International Public Health Commons^™

Findings From Landscape Analysis In Nigeria On Pre-Eclampsia/Eclampsia, Population Council

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal mortality. The Population Council conducted a landscape analysis on PE/E in 2015 in seven states in Nigeria. This brief details the findings on national policy awareness, service provider knowledge and skills, facility capacity and preparedness, quality of care and community knowledge and perceptions. The brief concludes with recommendations based on these findings.

Formative Research On Assessing Barriers To Fistula Care And Treatment In Nigeria, Charlotte E. Warren, Rachel Agbonkhese, Salisu Mohammed Ishaku

Reproductive Health

This report documents results of a systematic study of peer-reviewed and “grey” literature which identified studies relevant for understanding barriers to accessing obstetric fistula (OF) care in developing countries. To more comprehensively and holistically understand these barriers in Nigeria and potential enabling factors for alleviation, this study explored the perspectives of those involved in both identifying fistula and accessing care, such as family members and other community stakeholders including patriarchs, matriarchs, community leaders, and other opinion leaders. It also examines the cultural patterns, myths, and perspectives related to OF and how they influence women’s willingness and capacities to access surgical …

Findings From Landscape Analysis In Katsina On Pre-Eclampsia/Eclampsia, Population Council

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal deaths. To appreciate the enormity of this problem at country and state levels, a landscape analysis was conducted by the Population Council in 2015 on PE/E in seven states in Nigeria. This brief presents results for the landscape analysis in Katsina and recommends many areas of opportunity to prevent maternal death associated with PE/E throughout pregnancy, and different approaches to make the most of these opportunities. Maternal and newborn deaths due to PE/E are preventable: by …

Perceived Risks Associated With Contraceptive Method Use Among Men And Women In Ibadan And Kaduna, Nigeria, Hilary Schwandt, Joanna Skinner, Luciana E. Hebert, Abdulmumin Saad

Fairhaven Faculty Publications

Research shows that side effects are often the most common reason for contraceptive non-use in Nigeria; however, research to date has not explored the underlying factors that influence risk and benefit perceptions associated with specific contraceptive methods in Nigeria. A qualitative study design using focus group discussions was used to explore social attitudes and beliefs about family planning methods in Ibadan and Kaduna, Nigeria. A total of 26 focus group discussions were held in 2010 with men and women of reproductive age, disaggregated by city, sex, age, marital status, neighborhood socioeconomic status, and—for women only—family planning experience. A discussion guide …

Annotated Bibliography Of Peer-Reviewed Literature Related To The Sexual And Reproductive Health Of Young People In Nigeria (2000-2014), Population Council

HIV and AIDS

The 1994 International Conference on Population and Development’s Programme of Action identified eight components (safe motherhood, gender equity, family planning information and services, prevention and treatment of infertility and sexual dysfunction in both men and women, prevention and management of the complications of abortion, prevention and treatment of reproductive tract infections and sexually transmitted infections including HIV, elimination of harmful customary practices, and screening for reproductive tract cancers—prostate, breast, and cervix) of sexual and reproductive health (SRH) for all persons including young people aged 10–24. This annotated bibliography is organized with the eight components as its guiding framework with several …

Willingness To Pay For Contraceptive Vaginal Rings In Nigeria, Salisu Mohammed Ishaku, Ayodeji Oginni, Godwin Unumeri, Deepa Rajamani

Reproductive Health

During the last two decades, Nigeria’s contraceptive prevalence rate (CPR) for modern methods remained at 10 percent, one of the lowest rates in sub-Saharan Africa. Following the renewed global commitments culminating in the 2012 London Summit on Family Planning with promises to reach an additional 120 million new users of modern contraceptives worldwide, Nigeria’s Federal Ministry of Health set a new target of raising Nigeria’s CPR to 36 percent by 2018. One way to accomplish this is by meeting the contraceptive needs of women in the immediate postpartum period and beyond. Attention is being focused on making proven contraceptive methods …

Delivering Contraceptive Vaginal Rings—Task Sharing Policies And Practices In The Delivery Of Family Planning Services: Experiences From Nigeria, Godwin Unumeri, Salisu Mohammed Ishaku

