adopt family planning and thus significantly reduce the country's high fertility and maternal mortality rate. Using Kress and Van Leeuwen's (2006) visual grammar in Reading Images and Van Leeuwen's (2008) social actor framework in Discourse and Practice, combined with research in the Nigerian social and cultural context, the study finds that the campaign uses both visual and verbal means to create awareness of contraceptive methods and to counter misconceptions about them. The author also finds that the campaign primarily addresses married couples and includes people from different ethnoreligious backgrounds, but excludes young people, subtly affirming 'sexual abstinence' before marriage. Furthermore, the campaign uses a range of strategies for persuading Nigerians to adopt family planning, including linking the adoption of family planning to the benefits of a modern urban lifestyle, engaging religious and community leaders as supporters of the campaign and countering patriarchal traditions by promoting the participation of men in family planning. [ABSTRACT FROM AUTHOR]

Background: Patent medicine vendors (PMVs) play vital roles in the delivery of family planning services in Nigeria and other developing countries. There is a growing recognition of the need to integrate them into the formal health care system as a strategy to increase the contraceptive prevalence rate and achieve universal health coverage. Though promising, the success of this proposition is largely dependent on a critical analysis of the factors which influence their operations. This study was designed to identify the contextual factors influencing the provision of injectable contraceptive services by PMVs and the broader effects of their activities on the health system to inform similar interventions in Nigeria. Methods: This was a qualitative study guided by the UK Medical Research Council's Framework for Complex Interventions. Twenty-seven in-depth interviews were conducted among officials of the association of PMVs, health workers, government regulatory officers and programme implementers who participated in a phased 3-year (2015–2018) intervention designed to enhance the capacity of PMVs to deliver injectable contraceptive services. The data were transcribed and analyzed thematically using NVIVO software. Results: The contextual factors which had implications on the roles of PMVs were socio-cultural and religious, the failing Nigerian health system coupled with government regulatory policies. Other factors were interprofessional tensions and rivalry between the PMVs and some categories of health care workers and increasing donors' interest in exploring the potentials of PMVs for expanded healthcare service provision. According to the respondents, the PMVs bridged the Nigerian health system service delivery gaps serving as the first point of contact for injectable contraceptive services and this increased contraceptive uptake in the study sites. A negative effect of their operation is the tendency to exceed their service provision limits, which has spurred a planned tiered PMV accreditation system. Conclusions: This study has highlighted the contextual factors which define the roles and scope of practice of PMVs involved in injectable contraceptive service provision. Strategies and interventions aimed at expanding the healthcare delivery roles of PMVs must be encompassing to address the broader contextual factors which underpin their capacities and functions. [ABSTRACT FROM AUTHOR]

Background: Reports from various parts of the world suggest that the COVID-19 pandemic may have severe adverse effects on the delivery and uptake of reproductive health, maternal, neonatal, and child health (RMNCH) services. The objective of the study was to explore women's experiences with utilization of RMNCH services during the COVID-19 pandemic in Nigeria, and to elicit their perceptions on ways to sustain effective service delivery during the pandemic. Methods: A cross-sectional survey of 2930 women using primary health care facilities for antenatal, delivery, postnatal, and child care services before and after the onset of the pandemic in 10 States of Nigeria were interviewed with a semi-structured questionnaire. Data were collected on women's socio-demographic characteristics and pregnancy histories, the services they sought before and after the pandemic, the challenges they faced in accessing the services, their use of alternative sources of health care, and their recommendations on ways to sustain RMNCH service delivery during the pandemic. The data were analyzed with descriptive statistics, and multivariable logistic regression using SPSS 20.0. All the statistical analyses were two-tailed with a 95% confidence interval, and the p-value was set at 0.05. Results: The logistic regression results showed that women were at least 56% more likely to report that they used family planning, antenatal, and delivery services before the pandemic than after the pandemic started, but 38% less likely to report use of postnatal services. The experience of difficulty accessing RMNCH services was 23% more likely after the pandemic started than before the pandemic. Three categories of recommendations made by the respondents on measures to sustain RMNCH delivery during the pandemic included 1) facility improvement, and staff recruitment and re-training; 2) free and readily accessible PHC services, and 3) the provision of social safety nets including transportation and palliatives. Conclusion: We conclude that the COVID-19 pandemic limited women's access to antenatal, delivery, and childcare services offered in PHCs in Nigeria. Addressing the recommendations and the concerns raised by women will help to sustain the delivery of RMNCH services during the COVID-19 pandemic and future epidemics or health emergencies in Nigeria. [ABSTRACT FROM AUTHOR]

