Vaccine-preventable diseases are responsible for severe rates of morbidity and mortality in Africa. Despite the availability of appropriate vaccines for routine use on infants, vaccine-preventable diseases are highly endemic throughout sub-Saharan Africa. Widespread disparities in the coverage of immunization programmes persist between and within rural and urban areas, regions and communities in Nigeria.
This study assessed the individual- and community-level explanatory factors associated with child immunization differentials between migrant and non-migrant groups.
Methods: The proportion of children that received each of the eight vaccines in the routine immunization schedule in Nigeria was estimated. Multilevel multivariable regression analysis was performed on a nationally representative sample of 6029 children from 2735 mothers aged 15-49 years and nested within 365 communities. Odds ratios with 95% confidence intervals were used to express measures of association between the characteristics.
Results: The pattern of full immunization clusters within families and communities. Findings provide support for the traditional migration hypotheses, and show that individual-level characteristics, such as, migrant disruption (migration itself), selectivity (demographic and socio-economic characteristics), and adaptation (health care utilization), as well as community-level characteristics (region of residence, and proportion of mothers who had hospital delivery) are important in explaining the differentials in full immunization among the children.
Conclusions: Migration is an important determinant of child immunization uptake. This study stresses the need for community-level efforts at increasing female education, measures aimed at alleviating poverty for residents in urban and remote rural areas, and improving the equitable distribution of maternal and child health services.
Author: Diddy Antai Credits/Source: BMC Public Health 2010, 10:116
The Measurement, Learning & Evaluation Project will spotlight six stories a year that personalize the reproductive health barriers and challenges for women and men living in urban slums. Future stories will be on Senegal (February 2010), and Kenya (April 2010)
This feature story describes the fictional life of Olubukola and Kehinde, a married couple, and their children living in the slums of Abuja, Nigeria, the difficulties they face in accessing health care, and how low-cost, high-quality, accessible family planning services integrated into primary, maternal, and HIV care could empower the family.
Lagos — More Nigerians currently depend on generators to power business and homes. Consequently, instances of fumes emitted and discharged right into the streets are common, a situation that is occasioned by the epileptic power supply in the country.
Experts consider the emissions highly dangerous given that they constitute danger to healthy living since they end up polluting the airways. They are also primary air pollutants because the fumes are emitted directly into the airways while the average residents and passersby inhale them daily.
The situation is actually compounded by the failure of the Power Holding Company of Nigerian (PHCN) to supply the needed power to run businesses in the country. Consequently, most businesses are powered by generators. And apart from the air pollution, noise pollution is said to have resulted in hearing losses for some 7.2 million Nigerians; representing 17.9 percent of the population aside the health implications.
It is also stated that prolonged exposure to intense noise leads to permanent hearing loss; induces stress; causes inefficiency at work; prevents sleep; causes irritability and generally degrades the quality of life.
According to Akeem Bello of the faculty of Law, University of Lagos, one of the principal sources of noise pollution in the state is neighbourhood noise which he defined as ‘great variety of sources of noise which may cause disturbance and noise to the general public not including road traffic and aircraft noise and industrial noise affecting workers and residents’.
He added that the impact of neighbourhood noise is more on densely populated cities like Lagos.
‘In a typical densely polluted urban area, the picture is one of a thick cloud of noise coming from a variety of sources. The sources include loud noise emanating from loudspeakers used by record stores; generating plants; pumping machines; grinding machines; television sets; musical sets; intruder alarms; night parties; churches and mosques,” he said.
The University lecturer noted that with the proliferation of religious places of worship, noise emanating from religious activities has been one of the primary sources of neighbourhood noise in the state.
He also identified others sources of air pollution in the state to road traffic and vehicular emissions
“It is estimated that Lagos has the highest national vehicular density of over 222 vehicles per kilometer against a country average of 11/kilometers while the growth of the use of motorcycles popularly known as okada has also greatly increased the problem of air pollution,” Bello noted.
However, as part of efforts at curbing neighbourhood noise pollution, the Lagos State Government through the Ministry of the Environment issued a ministerial directive to all religious houses to confine their loudspeakers inside their places of worship to the auditoriums.