Reproductive Health

Despite tremendous progress over the past decades in family planning and fertility reduction, more than 220 million women have unmet need for contraception globally. The government of Nigeria pledged over $11 million to procure contraceptive commodities for distribution in the public sector from 2011–2015, to increase the contraceptive prevalence rate (CPR) that had stalled at 10 percent for almost two decades. The Population Council is facilitating the registration, introduction, and scale-up of the Progesterone Contraceptive Vaginal Ring (PCVR), designed particularly for breastfeeding women, in the sub-Saharan African countries of Kenya, Nigeria, and Senegal. In Nigeria, restrictive policies regarding matching health …

Delivering Contraceptive Vaginal Rings: Review Of Postpartum And Postnatal Care Programs In Nigeria, Godwin Unumeri, Salisu Mohammed Ishaku

Reproductive Health

Postpartum family planning is a major component of postpartum care services. The Population Council is working to introduce an additional method of contraception in Nigeria—the Progesterone Contraceptive Vaginal Ring (PCVR). The PCVR is administered vaginally but acts systemically to inhibit ovulation. The PCVR contains natural progesterone and is meant for breastfeeding women to augment lactational amenorrhea. As the Council conducts a series of activities as a prelude to eventual introduction of the PCVR in sub-Saharan Africa, including Nigeria, the detailed evaluation of the postpartum program environment is very important. Understanding the prevailing postpartum and postnatal care landscapes will be crucial …

Progesterone Vaginal Ring: Results Of An Acceptability Study In Nigeria, Salisu Mohammed Ishaku, Afolabi Kayode, Godwin Unumeri, Ayodeji Oginni, Adekunle Adeyemi, Deepa Rajamani, Heather Clark, Naomi Rijo, Saumya Ramarao

Reproductive Health

The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. The PVR was first registered in Chile and Peru in 1998 for use by postpartum women and has since been expanded to other Latin American countries. Previous studies have shown that contraceptive vaginal rings are safe, effective, and well accepted in varied cultural settings. However, the extent to which the ring is acceptable in the sub-Saharan African context is unknown. This study examined the acceptability of the PVR in Nigeria as part of a larger project that was also conducted in Kenya …

Progesterone Vaginal Ring: Results Of A Three-Country Acceptability Study, Saumya Ramarao, Heather Clark, Deepa Rajamani, Salisu Mohammed Ishaku, Babacar Mane, Francis Obare, Harriet Birungi, Nafissatou Diop, Wilson Liambila, Fatou Mbow, Chi-Chi Undie, Godwin Unumeri, John Townsend

Reproductive Health

Global and national policies have refocused attention on postpartum family planning as an important component of ensuring healthy outcomes for women and babies. The progesterone vaginal ring (PVR) is used to extend the contraceptive effectiveness of lactational amenorrhea among breastfeeding women. Clinical trials have proven the PVR to be safe and effective; it is currently registered in eight Latin American countries. There is a need to assess acceptability prior to introduction into country programs, and the Population Council conducted PVR acceptability studies in Kenya, Nigeria, and Senegal. This report represents the results from a pooled analysis of data from the …

Emerging Priorities In Reproductive, Maternal, And Newborn Health, Population Council

Reproductive Health

The Population Council’s Ending Eclampsia project seeks to expand access to proven, underutilized interventions and commodities for the prevention, early detection, and treatment of pre-eclampsia and eclampsia (PE/E) and to strengthen global partnerships. Ending Eclampsia is working in Nigeria and Bangladesh to assess the level of program activities, gaps, and challenges around prevention and treatment of PE/E and magnesium sulfate (MgSO4). The project will build upon this landscape analysis to expand services to detect and manage PE/E, develop and support implementation of strategic plans for replicating the intervention package, and increase global PE/E evidence shared through knowledge and learning platforms. …

Landscape Analysis Of Pre-Eclampsia/Eclampsia In Nigeria, Charlotte E. Warren, Salisu Mohammed Ishaku, Ayodeji Oginni, Gloria Adoyi, Karen Kirk, Amy Dempsey

Reproductive Health

The Population Council’s Ending Eclampsia project, with support from USAID, seeks to expand access to proven, underutilized interventions and commodities for the prevention, early detection, and treatment of pre-eclampsia and eclampsia (PE/E) and to strengthen global partnerships. The Council conducted a landscape analysis on PE/E in Nigeria in 2015. Its main objectives were to understand the level of programmatic and policy support for PE/E prevention and treatment; to analyze gaps in providers’ competence to prevent, detect, and manage PE/E; to determine capacity at primary health facilities to manage PE/E; to assess community awareness, beliefs, and experiences around PE/E; to understand …

