National HIV/AIDS and Reproductive Health Survey (NARHS Plus

National HIV/AIDS and
Reproductive Health Survey
(NARHS Plus, 2007)
FEDERAL REPUBLIC OF NIGERIA
FEDERAL MINISTRY OF HEALTH
ABUJA, NIGERIA
F
ITY &
UN
AIT H, PEA CE & PRO
G RE
SS
December, 2008
This report represents the results from the 2007 National HIV/AIDS and
Reproductive Health Survey (NARHS Plus) which was undertaken by the
Federal Ministry of Health. Financial assistance for the survey was
provided by U.S. Agency for International Development (USAID). The
Society for Family Health (SFH) provided technical support in planning
implementation, data processing, analysis and report writing.
Additional information about NARHS Plus may be obtained from the office
of the Federal Ministry of Health, Federal Secretariat, Abuja, Nigeria
Recommended citation:
Federal Ministry of Health [Nigeria] (2008). National HIV/AIDS and
Reproductive Health Survey, 2007 (NARHS Plus). Federal Ministry of
Health Abuja, Nigeria
ISBN: 978-076-58-8
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EXECUTIVE SUMMARY
The 2007 National HIV and AIDS and Reproductive Health survey
is a nationally representative survey to provide information on key
HIV/AIDS and reproductive health knowledge and behaviour
related issues. The survey includes a biological marker component
(HIV testing) and is called NARHS Plus. The major objective of
NARHS Plus is to obtain accurate HIV prevalence estimates and
information on risk factors related to HIV infection at the national,
zonal and to some extent at state levels. In addition, it aims to
provide information on the situation of reproductive and sexual
health in Nigeria, the variety of factors that influence reproductive
and sexual health, and to provide data regarding the impact of
ongoing Family Planning and HIV/ AIDS behaviour change
interventions, and to yield insights into existing gaps that may
require attention.
Data collection took place in December 2007 with a total of 11521
respondents consisting of 6161 men aged 15 to 64 years and 5360
women aged 15 to 49 years. Data was analysed centrally and are
presented in this report on basis of Zones and other selected
background variables.
Sexual behaviour
Overall, about four fifths (83%) of the female respondents
compared with 73% of the male respondents had ever had sex.
Among young people of age group 15-19 years, 43% of the female
and 22% of the males had engaged in sex while from the age of 30
years nearly all respondents reported that they had ever had sexual
intercourse. The median age at first sex for all respondents aged
15-24 years was 16 years for females and 17 years for males.
Females in the North East and North West reported the lowest
median age at first sexual intercourse (15 years) while among the
males it was lowest in the South South (16 years). Median age for
first sex for females in rural area (15 years) was lower than the
urban areas (17 years). For males the median age at first sex was
(17 years) in both urban and rural areas. Sixty seven percent of
females and 61% of males had sex in the last twelve months
preceding the survey. Of all the respondents who had ever had sex
within the period, 3% of females compared with 27% of males
reported having multiple partners. Overall about 9% of females and
20% of males reported that they had had sex with non-marital
partners in the last 12 months preceding the survey. Among
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females, non marital sex was more common in the Southern zones
than in the north and persons in age group 15-29 years were more
likely to have engaged in non-marital sex. Five percent of females
and 8% of males reported that they have ever accepted or given
gifts of some kind or favour in exchange for sex.
Knowledge, opinion and attitude about HIV and AIDS
Awareness about HIV and AIDS was generally high in the country
(94%). However, less than a quarter (22%) indicated that they had
seen someone with HIV or knew someone who died of AIDS.
Overall, only 2% of respondents rated their chances of being
infected by HIV as high, 34% rated their chances low, and 60%
believed that they were at no risk at all. Fifty four percent of
respondents knew all five HIV transmission routes. Misconceptions
about transmission were prevalent. The misconception that HIV is
transmitted through mosquitoes and bedbugs, and by kissing was
highest (22% for both), followed by sharing of toilets (19%), sharing
eating utensils (17%), witchcraft (12%) and hugging (7%).
Knowledge about how to prevent HIV was also investigated. It was
observed to be generally high. Knowledge of staying with one
uninfected partner was highest (85%), followed by avoiding sharing
sharp objects (82%), abstaining from sex (75%), avoiding sex with
sex worker (71%), avoiding sex with people who have multiple
sexual partners (70%), reducing number of sexual partners (63%),
using condoms every time (55%) and, finally, by delaying sexual
debut (49%).On mother to child transmission, 62% reported that
HIV can be transmitted from mother to child during pregnancy.
Condom knowledge, access and use
Seventy one percent of all respondents reported having heard of
the male condom. There were rural-urban differences, with 63% in
rural areas compared to 87% in urban areas reporting that they had
heard of condoms. Similarly, a higher proportion of males (80%)
than females (62%) had heard of male condoms. Overall, 69% of
respondents who had heard of condoms considered them
accessible and 67% thought condoms were affordable. Most
respondents considered male condoms to be effective in preventing
unplanned pregnancy (57%), protecting against STIs (55%) and
HIV and AIDS (55%).Over a quarter (27%) of all sexually active
respondents had ever used condoms. Overall, 16% of the sexually
active respondents reported using male condoms as at the time of
the survey. Almost half( 49%) of respondents who had sex with a
non-marital partner in the last 12 months preceding the survey
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reported using condoms with their last non-marital partners.
Awareness of the female condom (13%) was considerably lower
than that of the male condom (71%).
HIV counselling and testing
More male (56%) than female respondents (49%) had knowledge
of where to get an HIV test. A large proportion of the respondents
expressed the desire to take the HIV test. The proportion of males
who expressed a desire to take the test was higher among males
(74%) than the females (70%). Most respondents (87%) were
interested to take the test to know their HIV status, and to allay their
fear and anxiety over HIV status (11%).Few (14%) of the
respondents reported that they had gone for HIV test.
Sexually transmitted infections
Many (69%) of the respondents reported that they were aware of
STIs. There was a low level of knowledge of the symptoms of STIs
in women. The most commonly recognized symptoms of female
STIs were itching (34%), genital discharge (30%), burning pain on
urination (24%), and lower abdominal pain (18%). The most
commonly recognized symptoms of STIs in men were a burning
sensation on urination (48%), genital discharge (32%), genital
ulcers (16%), and swelling in the groin (13%).
Genital discharge, ulcer and itching were used as proxies for STI
symptoms. Respondents who had ever had sex were asked
whether they had experienced any of these symptoms in the last 12
months preceding the survey. About 7% of respondents had
experienced symptoms of STI in the 12 months preceding the
study. A higher proportion of females (11%) compared to males
(3%) reported having experienced STI symptoms within the one
year period preceding the survey. A larger proportion of
respondents in the younger age groups had experienced symptoms
compared to those in the older age groups (above 30 years).
Respondents who reported experiencing symptoms of STIs in the
12 months preceding the survey reported use of a variety of
facilities to obtain treatment for the condition. The commonly used
facilities included government health facilities (25%), patent
medicine store (13%) traditional healers (11%), private health
facilities (10%) and pharmacies (8%).
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Stigma and discrimination against PLWHA
Majority of respondents were willing to care for male or female
relatives who are living with HIV and AIDS. Half of the respondents
wanted to keep relatives who are infected with HIV and AIDS as a
family secret: Many (63%) of the respondents were willing to work
with an HIV infected colleague, 65% were willing to allow an HIV
infected student or child in school, and 61% willing to allow a
female HIV infected teacher to continue to teach in school. Also,
47% of respondents were willing to share meals with HIV infected
persons and about a third (35%) were willing to buy food from a
shopkeeper known to be HIV infected. Less than a half of the
respondents (48%) believed that the rights of persons living with
HIV and AIDS were adequately protected in Nigeria.
Ante-natal and postnatal care
Among women who had given birth in the last five years, women,
63% received ante-natal care during their last pregnancy. The
proportion that received ANC was higher among urban (83%)
compared to rural dwellers (54%). In terms of zones, South East
had the highest proportion (86%) of pregnant women that received
ANC in their last pregnancy, while the lowest proportion (45%) was
recorded in the North West. About half (52%) of pregnant
adolescents (15-19 years) received ANC.
Nurses/midwives were the commonest group that provided antenatal care in each zone, ranging from 82% in the South West to
73% in the South South. The next category of ANC providers was
doctors (50%), higher in the urban areas (63%) than rural (40%)
and increasing with higher educational level. The South West
(72%) reported the highest proportion receiving ANC from doctors
while the least was North East (27%). The highest proportion of
those that received ANC from traditional birth attendants (TBAs)
was recorded in the South West and South South zones (8% and
7% respectively). Overall, more than three-quarters of the
respondents (79%) received ANC from nurses/midwives and 50%
from doctors while TBAs provided ANC to only about 4% of
pregnant women. Less than half (47%) were attended to by skilled
attendants at birth. The proportion of pregnant women that received
Post-natal Care (PNC) for their last pregnancy out of women that
gave birth within the last 5 years preceding the survey was about
42% nationally. The proportion of women that received PNC was
higher in urban (60%) than rural locations (33%),
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Only 44% of the mothers commenced breastfeeding immediately
after delivery, while 42% commenced breastfeeding within a day of
the delivery and 13% commenced breastfeeding days after the
delivery. A few (4%) of the women indicated that they did not
breastfeed their babies at all.
Maternal mortality
Six percent of respondents reported cases of maternal mortality in
their households in the past one year. Among the regions, the
North West (9%) had the highest proportion of households that
reported maternal deaths, followed by South South (7%). The
South West had the lowest proportion (2%) of maternal mortality
figures.
Sixty percent of deaths were reported to have taken place during
childbirth, while 19% occurred during pregnancy, and 17% in the
postnatal period. Findings on the medical causes of maternal
mortality indicate that heavy bleeding (38%) and obstructed labour
(26%) are the leading causes of maternal death. This picture was
similar across all the zones, and across all other background
characteristics of the respondents.
Family planning
Seventy-three percent of women knew at least one method of
contraception compared to 82% of men who knew any method.
Regarding modern contraceptive methods, 68% of women and
79% of men knew at least a method. While 78% of all the male and
female respondents knew of at least one contraceptive method,
74% knew of at least one modern contraceptive method and 51%
knew at least one natural family planning method Among the
modern methods, the most known method by men and women
were male condom (65%), injectables (37%) and female
sterilization (21%).The percentage of all female respondents that
were currently using any modern contraceptive method as at the
time of the survey was 10% while that of all men was 16%.
Thirteen percent of all females and 18% of all males were recorded
to be using any method of contraceptive/child spacing at the time of
the survey. The proportion of non-users of contraceptives that
indicated intention to use modern contraceptives was 20% among
the males and 13% among the females. Almost half of the
respondents (44%) indicated that decisions about use of family
planning methods should be jointly undertaken by the couple, while
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a fifth (20%) expressed the opinion that the husband should take
the decision alone and 5% indicated that it should be the wife’s
decision alone. A higher proportion of the respondents desired to
have five or more children (35%) compared to those that desired
maximum of four children (24%). However, 34% of the respondents
expressed the opinion that the number of children they would want
to have was “up to God”.
Gender based violence
Higher proportions of females than males justified wife beating. For
example, 25% of females compared with 21% of males were of the
opinion that a husband was justified in beating his wife if she
refuses to have sex with him. Twenty-three percent of women
compared to 21% of men justified wife beating if the woman argues
with the husband while 17% of women as against 16% of men
justified the beating if food was not ready on time.
About half of the respondents were aware of female circumcision,
and 23% indicated that they knew a relative or a person close to
them who had been circumcised. Only a third of the respondents
(33%) who were aware of Female Genital Mutilation (FGM) felt that
female circumcision was a health problem. Fifty-five percent of
respondents that were aware of FGM were of the opinion that
female circumcision should be discontinued.
Sexual rights
Many respondents felt a wife was justified to refuse sexual
intercourse with her husband under certain circumstances. The
most common reasons given for justifying such refusal were recent
childbirth (73%) and wife’s knowledge that the husband has a
sexually transmitted infection (69%). About half of respondents
expressed support for the wife to refuse sex with the husband on
the basis that the wife knew that the man has been engaging in sex
with other women (55%) or that the wife is tired and not in the mood
for sex (54%).
Cancers of the reproductive system
Awareness of cancer of the breast (59%) was higher than
awareness of cancer of the womb (21%) and cancer of male
reproductive organs (17%).Although half of the respondents (52%)
knew of self breast examination, knowledge about other procedures
for detecting cancers was generally low. Only 32% knew about
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blood test, 29% knew about examination of male reproductive
organs, 5% knew of mammography and 9% knew of Pap smear.
Vesico – vaginal fistula (VVF)
Only 28% of the respondents had heard about VVF. Awareness of
VVF was generally higher in the North than the South. Awareness
of VVF was higher among females than males and similar in urban
and rural areas. In terms of education, respondents with only
Qur’anic education (56%) had the highest level of awareness of
VVF. About a fifth (21%) of respondents who were aware of VVF
indicated that they knew a woman with the condition. A higher
proportion of respondents in rural areas (23%) than urban areas
(19%) had knowledge of VVF victims. Nationally, the proportion of
all respondents that knew any woman with VVF was 21%. Among
respondents with awareness of VVF, early marriage was the
condition identified by the majority (62%) as being responsible for
VVF, followed by prolonged labour (32%) and large sized babies
(27%). Some of the respondents, however, regarded spiritual
forces/witchcraft (2%) and punishment from God (4%) as the
causes of VVF. Respondents expressed the opinion that avoidance
of early marriage (53%) and avoidance of early childbirth (64%) are
preventive measures. Twenty percent of respondents believed that
avoiding prolonged labour can prevent VVF; 14% believed that VVF
can be prevented by praying hard to God and 3% were of the
opinion that VVF can be avoided through avoidance of certain food
in pregnancy.
Tuberculosis
Seventy-two percent of respondents had heard about tuberculosis.
Eighty-nine percent of respondents believe TB is transmitted by air;
78% by sneezing, 51% by sharing eating utensils, 38% through
food, 30% through sexual contact and 16% by touching people with
TB or mosquito bites. A third (33%) of respondents were willing to
keep the status of a family member with TB secret and 88% were
willing to care for a family member with TB. Many (64%) of
respondents knew of a place to obtain treatment for TB. More
males (66%) than females (59%) had knowledge of a place to
obtain treatment. Three percent of respondents had household
members with chronic cough diagnosed as having TB.
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Communication and behaviour change
Respondents were asked of the types of issues they had discussed
with their children and wards that were older than 12 years within
the 12 months preceding the survey. Less than half of parents and
guardians had discussed reproductive health topics such as
STIs/HIV and AIDS , sexual relationship, abortion and family
planning with their children and wards.
Most respondents felt uncomfortable discussing sexual matters with
different family members. A higher proportion of respondents felt
comfortable discussing sexual matters with sisters (42%) and
brothers (40%) than their mothers (31%) or fathers (25%). Majority
of the respondents did not consider religious leaders and teachers
as persons with whom they could freely discuss sexual issues.
Most respondents had not discussed family planning with family
members and friends in the last 12 months preceding the survey.
The proportion of respondents that discussed family planning with
health workers, religious leaders and school teachers was very low.
Eleven percent discussed with health workers while only 5%
discussed with religious leaders and 4% with school teachers. Most
persons within union, whether married or cohabiting, had not
discussed family planning with their sexual partners. Only 12% of
females and 18% of males had discussed family planning or child
spacing with partners thrice or more in the last 12 months.
Majority of the respondents believed that health workers (62%) and
parents (40%) were most likely to support family planning. Thirty
one percent of the respondents from rural areas reported that
community leaders support Family Planning (FP) compared to 48%
of those in urban areas. Men and women were perceived as almost
equally likely to be supportive of FP (35% vs. 37%).
Majority of the respondents were of the opinion that the government
(71%) health care workers (67%) and young persons themselves
(50%) were in support of the use of condom by sexually active
young persons. Other social groups especially community leaders
(40%) and parents (39%) were perceived as less supportive.
Majority of the respondents reported that all the institutions cited in
the study, including religious groups, traditional leaders, the
government, private sector and the media were all supportive of
HIV and AIDS activities.
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Most respondents considered all forms of mass media – radio
(90%), television (81%), and print media (74%),acceptable for
communication on HIV, family planning and other sexually related
issues to the population. Almost half of the respondents indicated
that they listened to the radio almost everyday (42%) while 25%
indicated that they watched the television almost everyday.
HIV Sero - prevalence
The national HIV prevalence rate obtained in this survey was 3.6%.
It was higher among females (4.0%) than males (3.2%); slightly
higher in the urban area (3.8%) compared with the rural area
(3.5%). It was highest in the North Central zone (5.7%) and lowest
in the South East (2.6%). It was highest among respondents with
primary education (4.6%) and lowest among respondents that had
no education (2.7%). HIV prevalence was highest among the 30-39
years age group (5.4%) and lowest among the 15-19 years age
group (1.7%). In both rural and urban areas, prevalence of HIV was
higher among female respondents than male respondent. Peak
prevalence of HIV infection for both sexes is the 30-39 years age
group. The prevalence was 3.8% among male respondents who
were sexually active and 1.7% among male respondents who were
not. Prevalence was 1.7% among female respondents who were
sexually active and 1.2% among female respondents who were not.
Among female respondents, the HIV prevalence was higher in
urban than rural areas However, among males the prevalence was
higher in rural than urban areas. HIV prevalence was much higher
among females who were separated, divorced or widowed. The
prevalence of HIV was higher among those who rated themselves
as high risk for infection than among those who felt they were at a
low risk. HIV prevalence was higher among respondents who have
exchanged sex for gifts than among respondents who do not do so.
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Contents
Page
Executive Summary……………………………………………………..
vi
List of Tables……………………………………………………………..
xxii
List of Charts……………………………………………………………..
xxv
List of Abbreviations (Acronyms)..……………………………………... xxvii
Section 1
1.0
Introduction………………………………………………………
1
1.1
Nigeria Demographic Situation………..………………..
2
1.2
HIV/AIDS Situation in Nigeria……………………………
2
1.3
Responses to HIV/AIDS Situation in Nigeria..…………
3
1.4
Reproductive and Sexual Health Situation in Nigeria…
5
1.5
Maternal Morbidity and Mortality in Nigeria…...………… 6
1.6
Family Planning………………………...………………….
1.7
Adolescent Reproductive Health…………………………. 6
1.8
Harmful Practices and Reproductive Rights……………. 7
1.9
Non-Infections Conditions of the Reproductive System... 8
6
Section 2
Part One: Behavioural Component
2.0
Survey Objectives and Methodology………………………….
9
2.1
Specific Objectives……………………..………………….
9
2.2
Methodology…………………………………………….…. 10
2.3
Data Collection………………………………..………….. 10
2.4
Survey Management…………………………......………. 11
2.5
Data Retrieval…………………………………...………… 12
2.6
Level of Data Analysis…………...……………………….. 12
2.7
Training…………………………………………………….. 12
2.8
Pilot………………………………………….……………… 13
2.9
Data Management………………………………………… 13
Part Two: HIV Testing
2.10
Objectives……….……….…………………………..…
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14
2.11
Sampling Method.………………………………………
14
2.12
Approach to HIV Testing……………………………….
15
2.13
Field Staff Composition, Recruitment and Training.…… 15
2.14
Sample Processing and HIV Testing Procedure in the
Laboratory …………...................................................... 16
2.15
Quality Control Measures during Data Collection………17
2.16
Ethical Issues………………………………………………. 18
2.17
Dissemination………………………………………………18
Section 3
3.0
Characteristics of the Survey Population……………….….. 19
3.1
Age Sex Composition…………………..………………... 19
3.2
Educational Attainment…….……………………………. 21
3.3
Languages Respondents can Read or Speak…………. 25
3.4
Religious Affiliation………………………………………... 26
3.5
Marital Status……………………………………………… 27
3.6
Age at First Marriage……………………......................... 28
3.7
Polygamous Unions…………….………………………… 29
3.8
Occupational Distribution………………….……………… 30
3.9
Mobility……………………………………………………… 31
3.10
Access to Communication Facilities…………………….. 32
3.11
Use of Drinks Containing Alcohol ………..……………… 32
3.12
Use of Psychoactive Drugs ……………………………… 33
3.13
Discussion and Conclusions ..………………………...... 35
Section 4
4.0
Sexual Behaviour ………………………………...…………….
36
4.1
Ever Had Sex……….…………………..………….……. 36
4.2
Age at First Sex…….…….………………………….…… 37
4.3
Current Sexual Activity……………………………….…. 38
4.4
Types of Sexual Partners…………………………….…. 40
4.5
Sex in Exchange for Gift or Favour……………………
44
4.6
Multiple Partners…………………………………………
45
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4.7
Multiple Non Marital Partners…………………………... 47
4.8
Non-Marital/Non Co-habiting Relationship………..….. 48
4.9
Discussion and Conclusions……………………………
50
Section 5
5.0
Knowledge, Opinion and Attitudes about HIV and AIDS…51
5.1
Knowledge About HIV and AIDS……..………………..
51
5.2
Knowledge of a Cure for AIDS…………………………. 52
5.3
Knowledge of Someone who had HIV………………… 53
5.4
Personal Risk Perception of Contracting HIV…………. 54
5.5
Knowledge of Routes of HIV Infection…………………. 56
5.6
Misconceptions about HIV Transmission……………..... 58
5.7
Knowledge of How to Avoid the Virus that Causes
AIDS.……………………………………………….……… 59
5.8
HIV Prevention Methods (UNAIDS)…………………….. 60
5.9
Misconceptions about How to Avoid HIV….…………… 62
5.10
Mother to Child Transmission of HIV………….………… 63
5.11
Knowledge about whether a Healthy looking Person
could be HIV Positive………………………………….… 64
5.12
Knowledge about HIV Transmission (UNAIDS
Indicators)………………………………………………… 65
5.13
Young People’s Knowledge about HIV Transmission... 65
5.14
Discussion and Conclusions……………………………. 66
Section 6
6.0
Knowledge, Access and Use of Condoms…………….…..
67
6.1
Awareness of Male Condom ……………..……………. 67
6.2
Opinions about Affordability and Accessibility of Male
Condom…………………………………………………..... 69
6.3
Efficacy of Male Condom……………..………………….. 70
6.4
Ever Use Male Condom………..…………………….... 72
6.5
Current Use of Condoms……………..………………… 74
6.6
Current Status of Respondents who Had Ever Used
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Male Condom………………………………..…………... 75
6.7
Use of Male Condoms with Non-Marital Partners….76
6.8
Boyfriend/Girlfriend……………………………………… 78
6.9
Reasons for using Male Condoms……………………. 80
6.10
Reasons for Stopping the Use of Male Condom…….. 81
6.11
Use of Male Condom during last Sex Act by Young
People with Non-marital Partners……………………. 82
6.12
Awareness about Female Condom…………………… 83
6.13
Discussion and Conclusions..…………………………. 84
Section 7
7.0
HIV Counselling and Testing…………………….…………… 86
7.1
Knowledge of where to Get an HIV Test…..………… 86
7.2
Desire for HIV Test……………………………………… 87
7.3
Reasons for Desiring or Not Desiring an HIV Test….. 89
7.4
Reasons for not desiring an HIV Test……….………… 90
7.5
Ever Been Tested for HIV……………………………… 91
7.6
How long Ago was HIV Testing Conducted..……....... 93
7.7
Reasons for HIV Test……………..…………….……… 94
7.8
Receiving HIV Test Results……………………………..96
7.9
Discussion and Conclusions………….….…………….. 96
Section 8
8.0
Sexually Transmitted Infection (STIs)…………………..…. 98
8.1
Awareness and Knowledge of Sexually Transmitted
Infections……………………………………………..…. 98
8.2
Knowledge of Symptoms of STIs in Women………… 99
8.3
Knowledge of Symptoms of STIs in Men……………. 100
8.4
Knowledge of the Effect of STIs on Fertility………… 101
8.5
Experience of STI Symptoms in the Past 12 Months.. 102
8.6
Health Seeking Behaviour of Respondents with STI
Symptoms……………................................................ 104
8.7
Discussion and Conclusions………………….………. 105
xviii
Section 9
9.0
Stigma and Discrimination…………………..……………… 104
9.1
Attitude towards Family Members Living with HIV and
AIDS……………………………………………………… 104
9.2
Attitude towards Non-family members who are
infected with HIV……………………………………….. 105
9.3
Health Care for People Living with HIV and AIDS ….. 107
9.4
Rights of People Living with HIV and AIDS………….. 108
9.5
Open Discussions about AIDS in Nigeria……………. 110
9.6
Discussion and Conclusions………….……………..... 111
Section 10
10.0
Safe Motherhood…………………..……………..…………… 112
10.1
Planning Status of Births……….……..………………. 112
10.2
Ante-natal Care …………..…………………………..... 112
10.3
Ante-natal Care Providers…………..…………………. 115
10.4
Intra-partum Care……………………………………… 116
10.5
Post-natal Care………………………………………… 117
10.6
Breast feeding…………………………..……………... 118
10.7
Maternal Mortality……………………………………… 119
10.8
Discussion and Conclusions…………………………. 122
Section 11
11.0
Family Planning…………………………………..…………… 124
11.1
General Knowledge of Contraceptive Methods……… 124
11.2
Types of Contraceptives Known…………………......... 126
11.3
Perception about Contraceptive Methods and Issues.127
11.4
Affordability and Accessibility of Family Planning
Methods………………………………………………… 128
11.5
Current Use of Contraceptives…..…………………… 130
11.6
Intention to use Family Planning……..…………….... 130
11.7
Decision-making about Family Planning……………. 136
11.8
Desired Family Size…………………………………… 137
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11.9
Sex Preference………………………………………… 138
11.10 Infertility…………………………………………………
139
11.11 Discussion and Conclusions…………………………. 141
Section 12
12.0
Gender Violence, Female Circumcision, Sexual Rights
Reproductive Cancers and Tuberculosis……………….
143
12.1
Gender Violence………………….……..……………
143
12.2
Female Circumcision …………..……………………
144
12.3
Perspectives about Female Circumcision….………
145
12.4
Sexual Rights…..……………..………………………
146
12.5
Cancer of the Reproductive Tract….……………….
147
12.6
Cancer Detention………………………..…………….
148
12.7
Vesico-vagina Fistula…………………………………
151
12.8
Awareness of Tuberculosis.………………………….. 153
12.9
Knowledge of Routes of TB Transmission………….. 154
12.10 Knowledge about Cure for Tuberculosis…………….. 155
12.11 TB Status Disclosure and Stigma……………………. 156
12.12 Knowledge of a place to Obtain Treatment for
Tuberculosis……………………………………………
157
12.13 Presence of Household member with Tuberculosis… 158
12.14 Discussion and Conclusions………………………….. 159
Section 13
13.0
Communication for Behavioural Change……………….... 161
13.1
Communication for Behavioural Change……………. 161
13.2
Personal Communication on Family Planning……..... 165
13.3
Community Support for Modern Methods of Family
Planning…………………………………………………. 173
13.4
Perceived Support for Condom Use………………….. 177
13.5
Support for HIV and AIDS Activities…..…………….... 179
13.6
Mass Media for Reproductive Health
Communication………………………………………… 181
xx
13.7
Discussion and Conclusions………………………….. 184
Section 14: HIV Sero- Prevalence
14.0 Introduction……………………………………………………..
186
14.1
Coverage of HIV Testing……………………………… 186
14.2
Overall Prevalence Rates…………………….……….. 188
14.3
HIV Prevalence Rates by Selected Characteristics
Disaggregated by Sex………………………………….. 189
14.4
Use of Drinks Containing Alcohol..……………………. 191
14.5
HIV Prevalence by Usage of Condom in Non-marital
Sex…………………………………………………….... 192
14.6
HIV Prevalence According to Knowledge of
Prevention of HIV Infection……………………………. 193
14.7
HIV Prevalence According to Knowledge of Routes of
HIV Infection …………………………………………… 195
14.8
HIV Prevalence and Self-risk Assessment………….. 196
14.9
HIV Prevalence and Numbers of Non-marital
Patners………………………………………………….. 198
14.10 HIV Prevalence and Current Sexual Activity………... 199
14.11 HIV Prevalence among Respondents who have ever
had sex in exchange for gifts or favours……………. 200
14.12 HIV Prevalence and Sexual Activity…………………. 201
14.13 External Quality Control………………………………. 202
14.14 Acute Infections………………………………………… 202
14.15 Discussion and Conclusions………………………….. 202
Section 15: Policy Implication
15.0
Policy Implication
204
15.1
HIV/AIDS (Behavioural) ……………………………..204
15.2
Reproductive Health ………………………………205
15.3
Sero-prevalence …………………………………..207
15.4
Conclusion…………………………………………208
xxi
References………………………………………………………. 209
Appendix…………………………………………………………. 210
List of Tables
Table 3.1
Table 3.2
Table 3.3
Table 3.4
Table 3.5
Table 3.6
Table 3.7
Table 3.8
Table 3.9
Table 3.10
Table 3.11
Table 3.12
Table 4.1
Table 4.2
Table 4.3
Table 4.4
Table 4.5
Table 4.6
Table 4.7
Table 4.8
Table 4.9
Table 4.10
Table 5.1
Table 5.2
Table 5.3
Table 5.4
Table 5.5
Table 5.6
Table 5.7
Table 5.8
Table 5.9
Table 5.10
Table 5.11
Table 5.12
Table 5.13
Table 6.1
Table 6.2
Table 6.3
Table 6.4
Table 6.5
Table 6.6
Table 6.7
Age – Sex Composition …………………………........... 21
Level of Education ……………………………………….. 23
Language Respondents can Read or Speak …………. 25
Religions Affiliation ………………………………………. 26
Marital Status ……………………………………………... 27
Median Age at First Marriage …………………………... 28
Polygamous Unions ……………………………………… 29
Occupation Distribution ………………………………….. 30
Mobility of Respondents ……………………………….... 31
Access to Communication Facilities …………….......... 32
Use of Alcohol …………………………………………….. 33
Use of Psychoactive Drugs ……………………………... 34
Ever had Sex ……………………………………………… 37
Median Age by First Sex ………………………………… 38
Median Age at First Intercourse for Female for
Different Age Groups ………………………………..... 38
Sexual Activity of the General Population ……………… 39
Sexual Activity in the Last 12 Months among
Respondents who had Ever Had Sex …………………. 40
Non Martial Sexual Partner Last 12 Months ………….
42
Transactional Sex ……………………………………….. 45
Multiple Martial and Non Martial Partners Last
12 Months …………………………………………………. 46
Multiple Non-Marital Partners Last 12 Months ………... 48
Boyfriend/Girlfriend Relationships ………………………. 49
Awareness of HIV/AIDS ………………………………….. 52
Knowledge of AIDS Cure ………………………………… 53
AIDS Related Death ………………………………………. 54
Risk Perception ……………………………………………. 55
Knowledge of Routes of HIV Transmission ……………. 57
Misconceptions about HIV Transmission ………………. 58
Knowledge of HIV Prevention Methods ………………… 59
Knowledge of HIV Prevention Methods (UNAIDS) …… 61
Misconceptions about How to Avoid HIV ………………. 62
Knowledge of Mother to Child Transmission ………….. 63
Asymptomatic Transmission of HIV …………………….. 64
Knowledge about HIV Transmission
(UNAIDS Indicators) ………………………………………. 65
Young Peoples Knowledge of HIV Transmission ……… 66
Knowledge of Male Condoms …………………………….. 69
Condom Accessibility and Affordability ………………….. 70
Opinions on Male Condom Efficacy …………………….. 71
Ever Use Condom …………………………………………. 73
Current Use of Condom …………………………………… 75
Current Status of Use of Male Condom …………………. 76
Condom Use with Non-Martial Partners ………………… 77
xxii
Table 6.8
Table 6.9
Table 6.10
Table 6.11
Table 6.12
Table 7.1
Table 7.2
Table 7.3
Table 7.4
Table 7.5
Table 7.6
Table 7.7
Table 7.8
Table 8.1
Table 8.2
Table 8.3
Table 8.4
Table 8.5
Table 8.6
Table 9.1
Table 9.2
Table 9.3
Table 9.4
Table 9.5
Table 10.1
Table 10.2
Table 10.3
Table 10.4
Table 10.5
Table 10.6
Table 10.7
Table 10.8
Table 10.9
Table 11.1
Table 11.2
Table 11.3
Table 11.4
Table 11.5
Table 11.6
Table 11.7
Table 11.8
Table 11.9
Table 11.10
Table 11.11
Table 11.12
Table 11.13
Table 12.1
Use of Male Condom in the Last Sexual Intercourse
with Boyfriend or Girlfriend ……………………………….. 79
Reason for Condom Use …………………………………. 81
Reason for Stopping Condom Use ……………………… 82
Use of Male Condom by Young Peoples
15 – 24 Years of Age during their Sex Act with
a Non-Martial Partner ……………………………………. 83
Awareness of Female Condom ………………………… 84
Knowledge of Where to get HIV Test ………………….. 87
Desire for an HIV Test …………………………………… 88
Reasons for Desiring an HIV Test ……………………… 90
Reasons for not Desiring an HIV Test …………………. 91
Ever Tested for HIV ………………………………………. 92
Period HIV Test was conducted ………………………… 94
Reasons for HIV Test …………………………………….. 95
Receipt of HIV Test Results ……………………………… 96
Awareness of STIs ……………………………………….. 99
Knowledge of Symptoms of STIs in Women ………….. 100
Knowledge of Symptoms of STIs in Men ……………… 101
Knowledge of Effect of STIs on Fertility………………… 102
Experience of STIs Symptoms ………………………….. 103
Sources of Treatment of STIs …………………………… 105
Attitude Towards Family Members living with
HIV/AIDS…………………………………………………… 107
Attitude towards Non-family Persons living with
HIV/AIDS …………………………………………………... 108
Health Care for People living with HIV/AIDS ………….. 110
Rights of People Living with HIV/AIDS )PLWHA)……… 111
Open Discussion about HIV/AIDS ………………………. 112
Planning Status of Births …………………………………. 115
Ante-natal Care ……………………………………………. 116
Ante-natal Care Providers ……………………………….. 117
Delivery Care ………………………………………………. 118
Post-Natal Care ……………………………………………. 120
Breast Feeding …………………………………………….. 121
Reported Cases of Material Mortality …………………… 122
Timing of Materials Death ………………………………... 123
Medical Causes of Material Mortality …………………… 124
Knowledge of Contraceptive Methods ………………….. 127
Knowledge of Specific Contraceptive Methods ……….. 129
Perception of Contraceptive Methods…………………… 130
Affordability of Conceptive………………………………… 131
Accessibility of Conceptive ………….……………………. 132
Current Use of Contraceptives by Female ……………... 134
Current Use of Contraceptive by Males ………………… 135
Characteristics of Current Use of Contraceptives
by Females ………………………………………………… 136
Intention to Use Family Planning ……………………….. 138
Decision Making about Family Planning ……………….. 139
Desired Family Size ………………………………………. 140
Sex Preference ……………………………………………. 141
Infertility …………………………………………………….. 143
Gender violence …………………………………………… 146
xxiii
Table 12.2
Table 12.3
Table 12.4
Table 12.5
Table 12.6
Table 12.7
Table 12.8
Table 12.9
Table 12.10
Table 12.11
Table 12.12
Table 12.13
Table 12.14
Table 12.15
Table 13.1
Table 13.2
Table 13.3
Table 13.4
Table 13.5
Table 13.6
Table 13.7
Table 13.8
Table 13.9
Table 13.10
Table 13.11
Table 13.12
Table 13.13
Table 13.14
Table 13.15
Table 13.16
Table 14.1
Table 14.2
Table 14.3
Table 14.4
Table 14.5
Table 14.6
Table 14.7
Table 14.8
Table 14.9
Table 14.10
Table 14.11
Awareness of Female Circumcision …………………….. 147
Perspectives about Female Circumcision ………………. 148
Sexual Rights……………………………………………….. 149
Cancer of the Reproductive Tract ……………………….. 150
Cancer Detection ………………………………………….. 151
Knowledge of Vesico-Vaginal Fistula …………………… 153
Causes and Treatment of VVF …………………………... 154
Prevention of VVF …………………………………………. 155
Awareness of Tuberculosis ……………………………….. 156
Knowledge of Routes of TB Transmission ………………. 157
Knowledge about TB Cure ………………………………... 158
TB Status disclose and stigma …………………………… 159
Knowledge of a place to obtain Treatment
for Tuberculosis ……………………………………………... 160
Household Member with Tuberculosis …………………... 161
Health Communication with Male Wards ………………... 164
Health Communication with Female Wards …………….. 165
Health Communication with Family Members …………... 166
Health Communication with Non-Family Members……...168
Personal Communication with Family Members
and Friends on Family Planning ………………………….. 169
Personal Communication with Health Workers and
Religious Leaders about Family Planning……………….. 171
Frequency of Personal Communication about Family
Planning with Martial or Co-habiting Partner …………… 173
Persons Initiating Personal Communication ……………. 174
Perceived Support of Social Groups for Family
Planning …………………………………………………...... 176
Personal Support for Family Planning …………………… 177
Family Planning Decisions ………………………………… 178
Opinion on Support provided by Social Groups for
Condom Use ………………………………………………... 180
Perceived Institutional Support for HIV/AIDS
Activities …………………………………………………….. 182
Acceptable Media for Communication ………………….. 184
Radio Listening Habits …………………………………..... 185
Television Viewing Habits …………………………………. 186
Coverage of HIV Testing ………………………………….. 189
Overall Prevalence Rates …………………………………. 191
HIV Prevalence Rates by Selected Characteristics
disaggregated by Sex ……………………………………... 192
Use of Drinks containing Alcohol …………………………. 194
HIV Prevalence by Usage of Condom in Non-martial
Sex …………………………………………………………... 195
HIV Prevalence and Knowledge of Prevention of
HIV Infection ……………………………………………….. 196
HIV Prevalence by Knowledge of Routes of HIV
Transmission ……………………………………………..... 198
HIV Prevalence and Self-risk Assessment ……………… 199
HIV Prevalence and Number of Non-martial
Sexual Partners …………………………………………….. 200
HIV Prevalence and Current Sexual Activity …………… 201
HIV Prevalence by Sex for Gift …………………………… 202
xxiv
Table 14.12
HIV Prevalence and Sexual Activity …………………….. 203
List of Charts
Chart 3.1
Chart 3.2
Chart 4.1
Chart 4.2
Chart 4.3
Chart 5.2
Chart 6.1
Chart 6.2
Chart 7.1
Chart 7.2
Chart 8.1
Chart 9.1
Chart 11.1
Chart 11.2
Chart 12.2
Chart 13.1
Chart 13.2
Chart 13.3
Percentage Distribution of Age and Sex Composition
of Respondents by Location; FMOH, Nigeria 2007 …… 20
Percentage Distribution of Females and Males by the
Highest Level of Education; FMOH, Nigeria 2007..…… 23
Percentage Distribution of Male and Female
Respondents who had Sex with a Non Martial Partner in
the Last 12 Months before Survey by Zone;
FMOH; Nigeria 2007 ……………………………………… 43
Percentage of Respondents who had Sex with a Non
Martial Partner in the Last 12 Month before Survey by
Age and Sex; FMOH Nigeria, 2007 ….........................
44
Percentage Distribution of Respondent who had Sex
with More than one Sex Partner in the Last 12 Months
by Zone and Sex; FMOH, Nigeria, 2007 .....………….... 47
Percentage of all Respondents with Knowledge of
Ways of Preventing HIV Infection by Zones;
FMOH, Nigeria, 2007 …………………………………….. 60
Percentage Distribution of Respondents who had ever
heard Condoms by Zones; FMOH, Nigeria, 2007 ……. 68
Percentage Distribution of Sexually Active
Respondents who had ever used Condoms by
Zone and Sex; FMOH, Nigeria, 2007 …………………… 74
Percentage of Respondents who have ever heard of
AIDS but never tested for HIV Expressing desire to have
HIV Test by Zone and Sex; FMOH, Nigeria,2007 …….. 88
Percentage of all Respondents who Reported to have
been Tested for HIV by Education and Sex;
FMOH, Nigeria, 2007 ……………………………………... 92
Percentage Distribution of Respondents that Reported
STI Symptoms by Sex, FMOH, Nigeria, 2007 ………… 103
Respondents attitudes towards other Persons living
with HIV/AIDS by Sex …………………………………….. 108
Percentage Distribution of Respondents with Knowledge
of Modern Contraceptive Methods by Zone and Sex;
FMOH, Nigeria, 2007 ……………………………………… 126
Child Sex Preference by Respondents’ Sex;
FMOH, Nigeria, 2007 ……………………………………… 141
Percentage Distribution of all Respondents who knew
any Woman with VVF; FMOH, Nigeria, 2007 ………….. 151
Percentage of Respondents willing to discuss Sexual
Matters with Religious Leaders and Teachers by Ages
and Sex; FMOH, Nigeria, 2007 …………………………… 165
Percentage of Respondents who discussed Family
Planning with Health Workers and Religious Leaders
in the Last 12 Months by Zone; FMOH, Nigeria, 2007 … 168
Frequency at which Married/Co-habiting Respondents
discussed Family Planning (three or more times)
xxv
Chart 13.4
Chart 13.5
Chart 13.6
Chart 14.1
Chart 14.2
with Partners in the last 12 Months by Level of
Education; FMOH, Nigeria, 2007 …………………………. 170
Respondents who Reported about the Various Persons
and Social Groups Supporting Family Planning ……….. 173
Frequency at which Married/Co-habiting Respondents
Discussed Family Planning (three or more times)
with Partners in the last 12 Months by Level of Social
Group; FMOH, Nigeria, 2007 ………………………….
179
Acceptability of Various Sources of Information on
HIV/AIDS and Family Planning; FMOH, Nigeria, 2007… 182
HIV Prevalence by Sex and Zones in Nigeria,
FMOH, 2007 ………………………………………………... 188
HIV Prevalence by Age Group and Sex;
FMOH, Nigeria, 2007 ……………………………………… 191
xxvi
ACRONYMS
AIDS
-
Acquired Immune Deficiency Syndrome
ANC
-
Ante-natal care
ART
-
Anti Retroviral Therapy
BIT
-
Behavioural Interview Team
CPR
-
Contraceptive Prevalence Rate
CSPro
-
Census and Surveys Processing Software
CTs
-
Counsellors Testers
DBS
-
Dried Blood Spots
EA
-
Enumeration Areas
EIAS
-
Environment Impact Assessment Survey
ELISA
-
Enzyme Linked Immuno Sorbent Assay
FCT
-
Federal Capital Territory
FGM
-
Female Genital Mutilation
FMOH
-
Federal Ministry of Health
FP
-
Family Planning
FSW
-
Female Sex Workers
HCT
-
HIV Counselling and Testing
HEAP
-
HIV/AIDS Emergency Action Plan
HIV
-
Human Immuno-deficiency Virus
IBBSS
-
Integrated Biological and Behavioural Surveillance
Survey
ICPD
-
International Conference on Population Development
IDU
-
Injecting Drug Users
IMNCH
Integrated Maternal New-born and Child Health Strategy
IRB
-
Institutional Review Board Management System
IUD
-
Intra Uterine Device
MDGs
-
Millennium Development Goals
MSM
-
Men having Sex with Men
NACA
-
National Agency for the Control of AIDS
NARHS
-
National HIV and AIDS and Reproductive Health
NASCP
-
National AIDS and STIs Control Programme
NDHS
-
Nigeria Demographic and Health Survey
NEACA
-
National Expert Advisory Committee on AIDS
NGO
-
Non Governmental Organization
xxvii
NNRIMS
-
Nigeria National Response Information Management
Systems
NPC
-
National Population Commission
NSF
-
National Strategic Framework
PBS
-
Phosphate Buffered Saline
PCA
-
Presidential Council on AIDS
PLWHA
-
Persons Living with HIV/AIDS
PNC
-
Post-natal Care
POA
-
Programme of Action
RH
-
Reproductive Health
RHC
-
Reproductive Health Coordinator
SAPC
-
States AIDS Programme Coordinator
SFH
-
Society for Family Health
SMC
-
Survey Management Committee
SMOH
-
State Ministry of Health
SPSS
-
Statistical Package for Social Scientists
STIs
-
Sexual Transmitted Infections
STT
-
Sero-testing Team
TB
-
Tuberculosis
TBA
-
Traditional Birth Attendants
TC
-
Technical Committee
TFR
-
Total Fertility Rate
TOT
-
Training of Trainers
UA
-
Universal Access
UCH
-
University College Hospital (Ibadan)
UNAIDS
-
Joint United Nation Programmes on HIV/AIDS
UNFPA
-
United Nations Fund for Population Activities
UNGASS
-
United Nations General Assembly Special Session
USAID
-
United States Agency for International Development
UNICEF
-
United Nations Children Fund
VVF
-
Vesico-Vaginal Fistula
WHO
-
World Health Organisation
xxviii
SECTION 1
1.0
INTRODUCTION
Good health is basic to human welfare and is a fundamental objective of
social and economic development. HIV/AIDS and reproductive health still
constitute major challenges to health and development in Nigeria.
Addressing health challenges starts with identifying the problems, their
causes and determinants. The health environment is ever changing and
shaped by new science, information, policies and socio-cultural forces.
Thus, there is need to actively continue the collection of reliable data to
monitor progress being made with regards to sexual and reproductive
health knowledge, attitude and behaviour and of the magnitude of the
HIV/AIDS epidemic. This is necessary in order for us to improve our
understanding of changing prevention needs, challenges and
opportunities and to stimulate appropriate public health action. This will
ensure that on-going interventions and our future directions in policy
formulation and programme development remain evidence-based.
Scientific evidence must be incorporated in making management
decisions, developing policies and implementing programmes in order to
recognize and respond effectively to health problems.
As part of efforts to generate reliable data for effective programming, the
Federal Ministry of Health (FMOH) in collaboration with the National
Agency for the Control of AIDS (NACA), the Society for Family Health
(SFH), other development partners and key stakeholders conducted
Nigeria’s first National HIV and AIDS and Reproductive Health Survey
(NARHS) in 2003 and the second in 2005. The 2007 survey is the third in
the series. NARHS was conceptualised to be a biennial nationwide
survey to generate a series of datasets and reliable figures on key sets of
indicators that will facilitate trend analysis in the HIV/AIDS and RH field. A
similar methodological approach, including instruments, survey methods,
analysis plan and writing format was used for easy comparability of the
2003, 2005 and 2007 survey results. However, the 2007 survey includes
a biological marker component (HIV testing) and is called NARHS Plus.
Incorporating HIV testing into the NARHS provides a population based
estimates of HIV prevalence as recommended by UNAIDS and WHO for
countries with a generalized epidemic. Prior to NARHS Plus 2007, HIV
estimates have been based on sentinel surveillance among pregnant
women attending antenatal clinics, a system which excludes men and
non pregnant women in the population. NARHS plus provides the much
needed information on HIV infection in the various categories of the
population which is essential to guide policy makers and programme
1
managers as they plan and implement interventions to address the
HIV/AIDS epidemic.
1.1
Nigeria Demographic Situation
Nigeria is the most populous country in sub-Saharan Africa and has a
land area of 923,768 square kilometres. Based on the 2006 national
population census figure, Nigeria’s population is estimated at over 140
million (NPC, 2006).Approximately two-thirds of the population live in rural
areas, which are areas mostly lacking in many modern social amenities.
The population distribution in Nigeria is very uneven. While large expanse
of sparsely populated land occurs in some parts of the country, many of
the major urban centres have high population density. A high level of
rural-urban migration occurs in the country and this has implications on
the demand for social infrastructure, general development planning and
quality of life of the citizenry.
The Total Fertility Rate (TFR) in Nigeria has remained high. The results
obtained from the 2003 Nigeria Demographic and Health Survey was 5.7
(NPC [Nigeria] & ORC Macro, 2004). One of the major reasons for the
high fertility level is the pro-natalistic attitude of the population and low
use of contraceptive methods. The total demand for family planning
services remains low, while the ideal family size is high. As reported in
the 2005 NARHS, only 24.1% of the respondents desired to have less
than 5 children (FMOH, 2006a).
Life expectancy in Nigeria has remained low, and this has declined in
recent times, partially due to the effect of HIV and AIDS. The life
expectancy at birth, which was 53.8 years for females and 52.6 years for
males in 1991(UNFPA, 2005), has declined to 46 years for females and
45years for males (WHO, 2006). The infant mortality rate (IMR) has
remained high and is estimated at 99 per 1000 live births while the underfive mortality rate (U5MR) is 191 per 1000 live births (UNICEF, 2007).
1.2
HIV/AIDS Situation in Nigeria
The spread of HIV has increased significantly in Nigeria since the official
report of the first case in 1986. The results of periodic national surveys
among ante-natal clinic attendees has shown a progressive increase in
the adult HIV sero-prevalence rate from 1.8% in 1991 through 4.5% in
1996 to peak at 5.8% in 2001 before declining to 5.0% and 4.4% in 2003
and 2005 respectively. Going by the 2005 HIV prevalence, about 2.9
million people in Nigeria are estimated to be living with HIV and AIDS
(FMOH, 2006b). Nigeria is currently experiencing a generalised epidemic
with every state having a prevalence of over 1 %. The 2005 national seroprevalence rates showed that the HIV prevalence among the states
2
ranged from 1.6% in Ekiti to 10.0% in Benue (FMOH, 2006b). In general,
HIV prevalence is higher in urban areas than in rural areas.
HIV and AIDS have extended beyond the commonly classified high-risk
groups and are now common in the general population. HIV infection in
Nigeria cuts across both sexes and all age groups. However, youths
between the ages 20–29 years are more infected with sero-prevalence
rates of 4.9% for 25-29 age group and 4.7% for 20-24 age group. The
number of HIV-positive children is increasing, with mother-to-childtransmission as the principal route of infection. The number of children
orphaned by AIDS has also increased substantially to an estimated 1.2
million (FMOH, 2006b). By all indications, the HIV and AIDS epidemic has
continued to grow largely through heterosexual unprotected sexual
relationships, mother-to-child transmission and contaminated blood and
blood products. Among the high-risk groups1, however, the findings from
the 2007 IBBSS showed that the most affected group is Female Sex
Workers (FSW) with HIV prevalence of 34.0% followed by Men having
Sex with Men (MSM) and Injecting Drug Users (IDU) with prevalence of
13.5% and 5.6% respectively and the least is members of the Armed
Forces with HIV prevalence of 3.1% (FMOH, 2007a).
1.3
Responses to HIV/AIDS Situation in Nigeria
Nigeria has passed through several phases in her response to the AIDS
epidemic. The stages included an initial period of denial, a large health
sector response, and now a multi-sectoral response that focuses on
prevention, treatment and mitigation of impact interventions and divorces
coordination and implementation as distinct response components. A
central body is dedicated to leading and coordinating the response, while
the various sectors, including civil society organisations, faith based
organisations and networks of people living with HIV and AIDS support
groups focus on packaging and implementing interventions based on a
national action plan.
The health response commenced with the setting up of an ad hoc
National Expert Advisory Committee on AIDS (NEACA) in 1987. By 1988,
the National AIDS and STDs Control Programme (NASCP) was formally
established, with state counterparts set up thereafter to organise as well
as to coordinate all HIV and AIDS activities at national and state levels.
Federal Ministry of Health’s HIV/AIDS division (formerly known as
1
High risk groups include Brothel-based Sex workers, non-brothel based sex workers,
Men having sex with men, injecting drug users, uniformed service men (Armed forces and
Police) and Transport workers.
3
NASCP) played a key role in developing guidelines on key interventions
and monitoring of the epidemic.
In 1997, the National Council on Health formally endorsed the multisectoral approach and in 2000 the Federal Government of Nigeria
commenced the implementation of this approach with the establishment
of a Presidential Council on AIDS (PCA) and National Action Committee
on AIDS (NACA). NACA has been transformed from a committee to an
agency; National Agency for the control of AIDS (NACA), for effective
coordination of the national multi-sectoral response to HIV/AIDS. An
HIV/AIDS Emergency Action Plan (HEAP) was initiated in 2001 which ran
through 2004. The partners implementing the plan included governmental
institutions, non-governmental organizations, community based
organizations, faith-based organizations and persons living with or
affected by HIV and AIDS. As part of renewed efforts, Nigeria launched a
revised HIV and AIDS policy and a five year (2004-2008) National HIV
and AIDS Behaviour Change Communication Strategy in 2003 and 2004
respectively. The country also launched the Nigeria National Response
Information Management System (NNRIMS) for HIV and AIDS (NACA,
2004). NNRIMS has been reviewed and an operational plan (2007 –
2010) has been developed.
Failure of access to HIV/AIDS treatment and services by the people
needing them has prompted a rapid scale-up of the national response
and made it appropriate to align the NNRIMS framework with issues
articulated in the National Strategic Framework (NSF) as well as in the
Nigerian road map moving towards universal access (UA) for prevention,
treatment and support. This is done in collaboration with donors and
partners.