And recently its efforts received a boost when West African Gas Pipeline Company (WAGPC) donated noise measuring meter and other equipment to it.
The equipment, which will help the Ministry to measure the level of noise generated from industrial and residential areas, will assist in reducing noise pollution to the barest minimum in order to safeguard the health of the citizenry.
WAGPC Corporate Affairs Manager, Mrs. Harriet Wereko-Brobby, who led the delegation, said the donation was a way of appreciating government’s effort at attaining sustainable environment devoid of pollution and degradation.
“The items will help the Ministry measure the level of noise at any time,” she said.
Stressing that noise level at any point in time, should not be more than 85 decibels, she noted that anything above that was capable of negatively affecting the health of the people.
She lauded the Ministry on its beautification, drainage, sanitation and landscaping projects, noting that, those projects would go a long way in combating the menace of climate change which she noted is at present the problem confronting the whole World.
Dr. Titilayo Anibaba, the Permanent Secretary in Ministry of the Environment who received the equipment thanked the company for its concerns for the environment and healthy living of the citizens.
She urged the management of the company to do more in the areas of capacity building and exchange programmes that would benefit both parties.
Anibaba explained that the issue of noise pollution has reached an alarming rate with a recently conducted study among public school pupils in the state indicating that more than 60 per cent of them have hearing impairment due to their daily exposure to a noisy environment.
She also disclosed that the Ministry has received several complaints from the public against noise pollution from the religious groups, merry makers, musical and video centres as well as household generators.
While appealing to members of the public to support government’s effort at reducing pollution to the barest minimum, Anibaba revealed that experts have found out that noise pollution is the major cause of sleeplessness leading to high blood pressure, hypertension and a times stroke.
She, however, assured that the state government would deploy the equipment for the purpose they were donated and also do everything possible to protect the lives and well-being of the citizens through the implementation of sustainable programmes that will promote healthy and sustainable environment.
The Measurement, Learning & Evaluation (MLE) Project will use rigorous evaluation methods to determine if Urban Reproductive Health Initiative (URHI) interventions in four countries (India, Nigeria, Kenya, and Senegal) increase contraceptive use among urban populations (particularly the urban poor) and improve the quality of and access to integrated reproductive health services in urban areas. The MLE project will also identify the cost-effectiveness of URHI interventions, when feasible. Using a quasi-experimental design with four intervention and two comparison cities in each country, the MLE project will survey women and evaluate reproductive health service delivery points at two-year intervals for up to four years. The study will also include cross-sectional surveys of women (and men in some countries) in a hybrid study design. This report highlights the MLE study design and its technical components.
The Measurement, Learning & Evaluation (MLE) Project for the Urban Reproductive Health Initiative (URHI) is pleased to announce the launch of its website: www.urbanreproductivehealth.org. Through a rigorous evaluation study design, the MLE project will identify approaches that increase contraceptive prevalence rates in rapidly growing cities in India, Nigeria, Kenya, and Senegal.
The MLE project serves as the technical resource for local efforts to monitor and evaluate URHI programs in these countries and documents evidence-based best practices for health services that target the urban poor. Through the website and other dissemination events, the MLE project plans to share promising approaches with policy makers, program managers, and researchers globally and build local capacity to undertake rigorous measurement and evaluation of population, family planning, and integrated reproductive health activities targeting vulnerable urban populations.
To receive the MLE quarterly e-newsletter, please register at: http://www.cpc.unc.edu/urbanreproductivehealth/registration.
Abuja — Programme Officer of the United Nations Habitat Programme Support Office (HAPSO), Barnabas Atiyaye, has said 50 million out of the 140 million Nigerians live in slums across the country.
Atiyaye stated this at a media chat organised by Women Environmental Programme on climate change and housing for the poor in the context of Nigeria in Abuja.
He said the shelter conditions of the poor are deteriorating, as 70 per cent of the urban dwellers live in slums.