Trends In Hiv Prevalence, Sexual And Health Seeking Behaviors, And Hiv-Related Discrimination Among Nigerian Youth, Population Council

HIV and AIDS

Nigeria, home to over 170 million people, has a disproportionately heavy youth population of 32 percent whose well-being is intricately tied to the country’s prospects for sustainable development. Nigeria has an HIV prevalence of 3.4 percent, the second highest number of infections in the world. In 2013, it was estimated that 160,000 adolescents in Nigeria were living with HIV. Although Nigeria has developed a national HIV strategic plan that forms a basis for the HIV response, national AIDS and related policies contain few youth-centered provisions. Overall, the national strategic plan targets youth as part of the general population. To fill …

Annotated Bibliography Of Nigerian Youth-Focused Hiv And Sexual And Reproductive Health Project Publications (Grey Literature), Population Council

HIV and AIDS

Adolescents and young adults (15–24 years) constitute about one-third of the total population of Nigeria, and their well-being is intricately tied to the country’s prospects for sustainable development. The HIV prevalence among 15–24-year-old men and women is 2.5 percent and 3.1 percent, respectively. In 2013, it was estimated that 160,000 adolescents (aged 10–19) in Nigeria were living with HIV. Rightfully, an increasing focus is being paid to the sexual and reproductive health (SRH) of young Nigerians, however it is essential that the dialogue and interventions around young people’s SRH be informed and take into account the body of evidence available …

Strengthening The Role Of Patent Medicine Vendors In The Provision Of Injectable Contraception In Nigeria, Population Council, The Evidence Project

Reproductive Health

The majority of contraceptive services in Nigeria are offered in private settings, including Patent Medicine (PM) shops. PM shops are informal businesses owned by Patent Medicine Vendors (PMVs) licensed to sell patent or proprietary drugs. Injectable contraception is the most popular modern contraceptive method in Nigeria. However PMVs are not regulated to sell or administer injectable contraceptives because the businesses do not receive formal training. Despite this, some PMVs are selling and administering injectable methods in response to high demand. The Evidence Project, in collaboration with the Federal Ministry of Health, conducted implementation research to: demonstrate the feasibility of PMVs …

Hiv/Aids Vulnerabilities, Discrimination, And Service Accessibility Among Africa's Youth: Insights From A Multi-Country Study, Babatunde A.O. Ahonsi, Nahla G. Abdel-Tawab, Scott Geibel, Sam Kalibala, Jerry Okal, Babacar Mane, Nathi Sohaba, Julialynne Walker, Eric P. Green

HIV and AIDS

This report contains information from a study implemented between August 2011 and July 2012 that sought to provide a comprehensive, evidence-based picture of the HIV-related issues facing young people across Africa, and the prevailing legal, policy, and programmatic responses. The study was designed to establish a basis for a sharper focus on youth within the response to HIV on the continent. Researchers conducted country-specific analytical reviews of the relevant literature on factors associated with HIV risk-taking and health-seeking behaviors among young people aged 15–24 in six countries across Africa—Egypt, Kenya, Nigeria, Senegal, South Africa, and Uganda. In addition, qualitative and …

Hiv/Aids Vulnerabilities, Discrimination, And Service Accessibility Of Nigeria's Youth: Summary Of Study Findings, Population Council

HIV and AIDS

Nigerian youth, especially females, are disproportionately affected by HIV yet remain a neglected subpopulation in the response to HIV. Current HIV-prevention interventions are often not youth-friendly in design and implementation. Youth, therefore, fail to access these services which further worsens their vulnerability to HIV/AIDS. This study, implemented between August 2011 and July 2012, sought to provide a comprehensive evidence-based picture of the HIV-related issues facing Nigerian youth and the prevailing legal, policy, and programmatic responses. Researchers conducted an analytical review of the relevant literature on factors associated with HIV risk-taking and health-seeking behaviors among young people aged 15–24 in Nigeria. …

Baseline Survey Of Nigerian Media Coverage Of Youth Sexual And Reproductive Health And Hiv And Aids Related Issues, January 1st–December 31st, 2012, Population Council

HIV and AIDS

To promote more informed public dialogue on youth vulnerabilities, responses to HIV/AIDS, and positive changes in relevant policies and programs via learning and advocacy interventions at the state and national levels in Nigeria, the Population Council commissioned a study of the print and electronic media’s coverage of HIV/AIDS and sexual and reproductive health–related issues among youth aged 15–24 years in Nigeria for the period January 1 to December 31, 2012. The study entailed a content analysis of four national and two regional newspapers, and an online forum that is one of the most frequently visited social media sites in Nigeria. …

