| 1. |
- Antai, Diddy, et al.
(author)
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Inequities in Under-Five Mortality in Nigeria : Differentials by Religious Affiliation of the Mother
- 2009
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In: Journal of religion and health. - : Springer Science and Business Media LLC. - 0022-4197 .- 1573-6571. ; 48:3, s. 290-304
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Journal article (peer-reviewed)abstract
- Observations in Nigeria have indicated polio vaccination refusal related to religion that ultimately affected child morbidity and mortality. This study assessed the role of religion in under-five (0-59 months) mortality using a cross-sectional, nationally representative sample of 7,620 women aged 15-49 years from the 2003 Nigeria Demographic and Health Survey and included 6,029 children. Results show that mother's affiliation to Traditional indigenous religion is significantly associated with increased under-five mortality. Multivariable modelling demonstrated that this association is explained by differential use of maternal and child health services, specifically attendance to prenatal care. To reduce child health inequity, these results need to be incorporated in the formulation of child health policies geared towards achieving a high degree of attendance to prenatal care, irrespective of religious affiliation.
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| 2. |
- Antai, Diddy
(author)
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Social context, social position and child survival : social determinants of child health inequities in Nigeria
- 2010
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Doctoral thesis (other academic/artistic)abstract
- Under-five mortality rate is a key indicator of the level of child health and overall well-being of a given population and is an indicator of the United Nations Millennium Development Goals 4. Of the estimated more than 10 million children that die worldwide each year, 41% of these deaths occur in sub-Saharan Africa. With over one million children dying yearly from preventable diseases in Nigeria, the country may not meet the other Millennium Development Goals by 2015. Child survival in Nigeria is threatened by poverty, nutritional deficiencies and illnesses, such as malaria, diarrhoeal diseases, acute respiratory infections, high maternal morbidity, mortality and vaccine preventable diseases. These are closely associated with measures of social position. The overall aim of this thesis was to contribute to an understanding of the underlying mechanisms of child health inequities in under-five mortality in Nigeria in relation to socialcontext, social stratification and social position. Specific objectives were to assess the role of mothers' religious affiliation, ethnicity, rural-urban migration and residence in disadvantaged urban neighbourhoods on under-five mortality in Nigeria. Data from the 2003 Nigeria Demographic and Health Survey was used in these studies. This is a nationally-representative probability sample of 7864 households collected using a stratified twostage cluster sampling procedure, from which data was collected by face-to-face interviews from 3725 women aged 15 to 49 years. These women contributed a total of 6029 live born children born to the survey. Information collected included birth histories, in-depth demographic and socio-economic information on illnesses, medical care, immunizations, and anthropometric details of children. The relationships between under-five mortality and mothers' religious affiliation was analysed in paper I using Cox regression. In papers II - IV, we used multilevel logistic regression analysis to assess the relationship between ethnicity, rural-urban migration and residence in disadvantaged urban neighbourhoods and under-five mortality. Multivariate analyses showed that religious mortality differences were closely associated with the differential use of maternal and child health services among mothers of Traditional indigenous religion, which are in turn associated with poverty and low socio-economic position. Ethnic mortality differences were dependent in part on differences in individual-level socioeconomic characteristics, and less directly related with inter-ethnic variation in health behaviour of the mothers. Applying three migration perspectives, mortality differences among migrant groups were associated with disruption of the migrant s social and economic well-being, their demographic and socio-economic selectivity, disparities in adaptation (utilization of maternal health services) due to underlying socio-economic differences between and within migrant and nonmigrant populations, as well as the influence of community contexts. Residence in disadvantaged urban areas was associated with increased risks of under-five deaths. The risks increased with increasing level of disadvantage, and were explained both as a direct effect of living in a disadvantaged neighbourhood, and indirectly as a result of the socioeconomic characteristics of people living in these disadvantaged neighbourhoods. Together, the observed mortality differences among children of mothers assessed by the different measures of social position in this thesis are a reflection of the health inequities confronting children of mothers in low social positions.
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| 3. |
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| 4. |
- Ghilagaber, Gebrenegus, et al.
(author)
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Modeling Spatial Effects on Childhood Mortality Via Geo-additive Bayesian Discrete-Time Survival Model : A Case Study from Nigeria
- 2014
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In: Advanced Techniques for Modelling Maternal and Child Health in Africa. - Dordrecht : Springer. - 9789400767775 - 9789400767782 ; , s. 29-48
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Book chapter (peer-reviewed)abstract
- Childhood mortality is an important indicator of overall health and development in a country. It is the result of a complex interplay of determinants at many levels, and as such several studies have recognized that, for instance, maternal (Caldwell 1979; Cleland and van Ginneken 1988), socio-economic (Castro-Leal et al. 1999; Wagstaff 2001), and environmental (Wolfe and Behrman 1982; Lee et al. 1997) factors are important determinants of childhood mortality. However, only a few studies have incorporated environmental factors that are spatial in nature and derived from geographic databases, such as distances from households or communities (Watson et al. 1997).
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| 5. |
- Rashid, Mamunur, et al.