Background: Postpartum family planning is vital in the prevention of unintended pregnancy and closely spaced pregnancies in the first year post-delivery. This study was designed to examine the postpartum women's knowledge, attitude, belief and readiness to contraceptive use. Methods: This descriptive cross-sectional study was conducted among one hundred and ninety-four consenting women, six weeks post-delivery, at the University College Hospital, Ibadan, Nigeria using an interviewer-assisted structured questionnaire. Data was analysed using IBM Statistics for Windows Version 23.0. Tests of association was done using chi-square and statistical significance was set at p-value of < 0.05. Results: Many of the respondents (60.8%) were in the age group 30-39 years and the majority (90.3%) had tertiary level of education. Most of the respondents got their information from health talks at antenatal clinic (42.8%) and health workers (42.3%). The majority (82.5%) of respondents were aware of contraception and 157(80.9%) intended to use contraceptives. The most preferred contraceptive methods were implants(19.1%). Respondents with three or more children alive(p=0.001), had statistically significant associations with prior use of contraception while those with the tertiary level of education(p=0.001), of the Christian religion (p=<0.001) and had contraceptive counselling during pregnancy (p=0.031)had statistically significant associations with good knowledge of contraception. Conclusion: The knowledge and readiness to use contraceptives was high but only about half were willing to adopt contraception post-delivery. There is therefore the need for the enactment of government policy and legislation that will ensure wide coverage and availability of contraception counselling among pregnant women. [ABSTRACT FROM AUTHOR]

Background: In collaboration with local partners, we reviewed 18 national policy documents across two sub-Saharan African countries identified as pre-dividend nations by the World Bank in 2017: Nigeria and Tanzania. Our aim was to assess national policies in pre-dividend countries and to determine whether national strategies were primed to capitalize on changing demographic structures, maximally attain the demographic dividend, and augment socio-economic growth. Methods: We conducted policy reviews by focusing on five key sectors of the Gates Institute Demographic Dividend Framework: Family Planning, Maternal and Child Health, Education, Women's Empowerment, and Labor Market. This framework was developed as a tool for countries to apply targeted policies for accelerating the demographic dividend based on their demographic structure. For each component we used a comprehensive list of indicators, defined via a systematic literature review, through which we assessed national policies aimed at maximizing the demographic dividend. Results: Between the two countries, we observed persistent gaps in policies targeting family planning. Although more comprehensive, policies addressing maternal and child health, education, women's empowerment, and labor market still lagged in their specificity and measurability. We identified specific policy amendments and alternatives that Nigeria and Tanzania could consider to mitigate these gaps. We also stress the importance of designing measurable policy initiatives across sectors. Conclusions: Based on these recommendations, as Nigeria, Tanzania, and other pre-dividend nations start experiencing rapid demographic changes, they may consider implementing routine policy reviews to strengthen policies across the five key sectors and harness the benefits of a demographic dividend. [ABSTRACT FROM AUTHOR]