The Federal Ministry of Health has recently undertaken an intensive
review of the health sector HIV and AIDS response and developed the
Health Sector Strategic Plan. The HIV and AIDS National Strategic
Framework for Action (2005-2009) have been recently developed under
the leadership of NACA to replace HEAP. With the intention of
significantly scaling up the anti-retroviral treatment programme
commenced in 2001, the country has completed a policy document titled
“Plan to Scale-up Antiretroviral Treatment for HIV or AIDS in Nigeria
2005-2009” with the overarching goal of improving the survival, quality of
life and productivity of people living with HIV and AIDS (PLWHAs). The
HIV and AIDS response in Nigeria subscribes to the principle of “Three
Ones”: one agreed AIDS Action Framework that provides the basis for
coordinating the work of all partners; one national AIDS Coordinating
Authority, with a broad-based multi-sectoral mandate; and, one agreed
4
country level Monitoring and Evaluation system (FMOH 2005a, FMOH
2005b)).
Nigeria currently benefits from a high level of political commitment and
support from international partners. The level of response to HIV and
AIDS has increased in virtually all sectors. Current areas of interventions
include advocacy, prevention, care and support and the mitigation of the
impact of the epidemic. However, there is a need to further scale up
activities in some areas to improve overall national coverage, and monitor
and evaluate the progress and effects of the interventions to ensure that
the desired goals and objectives are achieved.
Tracking of resource commitment, resource utilisation, and behavioural
pattern of the population is particularly important at the nation’s current
phase of HIV and AIDS response. There is need to actively transform the
various policy documents into effective action.
1.4
Reproductive and Sexual Health Situation in Nigeria
The 1994 International conference on population and Development
(ICPD) held in Cairo recognised that reproductive health (RH) is a critical
part of an individual’s well being and is central and critical to human
development. After the conference, many countries including Nigeria
shifted the focus of their population and development programmes to
reproductive health. Reproductive Health is a “state of complete physical,
mental and social well-being and not merely the absence of disease or
infirmity, in all matters related to the reproductive system and to its
functions and process” (UN 1994). The components of RH as adopted by
Nigeria are:
• Safe motherhood comprising prenatal care, safe delivery, essential
obstetric care, post- partum care, neonatal care and breastfeeding;
• Family planning information and services;
• Prevention and management of infertility and sexual dysfunction in
both men and women;
• Prevention and management of complications of abortion;
• Prevention and management of reproductive tract infections, especially
sexually transmitted infections (STIs), including HIV infections and
AIDS;
• Promotion of healthy sexual maturation from pre-adolescence,
responsible and safe sex throughout life and gender equality;
• Elimination of harmful practices, such as Female Genital Mutilation
(FGM), child marriage, domestic and sexual violence against women;
5
and,
• Management of non-infectious conditions of the reproductive system,
such as genital fistula, cervical cancer, complications of FGM and
reproductive health problems associated with menopause.
Available statistics show that the reproductive health status of men,
women and adolescents has remained poor in Nigeria.
1.5
Maternal Morbidity and Mortality in Nigeria
Nigeria has one of the highest maternal mortality rates in the world
estimated at 800 maternal deaths per 100,000 live births (WHO 2006).
Medically, most of the maternal deaths result from five major
complications – haemorrhage, infection, unsafe abortion, hypertensive
disease of pregnancy, and obstructed labour. Over 600,000 induced
abortions are estimated to be taking place in Nigeria annually (Henshaw
et al., 1998).
The health behaviour of Nigerian women regarding pregnancy related
care remains poor and poses one of the greatest challenges to maternal
mortality reduction in the country. As reported in NAHRS 2005; less than
two – thirds of pregnant women received antenatal care, only about half
were attended to at delivery by skilled attendants and less than half
received post-natal care (FMOH, 2006a).
1.6
Family Planning
There is knowledge–use gap for contraception in Nigeria. Despite the
high level of awareness of family planning, the level of utilisation remains
low despite decades of programme efforts. The contraceptive prevalence
rate (CPR) among currently married women in 2003 was in the range of
8.1% for modern methods and 12.4% for all methods (NPC [Nigeria] &
ORC Macro, 2004). Similarly, in 2005 only 10% of married women were
using modern contraceptive methods (FMOH, 2006a).The level of
contraception among sexually active young women is particularly low,
with a reported prevalence of 7.3 %.(Oye-Adeniran et al., 2005). This
contributes to the high level of unwanted pregnancy, unsafe abortions
and maternal mortality.
1.7
Adolescent Reproductive Health
With adolescents comprising about a fifth of the national population the
need to address the RH challenges they face is great (FMOH 2007b).
Adolescents in Nigeria are caught between traditions and changing
6
cultures brought about by urbanisation, globalised economies and media
influences. Traditional mechanisms for coping with and regulating
adolescent sexuality especially norms of chastity are being eroded
resulting in early unprotected intercourse. A quarter of adolescent males
and half of the females were recorded to be sexually active, with 20.3% of
the females and 7.9 percent of the males already engaging in sexual
intercourse by the age of 15 years. Forty six (46) percent of women
nationally and about 70% in some regions give birth before their 20th
birthday (NPC [Nigeria] & ORC Macro, 2004). Among women aged 15 –
24 years who have given birth, only half received care from trained health
care professionals during their pregnancy, and less than a third received
such care during their delivery (The Alan Guttmacher Institute, 2004).
Sexual intercourse among adolescents is mostly in the absence of
contraception. Consequently, incidence of unwanted pregnancy, unsafe
abortions, HIV and other STIs are high among adolescents. Overall, 17%
of women aged 15 – 19 years have an unmet need for effective
contraception (The Alan Guttmacher Institute, 2004)
1.8
Harmful Practices and Reproductive Rights
Female genital mutilation (FGM) and domestic violence constitute leading
reproductive rights violation and harmful traditional practices in Nigeria.
FGM occurs in all parts of the country, but with higher reported
occurrence in the south relative to the north. South West geo-political
zone region has the highest reported occurrence of female circumcision
(85.7%), followed by South East (40.8%) and South South (34.7%) while
the prevalence was as low as 0.4% in the North West (NPC [Nigeria] &
ORC Macro, 2004). South-south zone has the highest prevalence (7.5%)
of infibulation, which is the most severe form of FGM. In 2003, only a third
of Nigerians who had heard of FGM regarded it as a health problem
(FMOH, 2003). Fully convinced that FGM is a form of violence against
women and girls and also infringes on their human rights, Nigeria
developed the National policy and plan of action for the elimination of
FGM in 2002 (FMOH, 2002).
Domestic violence is prevalent in many societies in the world, including
Nigeria. As the result of the 2005 NARHS has shown, many Nigerians
justified wife beating on various grounds, with a higher proportion of
women compared to men approving. For example, 32.6% of females
compared to 23.1% of males felt that a husband is justified beating his
wife if she refuses to have sex with him (FMOH, 2006a).
7
As the 2003 NDHS showed, early (child) marriage is quite prevalent in
Nigeria. About a third of adolescent girls (15-19 years) were already
married in 2003, and 16% were actually married by age 15 (NPC
(Nigeria) & ORC Macro 2004). Child marriage violates the sexual rights of
the young females involved as it is often forced on them, and has great
consequences on their reproductive health and development. An
estimated 20,000 new cases of vesico-vagina fistula (VVF) occur annually
in Nigeria, with young females disproportionately affected (UNFPA,
2002).
1.9 Non-Infectious Conditions of the Reproductive Health
System
The Nation is undergoing an epidemiological transition. Cancers have
become important causes of morbidity and mortality. Cancer of the cervix
and cancer of the breast have become one of the major causes of death
among Nigerian women, while the number of men presenting in Nigerian
hospitals with cancer of the prostate has also been rising. Knowledge
about these cancers and screening practices to promote early detection is
quite poor among the population. As reported in the NARHS 2005, 58.3%
of respondents were aware of cancer of the breast, 20.9% were aware of
cancer of the cervix while 16% were aware of cancers affecting male
reproductive organs (FMOH, 2006a). Problems associated with
menopause and andropause have been associated with emotional and
psychological disturbances, sexual dysfunction and marital disharmony.
While menopause is a universal phenomenon, the health challenges that
it may pose have largely been overlooked in Nigeria. Awareness about
andropause (male menopause) is very poor among Nigerians (Fatusi et
al., 2003).
8
SECTION 2
2.0 SURVEY OBJECTIVES AND METHODOLOGY
This section provides information on the objectives and methodology of
the behavioural and HIV testing components of the survey. Detailed
information is provided in Appendix 1.
General objective
The major objective of NARHS Plus is to obtain accurate HIV prevalence
estimates and information on risk factors related to HIV infection at the
national, zonal and to some extent at state levels. In addition, it aims to
provide information on the situation of reproductive and sexual health in
Nigeria, the variety of factors that influence reproductive and sexual
health, and to provide data regarding the impact of ongoing Family
Planning and HIV/AIDS behaviour change interventions, and to yield
insights into existing gaps that may require attention.
PART ONE: BEHAVIOURAL COMPONENT
2.1 Specific Objectives
The following were the specific objectives of the 2007 NARHS Plus:
•
•
•
•
•
To collect quantitative data on key sexual and reproductive health
indicators among females aged 15 – 49 years and males aged 15 - 64
years in Nigeria.
To monitor trends and changes in behaviour, which influence
reproductive health and HIV/AIDS in Nigeria, especially with regards
to national level indicators such as NNRIMS and UNGASS.
To identify information gaps which may be further explored using
qualitative surveys.
To use data obtained to review and re-programme HIV/AIDS and
reproductive health interventions in the country and provide
information that would guide the development of appropriate
intervention strategies viz. communication strategies.
To obtain data from respondents on: breastfeeding, ante-natal and
post-natal care, condom knowledge, access and use, sexual history,
STIs and treatment seeking behaviours, knowledge, opinions and
attitudes about HIV/AIDS, stigma and discrimination, family planning
and communications.
9
•
2.2
To ascertain the relationship between behaviour and HIV infection in
the survey population.
Methodology
This is a cross-sectional study covering all the 36 states and the Federal
Capital Territory (FCT) among men and women of reproductive age.
2.2.1 Sampling Method
The population for the 2007 National HIV/AIDS and Reproductive Health
and Serological Survey (NARHS Plus) was all females aged between 15
and 49 years and males aged 15 to 64 years living in Nigeria. A nationally
representative sample of females aged 15-49 years and males aged 1564 years living in households in rural and urban areas in Nigeria was
drawn from the updated master sample frame of rural and urban localities
developed and maintained by the National Population Commission
(NPC). It is a national survey. The study area consists of all the 36 states
of the federation and the Federal Capital Territory.
Probability sampling was used for the survey. The sampling procedure
was a (four-level) multi-stage cluster sampling aimed at selecting eligible
persons with known probability. Stage 1 involved the selection of rural
and urban localities. Stage 2 involved the selection of Enumeration Areas
(EA) within the selected rural and urban localities. Stage 3 involved the
listing of eligible individuals within households while stage 4 involved
selection of actual respondents for interview and testing. Overall, 11,822
respondents were selected for interview of which 11,521 were
successfully interviewed resulting in a 2.5% non response rate.
2.3 Data Collection
Data were collected by personal interview method using structured and
semi-structured questionnaire.
2.3.1 Questionnaire themes
The survey captured; among others, the following broad themes:
1.
Socio demographic characteristics
2.
Sexual behaviour
3.
Knowledge and treatment of STIs
4.
Knowledge and perception of HIV/AIDS.
5.
Condom accessibility and use
6.
Stigma and discrimination
10
7.
8.
9.
10.
11.
12.
13.
Knowledge about family planning
Attitude and use of family planning
Availability, affordability and accessibility of family planning products
Reproductive rights and violence against women
Awareness of Maternal mortality and vesico-vaginal fistula and its
causes
Exposure to Health Communication
Knowledge and treatment of Tuberculosis
2.3.2 Fieldwork
To enhance objectivity and independence in data collection and
management, an independent research agency was contracted, through
a competitive bidding process, to undertake the fieldwork. National
Population Commission staff in the states carried out the listing of the
population in the selected clusters and selected the final eligible
respondents. The agency recruited supervisors and interviewers in
conjunction with local States’ AIDS Programme Coordinator
(SAPC)/Reproductive Health Coordinator (RHC) staff. The training of all
field workers was conducted by members of the survey Technical
Committee (TC). Central supervision of field work was undertaken by
SMC and TC members. This supervision was to ensure compliance with
the protocol and monitor field work.
While it may be useful to translate questionnaire into local languages,
given the multiplicity of languages in Nigeria, key words /phrases
(including sensitive ones) for each selected community were translated
during training of interviewers. Interviewers used the semi-translated ones
as master copies. A similar approach was successfully used for the 2003
and 2005 NARHS as well as the 2005 Behavioural Surveillance Survey
and 2007 IBBSS.
There was one team per state (except Lagos and Kano states where two
teams each were required because of the population size). Two
supervisors and eight interviewers were trained per state but only 6
interviewers were used. The SAPC/RHC served as administrative heads
in monitoring the whole fieldwork.
2.4
Survey management
Two key committees managed the survey. The day-to-day technical
management of the entire survey was carried out by a Technical
Committee (TC). Oversight of the survey was provided by a larger central
Survey Management Committee (SMC). The latter is a multi-disciplinary
11
committee drawn from all relevant stakeholders (including development
partners), NGOs, Government institutions, and technical experts from
academic institutions. Independent reviews of the entire survey process
and questionnaire were undertaken by technical advisors (through WHO).
All aspects of the study, including sampling and questionnaire, were
reviewed by both committees and external technical experts.
2.5
Data retrieval
This was done on a daily basis. The interviewer collected the information
from the respondent, edited the questionnaire in the field and submitted
his/her quota for the day to the representative of the research agency
who edited the questionnaires. At the end of each day in the field, and
after editing, the representative of the research agency submitted
completed questionnaires to the survey supervisor who as the State field
editor; undertook complete editing of all questionnaires. Where possible,
data errors were tracked to their original source through re-visits and
mistakes and omissions corrected.
The supervisor who is also the State field editor checked that all
instructions are obeyed, responses were consistent and the questions
were fully answered. A questionnaire was not considered accepted until it
has been so certified by the State field editor.
2.6
Level of data analysis
Analysis was done at geopolitical zonal level and also at state level for
some key indicators. In addition there was analysis of selected indicators
for key stakeholders as required.
2.7
Training
The training of survey personnel was at two levels: central training (TOT)
and state level training. A comprehensive training manual was developed
and finalized for the purposes of both central and state level trainings.
Given the large number of participants, the central level training was in
two batches (north and south). The three-day central training involved
NPC staff, SAPCs, RHCs state laboratory scientist, one state counsellor,
research agency supervisors and quality controllers as well as Technical
committee members. Experience from previous surveys showed that
bringing all related personnel together for a comprehensive training on all
aspects of the fieldwork is highly beneficial. The training was on sample
selection (including household listing and selection) and all aspects of
fieldwork. In view of its complexity and sensitivity, considerable amount of
time was devoted to the review and role play with the questionnaire.
12
Coordination, logistics, standardisation, and shared understanding of the
survey procedures were the key objective of the central training, but this
did not prevent the discussion of local problems.
State level training was undertaken by the centrally trained supervisors,
SAPCs, RHCs, NPC officer and a member of the survey technical group
as an additional quality control measure. This, among others, minimised
state-to-state variability in training procedures.
Two types of Training manual were developed; General Guidelines for
Interviewers and Supervisors and Training Manual for Interviewers
and Supervisors items. The training of field staff included a detailed
discussion of the contents of the questionnaire, how to complete the
questionnaires, and interviewing techniques with respect to data
collection.
2.8
Pilot
A pilot study was conducted in two states (Nasarawa and Lagos) by
visiting one urban and one rural cluster in each state to test the
instruments and other aspects of the survey including fieldwork and data
entry. This was conducted with the state coordinators, independent
research agency’s supervisors as well as NPC staff. The pilot assisted in
determining problems that could arise during the survey, and discovering
problems in the questionnaire and other elements of the survey which
were all addressed accordingly.
2.9
Data Management
The Census and Surveys Processing Software (CSPro) was used for
data entry, validation, and cleaning. In order to further minimise
inconsistent and illegal entries, checks were used to guide the data entry
exercise. Subsequently, 30% of the data was re-entered by different data
entry clerks and the entries validated.
The data was subsequently imported into SPSS and the sampling
weights applied in the analysis. The weighting in the analysis was based
on the sampling fractions derived from sample size and the population of
the states. For most variables, the analysis was done at the national and
zonal levels and state level analysis was carried out for selected
variables. The various sample sizes (number of women and men) for all
groups and subgroups was based on unweighted cases. This implies that
all percentages were weighted but the numbers of cases were not. This
was to ensure that the exact number of cases upon which the weights
were applied is known.
13
Data analysis was done at geopolitical zone level. State level analysis
was done for some selected variables only. National level and geopolitical
zone level analysis was done for sero results. Tables were generated
based on the detailed analysis plan and to allow monitoring of key
national and international indicators.
PART TWO: HIV TESTING
Incorporating HIV testing in the Nigeria NARHS Plus affords the
opportunity to link the sero-prevalence results to the other data obtained
in the NARHS Plus. The following summarises key aspects of the
integration of HIV testing into the NARHS Plus, survey organisation and
methodology. Additional information is included in the appendix.
2.10 Objectives
The HIV testing component of the 2007 Nigeria NARHS Plus was
undertaken to provide information to address the needs of government
and non-governmental organisation programs addressing HIV/AIDS, and
to provide programme managers and policy makers with the information
that they need to effectively plan and implement future interventions. The
overall objective of this component of the survey is to collect high-quality
representative data on the prevalence of HIV infection among women and
men.
The Specific objectives were:
•
To obtain baseline estimates of HIV prevalence at national, zonal and
states’ levels as well as demographic variation in HIV prevalence in
the reproductive age group of the general population.
•
To improve the understanding of the variation in sero-prevalence
levels with social and economic characteristics and behavioural risk
factors; and
•
To facilitate a comparison of HIV prevalence obtained in the 2007
Nigeria NARHS Plus and prevalence from facility-based surveys
such as the sentinel surveillance system.
2.11 Sampling Method
The 2007 Nigeria NARHS Plus was conducted using a stratified national
sample1 of over 11,000 individuals residing in private households
nationwide. All women age 15-49 years and men age 15-64 years living
permanently in the selected households were eligible to be interviewed in
1
This was calculated based on appropriate formula and parameters
14
the NARHS Plus and for HIV testing. The sample allows for HIV seroprevalence estimates for women and men at the following levels: national;
urban/rural, and for state level estimates of prevalence. Of the 11,521 that
completed the interview, only 9,039 agreed to be tested resulting in
21.5% refusal rate.
2.12 Approach to HIV testing
In this survey, a linked anonymous testing approach with the provision of
test results was adopted. The HIV testing was done using blood samples.
Informed consent was sought from all eligible women and men for their
blood to be tested and for further use of the blood sample if necessary. In
the case of never-married adolescents’ aged 15-17 years, consent was
sought from a parent before the adolescent was asked for his/her assent.
When there was no parent living in the household, consent was
requested from the adult who was in charge of the youth’s health and
welfare at the time of the NARHS Plus visit and who makes decisions on
his/her behalf.
The testing approach involved the collection of five blood spots from a
finger prick on the same filter paper card and stored as dried blood spots
(DBS). A unique random identification number (bar code) was assigned to
each DBS and labels containing that code affixed to the filter paper card,
the questionnaire, and a field tracking form at the time of the collection of
the sample. After fieldwork was completed in a sampled cluster, the
questionnaires, dried blood spot and sample transmittal forms were sent
to the central office of the technical Management committee for logging
and checking prior to data entry. DBS samples were checked against the
transmittal form and then forwarded to designated testing laboratories. No
identifier other than the unique identification label affixed at the time of the
collection of the samples accompanied the specimen to the laboratory.
ELISA testing of all the DBS samples occurred at a central laboratory
concurrently with the processing of the survey questionnaires. The results
of the HIV testing were obtained from APIN Plus HIV Reference
Laboratory, Department of Virology, University College Hospital (UCH),
Ibadan and added to the survey data file. The unique random
identification number assigned to the samples and questionnaire served
as the means for merging the survey and testing files.
2.13 Field Staff Composition, Recruitment and Training
A Sero-testing team (STT) composed of 4 counsellors/testers, 1
laboratory scientist all of whom were selected as stipulated in the survey
protocol. Staff from the FMoH, NPC, UCH Virology, WHO and USAID IPs
participated in the field staff training. Counsellors/ testers (CTs) received
15
a three-day training plus additional field practice. All the CTs were given a
thorough training on informed consent procedures, how to take finger
prick blood spot samples, and how to handle and package the dried blood
spots. Emphasis was placed on universal precautions and the disposal of
hazardous waste.
2.14 Sample Processing and HIV Testing Procedure in the
Laboratory
2.14.1 Preparation of sample from DBS
Each DBS card was examined to establish proper sample collection and
card labelling. The DBS cards were arranged serially using the sample
codes by state. A tube was labelled appropriately with the respective
sample code for each DBS card. With the use of hand punch, two discs of
dry blood spots were punched from each DBS card into the appropriate
tube. Five hundred microlitres (500ul) of Phosphate Buffered Saline
(PBS) was then added into each tube containing the punched DBS discs.
The DBS discs were allowed to soak in the PBS for 30 minutes at room
temperature and then vortexed for 30 seconds to enhance the sample
elution. Sample were treated by state to avoid mix-up.
2.14.2 Laboratory HIV Testing Algorithm
HIV status of each specimen was determined in a parallel algorithm using
two commercially available EIAs; Genscreen Ultra HIV Ag-Ab, a 4th
generation assay with the ability to detect both HIV antibodies and
antigen and Vironostika HIV Uni-Form II plus O, that detects only HIV
antibodies. Some of the EIA positive samples were further tested by
Western blotting (New Lav Blot 1 and 2, Biorad, Paris). All assays were
performed by trained personnel in accordance with the manufacturers’
recommendation. Brief descriptions of assay procedures are stated
below.
2.14.3 Test Procedure
A.
Genescreen Ultra HIV Ag-Ab
Wash buffer and conjugate 2 working solution were prepared as
recommended by manufacturer. Samples were arranged serially in a rack
and sample ID recorded into a template worksheet. Depending on the
sample size from each state, appropriate number of microtitre strips was
removed from the protective pouch and 25ul of conjugate dispensed into
each well. 75ul of specimen or test controls were added into the
corresponding well as recorded in the worksheet. The microplate was
16
covered with adhesive film and incubated at 370C for 1 hour. After
incubation, microplate was washed using an automatic ELISA plate
washer, and then 1000ul of conjugate 2 working solution added to each
micro-well. The plate was incubated of 30 minutes at room temperature
(18-300C) after which the washing step was repeated and then, 80ul of
substrate solution (freshly prepared) was added and the reaction allowed
to develop in the dark for 30 minutes at room temperature (18-300C). The
reaction was then stopped by adding 100ul of stopping solution into each
micro-well and the plate read with ELISA plate reader at 450/620
wavelength to determine the OD value. The test result was then validate
and interpreted as described in the manufacturer’s manual.
B.
Vironostika HIV Uni-Form II plus O
The required number of microelisa strips was removed from the protective
pouch and 100ul of specimen diluents dispensed into each micro-well
including the control wells. Samples were arranged serially and 50ul of
sample and controls were added into assigned well as previously
recorded in the worksheet. The microplates was covered with adhesive
film, incubated at 370C for 1 hour and then washed with the aid of
automatic ELISA plate washer. Freshly prepared TMB substrate (100ul)
was dispensed into each sample and controls wells, reaction allowed to
develop at room temperature (15-300C) for 30 minutes and then stopped
by adding 100ul of sulphuric acid. The plate read was with an ELISA plate
reader and the test result validated and interpreted as described in the
manufacturer’s manual.
2.14.4 Interpretation of Results
Samples that were positive in both Genscreen (antigen and antibody
detection assay) and Vironostika (antibody detection assay) were
considered HIV positive while those positive only in the antigen and
antibody assay were assumed to be detecting just antigen based on the
principle of the test and therefore considered as recent infections.
2.15 Quality Control Measures during Data Collection
Quality control during the period of the survey fieldwork was ensured
through effective supervision of the teams during fieldwork. The first level
of supervision was provided by the team supervisors. They observed the
process of blood collection in order to ensure that all informed consent
and specimen collection procedures were correctly implemented. All
positive samples and a random sample of 10% of all negatives were
collected, processed and tested at the QC Laboratory. For external
quality control purposes, a 10 percent random sample of HIV negative
17
specimens was retested. All HIV positive and discordant samples were
retested using the same algorithm with western blot as a tie breaker.
SMOH teams visited on a daily basis to ensure that all activities were
carried out as planned. Questionnaires and DBS from completed clusters
were picked up during these visits. As a further quality control measure,
central supervisory visit were made by TC and SMC members during the
survey.
Finally, a monitoring of the “response rate” for HIV testing was done at
the field level. Problems identified during the review were discussed with
the appropriate teams, and steps were taken to address the problems.
2.16 Ethical issues
Ethical clearance was obtained from the Institutional Review Board (IRB)
of the National Institute of Medical Research prior to the commencement
of the survey. Oral and written informed consent was sought from each
respondent before a questionnaire was administered, and each sero test
conducted. Pre and Post Test counselling were provided to all
respondents who agreed to be tested. Where a respondent chose not to
participate, the questionnaire was returned as refusal. Respondents who
were sero-positive were referred to a HCT/ART site for follow up.
2.17 Dissemination
Key results and lessons learned will be disseminated to appropriate
stakeholders at different levels in different format depending on audience
and user type. Formats will include a technical report, wall charts, data
sheets, and brochures.
18
SECTION 3
3.0
CHARACTERISTICS OF THE SURVEY POPULATION
This section deals with the characteristics of the survey population. The
characteristics considered include age, sex, ethnic composition, level of
education, languages respondents can read or speak, religious affiliation,
marital status, types of marriage, occupation, length of stay and place of
residence. Knowledge of these characteristics will enhance an
understanding of the factors that are likely to affect sexual and
reproductive health issues.
3.1
Age–Sex Composition
The survey population included 11,521 respondents consisting of 6,161
males and 5,360 females. The mean age of female respondents was 27.8
(s.d.=9.4) years and that of males was 31.5 (S.D=13.3) years. The survey
population is presented in Table 3.1 by location (rural / urban), zone, age
and sex composition. The rural/ urban composition is presented in Chart
3.1.
The proportion of females in the rural population (46%) was similar to that
in the urban population (47%). The table shows that in the rural
population about 43% of females were aged 15-24 years compared to
about 38% of males. In the urban population, a similar proportion of about
42% of females compared to about 38% of males were aged 15-24 years.
19
Chart 3.1: Percentage Distribution of Age and Sex Composition
of Respondents by Location; FMOH, Nigeria, 2007
female
50-64
male
12
0
14.1
14.5
40-49
19.6
30-39
15.9
25-29
25.6
18.2
18.9
19.7
15-19
19.5
22
A g e g ro u p
20-24
50-64
14.1
0
13.9
40-49
16.9
18.6
30-39
15.1
25-29
17.1
16.8
20-24
23.2
20.5
21.4
22.3
15-19
0
5
10
Percentage 15
20
20
25
30
Table 3.1: Age -Sex Composition
Percent Distribution of Age and Sex Composition of Respondents by Location;
FMOH, Nigeria 2007
Age
Age
group
Female
North
Centra
l
Male
Rural
669
773
531
598
994
1152
406
384
548
655
365
481
3513
4043
15-19
22.6
19.1
20.9
18.1
23.8
23.3
23.4
25.0
21.9
20.2
18.9
23.9
22.3
21.4
20-24
19.3
17.1
23.7
19.4
20.7
14.1
20.4
16.1
20.1
20.2
18.4
15.4
20.5
16.8
25-29
17.6
16.2
16.2
14.4
18.3
16.0
13.5
8.9
16.1
16.3
19.2
15.4
17.1
15.1
30-39
22.9
19.9
24.9
23.4
22.8
18.8
19.5
13.0
26.1
17.9
22.2
16.0
23.2
18.6
40-49
17.6
12.7
14.3
12.7
14.3
14.1
23.2
16.1
15.9
14.5
21.4
14.3
16.9
13.9
50-64
NA
15.0
NA
12.0
NA
13.8
NA
20.8
NA
11.0
NA
15.0
NA
14.1
Total
100
100
100
100
100
100
100
100
100
100
100
100
100
100
Urban
273
332
187
220
339
362
233
271
263
310
552
623
1847
2118
15-19
22.3
20.2
23.5
16.4
25.4
19.3
23.2
23.2
20.2
15.2
19.7
20.9
22.0
19.5
20-24
20.1
17.8
18.2
18.6
22.4
19.1
18.0
15.9
18.3
22.9
19.6
18.8
19.7
18.9
25-29
13.6
17.8
16.0
16.8
16.2
18.2
18.0
12.9
22.4
18.1
19.0
13.3
18.2
15.9
30-39
26.4
15.7
11.2
20.0
24.5
15.7
12.5
19.6
20.9
18.4
27.2
22.3
25.6
19.6
40-49
14.6
13.9
9.7
12.4
11.5
13.8
25.3
14.4
18.3
12.3
29.9
14.3
14.5
14.1
50-64
NA
14.1
NA
11.4
NA
13.8
NA
14.9
NA
13.2
NA
10.4
NA
12.0
Total
100
100
100
100
100
100
100
100
100
100
100
100
100
100
3.2
North East
North West
South East
Female
Male
Fem
ale
Male
Femal
e
SouthSouth
South West
Total
Male
Female
Male
Female
Male
Female
Male
Educational Attainment
Table 3.2 presents the distribution of the survey population according to
the level of education attained. There were differences in the educational
attainment between respondents in the rural and urban areas and
between zones. A higher proportion of urban respondents (20%) had
higher level of education than rural residents (6%). Also a higher
proportion of males than females had formal education. Thirty nine (39)
percent of females and 19% of male respondents in the rural area never
attended any formal school compared to 13% and 6% of female and
male respondents respectively in the urban area.
21
Table 3.2: Level of Education
Percentage Distribution of Females and Males by the Highest Level of
School Attended by Zones; FMOH, Nigeria 2007
Educatio
n
Rural
North Central
North East
North West
South East
SouthSouth
South West
Total
Female
669
Mal
e
773
Female
531
Male
Fe-male Male
Male
Fe-male Male
Fe-male
Male
598
993
1152
Female
406
384
548
655
365
47.2
25.9
53.9
34.6
61.1
20.7
8.9
7.0
12.4
3.8
17.0
481
Female
3513
Male
4043
10.4
39.2
18.5
Never
attended
school
Qur’anic
only
Primary
Seconda
ry
Higher
1.9
6.6
9.8
12.9
22.5
35.1
0.2
0.0
0.2
0.0
0.0
0.4
8.3
13.2
23.0
24.8
23.5
36.1
17.7
16.9
13.4
29.8
9.2
6.2
18.6
22.5
26.8
53.7
30.7
54.4
27.2
56.0
22.4
61.2
25.2
50.4
19.3
55.1
19.6
29.2
20.6
39.4
3.0
7.9
1.7
9.4
1.0
3.2
10.3
7.8
4.2
12.5
7.4
14.8
3.7
8.3
Total
100
100
100
100
100
100
100
100
100
100
100
100
100
100
Urban
273
332
186
220
339
362
233
271
263
310
552
623
1847
2118
Never
attended
school
14.7
5.4
26.9
8.2
23.6
8.3
7.7
4.4
5.3
2.9
7.8
4.8
13.3
5.5
Qur’anic
only
Primary
Seconda
ry
Higher
5.5
3.9
12.4
14.5
19.8
12.2
0.4
0.0
0.0
0.6
0.0
0.6
5.7
4.5
18.7
41.8
14.8
46.1
23.1
28.0
13.6
35.5
14.7
28.6
18.2
38.4
16.7
57.5
24.4
56.1
16.7
58.2
13.9
61.9
22.5
53.6
16.9
54.7
19.0
45.8
16.9
49.8
19.4
29.8
9.7
28.2
13.3
22.9
17.6
15.1
19.8
20.6
16.1
23.0
16.1
23.2
Total
100
100
100
100
100
100
100
100
100
100
100
100
100
100
22
Chart 3.2: Percentage Distribution of Females and Males by the
Highest Level of Education; FMOH, Nigeria, 2007
female
50-64
male
12
0
14.1
14.5
40-49
19.6
30-39
15.9
25-29
25.6
18.2
18.9
19.7
15-19
19.5
22
A g e g ro u p
20-24
50-64
14.1
0
13.9
40-49
16.9
18.6
30-39
15.1
25-29
17.1
16.8
20-24
23.2
20.5
21.4
22.3
15-19
0
5
10
Percentage 15
23
20
25
30
Table 3.3: Language Respondents Can Read or Speak
Percent Distribution of Respondents Who Could Read and Speak
Selected Languages According to Sex and Zone; FMOH, Nigeria 2007
Language
North West
Read Speak
Total
North East
Read
2847
Speak
North Central
Read
1536
Pidgin
6.2
8.5
5.9
English
23.3
Hausa
46.7
Speak
South West
Read
2047
Speak
South East
Read
2021
South-South
Speak
Read Speak
1294
Total
Number of
Women and
men
Read
Speak
1776
11521
10.7
12.8
34.9
13.6
23.5
17.6
36.9
23.0
72.2
12.5
29.1
34.6
29.0
49.3
48.5
66.5
62.5
74.4
73.1
76.8
74.3
51.0
47.8
47.9
93.8
24.2
58.5
3.7
5.8
0.9
3.6
0.8
2.6
23.1
48.8
Arabic
19.9
19.
0
97.
5
9.2
17.3
7.5
8.3
4.7
2.0
1.8
0.9
1.0
0.1
0.1
9.2
4.6
Igbo
1.0
1.4
0.5
0.5
1.8
3.4
4.2
6.9
73.2
97.8
7.0
12.3
10.7
15.1
Yoruba
0.8
1.3
0.7
0.9
12.0
19.8
81.0
91.6
1.8
4.6
1.5
4.1
17.1
21.2
Fulfude
0.7
2.9
4.8
31.0
0.2
1.5
0.1
0.3
0.0
0.0
0.0
0.2
0.9
5.2
Edo
0.0
0.3
0.0
0.2
0.2
0.5
0.5
0.9
0.2
0.2
1.4
5.7
0.4
1.2
2.3
Tiv
0.1
0.1
0.1
0.3
8.1
11.8
0.1
0.2
0.0
0.1
0.2
0.6
1.5
Nupe
0.1
0.1
0.0
0.3
1.9
7.7
0.0
0.1
0.0
0.0
0.0
0.1
0.4
1.5
Urhobo
0.0
0.0
0.0
0.1
0.1
0.2
0.3
0.5
0.1
0.1
2.7
6.4
0.5
1.1
Ijaw
0.0
0.0
0.1
0.1
0.0
0.2
0.2
0.3
0.0
0.0
10.5
20.3
1.7
3.2
2.8
Efik
0.0
0.0
0.1
0.1
0.0
0.0
0.1
0.5
0.4
0.7
10.0
16.7
1.6
Kanuri
0.0
0.2
2.7
14.5
0.1
0.8
0.0
0.0
0.0
0.0
0.1
0.2
0.4
2.2
Idoma
0.2
0.1
0.1
0.1
1.8
3.8
0.2
0.3
0.2
0.3
0.1
0.4
0.4
0.9
Other
1.4
5.0
10.4
34.7
12.1
34.0
3.5
4.2
0.9
2.4
14.4
45.8
6.8
20.0
3.3
Languages Respondents can Read and Speak
The distribution of respondents according to the language they can read
with understand and speak fluently is presented in Table 3.3. All
respondents could speak and read at least one of listed languages. The
main languages that people could read were English, Hausa, Yoruba,
Pidgin English and Igbo in that order. Similarly, the main languages
people could speak were Hausa, English, Yoruba, Pidgin English and
Igbo.
24
3.4
Religious Affiliation
Table 3.4 presents the distribution of the respondents according to their
religious affiliation. Almost half of the respondents reported that they were
Christians (36% protestants and 13% Catholics) while 50% reported their
religion as Islam. Ninety three percent (93%) of the respondents in the
North West were Muslims while in the South East 97% of respondents
were Christians.
Table 3.4: Religious Affiliation
Percentage Distribution of all Respondents by Religions Affiliation
According to Zone; FMOH, Nigeria 2007
Marital Status
North Central
North East
Female
Female
Male
Male
North West
South East
Fem
ale
Mal
e
Female
Mal
e
South-South
South West
Fem
ale
Female
Male
Total
Male
Female
Male
Rural
669
773
531
598
994
384
548
655
365
481
3513
4043
68.9
48.5
74.0
54.0
85.3
115
2
53.6
406
Currently married
46.6
39.1
48.5
41.1
57.0
41.4
67.3
47.8
Living with a sexual
partner
2.4
1.8
1.1
0.8
1.2
4.5
1.7
4.4
9.3
4.6
6.6
3.7
3.3
3.4
Never married
22.6
45.8
19.8
41.5
8.8
39.8
43.1
53.4
35.0
51.6
30.1
50.1
23.3
45.6
Separated
1.5
1.0
0.8
1.2
0.3
0.6
0.7
0.3
1.3
1.5
1.9
1.9
1.0
1.0
Divorced
1.0
1.6
1.5
0.8
1.5
0.4
0.2
0.3
2.0
0.5
0.5
1.0
1.3
0.8
Widowed
3.4
1.3
2.8
1.2
2.5
1.0
7.4
2.1
3.8
0.8
3.8
1.9
3.6
1.2
No response
0.1
0.0
0.0
0.5
0.4
0.2
0.2
0.3
0.0
0.0
0.0
0.0
0.2
0.2
Total
100
100
100
100
100
100
100
100
100
100
100
100
100
100
Urban
273
332
187
220
339
362
233
271
263
310
552
623
1847
2118
Currently married
59.7
39.8
67.4
46.4
67.0
43.6
45.9
40.6
47.5
37.1
54.2
43.0
56.7
41.8
Living with a sexual
partner
2.2
3.0
0.5
1.8
0.3
1.9
0.9
3.0
11.4
3.2
6.0
2.6
4.0
2.6
Never married
34.4
56.0
25.7
50.5
26.5
53.9
48.5
53.9
36.1
57.1
36.2
52.5
34.7
53.9
Separated
0.7
0.3
1.1
0.9
0.9
0.3
0.4
0.7
0.8
1.6
1.4
1.3
1.0
0.9
Divorced
0.7
0.3
3.7
0.5
2.4
0.0
0.9
0.0
0.8
0.6
0.5
0.2
1.3
0.2
Widowed
2.2
0.3
1.6
0.0
2.9
0.0
3.4
1.5
3.0
0.3
1.6
0.2
2.4
0.3
No response
0.0
0.3
0.0
0.0
0.0
0.3
0.0
0.4
0.4
0.0
0.0
0.3
0.1
0.2
Total
100
100
100
100
100
100
100
100
100
100
100
100
100
100
25
3.5
Marital Status
The distribution of both females and males according to their marital
status is shown in Table 3.5. The proportion of females and males
currently married was generally higher in the North West, North East and
North Central than in the South East, South South and South West. In
general, the proportion of females and males currently married was
consistently higher in the rural areas and among the females across the
zones. The proportion of female and males who were not married but
living with a partner was generally low in rural and urban area except in
the South South and South West, where the females were higher in both
the rural and urban areas.
Table 3.5: Marital Status
Percent Distribution of all Respondents according to Selected
Characteristics; FMOH, Nigeria 2007
Religion
North
Central
NorthEast
NorthWest
South
East
SouthSouth
South
West
Total
Islam
Protestant
Catholic
Traditional
Others
Total (%)
Total men &women
53.8
28.5
16.5
1.0
0.2
100
2047
81.8
16.0
1.8
0.1
0.3
100
1536
93.1
5.1
1.7
0.0
0.1
100
2847
0.5
47.8
48.9
1.6
1.2
100
1294
1.1
80.0
15.9
1.2
1.8
100
1776
36.5
56.2
6.6
0.4
0.3
100
2021
50.1
36.0
12.7
0.6
0.6
100
11521
26
3.6
Age at First Marriage
Information on age at first marriage is presented in Table 3.6. The median
age at first marriage was 17.0 years for females and 25.0 for males. For
the females, marriage was generally earlier for respondents who had
never attended school and those who had Qur’anic education only. For
the males, marriage was earlier for those who had to Qur’anic education.
Females in the northern zones also reported a lower median age at
marriage.
Table 3.6: Median Age at First Marriage
Median Age at First Marriage for Females and Males according to
Selected Characteristics; FMOH, Nigeria, 2007
Characteristics
Female
median age
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
TOTAL
27
Male
median
age
16.0
19.0
20.0
22.0
18.0
15.0
15.0
20.0
19.0
21.0
25.0
22.0
21.0
30.0
26.0
26.0
15.0
15.0
18.0
20.0
23.0
17.0
22.0
20.0
25.0
25.0
27.0
25.0
3.7
Polygamous Unions
The percentage distribution of currently married females and males in
polygamous unions is presented in Table 3.7. Generally, more females
(36%) than males (24%) were in polygamous unions. The proportion of
respondents in polygamous unions was also generally higher in the North
than in the South, and higher among females and males that never
attended school or with Qur’anic education only compared with those with
other levels of education. In northern zones, there was not much
difference between the level of polygamy as reported by the respondents.
In the South, polygamy was more common in the South West (27%) than
in the South East (9%) and South South (16%).
Table 3.7: Polygamous Unions
Percent Distribution of Currently Married Females and Males who are in
Polygamous unions according to Selected Background Characteristics;
FMOH; Nigeria 2007
Characteristics
Female
3412
Male
2818
39.8
26.2
27.9
16.6
41.2
45.2
46.5
8.5
16.4
26.8
28.4
28.0
33.2
6.6
10.7
22.9
48.5
46.6
31.7
17.4
16.8
30.9
39.8
23.4
15.6
18.1
30.4
29.4
32.2
39.1
41.8
NA
35.7
9.1
6.5
11.8
19.8
28.2
35.4
24.3
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20.24
25-29
30-39
40-49
50-64
Total
28
3.8
Occupational Distribution
Table 3.8 presents the occupational distribution of all the respondents
according to rural/urban locations and zones. Farming and fishing were
reported as occupations by about one quarter of the respondents in the
rural areas with varying proportions from 14.5% in the South West to 32%
in the North Central. Generally, a higher proportion of respondents in the
urban areas owned their own businesses (24%) compared with 17.2% of
the respondents in rural areas. The proportion of students in the rural
area was 22%, higher in South East (33%), South South (32.3%) and
South West (32%) than in the North Central (20.9%), North East (15.8%)
and North West (11.3%). A higher proportion of the respondents in the
rural area were housewives (14.8%) compared with 7.6% in the urban
area. A very low proportion 4.5% in urban and 4.4% in rural reported that
they were unemployed. The proportions were highest in the South South
being 6.1% and 6.7% in urban and rural locations respectively.
Table 3.8: Occupation Distribution
Percentage Distribution of All Respondents According to Location and
Zone; FMOH, Nigeria 2007
Occupation
Rural
Upper management
Own business
Blue collar skilled and semi
Unskilled Jobs
Civil servant/clerical
Farming/forestry/fishing/mining
House wife
Pensioner/retired
Unemployed
Student
Others
Total
Urban
Upper management
Own business
Blue collar skilled and semi
Unskilled Jobs
Civil servant/clerical
Farming/forestry/fishing/mining
House wife
Pensioner/retired
Unemployed
Student
Others
Total
North
Central
1442
1.0
17.6
3.4
4.9
3.1
32.0
12.8
0.6
3.3
20.9
0.5
100
605
2.8
18.8
7.8
4.3
14.4
3.3
7.3
1.0
4.3
35.4
0.7
100
North
East
1129
1.0
13.8
3.0
4.0
4.6
27.7
23.8
0.4
5.4
15.8
0.5
100
406
1.7
18.7
4.7
4.7
15.0
5.2
18.4
0.7
5.2
25.8
0.0
100
29
North
West
2146
1.2
13.9
2.0
6.2
1.5
31.5
27.8
0.2
3.3
11.3
1.1
100
701
4.7
21.0
4.7
6.0
7.3
6.8
17.1
1.7
4.6
25.0
1.1
100
South
East
790
2.7
19.0
2.2
6.1
3.3
22.8
3.2
0.6
6.3
33.0
0.9
100
504
2.4
29.8
3.4
7.1
6.2
9.5
2.6
0.4
0.5
31.3
0.8
100
SouthSouth
1203
2.1
20.4
4.1
2.3
4.3
23.6
3.5
0.6
6.7
32.3
0.2
100
573
4.5
25.5
6.5
3.1
9.1
5.4
4.7
1.4
6.1
33.2
0.5
100
South
West
846
2.5
23.2
8.5
10.9
3.4
14.5
0.2
1.2
3.1
32.0
0.5
100
1175
5.6
25.5
8.9
11.6
7.7
2.2
1.8
0.8
2.6
33.1
0.1
100
Total
7556
1.6
17.2
3.5
5.5
3.1
27.0
14.8
0.5
4.4
21.7
0.6
100
3965
4.1
23.5
6.5
7.0
9.4
4.9
7.6
1.0
4.5
31.0
0.5
100
3.9
Mobility
Respondents were asked to indicate whether they had been away from
home for more than one month in the last twelve months preceding the
survey on the assumption that people who travel away from home are
more likely to engage in risky sexual behaviour. The responses are
presented in Table 3.9. The highest proportion of respondents who had
travelled from home in the last month was in the age group 25-29 years.
A higher percentage of male respondents (33%) compared with females
(26%) as well as respondents living in urban (35%) compared with rural
(28%) areas had been away from home for more than one month in the
survey year. A higher proportion of respondents in the South West (39%)
and South South (38%) had been away from home during the reference
period compared to the other zones.
Table 3.9: Mobility of Respondents
Percent Distribution of Respondents who had been away from Home for
more than one Month in the last 12 Months prior to Survey according to
selected background characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
North
Central
North
East
North
West
South
East
SouthSouth
South
West
Total
2047
1536
2847
1294
1776
2021
11521
23.0
28.7
22.4
29.1
20.1
27.9
24.3
35.0
32.7
41.6
36.5
41.0
26.1
33.4
23.9
31.4
22.9
34.4
23.3
27.1
26.1
35.3
36.2
40.4
40.0
38.3
27.6
34.8
21.3
29.3
33.6
25.7
21.9
23.7
26.1
20.7
24.0
33.9
27.9
27.0
19.6
26.0
20.0
28.0
29.6
23.2
23.7
20.1
24.2
24.4
38.7
36.1
28.6
26.8
24.6
29.7
31.8
41.7
41.3
37.4
33.2
42.5
37.5
27.7
42.1
41.3
41.8
46.8
32.8
39.0
23.8
33.4
35.4
30.4
29.9
26.5
30.0
30
3.10
Access to Communication Facilities
Table 3.10 presents information on access to communication facilities
according to the zones and locations. About 77% of the respondents in
the rural and 90% in the urban areas reported that they had access to
radio. In the rural area the proportion of respondents that had access to
radio ranged from 66% in the North East to 91% in the South East. In the
urban area, it ranged from 82% in the North East to 95% in the South
East. Access to television was lower than that of the radio in both rural
and urban areas across the zones. Overall access to telephone was
higher in urban areas than the rural area. The percentage of the
respondents who had access to GSM phone was higher in urban (71%)
than rural (28%) areas. Also the proportion of those who had access to
telephone (landline) was higher in urban (8%) than rural (1%) areas.
Table 3.10: Access to Communication Facilities
Percent Distribution of Respondents by Access to Communication
Facilities According to Location and Zone; FMOH, Nigeria 2007
Facility
Rural
Radio
Television
Video
Cable/Satellite
GSM phone
Telephone
Urban
Radio
Television
Video
Cable/Satellite
GSM phone
Telephone
3.11
North
Central
1442
76.5
28.1
20.6
1.0
29.4
1.0
605
91.4
84.1
69.9
16.4
78.3
9.1
North
East
1129
66.2
14.8
11.4
3.4
14.8
0.7
406
81.6
65.1
51.4
11.3
53.1
3.7
North
West
2146
72.1
18.7
14.9
0.9
16.0
1.3
701
88.7
70.5
59.5
19.1
58.2
10.6
South
East
790
90.6
50.5
30.4
1.5
41.8
2.2
504
95.0
76.2
60.3
8.9
68.3
7.9
SouthSouth
1203
81.3
48.3
31.2
2.4
40.1
1.2
573
89.0
84.8
65.6
20.3
76.9
5.4
South
West
846
85.4
53.4
37.5
2.6
46.4
1.2
1175
90.4
87.0
67.5
4.4
78.7
8.1
Total
7556
77.0
31.8
22.2
1.8
28.3
1.2
3965
89.7
79.7
63.6
12.4
70.8
7.8
Use of Drinks Containing Alcohol
Among the background information sought from the respondents was
how often they had drinks containing alcohol during the last four weeks
preceding the investigation and whether they had ever used psychoactive
drugs. This information was sought on the assumption that those who
have drinks containing alcohol or use drugs may be more likely to engage
in risky sexual behaviour than those who do not.
31
In Table 3.11, 16% of the respondents reported that they took drinks
containing alcohol during the last four weeks preceding the survey.
Frequency of alcohol intake within the period showed that 3% had daily
intake and 8% did so at least once a week. Alcohol intake was reported in
all the zones in the country but the lowest was reported in the North West
(3%) and the North East (5%) while the highest rates of intake were
reported in the South South (38%) and South East (32%).
Table 3.11: Use of Alcohol
Percentage Distribution of All Respondents Who have used Drinks
containing Alcohol within the Last One Month According to Zone; FMOH,
Nigeria 2007
Frequency of Alchol Use
North
central
2047
1536
2847
1294
Every day
3.2
1.8
0.8
2.9
At least once a week
7.7
2.1
1.3
16.5
Less than once a week
3.6
0.8
0.5
% using drinks
containing alcohol in last
one month
14.5
4.7
2.6
3.12
North
East
North
West
South
East
SouthSouth
South
West
Total
1776
2021
11521
5.2
2.6
2.6
18.8
7.4
8.0
12.5
13.6
6.6
5.5
31.9
37.6
16.6
16.1
Use of Psychoactive Drugs
Respondents were asked to indicate whether they had ever tried any
psychoactive drugs such as marijuana, cocaine, heroin and solvents
(glue). Two percent of the respondents reported ever using any of the
psychoactive drugs. South East (2.0%) and South South (2.2%) zones
had the highest prevalence of use and a higher proportion of males
(2.7%) than females (0.5%). Furthermore, use of psychoactive drugs was
higher among those in the age group 25 to 29 (2.8%) and among those
who had higher education (2.4%).
32
Table 3.12: Use of Psychoactive drugs
Percentage distribution of all respondents who have used any of
psychoactive drugs according to selected characteristics; FMOH, Nigeria
2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Education
None
Qur’anic
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
North
Central
North
East
North
West
South
East
SouthSouth
South
West
Total
2047
1536
2847
1294
1776
2021
11521
0.1
3.3
0.3
1.7
0.9
2.4
0.2
3.8
0.6
3.5
0.7
1.7
0.5
2.7
1.5
2.5
0.9
1.5
1.1
3.7
1.5
2.8
2.5
1.6
1.3
1.2
1.4
2.1
1.0
2.2
1.4
2.5
2.1
0.4
1.1
1.2
1.5
2.1
1.4
0.7
1.4
3.4
3.4
0.0
0.0
3.9
1.8
0.0
2.6
0.0
1.6
2.5
1.8
1.1
0.0
1.4
0.8
2.4
1.0
0.9
1.8
2.0
2.1
1.2
1.9
2.9
2.5
0.3
2.0
1.8
0.0
1.3
2.5
0.8
1.4
0.0
1.0
0.8
1.8
2.9
2.1
1.5
1.4
1.7
0.3
2.2
4.2
2.9
2.2
0.8
2.0
0.3
1.9
4.2
2.4
1.9
3.5
2.2
0.7
1.4
0.9
1.6
0.9
2.9
1.2
0.6
1.7
2.8
2.0
1.3
1.8
1.7
33
3.13 Discussion and Conclusions
The mean age of female respondents was 28 years while that of male
respondents was 32 years. There were differences in the educational
attainment between respondents in the rural and urban areas and
between zones. A higher proportion of urban respondents had higher
level of education than rural respondents. Also a higher proportion of
males than females had received formal education. Almost half of the
respondents reported that they were Christians (36 % Protestants and
13% Catholics) while 50% reported their religion as Islam. Majority of the
respondents in the North were Moslems while in the South respondents
were predominantly Christians
The proportion of respondents who were married was generally higher in
the northern zones than in the southern zones. In general, the proportion
of married respondents was higher in rural than urban areas and among
the females. The median age at first marriage was much lower among
females than males. For females, marriage was generally earlier for
respondents who had never attended school and those with
Qur’anic education only. Females in the northern zones reported a lower
median age at marriage.
The main communication facility which respondents in the urban and rural
areas had access to was the radio. However the proportion of
respondents who have access to GSM phones in urban areas has risen
from 50% reported in 2005 to 71%. Alcohol intake was reported in all
zones but consumption was higher in the southern zones than in the
northern zones. The use of psychoactive rugs was low in all zones.
