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Article: African Journal of Reproductive Health: 26 years and soaring.

Okonofua, Friday / Eimuhi, Karl E

2023 Volume 25, Issue 6, Page(s) 11–14

Language	English
Publishing date	2023-08-16
Publishing country	Nigeria
Document type	Editorial
ZDB-ID	2111906-5
ISSN	1118-4841
ISSN	1118-4841
DOI	10.29063/ajrh2021/v25i6.1
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Article: Nigeria's 2023 presidential election and the future of healthcare in the country.

Okonofua, Friday E / Balogun, Joseph Abiodun

African journal of reproductive health

2023 Volume 27, Issue 3, Page(s) 9–18

Abstract: On February 25, 2023, Nigerians took a step forward as a democratic state by voting for a new president. The election is history as the ruling party's candidate, Bola Tinubu, was declared the winner. He polled 37% of the vote, his main rival Abubakar ... ...

Abstract	On February 25, 2023, Nigerians took a step forward as a democratic state by voting for a new president. The election is history as the ruling party's candidate, Bola Tinubu, was declared the winner. He polled 37% of the vote, his main rival Abubakar Atiku garnered 29%, and Labour's Peter Obi 25%. Only 27% of registered voters came out to vote. International election observers noted that the election lacked transparency and was marred by logistical challenges and multiple incidents of political violence. The currency and fuel shortages in the country burdened many voters and election officials and therefore marginalised many groups, especially women, who continue to face barriers to political office. The outcome of the election is in contention and inconclusive. The aggrieved parties have taken their case to court, so the nation awaits the outcome of the court decision. In this Editorial, AJRH analyses the prospects and implications of Tinubu's presidency for healthcare in Nigeria.
MeSH term(s)	Male ; Humans ; Female ; Nigeria ; Delivery of Health Care ; Politics ; Health Facilities
Language	English
Publishing date	2023-08-16
Publishing country	Nigeria
Document type	Editorial
ZDB-ID	2111906-5
ISSN	1118-4841
ISSN	1118-4841
DOI	10.29063/ajrh2023/v27i3.1
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Article: Spontaneous second trimester rupture of a previous caesarean section scar: A case report.

Isikhuemen, Maradona E / Imarengiaye, Celestine A / Oyelade, Temitope A / Okonofua, Friday E

African journal of reproductive health

2024 Volume 28, Issue 2, Page(s) 125–128

Abstract: Spontaneous uterine rupture before the onset of labour is rare in pregnancy especially before the third trimester. It is life threatening with devastating consequences to the mother and fetus. We report a case of spontaneous second trimester uterine ... ...

Abstract	Spontaneous uterine rupture before the onset of labour is rare in pregnancy especially before the third trimester. It is life threatening with devastating consequences to the mother and fetus. We report a case of spontaneous second trimester uterine rupture in a multipara with a previous uterine scar with the aim of creating awareness and sharing the challenges in diagnosis and management of this unusual complication of pregnancy. A 34-year-old woman with two previous deliveries presented at 16 weeks gestation with abdominal pain and vaginal bleeding of one day duration. At presentation, she was pale and in shock. There was generalized abdominal tenderness with guarding and rebound tenderness. At laparotomy, there was uterine rupture involving the lower segment with right lateral upward extension which was repaired. She remained stable at the follow up visit. In conclusion, Spontaneous uterine rupture of a previous caesarean section scar in the second trimester is rare. The diagnosis should be considered in a woman with previous caesarean section who experience an acute abdomen in the second trimester of pregnancy.
MeSH term(s)	Pregnancy ; Female ; Humans ; Adult ; Pregnancy Trimester, Second ; Uterine Rupture/diagnosis ; Uterine Rupture/etiology ; Uterine Rupture/surgery ; Cesarean Section/adverse effects ; Cicatrix/complications ; Cicatrix/surgery
Language	English
Publishing date	2024-03-06
Publishing country	Nigeria
Document type	Case Reports
ZDB-ID	2111906-5
ISSN	1118-4841
ISSN	1118-4841
DOI	10.29063/ajrh2024/v28i2.12
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Article ; Online: An empirical analysis of the demand for family planning satisfied by modern methods among married or in-union women in Nigeria: Application of multilevel binomial logistic modelling technique.