Background: Long-acting reversible contraceptives (LARCs), including hormonal implants and intrauterine devices, are highly effective pregnancy prevention methods. Aside its advantages over other hormonal methods, LARCs are cost-effective, easy to maintain, and have a low risk of non-compliance-related method failure. Besides, LARCs are also relatively safe for all sexually active women in the postpartum or post-abortion period. However, despite its effectiveness, most sexually active women use other short-term methods, such as condoms and contraceptive pills, which are associated with high discontinuation rates. Thus, this study examines the spatial distribution and multilevel factors associated with LARC use among sexually active reproductive-age women in Nigeria. Methods: This is a cross-sectional analysis of a population-based study from the 2018 Nigeria Demographic Health Survey (NDHS). The NDHS is a nationally representative survey that collects data on socio-demographic characteristics, sexual and reproductive health-related indicators such as contraceptive use and child & maternal health. A sample of 3,978 sexually active reproductive-age women (15–49 years) in Nigeria was used in the analysis. Frequency distribution and spatial analysis of LARC use were displayed with tables and maps, respectively, while multilevel analysis at a 95% confidence interval (CI) and a p-value of less than 0.05 was used to determine factors associated with LARC use among the sample. Results: The spatial distribution of LARC use among sexually active women of reproductive age in Nigeria ranges between 20 and 34.8%. Fifteen of the 36 states (excluding the Federal Capital Territory, FCT) recorded low utilization of LARCs. These states include Adamawa, Lagos, Ogun, Enugu, Anambra, Imo, Abia, Rivers, Kogi, Taraba, Yobe, Gombe, Jigawa, Borno, and Kebbi. Besides, the likelihood of LARC use was lower among participants with a prior history of pregnancy termination [aOR = 0.62; 95%(CI = 0.48–0.80)] compared to their counterparts without pregnancy termination history. Also, participants with no fertility intention had a higher likelihood of using LARCs [aOR = 1.65; 95%(CI = 1.30–2.08)] compared to those with fertility intention. At the community level, women with higher socioeconomic status were less likely to use LARCs [aOR = 0.66; 95%(CI = 0.45–0.97)] compared to women with lower socioeconomic status. Conclusions: This study showed a relatively low utilisation of LARC among sexually active reproductive-age women in Nigeria. Notably, this low utilisation is also common in states that could be described as cosmopolitan, indicating a need for closer investigation to understand context-specific factors associated with LARC use. Population-specific family planning education and counselling for this population are important to address common misconceptions about LARCs in particular and modern contraceptive use in general. [ABSTRACT FROM AUTHOR]

Background: Family planning (FP) is an important public health intervention that is proven to reduce unplanned pregnancies, unsafe abortions, and maternal mortality. Increasing investments in FP would ensure stability and better maternal health outcomes in Nigeria. However, evidence is needed to make a case for more domestic investment in family planning in Nigeria. We undertook a literature review to highlight the unmet needs for family planning and the situation of its funding landscape in Nigeria. A total of 30 documents were reviewed, including research papers, reports of national surveys, programme reports, and academic/research blogs. The search for documents was performed on Google Scholar and organizational websites using predetermined keywords. Data were objectively extracted using a uniform template. Descriptive analysis was performed for quantitative data, and qualitative data were summarized using narratives. Frequencies, proportions, line graphs and illustrative chart were used to present the quantitative data. Although total fertility rate declined over time from 6.0 children per woman in 1990 to 5.3 in 2018, the gap between wanted fertility and actual fertility increased from 0.2 in 1990 to 0.5 in 2018. This is because wanted fertility rate decreased from 5.8 children per woman in 1990 to 4.8 per woman in 2018. Similarly, modern contraceptive prevalence rate (mCPR) decreased by 0.6% from 2013 to 2018, and unmet need for family planning increased by 2.5% in the same period. Funding for family planning services in Nigeria comes from both external and internal sources in the form of cash or commodities. The nature of external assistance for family planning services depends on the preferences of funders, although there are some similarities across funders. Irrespective of the type of funder and the length of funding, donations/funds are renewed on annual basis. Procurement of commodities receives most attention for funding whereas, commodities distribution which is critical for service delivery receives poor attention. Conclusion: Nigeria has made slow progress in achieving its family planning targets. The heavy reliance on external donors makes funding for family planning services to be unpredictable and imbalanced. Hence, the need for more domestic resource mobilization through government funding. [ABSTRACT FROM AUTHOR]