34
SECTION 4
4.0
SEXUAL BEHAVIOUR
In Nigeria as in other parts of Sub-Saharan Africa, sexual intercourse is
the main mode of transmission of HIV and AIDS as well as other sexually
transmitted infections. The understanding of patterns of sexual behaviour
is important in assessing the factors contributing to the HIV and AIDS
epidemic and other sexually transmitted infections, and also to determine
the impact of interventions on sexual behaviour. This section presents the
findings from the questions posed to the respondents on their sexual
behaviour. Information in this section includes age at first sex, types and
number of sexual partners, and the practice of sex in exchange for
money, favours or gifts.
4.1
Ever Had Sex
The percentage distribution of both male and female respondents who
had ever had sex according to rural-urban location, zone, education and
age is presented in Table 4.1. Overall, about four fifths (83%) of the
female respondents compared with 73% of the male respondents had
ever had sex. The proportion of female respondents that had ever had
sex ranged from 72% in the South East to 87% in the North West while
for the males the proportion ranged between 61% (North West) and 84%
(South South). Among young people of age group 15-19 years, 43% of
the female and 22% of the males had engaged in sex while from the age
of 30 years nearly all respondents reported that they had ever had sexual
intercourse. A higher proportion of female rural dwellers had engaged in
sex compared to their urban counterparts however, this proportion was
similar (73%) among the males in both locations.
35
Table 4.1: Ever had Sex
Percent Distribution of Respondents Who Have Ever had Sex According
to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Female
Number of
women
Male
Number of
men
78.5
3513
1847
72.9
73.2
4043
2118
83.2
82.3
87.1
72.0
86.9
80.8
942
718
1333
639
811
917
77.8
68.7
60.9
73.0
84.2
78.3
1105
818
1514
655
965
1104
94.5
1622
82.4
864
89.6
89.0
67.8
83.9
396
1040
1873
429
70.7
78.0
64.0
86.7
629
1193
2646
829
42.9
84.4
95.6
98.5
99.0
NA
82.9
1190
1084
936
1287
863
NA
5360
22.2
60.1
80.0
96.8
99.2
99.6
73.0
1280
1079
946
1169
861
826
6161
85.2
NA: Not applicable
4.2
Age at First Sex
The median age at first sex for both females and males 15-24 years of
age based on the responses obtained during the survey and
disaggregated by rural-urban location and zone is presented in Table 4.2.
The median age at first sex for all respondents aged 15-24 years was 16
years for females and 17 years for males. Females in the North East and
North West reported the lowest median age at first sexual intercourse (15
years) while among the males it was lowest in the South South (16
years). Median age at first sex for females in the rural area (15 years)
was lower than the urban areas (17 years). For males (15-24 years), the
median age at first sex was (17 years) in both urban and rural areas.
36
Table 4.2: Median Age at First Sex
Percent Distribution of Median Age at First Sex among Youths 15-24
Years Old according to Selected Characteristics: FMOH, Nigeria 2007
Characteristics
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South South
South West
National
Youth 15 to 24 years of age
Female
Male
15.0
17.0
17.0
17.0
16.0
15.0
15.0
17.0
16.0
18.0
16.0
17.0
18.0
18.0
18.0
16.0
17.0
17.0
All female respondents were asked about the age at which they had their
first sexual intercourse (Table 4.3).
Table 4.3: Median Age at First Intercourse for Female for Different
Age Groups
Median Age at First Sex of Females Respondents according to Age
Groups: FMOH; Nigeria 2007
Characteristics
Females Median age at first
sexual experience
Median age at first sex
Age group
15-19
20-24
25-29
30-39
40-49
15-49
xx
17.0
17.0
17.0
17.0
16.0
xx - Figure suppressed because less than 50% of respondents in this age group
have had sexual intercourse
4.3 Current Sexual Activity
Information on the proportion of persons who had sex within the twelve
months prior to the survey is important in assessing the extent of current
sexual activity in a country and provides a basis for measuring other
useful indicators. Table 4.4 shows the percentage of respondents who
had sex in the last twelve months preceding the survey. Sixty seven
percent of females and 61% of males had sex in the last twelve months
preceding the survey. In general, sexual activity is higher among females
37
in the age range of 25-39 years and among males in the 30-49 age
groups. It was also observed that sexual activity among women in the last
12 months preceding the survey was highest in the South South (73%)
and lowest in the South West (66%). For men current sexual activity
ranged from (53%) in the North West to 74% in the South South.
Table 4.4: Sexual Activity of the General Population
Percent Distribution of Female and Male Respondents Who Had Sexual
Intercourse in the Past 12 Months Preceding the Survey Among all
Respondents according to Selected Characteristics: FMOH, Nigeria 2007.
Characteristics
Female
Number of
Women
Male
Number of
Men
Location
Rural
67.3
3513
61.5
4043
Urban
66.8
1847
59.6
2118
North Central
67.1
942
64.6
1105
North East
North West
South East
South-South
67.1
71.0
53.8
72.6
718
1333
639
811
58.1
53.0
56.0
74.0
818
1514
655
965
Zone
Education
Never attended
school
Qur’anic only
Primary
70.0
1622
64.7
864
75.8
74.2
396
1040
61.4
65.7
629
1193
Secondary
Higher
57.4
73.4
1873
429
53.0
74.3
2646
829
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
35.8
72.9
82.5
81.7
64.5
0.0
67.1
1190
1084
936
1287
863
0
5360
15.9
47.4
67.9
87.6
87.5
74.5
60.8
1280
1079
946
1169
861
826
6161
Table 4.5 presents the proportion of sexually active respondents who had
sex in the last twelve months preceding the survey according to selected
characteristics. Eighty one percent of sexually active female respondents
compared with 83% of males reported having had sex in the twelve
months preceding the survey. Among the never married sexually active
38
respondents 76% of the females and 74% of the males had engaged in
sex in the last twelve months preceding the survey.
Table 4.5: Sexual Activity in the Last 12 Months among Respondents
Who had Ever Had Sex
Percent Distribution of Respondents who had Sex in the Last 12 Months
among all Respondents who have ever had Sex According to Selected
Characteristics: FMOH, Nigeria 2007
Characteristics
Female
Male
Women who
had sex in the
last 12
months
Number of
women who
have ever had
sex
Men who
had sex in
the last 12
months
Number of
men who
have ever had
sex
Rural
Urban
79.0
85.1
2993
1449
84.3
81.4
2948
1551
Zone
North Central
North East
North West
South East
South South
80.6
81.6
81.6
74.8
83.5
784
591
1161
460
705
83.0
84.5
87.1
76.8
87.8
860
562
922
478
813
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Marital status
Never married
81.4
741
78.1
864
74.1
84.5
83.4
84.7
87.5
1532
355
926
1269
360
78.5
86.7
84.3
82.9
85.7
712
445
930
1693
719
83.5
86.3
86.3
83.0
65.2
NA
510
915
895
1268
854
NA
71.5
78.7
84.8
90.5
88.2
74.7
284
649
757
1132
854
823
76.3
566
73.7
1354
Ever married
Total
81.7
81.0
3870
4442
87.5
83.3
3141
4499
Location
NA: Not applicable
4.4 Types of Sexual Partners
Both male and female respondents who reported having sexual
intercourse in the last twelve months preceding the survey were asked to
39
state the number and type of partners they had. A distinction was made
between marital and cohabiting partners, boy/girlfriends, casual and
commercial partners.
A marital/cohabiting partner was defined as a partner either married or
living together as married with the respondent. All non-marital, non cohabiting sexual partners were considered non-marital partners. A boy
friend/girlfriend was defined as a non-spousal partner but more stable
than a casual sex partner. A casual partner was defined as a partner one
met on a casual basis and who may or may not have demanded
payment, gift or favour for sex with little or no commitment on either side.
A commercial partner was defined as one who demanded payment for
sex on a strictly cash basis.
4.4.1 Sex with Non-Marital Partners
Given the risky nature of non-marital sex, Table 4.6 shows the
percentage of females and males that had sex with non marital partners
during the last 12 months preceding the survey. Overall about 9% of
females and 20% of males reported that they had had sex with nonmarital partners in the last 12 months preceding the survey. Among
females, non marital sex was more common in the Southern zones than
in the North and persons in age group 15-29 years were more likely to
have engaged in non-marital sex.
40
Table 4.6: Non-Marital Sexual partner Last 12 Months
Percent Distribution of Respondents who had Sex in the Last 12 Months
with a Non-Marital Partner among all Respondents According to Selected
Characteristics: FMOH, Nigeria 2007.
Characteristics
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-south
South West
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
NA=Not Applicable
Women that
had non
marital
partner
Number of
Women
Men that had
non marital
partner
Number of
Men
8.2
11.5
3513
1847
18.1
22.9
4043
2118
8.2
2.9
0.9
13.8
21.5
14.2
942
718
1333
639
811
917
25.2
9.3
3.1
21.8
39.2
26.7
1105
818
1514
655
965
1104
12.0
17.2
10.8
4.1
2.2
NA
9.4
1190
1084
936
1287
863
NA
5360
14.4
36.6
34.1
17.7
9.9
2.9
19.8
1280
1079
946
1169
861
826
6161
Chart 4.1: Percentage distribution of male and female respondents who had sex with a nonmarital partner in the last 12 months before survey by Zone; FMOH, Nigeria, 2007
Males
Females
45
39.2
40
35
30
26.7
Percentage
25.2
25
21.8
21.5
20
10
14.2
13.8
15
8.2
5
9.3
2.9
3.1
0.9
0
North Central
North East
North West
South East
Zones
41
South South
South West
Chart 4.2: Percentage of respondents who had sex with a non-marital partner in the last 12
months before survey by Age and Sex; FMOH, Nigeria, 2007
Males
Females
40
36.6
34.1
35
30
P e rc en ta g e
25
20
15
17.7
17.2
14.4
12
10.8
9.9
10
4.1
5
2.2
2.9
0
0
15-19
20-24
25-29
30-39
40-49
50-64
Age groups
4.5 Sex in Exchange for Gift or Favour
Table 4.7 shows the distribution of respondents who had ever had sex in
exchange for gift or favour. Five percent of females and 8% of males
reported that they have ever accepted or given gifts of some kind or
favour in exchange for sex. The proportion of respondents who had
received or given some kind of gifts or favour for sex was higher among
the younger age group (15-29 years), in the urban areas and among
those with primary, secondary and higher education. The proportion that
had accepted or given gifts or some kind of favour in exchange for sex
was highest in the South South for both females (10%) and males (14%).
42
Table 4.7: Transactional Sex
Percent Distribution of Respondents Who Have Ever had Sex in
Exchange for Gifts or Favours among all Respondents who have ever
had sex According to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Women who
have ever
had sex in
exchange for
gifts or
favours
Number of
Women
Men who
have ever
had sex in
exchange for
gifts or
favours
Number of
Men
4.5
4.7
2993
1449
7.6
9.3
2948
1551
5.1
2.0
0.9
6.1
10.4
5.3
784
591
1161
460
705
741
7.7
6.8
3.8
11.1
14.4
6.9
860
562
922
478
813
864
1.8
0.6
5.1
7.9
7.2
1532
355
926
1269
360
4.6
2.9
9.0
11.0
7.2
712
445
930
1693
719
6.9
6.1
5.8
3.8
1.3
.NA
4.5
510
915
895
1268
854
NA
4442
8.8
10.3
9.1
8.7
7.6
5.5
8.2
284
649
757
1132
854
823
4499
NA = Not Applicable
4.6 Multiple Partners
An important aspect of sexual behaviour is engagement with multiple
sexual partners because it carries significant implication for sexual and
reproductive health, including transmission of HIV and other sexually
transmitted infections. Information was collected from all respondents
who had sex in the last 12 months preceding the survey on how many of
a particular type of partner (both marital and non-marital partners) they
had sex with in the said period. The results are presented in Table 4.8.
Of all the respondents who had ever had sex within the period, only 3% of
females compared with 27% of males reported having multiple partners.
There were differences within zones, age groups, marital status and
levels of education. Among females the lowest levels of sexual
engagement with multiple partners were reported in the North East (1%)
and North West (1.5%) while the highest was in the South South (5.5%).
43
The lowest level for males was in the South South (15%) while the
highest level was in the North West (31%). Among the females there was
no difference between the respondents in the rural and urban areas
however, there was a higher level in the rural (29%) than urban area
(24%) among the males. A higher proportion of never married females
(11%) compared to married (2%) females reported engagement with
multiple sexual partners. Among males there was also a slightly higher
proportion with multiple sexual partners among the never married males
(30%) compared to the married males (26%).
Table 4.8: Multiple Marital and Non Marital Partners Last 12 Months
Percent Distribution of Respondents Who Kept More than One Sex
Partner (Marital or Non- Marital) in the Past 12 Months among those who
had ever had sex according to Selected Characteristics: FMOH, Nigeria
2007.
Characteristics
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-south
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Marital status
Never married
Married
Total
Sexually active
women who had
more than one
sexual partner
Women who
have ever
had sex
Sexually
active men
who had
more than
one sexual
partner
Men who
have ever
had sex
2.9
3.0
2993
1449
29.2
23.9
2948
1551
2.9
1.0
1.5
2.8
5.5
4.3
784
591
1161
460
705
741
29.7
26.7
30.9
26.2
15.1
29.7
860
562
922
478
813
864
1.4
0.6
2.6
5.4
3.9
1532
355
926
1269
360
24.4
34.2
27.4
26.6
27.7
712
445
930
1693
719
4.7
4.8
2.6
1.9
1.8
NA
510
915
895
1268
854
NA
26.4
28.8
24.8
25.3
31.3
27.6
284
649
757
1132
854
823
11.1
1.7
2.9
566
3870
4442
29.8
26.3
27.3
1354
3141
4499
NA: not applicable
44
4.7 Multiple Non-Marital Partners
Sexual intercourse with non-marital sexual partners is often considered to
be of higher risk than sex with marital partners and this risk increases with
multiple non-marital partners. Table 4.9 shows the proportion of
respondents who had had multiple non-marital partners. At the national
level 1% of females who had sex in the 12 months preceding the survey
had multiple non-marital partners compared with 7 % of males. Females
with secondary (2%) or higher level (2%) of education reported a higher
level of multiple non marital partners. Similarly, among the males, it was
higher among those with higher level of education (12%). Respondents in
the South South zone reported the highest proportion of multiple partners.
Female and males who had never married were more likely to have
multiple non-marital sexual partners.
Figure 4.3 Percentage Distribution of Respondents who had sex with more than one
sex partner in the last 12 months by zone and sex; FMOH, Nigeria 2007
14
13.2
12
12
10
P e rc e n t a g e
8.2
8
Males
6
3.5
4
2
Females
5.2
2.6
1.8
1.4
0.3
1.7
0.6
0.1
0
North Central
North East
North West
South East
Zones
45
South South
South West
Table 4.9: Multiple Non-Marital Partners last 12 months
Percent Distribution of Respondents who had Sex with Non-Marital
Partners in the Past 12 Months among all Respondents According to
Selected Characteristics; FMOH, Nigeria 2007.
Characteristics
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Marital Status
Never married
Married
Total
NA: not available
Female
One
More
than one
Total
Male
One
7.3
10.6
1.1
1.1
3513
1847
6.8
2.6
0.8
13.1
19.5
12.5
1.4
0.3
0.1
0.6
2.6
1.7
1.2
More
than one
Total
12.6
15.7
6.5
8.5
4043
2118
942
718
1333
639
811
917
17.9
6.5
1.5
16.9
28.9
15.9
8.2
3.5
1.8
5.2
13.2
12.0
1105
818
1514
655
965
1104
0.2
1622
4.1
2.0
864
0.3
5.1
15.1
22.4
0.3
0.7
2.0
1.9
396
1040
1873
429
1.7
9.5
18.9
21.7
0.8
4.9
9.9
12.1
629
1193
2646
829
10.8
15.6
9.8
3.4
2.1
NA
1.3
2.0
1.0
0.7
0.1
NA
1190
1084
936
1287
863
0
9.8
24.2
24.0
12.3
7.7
2.1
5.1
14.3
12.4
6.8
2.4
1.0
1280
1079
946
1169
861
826
26.1
1.8
8.4
3.0
0.3
1.1
1460
3893
5360
22.3
5.5
13.6
11.7
3.0
7.2
2986
3163
6161
4.8 Non-Marital/Non Co-habiting Relationship
One of the most common types of non-marital non co-habiting
relationships in Nigeria is the boyfriend/girlfriend relationship.
Respondents were asked whether they had had sex with either a
boyfriend or a girlfriend in twelve months preceding the survey. Results
are presented in Table 4.10.
Nine percent of females compared with 19% of males had sex with
boyfriends and girlfriends respectively during the last 12 months
preceding the survey. There were substantial variations at the zonal level
ranging from 1% in the North West to 21% in the South South for females
and 3% in the North West to 26% in the South South and South West for
46
males. A higher proportion of respondents (both males and females)
living in Urban areas compared to respondents in rural areas reported
sexual activity with boyfriends and girlfriends.
The proportion of those in the younger age group, 15–29 years, who had
sex with a boyfriend/girlfriend, was highest among those respondents
aged 20-24years. In males and females, the proportion of those who have
had sex with boyfriend/girlfriend increased with level of education.
Table 4:10 Boyfriend/Girlfriend Relationships
Percent Distribution of Respondents Who have had Sex with a Boyfriend
or a Girlfriend in the Past 12 Months among all Respondents According to
Selected Characteristics: FMOH, Nigeria 2007.
Characteristics
Women who had
intercourse with a
boyfriend in the
last 12 months
Number of
women
Men who had
intercourse
with a girlfriend
in the last 12
months
Number of
men
Location
Rural
Urban
8.1
11.4
3513
1847
17.2
21.8
4043
2118
Zone
North Central
North East
North West
South East
South-South
South West
8.0
2.9
0.9
13.6
21.3
13.7
942
718
1333
639
811
917
24.2
8.7
3.0
20.9
26.2
25.9
1105
818
1514
655
965
1104
Education
Never attended school
1.1
1622
4.6
864
0.5
5.7
16.7
23.8
396
1040
1873
429
2.4
12.7
26.3
30.5
629
1193
2646
829
12.0
17.1
10.8
3.8
1.9
NA
1190
1084
936
1287
863
NA
14.0
35.7
33.0
16.3
8.5
2.1
1280
1079
946
1169
861
826
28.6
1.9
9.2
1460
3893
5360
31.5
6.7
18.8
2986
3163
6161
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Marital status
Never married
Married
Total
47
4.9 Discussion and Conclusions
Sexual activity is an important component of sexual health however
unsafe sexual practices may lead to ill health and disease, including HIV
and AIDS, other sexually transmitted diseases as well as unwanted
pregnancy. Eighty three (83) percent of female respondents and 73% of
male respondents have had sexual intercourse.
Among female respondents, sexual intercourse began much earlier in the
Northern zones where the median age at first sex was 15 years which
was below the National average of 16 years. The low median age at first
sex among females in North West and North East zones (15 years) could
be a reflection of the low median age at first marriage (15 years) in the
same zones.
Among the respondents who had ever had sex 76% of the unmarried
females and 74% of the unmarried males had some form of sexual
activity in the last 12 months preceding the survey. Having sex with non
marital partners and having multiple sexual partners are considered high
risk sexual behaviour. Three percent of females and 27% of males had
multiple partners while 10% of females and 21% of males have had sex
with at least one non – marital partner in the last 12 months preceding the
survey. This puts them at risk of STIs including HIV.
48
SECTION 5
5.0
Knowledge, Opinion and Attitudes about HIV and AIDS
This section presents information about awareness of HIV, knowledge of
how it is spread, knowledge of how it can be prevented, misconceptions
about transmission and prevention of HIV and respondents’ assessment
of their personal risk of contracting HIV.
5.1
Knowledge About HIV and AIDS
Awareness about HIV and AIDS was generally high in the country (94%).
It was higher in the urban areas (97%) compared to rural (92%). It was
also higher among males (95%) than the females (92%). However, the
lowest proportion was recorded among respondents who never attended
school (83%) and highest among people with higher education (99%). On
the whole, adolescents (aged 15 - 19years) had the lowest level of
awareness (91%). At zonal level, South-South has the highest level of
awareness (98%) and the least (93%) recorded in North Central.
49
Table 5:1 Awareness of HIV/AIDS
Percent Distribution of Respondents who have Ever -Heard of HIV/AIDS
according to Selected Characteristics: FMOH, Nigeria 2007.
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never
attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
5.2
Heard of HIV or AIDS
Number of women &
men
92.1
95.3
5360
6161
92.0
97.3
7556
3965
92.9
94.5
2047
1536
96.9
94.5
97.6
96.9
2847
1294
1776
2021
82.9
2486
90.0
95.4
98.4
99.3
1025
2233
4519
1258
90.6
95.0
95.3
94.7
93.8
94.6
93.8
2470
2163
1882
2456
1724
826
11521
Knowledge of a Cure for AIDS
Respondents were asked whether they thought there was a cure for HIV
and AIDS. The results are presented in Table 5.2. Seventy - five percent
reported that there was no cure. This proportion was higher among
respondents in rural areas (76%) compared to urban (73%) but about
same percentage (75%) between females and males. Uncertainty about
whether or not there was cure for HIV and AIDS was higher among
people who had never been to school and those who had Qur’anic
education only.
50
Table 5.2: Knowledge of AIDS Cure
Percent Distribution of Respondents Reporting that AIDS has or Does not
have a Cure According to Selected Characteristics; FMOH, Nigeria 2007.
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
AIDS does
not have
cure
AIDS does
have a cure
Don’t
know/have
not heard of
AIDS
Number of
women &
men
74.8
75.0
9.5
10.4
15.8
14.6
4937
5872
76.2
72.6
8.6
12.5
76.2
72.6
5294
3857
77.8
77.8
69.7
82.2
74.1
72.7
10.0
7.7
14.9
5.9
9.8
9.4
12.5
14.5
16.3
11.9
16.1
17.8
1902
1452
2491
1273
1733
1958
72.9
69.6
74.0
76.6
77.4
6.8
11.6
9.5
10.6
12.8
20.3
18.8
16.5
12..8
9.8
2061
922
2130
4447
1249
76.3
76.3
76.1
75.6
71.6
69.1
74.9
10.6
10.8
10.5
8.9
9.5
9.2
10.0
13.1
12.9
13.4
15.5
18.9
21.6
15.1
2237
2055
1793
2326
1617
781
10809
5.3
Knowledge of Someone Who had HIV and AIDS or Died
of AIDS
When respondents were asked whether they had seen someone with HIV
or knew someone who died of AIDS, less than a quarter (22%) indicated
that they had seen someone with HIV or knew someone who died of
AIDS. The percentage was about the same (22%) in the urban and in the
rural areas but higher among males (24%) than females (19%).
Knowledge was highest in the North East (30%) and lowest in the South
West (7%). Knowledge was also highest among those with higher
education (30%) and lowest among adolescents (aged 15-19 years).
51
Table 5:3: AIDS Related Death
Percent Distribution of all Respondents who knew a person who has HIV
and AIDS or who died of AIDS According to Selected Characteristics;
FMOH, Nigeria 2007
Characteristics
Knew someone with
AIDS
Sex
Male
Female
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-south
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
5.4
Number of
women &
men
23.7
19.3
5360
6161
21.5
22.1
7556
3965
25.1
30.0
24.7
29.2
16.6
7.3
2047
1536
2847
1294
1776
2021
14.6
25.0
23.2
21.7
30.1
2486
1025
2233
4519
1258
17.8
21.6
23.4
23.3
22.3
23.5
21.7
2470
2163
1882
2456
1724
826
11521
Personal Risk Perception of Contracting HIV
Respondents who had heard of AIDS were asked to rate their chances of
being infected with HIV; the results are presented in Table 5.4. Overall,
only 2% rated their chances of being infected high, 34% rated their
chances low, and 60% believed that they were at no risk at all. A low
percentage reported already infected with HIV (0.4%)
52
Table 5.4: Risk Perception
Percent Distribution of Respondents’ Personal Risk Perception of
Contracting HIV According to Selected Characteristics; FMOH, Nigeria
2007
Characteristics
Respondents opinions about their chances of contracting
HIV
High
chance
Low
chance
No risk
at all
Already
have
AIDS
No
response
No of
women
and men
who have
heard
of AIDS
Female
2.5
33.0
60.4
0.3
3.8
4937
Male
2.2
35.6
59.6
0.4
2.2
5872
Sex
Location
Urban
2.2
33.7
61.4
0.3
2.4
3857
Rural
2.3
34.9
59.1
0.4
3.3
6952
North Central
3.0
34.9
57.6
0.5
4.0
1902
North East
3.7
49.2
43.8
0.1
3.1
1452
North West
0.8
23.2
73.4
0.8
1.8
2491
South East
1.7
39.3
56.5
0.2
2.3
1273
South-South
3.9
35.9
56.1
0.3
3.8
1733
South West
1.4
32.9
62.7
0.0
3.0
1958
Never attended school
1.7
35.4
57.4
0.4
5.1
2061
Qur’anic only
0.3
25.4
70.9
0.8
2.6
922
Primary
2.7
35.1
59.0
0.4
2.8
2130
Secondary
2.9
34.2
60.2
0.4
2.4
4447
Higher
2.0
39.4
56.8
0.0
1.8
1249
15-19
2.1
31.6
63.8
0.2
2.3
2237
20-24
3.1
34.8
58.6
0.3
3.2
2055
25-29
2.3
37.6
56.1
0.3
3.7
1793
30-39
2.8
36.5
57.4
0.3
3.0
2326
40-49
1.4
34.0
61.0
0.4
3.2
1617
50-64
1.2
29.3
66.6
1.0
1.9
781
Total
2.3
34.4
60.0
0.4
3.0
10809
Zone
Education
Age group
53
5.5
Knowledge of Routes of HIV Infection
Correct knowledge of HIV transmission is important to enhance effective
preventive action. Respondents were, therefore, asked to indicate how
they thought a person could get the virus that causes AIDS. The routes of
HIV transmission mentioned by the respondents included sexual
intercourse (90%), sharing of sharp objects (84%), blood transfusion
(80%), sharing needles (79%) and mother to unborn child (60%). The
proportion that mentioned all five ways of transmitting HIV was 54%.
Knowledge of all five ways of transmission was higher in the southern
zones than in the north; was about the same proportion among males and
females; higher in urban than rural areas, and higher in persons with
higher levels of education.
54
Table 5.5: Knowledge of Routes of HIV Transmission
Percent Distribution of Respondents who Knew how a person Can get the
Virus that Causes AIDS According to Selected Characteristics; FMOH,
Nigeria 2007
Characteristics
Sexual
intercourse
Blood
transfusion
Mother
to
unborn
child
Sharing
sharp
objects
like
razors
Sharing
needles
Knew
five
all
Number
of
women &
men
Female
87.3
76.8
60.6
80.5
75.7
53.6
5360
Male
92.3
81.9
59.5
86.6
81.5
55.0
6161
Rural
87.4
74.6
54.9
80.1
74.5
49.0
7556
Urban
94.9
88.8
69.9
90.8
86.8
64.5
3965
North Central
88.8
77.4
59.2
82.4
76.6
54.0
2047
North East
91.0
77.0
54.3
81.2
76.3
47.7
1536
North West
82.8
70.9
52.3
75.3
70.0
46.0
2847
South East
96.7
92.0
75.1
92.7
89.4
69.1
1294
South-South
93.0
82.6
62.3
88.0
82.8
55.9
1776
South West
93.7
85.1
64.6
89.7
84.9
60.8
2021
Never attended school
75.7
59.5
42.5
63.3
58.1
35.6
2486
Qur’anic only
84.9
68.9
45.4
75.9
70.7
39.8
1025
Primary
91.4
80.6
60.9
85.0
79.6
54.5
2233
Secondary
95.8
87.8
68.0
92.5
87.6
62.7
4519
Higher
98.7
96.1
76.5
97.1
92.9
73.1
1258
15-19
85.5
73.8
53.3
80.2
74.7
47.5
2470
20-24
92.2
81.5
62.8
86.6
81.7
57.6
2163
25-29
92.6
84.2
63.9
86.2
82.2
58.5
1882
30-39
91.2
81.3
63.4
84.4
79.6
57.3
2456
40-49
88.6
78.2
60.6
82.0
76.9
54.5
1724
50-64
91.0
78.3
53.3
83.2
77.0
47.9
826
Total
90.0
54.4
11521
Sex
Location
Zone
Education
Age group
79.5
60.0
55
83.8
78.8
5.6
Misconceptions about HIV Transmission
Misconceptions about how HIV is transmitted were investigated as part of
the survey. Table 5.6 presents the prevalence of misconceptions about
how HIV is transmitted. The misconception that HIV is transmitted
through mosquitoes and bedbugs, and by kissing was highest (22% for
both), followed by sharing of toilets (19%), sharing eating utensils (17%),
witchcraft (12%) and hugging (7%). Misconceptions were generally lowest
among those with higher education.
Table 5.6: Misconception about HIV Transmission
Percent Distribution of Respondents who had Misconceptions About HIV
Transmission According to Selected Characteristics; FMOH, Nigeria
2007.
Characteristics
By
sharing
toilets
By
Sharing
Eating
utensils
By
mosquito
bites/bed
bugs
By
witchcraft
By
kissing
By
hugging
Women
& men
who
have
heard of
AIDS
20.3
17.8
17.1
16.7
21.3
22.6
13.3
11.1
23.4
21.6
8.3
5.8
4937
5872
19.2
18.5
18.2
14.5
22.7
20.8
12.7
11.0
23.1
21.2
7.5
5.8
6952
3857
16.0
12.9
17.7
19.3
21.5
25.2
15.0
13.2
17.4
16.9
15.6
21.9
25.9
16.7
24.7
13.2
23.7
23.0
18.3
8.1
9.0
10.7
21.5
5.5
26.0
24.7
19.7
24.5
20.5
22.3
4.5
8.1
8.1
8.7
7.0
5.7
1902
1452
2491
1273
1733
1958
16.9
17.2
19.8
10.7
20.7
9.2
2061
15.9
21.8
20.1
15.5
16.7
19.5
17.2
11.0
22.3
24.2
23.9
15.1
7.3
15.3
12.7
10.4
17.1
24.0
24.3
19.8
8.9
6.9
6.4
3.6
922
2130
4447
1249
15-19
19.7
19.3
24.2
12.3
24.0
8.4
2237
20-24
25-29
30-39
18.2
20.7
18.7
16.3
16.9
16.4
23.6
21.1
22.2
12.7
12.5
12.2
24.2
22.5
22.1
6.1
7.1
6.5
2055
1793
2326
40-49
50-64
18.9
15.1
16.8
12.9
19.5
18.3
12.0
8.8
21.2
16.4
6.9
5.6
1617
781
Total
18.9
16.9
22.0
12.1
22.4
6.9
10809
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
56
5.7
Knowledge of How to Avoid the Virus that Causes AIDS
Knowledge about how to prevent HIV was also investigated. It was
observed to be generally high. These results are presented in Table 5.7.
Knowledge of staying with one uninfected partner was highest (85%),
followed by avoiding sharing sharp objects (82%), abstaining from sex
(75%), avoiding sex with sex worker (71%), avoiding sex with people who
have multiple sexual partners (70%), reducing number of sexual partners
(63%), using condoms every time (55%) and, finally, by delaying sexual
debut (49%). Knowledge of ways to prevent HIV transmission was
generally higher among the males than the females, urban than the rural
and highest among respondents with higher education.
Table 5.7: Knowledge of HIV Prevention Methods
Percent Distribution of Respondents’ Knowledge of Ways of Preventing
HIV Infection According to Selected Characteristics; FMOH, Nigeria 2007
Characteristic
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South west
Education
Never
attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Stay with
one
uninfected
partner
Use of
condom
every
day
By
abstaining
from sex
By
delaying
sexual
debut
Avoid
sex
with
CSWs.
By
reducing
number
of
sexual
partners
By
avoiding
sex with
people
with
multiple
sexual
partner
82.3
86.6
44.9
63.1
70.1
78.5
47.9
50.5
64.9
76.4
62.1
63.8
67.9
72.3
79.2
84.0
5360
6161
82.4
88.8
49.7
64.1
71.0
81.5
48.2
51.3
69.3
74.4
60.6
67.6
67.2
76.2
78.1
88.8
7556
3965
83.0
87.3
79.6
86.5
86.0
88.8
59.2
48.7
32.2
59.0
69.4
70.3
74.4
78.8
59.7
90.7
80.6
77.0
56.6
48.2
34.4
54.0
53.9
56.6
74.0
77.4
67.5
67.3
72.0
69.9
68.3
57.4
54.5
62.0
65.3
72.5
73.8
66.8
65.7
69.3
70.6
76.1
81.1
80.7
74.3
86.9
85.1
87.5
2047
1536
2847
1294
1776
2021
71.3
26.8
55.6
37.5
58.8
51.5
56.8
62.7
2486
82.1
86.3
89.2
93.6
32.5
55.4
68.0
78.2
67.4
77.4
82.1
86.0
38.8
51.6
55.0
56.6
71.7
72.7
74.8
78.8
53.3
64.4
68.4
71.6
66.1
71.3
75.6
79.2
75.1
83.6
89.6
93.3
1025
2233
4519
1258
77.7
87.0
87.0
87.3
84.2
86.6
84.6
48.7
59.5
60.7
56.8
49.3
50.7
54.6
73.0
76.6
74.3
74.7
73.3
77.4
74.6
47.9
51.0
48.9
50.0
48.4
49.6
49.3
66.4
73.3
73.0
72.2
69.2
76.0
71.1
58.1
66.1
65.8
64.4
61.5
62.1
63.0
65.1
73.2
71.6
72.4
68.3
72.6
70.3
77.8
83.8
85.0
82.8
80.2
81.1
81.8
2470
2163
1882
2456
1724
826
11521
57
By
Avoid
sharing
of
sharp
objects
Number
of
women
and
men
Chart 5.2: Percentage of all respondents with knowledge of ways of preventing HIV
infection by Zones, FMOH, Nigeria, 2007
Stay with one uninfected partner
Use of condom every day
Avoiding sex with people with MSP
By abstaining from sex
100
90.7
90
87.3
86.5
88.8
86
83
78.8
80
80.6
79.6
76.1 77
73.8 74.4
70
P e rc e n ts
60
69.3
66.8
69.4
70.6
70.3
65.7
59.7
59.2
59
48.7
50
40
32.2
30
20
10
0
North Central
North East
North West
South East
South South
South West
Zones
5.8
HIV Prevention Methods (UNAIDS)
The UNAIDS indicator for knowledge of prevention methods is a very
useful, universal indicator for correct knowledge of HIV prevention
methods. The indicator specifically measures if individuals can correctly
respond to prompted questions that a person can reduce risk of
contracting HIV by using condoms and by having sex with only one
faithful uninfected partner. Fifty-three percent of all respondents knew
both means as ways of reducing one’s risk of contracting HIV. A higher
percentage among men (60%) compared to women (44%), urban
dwellers (61%) compared with rural dwellers (48%) knew the two
indicators. There were more individuals in the South West and amongst
those of higher educational levels who knew both means as ways of
reducing one’s risk of contracting HIV.
58
Table 5.8: Knowledge of HIV Prevention Methods (UNAIDS)
Percent Distribution of Respondents’ by Knowledge that One can reduce
One’s Risk of Contracting AIDS by having Sex with only One Faithful
Uninfected Partner and by Using Condoms According to the Selected
Characteristics; FMOH, Nigeria 2007.
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North West
North Central
North East
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Knowledge variables
Incomplete
Know two
knowledge
indicators
Number
of
women
& men
56.5
39.6
43.5
60.4
5360
6161
52.1
38.7
47.9
61.3
7556
3965
68.1
43.9
52.0
31.9
56.1
48.0
2847
2047
1536
42.8
35.2
32.2
57.2
64.8
67.8
1294
1776
2021
74.1
68.0
46.3
35.0
25.0
25.9
32.0
53.7
65.0
75.0
2486
1025
2233
4519
1258
53.8
42.9
42.1
45.0
52.0
50.6
47.5
46.2
57.1
57.9
55.0
48.0
49.4
52.5
2470
2163
1882
2456
1724
826
11521
59
5.9
Misconceptions about How to Avoid HIV
Table 5.9 presents the proportion of respondents who reported
misconceptions about how to prevent HIV. The reported misconceptions
were; praying to God (59%), going for check ups (39%), using antibiotics
(20%), and seeking protection from traditional healers (12%). Generally,
there was no major difference in the level of misconceptions between age
groups. Misconceptions were generally higher in the northern zones
compared with the southern zones. At the zonal level, the misconception
of the use of antibiotics as a preventive measure was highest in the North
West (24%) and lowest in the South East (11%). Seeking protection from
traditional healers was also fairly high, especially in the North West
(16%), but was lowest in the South East (7%).
Table 5.9: Misconceptions about How to Avoid HIV
Percent Distribution of Respondents’ Misconceptions about How to Avoid
HIV According to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Praying to
God
Going for
check-up
Using
antibiotics
Seek
protection
from
traditional
healers
Sex
Female
Male
Location
56.9
61.1
37.0
40.9
18.1
22.2
Rural
59.6
37.8
20.4
13.0
4.3
6952
Urban
58.4
41.5
20.2
10.9
1.7
3857
12.3
12.3
Nothing
4.4
2.5
Number of
women &
men who
have heard
of AIDS
4937
5872
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
60.6
61.1
69.8
51.9
58.4
48.0
41.1
39.3
36.5
29.6
49.9
37.0
22.9
22.0
23.9
10.9
19.7
18.7
12.4
12.9
15.9
7.3
11.4
11.1
3.8
3.5
4.8
1.5
2.9
2.7
1902
1452
2491
1273
1733
1958
58.1
31.8
17.9
14.7
8.2
2061
72.0
59.2
57.5
57.0
36.3
37.3
42.2
45.2
24.5
21.1
19.7
21.9
15.5
12.6
11.0
9.8
3.7
3.6
1.8
0.3
922
2130
4447
1249
59.2
60.0
59.3
58.4
57.2
62.5
59.1
39.8
41.7
40.2
37.6
36.9
36.9
39.1
20.3
21.9
20.1
19.8
20.2
18.7
20.3
13.9
12.9
11.5
12.1
10.8
11.4
12.3
4.7
2.2
2.9
3.1
4.3
2.4
3.4
2237
2055
1793
2326
1617
781
10809
60
5.10
Mother to Child Transmission of HIV
The respondents were asked if the virus that causes AIDS could be
transmitted from mother to child during pregnancy, during delivery and/or
by breastfeeding. The findings presented in Table 5.10 showed that 62%
reported that HIV can be transmitted from mother to child during
pregnancy, while 62% reported possible transmission through
breastfeeding and 59% during delivery. Knowledge of mother to child
transmission was generally higher among those with secondary and
higher education compared to those with at most primary education.
Table 5.10: Knowledge of Mother to Child Transmission
Percent Distribution of Respondent’s Knowledge of Mother to Child
Transmission of HIV According to Selected Characteristics; FMOH,
Nigeria 2007
Characteristics
Routes of HIV transmission from mother to child
During
During
Through
Number
pregnancy delivery Breastfeeding of
women
& men
who
have
AIDS
Sex
Female
60.6
Male
63.5
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
57.5
60.1
62.3
62.4
5360
6161
56.8
72.3
54.2
67.8
71.2
57.7
7556
3965
62.4
50.5
50.2
76.0
67.3
74.1
60.5
51.2
71.1
72.2
59.7
71.1
65.2
53.7
51.2
70.9
66.9
72.2
2047
1536
2847
1294
1776
2021
41.5
47.7
64.3
70.8
79.7
39.1
46.2
61.0
66.4
77.5
43.5
48.1
64.5
70.2
78.6
2486
1025
2233
4519
1258
54.4
63.5
67.0
66.5
62.6
56.5
62.1
49.7
60.1
62.5
64.2
61.5
53.3
58.9
53.6
65.6
67.1
66.4
63.4
55.2
62.3
2470
2163
1882
2456
1724
826
11521
61
5.11
Knowledge about Whether a Healthy Looking Person
could be HIV Positive
Respondents were asked if a healthy looking person could be HIV
positive. The findings are presented in Table 5.11. Sixty-eight percent
stated that a healthy looking person could be HIV positive. Knowledge
was higher in the urban than the rural, among males than females, as
well as among those with higher levels of education.
Table 5.11: Asymptomatic Transmission of HIV
Percent Distribution of Respondent’s Who Know that a Healthy Looking
Person could be HIV Positive According to Selected Characteristics;
FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
% who know that a
healthy looking
person could be
HIV positive
Number of
women and
men
63.6
71.2
5360
6161
61.1
80.2
7556
3965
66.3
64.7
51.7
81.6
75.9
77.7
2047
1536
2847
1294
1776
2021
41.9
49.7
68.6
78.8
91.7
2486
1025
2233
4519
1258
60.9
71.2
71.8
70.1
66.1
65.4
67.7
2470
2163
1882
2456
1724
826
11521
62
5.12
Knowledge about HIV Transmission (UNAIDS Indicators)
For purposes of international comparisons, five of the knowledge
indicators about HIV transmission were pooled together using the
UNAIDS guidelines. The results are presented in Table 5.12. Twentythree percent of the respondents reported all the five indicators correctly.
Males were generally more knowledgeable than females and the urban
dwellers more than the rural dwellers. Knowledge was also generally
higher in the Southern zones compared to the Northern zones.
Table 5.12: Knowledge About HIV Transmission (UNAIDS Indicators)
Percent Distribution of Respondents’ Knowledge About HIV Transmission
(UNAIDS Indicators) According to Selected Characteristics; FMOH,
Nigeria 2007.
Characteristics
Male
Rural
Urban
Female
Rural
Urban
All
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Total
HIV
transmission
can be
reduced by
staying with
one faithful
uninfected
partner
Can reduce HIV
transmission by
using condom
all the time
Healthy
looking
person
can be
HIV
positive
Mosquito
cannot
transmit
HIV
Sharing
meal
utensils
cannot
spread
HIV
Who
got all
five
right
Number
of
women
and men
85.2
89.3
59.9
69.2
65.4
82.2
49.9
63.4
57.5
71.2
23.1
34.7
4043
2118
79.2
88.3
37.9
58.3
56.1
78.0
47.7
57.8
52.5
67.7
14.8
27.4
3513
1847
82.4
88.8
49.7
64.1
61.1
80.2
48.9
60.8
55.1
69.6
19.3
31.3
7556
3965
83.0
87.3
79.6
86.5
86.0
88.8
84.6
59.2
48.7
32.2
59.0
69.4
70.3
54.6
66.3
64.7
51.7
81.6
75.9
77.7
67.7
47.0
53.8
47.0
66.5
53.8
57.2
53.0
58.0
59.4
56.6
67.8
63.4
59.9
60.1
25.0
22.9
13.0
27.3
28.5
29.9
23.4
2047
1536
2847
1294
1776
2021
11521
5.13 Young People’s Knowledge about HIV Transmission
Analysis of the five knowledge indicators among young people 15 to 24
years is displayed in Table 5.13. It revealed a similar pattern to that of the
general population. Males were more knowledgeable than females,
respondents in the urban areas more than those in the rural area, and
those in the Southern zones more knowledgeable than those in the
Northern zones. Overall, 24% knew all the five knowledge indicators.
63
Table 5.13: Young Peoples Knowledge of HIV Transmission
Percent Distribution of Young Peoples’ (15-24 years) Knowledge About
HIV Transmission According to Selected Characteristics; FMOH, Nigeria
2007
Characteristics
Female
Rural
Urban
Male
Rural
Urban
All
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Total
5.14
HIV
transmission
can be
reduced by
staying with
one faithful
uninfected
partner
Can reduce
HIV
transmission
by using
condom all
the time
Healthy
looking
person
can be
HIV
positive
Mosquito
cannot
transmit
HIV
Sharing
meal
utensils
cannot
spread
HIV
Who
got
all
five
right
Young
People
15-24
years
88.8
88.3
64.7
72.0
62.2
81.0
55.0
60.2
59.9
69.2
17.6
27.3
1336
743
88.2
88.9
43.4
56.3
67.6
82.3
50.4
63.5
59.3
73.0
23.3
33.8
1423
790
88.5
88.6
54.4
64.4
65.0
81.7
52.6
61.9
59.6
71.2
20.6
30.7
2759
1533
89.5
90.7
89.2
84.5
87.1
89.3
88.5
64.9
50.3
32.8
59.9
73.6
74.3
58.0
70.4
66.4
56.1
83.2
78.0
79.1
70.9
47.4
54.0
52.2
67.9
56.3
61.7
55.9
60.3
62.1
63.6
68.7
67.0
62.0
63.7
24.9
21.8
11.6
28.0
30.7
23.9
24.2
730
578
992
536
696
760
4292
Discussion and Conclusions
Awareness of HIV and AIDS was generally high among both sexes,
across all the zones and among all age groups. Three quarters of
respondents reported that AIDS has no cure while 23% knew of someone
who had died of AIDS. Many respondents (72%) were aware that a
healthy looking person could be HIV positive. Very few respondents (2%)
rated their risk of being infected with HIV as high. Knowledge on how to
prevent HIV infection was higher in males (63%) than in females (47%).
Knowledge on routes of transmission was generally high. However some
respondents had misconceptions including the perception that HIV can be
transmitted by mosquito bites/bugs and by kissing. These misconceptions
need to be addressed. Knowledge about HIV transmission among young
people 15 to 24 years revealed a similar pattern to that of the general
population.
64
SECTION 6
6.0
Knowledge, Access and Use of Condoms
The most common mode of transmission of HIV and AIDS in subSaharan Africa is unprotected sexual intercourse. It is also the mode of
transmission of other STIs. The use of preventive measures such as latex
condoms substantially reduces the risk of infection for both partners
provided the condoms are used correctly and consistently. Condoms
have in addition contraceptive benefits. The survey assessed the
awareness of respondents on condoms, access to condoms, reasons for
use or non-use as well as obstacles to use. The results are presented in
this section.
6.1
Awareness of Male Condom
The first step towards knowledge acquisition is usually awareness. All
respondents, including those who were not sexually active, were asked
whether they had ever heard of the male and female condoms. As shown
in Table 6.1, seventy one percent of all respondents reported having
heard of male condom. There were obvious rural-urban differences, with
63% in rural areas compared to 87% in urban areas reporting that they
had heard of condoms. Similarly, a higher proportion of males (80%) than
females (62%) had heard of male condoms. The urban-rural difference
persisted across sex, zone, education and age. Rural-urban difference
was especially high for women (51% vs. 81%) and in the North West
zone (37% vs. 70%). In both rural and urban areas, the highest
proportions of respondents who had heard of male condoms were those
in the age range of 20 to 39 years and the proportion who had heard of
male condoms increased progressively with increased education. In rural
areas, for example, the proportion ranged from 31% for those with no
formal education to 98% among those with higher education. Chart 6.1
illustrates the awareness of male condoms by zones. It reveals a
consistently higher awareness of male condoms in southern zones when
compared with the north.
65
Chart 6.1: Percentage Distribution of Respondents who had ever heard condoms by
Zones; FMOH, Nigeria, 2007
Rural
100
Urban
89.4
90
92.5
91.5
84.2
81.1
86
92.1
84.2
80
70
70.1
69.9
P e rc e n ta g e
60
51
50
37.4
40
30
20
10
0
North Central
North East
North West
South East
Zone
66
South South
South West
Table 6.1: Knowledge of Male Condoms
Percent Distribution of Respondents who have Ever-Heard of Condoms
According to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Percentage who have heard of male condom
Rural
Urban
Total
Number of
women and men
51.1
74.0
81.2
91.4
61.5
79.9
5360
6161
70.1
51.0
37.4
84.2
86.0
84.2
89.4
81.1
69.9
91.5
92.5
92.1
75.8
59.0
45.4
85.9
88.1
88.8
2047
1536
2847
1294
1776
2021
31.2
40.0
72.9
84.9
98.3
54.3
66.2
86.1
90.3
98..2
34.6
45.2
77.1
87.2
98.3
2486
1025
2233
4519
1258
53.5
67.6
70.0
66.6
60.6
63.9
76.0
89.9
93.8
91.2
83.2
83.5
61.0
75.5
78.5
75.5
68.0
70.0
2470
2163
1882
2456
1724
826
63.3
86.6
71.3
11521
6.2
Opinions about Affordability and Accessibility of Male
Condom
It may be difficult to achieve sustained use of male condom if people
perceive condoms to be unaffordable or difficult to obtain. In Nigeria,
socially marketed condoms constitute a large percentage of the market
share, making it essential to assess the affordability and accessibility of
condoms. The survey sought information on respondents’ perception of
condom affordability and accessibility, and the findings are presented in
Table 6.2. Overall, 69% of respondents who had heard of condoms
considered them accessible and 67% thought condoms were affordable.
A higher proportion of persons who felt condoms were affordable or easily
available were in the urban areas, and a lower proportion was among
persons with lower educational status. More males than females felt
condoms were accessible and affordable.
67
Table 6.2: Condom Accessibility and Affordability
Percent Distribution of Respondents who have heard of Male Condoms
and who Agree that Condoms are Easy to Obtain or Agree that Condoms
are Affordable According to Selected Characteristics; FMOH, Nigeria
2007.
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
6.3
Agree that
condoms are
easy to obtain
Agree that
condoms are
affordable
Respondents
who have
heard of
condom
63.4
72.2
57.2
72.9
3295
4925
63.6
75.7
62.7
72.0
4786
3434
69.3
64.1
46.8
68.6
79.0
77.1
69.1
65.0
39.8
68.3
80.1
71.7
1552
906
1293
1111
1564
1794
46.5
40.2
61.8
75.1
84.0
40.5
37.1
58.5
73.4
85.4
860
463
1721
1236
8220
67.7
74.3
71.8
69.5
61.7
58.7
68.7
63.9
72.8
70.5
67.3
59.9
57.4
66.6
1506
1632
1477
1854
1173
578
8220
Efficacy of Male Condom
General opinions of respondents about male condoms are presented in
Table 6.3. Most respondents considered male condoms to be effective in
preventing unplanned pregnancy (57%), protecting against STIs (55%)
and HIV and AIDS (55%). Overall, a higher proportion of males
expressed confidence in the efficacy of condoms than females. Similarly,
a higher proportion of respondents in urban areas had a higher level of
confidence in the efficacy of condoms than those in rural areas.
Knowledge on efficacy of condom increased as the level of education
increased.
68
Table 6.3: Opinions on Male Condom Efficacy
Percent Distribution of all Respondents’ Who Agree to Selected
Statement on Condom Efficacy According to Selected Characteristics;
FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North central
North east
North west
South east
South-south
South west
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Male
condoms
protect
against
unplanned
pregnancy
Male condoms
protect against
HIV
Male
condoms
protect
against
diseases that
are
transmitted
through
sexual
intercourse
All
respondents
45.0
67.3
42.7
64.7
42.6
65.1
5360
6161
50.3
69.6
48.4
66.0
48.0
67.2
7556
3965
63.1
45.4
30.7
64.2
75.5
75.4
60.2
41.1
30.2
56.3
73.1
75.4
60.6
40.6
29.8
57.8
73.7
75.6
2047
1536
2847
1294
1776
2021
23.0
21.5
21.2
2486
27.7
60.1
72.6
85.9
28.5
58.2
69.2
81.2
27.1
57.9
69.7
83.1
1025
2233
4519
1258
47.1
63.2
64.9
61.0
51.4
51.0
56.9
44.0
59.4
61.8
59.7
50.0
49.8
54.5
44.3
59.9
62.0
60.1
49.9
49.0
54.6
2470
2163
1882
2456
1724
826
11521
69
6.4
Ever Use Male Condom
One of the indicators of condom use is the proportion of persons who
have ever used condoms. This may not necessarily be a reflection of
current behaviour, however it may provide some insight into current
behaviour. People who have ever used condoms are more likely to be
current users and those who have ever used condoms but are not
currently doing so may also offer important reasons for not using it.
Over a quarter (27%) of all sexually active respondents had ever used
condoms (Table 6.4). A lower proportion of females (17%) compared to
males (36%) reported having ever used condoms. For both females and
males, the proportion of respondents who had ever used condoms
peaked between the age range 20 to 29 years and declined thereafter.
The proportion of males and females who had used condoms before was
consistently lower in the Northern zones than the Southern zones. The
lowest rates were in the North West (3% for females, and 8% for males)
and the highest in the South West (30% for females and 54% for males).
For both males and females, use of condoms increased with education,
ranging from 4.5% among males with Qur’anic education to 62% for those
with higher education. There were also substantial rural-urban variations
for both females and males. For example, while only 29% of males in
rural areas had ever used condoms, the proportion in urban areas was
50%.
