Dataset Information

Rural-urban comparison of routine immunization utilization and its determinants in communities in Anambra States, Nigeria.

ABSTRACT: Objectives:The study determined the levels of geographic differences in the utilization of routine immunization between households in an urban and a rural community. It also identified and compared the determinants of utilization of routine immunization in the two geographic areas. Method:The study was undertaken in two randomly selected communities (one rural and one urban) in Anambra State, Nigeria. Interviewer-administered questionnaires were used to collect information on utilization of immunization services from households. Data were analyzed using descriptive and multiple logistic regression analyses. Result:Households in the urban community had a higher level of utilization of routine immunization (95.5%) than those in the rural community (75.3%) and the difference was statistically significant (p?

SUBMITTER: Sibeudu FT

PROVIDER: S-EPMC6348577 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Rural-urban comparison of routine immunization utilization and its determinants in communities in Anambra States, Nigeria.

Sibeudu Florence Tochukwu FT Uzochukwu Benjamin Sc BS Onwujekwe Obinna E OE

SAGE open medicine 20190114

<h4>Objectives</h4>The study determined the levels of geographic differences in the utilization of routine immunization between households in an urban and a rural community. It also identified and compared the determinants of utilization of routine immunization in the two geographic areas.<h4>Method</h4>The study was undertaken in two randomly selected communities (one rural and one urban) in Anambra State, Nigeria. Interviewer-administered questionnaires were used to collect information on util ...[more]

PMID: 30719291

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Project description:ObjectiveTo determine providers' perceived barriers to utilization of antenatal and delivery services in urban and rural communities of Ebonyi state, Nigeria.MethodsA descriptive exploratory study design was used. Qualitative data was collected through the use of a pre-tested interview guide. Twelve providers participated in the study in urban and rural communities of Ebonyi State, Nigeria. They included nine officers in charge of primary health centers, two Chief Nursing Officers of a tertiary health institution and mission hospital and one Medical Officer-in-charge of a General hospital. QDA Miner Lite v2.0.6 was used in the analysis of the data.ResultsMost providers in urban and rural communities attributed good utilization of maternal health services to delivery of quality care. Most providers in urban linked poor utilization to poor health seeking behavior of women. In rural, poor utilization was credited to poor attitude of health workers. Few of participants (urban and rural) pointed out the neglect of primary health centers resulting in poor utilization. Most participants (urban and rural) considered ignorance as the main barrier to using health facilities for antenatal and delivery services. Another constraint identified was cost of services. Most participants attested that good provider attitude and public enlightenment will improve utilization of health facilities for antenatal and delivery care. All participants agreed on the need to involve men in matters related to maternal healthcare.ConclusionsParticipants were aware of values of good provider attitude and this is commendable. This combined with the finding of poor attitude of health workers necessitates that health workers should be trained on quality of care. There is need for public enlightenment on need to utilize health facilities for antenatal and delivery services. Community ownership of primary health centers especially in rural communities will enhance utilization of such facilities for maternal healthcare services and should be encouraged. Involvement of men in matters related to maternal healthcare may have a positive influence in improving maternal health in Nigeria.

Project description:Background:There are wide differences in the uptake of skilled delivery services between urban and rural women in the northern region of Ghana. This study assessed the rural-urban differences in the prevalence of and factors associated with uptake of skilled delivery in the northern region of Ghana. Methods:The study population comprised postpartum women who had delivered within the last three months prior to the study. The dataset was analyzed using the chi-square test and multivariable logistic regression. Results:The odds of skilled birth attendance (SBA) adjusted for confounding variables in urban areas were higher compared with their rural counterparts (AOR?=?1.59; CI: 1. 07-2.37; p=0.02). The determinants of skilled delivery were similar but of different levels and strength in rural and urban areas. The main drivers that explained the relatively high skilled delivery coverage in the urban areas were higher frequency of antenatal care (ANC) attendance, proximity (physical access) to health facility, and greater proportion of women attaining higher educational level of at least secondary school. Distance from health facility less than 4 km was the greatest independent contributor to the variance in skilled delivery in the urban areas, whereas frequency of ANC attendance was the greatest independent contributor in the rural areas. Conclusions:This study identified underlying determinants accounting for rural-urban differences in skilled delivery, and covariate effect was more dominant than coefficient effect. Therefore, urban-rural differences in SBA outcomes were primarily due to differences in the levels of critical determinants rather than the nature of the determinants themselves. Therefore, improving skilled delivery outcomes in this study population and other similar settings will not require different policy frameworks and interventions in dealing with rural-urban disparities in SBA outcomes. However, context-specific tailored approaches and strategies including targeting mechanisms have to be designed differently to reduce the rural-urban differences.