Introduction: the ravaging COVID-19 pandemic has worsened the levels of unmet need (UMN) for family planning (FP). A pulse survey showed that FP services were interrupted during the lockdown in 68% of countries. There is a need to investigate the demand gap for FP among women in the postpartum period. This study aimed to determine the prevalence and predictors of UMN of FP among women in the extended postpartum period attending immunization clinics. Methods: this was a facility-based cross-sectional study among 485 women recruited from 5 health facilities using a random sampling technique and proportional to size allocation. Data was collected using an interviewer-structured questionnaire. Analysis was done using IBM SPSS version 26. Adjusted odds ratios with 95% confidence intervals were computed. The level of significance was 5%. Results: the total unmet need was 45.4% (95% CI: 40.2--50.7) with a higher need for child spacing (60.4%) compared to limiting pregnancies (39.6%). The mean age was 30.3 ± 6.1 years. The significant predictors included age [35-39 years (aOR=5.39, 95% CI: 1.61-18.06); ≥ 40 years (aOR= 32.48, 95% CI: 6.48-162.77)], lower education status (aOR= 5.21, 95% CI: 2.09-13.01), lower income (aOR =2.21, 95% CI: 1.10-4.46), rural residence (aOR= 4.27, 95% CI: 2.15-8.47), denomination [Pentecostal (aOR= 4.09, 95% CI: 1.77-9.43); Orthodox (aOR= 5.44, 95% CI: 2.03-14.58)] and poor knowledge of postpartum FP (PPFP) (aOR= 33.93, 95% CI: 13.21-87.12). The commonest reason for FP non-use was fear of side effects. Conclusion: close to half of the women in the extended postpartum period experienced UMN for PPFP. Policymakers should consider these factors when designing FP interventions. [ABSTRACT FROM AUTHOR]

Background. Family planning (FP) is essential for improving health and achieving reproductive goals. Although men are important participants in FP decision-making within households in Nigeria, a country with one of the highest rates of maternal mortality, we know very little about their exposure to mass media FP messages. Methods. Drawing theoretical insights from the structural influence model of health communication and using the 2018 Nigeria Demographic and Health Survey (n = 13,294), and applying logistic regression analysis, we explored the factors associated with men's exposure to mass media FP messages in Nigeria. Results. A range of socioeconomic, locational, and demographic factors were associated with men's exposure to mass media FP messages. For example, wealthier, more educated, and employed men were more likely to be exposed to mass media FP messages than their poorer, less educated, and unemployed counterparts. In addition, compared to those in rural areas and other regions, men in urban areas as well as South East Region, were more likely to be exposed to mass media FP messages. Finally, younger men and those who belong to the traditional religion were less likely to be exposed to mass media FP messages, compared to their older and Christian counterparts. Conclusions. Based on these findings, we discuss implications and recommendations for policymakers as well as directions for future research. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to determine the prevalence and relationship between sexual autonomy and modern contraceptive use among Nigerian women. Methods: Secondary data analysis of the 2018 Nigerian Demographic and Health Survey was conducted among Nigerian women aged 15-49 years who were married or had a partner. Analysis was conducted using descriptive analysis and univariate and multivariate logistic regression. P < 0.05 was considered statistically significant. Results: Participants that had never heard or seen a family planning awareness message were 59.6%, whereas 55.9% were capable of deciding whether to refuse their husband/partner's sex or not. The prevalence of modern contraceptive use was 12%, and the likelihood of using modern contraceptives increased with the level of education, wealth status, and the number of living children. Sexual autonomy was also a significant predictor of modern contraceptive use (odds ratio = 1.35, 95% confidence interval: 1.25-1.46). Conclusion: There is a very low prevalence of modern contraceptive use among women in Nigeria. Sexual autonomy, poverty, education, and the number of living children play a major role. Thus, women empowerment and girl-child education are critical interventions needed for the best outcomes on contraceptive use in Africa. Male involvement in sexual autonomy is also key since they are major decisionmakers regarding women's issues. [ABSTRACT FROM AUTHOR]