Odjesa, Emomine / Okonofua, Friday Ebhodaghe

PloS one

2024 Volume 19, Issue 3, Page(s) e0300744

Abstract: Background: Given the health and economic benefits of family planning (FP), Nigeria's very low demand for FP satisfied by modern methods (mDFPS) of less than 50% is therefore a major public health concern, especially considering the global target aimed ... ...

Abstract	Background: Given the health and economic benefits of family planning (FP), Nigeria's very low demand for FP satisfied by modern methods (mDFPS) of less than 50% is therefore a major public health concern, especially considering the global target aimed at achieving an mDFPS of at least 75% by year 2030 for all countries. In view of this, together with recognising the possible contextual nature of health outcomes, this study aimed to empirically analyse the mDFPS among married or in-union women of reproductive age (WRA) in Nigeria. Materials and methods: A multilevel binomial logistic model with two levels of analysis was used: individual and community levels. Secondary cross-sectional data were obtained from the 2018 Nigeria Demographic and Health Survey, and analyses were performed using Stata 15.0. The analytical sample size was 9,122 WRA nested in a total of 1,072 communities. Results: The mDFPS was approximately 31.0%. The median odds ratio (MOR) estimated from the final multilevel model was 2.245, which was greater than the adjusted odds ratio (aOR) for most of the individual-level variables, suggesting that the unexplained/residual between-community variation in terms of the odds of women having their mDFPS was more relevant than the regression effect of most of the individual-level variables. This was with the exception of the regression effects of the following individual-level variables: women's husbands that had higher education level in comparison to their counterparts who had husbands with no formal education (aOR = 2.539; 95% CI = 1.896 to 3.399; p<0.001); and women from the Yoruba ethnic group in comparison to their counterparts from the Hausa/Fulani/Kanuri ethnic group (aOR = 2.484; 95% CI = 1.654 to 3.731; p value<0.001). However, other individual-level variables with positive statistically significant regression effects on mDFPS were: women who mentioned that money for accessing health care was not a problem; women's empowerment in relation to the visitation of family and relatives; and women being exposed to FP messages through various media sources, all in comparison to their respective counterparts. On the other hand, at the community level, women in communities where a high percentage of them had at least a secondary education had statistically significant greater odds of having mDFPS than women in communities with lower education levels (aOR = 1.584; 95% CI = 1.259 to 1.991; p<0.001). We found similar findings regarding women residing in communities with exposure to FP messages through various media sources. However, using the 80% interval ORs (80% IORs) as a supplemental statistical measure for further understanding the regression effects of community-level variables showed that all of the 80% IORs had a value of '1', signifying considerable uncertainty in the regression effects of all community-level variables due to the substantial residual variation existing between communities. Conclusions: Our study showed that to achieve the dire increase in mDFPS in Nigeria, policy interventions aimed at improving the education level of both females and males, especially beyond the secondary school level, should be implemented. Additionally, all of the various media sources should be extensively utilised, both at the individual and the community level, by the Nigerian government to spread information on the importance of women having their mDFPS.
MeSH term(s)	Male ; Humans ; Female ; Family Planning Services ; Contraception ; Nigeria ; Cross-Sectional Studies ; Contraception Behavior ; Multilevel Analysis
Language	English
Publishing date	2024-03-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0300744
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Article ; Online: Prevalence and determinants of condom use among the youth in Malawi: evidence from the 2015/16 Malawi Demographic and Health Survey.

