Sex-ratio at birth in Nigeria: A demographic perspective

The study attempts at estimating the sex-ratio at birth in Nigeria. The study focuses on demographic surveys with complete maternity histories, including some 0.50 million births. It compares results with published estimates from births in health facilities and a few data from vital registration, including some 1.13 million births. Results from demographic surveys give an estimate of about 106 boys for 100 girls. There were no significant variations by large region in the country, and no significant trend over the years (1990-2018). Published estimates provided a similar value (106.2), with somewhat lower value in health facilities (105.3), and somewhat higher values in local vital registration (106.8), and major variations among available studies. Despite uncertainty, Nigeria appears to have higher sex-ratios than most African countries, with the exception of Ethiopia, and higher values than its five neighboring countries. Reasons for these high values of the secondary sex-ratio are discussed. (Afr J Reprod Health 2022; 26[4]: 92-97).

Controlled impact evaluation of a birth registration intervention, Burkina Faso

Objective To evaluate the impact of the introduction of secondary civil registration centres on birth registrations within 60 days of birth, in Burkina Faso. Methods The faith-based organization Sant'Egidio supported the inauguration of secondary birth registration centres within seven health centres in Réo from July 2015 and four health centres in Godyr from February 2015, at which delivery and vaccination services were available. We calculated the number of timely registrations per 1000 population before and after the launch of the intervention in both the intervention and control municipalities. We used a logistic regression model to evaluate the probability of non-registration as a function of the health centre services used and various demographic and health characteristics, obtained through health registers data and interviews. Findings Compared with the previous 12 months, the number of timely birth registrations in Réo and Godyr rose from 502 to 2094 (317.1%) and from 267 to 793 (197.0%) during the first 12 months of the intervention. In the two control municipalities, the numbers were unchanged. Infants whose mothers attended health centres for delivery, but did not return for vaccinations, had the lowest proportions of birth registration (69.0%; 294/426; in Réo and 70.2%; 40/57 in Godyr). Infants of mothers who were not interviewed were more likely to not having a timely birth registration (in Réo odds ratio, OR: 6.25; 95% confidence interval, CI: 4.10­9.52 and in Godyr OR: 25.64; 95% CI: 4.31­166.67).Conclusion Introduction of secondary registration centres within health centres increased timely birth registrations

Validation of verbal autopsy methods for assessment of child mortality in sub-Saharan Africa and the policy implication: a rapid review

Reliable data on the cause of child death is the cornerstone for evidence-informed health policy making towards improving child health outcomes. Unfortunately, accurate data on cause of death is essentially lacking in most countries of sub-Saharan Africa due to the widespread absence of functional Civil Registration and Vital Statistics (CRVS) systems. To address this problem, verbal autopsy (VA) has gained prominence as a strategy for obtaining Cause of Death (COD) information in populations where CRVS are absent. This study reviewed publications that investigated the validation of VA methods for assessment of COD. A MEDLINE PubMed search was undertaken in June 2018 for studies published in English that investigated the validation of VA methods in sub-Saharan Africa from 1990-2018. Of the 17 studies identified, 9 fulfilled the study inclusion criteria from which additional five relevant studies were found by reviewing their references. The result showed that Physician-Certified Verbal Autopsy (PCVA) was the most widely used VA method. Validation studies comparing PCVA to hospital records, expert algorithm and Inter VA demonstrated mixed and highly varied outcomes. The accuracy and reliability of the VA methods depended on level of healthcare the respondents have access to and the knowledge of the physicians on the local disease aetiology and epidemiology. As the countries in sub-Saharan Africa continue to battle with dysfunctional CRVS system, VA will remain the only viable option for the supply of child mortality data necessary for policy making

Socio-Demographic Determinants of Birth Registration among Mothers in an Urban Community in Southern Nigeria

Background: Birth registration is both a fundamental human right and an essential means of protecting a child's right to identity. Objective: The aim was to assess the awareness; knowledge and practice of birth registration by mothers and the socio-demographic determinants of birth registration in an urban community in southern Nigeria. Methodology: A community-based descriptive cross-sectional study was carried out among mothers in an urban community in Ovia North East local government area of Edo State; Nigeria. A structured interviewer administered questionnaire was used for data collection. Data were analyzed using SPSS version 20. Results: Awareness of birth registration was high (69.6) with mass media as the major source of information (60.5); but the composite knowledge of it was poor. Awareness of the agency responsible for birth registration was poor. Only 44.2 of the respondents registered the births of their children; two-thirds of those who registered births possess a birth certificate. Marital status and level of education were significantly associated with the knowledge of birth registration. Age; level of education; marital status; occupation; and place of delivery were the determinants of the practice of birth registration. Conclusion: There is a need for a change of strategy in the campaign for birth registration so that awareness can translate into better knowledge and practice. We advocate the establishment of community-based birth registration centers to improve accessibility and practice of birth registration

Review of the Structure and Function of Vital Registration System in Ghana: Towards Improvement in Mortality Data Quality for Health Policy Analysis

Vital registration systems (VRS) are important in the collection of routine data on indicators of development. These are particularly useful if they are properly built to address weaknesses in the system leading to poor data quality. For instance; routine data on health events (e.g. morbidity; mortality etc.) are crucial for rapid assessment of disease burden and mortality trends in the population. They are also useful in the identification of vulnerable groups in populations. Despite their usefulness; VRS in many developing countries including Ghana are poorly structured raising questions about the quality of the output data from these systems. The present study aimed at assessing and documenting the structure and function of the VRS in Ghana; as well as at identifying the structural features that potentially compromise the reliability and validity of the output data the system. To perform this study; collection and review of policy and legal documents establishing the VRS; documentation and evaluation of component structures of the system; assessment of procedural protocols guiding data collection processes and in-depth interviews with staff at the Ghana Births and Deaths Registry were performed. The assessment of the structure of the Ghana VRS; policy documents setting it up and the operational procedures reveals important lapses (e.g. presence of outmoded practices; imperfections in Births and Deaths Registry Act; 1965; Act 301 and imperfect system design) in the system that could compromise validity and reliability of the data generated from the registration in Ghana

A study of factors contributing to low attendance of children aged between 1-5 years at growth-monitoring programmes; Kitwe; Zambia

The study revealed that there were various factors contributing to low attendance; among them being mothers education and social status; distance health centres; laziness; long queues; shortage of scales and staff