Food insecurity remains a serious threat to development in developing countries globally. Several studies have been conducted on food insecurity. However, none of these studies have focused on the relationship between microfinance households' food security status and the attributes of the microcredit they accessed. Therefore, this study was carried out to bridge this gap by providing relevant information in this regard. The paper therefore presents a food insecurity profile of rural microcredit households in Ekiti State, Nigeria. A multi-stage sampling technique was used to select 386 households for this study. Data collection was carried out using a wellstructured questionnaire. Descriptive statistics and Foster, Greer and Thorbecke (FGT) food security index were used to achieve the study objectives. The findings revealed that the average age of a rural microcredit household head was 47.28 years, while the average household size was 7 people. Average credit borrowed by the respondents was about N78,012.01. It was further revealed that average monthly food expenditure per capita was N3,108.41 from which a food security line of χ2,072.27 was determined. Based on the estimated food security line, 62% and 38% of the respondents were classified as food secure and food insecure, respectively. Furthermore, the study showed that food insecurity incidence was most prevalent among respondents that were over 60 years, as 86% of them were food insecure. The results further showed that respondents with no formal education were more food insecure than their counterparts with formal education as 78% of them were food insecure. Also, those with more than 12 people in their households showed higher incidence of food insecurity, as 90% of them are food insecure. Furthermore, respondents without microcredit facility exhibited higher food insecurity incidence than those with microcredit facility, as 64% of them were food insecure. The paper concludes that food insecurity is very rife in the study area. Therefore, the study suggests that efforts should be directed towards acquisition of basic education which could enhance the earning potentials of respondents and provision of social security services. Coupled with an intensive campaign on birth control and family planning, this could enhance respondents' access to microcredit facilities and invariably lower the food insecurity situation in the study area. [ABSTRACT FROM AUTHOR]

This study evaluated the extent to which married Idoma (Benue State) and Igala people (Kogi State) in North-Central Nigeria were exposed to the 2017 National Family Planning Communication Campaigns. The study also examined their level of knowledge, the extent to which they adopted the campaign messages, and how Alekwu/Ibegwu and other socio-cultural factors influenced their level of adoption of the campaign messages. The study adopted a quantitative (questionnaire survey) research method. The data were subjected to a descriptive analysis, correlation, ANOVA, Pearson Product Movement Correlation (PPMC), and Binary Logistics Regression. The findings showed that the majority of the people were exposed to information on condoms, implants, and Intrauterine Contraceptive Devices (IUCDs) (Cuppar T) in the course of the campaign; however, most of them were not exposed to information on Oral Pills, Vasectomies, Tubal ligation and Injections. Findings also revealed that knowledge of modern family planning in the study areas (51.2%) was below the 85.8% national family planning knowledge threshold and far below the expected 95% target of the 2017–2020 family planning communication campaign goal. Findings equally showed poor adoption of the campaign messages due to their cultural beliefs. The study concluded that family planning was often accepted among people whose ways of life have been significantly altered in favour of the idea. [ABSTRACT FROM AUTHOR]

This study evaluated the perception of patent and proprietary medicine vendors (PPMVs) of the accreditation programme to improve their capacity to provide family planning (FP) services in Lagos and Kaduna, Nigeria. A cross-sectional mixed-method approach among 224 PPMVs was used to investigate their perception, willingness to pay for and adhere to the programme, its benefits, and the community women's perception of the value of PPMVs. Chi-square analysis and structural equation modelling (SEM) were used to analyse survey data, while focus group discussions (FGDs) were analysed using the grounded theory. PPMVs were enthusiastic because of the benefits, including increased clientele, revenue, and improved service provision capacity. Approximately 97% of PPMVs found the programme acceptable and were willing to pay, with 56% and 71% willing to pay between N5000-N14900 ($12–36) and N25000-N35000 ($60–87), respectively. A significant relationship between educational attainment, location, and willingness to pay was revealed. Among community women, the fear of side effects, lack of partners' support, myths and misconceptions, and lack of access to modern contraceptives were factors affecting contraceptive uptake. The capacity of PPMVs to improve FP uptake is promising and can be leveraged to improve health outcomes in communities while strengthening their businesses. [ABSTRACT FROM AUTHOR]

