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Please use this identifier to cite or link to this item: http://hdl.handle.net/10625/50506

Title: Male responsibility and maternal morbidity: a cross-sectional study in two Nigerian states
Authors: Andersson, Neil
Omer, Khalid
Caldwell, Dawn
Dambam, Mohammed Musa
Maikudi, Ahmed Yahya
Keywords: NIGERIA
PLANNING
HEALTH SYSTEMS
HEALTH INFORMATION SYSTEMS
Issue Date: 2011
Citation: Andersson, N., Omer, K., Caldwell, D., Dambam, M. M., Maikudi, A. Y., Effiong, B.,… Hamel, C. (2011). Male responsibility and maternal morbidity: a cross-sectional study in two Nigerian states. BMC Health Services Research, 11(Suppl 2):S7. doi:10.1186/1472-6963-11-S2-S7
Abstract: Background: Nigeria continues to have high rates of maternal morbidity and mortality. This is partly associated with lack of adequate obstetric care, partly with high risks in pregnancy, including heavy work. We examined actionable risk factors and underlying determinants at community level in Bauchi and Cross River States of Nigeria, including several related to male responsibility in pregnancy. Method: In 2009, field teams visited a stratified (urban/rural) last stage random sample of 180 enumeration areas drawn from the most recent censuses in each of Bauchi and Cross River states. A structured questionnaire administered in face-to-face interviews with women aged 15-49 years documented education, income, recent birth history, knowledge and attitudes related to safe birth, and deliveries in the last three years. Closed questions covered female genital mutilation, intimate partner violence (IPV) in the last year, IPV during the last pregnancy, work during the last pregnancy, and support during pregnancy. The outcome was complications in pregnancy and delivery (eclampsia, sepsis, bleeding) among survivors of childbirth in the last three years. We adjusted bivariate and multivariate analysis for clustering. Findings: The most consistent and prominent of 28 candidate risk factors and underlying determinants for nonfatal maternal morbidity was intimate partner violence (IPV) during pregnancy (ORa 2.15, 95%CIca 1.43-3.24 in Bauchi and ORa 1.5, 95%CI 1.20-2.03 in Cross River). Other spouse-related factors in the multivariate model included not discussing pregnancy with the spouse and, independently, IPV in the last year. Shortage of food in the last week was a factor in both Bauchi (ORa 1.66, 95%CIca 1.22-2.26) and Cross River (ORa 1.32, 95%CIca 1.15-1.53). Female genital mutilation was a factor among less well to do Bauchi women (ORa 2.1, 95%CIca 1.39-3.17) and all Cross River women (ORa 1.23, 95%CIca 1.1-1.5). Interpretation: Enhancing clinical protocols and skills can only benefit women in Nigeria and elsewhere. But the violence women experience throughout their lives – genital mutilation, domestic violence, and steep power gradients – is accentuated through pregnancy and childbirth, when women are most vulnerable. IPV especially in pregnancy, women’s fear of husbands or partners and not discussing pregnancy are all within men’s capacity to change.
URI: http://hdl.handle.net/10625/50506
ISSN: 1472-6963
Project Number: 104613
Project Title: Nigeria Evidence-based Health System Initiative (NEHSI) : Implementation
Appears in Collections:Nigeria Evidence-based Health System Initiative (NEHSI) / Initiative Données probantes et systèmes de santé au Nigeria (NEHSI)
Research Results (GEHS) / Résultats de recherches (GESS)
IDRC Research Results / Résultats de recherches du CRDI
2010-2019 / Années 2010-2019

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