(author)
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Socioeconomic Position as a Determinant of Maternal Healthcare Utilization : A Population-Based Study in Namibia
- 2014
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In: Journal of Research in Health Sciences. - : Hamadan University of Medical Sciences, Iran. - 1682-2765. ; 14:3, s. 187-192
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Journal article (peer-reviewed)abstract
- Background: Improving maternal health is one of the eight Millennium Development Goals(MDGs) aimed at improving maternal healthcare and reducing maternal mortality. The utilization of maternal health services is influenced by several factors that need to be better understood. The objective of this study was to estimate the role of socio-economic position as a determinant of the utilization of maternal health care in Namibia.Methods: Data were collected from the Namibia Demographic and Health Survey in 2006-2007, based on survey responses from 9,804 female respondents aged 15-49 years. Multivariate logistic regression analysis was performed accounting for socio-economic factors associated with the use of maternal health care services.Results: The results from both bivariate and multivariate analyses confirmed the importance of education, wealth index, place of residence, and marital status in explaining the utilization of maternal health care services. The wealth index was the only consistently significant predictor of all indicators of maternal health services; with other factors being significantly associated with one or more of the indicators. Women’s age and occupation showed inconclusive results in relation to access to maternal health care services.Conclusion: Several socio-economic factors significantly influence the three indicators of maternal health services utilization. Effective interventions need to take these factors into consideration and explore means that increase maternal health service utilization especially among lowly educated and poor women in rural areas.
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| 6. |
- Zacarias, Antonio Eugenio, et al.
(author)
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Intimate partner violence against women in Maputo city, Mozambique
- 2012
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In: BMC International Health and Human Rights. - 1472-698X. ; 12:1
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Journal article (peer-reviewed)abstract
- BackgroundThere is limited research about IPV against women and associated factors in Sub-Saharan Africa, not least Mozambique. The objective of this study was to examine the occurrence, severity, chronicity and "predictors" of IPV against women in Maputo City (Mozambique).MethodsData were collected during a 12 month-period (consecutive cases, with each woman seen only once) from 1,442 women aged 15--49 years old seeking help for abuse by an intimate partner at the Forensic Services at the Maputo Central Hospital, Maputo City, Mozambique. Interviews were conducted by trained female interviewers, and data collected included demographics and lifestyle variables, violence (using the previously validated Revised Conflict Tactics Scale (CTS2), and control (using the Controlling Behaviour Scale Revised (CBS-R). The data were analysed using bivariate and multivariate methods.ResultsThe overall experienced IPV during the past 12 months across severity (one or more types, minor and severe) was 70.2% (chronicity, 85.8 +/- 120.9).a Severe IPV varied between 26.3-45.9% and chronicity between 3.1 +/- 9.1-12.8 +/- 26.9, depending on IPV type. Severity and chronicity figures were higher in psychological aggression than in the other IPV types. Further, 26.8% (chronicity, 55.3 +/- 117.6) of women experienced all IPV types across severity. The experience of other composite IPV types across severity (4 combinations of 3 types of IPV) varied between 27.1-42.6% and chronicity between 35.7 +/- 80.3-64.9 +/- 110.9, depending on the type of combination. The combination psychological aggression, physical assault and sexual coercion had the highest figures compared with the other combinations.. The multiple regressions showed that controlling behaviours, own perpetration and co-occurring victimization were more important in "explaining" the experience of IPV than other variables (e.g. abuse as a child).ConclusionsIn our study, controlling behaviours over/by partner, own perpetration, co-occurring victimization and childhood abuse were more important factors in "explaining" sustained IPV. More investigation into women's IPV exposure and its "predictors" is warranted in Sub-Saharan Africa, particularly Mozambique.
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| 7. |
- Zacarias, Antonio Eugenio, et al.
(author)
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Symptoms of depression, anxiety, and somatization in female victims and perpetrators of intimate partner violence in Maputo City, Mozambique
- 2012
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In: International Journal of Women's Health. - 1179-1411. ; 4, s. 491-503
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Journal article (peer-reviewed)abstract
- Background: Little knowledge exists in Mozambique and sub-Saharan Africa about the mental health (symptoms of depression, anxiety, and somatization) of women victims and perpetrators of intimate partner violence (IPV) by type of abuse (psychological aggression, physical assault without/with injury, and sexual coercion). This study scrutinizes factors associated with mental health among women victims and perpetrators of IPV over the 12 months prior to the study.Methods and materials: Mental health data were analyzed with bivariate and multiple regression methods for 1442 women aged 15–49 years who contacted Forensic Services at Maputo Central Hospital (Maputo City, Mozambique) for IPV victimization between April 1, 2007 and March 31, 2008.Results: In bivariate analyses, victims and perpetrators of IPVs scored higher on symptoms of mental health than their unaffected counterparts. Multiple regressions revealed that controlling behaviors, mental health comorbidity, social support, smoking, childhood abuse, sleep difficulties, age, and lack of education were more important in explaining symptoms of mental health than demographics/socioeconomics or life-style factors. Victimization and perpetration across all types of IPV were not associated with symptoms of mental health.Conclusion: In our sample, victimization and perpetration were not important factors in explaining mental ill health, contrary to previous findings. More research into the relationship between women’s IPV victimization and perpetration and mental health is warranted as well as the influence of controlling behaviors on mental health.
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