Background: It is predicted that the population of sub‑Saharan Africa will be thrice its size by the end of the 21st century. Our study compared patterns, incentives and disincentives for the uptake of contraceptives in rural and urban communities of Lagos, Nigeria. Materials and Methods: This is a population‑based cross‑sectional study on 1445 women of reproductive ages 15–49 years using a cluster sampling technique and a pre‑tested, interviewer‑administered electronic questionnaire in 2020. Data were analysed using the Statistical Package for the Social Sciences (SPSS) software version 26.0 and ethical approval was obtained for the study. Results: About 32.4% of the respondents were rural dwellers and 67.6% were urban residents. The overall mean age was 31.7 ± 7.8 years. In terms of pattern, slightly over half (53.3%) of all respondents had ever used family planning (FP), including modern contraceptives and slightly less than a third (30.8%) currently use FP methods in both rural and urban communities, respectively. Predominant disincentives for non‑use of FP include a desire to retain fertility, lack of further need, unbearable side effects and lack of spousal support. The odds of being an urban dweller currently using a method of contraceptive method is 4.169 times higher for earners above ₦60,000, which is twice the minimum wage compared to those without income (adjusted odd’s ratio: 4.169, 95% confidence interval: 1.395–12.462). Conclusion: Sustained effort is required to improve contraceptive uptake, FP service delivery and demand satisfaction for modern contraceptives to enable the achievement of demographic dividends and gains. [ABSTRACT FROM AUTHOR]

Background: Injectable contraceptives have contributed substantially to Nigeria's rise in modern family planning methods usage. They are one of the most commonly used and preferred means of contraception among women in the country. Enabling policies are required to assure contraceptive access, security, and use. This study aimed to investigate the policy environment and how it supports or limits Nigeria's introduction and scale-up of subcutaneous depot-medroxyprogesterone acetate (DMPA-SC). Methods: The design of this mixed-methods study was cross-sectional. Desk reviews of policy papers, key informant interviews, and in-depth interviews were used to obtain information from respondents about the introduction of DMPA-SC in Nigeria and how existing policies influenced its scale-up. Data on DMPA-SC and other injectables were gathered from Nigeria's national electronic logistics management information system. Results: The findings suggest that policies such as task-shifting and task-sharing, cost-free policies, reproductive health policies, and others created an enabling environment for the scale-up of DMPA-SC adoption in Nigeria. The inclusion of DMPA-SC on the essential medicines list and the approved patent medicines list facilitated the scale-up process by ensuring private sector participation, removing economic barriers to access, fostering greater collaboration among health worker cadres, improving intersectoral partnerships, and improving logistics and client access. Despite significant anomalies in some implementing policies, injectable contraceptive consumption data demonstrate a progressive increase in DMPA-SC use during the study period. The results also indicate that policy initiatives have a favorable impact on the use of DMPA-SC throughout the country. Conclusion: The existence of policies, the active participation of stakeholders, and the political will of the Nigerian health system's leadership have all aided in the scaling-up of the DMPA-SC. Understanding how to build an enabling policy climate is critical for providing women with family planning options. These lessons from Nigeria emphasize the importance of these levers, which should be considered by teams intending to introduce innovative health products, particularly in developing countries. [ABSTRACT FROM AUTHOR]