Jimu, Scholastica Eunice / Ntoimo, Lorretta F C / Okonofua, Friday E

Reproductive health

2023 Volume 20, Issue 1, Page(s) 170

Abstract: Background: Unprotected sexual intercourse among the youth is common in Malawi. This has led to high rates of sexually transmitted infections (STIs), Human Immunodeficiency Virus (HIV), and unplanned pregnancies. The study investigated the prevalence ... ...

Abstract	Background: Unprotected sexual intercourse among the youth is common in Malawi. This has led to high rates of sexually transmitted infections (STIs), Human Immunodeficiency Virus (HIV), and unplanned pregnancies. The study investigated the prevalence and the determinants of male and female condom use for the prevention of sexually transmitted infections and unplanned pregnancies among the youth in Malawi. Methods: The 2015/2016 Malawi Demographic and Health Survey (MDHS) data were used among 15 to 24-year-old male and female who had sexual intercourse four months preceding the survey. A total of 1543 male and 5143 female were selected from 3226 male and 10,367 female respectively and analyzed with SPSS version 20 using.descriptive, bivariate, and logistic regression. Results: The study found a low prevalence (27.1%) of condom use among the youth in the last sexual intercourse within four months before the survey. More male (55.8%) used condoms than female (18.5%). The significant predictors of condom use among the male and female youth were: being sexually active (OR 0.39 CI 0.33-0.47), aged 20-24 (OR 0.80 CI 0.68-0.95), ever married (OR 0.07 CI 0.06-0.08), coming from central region (OR 0.56 CI 0.40-0.77), and southern region (OR 0.59 CI 0.42-0.83), residing in the rural area (OR 0.74 CI 0.61-0.90) and ever tested of HIV (OR 1.29 CI 1.03-1.55). Conclusion: Having established low prevalence of condom use among the youth in Malawi, there is a need to scale up programs and policies that target the youth to practice safe sex, which will assist in addressing the challenges of STIs, including HIV, and preventing unplanned pregnancies in Malawi.
MeSH term(s)	Adolescent ; Adult ; Female ; Humans ; Male ; Pregnancy ; Young Adult ; Condoms ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Malawi/epidemiology ; Marriage ; Prevalence ; Safe Sex ; Sexual Behavior ; Sexually Transmitted Diseases
Language	English
Publishing date	2023-11-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2149029-6
ISSN	1742-4755 ; 1742-4755
ISSN (online)	1742-4755
ISSN	1742-4755
DOI	10.1186/s12978-023-01714-9
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Article ; Online: Seeking maternal health care in rural Nigeria: through the lens of negofeminism.

Udenigwe, Ogochukwu / Okonofua, Friday E / Ntoimo, Lorretta F C / Yaya, Sanni

Reproductive health

2023 Volume 20, Issue 1, Page(s) 103

Abstract: Background: Feminist scholarship is acutely aware that health is not dependent on behavioural choices alone but on interlocking social determinants that affect people's capacity to lead healthy lives. Women are situated within social structures that ... ...