70
Table 6.4: Ever Use Condom
Percent Distribution of Sexually Active Respondents who had Ever Used
Condoms According to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Female
Male
Total
Number
Location
Rural
11.8
29.1
20.4
5941
Urban
26.6
50.4
38.9
3000
North central
17.9
40.5
29.7
1644
North east
North west
South east
South-south
South west
Education
Never attended School
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
4.2
2.8
26.1
28.1
30.1
16.7
8.4
49.8
50.8
54.2
10.3
5.3
38.2
40.3
43.1
1153
20883
938
1518
1605
0.8
0.6
5.6
15.9
28.3
6.5
4.5
26.1
52.3
61.8
3.3
2.8
20.6
42.8
58.4
2244
800
1856
2962
1079
14.7
22.3
21.8
15.8
7.6
NA
16.6
45.4
58.4
49.8
36.5
26.0
14.3
36.4
25.7
37.3
34.6
25.5
16.8
14.3
26.6
794
1564
1652
2400
1708
823
8941
Zone
NA: Not applicable
71
Chart 6.2: Percentage distribution of sexually active respondents who had ever used condoms
by Zone and Sex; FMOH, Nigeria, 2007
Female
Male
50
46.3
45.7
45
40.2
40
36.6
35
30
P ercen tag e
30
25
23.3
28.5
23.1
20
16
15
10
8
8.8
7.9
5
0
North central
North east
North west
South east
South-south
South west
Zones
6.5
Current Use of Condoms
Abstinence, mutual fidelity, condom use, and partner reduction are key
strategies aimed at preventing HIV. Table 6.5 shows the proportion of
sexually active respondents who reported using male condoms at the
time of the survey. Overall, 16% of the sexually active respondents
reported using male condoms as at the time of the survey. Eight percent
of females and about a quarter (24%) of males were current condom
users. Substantial variation in current condom use was obtained with
regard to location, zone, education and age. There was a significant
variation between the proportion of male current users in urban areas
(32%) and in the rural areas (19%). Similarly across the zones, while the
lowest proportion of male users in the Southern zones was 31% in the
South East, the highest in the North was 26% in the North Central, and
only 5% and 10% in the North West and North East respectively. Condom
use was positively associated with education (those with high education
were more likely to use condoms) but negatively associated with age
beyond the age of 29 years.
72
Table 6.5: Current Use of Condom
Percent Distribution of Sexually Active Respondents who are Current
Users of Condoms according to Selected Characteristics; FMOH, Nigeria
2007
Characteristics
Currently using a male condom
Female
Male
Total
Women and
who have
ever had sex
5.7
13.8
19.4
32.4
12.5
23.4
5941
3000
9.7
1.4
0.9
12.2
15.9
14.4
26.4
10.0
4.8
31.2
34.9
36.2
18.4
5.6
2.6
21.9
26.1
26.2
1644
1153
2083
938
1518
1605
0.8
4.4
1.9
2244
0.6
5.6
15.9
28.3
2.2
13.7
35.7
41.7
1.5
9.6
27.2
37.3
800
1856
2962
1079
11.2
12.2
12.5
5.6
2.1
NA
8.3
35.6
45.9
37.3
20.8
13.3
5.2
23.8
19.9
26.2
23.8
12.8
7.7
5.2
16.1
794
1564
1652
2400
1708
823
8941
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never
attended
School
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
NA: Not applicable
6.6 Current Status of Respondents Who Had Ever Used Male
Condom
Respondents who reported ever using male condom were asked of their
current status (Table 6.6). Majority were still using condoms: 57%
reported that they had been using condoms for some time; 2% had just
started using for the first time and 2% had just resumed after stopping for
some time. On the whole, 61% of “ever users” were still using condoms
while 39% had stopped using. Some zonal variations were observed: the
highest proportion of respondents who had stopped using condoms was
in the North West (47%) and lowest in the South South (35%).
73
Table 6.6: Current Status of Use of Male Condom
Percent Distribution of Current Status of Condom Use among Sexually
Active Respondents who have Ever Used Male Condoms According to
Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
6.7
Has used
condoms
for some
time
Has
used
in the
past
but no
longer
using
Has
resumed
after
stopping
Just
started
using
for the
first
time
No
response
Respond
ents who
have ever
used
condoms
44.7
61.9
49.3
34.2
2.2
2.2
3.7
1.6
0.3
0.1
1639
739
58.1
54.9
37.7
40.1
1.5
2.9
2.6
1.9
0.1
0.3
1210
1168
58.0
53.3
46.4
52.8
60.9
55.7
56.0
54.5
36.7
44.2
47.3
43.3
35.0
39.2
38.7
0.9
0.8
0.0
4.5
2.2
1.8
3.5
4.0
4.5
4.3
0.3
1.8
1.7
2.1
1.3
1.3
0.0
0.2
0.0
0.0
0.0
0.2
0.3
0.0
0.0
488
120
110
358
611
691
75
22
43.6
58.4
60.6
56.5
52.7
35.9
36.3
38.9
1.6
2.3
2.1
2.2
1.6
3.2
1.0
2.3
0.5
0.2
0.0
0.2
383
1268
630
2378
66.2
64.3
64.7
47.6
45.6
34.7
56.5
24.5
30.0
30.8
48.5
52.3
63.6
38.9
1.0
1.9
3.1
2.8
1.0
0.8
2.2
8.3
3.4
1.4
1.0
1.0
0.0
2.3
0.0
0.3
0.0
0.2
0.0
0.8
0.2
204
583
572
614
287
118
2378
Use of Male Condoms with Non-Marital Partners
Table 6.7 shows the percentage of respondents who had sex with nonmarital partner(s) and used condoms in the last 12 months by zone, age
group and educational level. All respondents who reported that they had
had a non-marital partner(s) in the last twelve months were asked if they
used a condom in the last sex with the sex partner. The response to this
question was used to assess the practice of condom use with non-marital
partners. Overall, 49% of respondents who had sex with a non-marital
74
partner in the last 12 months preceding the survey reported using
condoms with their last non-marital partners. North West reported the
highest level (59%) of condom usage with non-marital partners, while the
lowest level was obtained in South South (38%). The use of condom with
non-marital partners increased generally with education. It also increased
with age and peaked at 25-29 years of age after which it declined.
Table 6.7: Condom Use with Non-Marital Partners
Percent Distribution of Respondents Who Reported Condom Use with
Non-Marital during the Last Sexual Intercourse among Respondents who
had Sex with Non-marital Partners in the Last 12 Months According to
Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Used condom with last
non-marital partner
Location
Rural
Urban
Zone
North Central
North East
North West
South East
Female
28.7
44.1
Male
47.3
64.5
All who had sex with
non-marital partners in
the last 12 months
All
Total
42.1
1022
58.3
698
42.9
xx
xx
39.8
51.6
47.4
68.1
69.9
49.7
41.2
59.3
58.4
356
97
59
231
31.6
36.2
41.5
64.7
38.4
56.0
552
425
xx
xx
25.0
32.0
55.9
30.6
Xx
47.0
50.8
73.5
25.4
xx
41.1
45.1
68.5
71
xx
224
1046
362
28.7
38.7
47.5
24.5
15.8
NA
35.3
47.8
54.2
62.2
54.1
43.5
Xx
54.2
39.4
49.2
58.7
48.1
38.5
xx
48.7
327
581
424
260
104
xx
1720
South-South
South West
Education
Never attended School
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
xx Fewer than 30 unweighted cases; hence figure suppressed
NA: Not available
75
6.8
Boyfriend/Girlfriend
Perhaps the most common non-marital sex act in Nigeria occurs in
boyfriend/girlfriend relationships and therefore the use of male condoms
in the last sexual intercourse with boyfriend/girlfriend was investigated.
The findings are shown in Table 6.8. Respondents with higher levels of
education had a higher level of condom use in sexual encounters with
boyfriends or girl friends. Similarly, a higher proportion of urban dwellers
(58%) compared to rural dwellers (42%) were more likely to use condoms
in such relationships. A higher proportion of males (54%) than females
(35%) reported use of condoms in sexual intercourse with boyfriend or
girlfriend. The use of condoms with boyfriend/girlfriend rose from 39%
among 15-19 age groups and peaked at 59% among 25-29 age groups
and then fell progressively to 39% among 40-49 year age group.
76
Table 6.8: Use of Male Condom in the Last Sexual Intercourse with
Boyfriend or Girlfriend
Percent Distribution of Respondents Reporting Condom Use in Last
Sexual Intercourse with Boyfriend or Girlfriend among Respondents who
had Sex with a Boyfriend/Girlfriend in the Last 12 Months According to
Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended School
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
% Used condom with
boy/girl friend
Number of respondents
who had sex with a
Boyfriend or Girlfriend
in the last 12 months
34.8
53.8
494
1156
41.4
57.9
977
673
48.5
40.2
50.0
59.8
37.5
56.3
342
92
58
224
522
412
27.6
Xx
41.4
44.4
66.8
58
xx
210
1010
355
39.4
47.0
57.4
49.4
41.4
Xx
48.1
322
570
413
239
89
xx
1650
XX Fewer than 30 unweighted cases; hence figure suppressed
77
6.9
Reasons for Using Male Condoms
The reasons for using male condoms are presented in Table 6.9.
Protection against unwanted pregnancy only was cited as a reason for
condom use by a higher proportion of females (37%) than males (14%).
On the other hand, protection from HIV/STIs only as the reason for
condom use was stated by a higher proportion of males (27%) compared
to females (14%). A slightly higher proportion of condom users (52%)
reported dual protection to prevent HIV/STIs and unwanted pregnancy as
reasons for its use. The use of condoms for dual protection was higher in
rural (54%) compared to urban (49%) areas. Across the zones, the
highest level was in the South East (61%) while the lowest was in the
North West (36%).
78
Table 6.9: Reason for Condom Use
Percent Distribution of Reason for Condom Use among Respondents
who are Currently Using Condom According to Selected Characteristics;
FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
School
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
To
protect
myself
from
HIV/STIs
To protect
unwanted
pregnancy
To protect
myself
from both
HIV/STIs
and
unwanted
pregnancy
Other
reasons
Number of
respondents
who are
currently
using
condom
13.5
26.9
37.0
14.2
44.9
54.0
0.0
0.5
370
1073
22.9
24.1
18.2
21.9
54.1
49.0
0.4
0.3
741
702
22.4
35.9
21.8
19.5
26.8
21.4
18.2
18.8
29.1
16.1
15.9
26.2
55.4
40.6
36.4
61.0
52.5
47.1
0.3
0.0
3.6
0.0
0.3
0.2
303
64
55
205
396
420
14.0
32.6
53.5
0.0
43
xx
24.0
24.0
22.9
xx
26.3
18.0
19.9
Xx
43.0
53.4
52.2
xx
0.6
0.4
0.2
12
179
807
402
23.4
21.2
24.1
24.5
27.3
20.9
23.5
13.3
15.6
20.1
24.5
30.3
23.3
20.0
58.9
58.8
51.5
45.8
35.6
48.8
51.6
0.0
0.2
0.0
1.0
0.0
2.3
0.3
158
410
394
306
132
43
1443
Xx: Fewer than 30 unweighted cases; hence figure suppressed
6.10
Reasons for Stopping the Use of Male Condom
Table 6.10 presents reasons given by respondents for stopping condom
use. The main reasons were the desire for a child (32%) and interference
of sexual enjoyment (22%). A higher proportion of female (38%) than
male (28%) respondents reported the desire for a child to be the main
reason for stopping condom use. A higher percentage of males (10%)
than females (4%) stopped using condoms for religious reasons. The
proportion of females who reported that they stopped using condom
79
because of partner’s opposition (18%) was higher than the proportion of
males with a similar reason (10%).
Table 6.10: Reason for Stopping Condom Use
Percent Distribution of Reason for Stopping using Condom among
Respondents who were Formerly Using Condoms but have Stopped
According to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Did not
enjoy
using
condom
Wanted
a child
Partner
opposed
Religious
reasons
Sex
Female
21.4
37.6
17.9
4.4
Male
22.7
28.4
10.2
10.0
Location
Rural
22.8
34.4
11.8
5.7
Urban
21.6
29.7
14.5
9.8
Zone
North Central
24.0
27.9
8.4
10.1
North East
28.3
37.7
3.8
13.2
North West
21.2
23.1
13.5
3.8
South East
21.3
37.4
13.5
5.8
South-South
17.8
31.8
18.7
9.3
South West
24.0
32.5
13.7
5.9
Education
Never
attended xx
xx
Xx
xx
School
Qur’anic only
xx
xx
Xx
xx
Primary
23.8
34.7
8.4
5.0
Secondary
21.8
32.3
14.3
7.5
Higher
20.5
29.3
16.2
11.4
Age group
15-19
30.0
8.0
14.0
20.0
20-24
24.0
25.7
11.4
10.9
25-29
20.5
35.2
11.4
10.8
30-39
17.4
41.3
14.4
5.0
40-49
22.0
30.0
15.3
4.7
50-64
36.0
22.7
12.0
2.7
Total
22.2
32.0
13.2
7.8
xx: Fewer than 30 unweighted cases; hence figure suppressed
6.11
Other
reasons
Number of
respondents
who were
formerly
using
condoms
but have
stopped
18.7
28.8
364
560
25.2
24.4
456
468
29.6
17.0
38.5
21.9
22.4
24.0
179
53
52
155
214
271
xx
29
xx
28.2
24.2
22.7
9
202
455
229
28.0
28.0
22.2
21.8
28.0
26.7
24.8
50
175
176
298
150
75
924
Use of Male Condom during Last Sex Act by Young
People with Non-marital Partner
Table 6.11 shows the use of male condom during last sex act by young
people with non-marital partners in the last 12 months preceding the
80
survey (UNAIDS recommended indicator). Forty six percent of young
people reported using condom during last sex act with non-marital
partner. The proportion was higher in males (52%) compared to females
(34%) and higher in urban than rural areas. The proportion of young
people reporting such use of condom was highest in the North West
(62%) and lowest in the North East (31%).
Table 6.11: Use of Male Condom by Young Peoples 15 to 24 Years of
Age during their Last Sex Act with a Non-Marital Partner
Percent Distribution of Condom use by Young Persons 15-24 Years of
Age during their Last Sexual Act with a Non-marital Partner among
Respondents who had Sex with Non-marital Partner in the Last 12
Months According to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
% who used condom
at last sex act with
non-marital sexual
partner N= 908
Female
Rural
Urban
Total
Male
Rural
Urban
Total
Both Sexes
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Total
6.12
27.4
43.9
34.3
43.8
65.5
52.2
38.1
57.2
47.0
31.0
61.5
51.6
36.8
54.1
45.7
Awareness about Female Condom
Nationally, 13% of respondents reported that they had ever heard about
or seen a female condom (Table 6.12). There were more male (14%)
than female respondents (11%) who were aware of the female condom.
The proportion of urban respondents (20%) that were aware of female
condom was higher than that of the rural respondents (8%). Awareness of
female condoms was highest among those who had higher education
(38%). The South West (19%), South South (17%), North Central (15%)
81
and South East (13%) had the highest proportion of respondents who
were aware of female condoms, while the North East (8%) and North
West (6%) had the lowest.
Table 6.12: Awareness of Female Condom
Percent Distribution of all Respondents who have ever heard or seen
Female Condom According to Selected Characteristics; FMOH, Nigeria
2007
Characteristics
Heard or seen female
condom
Number of
men
women and
Sex
Female
10.9
5360
Male
14.0
6161
Location
Rural
Urban
8.2
20.3
7556
3965
Zone
North Central
North East
15.1
7.8
2047
1536
North West
South East
5.6
13.3
2847
1294
South-South
South West
16.8
18.9
1776
2021
Education
Never attended School
Qur’anic only
2.0
3.5
2486
1925
Primary
8.0
2233
Secondary
Higher
15.4
37.5
2419
1258
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
13.6
12.7
12.9
12.0
12.8
9.7
12.6
2470
2163
1882
2456
1724
828
11521
6.13
Discussion and Conclusion
The awareness of male condoms was generally high especially in urban
areas, in the Southern zones and among respondents with higher level of
education. The majority of both female and male respondents felt that
male condoms were accessible and affordable. Despite the high level of
awareness, only 29% of all the sexually active respondents had ever
82
used male condoms. This may be linked with the finding that a
considerable proportion of the respondents did not know that condoms
effectively protect against pregnancy and STIs, including HIV. Majority of
those who had ever used male condoms were from the Southern zones,
younger age groups, educated (primary education or more) and from
urban areas. Male condoms were used mainly for dual protection from
STIs including HIV and AIDS and unwanted pregnancy.
The current status of sexually active respondents who had ever used
male condoms indicated that majority had been using condoms for some
time, while a small proportion recently started using condoms for the first
time. It is pertinent to note that approximately two fifth of the respondents
who had ever used male condoms in the past had stopped and also that
only about a third of those who stopped did so because they desired to
have a child. About a fifth of those who stopped using condoms did so
because they did not enjoy using them, about a tenth because their
partner objected and 8% did so due to religious reasons.
Less than half (49%) of those who reported having had sex with a non
marital partner in the last 12 months had used condom in such sex act
with a non-marital partner. This low level of condom use with non-marital
partners among the respondents puts them at risk of HIV and other
sexually transmitted diseases as well as for unwanted pregnancy and
unsafe abortion. Overall, young people (15-24 years) reported a higher
level of male condom use during last sex act with non-marital partner
compared to the general respondents.
Awareness of the female condom (13%) was considerably lower than that
of the male condom (71%). Awareness was higher among the urban
population. Considering the potential of the female condom as an
effective female barrier contraceptive method, appropriate interventions
need to be put in place to increase its awareness, acceptance and use
nationwide.
83
SECTION 7
7.0
HIV Counselling and Testing
HIV counselling and testing (HCT) is an effective means of addressing
the psychological and socio-sexual aspects of HIV and AIDS. It is also an
entry point for many forms of HIV and AIDS prevention and control
interventions including prevention of mother-to-child transmission. HCT
also constitutes a good platform for linkage between reproductive health
and HIV and AIDS-related programmes. The survey sought to obtain
information on the level of awareness and use of voluntary counselling
and testing services among respondents.
7.1
Knowledge of Where to Get an HIV Test
The respondents were asked if they knew of a place where they could get
an HIV test. This was to assess the availability of HCT services. The
result was disaggregated by background characteristics of the
respondents as shown in Table 7.1. Overall, 56% of males and 49% of
females had knowledge of where to get an HIV test. In terms of zones,
male respondents from the South East had highest knowledge (65%)
while those from North East had lowest knowledge (48%) of where they
could get an HIV test. .Respondents from the rural areas reported less
knowledge than those from the urban areas. Education is positively
related with knowledge of where to seek an HIV test. Male respondents
with higher education had higher knowledge (77%) compared to those
who had not been to school (31%) or those with Qur’anic education only
(42%). In terms of age, knowledge was lowest among respondents aged
15-19 years with the peak at the 25-29 year age group.
84
Table 7.1: Knowledge of Where to Get HIV Test
Percent Distribution of Respondents who knew Where to Get an HIV Test
According to Selected Characteristics FMOH, Nigeria 2007
Characteristics
Male
Number of
men
Female
Number
of
women
Location
Rural
Urban
Zone
49.9
66.7
4043
2118
41.9
62.3
3513
1847
North Central
58.6
1105
52.2
942
North East
North West
47.9
54.2
818
1514
43.0
36.2
718
1333
South East
South-South
64.9
57.6
655
965
68.7
55.0
639
811
South West
53.4
1104
49.4
917
Education
Never attended school
30.7
864
30.0
1622
Qur’anic only
41.7
629
41.2
396
Primary
Secondary
56.3
60.1
1193
2646
48.7
59.7
1040
1873
Higher
77.2
829
80.7
429
15-19
47.0
1280
43.2
1190
20-24
57.4
1079
51.0
1084
25-29
30-39
61.5
58.6
946
1169
54.1
51.4
936
1287
40-49
60.2
861
44.7
863
Age group
7.2
50-64
51.3
826
NA
NA
Total
55.7
6161
48.9
5360
Desire for HIV Test
In addition to enquiring about knowledge of where HIV testing is
available, respondents were asked if they desired to take the HIV test.
The results are presented in Table 7.2. A large proportion of the
respondents expressed the desire to take the HIV test. The proportion of
males who expressed desire to take the test was higher (74%) than the
females (70%). Respondents in South-South reported highest desire for
an HIV test (79%). The lowest proportion of those who desired an HIV
test was reported in the North West (62% of males and 55% of females).
There was a higher desire among rural respondents compared to their
85
counterparts in the urban areas: 72% of rural females desired to have the
test compared to 67% of urban females and 76% of rural males
compared to 71% of urban males desired to have an HIV test. In terms of
level of education, respondents who had Qur’anic education only
expressed the least desire (58%), while those with secondary education
had the highest desire (77%) for an HIV test. Among age groups, the
proportion of those that desired an HIV test ranged from 68% (among 40 49 age group) to 75% (among those of 20-24 age groups).
Table 7.2: Desire for an HIV Test
Percent Distribution of Respondents who Have Heard of AIDS and Have
Never been Tested for HIV Expressing Desire to have an HIV test
According to Selected Characteristics FMOH, Nigeria 2007
Characteristics
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Male
Number
of men
Female
Number of
women
75.9
70.8
3362
1578
71.7
67.1
2758
1388
75.1
80.5
62.2
74.5
79.2
80.8
866
707
1234
463
769
901
77.9
72.9
54.5
75.8
79.2
71.6
682
617
1037
624
443
743
69.8
58.8
75.1
79.5
73.2
683
548
983
2185
541
64.5
58.1
73.1
74.7
76.0
1234
320
862
1480
250
76.4
79.4
75.1
73.1
69.2
69.7
74.3
1077
893
732
888
676
674
4940
70.0
70.0
72.7
71.1
66.5
NA
70.1
978
847
695
954
672
NA
4146
NA: Not applicable
86
Chart 7.1: Percentage of Respondents who have ever heard of AIDS but never tested for HIV,
Expressing desire to have HIV test by Zone and Sex; FMOH, Nigeria, 2007
Male
Female
90
80
75.1
77.9
80.5
79.2 79.2
74.5
72.9
80.8
75.8
71.6
70
62.2
P e rc e n ta g e
60
54.5
50
40
30
20
10
0
North Central
North East
North West
South East
South-South
South West
Zone
7.3
Reasons for Desiring or Not Desiring an HIV Test
As indicated in Table 7.2 above, about 72% of the respondents
expressed the desire to have an HIV test. The reasons for desiring an
HIV test are presented in Table 7.3. Most respondents (87%) were
interested to take the test to know their HIV status, 11% to allay fear and
anxiety over HIV status, 1% as a marriage requirement and less than 1%
for employment purposes. There were no striking differences in
respondents in terms of sex and location. The proportion of respondents
who desired to know their HIV status was highest in the South East (91%)
and lowest in the North West (81%). Considering age distribution, 15-19
age group had the highest proportion of respondents desiring HIV test
(89%) while 30-39 age group had the lowest proportion (84%).
87
Table 7.3: Reasons for Desiring an HIV Test
Percent Distribution of Respondents who have heard of HIV/AIDS and
who have Never had an HIV Test according to Reasons for Desiring to
have an HIV test According to Selected Characteristics; FMOH, Nigeria
2007.
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
7.4
Reasons for desiring to have an HIV test
To
Required
For
To
reduce for
marriage know
fear &
employment
HIV
anxiety
status
Others
Am
faithful
All
11.8
10.5
0.3
0.3
1.3
1.0
85.7
87.3
1.0
0.8
0.0
0.0
2908
3669
11.0
11.2
0.3
0.3
1.0
1.5
86.8
86.0
0.9
0.9
0.0
0.0
4528
2049
11.4
7.7
14.9
6.5
13.2
9.8
0.2
0.1
0.5
1.0
0.3
0.0
0.4
0.4
2.2
1.8
1.2
1.0
87.6
89.8
80.9
90.7
84.9
88.2
0.3
2.1
1.4
0.0
0.5
1.0
0.0
0.0
0.1
0.0
0.0
0.0
1181
1019
1333
681
1103
1260
13.6
0.5
1.1
82.3
2.4
0.0
1273
14.0
10.7
9.9
9.0
0.2
0.4
0.1
0.3
2.0
0.6
1.2
1.5
82.7
87.6
88.3
88.6
1.2
0.7
0.4
0.5
0.0
0.0
0.0
0.0
508
1368
2842
586
8.8
10.2
11.7
13.7
11.4
10.9
11.0
0.2
0.3
0.4
0.2
0.2
1.1
0.3
1.1
1.8
1.1
1.1
1.0
0.4
1.2
89.0
86.9
85.9
83.9
86.7
86.6
86.6
0.9
0.7
0.9
1.1
0.8
1.1
0.9
0.0
0.1
0.0
0.0
0.0
0.0
0.0
1508
1302
1055
1327
915
470
6577
Reasons for not desiring an HIV test
The main reason why the HIV test was not desired was that respondents
felt it was not necessary (68%). For 14.6% of respondents, the fear of the
result was their reason for not desiring the test. Only 4% gave high cost
as the reason for not desiring the test.
88
Table 7.4: Reasons for not Desiring an HIV Test
Percent Distribution of Respondents who Have Heard of HIV/AIDS and
who have Never had an HIV Test According to Reasons for not Desiring
to have an HIV test According to Selected Characteristics FMOH, Nigeria
2007
Characteristics
Sex
Male
Female
Location
Rural
Urban
Zone
North West
North East
North Central
South East
South West
South South
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Do not desire an HIV test
Don’t
Fear of
Not
want to result
necessary
know
Can’t
afford
Others
All
who
did
not
desire
an
HIV
test
10.7
10.7
13.9
15.3
68.8
67.0
3.5
3.9
2.5
2.9
1270
1238
11.6
9.1
15.6
13.0
66.1
71.0
4.1
2.9
2.1
3.8
1591
917
8.6
8.5
16.3
9.6
12.4
12.4
15.2
10.2
12.3
10.9
17.3
23.4
68.5
76.4
65.9
72.4
63.6
56.9
4.7
3.3
3.8
2.9
1.8
3.4
2.2
1.3
1.6
3.9
4.9
3.8
937
305
367
384
225
290
11.2
8.4
11.3
11.2
9.8
16.0
9.5
10.3
17.9
16.6
66.1
73.0
72.7
64.5
66.8
4.5
5.6
3.1
2.7
3.4
1.9
2.8
2.3
3.5
2.9
644
359
477
823
205
13.2
13.0
10.5
8.8
9.2
7.4
10.7
20.3
14.4
18.0
12.3
9.9
9.8
14.6
58.7
65.5
65.1
71.4
74.8
794
67.9
4.9
4.6
3.0
3.3
3.7
1.0
3.7
2.7
2.3
3.2
3.5
2.1
2.0
2.7
547
438
372
514
433
204
2508
7.5 Ever Been Tested for HIV
Respondents were asked if they had actually taken an HIV test. The
results are presented in Table 7.5. Only about 14% of the respondents
reported that they had gone for HIV test. In terms of zonal comparison,
the highest proportion was from the South East (27% in males and 29%
in females) and the least from the North West (8% in males and 7% in
females). Overall, almost same proportion of females and males reported
89
having tested for HIV. In all zones except in the South-South, more males
than females expressed a desire to have the HIV test. Less rural
respondents (11%) than urban (22%) reported having ever been tested.
Those who had Qur’anic education only were much less likely to have
had the test than persons with higher education (see Chart 7.2). The
respondents in the 25-29 and 30-39 age groups were far more likely to
have had an HIV test than those in other age groups.
Table 7.5: Ever Tested for HIV
Percent Distribution of Respondents who Reported Ever Tested for HIV
According to Selected Characteristics FMOH, Nigeria 2007
Characteristics
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Male
Number of
men
Female
Number of
women
10.7
22.4
4043
2118
10.8
21.4
3513
1847
17.6
8.7
7.9
27.0
18.8
14.9
1105
818
1514
655
9650
1104
16.6
7.1
6.9
28.5
19.4
14.7
942
718
1333
917
811
917
4.9
3.7
13.2
15.4
33.5
683
548
983
2185
541
5.7
7.3
11.3
19.1
40.8
1234
320
862
1480
250
7.0
13.2
20.0
19.5
18.0
12.5
14.7
1280
1079
946
1169
861
826
6161
7.1
15.3
18.4
19.0
12.3
0.0
14.4
1190
1084
936
1287
863
0
5360
90
Chart 7.2: Percentage of all Respondents Who Reported to have been Tested for HIV by
Education and Sex; FMOH, Nigeria, 2007
Male
Female
45
40.8
40
35
33.5
P e r c e n ta g e
30
25
19.1
20
15.4
15
13.2
11.3
10
7.3
5
4.9
5.7
3.7
0
Never attended school
Qur’anic only
Primary
Secondary
Higher
Level of Education
7.6
How Long Ago was HIV Testing Conducted
Respondents who had been tested for HIV were asked how long ago they
took the test. Overall as shown in Table 7.6, 41% had their test recently
(less than 12 months), 22% took the test more than 24 months prior to the
survey while 23% had their tests between 12 and 23 months. A slightly
higher proportion of females compared to males reported to have had the
test less than 12 months before the survey. More of urban dwellers,
young adults (20-24 years) and those with higher education had taken
their tests within the 12 months preceding the survey.
91
Table 7.6: Period HIV Test was Conducted
Percent Distribution of Respondents who had an AIDS Test and the
Period that has Elapsed Since Testing for HIV According to Selected
Characteristics FMOH, Nigeria 2007
Characteristics
Sex
Male
Female
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
7.7
Time elapsed since test was done
Less than 12 to 23
24
12
months
months
months
ago
and
ago
above
No
response
Number
of men
and
women
who ever
had an
HIV test
40.8
42.0
21.8
24.2
23.3
21.2
14.1
12.5
907
773
39.4
43.2
22.7
23.1
19.6
24.8
18.3
8.9
810
870
45.7
43.4
44.5
35.9
42.3
38.7
22.6
14.8
25.1
22.6
20.1
28.7
21.1
27.9
18.5
23.1
19.8
26.0
10.6
13.9
11.8
18.4
17.8
6.7
350
122
211
359
338
300
34.8
22.2
25.9
17.0
135
34.6
33.8
41.8
47.9
32.7
21.8
22.6
23.2
15.4
29.1
20.4
21.2
17.3
15.3
15.2
7.7
52
275
765
453
39.7
45.8
42.4
44.4
36.4
26.2
41.4
18.4
25.3
24.7
23.3
20.3
22.3
22.9
12.1
13.0
24.7
23.0
30.7
35.0
22.3
29.9
15.9
8.3
9.3
12.6
16.5
13.4
174
308
361
473
261
103
1680
Reasons for HIV Test
Respondents who ever had an HIV test were asked whether the last test
they had was voluntary or mandatory. The results are presented in Table
7.7. Overall, 39% reported that they voluntarily requested for an HIV test,
23% were offered an HIV test and they accepted to be tested, and same
proportion, 23%, took the test because they were mandated to do so.
Voluntary testing was highest type of HIV test taken in all zones. A higher
proportion of men than women voluntarily requested for an HIV test. The
92
proportion of tested persons who had the HIV testing voluntarily was
highest in the North Central and North East zones (43%), urban areas
(41%), among males (44%), those with higher education (47%) and those
in age group 30-39 years (43%).
Table 7.7: Reasons for HIV Test
Percent Distribution of Respondents who have Ever had an HIV test by
Reasons for the HIV Test According to Selected Characteristics FMOH,
Nigeria 2007
Characteristics
Voluntary
Reasons for test
Offered
Mandatory
44.3
32.7
20.0
25.9
37.0
40.8
No
response
Number of
men and
women
who ever
had an HIV
test
19.7
27.0
16.0
14.4
907
773
23.7
21.7
19.0
26.9
20.2
10.6
810
870
42.6
42.6
36.0
38.7
41.4
33.0
20.0
23.0
28.9
18.7
21.0
28.0
24.9
18.0
20.9
23.1
18.3
30.0
12.6
16.4
14.2
19.5
19.2
9.0
350
122
211
359
338
300
28.9
28.9
23.0
19.3
135
28.8
37.5
37.3
47.0
30.8
22.2
23.1
19.4
21.2
21.8
23.3
23.8
19.2
18.5
16.3
9.7
52
275
765
453
28.7
36.0
40.7
42.5
41.8
35.9
39.0
24.1
22.1
24.4
23.3
19.5
21.4
22.7
16.1
24.0
24.9
23.5
23.0
24.3
23.1
31.0
17.9
10.0
10.8
15.7
18.4
15.2
174
308
361
473
261
10.3
1680
Sex
Male
Female
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
93
7.8
Receiving HIV Test Results
Respondents who have been tested for HIV were asked if they received
their results after testing. The results are shown in Table 7.8. Seventythree percent of all those tested received their results. Seventy-eighty
percent of respondents who undertook the HIV test in urban areas
received their results compared with 67% in rural areas. A similar
proportion of males and females received their results. The proportion of
those who received their results increased with level of education.
Table 7.8: Receipt of HIV Test Result
Percent Distribution of Respondents who have had an HIV Test and
Received HIV test Results According to Selected Characteristics FMOH,
Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Get the
result of the
test
Total
72.1
73.3
773
907
66.8
78.3
810
870
75.1
70.5
71.1
74.4
68.6
74.7
350
122
211
359
338
300
58.5
69.2
70.2
71.8
80.6
135
52
275
765
453
57.5
70.8
75.6
77.2
74.3
69.9
72.7
174
308
361
473
261
103
1680
7.9 Discussion and Conclusions
Only about half of the respondents knew where to have an HIV test.
Knowledge of where to get the HIV test was generally higher among male
than female respondents, higher among those in urban areas than those
94
in rural areas, higher in more of the Southern zones than the Northern
ones, and higher among those with formal education than those who had
never attended school or with Qur’anic education. Respondents of age
group 25-29 years had higher knowledge of where to get an HIV test
compared to other age groups.
About three quarters (72%) of respondents expressed a desire to get
tested. This is much higher than 43% reported in the 2005 survey and
may be due to the reduction in stigmatization, rapid scale up of HIV
testing facilities and improved treatment care and support for PLWHA.
Among the respondents who desired to have an HIV test, majority wanted
to do so in order to know their HIV status; while a smaller proportion
desired the test to reduce fear. This unmet need for HIV testing has to be
addressed. Despite the high percentage of those who expressed a desire
to be tested, only about 15% of respondents had ever been tested for
HIV. This may be due to a lack of awareness of where to get the test.
Comparatively urban dwellers, highly educated persons, and those from
Southern zones were more likely to have ever been tested. Respondents
between the ages of 25 and 39 years were also more likely to go for an
HIV test than other age groups.
Although almost a quarter of the respondents were offered the test and
they accepted, 39% of those that had the test indicated they took the test
voluntarily. However, about a quarter of those who undertook the HIV test
did so because it was mandatory. Majority (73%) of those who went for
the test received their results.
95
SECTION 8
8.0
Sexually Transmitted Infections (STIs)
Sexually transmitted infections (STIs) constitute a major public health
problem affecting hundreds of millions of people globally and causing farreaching health and socio-economic consequences. The prevalence of
STIs in Nigeria is not known but hospital based studies show high levels
of prevalence of various types of STIs including gonorrhoea, syphilis,
chlamydia, genital herpes and trichomoniasis.
Consequences of STIs include female and male infertility, spontaneous
abortions, ectopic pregnancies, stillbirths, chronic lower abdominal pain,
cervical cancer and death. There are many problems associated with the
diagnosis of STIs because many are asymptomatic and may require
sophisticated equipment for diagnosis. The control of STIs is an important
element of reproductive health. There are indications that in Nigeria many
people self-medicate or patronize traditional healers. Because the
presence of STIs can increase the likelihood of HIV transmission, proper
education and control of STIs are important strategies for preventing the
spread of HIV. The survey elicited information on the awareness,
knowledge, attitudes and health seeking behaviour of respondents on
sexually transmitted infections.
8.1 Awareness and Knowledge of Sexually Transmitted
Infections
All respondents were asked if they had ever heard of sexually transmitted
infections; the results are shown in Table 8.1. Many (69%) of the
respondents reported that they were aware of STIs. Awareness was
higher in the urban (79%) than in the rural areas (64%) and higher in all
the regions of the South than in the North. Persons with higher levels of
education (93%) and older age groups (50-64 years) reported higher
levels of awareness (81%).
96
Table 8.1: Awareness of STIs
Percent Distribution of Respondents who have Ever Heard of STIs
According to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
8.2
Respondents who
have heard of STIs
Number of
women
and men
59.1
78.3
5360
6161
64.3
79.0
7556
3965
73.6
59.6
51.8
86.4
81.5
75.8
2047
1536
2847
1294
1776
2021
44.3
54.4
73.4
77.9
93.4
2486
1025
2233
4519
1258
56.5
70.0
74.3
72.9
71.2
80.8
69.4
2740
2163
1882
2456
1724
826
11521
Knowledge of Symptoms of STIs in Women
There was a low level of knowledge of the symptoms of STIs in women.
As shown in Table 8.2, the most commonly recognized symptoms of
female STIs were itching (34%), genital discharge (30%), burning pain on
urination (24%), and lower abdominal pain (18%). Knowledge of
symptoms of STIs in women was lowest with regards to foul smelling
discharge (12%), genital ulcers (11%), painful sexual intercourse
(dyspareunia) (8%) and swelling in the groin area (7%). Respondents with
higher educational attainment had a higher level of knowledge about the
symptoms than others. Females generally showed higher level of
knowledge about the STIs symptoms in women than male respondents
except for genital itching.
97
Table 8.2: Knowledge of Symptoms of STIs in Women
Percent Distribution of Respondents who have Heard of STIs and Can
describe Various Symptoms of STIs in Women According to Selected
Characteristics; FMOH, Nigeria 2007.
Characteristics
Low
abdominal pain
Genital
discharge
Foul
smelling
discharge
Burning
pain on
urination
Genital
ulcers/
sores
Swelling in
groin area
Itching
Painful
sexual
intercourse
Number
of
women
and
men
who
have
heard
of STIs
Sex
Female
Male
20.8
15.8
29.5
31.0
11.3
11.8
24.8
22.1
10.7
10.5
7.7
5.9
29.1
40.7
8.8
6.9
4827
3166
Location
Rural
Urban
18.4
16.9
29.2
32.3
11.0
12.3
24.6
22.4
10.5
10.9
6.0
7.7
35.5
32.6
8.3
8.0
3133
4860
19.2
26.3
12.0
26.3
8.6
4.8
32.8
8.4
1506
31.1
36.8
12.1
37.2
10.5
9.8
32.5
9.0
915
20.3
12.8
15.7
33.7
28.4
27.1
11.2
13.7
13.3
21.7
22.6
21.6
14.6
12.7
11.0
10.1
9.7
6.0
32.9
43.4
35.0
7.7
10.9
6.6
1476
1118
1447
11.5
32.0
7.6
18.0
7.2
3.5
27.8
7.0
1531
20.1
27.8
10.3
23.7
8.0
7.1
33.7
7.4
1102
21.0
29.7
9.7
22.2
10.6
10.2
24.4
6.3
558
17.3
14.8
23.7
29.7
28.4
40.1
9.9
10.9
17.7
24.5
22.1
28.3
10.8
10.4
13.7
5.7
6.7
8.3
32.8
33.2
40.9
8.0
7.7
10.9
1638
3520
1175
Age group
15-19
20-24
25-29
11.8
15.5
19.0
18.7
28.1
34.4
7.0
10.6
12.3
16.0
23.1
23.8
8.4
9.2
11.2
4.9
5.9
8.0
28.2
32.0
37.0
4.9
6.8
7.4
1 395
1514
1398
30-39
40-49
50-64
20.4
21.1
19.5
33.2
35.1
35.4
13.1
13.2
13.9
26.3
27.6
27.4
11.3
13.2
10.8
6.6
8.7
9.7
37.7
35.2
28.6
9.7
10.4
10.6
1791
1228
667
Total
17.8
30.4
11.5
23.7
10.6
7.0
33.7
8.1
7993
Zone
North
Central
North East
North West
South East
SouthSouth
South
West
Education
Never
attended
school
Qur’anic
only
Primary
Secondary
Higher
8.3
Knowledge of Symptoms of STIs in Men
Table 8.3 reports on knowledge of STIs symptoms in men. About half
(48%) of the respondents knew a burning sensation on urination could be
a symptom of STI, a third of them (32%) knew of genital discharge, 16%
genital ulcers and 13% swelling in the groin. A higher proportion of men
compared with women knew about the symptoms of STIs in men. There
98
was also a higher level of knowledge among respondents with higher
levels of education and those in older age groups.
Table 8.3: Knowledge of Symptoms of STIs in Men
Percent Distribution of Respondents who have heard of STIs and can
Describe Various Symptoms in Men According to Selected
Characteristics; FMOH, Nigeria 2007.
Characteristics
Sex
Male
Female
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
8.4
Genital
discharge
Burning
pain on
urination
Genital
ulcers
Swellings in
the groin
Number of
women
and men
who have
heard of
STIs
39.2
21.3
54.2
39.5
18.1
12.3
15.4
10.1
4827
3166
32.3
31.8
50.2
45.5
15.7
16.0
13.7
12.7
4860
3133
32.1
44.2
40.2
23.9
20.7
33.8
57.9
55.6
40.4
51.2
50.9
37.9
12.8
14.9
22.4
18.2
15.3
11.8
13.5
15.5
19.1
15.9
11.4
6.0
1506
915
1476
1118
1447
1531
31.0
44.9
11.6
12.6
1102
37.5
32.8
28.1
41.4
42.1
49.7
46.6
58.1
17.7
16.3
14.6
21.9
16.7
12.0
12.0
18.0
558
1638
3520
1175
20.4
28.1
34.1
35.2
37.5
43.3
34.1
45.0
51.9
51.9
53.4
60.0
11.0
13.3
16.2
18.1
19.0
19.2
8.1
10.7
14.8
13.6
17.2
18.9
1395
1514
1398
1791
1228
667
32.1
48.4
15.8
13.3
7993
Knowledge of the Effect of STIs on Fertility
One of the possible consequences of STIs is infertility, along with its
grave social implication in the Nigerian environment. The survey
99
investigated knowledge of the respondents on the effect of STIs on
fertility and the result is shown in Table 8.4. Among respondents who
were aware of STIs, (62%) knew that STIs have an effect on the fertility of
females while (59%) knew that it has a similar effect in men. Knowledge
levels generally increased with increasing age and educational status.
Respondents in the urban areas and in the Southern zone had higher
levels of knowledge than those in the rural areas and Northern zone
respectively.
Table 8.4: Knowledge of Effect of STIs on Fertility
Percent Distribution of Respondents who Know that STIs can cause
Infertility in Males and Females According to Selected Characteristics;
FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
8.5
% of persons
who know
that STI has
an effect on
female fertility
% of persons
who know that
STI has an
effect on male
fertility
Respondents
who have
heard of STI
62.2
61.3
57.3
60.8
3166
4827
60.0
64.3
57.7
62.0
4860
3133
58.7
57.3
55.8
71.5
63.3
64.3
54.6
55.3
54.8
70.1
60.0
62.6
1506
915
1476
1118
1447
1531
55.4
52.7
62.3
61.1
72.9
51.9
53.2
59.8
59.0
70.0
1102
558
1638
3520
1175
48.9
59.2
67.4
65.1
66.0
64.9
61.7
45.7
57.4
64.7
63.3
63.0
64.5
59.4
1395
1514
1398
1791
1228
667
7993
Experience of STI Symptoms in the Past 12 Months
Genital discharge, ulcer and itching were used as proxies for STI
symptoms. Respondents who had ever had sex were asked whether they
100
had experienced any of these symptoms in the last 12 months preceding
the survey. The results are shown in Table 8.5. About 7% of respondents
had experienced symptoms of STI in the 12 months preceding the study.
It ranged from 5% in the South West to 11% in the North Central zone. A
higher proportion of females (11%) compared to males (3%) reported
having experienced STI symptoms within the one year period preceding
the survey. Urban dwellers (8%) reported a similar incidence of symptoms
of STIs to rural-based respondents (6%). A larger proportion of
respondents in the younger age groups had experienced symptoms
compared to those in the older age groups. Of the three STI symptoms,
genital itching was the most commonly reported by both males and
females. A higher percentage of females than males reported symptoms
(see Chart 8.1).
Table 8.5: Experience of STIs Symptoms
Percent Distribution of Respondents who have had Sex and who
Experienced STI Symptoms in the Past 12 Months According to Selected
Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Percentage who
experience STI
symptoms last 12
months
Number of
women and
men who
had ever has
sex
10.6
3.4
4442
4499
6.3
8.2
5941
3000
10.8
6.1
6.5
5.2
7.2
4.9
1644
1153
2083
938
1518
1605
5.6
5.9
6.9
8.2
7.1
2244
800
1856
2962
1079
9.4
10.4
8.3
6.2
5.0
1.6
6.9
794
1564
1652
2400
1708
823
8941
101
Chart 8.1: Percentage distribution of respondents that reported STI symptoms by Sex, FMOH,
Nigeria, 2007
Male Female
8
7.3
7
6
5.5
P e rc e n ta g e
5
4
3
2
1.8
1.9
1.2
1
0.5
0
Genital discharge
Gental itching
Genital sore
STI symtoms
8.6
Health Seeking Behaviour of Respondents with STI
Symptoms
Respondents who reported experiencing symptoms of STIs in the 12
months preceding the survey reported use of a variety of facilities to
obtain treatment for the condition. The commonly used facilities as shown
in Table 8.6 included government health facilities (25%), patent medicine
store (13%) traditional healers (11%), private health facilities (10%) and
pharmacies (8%). For respondents in the urban and rural areas, the main
source of treatment was government health institutions.
102
Table 8.6: Sources of Treatment for STIs
Percent Distribution of Respondents According to Sources of Treatment
during Last Episode of STI Symptoms According to Selected
Characteristics; FMOH, Nigeria 2007.
Characteristics
Sex
Female
Male
Location
Rural
Urban
Total
8.7
Govt.
health
facility
Workplace
health
facility
Religious
health
facility
Private
health
facility
Pharmacy
Traditional
healers
Patent
medicine
store
Total
24.2
27.4
5.6
10.6
1.9
1.9
11.2
6.7
7.3
10.6
9.7
12.5
11.6
15.9
534
208
22.3
28.8
25.1
3.5
11.9
7.0
1.4
2.6
1.9
6.0
15.4
10.0
5.8
11.5
8.2
14.4
5.1
10.5
14.7
10.3
12.8
430
312
742
Discussion and Conclusions
The level of awareness of STIs was generally high. Higher proportions of
males than females, urban than rural, older than younger, respondents
from Southern zones than those from the Northern, and those with higher
education than those with lower education were aware of STIs.
Knowledge of symptoms of STIs was generally low. Respondents were
more knowledgeable about male symptoms than those in females.
Knowledge of respondents was however high with regards to the possible
effect of STIs on fertility. Higher proportions of females than males
reported that they experienced STI symptoms during the 12 months
preceding the survey despite the fact that STIs were better recognized in
males. This may be due to the symptoms that were used as proxies for
STI (genital discharge, ulcer and itching). It is important to note that
higher proportions of younger respondents than older ones reported that
they had experienced STI symptoms. This may be a reflection of the
effect of high risk sexual behaviour associated with this age group.
Interventions to prevent STIs need to be targeted at the younger age
groups.
Generally, government health facilities, patent medicine store, traditional
healers and private health facilities in that order, were the main sources of
STI treatment. It is noteworthy that in rural areas, government health
facilities were the main source of treatment unlike in 2005, where the
most common source of treatment used by respondents in rural areas
was traditional healers. With 13% of respondents with STIs reporting use
of patent chemist store for treatment and 8% reporting use of pharmacy
for the same purpose, intervention to improve the management practice
of the operators of these facilities is important particularly focusing on
syndromic management, counselling and appropriate referral.
103
SECTION 9
9.0
Stigma and Discrimination
Stigma and discrimination are two major problems often faced by people
living with HIV and AIDS in many developing countries, including Nigeria.
Stigma and discrimination shown to persons living with and affected by
HIV and AIDS can worsen the spread and the impact of the HIV and
AIDS epidemic. As a result of fear of discrimination and stigma, many
individuals are afraid of seeking HIV testing to know their HIV status while
persons living with HIV and AIDS (PLWHAs) may be less inclined to
declare and openly acknowledge their HIV sero status. This can lead to
continued under-reporting of the epidemic, increased transmission, and
limited access to treatment, care and support programmes. On the other
hand, stigma and discrimination violate the human rights and dignity of
people living with HIV and AIDS and those affected by the epidemic.
Series of questions were asked of respondents who had heard of AIDS to
assess the degree of HIV and AIDS-related stigma and discrimination.
The responses are presented in this section.
9.1 Attitude towards Family Members Living with HIV and
AIDS
Table 9.1 presents information on respondents’ attitudes towards HIV
infected family members. Majority of respondents were willing to care for
male or female relatives who are living with HIV and AIDS. A higher
proportion of males than females (76% and 65% respectively) indicated
willingness to take care of their family members living with HIV and AIDS.
Respondents in the urban areas indicated more willingness to care for
HIV infected relatives than those in the rural areas. In the Northern zones,
respondents were more willing to care for infected relatives than their
counterparts in the South. Overall, there appeared to be no major
differences in the attitude of the respondents as it related to the sex of the
infected person. No definite pattern of association was observed between
attitude to family members with HIV and AIDS and educational level or
religion of the respondents. Half of the respondents wanted to keep
relatives who are infected with HIV and AIDS as a family secret: with an
equal proportion of males and females and higher proportion of urban
respondents (53%) than those in the rural areas (48%).
104
Table 9.1: Attitude Towards Family Members Living with HIV/AIDS
Percent Distribution of Respondents who have Heard of AIDS According
to Attitude Towards HIV Infected Family Members According to Selected
Characteristics; FMOH, 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’ranic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Willing to
care for male
relatives
living with
HIV/AIDs
Willing to
care for
female
relatives
living with
HIV/AIDs
Willing to
keep AIDs
in family
secret
Number
of men
and
woman
who
have
heard of
AIDs
64.5
76.0
64.9
73.8
50.2
49.5
4937
5872
67.8
76.1
66.1
76.3
48.1
52.9
6952
3857
71.9
82.4
72.5
71.6
67.9
60.8
70.8
80.2
72.8
69.4
66.2
60.3
43.8
54.8
58.1
52.0
44.1
45.1
1902
1452
2491
1273
1733
1958
59.0
59.7
45.3
2061
74.6
68.2
72.8
84.4
72.8
66.0
71.6
83.8
54.0
47.2
51.0
54.4
922
2130
4447
1249
68.4
73.3
69.7
70.2
69.4
77.5
70.7
67.2
72.2
69.2
69.5
68.7
74.5
69.7
52.8
53.5
46.6
50.0
46.8
44.7
49.8
2237
2055
1793
2326
1617
781
10809
9.2 Attitude towards Non-family Members who are
Infected with HIV
Table 9.2 presents information on attitudes of respondents toward nonfamily members living with HIV and AIDS. Overall, 63% of the
respondents were willing to work with an HIV infected colleague, 65%
were willing to allow an HIV infected student or child in school, and 61%
willing to allow a female HIV infected teacher to continue to teach in
school. Also, 47% of respondents were willing to share meals with HIV
105
infected persons and about a third (35%) were willing to buy food from a
shopkeeper known to be HIV infected.
Table 9.2: Attitude towards Non-family Persons Living
with HIV/AIDS
Percent Distribution of Respondents who have heard of AIDS and their
Attitude towards other (Non-family) Persons Living with HIV/AIDS
According to Selected Characteristics; FMoH, Nigeria 2007.
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never
attended
school
Qur’ranic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Willing
to
meals
with
HIV
infected
persons
Willing
to allow
in HIV
infected
student
in
school
Willing
to allow
an
female
HIV
infected
teacher
in
school
Willing to
buy food
from an
HIV
infected
shopkeeper
Willing to
work with
an HIV
infected
colleague
Willing
to allow
an HIV
infected
child in
school
Number
of men
and
woman
who
have
heard
of AIDs
42.4
50.3
58.4
65.7
57.5
64.5
31.9
37.7
58.2
66.3
60.7
68.5
4937
5872
42.1
55.0
58.0
70.2
56.7
69.6
32.4
39.7
58.6
69.7
61.1
71.7
6952
3857
44.4
62.9
41.1
50.7
45.3
42.6
61.4
73.9
62.8
63.2
59.7
55.9
60.8
72.8
61.7
59.5
59.0
56.0
26.4
52.1
36.7
39.0
35.2
25.6
60.5
74.7
64.8
59.9
58.1
58.5
62.8
77.3
66.3
64.1
60.9
60.1
1902
1452
2491
1273
1733
1958
34.7
50.2
50.1
30.3
51.5
53.2
2061
38.5
43.1
49.6
68.4
62.3
58.2
64.7
81.0
59.2
57.5
63.6
79.9
36.3
32.3
34.4
48.5
62.5
58.9
64.4
80.5
65.1
61.5
66.9
82.9
922
2130
4447
1249
41.8
50.0
47.8
48.0
45.2
48.8
46.7
59.1
64.1
63.5
62.7
60.4
66.8
62.3
57.7
63.0
62.4
62.6
59.2
65.6
61.3
30.8
34.5
36.1
36.9
35.1
40.2
35.0
59.9
63.9
62.8
63.1
62.1
65.8
62.6
62.1
67.5
65.9
64.9
63.0
68.0
64.9
2237
2055
1793
2326
1617
781
10809
106
Chart 9.1: Respondents attitudes towards other persons living with HIV/AIDS by Sex
68.5
Willing to allow an HIV infected child in school
60.7
66.3
Willing to buy food from an HIV infected
colleague
58.2
37.7
Willing to buy food from an HIV infected
shopkeeper
A ttitu d e
31.9
Male
Female
64.5
Willing to allow an female HIV infected teacher
in school
57.5
65.7
Willing to allow in HIV infected student in school
58.4
50.3
Willing share meals with HIV infected persons
42.4
0
10
20
30
40
50
60
70
80
Percentage
9.3
Health Care for People Living with HIV and AIDS
Table 9.3 shows that four-fifths (80%) of respondents who had heard of
HIV and AIDS were of the opinion that persons living with HIV and AIDS
need more health care than persons not living with HIV. Only 2% of
respondents believed that less care should be offered PLWHAs. The
opinions of respondents varied by zones, with respondents who believed
that more health care should be provided to PLWHAs ranging from 76%
in the North West to 86% in the South West. Respondents in urban areas
and those with higher levels of education were more disposed to more
health care being provided for PLWHAs.
