Hunger in the midst of plenty: a survey of household food security among urban families in Lagos State, Nigeria

Research has documented that food security at national level does not translate to food security at household level. The study assessed the level of food security among urban households in Shomolu LGA, Lagos State. Using the 9-item Household Food Insecurity Access Scale (HFIAS) information was collected from 306 heads of households on adequacy of food availability and consumption. Data were analyzed using Epi info and presented as frequencies and percentages. Associations between variables were tested using Chisquare at a significance level of 0.05. Households were classified as food secure, food insecure without hunger and food insecure with hunger. Only 33.8% of households were food secure, 45.1% were food insecure without hunger and 21.1% were food insecure with hunger. Food secure households were statistically significantly associated with households where heads had secondary or higher education, women were married, spending <40% of household monthly income on food and living in their own homes (P=0.001). Household food insecurity is found in urban communities and is positively associated with indicators of poverty

Health insurance and user fees: a survey of health service utilization and payment method in Mushin lga, Lagos, Nigeria

Background: Studies have documented how out-of-pocket payments (OOP) and user fees result in catastrophic health expenditures, providing evidence that health systems are better financed through prepayment mechanisms such as health insurance. Aim: This study sought to determine the perception of community residents to health insurance, their pattern of health service utilization and method and amount of payment. Methods: This descriptive cross-sectional study among 422 household members in Mushin LGA obtained data on sociodemographic characteristics, perception of health insurance, enrollment status and willingness to enroll; last use of health services and method of payment for health care services. Data analysis was done with Epi-info (ver 7) and results were presented as frequencies, percentages, means and standard deviations. Statistically significant associations were determined using the Chi-square test at significance level of p < 0.05. Results: Over half the respondents (56.6%) had not heard about health insurance. Very few (19.7%) were enrolled. Of those not enrolled, 57.1% were willing to consider buying health insurance. The method of payment for health services reported by respondents was OOP (98.3%). Those in younger age groups, with higher levels of education and higher household incomes reported having heard of health insurance. Higher educational level and household incomes were positively associated with willingness to enroll in a health insurance scheme. Conclusion: Awareness was insufficient, health services were paid for mostly from OOP. The authors recommend taking the opportunity to encourage uptake of health insurance for young adults and those in low- and middle-income households

Genetic Diseases and Prenatal Genetic Testing: Knowledge Gaps, Determinants of Uptake and Termination of Pregnancies among Antenatal Clinic Attendees in Lagos, Southwest Nigeria

Background: Though prenatal genetic testing has been shown to have immense benefits, reports suggest it is not routinely done and is unavailable to many pregnant women in Nigeria. Factors associated with prenatal genetic testing as well as ethical aspects of consequent options available need to be assessed if prenatal testing is to be proposed to Nigerian women. Aims: This study evaluated the knowledge of genetic diseases and prenatal genetic testing, willingness to test, attitudes towards testing, use of common tests available as well as willingness to terminate affected pregnancies among antenatal clinic attendees in selected health facilities in an urban local government area (LGA) in Lagos, southwest Nigeria. Materials and Methods: This was a descriptive cross-sectional study. The study participants were 327 pregnant women in any of the three trimesters of pregnancy interviewed with structured questionnaires in two primary and one secondary health facility in the Local Government Area. Collected data was analysed using Epi-Info 7.2 statistical software. Results: Respondents' mean age was 30 years ± 4.22. Majority of the respondents had post-secondary education, were experiencing their first pregnancy, and had no previous pregnancies or relatives with genetic diseases. More than half (69.4%) of the respondents had poor knowledge of genetic diseases. Almost all the respondents (97.6%) had poor knowledge of prenatal genetic testing. Majority of respondents (61.8%) were willing to undergo testing. Only 23.9% of the respondents had good attitude scores. Majority (26.9%) of the participants who had made use of a prenatal screening or diagnostic test had made use of ultrasound and blood test before three months of pregnancy. Only 10.1% of the population stated that they would opt to terminate affected pregnancies. Knowledge of genetic diseases significantly correlated with decision to terminate affected pregnancies. Conclusion: Education and approaches to ensure improved supportive care and treatment for children with genetic diseases should be explored in our environment