1
|
Wright KO, Fagbemi T, Omoera V, Johnson T, Aderibigbe AA, Baruwa B, Oludara F, Ogboye O, Imosemi D, Omololu O, Odugbemi B, Adeyemi O, Omosun A, Akinola I, Akinyinka M, Balogun M, Abe J, Sadiku B, Banke-Thomas A, Fabamwo AO. A population-based estimation of maternal mortality in Lagos State, Nigeria using the indirect sisterhood method. BMC Pregnancy Childbirth 2024; 24:314. [PMID: 38664731 PMCID: PMC11044405 DOI: 10.1186/s12884-024-06516-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/14/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Pregnancy and delivery deaths represent a risk to women, particularly those living in low- and middle-income countries (LMICs). This population-based survey was conducted to provide estimates of the maternal mortality ratio (MMR) in Lagos Nigeria. METHODS A community-based, cross-sectional study was conducted in mapped Wards and Enumeration Areas (EA) of all Local Government Areas (LGAs) in Lagos, among 9,986 women of reproductive age (15-49 years) from April to August 2022 using a 2-stage cluster sampling technique. A semi-structured, pre-tested questionnaire adapted from nationally representative surveys was administered using REDCap by trained field assistants for data collection on socio-demographics, reproductive health, fertility, and maternal mortality. Data were analysed using SPSS and MMR was estimated using the indirect sisterhood method. Ethical approval was obtained from the Lagos State University Teaching Hospital Health Research and Ethics Committee. RESULTS Most of the respondents (28.7%) were aged 25-29 years. Out of 546 deceased sisters reported, 120 (22%) died from maternal causes. Sisters of the deceased aged 20-24 reported almost half of the deaths (46.7%) as due to maternal causes, while those aged 45-49 reported the highest number of deceased sisters who died from other causes (90.2%). The total fertility rate (TFR) was calculated as 3.807, the Lifetime Risk (LTR) of maternal death was 0.0196 or 1-in-51, and the MMR was 430 per 100,000 [95% CI: 360-510]. CONCLUSION Our findings show that the maternal mortality rate for Lagos remains unacceptable and has not changed significantly over time in actual terms. There is need to develop and intensify community-based intervention strategies, programs for private hospitals, monitor MMR trends, identify and contextually address barriers at all levels of maternal care.
Collapse
Affiliation(s)
- Kikelomo Ololade Wright
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine (LASUCOM), Ikeja, Lagos, Nigeria.
- Centre for Reproductive Health Research and Innovation (CHRHI), LASUCOM, Ikeja, Lagos, Nigeria.
- Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital (LASUTH), Lagos, Nigeria.
| | - Temiloluwa Fagbemi
- Centre for Reproductive Health Research and Innovation (CHRHI), LASUCOM, Ikeja, Lagos, Nigeria
| | - Victoria Omoera
- Directorate of Family Health and Nutrition, Lagos State Ministry of Health (LSMoH), Lagos, Nigeria
| | - Taiwo Johnson
- Directorate of Family Health and Nutrition, Lagos State Ministry of Health (LSMoH), Lagos, Nigeria
| | - Adedayo Ayodele Aderibigbe
- Centre for Reproductive Health Research and Innovation (CHRHI), LASUCOM, Ikeja, Lagos, Nigeria
- Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital (LASUTH), Lagos, Nigeria
| | - Basit Baruwa
- Lagos Bureau of Statistics (LBS), Lagos, Nigeria
| | - Folashade Oludara
- Directorate of Family Health and Nutrition, Lagos State Ministry of Health (LSMoH), Lagos, Nigeria
| | - Olusegun Ogboye
- Directorate of Family Health and Nutrition, Lagos State Ministry of Health (LSMoH), Lagos, Nigeria
| | | | | | - Babatunde Odugbemi
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine (LASUCOM), Ikeja, Lagos, Nigeria
- Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital (LASUTH), Lagos, Nigeria
| | - Oluwatoni Adeyemi
- Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital (LASUTH), Lagos, Nigeria
| | - Adenike Omosun
- Department of Planning, Research and Statistics, Lagos State Health Service Commission, Lagos, Nigeria
| | - Ibironke Akinola
- Department of Paediatrics and Child Health, LASUCOM, Lagos, Nigeria
| | - Modupe Akinyinka
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine (LASUCOM), Ikeja, Lagos, Nigeria
- Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital (LASUTH), Lagos, Nigeria
| | - Mobolanle Balogun
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - John Abe
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Osun, Nigeria
| | | | - Aduragbemi Banke-Thomas
- Centre for Reproductive Health Research and Innovation (CHRHI), LASUCOM, Ikeja, Lagos, Nigeria
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | |
Collapse
|
2
|
Ogboye A, Akpakli JK, Iwuala A, Etuk I, Njoku K, Jackson S, Okoli U, Hill K, Omoera V, Oludara F, Ekong I, Mobisson N. Prevalence of non-communicable diseases and risk factors of pre-eclampsia/eclampsia in four local government areas in Nigeria: a cross-sectional study. BMJ Open 2023; 13:e071652. [PMID: 37813536 PMCID: PMC10565324 DOI: 10.1136/bmjopen-2023-071652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 09/14/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVES To assess the prevalence of non-communicable diseases (NCDs) and risk factors associated with pre-eclampsia and eclampsia (PE/E) in women of reproductive age (WRA) in Nigeria. DESIGN A cross-sectional survey was administered to the entire study population. In the point-of-care testing, physical and biochemical measurements were taken in a subset of the participants. SETTING