Abstract	Background: Feminist scholarship is acutely aware that health is not dependent on behavioural choices alone but on interlocking social determinants that affect people's capacity to lead healthy lives. Women are situated within social structures that impact their health. but there is limited engagement with interpretive tools such as feminist theories that centre the realities of African women, particularly in the context of maternal health. It is imperative that women's control over their reproductive health and autonomy in seeking care, particularly skilled maternal healthcare are understood within this context. This study seeks to examine pregnant women's socio-cultural realities in a Nigerian context and in congruence with articulations of African feminism. Feminist scholarship acknowledges that women are situated within social structures that impact their health. Therefore, this paper seeks to examine pregnant women's socio-cultural realities in a Nigerian context and in congruence with articulations of African feminism. Method: This is a cross-sectional qualitative study of a total of 64 participants: 39 women and 25 men in Ewato and Okpekpe communities, two Local Government Areas of Edo State in southern Nigeria. The study presents findings from eight sex-and-age desegregated focus group discussions. This study reports on emergent data related to women's decision-making in accessing skilled maternal care. Data were transcribed and translated to English. Using the NVivo 1.6 software, data were coded and analyzed using a conventional approach to content analysis. Results: Findings describe ways in which women negotiate authority by ascribing the role of decision-maker to their men spouses while maintaining influence over their pregnancy healthcare decisions and actions. Negofeminism's concepts of alliance, community and connectedness were highlighted through men's constructive involvement in maternal health. Furthermore, women were shown to maneuver patriarchal norms to gain control of their healthcare decisions. Conclusion: This study offers a different narrative from the dominant view of non-Western women, specifically African women, as oppressed passive victims who are ineffectual in taking charge of their health. From the perspective of negofeminism, women navigate patriarchal environments to yield the best possible maternal health outcomes. The current study can be useful in informing policy and programming that acknowledges women's social embeddedness.
MeSH term(s)	Male ; Humans ; Female ; Pregnancy ; Prenatal Care ; Maternal Health ; Nigeria ; Cross-Sectional Studies ; Qualitative Research
Language	English
Publishing date	2023-07-17
Publishing country	England
Document type	Journal Article
ZDB-ID	2149029-6
ISSN	1742-4755 ; 1742-4755
ISSN (online)	1742-4755
ISSN	1742-4755
DOI	10.1186/s12978-023-01647-3
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Article ; Online: Enablers and barriers to the acceptability of mHealth for maternal healthcare in rural Edo, Nigeria.

Udenigwe, Ogochukwu / Okonofua, Friday E / Ntoimo, Lorretta F C / Yaya, Sanni

Dialogues in health

2022 Volume 1, Page(s) 100067

Abstract: 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 ... ...

Abstract	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.
Language	English
Publishing date	2022-10-30
Publishing country	United States
Document type	Journal Article
ISSN	2772-6533
ISSN (online)	2772-6533
DOI	10.1016/j.dialog.2022.100067
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Article: COVID-19: Perspectives and Reflections from Africa.

Okonofua, Friday E / Eimuhi, Karl E / Omonkhua, Akhere A

African journal of reproductive health

2020 Volume 24, Issue 1, Page(s) 10–13

MeSH term(s)	Africa/epidemiology ; Betacoronavirus ; COVID-19 ; Coronavirus ; Coronavirus Infections/epidemiology ; Humans ; Pandemics ; Pneumonia, Viral/epidemiology ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-05-02
Publishing country	Nigeria
Document type	Editorial
ZDB-ID	2111906-5
ISSN	1118-4841
ISSN	1118-4841
DOI	10.29063/ajrh2020/v24i1.1
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Article ; Online: Understanding gender dynamics in mHealth interventions can enhance the sustainability of benefits of digital technology for maternal healthcare in rural Nigeria.

Udenigwe, Ogochukwu / Okonofua, Friday E / Ntoimo, Lorretta F C / Yaya, Sanni

Frontiers in global women's health

2022 Volume 3, Page(s) 1002970

Abstract: Introduction: Nigeria faces enormous challenges to meet the growing demands for maternal healthcare. This has necessitated the need for digital technologies such as mobile health, to supplement existing maternal healthcare services. However, mobile ... ...