Introduction: Sexual and reproductive health of young people involve a lot of stakeholders, traverse different sectors, and cut across all levels of government. For a clearer understanding of the activities of these stakeholders in adolescent sexual and reproductive health (ASRH) services, this paper was designed to explore the positions, attitudes and involvements of government/public institutions and non-governmental organizations (NGOs) in ASRH policy-making processes and implementations in Ebonyi State, Nigeria.Methods: The evidence was generated from a cross-sectional qualitative study, with data collected through in-depth interviews and focus group discussions from 81 and 59 stakeholders in adolescent sexual and reproductive health, respectively. A mapping tool was used for the stakeholder analysis.Results: The State Ministry of Health (MOH) was identified as playing a major role in ASRH policy development and so was categorized as a 'savior'. However, out of nine public institutions, four were categorized as 'trip wire' because they had non-supportive attitudes, weak powers and passive interests in ASRH policies and programs. All the NGOs were categorized as 'friend', because of their weak, but favorable disposition to ASRH policy-making processes. Regarding the implementation of ASRH programs, most public institutions were categorized as 'savior'. Similarly, most of the institutions were classified as 'trip wire' at the local government level, in relation to ASRH policy development. Only, the offices of traditional rulers/village heads and local government administrative secretaries were regarded as 'friend', while the public schools were classified as an 'acquaintance'. Concerning the implementation of ASRH programs at this level, public secondary schools, the offices of local government administrative secretaries and local government focal persons on ASRH were categorized as 'savior', while town union/ward development chairmen were considered 'friend'. Few stakeholders, including, religious leaders were classified as 'savior' regarding engagement with local authorities on ASRH matters.Conclusion: Although key stakeholders appear to play supportive roles in the implementation of ASRH programs in Ebonyi State, many of the relevant government and non-government institutions are not involved in the policy-making process. There is a need for more intentional and active involvement of relevant stakeholders in policy-making for better ownership and sustainability of ASRH interventions. [ABSTRACT FROM AUTHOR]