Project description:Mapping the distribution of parasitic diseases in time and space has a pivotal role to play in their control. This study mapped urinary schistosomiasis in Anambra State. Sampling covered the three senatorial districts, Anambra North, Anambra Central and Anambra South. However, only nine of the 21 local government areas (LGAs) and one town in each LGA were covered. A geographic information system (GIS) was used to map the distribution of schistosomiasis in the state. With the aid of GIS, the distance of the towns to water bodies was calculated. A total of 450 urine samples collected from the nine LGAs were examined for haematuria and Schistosoma haematobium eggs. A questionnaire was used to assess exposure and risks status to infection. The urine samples were examined for haematuria using dipstick and microscopy. Overall prevalence of infection in the study was 2.9% and 5.5% for microscopy and haematuria, respectively. Prevalence of schistosomiasis was different between the districts, and this was statistically significant (χ² = 7.763, p = 0.021). Prevalence of urinary schistosomiasis in the towns had a significant negative linear relationship with distance to water body (r = -0.767, p = 0.016). Based on infection status from microscopy, the adjusted odds of infection in fishers was over 103 times higher than in students; the difference was significant statistically (AOR = 103.0443, 95% CI = 4.6278-7093.972, p = 0.0114). People who washed things in stream had 12 times significantly greater odds of infection than those that did not (AOR = 12.4585, 95% CI = 1.9590-258.8108, p = 0.02542). The distance of respondents to stream was a major determinant of infection with urinary schistosomiasis in the state. Those who lived close to water were approximately 1131% more likely to be infected than those who lived far from water bodies (AOR = 11.3157, 95% CI 2.2473-90.6889, p = 0.00713). Anambra State is endemic for urinary schistosomiasis. There is therefore a need for focal studies; and there may probably be a need to design a health program aimed at controlling the infection in focal areas in the state. The study also provides relevant information for designing a plan of action for the selective integrated and targeted control of urinary schistosomiasis in the LGAs.

Project description:BackgroundChildhood immunization is a cost effective public health strategy. Expanded Programme on Immunisation (EPI) services have been provided in a rural Nigerian community (Sabongidda-Ora, Edo State) at no cost to the community since 1998 through a privately financed vaccination project (private public partnership). The objective of this survey was to assess vaccination coverage and its determinants in this rural community in NigeriaMethodsA cross-sectional survey was conducted in September 2006, which included the use of interviewer-administered questionnaire to assess knowledge of mothers of children aged 12-23 months and vaccination coverage. Survey participants were selected following the World Health Organization's (WHO) immunization coverage cluster survey design. Vaccination coverage was assessed by vaccination card and maternal history. A child was said to be fully immunized if he or she had received all of the following vaccines: a dose of Bacille Calmette Guerin (BCG), three doses of oral polio (OPV), three doses of diphtheria, pertussis and tetanus (DPT), three doses of hepatitis B (HB) and one dose of measles by the time he or she was enrolled in the survey, i.e. between the ages of 12-23 months. Knowledge of the mothers was graded as satisfactory if mothers had at least a score of 3 out of a maximum of 5 points. Logistic regression was performed to identify determinants of full immunization status.ResultsThree hundred and thirty-nine mothers and 339 children (each mother had one eligible child) were included in the survey. Most of the mothers (99.1%) had very positive attitudes to immunization and > 55% were generally knowledgeable about symptoms of vaccine preventable diseases except for difficulty in breathing (as symptom of diphtheria). Two hundred and ninety-five mothers (87.0%) had a satisfactory level of knowledge. Vaccination coverage against all the seven childhood vaccine preventable diseases was 61.9% although it was significantly higher (p = 0.002) amongst those who had a vaccination card (131/188, 69.7%) than in those assessed by maternal history (79/151, 52.3%). Multiple logistic regression showed that mothers' knowledge of immunization (p = 0.006) and vaccination at a privately funded health facility (p < 0.001) were significantly correlated with the rate of full immunization.ConclusionEight years after initiation of this privately financed vaccination project (private-public partnership), vaccination coverage in this rural community is at a level that provides high protection (81%) against DPT/OPV. Completeness of vaccination was significantly correlated with knowledge of mothers on immunization and adequate attention should be given to this if high coverage levels are to be sustained.

Dataset Information

Rural-urban comparison of routine immunization utilization and its determinants in communities in Anambra States, Nigeria.

Publications

Rural-urban comparison of routine immunization utilization and its determinants in communities in Anambra States, Nigeria.

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