Hiv/Aids Vulnerabilities, Discrimination, And Service Accessibility Among Nigeria's Youth, Population Council

HIV and AIDS

This report documents the findings of a study implemented between August 2011 and July 2012 that sought to provide a comprehensive, evidence-based picture of the HIV-related issues facing Nigerian youth and the prevailing legal, policy, and programmatic responses. The study was designed to establish a basis for a sharper focus on youth within the national response to HIV. Researchers conducted an analytical review of the relevant literature on factors associated with HIV risk-taking and health-seeking behaviors among young people aged 15–24 in Nigeria. In addition, qualitative and quantitative analyses enabled an evaluation of the factors associated with young people’s sexual …

Day Of Dialogue: Expanding Opportunities For Increased Access To Emergency Contraception (Ec) In Nigeria, Population Council

Reproductive Health

In order to create a supportive policy and service delivery environment for emergency contraception (EC) and improve uptake in Nigeria, the Population Council conducted a survey of service providers’ knowledge, attitudes, and practices regarding EC, supplemented by in-depth interviews with key opinion leaders regarding their perceptions. This study revealed gaps that have implications for policy and programming. In collaboration with the International Consortium for Emergency Contraception, the Population Council convened a “Day of Dialogue” on EC to discuss the key research findings and to recommend strategic considerations for repositioning EC within the country's family planning program. This report describes the …

A Geographical Analysis Of Hiv/Aids Infection In Nigeria, 1991-2001, Chinekwu Azuka Obidoa, Robert G. Cromley

Journal of Social, Behavioral, and Health Sciences

Abstract

Objectives: Within the gradually accumulating literature on the Acquired Immune Deficiency Syndrome (AIDS) in Nigeria, investigations concerning the spatial dimensions of the infection are virtually non-existent. An understanding of the spatial dimensions of the epidemic is central in the development and implementation of appropriate intervention strategies. This study is a geographic analysis of HIV/AIDS infection in Nigeria from 1991 – 2001. The three objectives of this study were: 1) to examine the geographic pattern of the epidemic, 2) to examine the spatial-temporal trend and diffusion pattern of the epidemic, and 3) to explore the factors associated with the spatial …

Marps Sensitization: A Diversity Training Guide For Health Care Providers In Nigeria, Enhancing Nigeria's Hiv/Aids Response (Enr) Programme

HIV and AIDS

Men who have sex with men (MSM) present specific diagnostic and management challenges to counselors and health-care providers. High prevalence of HIV infection has been reported among MSM in Nigeria, driven partly by stigma, discrimination, lack of appropriate prevention strategies, limited research evidence, little recognition by policymakers, and inadequate knowledge and skills in dealing with MSM clients. In Nigeria, where homosexuality is illegal, the risk embodied in same-sex activities is high and makes hiding MSM activities almost a norm. Currently, health-care provider training materials that address most at-risk populations’ (MARPs) specific health needs are nonexistent in Nigeria. Knowledge of these …

Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Concerning Emergency Contraception: A Multicountry Study In India, Nigeria, And Senegal, Martha Brady, M.E. Khan, Babatunde A.O. Ahonsi, Babacar Mane, Ian Askew, Saumya Ramarao

Reproductive Health

The Population Council conducted a cross-sectional, descriptive, multicountry study in India, Nigeria, and Senegal aimed at understanding the attitudes, beliefs, and practices of providers and key opinion leaders (KOLs) regarding the provision and use of emergency contraception (ECP). The overarching goal of this study was to investigate and document providers’ attitudes, beliefs, and practices regarding ECP, and to capture the opinions and insights of providers and KOLs on a range of policy and program issues. Findings indicate that many provider-related barriers can be overcome through implementation of targeted interventions such as training and values clarification, whereas other barriers will require …

Training Manual On The Use Of Magnesium Sulphate In The Management Of Severe Pre-Eclampsia And Eclampsia [Trainee Version], Federal Ministry Of Health, Population Council