He pointed out that housing represents the most basic of human needs and has a profound impact on the health, welfare and productivity of individuals, adding that globally, one billion people still lack adequate shelter and basic services.
He noted with dismay that the Nigerian government does not have data on the urban poor, thus making it difficult to plan for them.
To this end, he called on the government to prepare and adopt land use plans for all human settlements, suggesting that local government councils should administer land matters to make land more accessible to the poor.
Speaking in the same vein, former Vice Chancellor of Benue State University, David Ker, said “lack of housing options for the poor, the vagaries of climate change and its impact on the vulnerable, attendant urbanisation, present daunting challenges to us a people and a nation.”
He noted that climate change and urban poverty are inextricably linked, adding that the living conditions of low-income slum settlements are deplorable and deleterious to health and wellbeing of residents.
Isa earns a hard living pushing a heavy water cart around the rutted streets of the suburbs of Nigeria’s capital, Abuja.
He is one of tens of thousands of water vendors who deliver jerry cans full of water to houses built without any kind of sanitation.
“Kai! it is hard work, pushing my cart,” the 20-year-old says.
Nigeria is Africa’s most populous nation, and according to analysts has made over $1.1 trillion in revenues from the oil industry over the last 30 years; but most Nigerians still rely on people like Isa for their water.
He and a dozen of his friends sleep in a makeshift shelter behind a small household goods shop.
They wake before dawn to queue up at a nearby borehole, where they fill 14 yellow 25-litre jerry cans on their handcarts before setting off around the streets looking for customers.
Fully loaded, the carts weigh at least 350kgs.
The roads they push them over are dirt tracks, rocky and pitted, with sewers running down the middle.
“In the future I want to get another job, but at least I make enough money to live doing this,” Isa says.
The urban poor pay more for water than the urban rich
Prices for water from private boreholes vary in the suburbs.
Isa pays around 10 naira ($0.07, £0.05) per jerry can at the borehole and sells for double that.
He makes around 700 naira a day ($4.70, £3.20), to cover food and living costs.
A large Nigerian family may need around 10 of these jerry-cans every day, customers say.
That adds up to about $486 (£339) every year, a massive pressure on a country where the average person lives on $2 a day.
This is a pattern repeated around the world, according to the UN Development Programme.
The urban poor in developing world cities including Abuja pay much more for their water than citizens of rich cities such as New York or Tokyo, precisely because the poor have to depend on private providers rather a piped municipal supply.
Virtually none of the suburbs of Nigeria’s capital city have what is known here as “pipe-born water” provided by the government.
Private individuals have to drill boreholes for themselves.
They are most often fitted with two sets of taps – one for the household, and another facing the street so the owners can make a bit of money on the side.
John, a 25-year-old borehole manager, says the place he looks after in Nyanya Gwandara earns his boss 7,000 naira ($47, £32) a day.
We cannot wait for the government to do anything, we are relying on other wealthy people to dig boreholes.
“The man is from Kogi State where he lives, far away. He dug several boreholes in this area for an investment,” he says.
His customers are grateful.
“We cannot wait for the government to do anything, we are relying on other wealthy people to dig boreholes,” says Janet Daniels, who lives in the area.
She cannot afford to buy the water from the delivery boys, so comes every morning to the borehole to save money.
She fills two 20-litre buckets every morning and carries them on her head back to her home.
“I have to boil the water that we drink because its a very shallow borehole, and sometimes its got little particles of stuff in it.”
Otherwise the quality of the water from here is ok, she says.
Husseini, another water vendor working at a borehole in Nyanya Gwandara, says people like the water from this hole, and he even charges more for it on his rounds.
But other water vendors try and find free sources of water like streams and ponds.
These scummy rivulets are often fed by the sewer-streams that run through the middle of the streets. Diseases like polio, cholera and other types of gastric infection disproportionately affect those in poverty, who get water from bad streams.
Abuja, like other cities in Nigeria, is rapidly growing.
The government has fallen so far behind in providing water here, it may never catch up.
Over the last year the price of a jerry-can of water has doubled.
These problems will only get more acute, and the price of water will only go up.