The study was conducted in the Ikorodu and Alimosho local government areas (LGAs) in Lagos and the Abuja Municipal Area Council and Bwari LGAs in the Federal Capital Territory. PARTICIPANTS Systematic random sampling was used to randomly select and recruit 639 WRA (aged 18-49 years) between May 2019 and June 2019. OUTCOME MEASURES Prevalence of select NCDs (hypertension or raised blood pressure, diabetes or raised blood sugar levels, anaemia, truncal obesity and overweight/obesity) and risk factors associated with PE/E (physical activity, fruit and vegetable consumption, alcohol consumption and smoking). RESULTS The prevalence of raised blood pressure measured among the WRA was 36.0% (95% CI 31.3% to 40.9%). Approximately 10% (95% CI 7.2% to 13.4%) of participants had raised blood sugar levels. About 19.0% (95% CI 15.3% to 23.2%) of the women had moderate or severe anaemia. Excluding WRA who were pregnant, 51.9% (95% CI 45.7% to 58.0%) of the women were either overweight or obese based on their body mass index. Approximately 58.8% (95% CI 53.8% to 63.6%) of WRA surveyed reported three to five risk factors for developing NCDs and PE/E in future pregnancies. CONCLUSIONS The study identified a high prevalence of NCDs and associated PE/E risk factors in surveyed women, signifying the importance of early detection and intervention for modifiable NCD and associated PE/E risk factors in WRA. Further research is necessary to assess the national prevalence of NCDs.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Victoria Omoera
- Lagos State Government Ministry of Health, Ikeja, Lagos, Nigeria
| | - Folashade Oludara
- Federal Capital Territory Health & Human Services Secretariat, Abuja, Nigeria
| | - Iniobong Ekong
- Federal Capital Territory Health & Human Services Secretariat, Abuja, Nigeria
| | | |
Collapse
|
3
|
Etuk I, Iwuala A, Njoku K, Olagbegi B, Ogboye A, Akpakli JK, Okoli U, Hill K, Adetiloye O, Imosemi D, Omoera V, Oludara F, Ekong I, Alabi O, Mobisson N. Barriers to health in women of reproductive age living with or at risk of non-communicable diseases in Nigeria: a Photovoice study. BMC Womens Health 2023; 23:3. [PMID: 36593476 PMCID: PMC9808961 DOI: 10.1186/s12905-022-02146-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 12/26/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Nigeria has one of the highest maternal mortality ratios (MMR) globally with an MMR of 512 (per 100,000 live births) and the proportion of maternal deaths due to non-communicable diseases (NCDs) is increasing. While evidence shows that many of these deaths are preventable, limited attention is being paid to the unique vulnerabilities and experiences of women of reproductive age (WRA) with NCDs and their risk factors, as well as the barriers to the screening, diagnosis, and management of these diseases in Nigeria. METHODS This study explored the lives of WRA in Lagos and Federal Capital Territory in Nigeria from May to June 2019 using a community-based participatory research (CBPR) methodology called Photovoice which is aligned with CBPR as it includes procedures such as the identification of important community issues, discussion of photo assignments and data analysis. Twenty-four women of reproductive age were provided with digital cameras and trained on how to capture photos that conveyed their current health, healthcare utilization and engagement, and experience journeys. Individual interviews with the women were held for an in-depth exploration of the photographs. The data was then analysed thematically. RESULTS Six distinct themes were identified across the barriers highlighted by the women: food and nutrition, home and family, neighborhood-built environment, economic instability, religion and spirituality and low prioritization of self-care. These themes captured the challenge of reduced agency, limited contribution and participation, and a complex relationship between visible and invisible illness. CONCLUSION The perspectives of WRA in Nigeria obtained through this qualitative research provided a strong substratum for understanding the environmental barriers that predispose WRA to NCDs in Nigeria. The results of the study are useful for the improvement of woman-centred services of prevention, diagnosis, and management of NCD risk factors across the maternal and reproductive health care continuum in Nigeria.
Collapse
Affiliation(s)
- Imo Etuk
- mDoc Healthcare, 1a Hakeem Dickson Drive, Off T.F. Kuboye Street, Lekki Phase 1, Lagos, Nigeria
| | - Amira Iwuala
- mDoc Healthcare, 1a Hakeem Dickson Drive, Off T.F. Kuboye Street, Lekki Phase 1, Lagos, Nigeria
| | - Kendra Njoku
- mDoc Healthcare, 1a Hakeem Dickson Drive, Off T.F. Kuboye Street, Lekki Phase 1, Lagos, Nigeria
| | - Bosoye Olagbegi
- mDoc Healthcare, 1a Hakeem Dickson Drive, Off T.F. Kuboye Street, Lekki Phase 1, Lagos, Nigeria
| | - Ayoposi Ogboye
- mDoc Healthcare, 1a Hakeem Dickson Drive, Off T.F. Kuboye Street, Lekki Phase 1, Lagos, Nigeria.
| | - Jonas Kofi Akpakli
- mDoc Healthcare, 1a Hakeem Dickson Drive, Off T.F. Kuboye Street, Lekki Phase 1, Lagos, Nigeria
| | | | | | | | | | | | - Folashade Oludara
- Federal Capital Territory Health & Human Services Secretariat, Abuja, Nigeria
| | - Iniobong Ekong
- Federal Capital Territory Health & Human Services Secretariat, Abuja, Nigeria
| | - Olubunmi Alabi
- Federal Capital Territory Health & Human Services Secretariat, Abuja, Nigeria
| | - Nneka Mobisson
- mDoc Healthcare, 1a Hakeem Dickson Drive, Off T.F. Kuboye Street, Lekki Phase 1, Lagos, Nigeria
| |
Collapse
|