107
Table 9.3: Health Care for People Living with HIV/AIDS
Percent Distribution of Respondents who had Heard of AIDS and their
Attitudes Toward the Provision of Health Services for Persons living with
HIV/AIDS According to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
9.4
Opinion on providing health care towards
PLWHA
More
Equal
Less
Don’t No
health health
health know response
care
care
care
Number
of women
& men
who
heard of
AIDS
76.9
82.3
12.7
11.7
2.9
1.6
7.3
4.1
0.1
0.2
4937
5872
77.8
83.6
12.8
11.1
2.5
1.7
6.8
3.4
0.1
0.2
6952
3857
77.7
78.8
76.3
78.5
81.9
86.3
14.9
12.3
13.2
11.5
11.7
8.9
3.2
1.9
2.9
2.3
1.8
1.0
4.3
6.8
7.4
7.5
4.4
3.5
0.0
0.1
0.2
0.2
0.1
0.3
1902
1452
2491
1273
1733
1958
71.0
13.9
4.2
10.8
0.1
2061
77.3
80.1
82.0
88.2
13.0
12.1
12.2
8.9
2.1
2.1
1.8
0.9
7.3
5.5
3.9
1.9
0.3
0.1
0.1
0.2
922
2130
4447
1249
77.6
81.2
78.6
79.8
81.3
83.0
79.9
12.8
11.5
13.4
12.4
11.2
11.0
12.2
2.4
2.8
2.2
2.5
1.5
1.3
2.2
7.1
4.4
5.7
5.2
6.0
4.7
5.6
0.2
0.1
0.2
0.2
0.0
0.0
0.1
2237
2055
1793
2326
1617
781
10809
Rights of People Living with HIV and AIDS
Respondents were asked whether in their opinion the rights of people
living with HIV and AIDS were adequately protected. The responses are
presented in Table 9.4. Less than a half of the respondents (48%)
believed that the rights of persons living with HIV and AIDS were
adequately protected in Nigeria. Higher proportion of males, respondents
in urban areas and respondents with higher education were of the opinion
that PLWHAs’ rights were adequately protected. Among the zones, the
proportion of respondents that believed that the rights of PLWHAs were
108
adequately protected was lowest in the North Central (42%) and highest
in the South West (55%).
Table 9.4: Rights of People Living with HIV/AIDS (PLWHA)
Percent Distribution of Respondents who have heard of AIDS by Opinions
about the Rights of Persons Living with HIV/AIDS According to Selected
Characteristics; FMOH, Nigeria 2007
Characteristics
The rights
of PLWHA
are
protected in
Nigeria
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’ranic only
Number of
women and
men who have
heard of AIDS
45.5
49.9
4937
5872
46.1
51.0
6952
3857
41.5
49.2
42.4
54.6
49.1
54.7
1902
1452
2491
1273
1733
1958
34.6
2061
42.3
922
Primary
Secondary
Higher
48.7
52.5
56.0
2130
4447
1249
Age group
15-19
43.3
2237
20-24
49.4
2055
25-29
48.7
1973
30-39
48.6
2326
40-49
50-64
Religious
Islam
Protestant
50.2
48.3
1617
781
43.3
51.6
5204
4053
Catholic
Traditional
Other
54.7
46.3
36.7
1425
67
60
Total
47.9
10809
109
9.5
Open Discussions about AIDS in Nigeria
Respondents were also asked of their opinion on whether people talked
openly about HIV and AIDS in Nigeria. The results are presented in Table
9.5. Overall, about three-quarters (74%) of respondents believed that
AIDS is openly discussed in Nigeria. Among the zones, the proportion of
respondents that believed that AIDS is openly discussed in Nigeria was
lowest in the North West (62%) and highest in the South East (87%). The
pattern of response did not vary much by age group. A slightly higher
proportion of males (75%) than females (73%) and a higher proportion of
urban (78%) than rural respondents (73%) believed that AIDS is openly
discussed.
Table 9.5: Open Discussion about HIV/AIDS
Percent Distribution of Respondents who have heard of AIDS by Opinions
about Open Discussion on HIV/AIDS According to Selected
Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Religious
Islam
Protestant
Catholic
Traditional
Other
Total
AIDS is
openly
discussed in
Nigeria
Number of women and
men who have heard of
AIDS
73.1
74.9
4937
5872
72.5
77.9
6952
3857
71.0
76.7
62.1
86.7
78.8
79.7
1902
1452
2491
1273
1733
1958
60.3
65.0
76.2
79.7
82.8
2061
922
2130
4447
1249
71.5
75.9
74.4
75.4
76.4
71.8
2237
2055
1973
2326
1617
781
66.8
79.8
86.6
76.1
80.0
74.4
5204
4053
1425
67
60
10809
110
9.6
Discussion and Conclusions
Majority (70%) of the respondents were willing to care for relatives living
with HIV. The survey revealed a higher proportion of males than females;
respondents in urban than in rural areas, and those in the North than in
the South were willing to care for HIV infected relatives. However, half of
the respondents would keep it secret if a family member is infected
indicating that the fear of stigma and discrimination still persists. Similarly,
less than half of the respondents were of the opinion that the rights of
PLWHA are adequately protected in Nigeria. This implies that our
intervention programmes must continue to include strategies to reduce
stigma and protect the rights of PLWHA. On the whole, respondents’
attitude was less discriminatory to family members than to non-family
members who are infected with HIV. It is noteworthy that 80% of the
respondents believed that persons with HIV and AIDS need more health
care than others and 74% stated that people were talking openly about
HIV and AIDS in Nigeria.
111
SECTION 10
10.0 Safe Motherhood
Safe motherhood constitutes a major health challenge in Nigeria. The
country has one of the highest maternal and neonatal morbidity and
mortality rates in the world. The international community has identified
the reduction of maternal and childhood mortality as part of the
Millennium Development Goals (MDGs), and the Nigerian government is
committed to meeting the MDGs and other international goals as
embodied in the ICPD Programme of Action (POA) through the Integrated
Maternal, New born and Child Health Strategy (IMNCH). This section
covers major safe motherhood issues – antenatal care, delivery, postnatal
care, breastfeeding and maternal mortality.
10.1
Planning Status of Births
The percentage of women who had ever given birth and who reported
that they desired their last pregnancy is presented in Table 10.1. Almost
85 percent of the women reported that their last pregnancy was desired,
while 9% would have desired to have the pregnancy at a later time and
2% were not sure if they desired to get pregnant again. The proportion of
women who desired their last pregnancy was higher among persons
living in the rural areas (86%) than those of urban areas (81%). The
proportion of women who desired their last pregnancy at the time it
occurred was lowest in the South-South (77%) and highest in the North
West (91%). A higher proportion of respondents with less education
appeared to have desired their last pregnancy compared to those with
higher level of education. The highest percentage (about 15%) of those
who desired to have their pregnancy at a later time was in the age range
15-19 years.
112
Table 10.1: Planning Status of Births
Percent Distribution of Women who have ever given birth who desired
their last Pregnancy According to Selected Characteristics; FMOH,
Nigeria 2007
Characteristics
Desired the
pregnancy
then
Desired
pregnancy
but later
Desired no
pregnancy
again
Not
sure
All
women
who
have
ever
given
birth
Location
Rural
86.2
7.7
3.7
2.4
2419
Urban
81.4
11.8
5.4
1.4
1193
North Central
86.0
7.8
4.6
1.6
524
North East
82.2
7.9
7.2
2.6
515
North West
90.8
3.3
2.5
3.5
1047
South East
87.6
7.2
4.7
0.4
334
South-South
77.2
16.7
4.5
1.5
501
South West
79.9
15.2
4.0
0.4
683
Never attended
school
Qur’anic only
87.7
44.0
5.6
2.6
1325
90.4
3.4
3.1
3.1
312
Primary
86.1
9.4
3.0
1.5
857
Secondary
77.3
17.6
3.4
1.5
857
Higher
82.1
11.2
6.2
0.5
218
15-19
80.8
14.7
2.3
2.2
232
20-24
80.5
14.3
1.9
3.4
631
25-29
84.9
11.5
2.3
1.3
752
30-39
86.7
6.6
4.8
1.9
1184
40-49
85.7
4.7
7.7
1.9
812
Total
84.7
9.1
4.2
2.0
3612
Zone
Education
Age group
113
10.2
Ante-natal Care
Women who had given birth within the last five years preceding the
survey were asked questions on accessing antenatal care (ANC), and the
result regarding ANC attendance is presented in Table 10.2. Of these
women, 63% received antenatal care during their last pregnancy. The
proportion that received ANC was higher among urban (83%) compared
to rural dwellers (54%). In terms of zones, South East had the highest
proportion (86%) of pregnant women that received ANC in their last
pregnancy, while the lowest proportion (45%) was recorded in the North
West. About half (52%) of pregnant adolescents (15-19 years) received
ANC. Education is positively associated with ANC with 39% of
respondents who had no formal education receiving ANC compared with
91% of those with higher educational attainment.
Table 10.2: Ante-natal Care
Percent Distribution of Women who gave Birth over the Past 5 Years who
attended ANC during their Last Pregnancy According to Selected
Characteristics; FMOH, Nigeria 2007
Characteristics
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
Total
Received
antenatal care
Number of women who
gave birth in the last 5
years
54.1
82.8
1820
877
67.3
61.2
45.3
86.0
63.5
84.0
400
410
845
216
347
472
39.0
54.9
74.6
82.4
91.4
936
263
616
722
159
52.0
57.8
69.0
67.5
58.5
63.4
229
596
681
894
296
2697
114
10.3
Ante-natal Care Providers
Table 10.3 shows the category of health care providers who attended to
respondents during antenatal care visits. Nurses/midwives were the
commonest group that provided ante-natal care in each zone, ranging
from 82% in the South West to 73% in the South-South. The next
category of ANC providers was doctors (50%), higher in the urban areas
(63%) than rural (40%) and increasing with higher educational level. The
South West (72%) reported the highest proportion receiving ANC from
doctors while the least was North East (27%). The highest proportion of
those that received ANC from traditional birth attendants (TBAs) was
recorded in the South West and South-South zones (8% and 7%
respectively). Overall, more than three-quarters of the respondents (79%)
received ANC from nurses/midwives and 50% from doctors while TBAs
provided ANC to only about 4% of pregnant women.
Table 10.3: Ante-natal Care Providers
Percent Distribution of Women who have delivered in the last 5 years who
received Ante-natal Care from different Cadres of providers during their
last pregnancy According to Selected Characteristics; FMOH, Nigeria
2007
Characteristics
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
Total
Doctor
Nurse/Midwife
Auxiliary
Nurse
40.1
62.7
76.4
82.4
13.3
12.1
11.1
5.0
3.2
4.7
948
709
44.9
26.5
42.1
51.6
54.1
71.8
81.2
81.8
75.5
78.0
73.3
82.4
13.2
9.3
9.8
12.2
14.2
1
6.7
15.7
10.5
7.3
6.7
4.8
3.3
2.5
3.2
1.3
6.7
7.7
264
241
376
179
210
384
38.6
77.0
14.0
7.6
2.7
346
38.0
44.5
56.6
77.4
69.3
81.6
81.5
75.0
5.0
13.8
14.5
8.0
19.0
9.3
6.5
5.4
1.8
6.7
3.5
1.3
142
447
579
143
40.1
40.9
52.8
53.9
51.6
49.8
78.9
78.1
77.4
81.6
75.6
79.0
6.6
11.8
14.8
13.5
11.3
12.8
9.9
8.8
9.2
7.4
8.6
8.5
3.6
2.7
5.9
3.0
3.8
3.9
115
343
464
589
147
1658
115
CHEWs
Traditional
birth
attendants
Number of
women who
went for
antenatal care
during their
last
pregnancy
10.4
Intra-partum Care
The presence of skilled attendants at deliveries is now recognised
globally as a critical step in maternal mortality reduction. The term “skilled
attendant” refers exclusively to caregivers with midwifery skills, which
include the capacity to initiate the management of complications and
obstetric emergencies (i.e. physicians and nursing/midwifery
professionals). Women who delivered within the last five years preceding
the survey were asked about the category of health worker(s) that
attended to them during their last delivery, and the result regarding those
attended to by skilled attendants is shown in Table 10.4. Overall, 47%
were attended to by skilled attendants. The proportion of deliveries
attended to by skilled personnel in the last five years was lowest among
those with only Qur’anic education (16%) and no education (18.9%).
However, it was highest among those who obtained higher education
(84%). The proportion also increased generally with age and was higher
in urban locations (66%) than among women living in rural areas (37%).
Zonal variations were also evident in the proportion of respondents who
were attended to by skilled attendants, varying from 28% in the North
East to 81% in the South West.
Table 10.4: Delivery Care
Percent Distribution of Women who Gave Birth in the Last 5 Years and
who Received Skilled Care During Delivery According to Selected
Characteristics; FMOH, Nigeria 2007
Characteristics
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
Total
Delivered
by skilled
attendants
during last
delivery
Number of
women who
gave birth in
the last 5
years
36.7
66.0
1708
841
48.1
28.1
17.6
85.5
65.2
81.0
389
391
799
203
318
444
18.9
865
16.0
55.3
75.9
84.4
253
586
690
155
26.7
38.6
47.5
55.5
52.2
46.4
222
577
662
849
240
2550
116
10.5
Post-natal Care
As shown in Table 10.5, the proportion of pregnant women that received
Post-natal Care (PNC) for their last pregnancy out of women that gave
birth within the last 5 years preceding the survey was about 42%
nationally. The proportion of women that received PNC was higher in
urban (60%) than rural locations (33%), and increased with education
(from 19% for women who never attended school and 22% for women
who attended Qur’anic school only to 75% among those with higher
education). Generally, PNC was mostly sought from government
hospitals with about 71% of women who gave birth within the last 5 years
preceding the survey seeking PNC from government hospitals; and
followed by private hospitals (22%). Less than 1% of women sought PNC
from TBAs. The proportion that received PNC also increased generally
with age, although women in the 40-49 years age group had lower value
than those in 25-29 years age group. Wide zonal variations were also
observed: the proportion of mothers that had PNC in the South East
(58%) was more than two and a half times the proportion recorded in the
North West (23%).
117
Table 10.5: Postnatal Care
Percent Distribution of Women who Delivered in the Last Five Years who
Received Postnatal Care During Last Pregnancy from different Cadres of
Providers According to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
Total
10.6
All
women
who
delivered
in the
past 5
years
Govt.
hospital
Private
hospital
Maternity
home
public
private
Faith
based
TBAs
All
women
who
gave
birth in
the last
5 years
and
sought
PNC
1708
841
72.1
70.0
17.0
27.5
12.9
5.6
1.3
1.2
0.6
0.7
561
504
389
391
799
203
318
444
71.0
76.4
81.8
50.9
85.1
61.7
27.5
2.4
11.3
40.8
12.5
33.7
3.1
22.7
7.6
13.5
4.5
8.5
0.2
0.5
2.5
0.0
1.4
1.9
1.0
0.0
0.0
0.0
1.7
1.0
181
155
179
118
156
273
865
67.2
15.7
13.0
3.4
0.3
168
253
586
690
155
91.9
71.2
71.3
65.9
2.6
23.2
24.0
30.0
7.7
10.5
8.7
5.0
0.0
0.0
1.2
2.2
0.0
1.9
0.1
0.0
57
302
421
117
222
577
662
849
240
2550
79.9
74.1
72.9
69.1
63.7
71.1
11.0
18.5
21.7
25.2
22.7
22.0
9.7
11.0
8.7
9.6
7.6
9.4
1.7
0.8
0.9
1.9
0.6
1.2
1.3
0.4
1.0
0.7
0.0
0.7
44
222
299
393
107
1065
Breastfeeding
Table 10.6 presents information about the time of commencement of
breastfeeding of the last child by women who delivered in the last five
years preceding the survey. Only 44% of the mothers commenced
breastfeeding immediately after delivery, while 42% commenced
breastfeeding within a day of the delivery and 13% commenced
breastfeeding days after the delivery. Only 4% of the women indicated
that they did not breastfeed their babies at all. A slightly higher proportion
of women living in urban (45%) than in urban areas (44%) commenced
breastfeeding immediately after delivery. Mothers in the age range 15-19
118
years are as likely as mothers in the age range 30-49 years to commence
breastfeeding immediately after birth while those with higher education
are most likely to breastfeed immediately after birth (47%). The SouthSouth zone had the highest proportion of women who commenced
breastfeeding immediately after birth (58%) while the lowest proportion
was recorded in the South West (30%). The proportion of those who did
not breastfeed was lowest in the North East (less than 2%) and highest in
North West and South-South zones (6%).
Table 10.6: Breastfeeding
Breastfeeding practises and Time of Commencement of Breastfeeding
following Last Delivery by Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
Total
10.7
Did not
breastf
eed last
child
Immediately
Hours
after
delivery
Days
after
delivery
Don’t
know/No
response
Total
4.5
3.1
43.9
44.7
42.5
41.1
12.5
12.9
1.0
1.3
1632
815
54.5
34.5
10.0
0.9
379
2.7
1.5
5.8
4.6
5.8
2.7
45.4
44.0
33.6
57.6
30.0
45.1
41.2
53.7
26.3
52.8
8.8
13.7
12.4
15.2
15.1
0.7
1.2
0.3
1.0
2.1
385
752
193
30
432
4.7
45.3
41.6
11.3
1.8
825
3.1
4.1
3.2
5.0
43.5
43.4
43.1
46.5
40.4
44.4
42.8
34.8
16.1
11.2
13.4
17.2
0.0
1.0
0.7
1.4
245
562
668
147
4.7
3.7
3.1
3.4
8.5
4.0
46.6
40.2
42.7
46.8
46.1
44.2
41.1
44.0
43.2
40.0
42.0
42.1
11.8
14.8
12.9
12.4
8.4
12.7
0.5
1.0
1.2
0.8
3.4
1.1
211
556
641
820
220
2447
Maternal Mortality
Tables 10.7 to 10.9 present information obtained during the survey
regarding the experience of maternal mortality at the household level
within the one-year period preceding the survey. Table 10.7 presents
information regarding knowledge of the respondents concerning death of
women at household levels within a year, preceding the survey from
pregnancy-related causes during pregnancy or within 6 weeks of delivery.
This is, thus, reflective of the incidence of maternal mortality. Six percent
of respondents reported cases of maternal mortality in their households in
the past one year. Among the regions, the North West (9%) had the
119
highest proportion of households that reported maternal deaths, followed
by South-South (7%). The South West had the lowest proportion (2%) of
maternal mortality figures. In general, the maternal mortality report was
higher among respondents with lower educational level (at most primary).
Some respondents (4.6%) also attributed maternal death after 6 weeks to
pregnancy-related causes.
Table 10.8 presents findings on timing of pregnancy-related maternal
mortality as reported. Sixty percent were reported to have taken place
during childbirth, while 19% occurred during pregnancy, and 17% in the
postnatal period. Findings on the medical causes of maternal mortality as
reported by the respondents are presented in Table 10.9. Heavy
bleeding is the leading causes of maternal death (38%) and obstructed
labour (26%). This picture was similar across all the zones, and across all
other background characteristics of the respondents.
Table 10.7: Reported cases of Maternal Mortality
The Distribution of Respondents Knowledge of any Death of Woman
during Pregnancy According to Selected Characteristics; FMOH, Nigeria
2007
Characteristics
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
% of households
that recorded death
of a woman in the
preceding one year
% of households
with knowledge of
maternal death
Total
8.0
6.4
6.5
4.8
7317
4186
7.8
6.0
10.2
10.4
7.9
2.8
5.8
5.0
8.8
6.2
6.8
2.1
1649
1551
2916
1298
1678
2393
7.6
8.3
8.8
7.1
5.1
6.1
7.3
6.5
5.6
4.0
2356
1018
2249
4597
1268
6.8
7.6
6.8
8.0
7.9
7.3
7.4
5.4
6.0
5.0
6.7
5.9
5.8
5.9
2479
2136
1892
2461
1721
814
11503
120
Table 10.8: Timing of Maternal Death
Percentage Distribution of Respondents by Pregnancy Related Timing of
Household occurrence of Maternal Death According to Selected
Characteristics; FMOH, Nigeria 2007
Characteristics
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Period of Occurrence of Maternal
Death
During
During
Within six
Pregnancy Childbirth weeks of
Childbirth
More than
6 weeks
after
childbirth
/others
Total
21.3
14.8
54.3
70.7
19.0
11.9
5.5
2.5
590
271
25.8
16.2
16.4
16.5
22.7
22.7
48.1
61.8
64.1
60.6
52.1
69.1
21.0
20.6
12.8
20.5
21.2
4.8
5.1
1.4
6.6
2.4
4.0
3.4
128
90
307
136
133
66
27.8
52.2
14.2
5.7
187
16.5
17.3
18.7
7.2
62.2
56.5
64.3
61.7
17.3
19.7
14.0
27.9
3.9
6.5
3.0
3.2
85
199
326
65
17.9
22.7
20.6
16.9
17.9
22.1
19.3
63.1
60.3
53.0
59.4
61.3
57.1
59.5
14.6
14.0
21.4
17.7
16.5
17.4
16.8
4.4
3.0
5.1
6.0
4.3
3.4
4.6
171
162
131
199
138
60
861
121
Table 10.9: Medical Causes of Maternal Mortality
Percentage Distribution of Respondents by Reported Causes of Maternal
Death at Household Level According to Selected Characteristics; FMOH,
Nigeria 2007
Characteristics
Medical causes of Maternal Mortality
Heavy
bleeding
Infection
Fits/
convulsions
Difficult
labour
Baby
died in
the
womb
Others
/Don’t
know
Total
Location
Rural
Urban
37.4
38.5
4.2
1.2
7.4
5.4
24.9
28.2
7.1
6.7
19.0
20.0
473
201
Zone
North Central
North East
North West
South East
South-South
South West
39.9
35.9
33.6
54.5
38.4
29.3
3.9
4.6
2.2
0.7
7.2
1.2
1.5
8.4
9.4
5.0
7.5
2.7
26.1
32.1
25.9
9.4
26.5
40.8
8.5
12.4
6.8
5.4
4.0
5.8
20.1
6.7
22.1
25.0
16.3
20.3
96
78
256
80
37.7
4.0
9.0
25.3
7.9
16.0
143
28.5
41.4
36.4
47.5
4.5
2.5
6.8
12.0
5.8
5.0
4.9
34.8
21.5
25.5
29.1
8.3
7.1
7.0
2.0
16.4
19.8
23.7
9.6
75
147
258
51
39.3
33.9
35.7
38.7
36.4
47.2
37.7
4.6
3.3
4.8
1.2
2.8
5.0
3.3
3.3
8.2
12.6
8.0
5.5
6.8
23.8
29.1
19.4
27.1
29.8
23.8
25.9
6.7
5.3
12.1
5.6
7.3
6.1
7.0
22.3
20.2
15.5
19.3
18.2
17.9
19.3
136
129
95
166
101
47
674
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
51
10.8 Discussion and Conclusions
Majority of the women (85%) desired their last pregnancy. This is a
reflection of the pronatalistic nature of the Nigerian society. Women in
rural areas, in the North West, North Central and South East zones, and
those with lower education have higher proportion of mothers that desired
their last pregnancy compared to other groups.
Only 63% of pregnant women received ANC and less than half of them
(46%) were attended to at delivery by skilled attendants. The health
behaviour of Nigerian women regarding pregnancy-related care remains
poor and poses one of the greatest challenges to maternal and neonatal
122
mortality reduction in the country. Less than half of mothers (44%)
commenced breastfeeding immediately after delivery.
Seven (7%) percent of respondents reported the occurrence of maternal
mortality in their households in the one year preceding the survey. A wide
geographical variation in maternal mortality was obtained in the country;
the proportion of households that reported maternal mortality in the South
East (10%) was more than three times the proportion in the South West
(3%).
About three fifth of the maternal deaths were reported to have occurred
during childbirth. The leading medical causes of maternal mortality
reported by respondents in each of the zones were heavy bleeding and
obstructed labour. While the maternal mortality data recorded here might
not be totally accurate as a national maternal mortality figure due to
limitations that are known to be inherent in verbal autopsy approach to
maternal mortality, they do still give a good indication of the scope of the
maternal mortality challenge in Nigeria.
The data obtained indicates that interventions are needed in order to
improve health seeking behaviour and improve the quality and
accessibility of maternal health services in the country.
123
SECTION 11
11.0 Family Planning
Family planning is crucial to women’s health, family well-being and
national development. It has been shown that increased use of
contraceptives is associated with a decrease in maternal mortality
ratio as well as an increase in child survival. This section focuses on
family planning knowledge, practices and associated factors. The two
categories of family planning methods, modern and natural are
discussed.
11.1
General Knowledge of Contraceptive Methods
Table 11.1 presents information on the proportion of females and
males who know of any method of contraception and one modern
method of contraception. Seventy-three percent of women knew at
least one method of contraception compared to 82% of men who
knew any method. Regarding modern contraceptive methods, 68% of
women and 79% of men knew at least a method. A higher proportion
of men and women living in urban areas knew at least one family
planning method compared to their rural counterparts. Increased level
of education and age were also positively associated with knowledge
of modern contraceptive methods.
Among the females, the proportion of respondents who knew any
modern contraceptive method ranged from 46% in the North West to
85% in the South South. Among the males, the South South had the
highest proportion of respondents that knew at least one modern
contraceptive method (92%) while the North West had the lowest
(61%).
124
Table 11.1: Knowledge of Contraceptives Methods
Percentage Distribution of Respondents Knowledge of Contraceptives
methods according to selected Characteristics; FMOH, Nigeria 2007
Characteristics
Location
Rural
Urban
Zone
North central
North east
North west
South east
South-south
South west
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
NA: not available
Know
any
method
Female
Know
modern
method
Number
of
women
Know
any
method
Male
Know
modern
method
Number
of men
67.1
85.3
59.6
83.5
3513
1847
77.8
89.7
73.3
88.8
4043
2118
75.2
68.1
53.3
82.5
88.8
84.7
69.9
60.2
45.5
77.0
84.8
82.9
942
718
1333
639
811
917
90.9
69.8
65.4
89.8
93.7
89.4
86.8
65.8
60.6
87.8
91.8
87.7
1105
818
1514
655
965
1104
52.0
40.9
1622
59.7
49.4
864
65.9
81.4
84.1
94.2
58.1
77.8
81.8
93.5
396
1040
1873
429
61.5
83.2
89.0
95.9
54.1
80.8
87.6
95.8
629
1193
2646
829
60.3
76.8
78.1
79.4
72.9
NA
73.4
56.2
71.9
73.3
73.7
64.2
NA
67.9
1190
1084
936
1287
863
NA
5360
68.7
86.4
88.5
87.3
84.9
78.0
81.9
67.3
83.9
85.3
84.2
81.6
70.6
78.6
1280
1079
946
1169
861
826
6161
Chart 11.1: Percentage distribution of respondents with knowledge of modern contraceptive
methods by Zone and Sex; FMOH, Nigeria,2007
Female
Male
100
91.8
87.8
86.8
90
87.7
82.9
77
80
70
84.8
69.9
65.8
60.6
60.2
Percentage
60
50
45.5
40
30
20
10
0
North central
North east
North west
South east
Zones
125
South-south
South west
11.2
Types of Contraceptives Known
Knowledge of different types of contraceptives among women and
men of various marital status and sexual experiences is presented in
Table 11.2. While 78% of all the male and female respondents knew
of at least one contraceptive method, 74% knew of at least one
modern contraceptive method and 51% knew of at least one natural
family planning method. A higher proportion of sexually active
unmarried women knew at least one modern contraceptive method
(91%) compared to non sexually active women (58%).Among women
in union, 67% knew of at least one modern method of contraceptive.
Among sexually active unmarried men, 94% knew of at least one
modern contraceptive method while 66% of men with no sexual
experience knew of at least one modern method. Among men in union
79% knew of at least one modern method of contraceptive. Among the
sexually active unmarried respondents, a slightly higher proportion of
men (94%) compared to women 91% knew of at least one modern
contraceptive method.
Among the modern methods, the most known method by men and
women were male condom (65%), injectables (37%) and female
sterilization (21%). Among females, the proportion that knew male
condom, injectables and female sterilization was 54%, 40% and 21%
respectively. Among males, male condom was the most known
modern contraceptive method (74%), followed by injectables (35%)
while the proportion that knew both female sterilization and
emergency contraceptives was (20%). Less than a quarter of
respondents (20%) knew of emergency contraceptives (EC), this
proportion held for both male and female. Among sexually active
unmarried respondents, only 31% of females and 25% of males knew
of emergency contraceptives.
126
Table 11.2: Knowledge of Specific Contraceptives Methods
Percent Distribution of Respondents Knowledge of Contraceptives
Methods among women and men of various marital status and sexual
Contraceptive
Methods
All
males
and females
Females
only
Sexually
active unmarried
women
Women
in union
No sexual
experience
for
women
Males
only
Sexually
active unmarried
men
Men
in
union
No sex
ual
experience
for
men
Any
method
Any
Modern
methods
Pill
EC
Male
Condom
Female
Condom
Injectable
s
Implants
IUD
Foaming
tablets
Diaphrag
m
Female
sterilisatio
n
Male
sterilisatio
n
Natural
methods:
Rhythm
LAM
Withdrawa
l
Number
of women
and men
77.9
73.4
92.4
74.0
60.0
81.9
94.8
83.6
67.9
73.6
67.9
91.0
67.2
57.5
78.6
93.8
79.2
65.7
32.6
20.0
64.7
36.6
19.9
54.3
41.5
31.1
86.9
40.0
20.2
50.4
20.6
12.4
51.5
29.1
20.0
73.8
32.9
24.7
92.7
33.7
21.3
72.7
17.7
13.7
60.9
16.1
14.1
27.9
12.9
10.8
17.9
30.0
16.7
10.9
37.4
40.4
41.5
45.4
21.0
34.8
35.7
40.5
23.5
8.5
10.5
6.0
10.9
14.4
6.7
10.8
15.0
8.5
12.2
16.2
7.2
3.4
7.1
3.7
6.5
7.1
5.4
7.6
7.6
7.3
7.7
8.8
6.2
6.2
3.8
2.3
5.1
6.3
8.7
6.6
4.0
4.1
5.1
4.5
2.4
20.5
20.9
20.3
23.5
11.5
20.2
21.3
23.6
13.0
11.1
8.7
11.7
9.2
5.3
13.2
14.2
15.3
8.5
50.5
49.9
66.3
52.9
28.8
51.0
62.6
57.5
27.8
33.0
15.1
39.9
36.9
22.0
34.5
53.4
15.9
52.3
38.1
26.8
36.6
22.5
7.5
16.6
29.5
9.2
44.6
33.5
6.7
58.1
35.3
12.5
50.2
15.1
4.8
21.9
11521
5360
566
3601
918
6161
1354
3009
1662
experience: FMOH, Nigeria 2007
11.3
Perception about Contraceptive Methods and Issues
Table 11.3 shows the responses obtained to specific statements about
contraceptive methods. More than half of male (52%) and 47% of
female respondents agreed with the statement that family planning
(FP) methods are effective. One third of both male and female
respondents (33%) were of the opinion that FP methods encourage
young people to be ‘loose’. Twenty three percent of males and 22% of
females were of the opinion that contraceptives could cause infertility
in a woman. Only 34% of males and 32% of females agreed that
religion is not against FP while 28% of male and 25% of female
respondents agreed with the statement that FP encourages
promiscuity among women.
127
Table 11.3: Perception of Contraceptive Methods
Percentage Distribution of Respondents’ Perception about and
Attitude to Contraceptive Methods and Issues: FMOH, Nigeria 2007
Contraception/Family
Planning Issues
FEMALES
Agree
MALE
Disagree
FP/child spacing methods
are effective
47.2
8.3
FP encourage young
people to be ‘loose’
32.8
22.7
It is expensive to practice
FP/Child spacing
18.2
FP is women’s business
and men should not have
to worry about it
Don’t
know/no
response
44.5
Agree
Disagree
Don’t
know/no
response
40.1
51.5
8.4
44.5
33.1
24.5
42.3
29.6
52.3
17.7
34.7
47.6
18.1
39.1
42.7
15.1
44.7
40.3
Use of FP can lead to
infertility in a woman
21.8
24.7
53.5
22.5
23.7
53.8
FP/Child spacing methods
are not easily available
19.6
32.2
48.2
21.6
35.8
42.6
Condoms can protect a
woman from unwanted
pregnancy
Religion is not against FP
44.1
9.7
46.2
58.9
7.9
33.2
32.4
25.2
42.4
34.4
29.8
35.7
FP/Child spacing methods
encourage women to be
promiscuous
24.8
25.2
50.0
28.4
22.5
49.1
Condoms encourage male
infidelity
20.5
21.5
57.9
26.1
25.9
48.0
FP/Child spacing methods
cause cancer or other
disease
15.4
22.0
62.6
14.9
23.9
61.2
FP/Child spacing methods
are only meant for married
people
34.1
23.0
43.0
29.6
29.6
40.8
20.0
17.5
62.4
27.3
21.1
51.7
18.2
29.8
52.1
20.9
31.1
48.0
Being sterilized for a man
is equal to being castrated
A woman is the one who
gets pregnant so she
should be the one to get
sterilized
11.4
Affordability and Accessibility of Family
Planning Methods
Tables 11.4 and 11.5 present findings on the affordability and
accessibility of modern family planning methods respectively. The
proportion of respondents that considered the various methods as
affordable was 50% for male condoms, 22% for oral contraceptive
128
pills, 19% for injectables, 16% for emergency contraceptive pills and
7% for IUD/coil. The proportion of respondents that considered
modern contraceptive pills as accessible ranged from 8% for IUD/coil
to 51% for male condoms. It was generally higher in urban than rural
areas.
Table 11.4: Affordability of Contraceptives
Percent Distribution of Respondents Opinion on the Affordability of
Family Planning Methods According to Selected Characteristics:
FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never
attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Daily
pills
After
sex/Emergency
contraceptive
pills
Injectables
Condom
IUD/Coi
Number
of
women
and men
24.3
19.5
15.8
15.8
20.3
18.3
39.8
58.0
8.1
6.0
5360
6161
16.8
31.1
11.5
24.1
15.6
26.0
41.5
64.7
4.5
11.7
7556
3965
29.3
25.4
15.9
12.1
24.7
23.4
22.4
15.2
7.4
10.0
21.7
20.0
23.8
24.1
14.6
12.4
21.8
19.4
54.4
39.8
21.0
58.3
69.2
69.1
8.8
4.6
3.1
7.9
10.0
9.1
2047
1536
2847
1294
1776
2021
9.5
4.4
8.0
17.0
1.4
2486
15.3
22.4
22.9
45.9
5.7
15.9
18.5
36.9
13.8
20.5
20.2
39.9
19.1
50.0
64.8
82.5
1.7
7.2
7.6
19.7
1025
2233
4519
1258
11.1
22.4
26.8
29.2
23.0
15.6
21.8
8.0
16.0
20.5
20.2
16.6
13.6
15.8
8.9
19.2
23.4
25.2
21.2
18.0
19.2
40.4
55.6
56.4
54.5
44.0
41.8
49.5
129
2.8
5.5
8.2
9.6
9.3
7.5
7.0
2470
2163
1882
2456
1724
826
11521
Table 11.5: Accessibility of Contraceptives
Percent Distribution of Respondents Opinion on the Accessibility of
Family Planning Methods according to Selected Characteristics:
FMOH, Nigeria 2007
Characteristic
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never
attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
11.5
Daily
pills
are
easy
to
obtain
After
sex/Emergency
contraceptive
pills
Injectables
Condom
IUD/Coil
Number
of
women
and
men
26.5
20.9
18.0
17.1
22.4
20.6
41.9
59.0
10.2
6.4
5360
6161
18.4
33.3
12.9
26.3
17.7
28.6
42.9
66.7
5.5
13.2
7556
3965
32.6
28.1
16.0
12.8
25.7
26.4
24.8
17.6
8.0
11.6
23.1
22.3
28.4
25.1
15.4
13.8
23.9
22.9
56.7
41.3
21.5
59.4
71.2
71.5
10.3
5.5
3.6
8.7
10.5
12.3
2047
1536
2847
1294
1776
2021
10.6
4.8
9.4
17.9
1.9
2486
16.1
24.3
25.0
48.5
6.9
17.0
20.8
40.4
14.7
23.1
23.1
41.7
19.9
51.9
66.7
84.6
2.4
8.3
9.4
21.0
1025
2233
4519
1258
12.5
24.0
29.2
31.4
25.0
16.0
23.5
9.4
17.7
22.9
21.8
18.5
14.2
17.5
11.1
21.0
26.5
27.5
23.8
19.2
21.4
41.9
57.0
58.5
56.0
45.1
44.1
51.1
4.0
6.2
9.7
11.4
10.6
7.6
8.2
2470
2163
1882
2456
1724
826
11521
Current Use of Contraceptives
The percentage of females and males currently using any method of
family planning is presented in Tables 11.6 and 11.7. The percentage
of all female respondents that were currently using any modern
contraceptive method as at the time of the survey was 10% (Table
11.6), while that of all men was 16% (Table 11.7). Thirteen percent of
all females and 18% of all males were recorded to be using any
method of contraceptive/child spacing at the time of the survey. A
lower proportion of married females compared to the sexually active
130
unmarried individuals were using contraceptives. Nine percent of
currently married females compared to 31% of sexually active
unmarried females were using modern contraceptive methods.
Similarly, 13% of married males were using modern contraceptive
methods compared to 42% among their sexually active unmarried
counterparts.
131
Table 11.6: Current Use of Contraceptives by Females
Percent Distribution of Females Currently using any method of Contraceptives by Age: FMOH, Nigeria, 2007
ALL FEMALES
Age
Any
method
Modern
method
Pill
EC
Condom
Injectables
Implants
IUD
Jelly/
Foam
Fem.
Ster.
Any
Natural
Method
Rhy
thm
LAM
Withdrawal
Others
0.1
0.5
0.3
Not
currently
using any
method
93.9
86.1
80.6
15-19
20-24
25-29
6.1
13.9
19.4
4.7
10.7
15.2
2.2
1.1
2.1
0.3
0.5
0.6
3.9
8.8
9.3
0.3
0.4
3.0
0.0
0.0
0.0
0.0
0.0
0.1
0.0
0.0
0.0
0.0
0.0
0.0
1.6
3.0
4.4
0.7
1.6
2.1
0.2
0.4
0.9
0.8
1.1
1.4
30-39
40-49
15.9
12.6
10.7
8.1
2.6
0.9
0.3
0.2
4.2
2.2
1.9
2.3
0.5
0.0
1.0
2.2
0.0
0.0
0.2
0.2
5.1
4.6
2.9
3.0
0.9
0.2
Total
13.4
9.7
1.5
CURRENTLY MARRIED FEMALES
0.4
5.6
1.5
0.1
0.6
0.0
0.1
3.7
2.0
Age
Any
method
Modern
method
Pill
EC
Condom
Injectables
Implants
IUD
Jelly/
Foam
Fem.
Ster.
Any
Natural
Method
15-19
3.7
2.3
1.7
0.3
1.0
0.7
0.0
0.0
0.0
0.0
20-24
25-29
9.4
16.5
6.4
11.9
1.6
2.5
4.1
5.2
0.3
3.4
0.0
0.0
0.0
0.1
0.0
0.0
0.0
0.0
30-39
15.2
10.0
2.6
3.5
1.9
0.6
1.2
0.0
40-49
14.3
9.3
8.0
10.
9
12.
1
10.
8
1.2
2.3
2.8
0.0
2.5
Total
13.2
8.9
9.9
1.9
3.5
2.0
0.2
Number
of men
1190
1084
936
1.3
1.4
0.4
0.3
84.1
87.1
1287
863
0.5
1.2
0.3
86.6
5360
Rhy
thm
LAM
Withdrawal
Others
Not
currently
using any
method
Number
of men
1.7
0.3
0.7
0.7
0.0
96.3
301
2.7
4.7
1.4
2.4
0.5
1.1
0.8
1.1
0.5
0.3
81.6
84.5
628
708
0.1
5.2
3.0
0.8
1.4
0.4
84.8
1089
0.0
0.3
5.1
3.5
0.3
1.3
0.4
85.7
686
0.9
0.0
0.1
4.3
2.5
0.7
1.1
0.4
86.8
3412
Number
of men
566
SEXUALLY ACTIVE UNMARRIED MALES
Age
Any
method
Modern
method
Pill
EC
Condom
Injectables
Implants
IUD
Jelly/
Foam
Fem.
Ster.
Any
Natural
Method
Rhy
thm
LAM
Withdrawal
Others
15-19
20-24
25+
10.2
12.9
9.2
25.3
25.3
35.6
1.6
1.6
1.2
1.1
1.1
0.6
22.0
22.0
33.1
0.5
0.5
0.6
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
7.0
6.0
6.7
3.8
3.2
3.7
0.0
0.5
0.6
3.2
2.3
2.5
0.5
0.9
0.6
Not
currently
using
anymethod
89.8
87.1
90.8
Total
11.0
30.6
1.2
1.1
27.7
0.5
0.0
0.0
0.0
0.0
6.5
3.5
0.4
2.7
0.7
89.0
132
186
217
163
Table 11.7: Current Use of Contraceptives by Males
Percent Distribution of Males currently using any method of Contraceptives by Age: FMOH, Nigeria 2007
ALL MALES
Age
Any
method
Modern
method
Pill
EC
Condom
Injectables
Implants
IUD
Jelly/
Foam
Fem.
Ster.
Any
Natural
Method
Rhy
thm
LAM
Withdrawal
Others
Number
of men
0.0
0.1
0.1
Not
currently
using any
method
92.9
76.8
73.7
15-19
20-24
25-29
7.1
23.2
26.3
6.9
22.5
25.6
0.0
0.5
0.3
0.1
0.2
0.2
6.7
21.7
24.3
0.0
0.2
0.7
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.1
0.0
0.0
0.2
1.3
1.5
0.2
0.6
0.8
0.0
0.0
0.1
0.1
0.6
0.5
30-39
40-49
50-64
22.9
20.0
12.3
19.7
14.4
7.3
1.1
1.3
1.0
0.3
0.3
0.2
16.8
9.9
3.9
1.3
2.3
1.5
0.0
0.2
0.2
0.1
0.0
0.1
0.1
0.0
0.0
0.1
0.3
0.4
3.4
6.2
5.0
2.1
4.1
3.0
0.0
0.2
0.1
1.4
1.9
1.8
0.5
0.2
0.1
77.6
80.6
87.7
1169
861
826
Total
18.4
16.0
CURRENTLY MARRIED MALES
0.6
0.2
14.0
0.9
0.1
0.0
0.0
0.1
2.7
1.6
0.1
1.0
0.2
86.6
6161
Age
Any
method
Modern
method
Pill
EC
Condom
Injectables
Implants
IUD
Jelly/
Foam
Fem.
Ster.
Any
Natural
Method
Rhy
thm
LAM
Withdrawal
Others
Not
currently
using any
method
Number
of men
15-19
17.4
13.0
0.0
0.0
8.7
0.0
0.0
0.0
0.0
4.3
20-24
25-29
30-39
40-49
15.9
17.8
20.7
20.4
11.9
15.1
16.9
14.7
2.4
0.3
1.4
1.4
0.0
0.3
0.3
0.4
9.5
12.7
13.4
9.7
0.0
1.8
1.6
2.6
0.0
0.0
0.0
0.3
0.0
0.0
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.1
0.4
4.3
4.3
0.0
0.0
0.0
82.6
23
4.8
3.3
4.0
6.2
4.0
2.1
2.5
4.2
0.0
0.3
0.0
0.3
0.8
0.9
1.5
1.8
0.0
0.3
0.6
0.3
84.1
82.2
79.3
79.6
126
331
880
740
50+
Total
12.8
18.0
7.4
13.4
1.0
1.2
0.3
0.3
3.9
9.7
1.5
1.8
0.3
0.1
0.0
0.0
0.0
0.0
0.4
0.3
5.4
4.9
3.2
3.2
0.1
0.1
2.1
1.6
0.1
0.3
87.2
82.0
718
2818
Number
of men
1354
1280
1079
946
SEXUALLY ACTIVE UNMARRIED MALES
Age
Any
method
Modern
method
Pill
EC
Condom
Injectables
Implants
IUD
Jelly/
Foam
Fem.
Ster.
Any
Natural
Method
Rhy
thm
LAM
Withdrawal
Others
15-19
20-24
25+
7.1
11.7
11.2
33.2
43.9
43.0
0.0
0.4
0.5
0.0
0.4
0.0
33.2
42.9
41.8
0.0
0.2
0.3
0.0
0.0
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.8
1.6
1.5
0.4
0.4
0.5
0.0
0.0
0.0
0.4
1.2
1.0
0.0
0.2
0.2
Not
currently
using
anymethod
92.9
88.3
88.8
Total
10.6
41.5
0.4
0.1
40.6
0.2
0.1
0.0
0.0
0.0
1.4
0.4
0.0
1.0
0.1
89.4
133
253
503
598
Table 11.8: Characteristics of Current Use of Contraceptives by Females
Percent Distribution of Women Currently using any Method of Contraceptive according to selected Characteristics:
FMOH, Nigeria 2007.
Characteristics
Any
method
Any
modern
method
Daily
oral
pills
Emergency
contraceptive
Condoms
Injecta
bles
IUD/
Coil
Jelly/
foam
Female
sterilezation
Natural
method
Rhythm
LAM
Withdrawal
Other
Not
currently
using any
method
Number
women
13.4
30.0
6.3
9.7
20.0
3.1
0.4
0.0
0.0
0.4
0.0
0.0
5.6
20.0
0.0
1.4
0.0
0.0
0.7
0.0
3.1
0.0
0.0
0.0
0.0
0.0
0.0
3.7
10.0
3.1
2.0
10.0
0.0
0.5
0.0
3.1
1.2
0.0
0.0
0.3
0.0
0.0
86.6
70.0
93.8
4911
10
32
Number of living
children
0
1
2
3
9.6
7.7
0.0
0.0
7.7
0.0
0.0
0.0
0.0
1.9
0.0
0.0
1.9
0.0
90.4
52
4+
14.4
10.4
1.7
0.0
5.6
2.5
0.0
0.0
0.6
3.4
2.0
0.8
0.6
0.6
85.6
355
Location
Rural
11.0
7.1
1.2
0.3
3.9
1.3
0.3
0.0
0.1
3.8
2.1
0.6
1.2
0.4
89.0
3513
Urban
17.9
14.7
1.9
0.5
8.9
1.8
1.2
0.0
0.1
3.5
1.9
0.4
1.2
0.2
82.1
1847
Zone
North Central
17.1
11.9
1.9
0.0
0.6
0.9
0.3
0.0
0.3
5.5
3.1
0.8
1.6
0.3
82.9
942
North East
7.5
3.8
1.1
0.1
1.4
1.0
0.0
0.0
0.0
3.6
1.9
1.3
0.4
0.1
92.5
718
North West
3.4
2.7
0.8
0.7
6.2
2.3
0.3
0.0
0.1
0.5
0.2
0.2
0.2
0.3
96.6
1333
South East
15.8
9.5
0.2
0.5
9.7
2.1
0.6
0.0
0.0
6.6
4.4
0.2
2.0
0.0
84.2
639
South-South
24.7
16.5
1.7
0.2
8.1
0.0
1.1
0.0
0.0
7.4
3.3
1.0
3.1
1.0
75.3
811
South West
17.2
16.6
2.8
0.7
10.4
2.5
1.4
0.0
0.0
1.4
0.9
0.0
0.5
0.1
82.8
917
Never attended
School
4.7
2.2
0.4
0.1
0.7
0.7
0.0
0.2
0.1
2.5
1.0
0.7
0.7
0.4
95.3
1622
Qur’anic only
2.3
2.0
0.8
0.0
0.3
1.0
0.0
0.0
0.0
0.3
0.0
0.3
0.0
0.0
97.7
396
Education
Primary
15.7
10.5
2.5
0.4
4.0
2.5
0.1
1.0
0.0
5.2
2.9
0.6
1.7
0.3
84.3
1040
Secondary
17.5
13.2
1.7
0.5
8.6
1.5
0.2
0.6
0.1
4.4
2.6
0.4
1.4
0.3
82.5
1873
Higher
33.6
28.4
2.3
1.4
19.6
2.6
0.5
1.9
0.2
5.1
3.0
0.2
1.9
0.5
66.4
429
Total
13.4
9.7
1.5
0.4
5.6
1.5
0.1
0.6
0.1
3.7
2.0
0.5
1.2
0.3
86.6
5360
134
of
As Table 11.8 shows, the practice of contraceptive methods varied
considerably by background characteristics of the respondents. The use
of any contraceptive method and modern methods increased with
educational level. Twenty eight per cent of women with higher education
compared to 2% of women with no education used modern contraceptive
methods. A lesser proportion of women in the north (North West 3%;
North East 4%; North Central 12%) used a modern method compared to
their counterparts in the south (South West 17%; South South 17%;
South East 10%). Use of any method of contraceptive was also
influenced by location of residence. Eighteen percent of women in urban
areas reported using a modern method of contraception at the time of the
survey compared with 11% of women living in the rural areas.
11.6
Intention to Use Family Planning
As Table 11.9 shows, 17% of respondents who were not current users of
family planning indicated that they intend to use a modern method of
family planning in the next 12 months. The proportion of non-users of
contraceptives that indicated intention to use modern contraceptives was
20% among the males and 13% among the females. The proportion of
respondents with intention to use family planning among those living in
the urban area was 22% compared to 14% of people living in rural areas.
A higher proportion of non-contraceptive users in the southern zones
compared to those in the northern zones signified intention to use modern
method of contraceptives in the next 12 months following the survey. An
increase in intention to use modern family planning within the next 12
months was observed with increased educational level.
135
Table 11.9: Intention to Use Family Planning
Percent Distribution of Respondents Intending to use Family Planning
Method among Non-users in the Next 12 Months According to Selected
Characteristics: FMOH, Nigeria 2007.
Characteristics
11.7
Intends to use
modern method in
next 12 months
Non-users of
modern FP
methods
13.4
19.8
4643
4942
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended School
Qur’anic only
Primary
Secondary
Higher
Age group
14.1
21.9
6490
3095
21.8
8.2
6.5
18.0
26.6
23.5
1600
1410
2663
1061
1304
1547
3.8
6.0
15.1
22.5
33.9
2392
963
1795
3332
832
15-19
20-24
25-29
30-39
40-49
50-64
Total
10.1
22.6
25.0
18.4
10.7
3.5
16.8
2220
1674
1411
2005
1516
759
9585
Decision-making about Family Planning
Respondents’ opinions as to who should take decisions to use family
planning among couples are presented in Table 11.10. Almost half of the
respondents (44%) indicated that decisions about use of family planning
methods should be jointly undertaken by the couple, while a fifth (20%)
expressed the opinion that the husband should take the decision alone
and 5% indicated that it should be the wife’s decision alone. The pattern
was generally true for all sub-groups of respondents with respect to sex,
location, and education. Among the zones, the proportion of respondents
who indicated that FP decisions should be jointly made by couples
ranged from 28% in the North West to 57% in the South East zones. In all
zones, the most common opinion was that of joint decision making on FP
among couples.