Abstract	Introduction: Nigeria faces enormous challenges to meet the growing demands for maternal healthcare. This has necessitated the need for digital technologies such as mobile health, to supplement existing maternal healthcare services. However, mobile health programs are tempered with gender blind spots that continue to push women and girls to the margins of society. Failure to address underlying gender inequalities and unintended consequences of mobile health programs limits its benefits and ultimately its sustainability. The importance of understanding existing gender dynamics in mobile health interventions for maternal health cannot be overstated. Objective: This study explores the gender dimensions of Text4Life, a mobile health intervention for maternal healthcare in Edo State, Nigeria by capturing the unique perspectives of women who are the primary beneficiaries, their spouses who are all men, and community leaders who oversaw the implementation and delivery of the intervention. Method: This qualitative study used criterion-based purposive sampling to recruit a total of 66 participants: 39 women, 25 men, and two ward development committee chairpersons. Data collection involved 8 age and sex desegregated focus group discussions with women and men and in-depth interviews with ward development committee chairpersons in English or Pidgin English. Translated and transcribed data were exported to NVivo 1.6 and data analysis followed a conventional approach to thematic analysis. Results: Women had some of the necessary resources to participate in the Text4Life program, but they were generally insufficient thereby derailing their participation. The program enhanced women's status and decision-making capacity but with men positioned as heads of households and major decision-makers in maternal healthcare, there remained the possibility of deprioritizing maternal healthcare. Finally, while Text4Life prioritized women's safety in various contexts, it entrenched systems of power that allow men's control over women's reproductive lives. Conclusion: As communities across sub-Saharan Africa continue to leverage the use of mHealth for maternal health, this study provides insights into the gender implications of women's use of mHealth technologies. While mHealth programs are helpful to women in many ways, they are not enough on their own to undo entrenched systems of power through which men control women's access to resources and their reproductive and social lives.
Language	English
Publishing date	2022-09-06
Publishing country	Switzerland
Document type	Journal Article
ISSN	2673-5059
ISSN (online)	2673-5059
DOI	10.3389/fgwh.2022.1002970
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Article ; Online: Exploring underutilization of skilled maternal healthcare in rural Edo, Nigeria: A qualitative study.

Udenigwe, Ogochukwu / Okonofua, Friday E / Ntoimo, Lorretta F C / Yaya, Sanni

PloS one

2022 Volume 17, Issue 8, Page(s) e0272523

Abstract: Introduction: Existing studies have acknowledged the underutilization of skilled maternal healthcare services among women in rural Nigeria. Consequently, women in rural areas face a disproportionate risk of poor health outcomes including maternal ... ...

Abstract	Introduction: Existing studies have acknowledged the underutilization of skilled maternal healthcare services among women in rural Nigeria. Consequently, women in rural areas face a disproportionate risk of poor health outcomes including maternal morbidity and mortality. Addressing the challenge of non-use of skilled maternal healthcare in rural areas necessitates the involvement of multi-stakeholders across different sectors who have vital roles to play in improving maternal health. This study explores the factors contributing to the non-use of maternal healthcare services in rural areas of Edo, Nigeria from the perspectives of community elders and policymakers. Methods: In this qualitative study, data were collected through 10 community conversations (group discussions) with community elders each consisting of 12 to 21 participants, and six key informant interviews with policymakers in rural areas of Edo State, Nigeria. Participants were purposefully selected. Conversations and interviews occurred in English, Pidgin English and the local language; lasted for an average of 9 minutes; were audio-recorded and transcribed to English. Data were manually coded, and data analysis followed the analytical strategies for qualitative description including an iterative process of inductive and deductive approaches. Results: Policymakers and community elders attributed the non-use of maternal health services to poor quality of care. Notions of poor quality of care included shortages in skilled healthcare workers, apathy and abusive behaviours from healthcare providers, lack of life-saving equipment, and lack of safe skilled pregnancy care. Non-use was also attributed to women's complex utilization patterns which involved a combination of different types of healthcare services, including traditional care. Participants also identified affordability and accessibility factors as deterrents to women's use of skilled maternal healthcare. Conclusion: The emerging findings on pregnant women's combined use of different types of care highlight the need to improve the quality, availability, accessibility, and affordability of skilled maternal care for rural women in Nigeria.
MeSH term(s)	Aged ; Female ; Health Services Accessibility ; Humans ; Maternal Health Services ; Nigeria ; Pregnancy ; Qualitative Research ; Rural Population
Language	English
Publishing date	2022-08-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0272523
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