Background: Studies have identified various determinants of unmet need for contraception. These determinants cut across individual, household, community, and health facility levels. Despite this evidence, there remains a lack of information regarding differentials in the prevalence and determinants of unmet need for contraception among women in the low-priority segments (such as women of advanced reproductive age and women living with disabilities) and high-priority segments (such as adolescents, young adults, and unmarried women) for family planning demand generation, hence this study.Methods: The study design is cross-sectional. The study analyzed merged data from the individual, and persons recode of the 2018 Nigeria Demographic and Health Survey (NDHS). The samples analyzed are 5,147 women in the high-priority segment and 7,536 women in the low-priority segment. The outcome variable in the study was unmet need for contraception. The explanatory variables were selected at the individual, household, community, and facility levels. Statistical analyzes were performed using Stata 14. Three multilevel mixed-effects regression models were fitted. Model 1 was the empty model, while Model 2 included the sets of individual, household, and community variables. Model 3 controlled for the facility-level variables.Results: Findings show a higher prevalence of unmet need for contraception among women in the family planning low-priority segment compared to women in the family planning high-priority segment. Religion and desired family size were the two individual characteristics that significantly predicted the unmet need for contraception among women in the two segments. Sexual autonomy was the only household characteristic that predicted unmet need for contraception in both segments. There were differences in the community characteristics that predicted unmet need for contraception among women in the two segments.Conclusion: The prevalence of unmet need for contraception is not the same among women in low and high family planning priority segments. The determinants also differ among women in the two segments. Though, women in different family planning segments have the same contraceptive needs of avoiding pregnancy when not needed, however, getting the needs satisfied requires that existing programs be further examined to develop initiatives that will resonate with each segment of reproductive-age women. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: As more people now live in urban areas than in rural communities in Nigeria, urban development (UD) requires urgent policy and programmatic attention. Although the population factor has been identified as important to achieving national development goals, and evidence suggests that meeting the family planning (FP) and reproductive health (RH) needs of the vulnerable urban population can serve as an important recipe for achieving population growth rates consistent with building sustainable, habitable and prosperous urban settings, FP remains a neglected subject in UD initiatives in Nigeria. This study explored barriers and facilitators in achieving integrated policy formulation and implementation of FP and UD programmes in Nigeria.Methods: We conducted key informant interviews (n = 37) with relevant FP/RH and UD stakeholders in Ibadan and Kaduna-two megacities that have undergone several UD and FP intervention programmes in the south and north of Nigeria. The sample size was determined by data saturation. Data were organized using ATLAS.ti and NVivo 12 software, and analysis was conducted using a thematic approach.Results: We found that relevant government agencies largely work in silos. Other identified barriers to integrated policy formulation/implementation of FP and UD programmes in Nigeria include lack of knowledge about the FP-UD nexus between professionals, ineffective implementation and monitoring of existing guidelines, lack of policy documentation that clearly links FP and UD, and frequent transfer of government stakeholders. Notwithstanding the identified barriers, the study established ways of achieving synergy between FP and UD sectors, including stakeholder engagement, intersectoral collaborations, sensitization and publicity, roundtable discussion, interdisciplinary research, conferences and other interactive and knowledge-sharing fora.Conclusions: We conclude that addressing barriers to the intersectoral linkage between FP and UD is fundamental to achieving sustainable urbanization in Nigeria. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Post-abortion contraception enables women to effectively manage their fertility to prevent unintended pregnancies. Using data from population-based surveys of women aged 15-49 in Nigeria and Côte d'Ivoire, we examined contraceptive dynamics immediately before and after an abortion and examined factors associated with these changes using multivariable logistic regressions. Covariates included sociodemographic characteristics, abortion source, post-abortion contraceptive communication (wanting to and actually talking to someone about contraception after abortion), and perceived contraceptive autonomy. We observed higher contraceptive use after abortion than before abortion. In Nigeria, wanting to talk to someone about contraception post-abortion was associated with increased adoption and decreased discontinuation, whereas talking to someone about contraception post-abortion was associated with increased adoption. Obtaining care from a clinical abortion source was associated with increased adoption and decreased discontinuation. Both post-abortion contraceptive communication variables were associated with post-abortion contraceptive use in both countries, whereas clinical source was only associated with post-abortion contraceptive use in Nigeria. Our findings suggest that ensuring that women have access to safe abortion as part of the formal health care system and receive comprehensive, high-quality post-abortion care services that include contraceptive counseling enables them to make informed decisions about their fertility that align with their reproductive goals. [ABSTRACT FROM AUTHOR]

Area-based sampling approaches designed to capture pharmacies, drug shops, and other non-facility service delivery outlets are critical for accurately measuring the contraceptive service environment in contexts of increasing de-medicalization of contraceptive commodities and services. Evidence from other disciplines has demonstrated area-based estimates may be biased if there is spatial heterogeneity in product distribution, but this bias has not yet been assessed in the context of contraceptive supply estimates. The Consumer's Marker for Family Planning (CM4FP) study conducted censuses and product audits of contraceptive outlets across 12 study sites and 2–3 rounds of quarterly data collection in Kenya, Nigeria, and Uganda. We assessed bias in estimates of contraceptive product availability by comparing estimates from simulations of area-based sampling approaches with census counts among all audited facilities for each study site and round of data collection. We found evidence of bias in estimates of contraceptive availability generated from simulated area-based sampling. Within specific study sites and rounds, we observed biased sampling estimates for several but not all contraceptive method types, with bias more likely to occur in sites with heterogeneity in both spatial distribution of outlets and product availability within outlets. In simulations varying size of enumeration areas (EA) and number of outlets sampled per EA, we demonstrated that the likelihood of substantial bias decreases as EA size decreases and as the number of outlets sampled per EA increases. Straightforward approaches such as increasing sample size per EA or applying statistical weights may be used to reduce area-based sampling bias, indicating a pragmatic way forward to improve estimates where design-based sampling is infeasible. Such approaches should be considered in development of improved methods for area-based estimates of contraceptive supply-side environments. [ABSTRACT FROM AUTHOR]