136
Table 11.10: Decision making about Family Planning
Percent Distribution of Respondent’s Opinion on Who Should Take
Decision to Use Family Planning among Couples According to Selected
Characteristics: FMOH, Nigeria 2007
Characteristic
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
School
Qur’anic only
Primary
Secondary
Higher
Age group
Wife
Husband
Both
Either
Neither
of them
Total
6.7
3.2
17.1
22.7
45.2
42.5
7.1
7.1
3.4
3.8
5360
6161
4.2
5.9
20.5
19.3
39.8
51.1
6.9
7.4
4.2
2.5
7556
3965
5.8
2.0
3.1
3.1
6.4
8.1
27.5
18.9
24.9
10.6
14.8
17.5
43.2
37.8
28.0
57.3
56.4
51.1
4.4
3.6
6.8
11.0
7.1
10.4
3.6
4.9
5.0
1.9
4.4
0.9
2047
1536
2847
1294
1776
2021
3.3
23.0
26.8
5.9
5.0
2486
2.4
6.4
5.4
4.5
23.7
21.8
17.7
16.8
27.6
45.3
50.6
62.6
6.1
6.7
7.8
8.4
5.9
3.4
2.8
2.1
1025
2233
4519
1258
15-19
4.1
17.5
38.7
6.9
3.2
2470
20-24
5.1
19.2
46.7
7.2
3.4
2163
25-29
6.2
21.2
46.8
6.7
3.1
1882
30-39
5.3
22.5
44.7
6.8
3.7
2456
40-49
4.1
19.5
43.7
8.1
4.0
1724
50-64
2.7
21.5
41.0
7.1
5.1
826
Total
4.8
20.1
43.7
7.1
3.6
11521
Note: The value for each row is less than 100% as there are other options (outside the six
categories listed above) that are not reflected in the table.
11.8
Desired Family Size
Table 11.11 shows the result of the ideal family size desired by
respondents. A higher proportion of the respondents desired to have five
or more children (35%) compared to those that desired maximum of four
children (24%). However, 34% of the respondents expressed the opinion
that the number of children they would want to have was “up to God”. The
latter opinion was more common among rural dwellers (37%) than among
urban dwellers (27%) and more common among females (37%) than
males (30%). Among the zones, the proportion of the respondents that
specified a maximum of four as the ideal number of children desired was
lowest in South South (18%) and South East (20%), whereas the
proportion was highest in the North East and South West (29%).
137
Table 11.11: Desired Family Size
Percent Distribution of Respondents Desired Family Size According to
Selected Characteristics; FMOH, Nigeria 2007.
Characteristics
0-4 children
Sex
Male
22.4
Female
26.4
Location
Rural
22.3
Urban
28.0
Zone
North Central
24.3
North East
28.7
North West
24.4
South East
20.0
South-South
17.8
South West
29.1
Education
Never attended school
28.6
Qur’naic only
25.4
Primary
25.3
Secondary
21.6
Higher
22.8
Age group
15-19
18.0
20.24
19.9
25-29
25.9
30-39
29.4
40-49
25.7
50-64
32.7
Total
24.3
Note: No response – 7.4%
11.9
5 or more
children
“Up
God”
to
Total
38.4
30.4
30.3
37.4
6161
5360
33.0
37.9
37.0
27.0
7556
3965
34.5
33.0
36.0
33.5
32.9
36.5
30.5
31.1
34.1
38.9
41.4
27.8
2047
1536
2847
1294
1776
2021
33.2
35.0
32.5
35.5
38.2
32.3
32.8
34.4
35.2
29.5
2486
1025
2233
4519
1258
36.6
36.1
32.7
32.2
34.5
37.4
34.7
37.3
36.3
33.8
31.5
32.9
22.5
33.6
2470
2163
1882
2456
1724
826
11521
Sex Preference
Table 11.12 shows that, about a third of respondents (28%) preferred
more male than female children while 27% preferred equal numbers of
males and females, 33% had no particular preference. Only 7% of the
respondents indicated preference for more female children. Among
female respondents, the opinion that was most common was ‘no
particular preference’ (36%), whereas among male respondents an equal
proportion (30%) indicated preference for boys and “no particular
preference”. No particular preference for sex was the most common
opinion for North West, South East and South South zones which were
35%, 36% and 37% respectively. Only the North Central had a marginally
higher preference for boys (29%).
138
Table 11.12: Sex Preference
Percent Distribution of Respondents’ Sex Preference According to
Selected Characteristics: FMOH, Nigeria 2007
Characteristics
More
boys
Sex
Female
25.2
Male
29.6
Location
Rural
26.2
Urban
30.3
Zone
North Central
28.5
North East
26.2
North West
28.2
South East
27.6
South-South
24.3
South West
29.6
Education
Never attended school
27.8
Qur’anic only
26.9
Primary
25.3
Secondary
27.9
Higher
30.6
Age group
15-19
27.3
20.24
27.6
25-29
28.8
30-39
27.6
40-49
25.7
50-64
29.3
Total
27.6
Note: No response – 5.7%
More
girls
Equal
numbers
No
particular
preference
Total
7.3
7.0
27.5
26.7
35.7
29.7
5360
6161
6.7
7.9
26.2
28.8
34.6
28.4
7556
3965
7.4
6.6
7.3
8.0
6.6
7.0
27.2
31.2
25.9
23.9
25.4
29.2
27.6
30.9
35.1
35.5
36.6
29.5
2047
1536
2847
1294
1776
2021
7.0
7.2
7.1
7.4
6.5
29.1
26.1
28.2
25.9
26.6
31.3
35.2
34.0
32.5
30.0
2486
1025
2233
4519
1258
7.7
7.3
5.9
7.2
7.0
8.2
7.1
24.6
25.1
25.6
29.5
30.0
30.3
27.1
34.0
34.2
34.3
30.0
32.1
27.7
32.5
2470
2163
1882
2456
1724
826
11521
11.10 Infertility
Respondents were asked to indicate whether they think the problem of
infertility was that of females or males only or that of both males and
females. The responses obtained are presented in Table 11.13.
Approximately three fifth of the respondents (62%) were of the opinion
that infertility could be the problem of either the male or the female.
Majority of both male (62%) and female (63%) respondents were of the
opinion that infertility could be the problem of either the man or woman. A
similar opinion was also reflected across the zones, urban/rural locations,
educational level and age groups.
139
Chart 11.2: Child Sex Preference by Respondents’ Sex: FMOH, Nigeria, 2007
Female
Male
40
35.7
35
29.7
29.6
30
27.5
26.7
25.2
P e rc e n ta g e
25
20
15
10
7.3
7
5
0
More boys
More girls
Equal numbers
140
No particular preference
Table 11.13: Infertility
Percent Distribution of Respondents’ Opinion on which of the Partner has
the Problem in Cases of Infertility According to Selected Characteristics:
FMOH, Nigeria 2007
Characteristics
Problem
is
female
only
Problem
is male
only
Problem
of either
male
and
female
Other
ONLY
God
knows
Go for
necessary
check up
Either
man or
women
Don’t
know
Number
of
women
and
men
Sex
Female
6.8
3.3
63.1
0.6
0.9
0.1
0.3
23.5
5360
Male
6.1
4.3
61.9
1.0
1.0
0.1
0.3
20.1
6161
Location
Rural
6.1
3.8
61.2
0.8
0.7
0.1
0.3
23.0
7556
Urban
7.0
3.9
64.8
0.7
1.5
0.0
0.2
19.1
3965
Zone
North Central
5.9
3.1
60.4
0.4
2.0
0.1
0.2
20.8
2047
North East
8.3
4.0
62.1
1.0
1.0
0.0
0.7
19.1
1536
North West
6.9
4.1
65.4
0.6
0.4
0.0
0.0
20.4
2847
South East
6.6
4.3
59.9
0.9
1.2
0.1
0.5
23.1
1294
South-South
6.1
3.8
56.3
1.5
0.7
0.1
0.3
28.2
1776
South West
5.2
3.8
67.5
0.5
0.8
0.0
0.5
23.1
2021
Education
Never
attended
school
Qur’anic only
6.6
3.7
64.5
0.6
1.0
0.1
0.2
20.8
2486
7.6
3.0
66.6
0.5
0.8
0.0
0.2
19.2
1025
Primary
6.6
3.9
61.5
0.8
0.7
0.1
.0.2
23.0
2233
Secondary
Higher
6.4
5.2
4.2
3.4
60.9
61.9
0.9
1.0
1.0
1.4
0.0
0.0
0.4
0.3
21.7
22.5
4519
1258
15-19
6.0
4.5
60.9
1.0
0.8
0.1
0.4
21.3
2470
20.24
25-29
6.9
6.3
3.5
4.1
61.1
60.3
0.9
0.9
1.0
1.0
0.0
0.1
0.3
0.3
22.1
23.2
2163
1882
30-39
6.4
3.5
64.6
0.7
1.0
0.0
0.1
21.0
2456
40-49
7.0
3.2
63.2
0.4
1.3
0.1
0.3
22.6
1724
50-64
6.2
4.6
67.4
0.6
1.0
0.0
0.4
17.9
826
Total
6.4
3.8
62.4
0.8
1.0
0.1
0.3
21.6
11521
Age group
Note: No response – 3.6%
11.11 Discussion and Conclusions
There was a high awareness of contraceptive methods among all
categories of respondents. Among the modern contraceptives, male
condoms were considered to be the most affordable and accessible by
the respondents. This may indicate the effectiveness of the social
marketing of male condoms. However, despite the high level of
contraceptive awareness, less than a fifth of male and female
141
respondents were using any modern method of contraception. The
proportion of contraceptive users was highest among sexually active
unmarried females and males. Less than a fifth of current non-users of
contraceptives indicated intention to use modern contraceptive methods
within the next 12 months after the survey, and the proportion with such
intention was higher among males than the females. Almost half of all the
respondents expressed the opinion that couples should jointly take the
decision regarding the use of family planning methods.
With over a third of respondents desiring more than four children,
Nigerians still have a major challenge in the area of fertility management
and family planning utilisation. Desire for a large family size, with
minimum of five children, was more among males than females. About a
third of respondents indicated that the number of children they desired
was “up to God”. The majority of respondents were of the opinion that
infertility was a problem of both sexes. This finding indicates a reduction
in the stigma and social costs of infertility on the woman in the Nigerian
society.
142
SECTION 12
12.0
Gender Violence, Female Circumcision, Sexual
Rights, Reproductive Cancers and Tuberculosis
The Programme of Action adopted at the International Conference on
Population and Development (ICPD) recognises the elimination of
harmful practices as an element of the reproductive health package.
Common
harmful
practices
in
Nigeria
include
female
circumcision/female genital mutilation (FGM) and domestic and sexual
violence. These harmful practices constitute a violation of the sexual
and reproductive rights of individuals. As defined at the ICPD, the
elements of RH also include the management of non-infectious
conditions of the reproductive system such as genital fistulae, cancers
of the reproductive system, and complications of female genital
mutilation. Sexual rights of the woman, FGM, domestic violence,
cancer of the reproductive system and tuberculosis are the key issues
covered in this section. Tuberculosis (TB) is a major public health
problem in Nigeria. It is the leading cause of morbidity and mortality
among people infected with HIV and HIV infection is the most potent
risk factor for a latent TB infection to convert to active TB. There is a
dual epidemic of HIV/AIDS and TB.
12.1
Gender Violence
Domestic violence is an act of gender-based violence with severe
negative physical, psycho-social impact on the health and
development of women as well as the family. Respondents were
asked whether, in their opinion, wife beating was justified. Responses
presented in Table 12.1 show that under all listed circumstances,
higher proportions of females than males justified wife beating. For
example, 25% of females compared with 21% of males were of the
opinion that a husband was justified in beating his wife if she refuses
to have sex with him. Twenty-three percent of women compared to
21% of men justified wife beating if the woman argues with the
husband while 17% of women as against 16% of men justified the
beating if food was not ready on time. A higher proportion of
respondents with lower level of education compared to those with
higher level, and higher proportion in rural areas than those in urban
areas justified wife beating under various circumstances. Among the
zones, the South East and North East had the least proportion of
respondents that justified wife beating. Overall, 33% of respondents
justified wife beating if the husband felt the wife was unfaithful, 29%
justified the beating in circumstances that the woman neglected the
children, 24% justified the beating if the wife went out without telling
the husband and 23% justified beating if she refused to have sex with
him.
143
Table 12.1: Gender Violence
Percent Distribution of Respondents that Justified Wife Beating by
Specific Reasons According to Selected Characteristics; FMOH,
Nigeria 2007
Characteristics
If she
goes
out
without
telling
him
If she
neglects
the
children
If he
feels
she is
unfaithful
If food
is not
ready
on time
If she
argues
with
him
If she
refuses
sex
with
him
Number of
women
and
men
Sex
Female
25.9
29.5
37.7
16.8
22.8
25.3
5360
Male
21.8
24.0
29.0
15.6
21.1
21.2
6161
Location
Rural
25.1
27.0
33.9
17.1
23.9
24.8
7556
Urban
21.2
25.7
31.6
14.4
18.3
20.1
3965
Zone
North Central
27.3
33.2
42.3
19.3
27.9
27.6
2047
North East
15.6
16.9
24.5
9.8
18.8
22.1
1536
North West
31.4
30.1
37.8
20.8
28.5
32.3
2847
South East
16.0
20.1
25.1
12.5
13.9
12.3
1294
South-South
22.0
25.4
34.1
14.1
16.7
18.0
1776
South West
22.3
28.2
29.9
15.8
19.5
18.8
2021
Education
None
31.5
31.8
40.8
20.7
28.5
32.9
2486
Qur’anic
27.3
25.9
34.4
18.6
29.5
32.1
1025
Primary
26.3
29.0
34.8
17.3
22.7
23.5
2233
Secondary
20.2
25.2
30.9
14.4
18.5
18.5
4519
Higher
14.1
17.9
22.4
9.8
13.8
13.7
1258
22.6
25.0
31.7
15.1
20.7
20.5
2470
Age group
15-19
20.24
24.4
26.6
33.4
15.8
23.0
23.3
2163
25-29
24.9
27.1
34.3
16.5
21.7
25.2
1882
30-39
24.5
27.4
34.8
16.2
22.2
23.5
2456
40-49
23.3
28.7
33.7
18.1
22.7
25.3
1724
50-64
20.7
22.9
26.7
15.1
19.6
19.8
826
Total
23.7
26.5
33.1
16.1
21.9
23.1
11521
12.2
Female Circumcision
Female circumcision is an act of violation of the sexual and
reproductive rights of women and has both short- and long-term
serious health effects. Findings regarding respondents’ awareness of
female circumcision and their attitudes towards it are presented in
Tables 12.2 and Table 12.3 respectively. About half of the
respondents were aware of female circumcision, and 23% indicated
that they knew a relative or a person close to them who had been
circumcised. Awareness of female circumcision varied across zones
from 29% in the North West to 72% in the South East. Urban dwellers
and male respondents had a higher level of awareness of female
circumcision than respondents living in rural areas, and the females.
144
Table 12.2: Awareness of Female Circumcision
Percent Distribution of Respondents Awareness about Female
Circumcision According to Selected Characteristics; FMOH, Nigeria
2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20.24
25-29
30-39
40-49
50-64
Total
12.3
Awareness of
Female
Circumcision
Knowledge of
someone
Close who have had
Female
Circumcision
Number of men
and women
49.0
52.2
23.7
21.1
5360
6161
44.6
61.3
19.9
26.4
7556
3965
42.4
42.7
29.1
72.1
64.7
66.7
13.0
6.5
7.3
35.4
34.7
41.2
2047
1536
2847
1294
1776
2021
33.9
14.7
2486
33.1
55.7
53.8
76.1
8.1
28.9
23.8
30.4
1025
2233
4519
1258
31.9
45.0
52.6
58.3
63.4
68.9
50.7
12.2
17.9
23.4
25.8
31.8
31.2
22.6
2470
2163
1882
2456
1724
826
11521
Perspectives about Female Circumcision
As shown in Table 12.3, only a third of the respondents (33%) who
were aware of FGM felt that female circumcision was a health
problem. Fifty-five percent of respondents that were aware of FGM
were of the opinion that female circumcision should be discontinued.
The Northern zones had the highest proportion of respondents who
desired to have female circumcision discontinued. Respondents with
higher education had the highest proportion of those who view female
circumcision as a health problem and also had the highest proportion
of respondents who desired to have female circumcision discontinued.
145
Table 12.3: Perspectives about Female Circumcision
Percent Distribution of Respondents’ Views on Female Circumcision
According to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Proportion of
respondents who
view female
circumcision as a
health problem
Proportion of
respondents who
believe that
female
circumcision
should be
discontinued
Number that have
heard of female
circumcision
30.4
34.2
56.1
54.5
3573
2209
31.7
33.6
54.0
56.7
4023
1759
39.1
40.4
35.7
33.2
36.2
21.6
63.9
68.2
60.8
51.7
57.0
43.8
1180
874
1341
653
751
983
25.0
47.8
1499
32.7
28.0
32.0
45.9
57.9
52.1
54.1
67.6
522
1097
2115
549
26.3
33.4
33.8
35.5
32.0
31.0
32.5
52.2
56.0
54.2
57.3
55.9
53.2
55.2
1235
1052
940
1327
944
284
5782
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20.24
25-29
30-39
40-49
50-64
Total
12.4
Sexual Rights
Respondents were asked whether a wife was justified to refuse sexual
intercourse with her husband under certain circumstances. The results
are presented in Table 12.4. The most common reasons given for
such refusal were recent childbirth (73%) and wife’s knowledge that
the husband has sexually transmitted infection (69%). About half of
respondents expressed support for the wife to refuse sex with the
husband on the basis that the wife knew that the man has been
engaging in sex with other women (55%) or that the wife is tired and
not in the mood for sex (54%). People living in the urban areas had a
higher proportion of respondents supporting wife’s refusal to have sex
with the husband under the mentioned circumstances. A higher
proportion of respondents with higher educational attainment
supported the reasons for the wife’s sexual refusal.
146
Table 12.4: Sexual Rights
Percent Distribution of Respondents that gave Reasons for Justifying
Refusal of Sexual Intercourse with Husband According to Selected
Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20.24
25-29
30-39
40-49
50-64
Total
12.5
Wife is
tired and
not in
mood
Wife has
recently
given birth
Wife knows
her
husband
has sex
with other
women
Wife knows
he has a
STIs
Number of
women and
men
50.3
58.0
69.0
76.1
53.3
56.8
64.8
72.3
5360
6161
53.4
56.2
72.6
73.2
53.1
58.8
65.9
73.8
7556
3965
56.1
46.6
44.4
60.7
55.1
66.7
79.7
69.9
72.3
67.2
66.2
78.6
55.9
56.2
53.4
54.2
46.5
63.0
74.7
67.1
64.4
67.1
61.0
77.7
2047
1536
2847
1294
1776
2021
46.5
67.4
47.6
58.1
2486
44.3
57.3
58.2
58.5
72.2
75.7
73.5
76.0
54.2
57.6
57.3
58.1
63.5
73.9
70.9
76.4
1025
2233
4519
1258
49.3
54.1
55.2
54.7
57.6
61.2
54.4
65.2
73.2
74.1
75.1
76.4
77.7
72.8
50.9
54.2
56.5
57.9
56.9
55.9
55.2
61.1
68.8
69.9
72.3
71.3
73.8
68.8
2470
2163
1882
2456
1724
826
11521
Cancer of the Reproductive Tract
Table 12.5 shows the level of awareness of selected cancers of the
reproductive tract. Awareness of cancer of the breast (59%) was
higher than awareness of cancer of the womb (21%) and cancer of
male reproductive organs (17%). A higher proportion of females
compared to males reported awareness of cancer of the breast (60%
of females; 58% of males); A higher proportion of females compared
to females reported awareness of cancer of the womb (23% of males;
19% of females) and cancers of male reproductive organs (21% of
males; 12% of females). Higher level of awareness was generally
associated with living in urban areas and higher education.
147
Table 12.5: Cancer of the Reproductive Tract
Percent Distribution of Respondents’ Awareness on Selected Cancer
of the Reproductive Tract According to Selected Characteristics;
FMOH, Nigeria 2007
Characteristics
Cancer of
the breast
Cancer of
the womb
Cancer
affecting
reproductive
organs
Number of
women and
men
60.1
57.7
19.3
23.1
12.1
20.6
5360
6161
50.1
74.2
16.6
29.6
13.1
22.8
7556
3965
60.0
48.4
44.9
83.2
72.6
58.8
19.0
16.1
14.7
36.3
27.3
22.1
15.4
9.5
11.9
24.0
24.3
18.4
2047
1536
2847
1294
1776
2021
37.9
8.4
5.7
2486
42.2
58.4
14.3
20.5
11.6
15.0
1025
2233
65.2
88.7
23.1
46.0
18.7
36.9
4519
1258
43.9
60.3
61.5
64.7
66.0
61.2
58.8
11.2
19.8
22.4
25.1
27.7
28.4
21.3
9.2
15.2
17.2
18.8
21.0
26.0
16.6
2470
2163
1882
2456
1724
826
11521
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20.24
25-29
30-39
40-49
50-64
Total
12.6
Cancer Detection
As Table 12.6 shows, although half of the respondents (52%) knew of
self breast examination, knowledge about other procedures for
detecting cancers was generally low. Only 32% knew about blood test,
29% knew about examination of male reproductive organs, 5% knew
of mammography and 9% knew of Pap smear. There was no clear cut
location, education, urban-rural differentials, age or zonal variations.
More female than male respondents knew about self breast
examination and Pap smear; while more male than female
respondents knew about the procedures for detecting male related
cancers and mammogram.
148
Table 12.6: Cancer Detection
Percent Distribution of Respondents’ Knowledge on Procedures for
Detecting Cancer According to Selected Characteristics; FMOH,
Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never
attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20.24
25-29
30-39
40-49
50-64
Total
12.7
Self breast
examination
Pap
smear
Examination
of the male
organ
Blood
test
Mammogram
Number
of
women
and
men
aware
of any
of the
five
4221
1847
2347
6636
53.8
50.3
2362
11.1
7.2
1843
21.8
32.5
1843
23.8
36.0
6636
4.3
5.4
50.1
54.2
9.1
9.1
30.2
27.5
34.2
29.6
4.4
5.4
2485
1736
49.8
54.3
51.5
51.6
52.7
52.4
18.2
8.8
7.8
6.7
8.7
7.3
30.3
36.7
32.8
31.7
24.1
24.5
33.9
27.9
30.8
33.6
38.3
26.0
8.4
2.4
6.6
9.1
1.5
1.8
684
648
1044
486
596
763
50.1
10.1
24.8
22.7
2.8
848
46.1
49.9
51.9
58.1
4.1
8.5
8.6
11.5
23.9
26.3
29.1
32.5
22.0
29.6
34.5
33.9
3.5
4.5
4.5
8.6
390
815
1640
528
45.7
52.7
53.6
55.4
51.2
50.6
51.9
8.7
8.6
10.9
9.8
8.5
6.1
9.1
24.7
31.2
29.3
28.6
28.1
30.8
28.9
30.4
31.5
28.5
33.1
31.7
37.5
31.9
3.6
5.2
5.1
4.7
5.2
6.3
4.9
824
799
734
892
629
343
4221
Vesico-Vagina Fistula
Vesico-vaginal fistula (VVF) is a major reproductive health and rights
challenge in Nigeria. Respondents were asked about their awareness
of the condition, the perceived causes and treatment possibilities. The
results are presented in Table 12.7, Table 12.8 and Table 12.9
respectively.
As Table 12.7 shows, only 28% had heard about VVF. Awareness of
VVF was generally higher in the North than the South. Awareness of
149
VVF was higher among females than males and similar in urban and
rural areas. In terms of education, respondents with only Qur’anic
education (56%) had the highest level of awareness of VVF.
About a fifth (21%) of respondents who were aware of VVF indicated
that they knew any woman with the condition. A higher proportion of
respondents in rural areas (23%) than urban areas (19%) had
knowledge of VVF victims. Nationally, the proportion of all
respondents that knew any woman with VVF was 21% (Chart 12.2).
Among respondents with awareness of VVF (Table 12.8), early
marriage was the condition identified by the majority (62%) as being
responsible for VVF, followed by prolonged labour (32%) and large
sized babies (27%). Some of the respondents, however, regarded
spiritual forces/witchcraft (2%) and punishment from God (4%) as the
causes of VVF. Almost three quarters (70%) of these respondents
believed that VVF can be treated. Fifty -eight percent of them believed
that the condition can be treated in the general hospital while 33%
indicated that VVF can be treated in VVF centres.
With regards to prevention, Table 12.9 shows that 72% of
respondents with awareness of the condition believed that VVF can be
prevented. Respondents expressed the opinion that avoidance of
early marriage (53%) and avoidance of early childbirth (64%) are
preventive measures. Twenty percent of respondents believed that
avoiding prolonged labour can prevent VVF; 14% believed that VVF
can be prevented by praying hard to God and 3% were of the opinion
that VVF can be avoided through avoidance of certain foods in
pregnancy.
150
Table 12.7: Knowledge of Vesico-vaginal fistula
Percent Distribution of all Respondents who have ever heard of VVF
and know any woman with VVF According to Selected Characteristics;
FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20.24
25-29
30-39
40-49
50-64
Total
Awareness
of VVF
All
respondents
Percentage
who know a
woman with
VVF
Number
aware of
VVF
31.7
25.6
5360
6161
22.2
20.7
1699
1577
28.6
28.1
7556
3965
23.1
18.6
2161
1115
27.0
51.1
57.2
9.8
9.0
3.4
2047
1536
2847
1294
1776
2021
17.5
20.5
23.4
19.2
17.5
24.7
553
785
1628
127
160
67
34.6
2486
21.3
860
56.2
25.7
17.5
39.1
1025
2233
4519
1258
22.1
24.0
21.1
18.6
576
574
791
492
18.2
28.3
32.4
31.6
32.6
32.8
28.4
2470
2163
1882
2456
1724
826
11521
20.7
17.6
23.5
23.6
20.8
22.0
21.4
450
612
610
776
562
271
3276
151
Table 12.8: Causes and Treatment of VVF
Percent Distribution of Respondents who knew perceived Causes and Possible Treatment for VVF According to
Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Women in
labour too
long
Baby
too big
38.3
25.9
28.2
25.6
Early
marriage
60.9
63.5
Female
genital
cutting
12.6
10.1
Spiritual
forces/
witchcratf
1.8
1.8
Punishm
ent from
God
Condition
can be
treated
General
hospital
VVF
centre
Faith
based
spiritualists
Herbalists
Total
1.5
6.0
63.5
77.3
49.1
67.1
31.9
34.7
2.2
2.0
2.6
4.8
1699
1577
Location
Rural
33.1
28.6
58.4
11.0
2.1
3.8
67.9
56.5
27.5
2.0
3.8
2161
Urban
30.8
23.8
68.9
12.0
1.1
3.3
74.2
60.0
43.5
2.3
3.4
1115
Zone
North Central
22.5
22.5
57.5
8.5
1.1
0.9
65.5
54.5
22.1
2.9
5.2
2161
North East
30.2
24.2
70.5
7.5
1.3
1.9
77.9
66.4
39.0
0.5
2.9
1115
North West
37.4
29.4
63.7
13.2
1.1
5.4
70.0
56.9
34.4
2.4
3.4
553
South East
25.6
18.4
56.0
16.8
4.8
4.8
56.0
46.4
26.2
5.6
5.6
785
South-South
27.3
35.3
38.3
15.7
11.8
2.0
58.2
39.9
30.7
2.6
3.9
1628
South West
21.0
24.7
30.5
12.2
1.2
2.5
66.7
62.2
30.5
1.2
2.4
127
Education
Never attended School
40.9
30.5
59.0
13.5
2.1
2.5
56.3
44.1
25.1
2.6
4.1
860
Qur’anic only
37.6
24.9
57.5
10.7
1.1
6.3
73.6
59.6
34.2
1.1
2.5
576
Primary
29.4
28.4
58.0
10.3
2.1
5.7
73.9
62.4
28.9
2.1
4.5
574
Secondary
22.9
22.9
65.0
8.9
1.8
2.9
74.1
63.8
34.1
2.3
4.8
791
Higher
30.3
28.3
73.3
14.1
1.8
1.2
78.4
63.1
49.5
2.2
1.6
492
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
26.7
29.5
32.5
36.7
34.8
29.2
32.3
22.5
25.1
28.1
30.2
25.3
29.5
27.1
56.8
63.1
62.2
65.9
61.7
59.1
62.1
5.8
10.3
12.0
12.8
14.6
11.0
11.7
1.1
1.3
1.6
1.6
3.8
0.8
1.8
2.9
3.2
2.6
2.9
4.5
8.7
3.6
66.8
68.2
71.7
72.1
69.0
74.2
70.2
55.7
55.3
57.6
59.4
57.0
64.4
57.8
27.2
33\3
33.7
36.6
34.6
29.8
33.2
2.4
1.8
2.3
1.7
2.5
1.5
2.1
5.1
3.0
4.3
2.6
4.2
3.0
3.6
450
612
610
776
562
271
3276
152
Table 12.9: Prevention of VVF
Percent Distribution of Respondents on prevention of VVF According
to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20.24
25-29
30-39
40-49
50-64
Total
12.8
Believe
can be
prevented
Avoiding
early
childbirth
Avoiding
early
marriage
Avoiding
prolonge
d labour
Avoiding
certain
foods in
pregnancy
Pray
hard
to
God
Number
of
women
and
men
69.5
74.3
43.3
49.1
48.9
56.5
22.9
16.5
3.5
2.8
13.8
14.4
1699
1577
68.7
79.4
79.4
60.5
61.7
58.0
47.0
52.7
45.2
34.7
37.0
29.6
46.1
61.2
55.4
33.9
26.6
25.6
13.7
19.2
23.0
12.0
15.7
14.8
4.3
2.4
2.1
4.8
13.1
4.9
7.6
10.2
18.6
12.9
11.1
4.9
553
785
1628
127
160
67
61.1
37.4
43.2
23.3
2.5
13.6
860
71.5
72.6
74.7
84.3
42.9
44.3
50.6
59.1
52.5
49.1
55.5
67.5
18.8
19.9
16.2
21.4
1.8
2.8
3.3
6.5
17.6
15.2
13.0
11.6
576
574
791
492
66.6
70.4
73.4
75.5
71.9
69.4
71.6
37.6
44.5
46.6
52.6
46.1
44.2
46.1
50.3
51.7
50.7
56.3
52.5
52.7
52.6
13.6
17.8
21.4
23.6
19.7
20.8
19.8
2.9
2.5
4.6
3.0
3.2
2.3
3.2
12.2
13.7
15.1
13.4
15.7
15.2
14.1
450
612
610
776
562
271
3726
Awareness of Tuberculosis
Respondents were asked whether they had ever heard of TB. Table
12.10 shows the proportion of respondents who had heard of
tuberculosis. Seventy-two percent of respondents had heard about
tuberculosis. Awareness was higher among the males (78%), urban
dwellers (82%), respondents with higher education (93%) and
respondents in the 50-64 age-groups (84%) than among females
(66%), rural dwellers (67%), those with lower or no education and
younger age-groups.
153
Table 12.10: Awareness of Tuberculosis
Percent Distribution of Respondents who have Ever Heard of TB
According to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
12.9
Respondents who
have heard of TB
Number of
women and
men
66.1
77.7
5360
6161
66.9
81.8
7556
3965
73.6
80.1
63.6
86.6
77.4
85.7
2047
1536
2847
1294
1776
2021
54.1
65.0
75.0
76.3
93.3
2486
1025
2233
4519
1258
60.3
71.9
74.2
75.8
77.6
84.4
72.3
2470
2163
1882
2456
1724
826
11521
Knowledge of Routes of TB Transmission
Table 12.11 shows the level of respondents’ knowledge about routes
of TB transmission. Eighty-nine percent of respondents believe TB is
transmitted by air; 78% by sneezing, 51% by sharing eating utensils,
38% through food, 30% through sexual contact and 16% by touching
people with TB or mosquito bites. Among those that reported air as
the route of transmission, there was no location, sex, zonal,
educational or age differential, the proportions were high in all groups.
154
Table 12.11: Knowledge of Routes of TB Transmission
Percent Distribution of Respondents’ knowledge of route of TB
transmission According to Selected Characteristics; FMOH, Nigeria
2007
Characteristics
Number
of
women
& men
aware
of TB
Air
Mosquito
bites
Sneezing
Sharing
eating
utensils
Touching
person
with TB
Food
Sexual
contact
Female
88.9
15.2
75.1
51.3
18.1
36.5
27.1
5360
Male
89.7
16.6
80.3
50.9
14.7
38.3
32.2
6161
Location
Rural
Urban
89.0
89.9
17.4
14.0
77.9
78.4
52.1
49.7
18.3
13.0
40.5
33.1
31.0
28.6
7556
3965
Sex
Zone
North Central
92.2
14.4
81.1
53.7
15.2
38.1
28.1
2047
North East
North West
South East
South-South
South West
93.8
88.1
84.5
87.9
89.6
17.2
17.2
11.1
18.4
16.4
81.7
74.6
77.2
80.0
76.2
65.7
47.8
46.7
44.9
49.6
18.7
12.7
16.1
24.6
11.9
48.2
38.4
27.2
38.7
33.7
40.4
23.8
26.5
32.4
31.1
1536
2847
1294
1776
2021
85.2
23.2
69.0
49.1
18.0
38.6
27.7
2486
Education
Never attended
school
Qur’anic only
87.4
16.6
73.9
49.4
15.8
41.8
28.9
1025
Primary
Secondary
89.0
89.8
16.7
17.2
76.7
80.6
53.1
49.5
15.5
16.3
38.2
35.8
29.3
31.3
2233
4519
Higher
94.1
12.1
85.0
56.3
14.8
36.6
30.1
1258
Age group
15-19
88.0
18.4
76.0
43.4
15.7
32.3
27.7
2470
20-24
89.1
15.5
78.7
49.8
16.5
35.7
29.9
2163
25-29
89.8
16.1
77.7
52.2
17.2
40.9
29.9
1882
30-39
91.2
16.0
79.8
55.1
16.2
38.5
31.3
2456
40-49
89.3
15.1
77.9
54.0
16.7
41.1
31.6
1724
50-64
87.5
13.4
78.2
47.9
12.7
36.1
28.7
826
Total
89.4
16.0
78.1
51.1
16.1
37.5
30.0
11521
12.10
Knowledge about Cure for Tuberculosis
Overall, 80% of respondents knew TB can be cured. The proportion
of those who knew that TB can be cured was higher among males
than females; higher among urban dwellers than rural dwellers and
higher among those who had received formal education.
155
Table 12.12: Knowledge about TB cure
Percent Distribution of Respondents who have Ever Heard of TB and
know it can be cured According to Selected Characteristics; FM0H,
Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Respondents who
know TB can be
cured
Number of
women and
men aware of
TB
76.7
82.5
3517
4644
77.6
83.5
5024
3137
82.0
85.3
75.6
78.3
77.4
83.3
1119
1116
2102
929
1155
1740
67.8
79.5
80.8
81.3
89.0
1609
742
1595
3259
956
77.2
80.2
80.5
80.6
81.0
82.0
80.4
1686
1499
1367
1753
1227
629
8161
12.11 TB Status disclosure and Stigma
Table 12.13 shows that 33% of respondents were willing to keep the
status of a family member with TB secret and 88% were willing to care
for a family member with TB. A high proportion of respondents in all
zones were willing to care for family members with TB but the
proportion was highest in the Northern zones.
156
Table 12.13: TB Status disclosure and Stigma
Percent Distribution of Respondents who have Ever Heard of TB and
are willing to keep family member’s status secret and willing to care
for them According to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Willing
to keep
status of
family
member
with TB
secret
Willing to care for
family member
with TB
Number
of women
and men
aware of
TB
32.2
34.2
85.2
90.8
3517
4644
32.3
34.8
87.9
89.2
5024
3137
26.1
32.7
37.6
38.7
23.9
38.5
90.3
94.9
90.1
86.8
81.9
86.8
1119
1116
2102
929
1155
1740
31.0
34.4
33.1
32.7
37.4
87.5
93.3
86.7
88.1
90.2
1609
742
1595
3259
956
35.9
36.2
34.4
32.1
30.6
28.0
33.1
85.9
88.0
88.6
89.0
89.0
91.9
88.2
1686
1499
1367
1753
1227
629
8161
12.12 Knowledge of a place to obtain treatment
for Tuberculosis
Table 12.14 shows that 64% of respondents knew of a place to obtain
treatment for TB. More males (66%) than females (59%) had
knowledge of a place to obtain treatment. Respondents who had
received formal education had slightly higher level of knowledge of a
place to obtain treatment for TB than those who never attended
school. A higher proportion of urban dwellers (70%) had knowledge of
a place to obtain treatment than rural dwellers (59%).
157
Table 12.14: Knowledge of a place to obtain treatment for
Tuberculosis
Percent Distribution of Respondents who have Ever Heard of TB and
know a place to obtain treatment According to Selected
Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Respondents who
know a place to
obtain treatment for
TB
Number of
women and
men aware of
TB
59.0
66.1
3517
4644
58.5
69.7
5024
3137
67.8
63.9
61.6
54.2
59.6
69.8
1119
1116
2102
929
1155
1740
51.3
59.6
63.0
63.1
77.9
1609
742
1595
3259
956
54.3
63.3
64.4
66.1
64.8
67.7
63.6
1686
1499
1367
1753
1227
629
8161
12.13 Presence of Household member with Tuberculosis
Table 12.15 shows that 3% of respondents have household members
with chronic cough and diagnosed as having TB. Two percent of
respondents have household member that coughed for past three
months, and 1% of respondents have household members diagnosed
as having TB.
158
Table 12.15: Household member with Tuberculosis
Percent Distribution of Respondents who have Ever Heard of TB and
have a household member with chronic cough or diagnosed as having
tuberculosis According to Selected Characteristics; FMOH, Nigeria
2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Total
Household
member
coughed for
past 3
months
Household
member
diagnosed
as having
TB
Household
member with
chronic
cough and
diagnosed as
having TB
Number
of
women
and
men
aware
of TB
1.9
1.9
1.0
0.9
2.6
3.1
3517
4644
2.0
1.8
1.0
0.8
2.8
2.9
5024
3137
2.2
2.0
2.7
1.1
1.7
1.4
1.3
0.9
1.0
0.8
0.8
0.7
1.7
1.5
2.4
6.9
3.7
1.8
1119
1116
2102
929
1155
1740
2.0
0.9
2.0
1609
0.6
2.6
1.9
1.6
1.4
1.1
0.9
0.7
2.3
2.3
3.5
3.0
742
1595
3259
956
1.7
2.1
2.6
1.9
1.5
1.6
1.9
1.1
0.9
0.4
1.2
1.1
1.2
1.0
3.1
2.6
2.9
3.1
2.3
3.1
2.9
1686
1499
1367
1753
1227
629
8161
12.14 Discussion and Conclusions
The survey showed that some respondents support wife beating. More
females than males feel that wife beating is justified when a wife
refuses to have sex, argues with her husband or when food is not
ready on time. This finding is rooted in cultural contexts in Nigeria that
place women at a disadvantage within the family. However, majority of
respondents agreed that a wife is justified to refuse sexual intercourse
under certain circumstances particularly when she has just given birth
and if her husband has an STI.
About half of the respondents were aware of FGM and only a third
viewed FGM as a health problem. In order to eliminate FGM more
efforts must be made to enlighten Nigerians of the associated health
159
problems. Similarly, awareness of VVF was low. Awareness was
higher in the north than in the south.
Awareness of reproductive cancers and knowledge of screening
methods was low. Only 9 % of respondents knew about Pap smear.
This may explain the late presentation and poor prognosis associated
with cancer patients seen in Nigeria. More efforts need to be made to
increase knowledge of reproductive cancers and developing screening
programmes in the country.
Many respondents (72%) were aware of TB. Knowledge of the route
of transmission was also high. However, some respondents have
misconceptions that it can be transmitted by sharing utensils and food,
through sexual intercourse, by mosquito bites, and touching. A third of
respondents would keep it secret if a family member has TB. This
implies that stigma and discrimination against TB patients still exists.
Stigma may prevent patients from seeking care early and constitutes
an obstacle to effective prevention of TB. A small proportion of
respondents have household members who have been diagnosed
with TB.
160
SECTION 13
13.0
Communication for Behavioural Change
One of the major determinants of health status is patterns of human
behaviour. Sexual behaviour of individuals, for example, is central to
the continuous spread of HIV. Health awareness, knowledge, and
practices are also some factors responsible for influencing the
reproductive health status of individuals, households, communities
and nations. Thus, in the quest for the effective control of HIV and
AIDS and improved reproductive health status of the Nigerian
population, health communication should hold a central place. It is
crucial that for evidence-driven behaviour change communication to
be developed, the channels of information utilised and preferred by
people and its implications for behaviour development and change be
well understood. This section presents findings regarding the channels
of reproductive health and HIV and AIDS communication within the
family and society as well as the perception of the population
regarding the usefulness and influence of various mass media in
disseminating health information.
13.1
Health Communication
Respondents were asked of the types of issues they had discussed
with their children and wards that were older than 12 years within the
12 months preceding the survey. The results are presented in Tables
13.1 for sons and male wards and Table 13.2 for daughters and
female wards. A higher proportion of parents and guardians reported
talking about alcohol and drugs (46%) to their male wards than
reproductive health issues in the last 12 months preceding the survey.
Less than half of parents and guardians of the males had discussed
reproductive health topics such as STIs/HIV and AIDS (40%), sexual
relationship (34%), abortion (16%) and family planning (7%). A similar
pattern was also observed across location, religion, age and
education.
With regards to daughters or female wards, a higher proportion of the
parents and guardians had discussed SRH issues such as, STIs/HIV
and AIDS (44%) and sexual relations (42%) than alcohol and drugs
(36%) menstrual period (35%), abortion (33%) and family planning
(9%). As with sons and male wards, family planning (9%) was the
topic that parents and guardians least frequently discussed with their
daughters or female wards. It is expected that the family should be the
first and major source of information on sexual issues. Table 13.3
presents findings regarding respondents who felt comfortable
discussing sexual matters with different family members. A higher
proportion of respondents felt comfortable discussing sexual matters
with sisters (42%) and brothers (40%) than their mothers (31%) or
fathers (25%). The pattern was fairly consistent over the selected
background characteristics of location, zones, educational group, age
161
group and religion. Among the younger respondents aged 15-19
years, 24% felt comfortable discussing with their fathers and 31% with
their mothers. In general, a higher proportion of respondents talked to
siblings of either sex on sexual issues than with their parents. The
social institutions which contribute to the value system of persons in
the community include the family, educational and religious
institutions. They act as secondary socialisation institutions and shape
people’s ideas, perceptions and value systems. Table 13.4 presents
findings showing how comfortable respondents are in discussing
sexual matters with religious leaders and teachers.
Table 13.1: Health Communication with Male Wards
Percent Distribution of Respondents by Types of Reproductive Health
Communication with Sons and Male Wards According to Selected
Characteristics; FMOH, Nigeria 2007
Characteristics
Alcohol/drugs
STI &
AIDS/HIV
Sexual
relationship
Abortion
Family
planning
Number of
respondents
who had
male wards
over 12
years of age
42.5
51.3
37.4
42.7
30.6
36.1
14.3
16.1
6.5
6.5
1268
1579
42.3
56.1
36.0
48.0
29.8
40.5
11.9
21.6
4.0
11.3
1912
935
42.4
46.9
41.6
52.2
40.3
37.3
24.9
56.9
35.9
27.5
16.3
44.1
13.4
7.1
3.7
21.6
6.1
2.0
2.2
5.0
537
405
727
283
South-South
South West
Education
45.3
56.7
45.0
50.3
38.5
50.9
19.7
32.8
10.8
14.4
421
474
Never attended
school
Qur’anic only
35.5
26.7
21.8
9.6
2.8
635
45.6
28.4
22.0
3.8
1.6
256
Primary
Secondary
Higher
49.7
53.5
64.2
42.7
52.8
61.7
36.6
44.9
50.0
17.5
21.4
26.8
7.1
10.0
15.4
532
1121
303
15-19
20.24
25-29
45.1
49.5
48.1
39.8
40.2
39.4
34.6
34.0
33.8
15.3
14.9
16.4
7.0
6.3
6.2
616
502
474
30-39
40-49
50-64
47.2
46.6
43.9
40.9
40.3
39.2
33.5
30.8
32.8
15.0
15.4
13.3
7.1
6.6
3.9
635
419
201
Religious
Islam
Protestant
42.3
53.4
30.8
50.5
24.0
45.6
8.8
22.4
3.9
10.3
1475
990
Catholic
Traditional
49.6
45.2
51.6
40.5
41.5
29.3
23.3
14.3
7.8
2.3
353
28
Total
46.1
40.0
33.5
15.6
6.5
2846
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
Age group
162
Majority of the respondents did not consider religious leaders and
teachers as persons with whom they could freely discuss such issues.
Only 25% of respondents indicated that they were comfortable
discussing sexual matters with religious leaders, while 20% were
comfortable discussing such with teachers. Males were more willing to
discuss with religious leaders and teachers than females. A higher
proportion of people with formal education and urban dwellers were
willing to discuss sexual issues with their religious leaders and
teachers than other groups.
Table 13.2: Health Communication with Female Wards
Percent Distribution of Respondents by Types of Reproductive Health
Communication with Daughters and Female Wards According to
Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Alcohol/
Drugs
STI &
A IDS
Sexual
relationship
Abortion
Family
planning
Menstrual
period
Number
of
responde
nts who
had
female
wards
over 12
31.0
41.1
42.4
45.7
44.5
40.3
34.4
30.3
9.0
9.7
54.1
17.5
1172
1334
32.2
43.8
40.1
51.5
38.1
50.2
28.0
40.5
6.5
14.8
31.0
43.0
1680
826
32.3
23.5
26.7
46.7
41.4
50.0
46.1
40.4
27.5
61.5
49.7
51.6
46.6
34.1
26.3
50.2
47.1
56.4
30.3
26.8
14.9
43.7
37.0
49.4
7.9
4.3
3.4
9.0
15.5
17.6
32.1
35.2
24.9
42.7
34.8
46.0
465
343
637
262
361
438
21.8
31.0
31.5
25.6
3.2
34.7
562
25.6
40.2
47.3
57.1
29.4
48.4
53.6
67.3
25.9
50.8
48.1
57.4
14.4
37.1
39.2
44.5
2.2
10.9
13.4
23.3
21.6
37.8
36.8
41.2
232
490
953
269
37.0
38.1
38.0
32.9
38.9
29.5
46.9
41.8
44.3
44.1
45.2
38.5
46.4
42.0
43.4
40.3
40.6
37.2
33.7
32.0
35.3
28.3
33.7
31.0
10.0
10.1
11.0
9.2
7.8
4.5
36.7
36.8
33.1
33.7
36.1
34.0
541
446
413
550
390
166
Religious
Islam
Protestant
Catholic
26.5
47.9
43.5
33.3
55.7
55.4
33.0
53.7
47.3
22.0
43.9
41.0
5.9
14.1
11.7
29.1
43.5
37.0
1277
883
317
Traditional
Total
39.5
36.0
50.0
44.4
55.8
42.2
41.9
32.6
4.7
9.3
32.6
34.9
28
2506
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never
attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20.24
25-29
30-39
40-49
50-64
163
Table 13.3: Health Communication with Family Members
Percent Distribution of Respondents who were Comfortable
Discussing Sexual Matters with Family Members According to
Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20.24
25-29
30-39
40-49
50-64
Religious
Islam
Protestant
Catholic
Traditional
Total
Father
Mother
Brother
Sister
Number
of
women
and men
16.3
32.6
32.3
30.0
22.8
54.3
44.7
39.9
5360
6161
22.7
29.0
28.0
36.5
36.4
45.4
38.0
49.3
7556
3965
25.4
19.3
9.6
36.4
29.4
37.9
32.8
21.8
16.5
41.3
35.1
45.1
43.1
33.6
21.1
52.6
46.7
51.6
47.5
31.8
24.0
52.8
50.2
55.4
2047
1536
2847
1294
1776
2021
11.9
18.8
21.2
28.7
2486
14.8
29.5
27.9
38.3
21.0
35.1
33.7
45.3
29.1
44.1
43.5
60.3
29.4
46.8
44.3
60.9
1025
2233
4519
1258
24.2
24.7
25.8
24.8
25.4
26.3
30.9
31.3
31.5
30.8
30.9
30.6
39.4
39.1
40.6
39.5
39.6
40.1
42.9
43.1
42.1
41.2
40.9
42.2
2470
2163
1882
2456
1724
826
17.3
32.6
32.7
39.5
25.0
22.3
40.0
40.0
33.9
31.0
30.2
48.6
50.6
51.6
39.6
31.1
53.6
52.5
49.2
42.1
5771
4148
1462
139
11521
164
Chart 13.1: Percentage of respondents willing to discuss Sexual matters with Religious
leaders and Teachers by Age and Sex; FMOH, Nigeria, 2007
Religious leaders
Teachers
30
25.4
25.3
24.3
25
23.9
22.5
20.7
P ercen tag e
20
19.8
19.9
19.3
19.3
16.7
15.4
15
10
5
0
15-19
20-24
25-29
30-39
40-49
50-64
Age group(years)
13.2
Personal Communication on Family Planning
Communication with other persons such as family members and
friends has the potential to influence awareness, knowledge and
attitudes to family planning. Respondents in the study were asked
whether they had discussed about family planning in the past 12
months preceding the study and with whom. The results are presented
in Table 13.5. Most respondents had not discussed family planning
with family members and friends in the last 12 months preceding the
survey. Of those who had discussed family planning, 19% discussed
with their friends and 19% discussed with their spouses. Respondents
were least likely to discuss family planning with their daughters (3%)
and sons (3%). A higher proportion of those living in urban areas had
discussed family planning than those living in the rural areas. More
males than females had discussed family planning with others in the
last 12 months preceding the survey.
Table 13.6 shows the proportion of respondents who discussed family
planning with health workers, religious leaders and school teachers in
the last 12 months preceding the survey. The proportion of
respondents that discussed family planning with these categories of
persons was very low. Eleven percent discussed with health workers
while only 5% discussed with religious leaders and 4% with school
teachers. A higher proportion of males than females discussed with
165
religious leaders and school teachers. A higher proportion of
respondents living in urban locations and more educated persons
discussed family planning with health workers and religious leaders.
Chart 13.2 showed the variations across zones. In all zones more
respondents had spoken to health workers than religious leaders.
Table 13.4: Health Communication with Non-Family Members
Percent Distribution of Respondents Willing to Discuss Sexual Matters
with Religious Leaders and Teachers According to Selected
Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Religious
Islam
Protestant
Catholic
Traditional
Total
Religious leaders
Teacher
Total
15.2
33.0
11.5
28.1
5360
6161
23.4
27.1
17.9
24.7
7556
3965
24.6
28.2
16.8
30.4
23.7
30.0
17.4
21.7
15.0
23.3
26.3
22.5
2047
1536
2847
1294
1776
2021
14.4
24.1
29.4
23.9
39.5
7.4
16.8
19.9
23.2
38.5
2486
1025
2233
4519
1258
23.9
24.9
25.0
26.1
23.6
24.8
19.4
21.4
20.5
20.1
20.4
20.5
2470
2163
1882
2456
1724
826
21.6
27.6
29.5
20.8
24.7
16.0
25.3
23.8
20.8
20.4
5771
4148
1462
139
11521
166
Table 13.5: Personal Communication with Family Members and
Friends on Family Planning
Percent Distribution of Respondents who Discussed Family Planning
with Family Members and Friends in the Last 12 Months According to
Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South South
South-West
Education
Never
attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20.24
25-29
30-39
40-49
50-64
Religious
Islam
Protestant
Catholic
Others
Total
Parents
Spouse
Sons
Daught
ers
Other
relatives
Friends
Number
of
women
and men
4.1
5.3
18.4
18.9
2.2
2.7
2.8
2.8
6.6
10.3
16.1
20.6
5360
6161
3.6
6.7
15.3
24.4
2.0
3.3
2.1
3.6
6.8
11.7
14.7
25.2
7556
3965
3.2
5.5
2.3
8.1
7.2
4.5
21.2
14.3
9.7
23.9
28.1
21.0
2.4
1.8
0.8
3.7
3.2
4.0
2.9
1.6
1.0
3.6
3.5
4.2
9.3
10.1
5.8
10.4
11.7
7.3
22.9
19.8
13.4
21.2
23.0
16.2
2047
1536
2847
1294
1776
2021
1.4
7.8
1.8
2.0
3.5
8.0
2486
1.6
4.5
5.6
10.8
9.8
21.4
20.4
34.9
1.0
3.4
2.2
4.5
0.9
3.9
2.2
5.0
5.2
8.0
9.0
20.0
12.5
17.7
21.0
35.1
1025
2233
4519
1258
5.1
4.6
4.6
4.2
5.3
4.4
19.0
19.9
18.3
18.1
17.4
19.4
2.6
2.4
2.4
2.4
3.0
1.8
2.9
2.7
2.8
2.5
3.0
1.8
9.0
8.7
9.2
8.6
8.3
6.0
18.8
19.2
18.0
18.6
17.6
18.1
2470
2163
1882
2456
1724
826
3.0
6.8
5.6
3.2
4.7
12.3
25.5
24.1
20.2
18.8
1.5
3.6
3.2
4.0
2.5
1.7
3.8
3.5
4.0
2.8
6.6
11.1
9.8
3.2
8.8
15.1
22.1
22.6
9.7
18.9
5771
4148
1462
139
11521
167
Chart 13.2: Percentage of Respondents who discussed Family planning with Health
Workers and Religious leaders in the Last 12 Months by Zone; FMOH, Nigeria, 2007
Health workers
Religious leaders
16
14
13.6
11.9
12
11.6
11.3
11.1
10
8.3
8
6.3
Percentage
6
5.7
4.9
4.4
3.9
4
3.5
2
0
North Central
North East
North West
South East
South-South
Zones
Table 13.7 shows the frequency at which married or cohabiting
respondents discussed family planning with partners in the last 12
months preceding the survey. Most persons within union, whether
married or cohabiting, had not discussed family planning with sexual
partners. Only 12% of females and 18% of males had discussed
family planning or child spacing with partners thrice or more in the last
12 months, whereas 73% of females and 65% of males had never
discussed the issue during the period. The proportion of respondents
who discussed family planning was higher among the more educated
respondents and males (Chart 13.3). A higher proportion of people
located in the south had discussed family planning with their partners.