Reproductive Health

This training manual provides detailed, descriptive, and practical instructions and tips necessary to respond to obstetric emergencies (severe pre-eclampsia and eclampsia). The manual is an integral part of the collaborative efforts between the Federal Ministry of Health and the MacArthur Foundation to scale up the use of magnesium sulphate in the management of severe pre-eclampsia and eclampsia in Nigerian health facilities. Magnesium sulphate has been established as the gold standard in the management of severe pre-eclampsia and eclampsia, but lack of knowledge and necessary skill have been identified as some of the factors responsible for its limited use in Nigeria. …

An Assessment Of Individual And Institutional Research Utilization By Policy-Makers And Programme Managers At State And National Levels In Nigeria, National Agency For The Control Of Aids

HIV and AIDS

This report undertakes a systematic assessment of the need for evidence by decision-makers working on HIV and AIDS funding and policymaking, and implementing organizations at the national and subnational levels in Nigeria. The assessment identifies barriers and constraints to data use, identifies best practices, and offers recommendations for the design and prioritization of strategic approaches to address barriers and constraints in data use and production. Tools to monitor the adoption of evidence in policy and practice are also offered. The need for evidence-based practice in the national response to HIV and AIDS has been widely acknowledged and incorporated into policy …

The Experiences Of Men Engaged In Transactional Sex With Other Men In Urban Nigeria—A Size Estimation And Qualitative Study, Population Council

HIV and AIDS

Reports on a mixed-method research study to estimate the population size and understand the experiences of a sub-group of men who have sex with men presumed to be at particularly high risk of infection with HIV and other sexually transmitted infections: men who engage in transactional sex with other men.

Using Capture-Recapture Methodology For Enumerating Most-At-Risk Populations (Marps), Population Council

HIV and AIDS

Populations at higher risk for HIV infection are often the most difficult to reach and this is particularly true of men who have sex with men (MSM), injecting drug users, and female sex workers in sub-Saharan Africa. These subpopulations are frequently marginalized by society because of the illicit and/or illegal activities they engage in. Estimating the size of hard-to-reach populations is important to effectively plan, implement, monitor, and evaluate HIV and AIDS prevention and care programs. “Capture-recapture” is a method of estimating the prevalence of a trait in a population or more simply it’s a method that provides a good …

Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Regarding Emergency Contraception In Nigeria, Babatunde A.O. Ahonsi, Salisu Mohammed Ishaku, Araoyinbo Idowu, Ayodeji Oginni

Reproductive Health

Despite significant progress in product development, procurement, and distribution in the past few decades, emergency contraception’s (EC) capacity to benefit many women in countries such as Nigeria is hampered by a number of potential barriers, that are not well understood. The Population Council, with support from the International Consortium for Emergency Contraception, documented EC-related knowledge, attitudes, and practices among providers in Nigeria as well as perceptions of key opinion leaders who help shape the policy environment for EC and family planning in general. Findings suggest significant gaps in Nigeria, potentially necessitating continuous training and re-training to help dispel misperceptions and …

An Ethnographic Study Of Injecting Drug Users And Men Who Have Sex With Men In Selected States In Nigeria, Enhancing Nigeria's Hiv/Aids Response (Enr) Programme

HIV and AIDS

An ethnographic pre-assessment study of the behavioral dynamics of men who have sex with men (MSM) and injecting drug users (IDU) was conducted in 2009 as an integral part of the 2010 Integrated Biological and Behavioural Surveillance Survey (IBBSS). The study took place in Northern and Southern Nigeria and provided rich contextual information on the logistic and scientific factors that would aid successful conduct of the IBBSS and secure buy-in for it among study respondents. The study utilized a combination of rapid assessment procedures that were suitable to prevailing time exigencies and could foster preliminary understanding of the local contexts …

Providers' And Key Opinion Leaders' Attitudes, Beliefs, And Practices Regarding Emergency Contraception In Nigeria: Key Findings, Babatunde A.O. Ahonsi, Salisu Mohammed Ishaku, Araoyinbo Idowu, Ayodeji Oginni

Reproductive Health

This brief reports on a study in Nigeria to document provider attitudes, beliefs, and practices regarding emergency contraception (ECP), and to identify key opinion leaders’ opinions and insights pertaining to policy and programmatic issues in that country. Findings reveal that ECP is well known in urban Nigeria. Its provision is controlled mainly by the largely unregulated and unmonitored private sector. Government plays a distant role, thereby leaving family planning and ECP supply almost entirely in the hands of donor agencies. For wider availability and affordability of ECP products in both the private and public sectors, official policy action is required, …