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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.)

Cross-generational sexual relationships are a major route of transmitting HIV and STI between older and younger generations. However, previous research has focused mainly on the young women in these relationships. This study examined the characteristics of men engaging in non-marital sexual relationships with girls aged 15-19 in Nigeria. The data were drawn from the 2013 Nigeria Demographic and Health Survey, and the analysis was restricted to a sub-sample of 7557 men aged 30-49 who were sexually active in the 12 months prior to the survey. Data analysis was carried out using frequency distributions, chi-squared tests of association and binary logistic regression. It was found that 9.5% of men aged 30-49 reported engaging in cross-generational sexual relationships. Also, being older (OR = 0.35), married (OR = 0.37), having secondary or higher education (OR = 0.70; 0.59) and having sexual debut between ages 18 and 30 (OR = 0.73) were associated with a lower likelihood of having cross-generational sexual relationships. However, Muslim men (OR = 2.10), men from Igbo (OR = 1.90), Hausa/Fulani (OR = 8.47) and Northern and Southern minority tribes (OR = 4.73; 2.49), men living in rural areas (OR = 1.34), men who were over the age of 30 at sexual debut (OR = 2.67) and those with 2-4 and 5 or more lifetime sexual partners (OR = 1.43; 1.58) were significantly more likely to engage in cross-generational sexual relationships. Addressing the challenges of cross-generational sexual relationships can be an effective strategy to reduce the menace of HIV and STI transmission. Men who have low education, those aged 30-34 years, those who initiated sex at an older age, rural dwellers and those who have had several lifetime sexual partners need to be targeted while designing and implementing programmes and policies to reduce cross-generational sexual relationships in Nigeria. These interventions must also take into account the religious and cultural attitudes towards cross-generational sexual relationships, and further investigations should identify men's motives for engaging in the practice. [ABSTRACT FROM AUTHOR]

Gender inequality has been documented as a key driver of negative health outcomes, especially among women. However, studies have not clearly examined the role of gender inequality in maternal health in an African setting. Therefore, the authors of this study examined the role of gender inequality, indicated by lack of female autonomy, in exposing women to maternal health risk. Data were obtained from the 2007 Zambia Demographic and Health Survey on a weighted sample of 3,906 married or partnered women aged 15–49 years. Multivariable analyses revealed that low autonomy in household decision power was associated with maternal health risk (Odds Ratio (OR) = 1.52,p < .001). Autonomy interacted with household wealth showed that respondents who were in the wealthier households and had low autonomy in household decision power (OR = 2.03,p < .05) were more likely to be exposed to maternal health risk than their counterparts who had more autonomy. Efforts to lower women’s exposure to maternal mortality and morbidity in Zambia should involve interventions to alter prevailing gender norms that limit women’s active participation in decisions about their own health during pregnancy and delivery. [ABSTRACT FROM PUBLISHER]

Background: Although progress has been made toward reducing child morbidity and mortality globally, a large proportion of children in sub-Saharan Africa still die before age five and many suffer chronic malnutrition. This study investigated the influence of single motherhood on stunting and under-5 mortality in Cameroon, Nigeria and Democratic Republic of the Congo (DRC). Particular attention was paid to the influence of mother’s economic resources, parental care and health behaviour on the difference in children’s health in single and two-parent families. Methods: Data were obtained from most recent Demographic and Health Surveys in Cameroon (2011), Nigeria (2008) and DRC (2007). The sample included women aged 15–49 years old and their under-5 children 11,748 in Cameroon, 28,100 in Nigeria, and 8,999 in DRC. Logistic regression and Cox proportional hazard analysis were used to estimate stunting and under-5 mortality, respectively. Results: The result showed that compared with children whose mothers were in union, children of single mothers who were not widows were more likely to be stunted (OR 1.79 p < 0.01 in Cameroon and 1.69 p < .01 in DRC). Economic resources and parental care significantly influenced the higher odds of stunting in single mother households in Cameroon and DRC. Relative to children of mothers in union, the risk of under-5 mortality in single mother families was higher in the three countries (HR 1.40 p < .05 in Cameroon, 1.27 p < 0.10 in DRC, 1.55 p < .01 in Nigeria). Economic resources, parental care and health behaviour accounted for the difference in Nigeria and Cameroon; in DRC, only economic resources had marginal influence. Conclusions: Single motherhood is a risk factor for children’s nutritional status and chances of survival before age 5 years in sub-Saharan Africa. To achieve improved reduction in children’s exposure to stunting and under-5 mortality, there is the need for public health interventions targeted at single mother households in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Objective: Acceptability has become a key consideration in designing, implementing and evaluating digital health interventions. Current evidence points to acceptability as a crucial factor in sustaining mobile health programs for maternal health across sub-Saharan Africa particularly in Nigeria where the burden of maternal mortality is high. This paper describes the enablers and barriers to the acceptance of Text4Life, a mobile phone-based health intervention that extends maternal healthcare services to rural areas of Edo State Nigeria., Method: This is a cross-sectional qualitative study of women who used Text4Life, their spouses who were all men and Ward Development Committee chairpersons who oversaw the implementation of Text4Life. This study was set in Etsako East and Esan Central Local Government Areas of Edo State, Nigeria. Between September 2021 and January 2022, eight focus groups were conducted with 64 participants: 39 women and 25 men. Two in-depth interviews were conducted with Ward Development Committee chairpersons. Data collection was conducted in English and Pidgin English. Discussions and interviews were digitally recorded and translated to English from Pidgin English where necessary. Data analysis followed a mainly deductive approach to thematic analysis, however, emergent information from the data was also considered and reported., Results: The results show that participants' positive attitudes towards the intervention, the involvement of the community, participants' understanding of the intervention, and perceived effectiveness of the Text4Life program were enablers to women's acceptance of Text4Life and enablers to Ward Development Committee chairpersons' assistance with the program. On the other hand, limited resources and a clash with the community's value system presented barriers to the acceptability of the Text4Life program., Conclusion: Our findings demonstrate the importance of alleviating the burdens associated with participating in mobile health interventions while noting that the risk of obstructing the gains from mobile health interventions is high if plans for sustaining it are not incorporated early enough in the design phase., Competing Interests: FO is the founder of the Women's Health Action Research Centre (WHARC), the organization that implemented the Text4Life program. However, the other authors declare that the study was carried out in the absence of any commercial or financial interest that could be construed as a potential conflict of interest. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Friday Okonofua reports a relationship with Women's Health and Action Research Centre, Nigeria that includes: equity or stocks., (© 2022 The Authors.)