168
South West
Table 13.6: Personal Communication with Health Workers and
Religious Leaders about Family Percent Distribution of
Respondents who Discussed Family Planning with Health Workers
and Religious Leaders in the last 12 Months according to Selected
Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Religious
leaders
School teachers
Health workers
Total
2.4
1.9
11.7
5360
6.9
5.1
11.0
6161
Rural
4.1
2.7
9.5
7556
Urban
Zone
North Central
North East
6.0
5.2
14.5
3965
3.9
7.9
3.2
5.1
14.0
13.3
2047
1536
North West
South East
South-South
South West
Education
Never
attended
school
Qur’anic only
3.0
5.0
6.3
4.2
1.7
4.6
6.3
2.9
8.3
12.6
13.5
9.8
2847
1294
1776
2021
1.8
0.4
5.6
2486
3.4
1.4
8.1
1025
Primary
4.4
2.8
12.2
2233
Secondary
Higher
4.6
12.8
4.2
10.7
11.6
22.4
4519
1258
5.3
5.3
4.5
4.6
4.4
3.7
4.0
4.0
3.5
3.6
3.4
2.6
11.2
11.6
11.6
11.6
11.6
8.7
2470
2163
1882
2456
1724
826
3.9
6.1
4.8
1.6
4.7
2.4
5.3
4.0
0.8
3.7
8.9
13.5
15.3
5.6
11.4
5771
4148
1462
139
11521
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Religious
Islam
Protestant
Catholic
Traditional
Total
169
Chart 13.3: Frequency at which married/co-habiting respondents discussed family
planning (Three or more times) with partner in the last 12 months by level of Education;
FMOH, Nigeria, 2007
2007
Female
40
Male
35.1
35
31.6
30
25
22.8
20
23.5
18.4
14.2
15
10
6.9
5.4
5
4.5
2.8
0
Never attended school
Qur’anic only
Primary
Secondary
Higher
Level of Education
Respondents were asked to indicate the person who initiated the
conversation on family planning. The responses are presented in
Table 13.8. Many (60%), of the respondents reported that they
initiated the discussion. In 38% of cases, the spouse or cohabiting
partner initiated the discussion. A higher proportion of males (67%)
than females (52%) initiated discussions on family planning.
170
Table 13.7: Frequency of Personal Communication about Family
Planning with Marital or Co-habiting Partners
Percent Distribution of Frequency of Personal Communication About
Family Planning with Marital or Co-habiting Partners in the last 12
Months According to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South- South
South West
Education
Never
attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20.24
25-29
30-39
40-49
50-64
Total
Three
or
more
Female
Once
or
twice
Never
Number of
married and
Cohabiting
Three
or
more
Male
Once
or
twice
Never
Number of
married and
Cohabiting
8.5
19.8
11.8
20.5
79.7
59.7
2454
1111
14.3
25.7
15.1
20.6
70.6
53.7
2053
923
14.9
6.7
3.5
18.5
21.2
19.1
16.1
11.9
9.1
19.2
21.4
17.3
68.9
81.5
87.3
62.3
57.4
63.6
644
523
1079
297
472
550
19.5
14.2
8.6
32.7
25.4
19.7
15.1
10.9
11.2
23.0
24.9
22.5
65.4
74.9
80.1
44.2
49.8
57.8
529
430
824
278
422
493
2.8
6.6
70.5
1376
5.4
7.8
86.8
612
4.5
14.2
10.8
18.4
84.7
67.3
333
793
6.9
18.4
11.4
17.5
81.7
63.9
404
743
22.8
31.6
23.0
22..7
54.2
45.8
838
225
23.5
35.1
22.5
22.9
54.0
42.0
824
393
3.9
9.1
13.6
14.8
12.3
NA
12.0
8.4
12.4
19.1
15.4
12.9
NA
14.5
87.5
78.5
67.4
69.8
74.8
NA
73.4
311
660
745
1136
713
NA
3565
10.3
9.0
16.6
18.2
23.3
14.3
17.8
20.5
16.7
11.7
18.6
18.7
14.8
16.8
69.2
74.3
71.4
63.2
58.0
70.9
65.4
39
144
367
911
774
741
2976
171
Table 13.8: Persons Initiating Personal Communication
Percent Distribution of Persons Initiating Personal Communication
about Family Planning with Spouse or Cohabiting Partners According
to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Respondent
Spouse or
cohabiting
partner
Others
No
response
Number of
women & men
who
discussed FP
with spouse or
co-habiting
partner
Sex
Female
52.2
46.3
0.9
0.6
993
Male
66.6
31.1
1.4
0.9
748
58.9
60.7
38.7
38.0
1.2
1.0
1.1
0.2
1252
489
North Central
North East
60.8
70.5
38.5
29.1
0.3
0.5
0.3
0.0
351
279
North West
South East
52.1
53.3
42.2
43.8
1.6
2.9
4.1
0.0
428
200
South-South
South West
61.1
52.1
38.4
37.4
0.5
1.1
0.0
0.0
178
305
45.5
50.0
3.0
1.5
429
55.6
61.8
59.2
67.4
43.7
35.9
39.4
31.7
0.0
0.9
1.3
0.3
0.8
1.3
0.1
0.6
180
342
629
161
15-19
20-24
25-29
61.2
60.6
61.3
37.2
37.4
37.5
0.7
1.8
1.0
0.9
0.3
0.3
394
322
275
30-39
40-49
59.8
55.1
39.0
41.9
0.8
1.9
0.5
1.1
373
290
50-64
59.2
38.9
0.6
1.3
87
Total
59.8
38.4
1.1
0.7
1741
Location
Rural
Urban
Zone
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
172
13.3
Community Support for Modern Methods of
Family Planning
An environment that is supportive of behavioural intention is crucial to
behaviour change or behaviour maintenance. The opinion of the
respondents was sought on how they perceived the level of support
from social groups and community leaders for family planning. The
results are shown in Table 13.9 and in Chart 13.4. Majority of the
respondents believed that health workers (62%) and parents (40%)
were most likely to support family planning. Thirty one percent of the
respondents from rural areas reported that community leaders support
FP compared to 48% of those in urban areas. Men and women were
perceived as almost equally likely to be supportive of FP (35% vs.
37%).
Chart 13.4: Respondents who reported about the various Persons and Social Groups
Supporting Family Planning
65.4
64.6
South West
70.6
58.7
55.6
59.8
South-South
75.1
49.4
48.3
South East
86.2
74.2
Women
Men
Parents
Married Persons
Zones
86.6
17.4
15.6
16.3
North West
29.9
19.8
17.2
19.2
North East
36.3
45.9
40.6
44.3
North Central
0
10
20
30
40
50
173
63.2
60
70
80
90
100
Table 13.9: Perceived Support of Social Groups for Family
Planning
Percent Distribution of Respondents who Reported about the Various
Persons and Social Group Supporting Family Planning According to
Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Married
person
Men
Women
Parents
Religious
leaders
HCW*
Sch.
Teah
Comm.
leader
Number
of
women
& men
Male
56.8
31.2
33.8
37.9
29.4
58.2
30.6
32.6
5360
Female
54.3
38.6
38.9
41.8
35.0
65.2
43.0
40.0
6161
Sex
Location
Rural
47.7
29.5
30.4
32.6
28.0
56.8
32.1
30.7
7556
Urban
70.3
46.1
48.3
54.1
40.8
71.9
47.0
47.7
3965
Zone
North Central
61.4
37.8
39.5
40.3
33.1
69.7
40.7
37.3
2047
North East
41.0
23.6
24.0
26.0
22.5
52.4
31.1
28.8
1536
North West
24.7
11.1
12.8
12.8
10.3
43.8
13.6
14.9
2847
South East
66.0
43.9
44.7
53.9
38.6
67.1
41.5
43.4
1294
South-South
76.0
50.0
52.5
56.6
46.1
72.4
54.8
50.7
1776
South West
79.1
56.7
57.2
65.1
54.6
74.6
53.3
55.5
2021
28.4
14.9
16.5
16.0
15.3
41.7
15.9
18.0
2486
25.3
11.3
13.2
12.3
11.4
43.2
16.3
16.3
1025
Education
Never attended
school
Qur’anic only
Primary
61.6
38.6
40.3
43.7
35.6
67.2
38.5
39.6
2233
Secondary
67.5
44.5
45.7
51.3
40.1
69.5
47.2
44.4
4519
Higher
79.4
55.2
56.0
62.9
50.4
80.9
58.3
56.1
1258
15-19
48.6
29.6
30.8
36.1
26.9
53.9
35.9
30.3
2470
20.24
59.5
37.5
39.3
44.2
34.6
63.3
40.6
40.1
2163
25-29
58.6
35.6
37.0
42.3
32.1
64.8
38.1
36.0
1882
30-39
58.3
37.2
38.8
40.0
34.7
65.6
36.3
38.6
2456
40-49
56.3
36.8
38.1
39.8
34.8
63.8
35.3
38.5
1724
50-64
48.2
35.4
35.5
35.5
32.4
61.4
37.2
36.8
826
Total
55.5
35.2
36.6
40.0
32.4
62.0
37.2
36.6
11521
Age group
Respondents were also asked to indicate whether they were in
support of the use of family planning/child spacing methods by
couples to prevent unplanned/mis-timed pregnancy or not. The
findings are presented in Table 13.10. Forty eight percent of all
respondents indicated their support for family planning by couples,
and there was little difference between the male (49%) and female
(46%) respondents in this regard. A higher proportion of respondents
174
with higher levels of education supported family planning. There were
substantial urban-rural differences in response to support of family
planning, with 62% indicating their support in urban areas while 40%
indicated their support in rural areas. Generally respondents from
North West (21%) and North East (32%) zones reported the lowest
support for family planning while those from South West (68%) and
the South-South (67%) reported the highest degree of support for
family planning. This pattern was also reflected among both male and
female-respondents.
Table 13.10: Personal Support for Family Planning
Percent Distribution of Respondents’ who Support Family Planning
According to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20.24
25-29
30-39
40-49
50-64
Religious
Islam
Protestant
Catholic
Traditional
Total
Support Family
Planning
Male
Female
All
Number
of
women
& men
41.2
63.3
39.1
60.3
40.2
61.9
7556
3965
55.3
32.5
20.4
64.9
66.6
68.2
52.2
30.5
21.8
59.8
64.1
63.6
53.9
31.6
21.1
62.4
65.5
66.1
2047
1536
2847
1294
1776
2021
20.4
20.2
20.3
2486
13.5
47.1
59.3
74.1
25.3
55.8
61.3
77.2
18.0
51.1
60.1
75.1
1025
2233
4519
1258
41.7
55.5
52.1
51.9
49.8
41.8
41.3
47.9
50.6
49.7
42.1
NA
41.5
51.7
51.4
50.7
45.9
41.8
2470
2163
1882
2456
1724
826
31.3
66.8
67.9
55.9
48.8
29.8
63.4
62.8
27.0
46.4
30.6
65.2
65.5
48.2
47.7
5771
4148
1462
139
11521
175
Respondents were asked to identify among some selected members
of the community those whose opinion could affect their personal
decision on family planning. Table 13.11 presents the findings with
regards to the question. Health workers had the highest proportion of
respondents indicating that they personally viewed their opinion on
family planning as important (53%). Next to the health workers were
spouses (47%), parents (38%) and religious leaders (35%).
Table 13.11: Family Planning Decisions
Percent Distribution of Persons whose opinion may Affect
Respondents’ Family Planning Decisions According to Selected
Characteristics; FMOH, Nigeria 2007
Person who can influence opinion
Characteristics Spouse Parents
Other
relations
Son
Daughter
Religious
leaders
Health
workers
Community
leaders
Number
of men
&
women
Location
Rural
Urban
Zone
North Central
North East
North West
South East
43.3
53.6
34.3
44.5
30.8
39.6
11.5
13.6
11.4
13.7
32.9
38.2
49.6
58.3
29.4
35.3
7556
3965
48.1
36.3
34.4
45.3
36.5
32.6
24.9
42.5
32.0
31.2
20.7
37.6
9.2
9.5
6.6
15.3
8.9
9.6
7.1
15.4
38.9
36.6
22.7
32.2
55.3
44.8
40.2
54.6
28.3
34.5
19.8
31.9
2047
1536
2847
1294
South-South
58.6
45.0
42.4
15.8
15.9
37.1
61.1
37.3
1776
South West
61.7
51.8
46.5
19.9
19.6
45.6
64.6
42.9
2021
Education
Never attended
school
Qur’anic only
38.7
21.0
17.7
9.8
9.8
23.5
33.3
18.9
2486
32.8
23.6
22.1
8.5
8.7
27.4
37.9
23.1
1025
Primary
53.6
38.1
34.8
16.7
16.1
35.5
57.4
33.0
2233
Secondary
47.0
46.2
40.2
11.1
11.4
38.8
60.1
35.9
4519
Higher
61.7
51.5
51.0
16.0
16.3
47.2
67.8
43.8
1258
Age group
15-19
26.1
41.6
31.9
3.7
3.8
32.7
49.6
29.5
2470
20.24
43.8
43.1
36.0
6.8
7.3
36.0
53.6
33.0
2163
25-29
30-39
52.2
58.5
40.2
35.8
34.9
33.0
8.8
14.5
8.9
14.6
34.5
34.0
54.9
54.2
31.0
30.7
1882
2456
40-49
56.6
32.0
34.1
23.7
23.7
36.1
52.6
32.3
1724
50-64
49.2
24.8
33.8
28.5
27.2
37.9
49.4
34.3
826
Religious
Islam
Protestant
38.1
57.6
29.6
47.8
26.2
43.3
8.5
17.0
8.7
16.6
30.2
41.1
42.9
63.0
26.0
38.4
5771
4148
Catholic
50.2
42.0
37.8
13.1
13.7
36.0
61.9
33.9
1462
Traditional
48.9
32.4
27.3
12.9
12.9
20.1
48.9
20.9
139
Total
46.8
37.8
33.9
12.2
12.2
34.8
52.6
31.4
11521
176
13.4
Perceived Support for Condom Use
Condom remains the only contraceptive method that can reduce the
risk of transmission of STIs, including HIV, among sexually active
persons; this is in addition to its effectiveness in pregnancy
prevention. The adoption of consistent and correct condom use by
high risk groups is, thus, one of the strategic approaches to controlling
the transmission of HIV and reducing the rate of unplanned/mis-timed
pregnancy and its consequences. With young persons having a
disproportionately higher burden of HIV and AIDS as well as many
other reproductive health challenges, it is important that communities
and individuals support the use of condom among sexually active
young people. Respondents were asked whether they thought some
selected persons or institutions would support young persons using
condoms to protect themselves from HIV and STIs if they were
sexually active. Table 13.12 presents respondents’ opinion on the
various social groups’ support for such a strategy. (See also Chart
13.6).
Majority of the respondents were of the opinion that the government
(71%) health care workers (67%) and young persons themselves
(50%) were in support of the use of condom by sexually active young
persons. Other social groups especially community leaders (40%) and
parents (39%) were perceived as less supportive. Respondents in
urban areas reported higher levels of perceived support from all listed
groups than those in rural areas. Respondents with higher level of
education also reported higher levels of perceived support than those
with lower educational status.
177
Table 13.12: Opinion on Support Provided by Social Groups for
Condom Use
Percent Distribution of Respondents’ Views on whether groups would
Support the use of Condom by Sexually Active Young Persons by
Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Govt.
Parents
Religious
leaders
Young
persons
Health
care
workers
Comm..
leaders
Number
of
men and
women
62.9
77.1
34.2
43.7
27.2
34.9
45.4
54.5
59.5
72.7
34.7
45.1
5360
6161
64.8
33.0
27.1
44.2
61.1
34.7
7556
Urban
Zone
North Central
North East
North West
81.4
51.1
39.3
61.8
77.1
50.7
3965
72.3
64.3
49.4
38.2
29.1
12.1
29.2
27.5
9.7
56.1
44.5
17.9
71.0
61.1
45.5
40.1
36.5
15.4
2047
1536
2847
South East
South-South
74.3
86.5
39.7
58.1
28.8
44.7
54.2
70.8
71.3
79.4
41.1
56.6
1294
1776
South West
86.6
69.5
56.6
73.8
81.7
63.3
2021
47.0
20.0
18.7
27.4
44.4
22.2
2486
47.4
74.6
11.2
39.4
9.4
31.9
19.7
52.0
43.5
69.9
15.6
40.9
1025
2233
Secondary
Higher
Age group
15-19
20-24
25-29
81.1
90.3
50.3
60.2
39.0
45.5
62.9
71.9
76.7
87.0
49.9
60.0
4519
1258
61.0
73.9
73.4
32.1
42.4
41.6
25.1
32.8
32.1
43.4
54.3
51.2
58.3
70.1
69.6
33.3
43.3
41.3
2470
2163
1882
30-39
74.3
41.4
34.4
52.4
68.9
42.4
2456
40-49
50-64
Religion
70.1
73.2
39.0
41.4
31.4
34.9
50.8
50.8
65.9
69.9
40.4
43.5
1724
826
Education
Never
attended
school
Qur’anic only
Primary
Islam
58.9
25.7
21.8
34.7
55.4
28.3
5771
Protestant
83.4
55.4
43.0
67.0
78.5
54.0
4148
Catholic
79.3
46.2
35.9
63.2
76.5
49.0
1462
Others
76.3
47.5
30.2
60.4
74.8
36.0
139
Total
70.5
39.3
31.3
50.3
66.6
40.2
11521
178
Chart 13.5: Frequency at which married/co-habiting respondents discussed family
planning (Three or more times) with partner in the last 12 months by level of Education;
FMOH, Nigeria, 2007
Community leaders
40.2
Health care workers
66.6
Young persons
50.3
Religious leaders
31.3
Parents
39.3
Government
70.5
0
13.5
10
20
30
40
50
60
70
Support for HIV and AIDS Activities
Institutional support for HIV and AIDS programming is an increasingly
important issue as it relates significantly to the overall policy
environment for HIV and AIDS control interventions. Respondents
were asked to identify the various institutions and groups that
supported HIV and AIDS activities in Nigeria. Table 13.13 shows the
results obtained. Majority of the respondents reported that all the
institutions cited in the study, including religious groups, traditional
leaders, the government, private sector and the media were all
supportive of HIV and AIDS activities. The perceived support was
highest among the federal government (78%), state government
(75%), media (74%), and local governments (71%). The political
parties (47%) recorded the least proportion of respondents among the
listed institutions.
179
80
Table 13:13: Perceived Institutional Support for HIV/AIDS
Activities
Percentage Distribution of Respondent’s Opinion on the Support of
Selected Social Groups and Institutions towards HIV/AIDS Activities
according to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Christian
religious
groups
Islamic
groups
Political
parties
Traditional
leaders
Media
Federal
Govt.
Private
Companies
State
Govt.
Local
Govt.
NGO/
CBOS
Comm.
Leaders
Total
Female
53.0
47.6
42.5
49.5
68.4
72.3
49.4
67.2
63.8
52.3
50.7
5360
Male
61.6
52.4
51.0
56.1
79.1
85.5
63.9
81.1
76.6
67.5
59.9
6161
Rural
52.2
46.1
42.8
50.2
69.7
75.4
51.6
70.4
66.3
54.7
51.8
7556
Urban
67.8
58.1
55.2
58.2
82.4
86.9
67.8
82.7
78.8
71.2
63.0
3965
North Central
58.6
49.4
49.6
56.6
77.9
83.3
58.7
79.3
75.8
63.5
59.9
2047
North East
54.3
61.2
49.4
56.3
71.2
76.1
53.1
73.2
70.6
58.8
55.9
1536
North West
38.3
44.1
27.7
36.8
57.9
64.9
35.4
56.4
51.4
42.1
38.0
2847
Sex
Location
Zone
South East
70.8
37.8
52.0
58.1
82.9
85.0
62.8
82.4
78.4
71.6
62.1
1294
South-South
60.7
35.4
45.1
52.4
78.0
85.2
65.8
80.1
74.8
68.0
59.2
1776
South West
75.0
72.1
68.4
67.2
86.2
89.3
78.3
86.9
84.0
70.5
68.7
2021
Education
Never
attended
school
Qur’anic only
35.4
39.6
30.8
38.6
51.1
57.8
34.3
52.1
49.0
36.2
37.4
2486
36.4
45.4
32.2
38.0
61.8
68.4
37.8
62.5
57.4
44.4
40.0
1025
Primary
60.4
49.3
48.1
54.4
77.6
83.2
59.2
78.0
73.5
62.6
57.7
2233
Secondary
67.8
54.0
54.0
59.7
83.3
88.0
67.6
83.7
79.6
69.7
63.5
4519
Higher
77.1
63.0
64.5
67.5
90.4
93.1
77.3
90.3
86.9
83.9
72.7
1258
15-19
51.9
44.9
40.2
46.1
68.1
74.6
50.3
68.5
64.3
54.4
48.7
2470
20.24
60.1
52.6
48.9
55.9
77.7
82.3
60.5
77.9
73.3
63.5
59.3
2163
25-29
59.6
52.0
48.3
53.4
74.2
79.5
57.7
75.9
71.6
60.6
56.5
1882
30-39
59.0
51.8
50.6
55.3
76.1
80.1
59.8
76.0
72.5
62.6
57.2
2456
40-49
57.5
51.0
47.8
55.0
74.0
79.3
57.5
74.4
71.4
61.4
56.6
1724
50-64
59.2
49.2
47.5
54.6
76.4
83.1
59.7
77.8
73.1
61.4
57.9
826
Islam
45.2
53.2
39.7
46.5
66.0
72.2
46.8
66.0
61.9
50.8
47.6
5771
Protestant
70.7
49.1
54.5
59.5
82.5
86.5
68.7
83.4
79.6
69.9
63.7
4148
Catholic
70.5
43.6
55.5
61.1
82.4
87.1
65.5
83.8
80.0
71.9
65.0
1462
Others
47.5
28.8
44.6
48.2
72.7
77.7
59.0
73.4
69.8
55.4
49.6
139
Total
57.6
50.2
47.1
53.0
74.1
79.3
57.2
74.6
70.7
60.4
55.6
11521
Age group
Religious
180
13.6
Mass Media for Reproductive Health Communications
The mass media has a major role in reproductive health
communication particularly in view of their potential for wide audience
reach. Respondents were asked about the forms of mass media that
were acceptable to them for the transmission of information on family
planning, HIV and other STIs. The responses are presented in Table
13.14 and in Chart 13.7. Most respondents considered all forms of
mass media – radio (90%), television (81%), and print media (74%) –
acceptable for communication on HIV, family planning and other
sexually related issues to the population. The pattern obtained
nationally was consistent in virtually all the sub-categories of the
population as classified on the basis of selected background
characteristics, with radio receiving the highest level of acceptability
and the print media the least.
The pattern of listenership to radio and viewing of television is
represented in Tables 13.15 and 13.16. Almost half of the
respondents indicated that they listened to the radio almost every
day/everyday (42%) while 25% indicated that they watched the
television almost everyday/everyday. A higher proportion of males
compared to females listened to radio or watched television almost
everyday. There were substantial urban-rural differentials in both radio
listening and television viewing habits. Whereas only 38% of persons
in rural area listen to radio and 13% watch the television almost
everyday or everyday, the corresponding figure for urban-based
respondents were 50% for radio and 48% for television. A higher
proportion of the respondents with higher education listened to radio
and watched television viewing habits. A higher proportion of
respondents from the southern zones compared to the north listened
to radio and/or watched the television almost everyday or everyday.
The zonal differentials were particularly striking with television viewing.
The proportion of those that viewed the television almost everyday or
everyday ranged from 16% in the North East to 39% in the South west
zone. More than half of the respondents in the North East (56%) and
North West (54%) indicated that they did not watch the television at all
compared to only 14% of respondents in the South West.
181
Chart 13.6: Acceptability of various sources of information on HIV/AIDS and Family Planning:
FMOH, Nigeria, 2007
Radio
Media television
Print media
120
100
95.2
90.6
82.1
Percentage
80
75.8
83.4
74.3
95.3
92.7
89.3
84.6
88.6
93.4
85.7
81.1
80.2
70.6
65.1
57.8
60
40
20
0
North Central
North East
North West
South East
South-South
South West
Zones
Table 13.14: Acceptable Media for Communication
Percent Distribution of Respondent Acceptability of Various Sources
of Information on HIV/AIDS and Family Planning According to
Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20.24
25-29
30-39
40-49
50-64
Religiou
Islam
Protestant
Catholic
Traditional
Total
Radio
Media
Television
Print Media
Total
86.5
92.5
77.3
83.6
69.5
77.4
5360
6161
87.3
94.2
74.5
92.3
67.5
85.5
7556
3965
90.6
84.6
83.4
95.2
92.7
95.3
82.1
74.3
65.1
89.3
88.6
93.4
75.8
70.6
57.8
80.2
81.1
85.7
2047
1536
2847
1294
1776
2021
76.9
60.1
52.3
2486
86.0
91.3
94.7
97.2
63.5
82.9
90.3
96.3
54.1
74.1
84.5
92.4
1025
2233
4519
1258
87.9
90.7
90.9
89.3
89.6
91.5
78.9
81.7
81.4
81.3
80.7
79.2
72.2
74.9
75.0
73.4
74.0
72.4
2470
2163
1882
2456
1724
826
85.8
93.9
93.3
86.3
89.7
72.1
90.0
88.3
75.5
80.6
64.8
83.0
82.5
73.4
73.7
5771
4148
1462
139
11521
182
Table 13.15: Radio Listening Habits
Percentage Distribution of Respondents’ by Radio Listening Habits
According to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20.24
25-29
30-39
40-49
50-64
Total
Almost
every
day/every
day
Once a
week
Less
than
once a
week
Not
at all
Don’t
know
Number
of
women &
men
30.6
52.6
21.3
25.8
22.5
14.2
23.4
6.1
1.3
0.4
5360
6161
38.2
50.3
23.1
24.8
19.5
15.3
17.3
8.0
1.0
0.6
7556
3965
46.3
33.1
44.2
37.2
38.6
49.6
18.4
22.8
19.1
32.5
29.1
25.9
20.6
17.4
15.6
19.8
19.7
17.1
13.9
25.5
19.1
7.8
11.1
5.4
0.6
0.5
1.1
1.0
1.1
0.5
2047
1536
2847
1294
1776
2021
23.2
18.2
22.8
33.3
1.4
2486
44.9
42.0
46.4
64.2
21.6
24.4
27.9
19.9
16.4
19.9
17.0
10.6
15.4
12.3
7.0
4.0
1.0
0.7
0.7
0.2
1025
2233
4519
1258
36.8
41.9
46.2
41.4
41.7
55.7
42.4
26.2
26.5
23.0
22.4
20.9
20.1
23.7
19.9
16.2
17.0
19.3
18.3
15.5
18.1
15.3
14.2
12.5
15.0
16.5
6.7
14.1
1.2
0.5
0.4
0.8
1.2
1.0
0.8
2470
2163
1882
2456
1724
826
11521
183
Table 13.16: Television Viewing Habits
Percentage Distribution of Respondents Television Viewing Habits
According to Selected Characteristics; FMOH, Nigeria 2007
Characteristics
Sex
Female
Male
Location
Rural
Urban
Zone
North Central
North East
North West
South East
South-South
South West
Education
Never attended
school
Qur’anic only
Primary
Secondary
Higher
Age group
15-19
20.24
25-29
30-39
40-49
50-64
Religion
Islam
Protestant
Catholic
Others
Total
13.7
Almost
every
day/every
day
Once a
week
Less
than
once a
week
Not at
all
No
response
Number
of
women
& men
21.7
27.2
15.8
21.0
15.7
20.4
43.5
28.3
2.5
2.1
5360
6161
12.7
47.5
16.1
23.3
20.2
14.4
47.3
12.6
2.8
1.2
7556
3965
25.0
15.5
15.9
22.8
31.3
38.9
13.7
13.7
11.7
27.0
25.7
25.2
20.6
13.0
13.2
22.5
23.9
19.2
38.5
55.7
54.3
23.0
17.0
13.9
2.0
1.4
3.9
2.9
1.6
1.2
2047
1536
2847
1294
1776
2021
5.1
7.3
13.8
69.3
3.3
2486
8.3
18.9
33.6
54.5
9.7
19.4
24.9
23.8
15.0
22.9
20.4
13.2
62.3
35.2
18.7
6.3
4.0
2.8
1.5
1.0
1025
2233
4519
1258
24.9
27.7
28.0
23.5
21.3
18.6
19.9
20.2
19.1
17.5
16.8
15.6
19.6
16.8
17.9
18.0
17.7
20.7
32.7
33.0
32.0
37.6
39.9
41.2
2.3
1.5
2.2
2.4
3.0
2.8
2470
2163
1882
2456
1724
826
19.2
31.7
27.3
14.4
24.7
13.7
24.0
22.4
19.4
18.6
15.9
20.0
22.5
16.5
18.2
47.6
21.6
24.9
44.6
35.3
2.8
1.7
1.8
2.9
2.3
5771
4148
1462
139
11521
Discussions and Conclusions
The findings generally indicated poor level of personal
communications on RH issues among the Nigerian population. Most
parents and guardians did not engage in communication with their
adolescent children and wards about sexual and reproductive health
issues. There was poor reproductive health communication in family
and non-family settings. Many respondents were not comfortable
discussing sexually-related matters with family members or non-family
members such as religious leaders and teachers. The finding that only
about a quarter of young persons (15-19 years) were comfortable to
discuss sexual matters with their fathers and a third was comfortable
to discuss with their mothers has significant implications for the
acquisition of correct information on sexuality and related issues by
184
young people. The situation is made more challenging by the finding
that only 4% of young people age 15-19 years indicated that they
were comfortable with discussing sexual matters with their teachers
and 5% with their religious leaders. Some parents may still fear that
providing sex education will encourage young people to experiment
sex and may increase risky sexual behaviour. Adolescents need and
desire adult counselling therefore, there is a need to foster
relationships between parents and children and reduce inhibitions
about communicating sexual health messages with their children.
Appropriate strategies need to be identified to bridge this gap. The
finding that parents discuss reproductive health issues more with their
female than male children also indicates that parents believe that
reproductive health challenges are faced more by female than male
children.
The findings from the study indicate that very little communication on
family planning occurs among family members and friends. Most
respondents had not discussed about family planning in the 12
months preceding the study even with their spouses. More males had
initiated discussion on family planning with their partners than
females. Those who were educated, lived in urban areas and in
southern Nigeria were more likely to have discussed about family
planning. Less than half of respondents felt that community leaders
support family planning and condom use. These leaders need to be
further mobilised to further gain their support for family planning as
they are important channels for promoting family planning at
community level.
Communication is now a vital and indispensable part of many
interventions. Communication interventions can increase demand for
services and have an impact on health knowledge, attitudes
behaviours and practices. The findings indicate respondents support
the use of the radio, print media and television for communication on
reproductive health issues. The radio has a high listenership therefore
it is the channel that will likely provide the greatest reach. Mass media
is a powerful tool which needs to be continually tapped to establish
new social norms and promote social change.
185
SECTION 14
HIV Sero-Prevalence
14.0
Introduction
HIV prevalence data provides important information to plan the national
response, to evaluate programme impact, and to measure progress on
the national multi-sectoral strategic framework on HIV and AIDS. The
understanding of the distribution of HIV infection within the population and
analysis of the social, biological and behavioural factors associated with
HIV infection offer new insights about the HIV epidemic in Nigeria, which
should lead to more precisely targeted messages and prioritized
interventions.
In Nigeria, estimates of HIV prevalence have been based on sentinel
survey of women attending antenatal clinics (ANC). This system, which
excludes men, non pregnant women and even pregnant women who do
not attend antenatal clinics, does not provide a true representative data
for the general population. NARHS Plus is the first national HIV testing
survey of the general population which was aimed at providing HIV
estimates at national, zonal and state levels. It also provides a measure
of HIV prevalence for women and men.
14.1
Coverage of HIV Testing (Acceptance rate)
Table 14.1 shows that the national coverage of HIV testing in this survey
among respondents was 79%.This was higher in the rural areas (80%)
than in the urban areas (76%). Among male respondents, coverage was
higher in the rural area (81%) than the urban areas (75%). While among
female respondents, coverage was marginally higher in the rural area
79%) when compared with the urban area (78%).Overall, coverage was
highest in the North East zone (85%), among respondents with primary
education (82%), the 15-24 years age group (80%) and widowed
respondents (84%).
186
Table 14.1: Coverage of HIV Testing
Coverage of HIV testing among all respondents by selected
characteristics: FMOH, Nigeria 2007
Characteristics
Male
Total
Percent
tested
Percen
t who
refused
Rural
80.9
19.1
Urban
74.7
Zone
North West
North East
North Central
Female
Total
Percent
tested
Percen
t who
refuse
d
4043
78.6
21.4
25.3
2118
78.3
72.7
27.3
1514
85.9
14.1
818
78.1
21.9
1105
National
Percent
tested
Percent
who
refused
Total
3513
79.8
20.2
7556
21.7
1847
76.4
23.6
3965
65.8
34.2
1332
69.4
30.6
2846
84.4
15.6
717
85.2
14.8
1535
79.1
20.9
942
78.6
21.4
2047
2021
Location
South West
79.4
20.6
1104
86.4
13.6
917
82.6
17.4
South East
78.8
21.2
655
78.4
21.6
639
78.6
21.4
1294
South South
80.3
19.7
953
83.1
16.9
800
81.6
18.4
1753
Education
None
76.0
24.0
864
59.7
40.3
1622
73.3
26.7
2486
Quranic
74.0
26.0
629
72.1
27.9
396
73.3
26.7
1025
Primary
79.4
20.6
1193
84.7
15.3
1040
81.9
18.1
2233
Secondary
80.5
19.5
2646
81.4
18.6
1873
80.9
19.1
4519
Higher
76.0
24.0
829
78.4
21.6
429
76.8
23.2
1258
15-19
82.3
17.7
1280
77.1
22.9
1190
79.8
20.2
2470
20-24
81.0
19.0
1079
78.4
21.6
1084
79.7
20.3
2163
25-29
76.7
23.3
946
79.0
21.0
936
77.8
22.2
1882
30-39
78.3
21.7
1169
78.4
21.6
1287
78.4
21.6
2456
40-49
75.3
24.7
861
80.2
19.8
863
77.7
22.3
1724
50-64
76.0
24.0
826
0.0
0.0
0
76.0
24.0
826
Currently married
76.6
23.4
76.7
23.3
3412
76.7
23.3
6230
Cohabiting
77.1
22.9
191
81.1
18.9
189
79.1
20.9
380
Never married
80.9
19.1
2986
81.6
18.4
1460
81.1
18.9
4446
113
Age group
Marital status
2818
Separated
66.4
33.6
61
80.8
19.2
52
73.0
27.0
Divorced
78.4
21.6
36
74.8
25.2
68
76.0
24.0
104
Widowed
79.7
20.3
57
85.2
14.8
172
83.9
16.1
229
No Response
Total
xx
xx
8
xx
78.6
21.4
6161
78.5
187
xx
6
xx
21.5
5360
78.6
xx
21.4
14
11521
Figure 14.1: HIV Prevalence by Sex and Zones in Nigeria, FMOH
2007
7
6
5
4
Male
Female
All
Percentage
3
2
1
0
North
West
North North South
East Central West
South
East
South National
South
Zone
14.2
Overall Prevalence Rates
Table 14.2 shows the overall HIV prevalence rates and prevalence rates
by selected characteristics. The national HIV prevalence rate obtained in
this survey was 3.6%. It was higher among females (4.0%) than males
(3.2%); slightly higher in the urban area (3.8%) compared with the rural
area (3.5%). It was highest in the North Central zone (5.7%) and lowest in
the South East (2.6%). Prevalence was generally higher among those
who had received formal education than those who had not. It was
highest among respondents with primary education (4.6%) and lowest
among respondents that had no education (2.7%). HIV prevalence was
highest among the 30-39 years age group (5.4%) and lowest among the
15-19 years age group (1.7%).
188
Table 14.2: Overall Prevalence Rates
HIV prevalence and Ninety Five percent confidence intervals According to
Selected Characteristics
Characteristics
Gender
Female
Male
Location
Rural
Urban
Zone
North West
North East
North Central
South West
South East
South South
Education
None
Quranic
Primary
Secondary
Tertiary
Age
15-19
20-24
25-29
30-39
40-49
50-64
All respondents
Prevalence
n
95% Confidence
Interval
4.0
3.2
4192
4847
3.4 – 4.6
2.7 – 5.0
3.5
3.8
3198
5841
2.9 – 4.1
3.3 – 4.3
3.0
3.4
5.7
3.4
2.6
3.5
2019
1320
1290
1991
1030
1389
2.3 – 3.7
2.4 – 4.4
4.4 – 7.0
2.6 – 4.2
1.6 – 3.6
2.5 – 4.5
2.7
2.8
4.6
3.5
4.0
1761
748
1838
3717
974
1.9 – 3.5
1.6 – 4.0
3.6 – 5.6
2.9 – 4.1
2.8 – 5.2
1.7
3.2
4.1
5.4
4.0
2.7
1980
1706
1473
1925
1335
619
2.4
3.1
4.4
3.0
1.4
3.6
9039
3.2 – 4.0
– 2.3
– 4.0
– 5.1
– 6.4
– 5.1
– 4.0
14.3 HIV Prevalence Rates by Selected Characteristics
disaggregated by Sex
Table 14.3 shows that in both rural and urban areas, prevalence of HIV
was higher among female respondents than male respondents. Among
female respondents, the HIV prevalence was higher in urban than rural
areas (4.7% and 3.6% respectively).However, among males the
prevalence was higher in rural than urban areas (3.3% and 3.0%
respectively). HIV prevalence was higher among female respondents in
all zones except in the North West zone. For respondents with no formal
education or Qur’anic education only, HIV prevalence was higher among
males; while for respondents with primary education and above,
prevalence was higher among females. HIV prevalence was higher in
females among respondents aged 20-39 years. For Moslem respondents,
it was higher among males, while for all other religions, it was higher
among female respondents. HIV prevalence was much higher among
females who were separated, divorced or widowed. Peak prevalence of
HIV infection for both sexes is the 30-39 years age group (Figure 14.2).
189
Table 14.3: HIV Prevalence rates by Selected Characteristics
disaggregated by Sex
HIV Prevalence of all Respondents According to Selected Background
Characteristics: FMOH, Nigeria 2007
Characteristics
Male
Total
Female
Total
% total
Total
Location
Rural
3.3
3169
3.6
2672
3.5
5841
Urban
Zone
North West
North East
North Central
South West
South East
South South
Education
None
Qur’anic
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Religion
Islam
Protestant
Catholic
Traditional
Marital status
Currently married
Cohabiting
Never married
Separated
Divorced
Widowed
Total
3.0
1678
4.7
1520
3.8
3198
3.6
2.2
5.1
3.0
1.9
3.3
1120
718
686
1056
528
738
2.3
4.8
6.5
3.9
3.4
3.8
899
602
604
935
502
651
3.0
3.4
5.7
3.4
2.6
3.5
2019
1320
1290
1991
1030
1389
3.3
3.2
3.8
3.0
3.2
634
463
952
2167
630
2.4
2.1
5.4
4.3
5.5
1127
285
886
1550
344
2.7
2.8
4.6
3.5
4.0
1761
748
1838
3717
974
2.1
1.9
3.6
5.1
4.6
2.7
1065
863
727
920
654
619
1..3
4.5
4.7
5.7
3.5
-
915
843
746
1005
681
-
1.7
3.2
4.1
5.4
4.0
2.7
1980
1706
1473
1925
1335
619
3.3
2.9
4.1
2.6
2410
1729
633
39
2.6
5.2
5.2
6.7
1962
1667
536
15
3.0
4.0
4.6
3.7
4372
3396
1169
54
4.4
3.2
2.3
5.0
3.6
2.3
3.2
2163
142
2422
40
28
44
4847
4.0
2.1
2.8
9.8
11.8
9.7
4.0
2588
158
1207
41
51
144
4192
4.2
2.7
2.5
7.4
8.9
8.0
3.6
4751
300
3629
81
79
188
9039
190
Fig 14.2: HIV Prevalence by Age group and Sex; FMOH 2007
14.4
Use of Drinks Containing Alcohol
Drinking alcohol has been associated with high risk sexual behaviour.
Table 14.4 shows the HIV prevalence among respondents that use
alcohol. It shows a prevalence of 4.0% among respondents that take
drinks containing alcohol everyday, 5.3% among those that take alcohol
at least once a week, 3.4% among those that take alcohol less than once
a week and 3.4 % also among those that never take alcohol. For those
who take drinks containing alcohol everyday, HIV prevalence is higher
among females (7.1%) and in the urban area (6.2%). It was highest in the
North Central zone (9.1%), those with higher education (9.7%), 40-49
years age group (7.1%) and among respondents that are cohabiting
(9.1%).
191
Table 14.4: Use of Drinks Containing Alcohol
HIV Prevalence among Respondents According to Frequency of Alcohol
use by Selected Characteristics: FMOH, Nigeria 2007
Characteristics
Everyday
Sex
%
N
%
N
%
Male
Female
Location
Rural
Urban
Zone
North West
North East
North Central
South West
South East
South South
3.4
7.1
204
42
4.5
8.8
558
148
3.3
6.2
181
65
5.3
5.7
0.0
4.8
9.1
0.0
3.0
4.7
20
21
55
53
33
64
3.7
0.0
6.3
1.9
9.7
Education
None
Quranic
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Marital status
Currently
married
Cohabiting
Never married
Separated
Divorced
Widowed
Total
14.5
At least once
a week
Less
than
a
week
Never
Not
sure/
No
respon
se
N
%
N
%
N
3.4
3.2
339
156
2.9
3.8
3558
3776
7.5
4.3
40
67
469
264
3.4
3.3
296
211
3.3
3.5
4832
2611
3.2
10.4
63
48
6.1
3.6
8.6
6.1
2.3
6.2
37
28
105
132
173
258
0.0
0.0
8.0
2.4
1.6
4.9
14
11
50
123
129
182
3.1
3.4
5.2
3.5
2.5
2.3
1917
1253
1071
1666
676
860
0.0
12.5
0.0
0.0
16.7
11.5
32
8
9
19
18
23
55
5
63
103
20
5.3
0.0
3.5
6.7
4.6
75
4
200
344
109
0.0
4.5
4.0
1.1
33
156
225
93
2.6
2.9
4.6
3.1
4.1
1568
731
1402
3004
737
3.2
0.0
11.1
7.5
7.1
31
9
18
40
14
0.0
0.0
6.8
4.8
7.1
2.9
9
40
44
63
56
35
3.0
3.4
5.7
9.7
2.5
4.5
67
118
122
176
159
89
3.5
2.7
2.7
5.1
4.0
3.1
57
113
75
99
99
64
98.5
3.2
4.0
5.1
4.1
2.1
1825
1421
1213
1560
1003
422
86.4
7.1
0.0
0.0
5.3
10.0
22
17
19
27
19
10
4.6
152
5.1
8.3
3.9
254
4.2
3897
1.9
54
9.1
2.7
0.0
0.0
0.0
4.0
11
75
3
2
4
246
6.7
4.8
7.7
33.3
0.0
5.3
30
272
13
9
10
732
0.0
3.3
0.0
0.0
8.3
3.4
18
209
7
8
12
507
2.2
2.0
8.9
6.7
8.4
3.4
231
3030
51
60
155
7443
0.0
12.2
0.0
83.3
6.3
10
41
1
6
111
HIV Prevalence by Usage of Condom in Non-marital Sex
Table 14.5 shows HIV prevalence among all respondents who reported
male condom use in the last sex act with a non-marital partner. The
prevalence was 3.9% for those who used condom in their last non-marital
sex act, compared to 4.8% among those who did not use condom.
Among respondents who did not use condoms in their last non-marital
192
sex act, prevalence was higher in rural areas(5.1%) , in the North East
zone (9.6%), and in the 30-39 years age group (9.8%).
Table 14.5: HIV Prevalence by Usage of Condom in Non-marital Sex
HIV Prevalence among all Respondents who reported Male Condom use
in the last sex act with a Non-Marital partner According to Selected
Characteristics: FMOH, Nigeria 2007
Characteristics
Total
Location
Rural
Urban
Zone
North West
North East
North Central
South West
South East
South South
Education
None
Qur’anic
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Religion
Islam
Protestant
Catholic
Traditional
Marital status
Currently married
Cohabiting
Never married
Others
Total
14.6
Used condom in the
last non marital sex
659
Did not
3.8
4.1
5.1
4.2
3.8
3.1
3.8
3.1
3.7
5.5
5.3
9.6
7.3
4.2
3.6
3.2
Xxx
0.0
7.5
3.8
2.4
xxx
0.0
4.3
4.5
4.2
0.9
4.4
3.3
6.7
6.7
Xxx
3.5
2.7
6.3
9.8
5.9
xxx
1.9
4.8
4.2
Xxx
4.0
4.3
8.1
xxx
6.0
Xxx
3.5
Xxx
3.9
6.9
xxx
3.5
18.2
4.8
747
HIV Prevalence According to Knowledge of Prevention
of HIV infection
Table 14.6 shows HIV prevalence according to knowledge of prevention
of HIV infection (condom use and sex with faithful uninfected partner)
193
among those who ever heard of HIV/AIDS. Prevalence was 4.1% among
respondents who knew both means of prevention compared to 3.2%
among those who did not. Among respondents that knew both,
prevalence was higher among females (4.9%), in the North Central zone
(6.3%), among those with primary education (5.1%), and among the 3039 years age group (6.3%).
Table 14.6: HIV Prevalence and Knowledge of Prevention of HIV
infection
Prevalence of Respondents who knew means of HIV prevention
According to Selected Characteristics: FMOH, Nigeria 2007
Characteristic
Total
Sex
Male
Female
Location
Rural
Urban
Zone
North West
North East
North Central
South West
South East
South South
Education
None
Quranic
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Religion
Islam
Protestant
Catholic
Traditional
Marital status
Currently married
Living with partner
Never married
Separated/Divorced/Wid
owed
Total
Know both condom use
and sex with faithful
uninfected partner as
prevention modes
Know only one or
none
4840
4190
3.5
4.9
2.9
3.3
4.1
4.0
2.9
3.7
3.2
4.3
6.3
3.2
3.6
3.6
2.8
2.7
4.8
4.1
2.0
2.5
3.0
4.0
5.1
3.9
4.1
2.8
2.2
4.3
2.9
4.5
1.8
3.3
4.3
6.3
5.1
3.2
1.6
3.2
4.1
4.1
3.7
2.5
3.3
4.2
5.6
1.8
2.8
3.7
3.3
7.5
4.9
2.5
3.0
9.5
3.5
3.7
1.8
7.4
4.1
3.2
194
14.7
HIV Prevalence According to Knowledge of Routes
of HIV infection
Table 14.7 shows HIV Prevalence according to knowledge of routes of
HIV infection among those who ever heard of HIV/AIDS. The 5 routes
were sexual intercourse, blood transfusion, mother-to-child transmission,
sharing sharp objects such as razors, and sharing (hypodermic) needles.
Prevalence was 4.1% among respondents who knew all five routes. It
was 3.1% among respondents that did not know all five. Among
respondents that knew all five routes, prevalence was higher among
females (4.5%), slightly higher in urban areas(4.2%), in North Central
zone (6.4%), among those with primary education (5.6%), 30-39 years
age group (6.3%), and Catholics (5.0%).
14.8
HIV Prevalence and Self-risk Assessment
Table 14.8 shows HIV Prevalence by respondents’ personal risk
perception about HIV. Prevalence was 4.8% among respondents that
perceived they had a high chance; 3.7% among those that perceived they
had a low chance; and 0.4% among those that perceived they had no risk
at all. Few respondents (0.7%) reported that they already had AIDS. Of
respondents that perceived they had a high chance, prevalence was
higher among females (5.4%), in the urban area (9.2%), in the South East
zone (12.5%), among those with no education (10.7%), 50-64 years age
group (14.3%), Protestants (4.9%) and currently married respondents
(8.4%).
195
Table 14.7: HIV Prevalence by Knowledge of Routes of HIV
transmission
Prevalence of Respondents who knew main Means of HIV transmission
According to Selected Characteristics: FMOH, Nigeria 2007
Characteristic
Sex
Male
Female
Location
Rural
Urban
Zone
North West
North East
North Central
South West
South East
South South
Education
None
Qur’anic
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Religion
Islam
Protestant
Catholic
Traditional
Marital status
Currently married
Living with partner
Never married
Separated
Total
Know all five
modes of
transmission
Total
Does not
know all
five
Total
3.9
4.4
2672
2265
2.5
3.6
2162
1931
4.1
4.1
2980
1957
2.9
3.5
3047
1046
3.4
4.2
6.4
3.5
3.7
3.7
905
623
860
1021
712
816
2.5
2.8
4.8
3.4
1.3
2.7
1072
686
748
648
305
634
3.1
3.5
5.6
3.9
4.0
676
289
980
2291
701
2.7
2.4
3.7
2.9
4.6
1174
465
833
1362
259
1.9
3.2
4.6
6.0
5.0
3.9
949
1003
853
1091
737
304
1.5
3.3
3.8
4.4
3.5
1.8
1015
723
609
821
600
325
3.7
4.3
5.0
3.2
2077
2019
779
62
2.4
3.8
4.2
6.3
2285
1380
380
48
5.0
2.2
2.7
10.2
4.1
2576
134
2061
166
4937
3.2
3.6
2.3
6.6
3.1
2189
165
1541
198
4093
196
Table 14.8: HIV Prevalence and Self-risk Assessment
HIV Prevalence by Respondents’ Personal Risk Perception about HIV
According to Selected Characteristics: FMOH, Nigeria 2007
Characteristic
High
chance
Low
chance
No risk
at all
No
response
0.4
Already
have
AIDS
0.7
Total
Sex
4.8
3.7
Male
4.1
Female
Location
Rural
5.4
Urban
Zone
3.3
3.6
8556
3.4
3.0
11.1
3.2
3.2
4633
4.1
4.0
0.0
3.4
4.1
3923
2.4
4.3
3.1
9.5
3.7
3.5
5431
9.2
2.8
4.3
0.0
4.1
3.9
3127
North west
North east
0.0
5.1
3.5
4.2
3.0
2.5
7.7
-
0.0
6.5
3.1
3.5
1796
1252
North central
South west
South east
11.6
0.0
12.5
6.2
2.0
3.9
4.8
4.3
1.8
16.7
0.0
7.9
3.5
0.0
5.7
3.5
2.6
1204
1933
1020
South-south
Education
0.0
3.2
1.1
0.0
1.7
3.5
1355
None
Qur’anic
Primary
10.7
0.0
2.2
3.3
2.2
0.0
4.4
2.8
1487
Secondary
Higher
Age group
3.2
10.0
3.8
5.8
2.8
2.6
3.9
4.0
0.0
25.0
0.0
6.3
4.3
3.3
3.0
4.6
3.5
676
1758
3663
4.0
3.9
-
0.0
4.0
974
15-19
20-24
0.0
0.0
1.3
2.1
1.9
3.6
0.0
0.0
2.4
4.3
1.7
3.0
1817
1641
25-29
30-39
3.3
10.7
4.2
6.5
3.8
5.1
16.7
0.0
6.8
1.8
4.1
5.6
1412
1835
40-49
50-64
5.6
14.3
4.7
3.3
4.0
2.3
25.0
0.0
2.4
10.0
4.3
2.9
1266
590
Religion
Islam
4.3
3.0
3.0
7.7
1.1
3.0
3996
Protestant
Catholic
Marital status
Currently married
Living with partner
4.9
3.0
4.0
5.3
3.9
4.5
14.3
0.0
5.0
7.1
4.0
4.7
3324
1143
8.4
xx
4.7
xx
4.0
3.4
11.1
-
1.6
xx
4.3
2.8
4488
282
Never married
Separated
1.2
33.3
2.2
6.5
2.6
8.8
0.0
-
4.8
0.0
2.5
8.3
3467
72
Divorced
Widowed
xx
xx
16.7
6.1
4.2
9.7
-
50.0
12.5
9.2
8.6
76
163
xx: Fewer than 30 unweighted cases; hence figure suppressed
197
Total
14.9
HIV Prevalence and Numbers of Non marital Partners
Table 14.9 shows the prevalence of HIV by current numbers of non
marital partners. Of all respondents who had no non marital partners, HIV
prevalence was 3.5% compared with 5.0% among those who had one
non marital partner in the last one year. Among those who had 2 or more
non marital partners in the last 12 months.
Table 14.9: HIV Prevalence and Number of Non Marital Sexual
Partners
HIV Prevalence among all Respondents by Number of Sexual Partners
According to Selected Characteristics: FMOH, Nigeria 2007
Characteristic
Prevalence of persons with non-marital partners
None
Total
One
Total
Two or
more
Total
3.3
3.9
5182
2450
5.5
4.3
560
373
2.8
3.9
286
180
3.4
3.6
3854
3777
3.8
7.0
576
357
1.5
14.5
404
62
2.9
3.2
1932
1225
xx
7.4
Xx
54
Xx
6.7
Xx
30
North central
South west
South east
5.6
3.4
2.8
1328
1310
829
7.1
4.5
4.0
183
224
150
3.1
2.2
2.6
97
135
38
South-south
Education
2.9
1007
4.3
301
3.5
142
Never attended school
Qur’anic
Primary
2.6
1797
17.6
34
Xx
Xx
2.8
4.7
3.3
741
1631
2801
xx
6.5
4.9
xx
124
513
Xx
3.4
2.9
Xx
58
279
4.7
661
2.6
195
3.8
104
1.5
3.1
4.1
4.9
4.2
3.0
1685
1246
1137
1698
1257
608
2.5
3.1
6.2
12.0
5.4
xx
200
320
211
133
56
xx
2.5
4.4
1.8
2.5
8.3
Xx
79
160
114
81
Xx
Xx
3.0
3.9
4.4
5.3
4056
2564
917
94
3.1
4.9
7.7
xx
192
566
169
xx
2.6
3.7
2.7
Xx
114
269
73
Xx
4.1
3.1
2.0
6.5
3.5
4597
255
2469
310
7631
9.5
xx
4.0
15.4
5.0
95
xx
771
39
933
2.7
Xx
2.5
Xx
3.2
73
Xx
362
Xx
466
Location
Rural
Urban
Sex
Male
Female
Zone
North west
North east
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Religion
Islam
Protestant
Catholic
Traditional
Marital status
Currently married
Cohabiting
Never married
Others
Total
xx: Fewer than 30 unweighted cases; hence figure suppressed
198
14.10 HIV Prevalence and Current Sexual Activity
Table 14.10 shows HIV prevalence among all respondents who had
sexual intercourse in the last 12 months, disaggregated by sex.
Prevalence was 3.9% among male respondents who had sexual
intercourse in the last 12 months and 3.3% among male respondents who
did not have sexual intercourse in the last 12 months. Prevalence was
4.4% among female respondents who had sexual intercourse in the last
12 months and 5.6% among female respondents who had no sexual
intercourse in the last 12 months.
Table 14.10: HIV Prevalence and Current Sexual Activity
HIV Prevalence among all respondents who had sexual intercourse in the
last 12 months, disaggregated by sex according to selected
characteristics: FMOH, Nigeria 2007
Characteristic
Yes
Total
Location
Rural
Urban
Zone
North west
North east
North central
South west
South east
South-south
Education
None
Qur’anic
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Religion
Islam
Protestant
Catholic
Traditional
Marital status
Currently married
Cohabiting
Never married
Separated
Divorced
Widowed
Male
No
Female
No
Yes
3.9
3.3
4.4
5.6
4.1
3.5
3.1
3.5
4.0
5.1
4.6
8.1
5.1
3.0
6.1
2.8
1.7
3.6
77
75
3.2
4.2
1.1
3.8
2.0
6.3
8.0
4.2
4.1
3.6
5.6
3.3
6.8
5.1
4.5
7.9
3.8
4.9
4.2
3.8
3.2
2.9
2.6
4.4
3.3
2.5
2.3
1.8
6.2
5.6
4.8
3.0
2.8
5.9
8.2
16.1
3.5
2.0
4.2
5.2
1.2
2.6
1.5
4.3
1.2
3.6
6.3
2.7
1.6
5.1
4.7
5.5
3.1
4.7
3.2
6.5
7.4
4.5
4.1
3.4
4.5
3.3
5.5
2.1
2.0
0.0
2.7
5.6
7.1
12.5
4.3
7.1
5.0
0.0
4.6
1.8
2.3
7.1
0.0
0.0
2.2
5.3
3.7
4.0
5.3
2.7
4.0
1.6
5.8
15.4
26.3
23.1
4.7
11.5
3.1
7.1
3.1
8.4
-
199
-
14.11 HIV Prevalence among Respondents Who have ever had
sex in exchange for gifts or favours
Table 14.11 shows that the prevalence was 4.8% among male
respondents who had sex in exchange for gifts or favours and 3.7%
among male respondents who didn’t have sex in exchange for gifts or
favours. Prevalence was 6.2% among female respondents who had sex
in exchange for gifts or favours and 4.4% among female respondents who
didn’t have sex in exchange for gifts or favours.
14.11: HIV Prevalence by Sex for Gift
HIV Prevalence among respondents who have ever had sex in exchange
for gifts or favours according to selected characteristics: FMOH, Nigeria,
2007
Characteristics
Location
Rural
Urban
Zone
North west
North east
North central
South west
South east
South-south
Education
None
Qur’anic
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Religion
Islam
Protestant
Catholic
Traditional
Marital status
Currently married
Cohabiting
Never married
Separated
Divorced
Widowed
Total
Male
Female
Had sex in
exchange
for money
gifts or
favours
Did not have
sex in
exchange for
money, gifts
or favour
Had sex in
exchange for
money gifts
or favours
Did not have
sex in
exchange for
money, gifts
or favour
5.0
3.9
5.2
3.9
4.4
3.3
8.2
5.5
xx
0.0
5.1
4.3
10.3
5.9
5.3
2.9
5.6
3.1
0.6
3.5
xx
40.0
5.1
4.3
10.3
5.9
2.6
4.8
7.5
4.7
4.5
4.1
3.7
3.9
xx
2.3
8.3
10.9
3.4
4.5
6.3
3.8
xx
7.0
6.8
1.9
6.1
5.9
0.0
3.2
xx
6.5
**
0.0
7.4
6.4
5.8
0.0
3.2
2.6
3.6
4.9
4.4
2.8
3.2
10.4
2.2
7.5
xx
-
2.1
4.5
5.2
5.6
3.7
-
4.3
4.2
6.1
xx
4.2
3.1
3.8
3.0
12.9
2.6
9.7
-
2.9
6.2
6.3
xx
5.1
xx
5.1
xx
xx
xx
4.8
4.4
2.6
2.4
5.7
**
2.4
3.7
6.5
**
4.9
xx
xx
xx
6.2
3.9
3.6
5.1
10.8
10.9
10.4
4.4
xx: Fewer than 30 unweighted cases; hence figure suppressed
200
14.12 HIV Prevalence and Sexual Activity
Table 14.12 shows HIV prevalence rates by sexual activity of all
respondents. Prevalence was 3.8% among male respondents who were
sexually active and 1.7% among male respondents who had no sexual
activity. Prevalence was 1.7% among female respondents who were
sexually active and 1.2% among female respondents who had no sexual
activity.
14.12: HIV Prevalence and Sexual Activity
HIV Prevalence rates by Sexual Activity of all Respondents According to
Selected Characteristics: FMOH, Nigeria 2007
Characteristic
Age group (in
years)
Total
Location
Rural
Urban
Zone
North west
North east
North central
South west
South east
South-south
Education
None
Qur’anic
Primary
Secondary
Higher
Age group
15-19
20-24
25-29
30-39
40-49
50-64
Religion
Islam
Protestant
Catholic
Traditional
Marital status
Currently married
Cohabiting
Never married
Separated
Divorced
Widowed
Ever had sex
Male
Male
Female
Never had sex
Female
Male
Male
Female
Female
3.8
3521
4.6
3456)
1.7
1326
1.19
736
3.9
3.5
2312
1209
4.1
5.6
2268
1188
1.6
1.9
856
470
0.7
1.5
405
331
5.0
2.7
5.6
3.2
1.6
3.8
694
483
539
815
382
608
2.5
5.7
7.7
3.2
1.6
3.8
788
490
507
815
382
608
1.2
1.3
3.4
2.5
2.7
0.8
427
236
147
242
146
130
0.9
0.9
0.0
1.7
1.4
1.1
111
112
97
181
140
94
3.8
524
2.4
1066
1.8
111
1.7
59
4.6
4.2
3.7
327
738
1383
1.9
6.0
6.0
262
802
1039
0.0
2.6
1.7
136
215
784
4.3
0.0
1.0
23
84
512
3.1
549
284
284
3.7
81
3.3
60
3.3
2.3
3.9
4.9
4.6
2.6
244
524
589
895
650
618
2.1
4.8
4.8
5.8
3.7
-
375
702
712
989
677
-
1.7
1.2
2.2
XX
XX
XX
821
338
136
XX
XX
XX
0.7
1.4
2.9
XX
XX
-
539
140
34
XX
XX
-
4.2
3.2
4.0
2.9
1615
1365
476
35
3.0
5.9
6.7
xx
1672
1339
420
14
1.4
1.6
4.5
xx
796
364
157
4
0.7
1.8
0.9
xx
291
327
117
1
4.4
2.3
2.8
5.0
3.6
2.3
2163
132
1111
40
28
44
4.0
3.4
5.2
9.8
11.8
9.7
2586
149
480
41
51
144
XX
xx
1.8
XX
XX
XX
XX
xx
1311
XX
XX
XX
xx
xx
1.2
XX
XX
XX
2
8
72.7
XX
XX
XX
XX: Fever than 30 unweighted cases; hence figure suppressed
201
14.13 External Quality Control
As contained in the survey protocol, an external quality check (QC) of
10% negatives and 100% positives was conducted at the Nigerian
Institute of Medical Research (NIMR), Lagos. This was aimed at reconfirming the results of the tests done at Central Laboratory of the
University College Hospital (UCH) Virology Laboratory, Ibadan.
14.14 Acute Infections
The 2007 NARHS Plus sought information about acute infection. These
are infections that could be detected with antigens and were without
antibody formation during the period of the survey.
Based on the two ELISA test kits used, Genescreen detects viral antigens
and antibodies while Vironistika detects only antibodies. With this, it was
possible to detect respondents with acute infections. Any respondent that
reacted positive to Genescreen but negative to Vironistika was
considered to be in the phase of acute infection i.e. presence of viral
antigens only and no antibody formation.
Overall, about 7.3 per 1000 of respondents were considered to be living
with acute infection of HIV nationally. Substantial variations exist at the
level of geopolitical zones and states. North East has the least rate of
acute infection 3.7 per 1000 compared with the South West with 11.3 per
1000. The rates of acute infection were 9.3 in the North Central, 7.8 per
1000 in the North West, 5.3 per 1000 in the South East and 4.3 per
1000in the South South. At state level, the rates vary from 0.0 to 53.8 per
1000. For detailed information about this, see Appendix 2.
14.15 Discussion and Conclusions
National coverage of HIV testing among respondents was 79%. Overall,
the HIV prevalence was 3.6%. This is lower than the HIV prevalence of
4.4% reported in the 2005 HIV sentinel survey. It was higher among
females (4.0%) than males (3.2%); slightly higher in the urban area
(3.8%) compared with the rural area (3.5%). It was highest in the North
Central zone (5.7%) and lowest in the South East zone (2.6%). It was
highest among respondents with primary education (4.6%) and lowest
among respondents that had no education (2.7%). HIV prevalence was
highest among the 30-39 years age group (5.4%) and lowest among the
15-19 years age group.
In both rural and urban areas, prevalence of HIV was higher among
female respondents. Among female respondents, the HIV prevalence was
higher in urban than rural areas. However, among males the prevalence
was higher in rural than urban areas. HIV prevalence was higher among
female respondents aged 20-39 years but prevalence was higher among
males in the younger age groups (15 – 19 years) and older age groups
202
(above 39 years). HIV prevalence was much higher among females who
were separated, divorced or widowed. The prevalence of HIV was higher
among those who rated themselves as high risk for infection than among
those who felt they were at a low risk.
HIV prevalence was higher among respondents who have exchanged sex
for gifts than among respondents who do not do so. Transactional sex
may lead people to tolerate sex that entails considerable risk. This
practice needs to be discouraged, and innovative means to address this
will need to be developed.
203
SECTION 15
15.0
POLICY IMPLICATIONS
15.1
HIV AND AIDS
15.1.1 Sexual Behaviour
• Women should be targeted for interventions because they are
more vulnerable and they begin sexual activities earlier (median
age of sexual debut is 17 years, while male is 21 years)
•
Multiple non-marital sex is a major risk factor that the national
programme should aim at reducing by giving adequate information
on the risk involved and putting necessary interventions in place.
The present societal acceptance of multiple partnerships amongst
men should be discouraged
15.1.2 Knowledge, Opinion and Attitudes
• There is a need to integrate HIV/AIDS education into major life
activities to ensure that knowledge is widespread
• The Family Life and HIV/AIDS education curriculum should be
implemented and rapidly scaled up to ensure that the required
knowledge about HIV and AIDS is wide spread
15.1.3 Knowledge, Access and Use of Condoms
• Specific population groups particularly rural respondents and
those with lower educational status should be targeted for
interventions aimed at improving level of condoms usage
• Campaigns similar to those used for the male condoms can be
adopted to improve level of awareness and usage of female
condoms
15.1.4 HIV COUNSELLING AND TESTING
• Activities should be geared towards setting up more HCT centres
reaching far deep to the rural areas
• Periodic HCT Forum of all stakeholders should be conducted to
address issues/challenges relating to the HCT programme
• There should be publications on where to get an HIV test in prints,
electronic media and posters by government at all levels and
stakeholders
• The importance of HCT should be emphasized at all levels of
programming in order to encourage the desire and reasons for
HIV testing
204
•
•
More mobile HCT services should be provided by stakeholders
and government
Advocacy to community and religious leaders to support and
disseminate information on HCT
15.1.5 Sexually Transmitted Infections
• STIs should be given more attention since it has a very close
association with the transmission of HIV and fertility
• The national documents on STI should be made more available
for use (guidelines, protocol, manuals, SOPs etc)
• For the management of STIs, all providers of treatment should be
trained on how to improve the management by using the
syndromic management approach
15.1.6 Stigma and Discrimination
• There is a need to further study the causative factors of stigma to
improve interventions in this area
• Interventions on knowledge about the routes of transmission of
HIV should be scaled up amongst the general populace and
campaigns targeted at reducing discrimination should also be
intensified
• Ensure that laws to protect the rights of PLWHA are upheld
• Community and religious leaders specifically in rural areas must
be involved in the awareness programme
15.1.7 Behavioural Change Communication (BCC)
• There is a need to move from awareness raising to knowledge
building
• Behaviour change interventions need to be substantially increased
especially targeted to the youths and” “being faithful”
15.2 REPRODUCTIVE HEALTH (RH)
15.2.1 Safe Motherhood
• We need to understand reasons for poor use of ANC and provide
interventions that will increase access and use of maternal service
• The barriers to use of maternal services need to be identified in
further surveys so that informed decisions can be made to
overcome them (Knowledge, attitudes, beliefs & practices)
• Free maternal and child care already initiated by some State
Governments should be scaled up across the country and taken
down to Local Governments level
205
•
•
•
•
•
Continuous training of Traditional Birth attendants (TBA) and
supervision are important, the referrals system should be made
more effective
E-Health (GSM in creeks, etc.), this will close communication gap
and create access to information and help services
There is a need increase awareness on the need for ANC, skilled
attendants at delivery and post natal care women
There is also a need to improve access to maternal healthcare,
especially in the North where the rates of attendance are very low
in comparison with the South
Emergency Obstetrics Care (EOC) practices should be put in
place with adequate manpower and facilities
15.2.2 Family Planning
• There is the need to increase people’s awareness and knowledge
on the family planning methods and Increase gender
empowerment interventions including girl child education
• Novel mechanisms need to be used to overcome barriers to family
planning
• Subsidies need to be increased for other family planning
commodities apart from condoms
• Need for advocacy efforts to address known socio-cultural barriers
to FP
15.2.3 Adolescent Reproductive Health
• There is a need to scale up youth-focused BCC strategies such as
the “NYSC peer education scheme”
• Media/telephoning programme should focus more on youth e.g.
NACA telephoning programme
• The need to train our health care workers to be youth friendly
cannot be over emphasised
• Parents and guardians must live up to their responsibilities by
providing accurate information of health sexuality
• Methods for educating the youth on HIV/AIDS within all social
institutions including the family, schools and religious institutions
should be developed
15.2.4 Reproductive Rights and Gender Issues
• Education of women alone does not lead to gender equality.
However, opportunities exist for furtherance of female
reproductive rights as men were more knowledgeable and showed
more positive attitudes
206
•
•
•
There is a need to further educate women and men on
reproductive rights and dangers of FGM
The campaign to eliminate FGM by increasing the knowledge of
the dangers involved should be continued
Stringent measures should be taken to curtail this harmful
traditional practice through legislation and enforcement of laws
15.2.5 RH Communications
• The gatekeepers(community and religious) should be engaged in
the HIV/AIDS and FP/RH issues at community level to decrease
the opposition to it and also to empower men and women to
address the gaps and beliefs that mitigate against improving
reproductive health status
• Parents and teachers should be sensitised on the need for sexual
education for the youth
• Spousal communications to arrive at joint decision-making should
be encouraged
15.3 SERO-PREVALENCE
This is the first general population based HIV and AIDS Survey in Nigeria.
Findings from this survey revealed that the national HIV prevalence is
3.6%. The following interventions are hereby recommended for adoption.
• Promotion of condom use in risky sexual acts should be
intensified as the survey results showed clear indication of
advantage of use of condom in risky sex
• The survey showed that it is the use and not just the possession
of knowledge that protects from HIV infection hence
activities/interventions should be directed at information usage
• The prevalence in respondents with multiple partners is apparently
lower than that in those with one partner. This may be due to
different variables like consistent and correct condom use during a
risky sexual behaviour etc. Further research and studies will be
needed to unravel this.
• HIV and AIDS programme should emphasize assertive skills for
never married female,
• Interventions should target older men that patronise younger girls
• Promotion of ABC prevention should be sustained
• PMTCT and HCT services should be scaled up by government
and other stakeholders at all levels
• Interventions should be put in place to educate people that AntiRetroviral Therapy (ART) should not be considered as a cure for
HIV/AIDS
207
15.4 CONCLUSION
The reduction in the prevalence/transmission of HIV infection needs a
holistic approach focusing equally on all thematic areas involved in the
infection from behavioural change to prevention and even protection of
the rights of PLHA and OVC by the govt at all levels and other stake
holders with the full implementation of the principle of three ‘ones ’and an
integrated approach to RH/HIV/TB.
208
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Fatusi AO, Ijadunola KT, Ojofeitimi EO, Adeyemi MO, Omideyi AK, Akinyemi A,
Adewuyi AA. (2003). Assessment of Andropause Awareness and Erectile
Dysfunction among Married Men in Ile-Ife, Nigeria. Aging Male, 6 (2): 79 –
85.
Federal Ministry of Health (2002). National Policy and Plan of Action on
elimination of Female Genital Mutilation in Nigeria.
Federal Ministry of Health [Nigeria] (2003). National HIV/AIDS and Reproductive
Health Survey, 2003. Federal Ministry of Health, Abuja.
Federal Ministry of Health. (2005a). National AIDS and STI Control Programme:
National Health Sector Strategic Plan for HIV/AIDS in Nigeria 2005-2009.
Federal Ministry of Health, Abuja.
Federal Ministry of Health & World Health Organisation (2005b). Plan to ScaleUp Antiretroviral Treatment for HIV or AIDS in Nigeria 2005-2009.
Federal Ministry of Health, Abuja & World Health Organisation.
Federal Ministry of Health (2006a). National HIV/AIDS and Reproductive Health
Survey 2005, Federal Ministry of Health Abuja, Nigeria.
Federal Ministry of Health (2006 b). 2005 National HIV/Syphilis Sero –
prevalence Sentinel Survey. Federal Ministry of Health National AIDS /STI
Control Programme
Federal Ministry of Health (2007a). HIV/STI Integrated Biological and
Behavioural Surveillance Survey (IBBSS) 2007. Federal Ministry of Health
Abuja, Nigeria
Federal Ministry of Health (2007b). National Policy on the Health and
Development of Adolescents and Young People in Nigeria. Federal
Ministry of Health Nigeria.
Henshaw, S.K., Singh, S., Oye-Adeniran, B.A., Adewole, I.F., Iwere, N., Cuca, Y.
P. (1998). The Incidence of Induced Abortion in Nigeria. International
Family Planning Perspectives, 24(4):156 - 164.
National Action Committee on AIDS (NACA) (2004). HIV/AIDS National Strategic
Framework 2005-2009. Abuja, NACA.
National Population Commission [Nigeria] & ORC Macro (2004). Nigeria
Demographic and Health Survey 2003. Calverton, Maryland: National
Population Commission and ORC Macro.
National Population Commission (2006). Provisional report. 2005 population
census of the Federal Republic of Nigeria. Abuja, National Population
Commission
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Oye – Adeniran B.A, I.F Adewole, K.A Odeyemi, E.E Ekanem ,A.V Umoh (2005).
Contraceptive prevalence among young women in Nigeria. Journal of
Obstetrics and gynaecology, 25 (2): 182 -185.
The Alan Guttmacher institute (2004). Early childbearing in Nigeria: A continuing
challenge. Research in brief, 2004 series. No 2.
United Nations (1994). Programme of Action adopted at the International
Conference on Population and Development. Cairo 5 - 13 September,
1994. New York, United Nations. New York.
United Nations Population Fund (2002). Country Programme for Nigeria.
DF/FPA/NGA/5. 2 October 2002. New York, United Nations Population
Fund [UNFPA]
United Nations Population Fund (2005). State of the World Population 2005. The
Promise of Equality. Gender equity, reproductive Health and the
Millennium Development Goals. New York, United Nations Population
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United Nations Children’s Fund (2007). The state of the world’s children 2008.
Child survival. United Nations Children’s Fund (UNICEF) December 2007.
World Health Organization (2006). World Health Statistics 2006.
210
211
APPENDIX 1
Detailed Sampling Design
Part One: Behavioural Interview
1.
Background
In recent years, several countries have included HIV testing in national population
based surveys. Technological developments such as the use of dried blood spots for
collecting HIV samples and rapid HIV testing; have greatly facilitated the collection of
biological data in population based surveys. According to the guidelines for
measuring national HIV prevalence in population-based surveys (WHO, 2005),
combining the two sources of data will yield more accurate estimates of HIV
prevalence.
In Nigeria concerns about the representativeness and accuracy of national HIV
estimates derived from antenatal clinics surveillance have led to an increased
demand for more surveys and more data on the prevalence and distribution of HIV in
the whole population. In generalised epidemics, whilst sentinel HIV surveillance
among the general population can provide essential information for planning
treatment and care and support programme interventions, behavioural surveys have
been shown over several years to make important contributions to informing the
national response to the HIV epidemic as well as other areas of reproductive health.
These use reliable methods to track HIV risk behaviours as well as other behaviours
that put individuals at risk. Behavioural surveys indicate what factors affect
reproductive health practices or drive the HIV epidemic. They should provide
information on knowledge, perceptions and attitudes of individuals to reproductive
health issues including HIV/AIDS. They also provide information on the possible
impact of HIV prevention and care and support initiatives as well as programmes
aimed at improving women and men’s reproductive health.
The Federal Ministry of Health (FMOH) in collaboration with key partners is
committed to conducting a biennial National HIV/AIDS and Reproductive Health
Survey (NARHS). However, this third in the series (the first and second conducted in
2003 and 2005 respectively) would include a biological component and be called
NARHS Plus. In addition to measuring the overall Nigerian response and detect
changes in HIV and reproductive initiatives and interventions along key programme
indicators between 2003 till date, this wave would provide reasonable estimates of
HIV prevalence among the general population especially at national and zonal levels.
The survey, which started in 2003, is undertaken once in two years and funded till
2007. This is to ensure that key stakeholders especially the donor and Federal
Ministry of Health are provided with up-to-date and regular data to inform
programmes and monitor knowledge levels and behavioural trends of HIV and
reproductive health. In addition, it intends to provide information on HIV prevalence at
one point in time: to obtain a measure of the current state of the epidemic.
1.
Survey Objectives
The major objective of NARHS Plus is to obtain accurate HIV prevalence estimates
and information on risk factors related to HIV infection at the national, zonal and to
some extent at state levels. Such prevalence will inform the design, implementation
and evaluation of the national response to the HIV/AIDS epidemic in Nigeria. In
211
addition, it will provide information on the situation of reproductive and sexual health
in Nigeria, the variety of factors that influence reproductive and sexual health, and to
provide data regarding the impact of ongoing Family Planning behaviour change
interventions, and to yield insights into existing gaps that may require attention.
The following are the specific objectives of the 2007 NARHS Plus:
•
•
•
•
•
•
•
To collect quantitative data on key sexual and reproductive health
indicators among females aged 15 – 49 years and males aged 15 - 64
years in Nigeria.
To monitor trends and changes in behaviour, which influence reproductive
health and HIV/AIDS in Nigeria, especially with regards to national level
indicators such as NNRIMS and UNGASS.
To obtain baseline estimates of HIV prevalence at national, zonal and
states’ levels as well as demographic variation in HIV prevalence in the
reproductive age group of the general population.
To identify information gaps which may be further explored using
qualitative surveys.
To use data obtained to review and re-programme HIV/AIDS and
reproductive health interventions in the country and provide information
that would guide the development of appropriate intervention strategies
viz. communication strategies.
To obtain data from respondents on: breastfeeding, antenatal and
postnatal care, condom knowledge, access and use, sexual history, STIs
and treatment seeking behaviours, knowledge, opinions and attitudes
about HIV/AIDS, stigma and discrimination, family planning and
communications.
To ascertain the relationship between behaviour and HIV infection in the
survey population.
3.0
Methodology
NARHS Plus will be a nationally representative sample of females aged 15-49
years and males aged 15-64 years living in households in rural and urban areas
in Nigeria. The NARHS Plus sample will be drawn from the updated master
sample frame of rural and urban localities developed and maintained by the
National Population Commission (NPC).
3.1
Survey Population
The population for the 2007 National Sexual and Reproductive Health and
Serological Survey (NARHS Plus) shall be all females aged between 15 and 49
years and males aged 15 to 64 years living in Nigeria.
3.2
Study Area
It is a national survey. The study area consists of all the 36 states of the
federation and the Federal Capital Territory.
3.3
Sampling design
Probability sampling will be used for the survey. The sampling procedure is a
(four-level) multi-stage cluster sampling aimed at selecting eligible persons with
known probability.
Stage 1: This involves the selection of rural and urban localities;
Stage 2: This involves the selection of Enumeration Area (EA) within the selected
rural and urban localities;
Stage 3: This is the listing of eligible individuals within households.
Stage 4: Selection of actual respondents for interview and testing.
212
Within a state (the administrative division), all eligible persons irrespective of
nature of residence (rural or urban) will be given equal chance of being included
in the final sample, hence, the sample selected will be self – weighted within
state but weighting will be required when combined for zonal or national analysis.
3.4
Sample size and allocation
The reporting domain for this survey (i.e. level of analysis) shall be the six geo-political
zones. However, to ensure sufficient sample size for efficient analysis for some rare
events such as people with multiple non-marital sexual partners and condom users within
such relationships the analysis will be done on broad dichotomy of North – South; ruralurban; male-female.
The following formula will be used to determine the sample size for the target group
(persons with multiple non-marital partners).
[
n=D
2 P (1 − P ) Z1−α + P1 (1 − P1 ) + P2 (1 − P2 ) Z1− β
]2
∆2
where
D = design effect;
P1 = the estimated proportion at the time of the first survey;
P2 = the proportion at some future date such that the quantity (P2 - P1) is the size of
the magnitude of change it is desired to be able to detect;
P = (P1 + P2) / 2;
Z1-α = the Z-score corresponding to the probability with which it is desired to be able to
conclude that an observed change of size (P2 - P1) would not have occurred by chance;
and Z1-β = the z-score corresponding to the degree of confidence with which it is desired
to be certain of detecting a change of size (P2 - P1) if one actually occurred.
α
= 0.05 (Z1-α = 1.96)
β = 0.20 (Z1-β = 0.84)
To determine the necessary sample size to detect a change of at least 15 percent among
people with multiple sexual partners and condom users within such relationships in the
North of Nigeria, the 2003 NARHS value for this sub-population was used as P1 = 0.427
and P2 = P1 + 0.15 = 0.577. The design effect is estimated at 1.5 for the cluster design to
be used to sample the target groups. The level of precision is set at 0.05.
Application of the above formula yields a sample size of 225. Also from the 2005 NARHS
results it was estimated that the proportion of the eligible population (that is males 15 –
64 years and female 15 – 49 years) that reported having multiple non-marital sexual
partners was 5.04%, thus a minimum sample size of 4,495 of eligible persons is required
to yield the size required for the sub-population. Adjusting for non-response at a
maximum of 4% (the non-response rates for 2003 and 2005 NARHS were 2% and 1.65%
respectively) will yield a minimum required sample size of 4,682 per region.
The sample allocation for the 2003 NARHS was 5,521 for the North and 4,734 for the
South giving a total of 10,255. Since the 2003 NARHS sample allocation by region meets
the minimum required sample size it is agreed that this should be maintained (as it was
in 2005) during the 2007 survey for ease of comparison of results on zonal and state
basis without adjusting for effect of change in sample size. Nonetheless, the weights to
be used for combined data for national analysis will be based on 2007 estimated
population of eligible persons per state.
213
3.6
Multistage Sampling Procedure
In 32 states and the Federal Capital Territory five urban localities (consisting of three
from major towns1 and two from medium towns) and three rural localities (from 3
2
different rural localities) will be selected for each state . For the comparatively more
populous states, the allocation of localities will be as follows: Kaduna (7 urban, 4 rural);
Kano (12 urban, 5 rural); Lagos (18 urban, 1 rural) and Oyo (7 urban and 4 rural). In all,
a total of 319 localities – 203 urban and 116 rural- will be sampled. The selection of
more urban localities is explained by the heterogeneity of the urban population in Nigeria
compared to the rural population. The total sample allocation to the rural and urban
localities in each state is proportional to the rural-urban population distribution of
respondents in each state. A locality is a town, village or hamlet with neighbourhood
buildings within a defined geographical boundary with its own local administrative head,
and specified in the official Nigerian National Census records. A cluster is formed from
within an enumeration area (EA)3 or a combination of contiguous EAs called a
supervisory area (SA) within a locality. A cluster is a location with a maximum of 60
eligible respondents listed within neighbouring households of which a third will be
sampled for interview. It is important to note that a locality such as a major town or large
village may contain more than one cluster.
The different levels of the sampling procedure are described below.
Stage 1
All localities in a state will be stratified into urban and rural localities with settlements
less than 20,000 inhabitants classified as rural. The sampling frame of all rural localities
in a state (i.e. villages, small towns, hamlets and other settlements with a population of
less than 20,000 inhabitants) will be arranged in their geographic order, and grouped
into one stratum with their weights attached (weight being the number of inhabitants).
Using the population as a measure of size (MOS), a cumulative (total) population of the
rural dwellers within the state will be obtained (i.e. TP). A sampling interval S.I = TP/3
will be obtained and by using the Table of Random Numbers a Random Start (RS)
within the sampling interval is chosen. A rural settlement corresponding to a cumulative
MOS of the RS=R1 will be chosen. By adding the sampling interval value to the random
start (RS+S.I) another value R2 is obtained and the locality with cumulative MOS
corresponding to R2 will be chosen. A third value R3 = R2 + S.I will be obtained and the
locality with corresponding cumulative MOS of R3 will be selected.
The urban settlements will be stratified into ‘major towns’ and ‘medium towns. One
major’ town and one ‘medium’ town will be selected with probability proportional to the
size (population) of the town. The cumulative population of urban centres in the state
would be obtained for each stratum, and using the table of random numbers, a random
number between 1 and the cumulative population of the urban dwellers will be picked.
One ‘major’ town and one ‘medium’ town corresponding to the random number picked in
each stratum will be chosen for the formation of clusters and subsequent interview.
The first three biggest towns (by population) are classified as major towns in the state while
the remaining urban centres are classified as medium towns.
A common distinction between ‘major’ and ‘medium’ towns using population size was
avoided since most of the urban settlements (by population) are mainly in the southwest.
An enumeration area (EA) is a function of both land size and population. It is usually made
up of 500-650 persons. Four of five contiguous EAs make up a Supervisory area (SA). In
certain areas, especially in the north, given the geographical dispersion of settlements, an
EA may have far fewer residents.
214
Table 1: The selection procedure for rural localities
S/No
1
2
3
``
``
N
Total
Rural Localities
RL1
RL2
RL3
``
``
RLN
Population Size
S1
S2
S3
``
``
SN
Cumulative MOS
S1
S1 + S 2
S1 + S2 + S3
``
``
S1 + S2 + S3 + `` + `` +
SN
TP
Note: N=Number of rural localities within state,
RLi, i=1 to N
TP= Total rural population
S1+S2+…+SN=TP
Stage 2
For each of the three chosen rural localities the list of the EAs that make up the locality will
be arranged in a geographic order. One of the EAs will be chosen at random and from
which the number of allocated clusters will be formed by listing three times the number of
eligible persons to be interviewed using the EA as a starting point.
The number of allocated urban respondents per state would be distributed proportional to
size of the ‘major’ to ‘medium’ towns of the state. For the ‘major’ town chosen, different
locations will be selected using the EAs making up the town. The EAs that compose the
town will be arranged in their geographic order and the number of allocated clusters will
be chosen systematically and used as a reference starting point to form each cluster.
Stage 3
The number of eligible persons required (allocated) for the localities will be equally divided
among the clusters.
The next section describes the operational aspect of how individual respondents will be
selected and interviewed within selected EAs or SAs.
3.7
Listing, Interviewing and Testing procedures
1.
2.
3.
The EA selected will be identified for listing.
The EA sketch will be updated.
The starting point of the EA will be identified, and all the buildings to form a cluster
will also be identified and numbered in a single sequence.
Households within the residential buildings will be listed on the household listing
form (Form 01)
The eligible persons within the households identified will be listed on the eligible
persons listing form by sex with the age indicated (Form 02M & 02F).
The listing (beginning from the selected EA) will be continuous from household to
household till a cluster size is obtained (i.e. thrice the number of respondents
expected to be interviewed in that cluster is listed). This is to ensure a wider spread
of eligible persons to be included in the final interview. The listing will be done by
NPC personnel pre-interview.
The NPC personnel will do the identification and listing of the eligible persons to
form the cluster pre–interview. Also the NPC personnel trained centrally will sketch
the cluster area indicating buildings and landmark features and do the final sample
selection of individual eligible persons to be interviewed.
4.
5.
6.
7.
215
8.
9.
10.
11.
12.
13.
The ages of the eligible persons listed will be ranked in ascending order starting
from age 15 down to age 49 for female respondents and 15 to 64 for male
respondents.
Using the ranking, the expected eligible person targeted to be interviewed within
the cluster will be selected systematically.
The selected persons will be transferred to a designed form (indicating the selected
persons’ name, building number, name of head of household) by the NPC
personnel.
The final selected persons will be given to the Supervisor of Research Agency for
interview.
The Supervisor assigns persons on the selection list to the interviewers to
administer the questionnaire and where the respondent is not available, he/she
must make at least three repeated calls before returning the questionnaire as non
response. All such instances must be validated by the supervisor to ascertain the
reasons for non-response.
On completion of the behavioural questionnaire, the individual will be referred to the
sero-testing team. The counsellor and testing team will obtain consent for the serotest separately and perform the sero-test. Procedures on this are outlined later in
this protocol.
It is expected that there will be 6 interviewers with 1 supervisor to form a team that will
conduct Behavioural interview (this team will be designated as BIT = Behavioural
Interview Team), while 3 sero-testers with 1 coordinator that will conduct the sero-testing
will form another team designated as STT=Sero Testing Team.
For each state with exemption of Lagos and Kano states, there will be one Field Working
Group (FWG), which comprises of one BIT and one STT to be headed by the State
Coordinator (SC), which will be the respective state SAPC or RH-coordinator as the case
may be. Kano and Lagos states are expected to have two Field Working Groups each,
while the team members for Oyo and Kaduna States might be increased to accommodate
their relatively larger sample size to be completed within the same survey period with
other states. It is proposed that all the 10,254 respondents (Males aged 15-64 years and
Females aged 15-49 years) in the General Population will be involved in the sero-test.
3.8
Ethical issues
Ethical clearance shall be obtained from the appropriate body within the Federal Ministry
of Health and the IRB prior to the commencement of the survey. Oral and written informed
consent shall be sought from each respondent before a questionnaire is administered, and
each sero test conducted. Where a respondent chooses not to participate, the
questionnaire shall be returned as refusal. No incentives of any form are to be offered to
respondents who either complete an interview or refuse to do so.
4.0
Fieldwork
An independent research agency will be contracted, through a competitive bidding
process, to undertake the fieldwork. It is believed that this will enhance objectivity and
independence in data collection and management. To ensure that local peculiarities are
taken into account, the selected agency will be expected to work closely with the local
NPC staff. The agency will recruit the supervisors and the interviewers in conjunction with
local NPC staff, but the training of all field workers will be done by members of the survey
Technical Committee (TC) Supervisory visits will be undertaken by selected members of
the TC to monitor and undertake random field checks of all aspects of the fieldwork. A
detailed research agency brief will be prepared before the selection of the agency followed
by a binding contractual agreement.
216
While it is useful to translate questionnaire into local languages, given the multiplicity of
languages in Nigeria, full translation will be avoided. However, for each selected
community, key words/phrases (including sensitive ones) will be translated during training
of interviewers. Interviewers will use the semi-translated ones as master copies. A similar
approach was successfully used for the 2003 and 2005 NARHS as well as the 2005
Behavioural Surveillance Survey.
There will be one fieldwork group (FWG) per state (except Lagos and Kano where two
teams each are required because of the population size). Eight interviewers will be trained
per state but only 6 will be used. The SAPC/ Reproductive Health Coordinator will be the
main supervisor and the main field editor.
5.0
Survey management
Two key committees will manage the survey. The day-to-day technical aspects of the
entire survey will be handled by a Technical Committee (TC). An oversight of the survey
will be provided by a larger central Survey Management Committee (SMC). The latter is a
multi-disciplinary committee drawn from all relevant stakeholders (including developing
partners), NGOs, Government institutions, and technical experts from academic
institutions. Independent reviews of the entire survey process and questionnaire will be
undertaken by technical advisors (through WHO). All aspects of the study, including
sampling and questionnaire, will be reviewed by both committees and external technical
experts.
6.0
Data retrieval
This will be done on a daily basis. The interviewer collects the information from the
respondent, edits the questionnaire in the field and submits his/her quota for the day to the
representative of the research agency who edits the questionnaires. At the end of each
day in the field, and after editing, the representative of the research agency submits
completed questionnaires to the survey supervisor who as the State field editor;
undertakes complete editing of all questionnaires. Where possible data errors will be
tracked to their original source through re-visits and mistakes and omissions corrected.
The supervisor who is also the State field editor checks that all instructions are obeyed,
responses are consistent and the questions are fully answered. A questionnaire is not
considered accepted until it has been so certified by the State field editor. The working
relationship between the research agency and other members of the research team is
documented in a contractual agreement.
7.0
Data Management and report writing
A Data Management Team (DMT), a part of the technical committee will oversee all
aspects of data capture. A codebook containing details of each question including the
frequency distribution of the responses to the question will be produced. The Data
Management Team involved in the data capture will also provide to the TC a document
including audit trail, details of data entry activities, programs used in the analysis and an
overview of data management challenges and the way they were resolved. Details of the
data management procedure are contained in the data management manual.
8.0
Level of data analysis
Analysis will be done at geopolitical zonal level and also at state level for some key
indicators. In addition there will be analysis of selected indicators for key stakeholders as
required.
9.0
Training
The training of survey personnel will be at two levels: central training (TOT) and state level
training. A comprehensive training manual will be developed and finalized for the
217
purposes of both central and state level trainings. Given the large number of expected
participants, the central level training will be in two batches (north and south). The two-day
central training will involve NPC staff, SAPCs, RHCs state laboratory scientist, one state
counsellor, research agency supervisors and quality controllers as well as Technical
committee members. Experience from previous surveys showed that bringing all related
personnel together for a comprehensive training on all aspects of the fieldwork is highly
beneficial. The training will be on sample selection (including household listing and
selection) and all aspects of fieldwork. In view of its complexity and sensitivity,
considerable amount of time will be devoted to the review and role play with the
questionnaire. Coordination, logistics, standardization, and shared understanding of the
survey procedures will be the key objectives of the central training, but this will not prevent
the discussion of local problems.
State level training will be undertaken by the centrally trained supervisors, SAPCs, RHCs,
NPC officer and a member of the survey technical group as an additional quality control
measure. This, among others, will minimize state-to-state variability in training procedures.
All field enumerators in the state will undergo training in all aspects of the fieldwork. In
addition to the review and ‘trial’ field interviews, translation of selected words and phrases,
blood collection and sero-testing demonstration. Furthermore, there will be discussion on
the selection of EAs and sampling procedure. State level training is expected to last for
three days.
There will also be a one-day training for ‘listers’ (four per state) who will be responsible for
the listing of all appropriate household and household members. The training will be
undertaken mainly by staff of the State NPC who participated in the central training.
Two types of Training manual will be developed:
• General Guidelines for Interviewers and Supervisors. It provides details, among
others, related to general principles of interviewing and supervising with the roles
of different members of the field team
• Training Manual for Interviewers and Supervisors. Provides specific instructions
on how to ask and record responses for each of the survey questionnaire items.
10.0
Supervisors
The detailed responsibilities of the supervisor are stated in the training manual. There
should be one supervisor for every 6 interviewers (with 2 standby interviewers). The
supervisor shall have following prerequisites:
Normally must be a graduate
Familiar with the community / resident in that locality
Should speak local language and read English fluently
Must have previous field experience
10.1
Interviewers
Interviewers are to be recruited by the selected independent research agency in
collaboration with SAPC/ RHC with the supervision and approval of TC facilitators.. To
ensure high data quality, specific interviewer and supervisor attributes are prescribed for
the agency. As an additional quality control measure, SAPC/RHC are to ensure that
interviewers are paid the exact amount of wages quoted by the research agency and
approved by the technical committee. TC supervisor should monitor and document the
process in the supervisory checklist. Consideration will be given to ensure gender
balance.
11.0
Supervision plan
There will be three levels of supervisions to ensure quality of fieldwork and data.
ƒ Field editors/ supervisor –to supervise interviewers’ activities
218
ƒ
ƒ
SAPC/RHC-To supervise field editors, interviewers and counsellors/testers’
activities.
TC supervisors/ quality controllers- to supervise SAPC/RHC, Counsellors
interviewers and testers.
The detailed responsibilities of the interviewer are stated in the training manual. The
interviewer shall have following prerequisites:
Familiar with the community / resident in that locality
Minimum of school certificate
Should speak local language and read English Language fluently
May have had previous field experience
Must be available for the entire duration of the fieldwork
11.1
Pilot
A pilot study will be conducted in two states (Nasarawa and Lagos by visiting one urban
and one rural clusters in each state to test the instruments and other aspects of the survey
including fieldwork and data entry. This will be conducted with the state coordinators,
independent research agency’s supervisors as well as NPC staff. The pilot will assist in
determining any problems that could arise during the survey, and discover any problems
in the questionnaire and other elements of the survey and address them accordingly.
12.0
Questionnaire themes
The survey will capture, among others, the following broad themes:
1.
Sexual behaviour
2.
Knowledge and treatment of STIs
3.
Knowledge and perception of HIV/AIDS.
4.
Condom accessibility and use
5.
Stigma and discrimination
6.
Knowledge about family planning
7.
Attitude and use of family planning
8.
Availability, affordability and accessibility of family planning products
9.
Reproductive rights and violence against women
10.
Awareness of Maternal mortality and vesico-vaginal fistulae and its
causes
11.
Exposure to Health Communication
12.
Knowledge and treatment of Tuberculosis
Where appropriate, translation of key words and phrases will be generated for
use at each state’s training.
12.1
Data Quality Assurance Procedures (i.e. Quality Management System):
Ensuring the high quality of the information to be produced is a critical component of this
NARHS. All the personnel involved in this study shall work to achieve this goal.
Data of high quality are:
- Homogeneous: the information collected by an interviewer would not
have been different if collected by another interviewer (criterion for
“homogeneity”);
- Complete: the keyboarded questionnaires include all the indicators
previously defined as “mandatory” (criterion for “completeness”);
- Reliable: one filled questionnaire is reflecting the reality of one
interviewee (criterion for “reliability”);
- Accurate: the information reported on the questionnaire is consistent
with the information expressed by the interviewee (criterion for
“accuracy”, which is a sub set of “reliability”);
219
-
Consistent: the keyboarded data is consistent with the information
reported in the questionnaires (criteria for “consistency”);
Coherent: responses within the questionnaire must be logical,
comprehensible and meaningful to the questions.
A. Homogeneity
The criteria of homogeneity will be strengthened through intensive training sessions of the
interviewers and supervisors. First there is a need to ensure that only candidates who
meet the stated standards are recruited and that the training of the
interviewers/supervisors meets the expected standard. Then during in-state trainings, prior
to the implementation of the study, the state survey team will inform the potential
interviewers about the goals of the work; they will be trained through mock interview and
role-playing session- where one interviewer will play the role of an interviewee and viceversa. Then the interviewers shall be certified as able to conduct interviews through
passing an assessment, in which they will demonstrate their ability to perform the work.
The overall assessment will take into cognisance the level of the interviewers’
understanding of the questionnaire, ability to maintain communication/rapport with the
respondent, ability to probe for responses in a non-biased way, maintenance of a nonjudgemental attitude during interviews, ability to follow skip patterns and also to
understand and write the responses of the respondent in a legible way. Reports of these
training and certification processes shall be available to the TC. Besides, at any moment
of the study, the supervisors, SAPCs and members of the TC will be encouraged to
discuss with the supervisors and interviewers, to check their knowledge about the
interview process, and to report appropriately to the interviewer’s supervisor. It is also
expected that the SAPCs will manage and document regular end-of-the-day meetings,
with all the supervisors of an area, to address problems identified by the field workers.
The report of such meetings will be forwarded to the TC twice a week.
Certification of field team member-supervisors and interviewers
All supervisors and interviewers would be trained and certified at the central and state
level training respectively. Using the appropriate checklist, TC members (responsible for
each study location) would certify all the supervisors (during the central level training),
whilst the SAPC would in turn certify all the interviewers during the state level training
however with oversight from the TC member present in the state level training.
Replacement of field team member - supervisors and interviewers
If any of the supervisors’ fall short of the certification requirements, the Quality
controller/validator (employed by the Research Agencies) would have to replace him/her
immediately with someone from the pool of those who participated in the central level
training. Similarly, at the state level training, at least one extra interviewer is to be trained,
apart from the required number of interviewers needed as a possible replacement to any
interviewer who could not continue with the job for one reason or the other.
Criteria for completeness
A questionnaire will only be accepted as complete only if it meets the following
requirements as stipulated below:
• Identification particulars are correctly filled (e.g. state, LGA, cluster number etc)
• The age of respondent is filled and falls within the stipulated age bracket.
• The sex of respondent must be stated
• The social demographic background of respondent must be filled
• The interviewer result code has been recorded in the interviewers visit box on the
cover page of the questionnaire
• The interviewer must have signed the witnessed verbal and written consent
220
The supervisors and the SAPCs will also investigate reliability through the process of
carrying out back-checks. This is to ascertain whether interviewers actually went to a
house they claimed they have visited. At least one respondent will be visited, out of those
interviewed by any interviewer, per day by the supervisor.
It is also expected that technical committee members, during their presence in the field,
will use a checklist to document their observations on the conduct of the fieldwork,
adherence to the protocol and quality checks. They will also sign off on the completed
NARHS questionnaires they will be able to review, before the SAPC forward them to
central working group. Thus the staff of the third party research agency will have to work
with these individuals. It is expected that this will provide an additional check on data
quality.
B. Accuracy
The criteria of accuracy will be ascertained using different techniques in accordance to the
reality of the fieldwork, and among those we can identify:
• All skips and filter instructions have been respected.
• All responses must be verified as legible.
• Verified that only one response code is circled for each question unless
instructions allow for more than one response. It should also be ensured
that codes “2” (No) have been circle for all responses not coded “1”.
• Ensured that any corrections made by the interviewer are done legibly
and according to the instructions in the training manual.
• All internal consistency checks and coherence rule as outlined in the
protocol were utilised and adhered to.
• Back check: some interviewee will be interviewed twice, the first time by
the interviewer and the second time by the Supervisor or SAPC/RHC or
TC supervisor.
These processes shall be conducted as soon as possible, as the point is to identify
interviewers who are producing data of insufficient quality and to react to this situation by
re-training or dismissing him/her.
C. Coherence
Coherence edits look at the individual data items within a questionnaire or case, and
examine the validity and the consistency of each item (response to particular question(s))
with respect to other related items. At a minimum, consistency checks should seek to
resolve all errors, which might eventually lead to doubts about the quality of the data.
Generally, supervisors should ensure that all skip patterns are properly and religiously
obeyed so that those who have not heard of a product do not unnecessarily ask to provide
their experience about the product. Detailed knowledge and understanding of the
questionnaires should be sine qua non.
13.0
Data Management
The Census and Surveys Processing Software (CSPro) will be used for data entry,
validation, and cleaning. In order to further minimize inconsistent and illegal entries,
checks will be used to guide the data entry exercise. Subsequently, 30% of the data will
be re-entered by different data entry clerks and the entries validated.
The data will be subsequently imported into SPSS (version 11.5) and the sampling
weights applied in the analysis. The weighting in the analysis will be based on the
sampling fractions derived from sample size and the population of the states. For most
variables, the analysis will be done at the national and zonal levels and state level
221
analysis will be carried out for selected variables. The various sample sizes (number of
women and men) for all groups and subgroups will be based on unweighted cases.
This implies that all percentages will be weighted but the number of cases will not. This
was to ensure that the exact number of cases upon which the weights were applied is
known.
Data analysis will be done at zonal level. State level analysis will be done for some
selected variables only. National level and zonal level analysis will be done for sero
results. Tables will be generated based on the detailed analysis plan and to allow
monitoring of key national and international indicators.
14.0
Report writing
A report writing committee is constituted. This committee is made up of consultants from
Nigerian universities as well as members of the technical committee of the survey from the
FMOH, SFH, and other development partners. For the purpose of comparability,
internationally accepted definitions will be used for indicators where applicable.
15.0
Dissemination
Key results and lessons learned will be disseminated to appropriate stakeholders at
different levels in different format depending on audience and user types. Formats may
include technical report, wall charts, data sheets, and brochures.
222
Part Two: HIV Testing in the 2007 Nigeria NARHS (NARHS PLUS)
1.0
Project Description
Prior to the 2007 Nigeria NARHS Plus, HIV estimates in Nigeria were based on sentinel
surveillance system among pregnant women in the population4. This system not only
excluded men but non-pregnant women also. In addition, the health facilities were not
randomly selected and they tended to have an urban-bias. Thus, while the Nigeria sentinel
surveillance system is useful in providing data on trends of HIV prevalence, it is less
helpful in estimating the levels of current HIV infection in the entire population. Whilst this
dataset provided levels and patterns of HIV, the trends in HIV using population-based
information are yet to be established. The 2007 Nigeria NARHS should provide additional
data for HIV trend analysis. With the rapid scale-up of antiretroviral therapy (ART) in
Nigeria, it is recognised that HIV prevalence will become less useful and there is
increasing need for estimates of HIV incidence.
2.0
Rationale
UNAIDS and WHO recommend that a representative sample of the general population
should be included in the HIV second-generation surveillance systems in countries with a
generalised epidemic, in order to provide a) reliable measures of HIV prevalence for
women and men and b) information to calibrate the data resulting from the routine HIV
surveillance systems. (WHO 2005)
It is within this framework that it was planned to incorporate HIV testing in the 2007
Nigeria NARHS hence it was renamed NARHS Plus. The NARHS Plus, a periodic national
survey, provides an opportunity to collect population-based HIV sero-prevalence
estimates at a minimal cost. In addition, the survey is expected to benefit from the
experience of the previous small scale surveys conducted by SFH and other partners in
incorporating biomarkers in data collection into nationally representative population
surveys.
Incorporating HIV testing in the Nigeria NARHS Plus also affords the opportunity to link
the sero-prevalence results to the other data obtained in the NARHS Plus, including
numerous knowledge and behavioural indicators (e.g. knowledge of specific ways to avoid
HIV, knowledge of other sexually transmitted infections (STIs) including syphilis and
sources for treatment, the number of recent sexual partners, and the extent of condom
use by type of partner). The Federal Ministry of Health, National Agency for the Control of
AIDS (NACA), government and donor organisations in Nigeria are strongly supportive of
the decision to continue obtaining population-based estimates of HIV as well as to link HIV
status to the behavioural and background data collected in the NARHS Plus.
3.0
Project Objectives
The HIV component of the 2007 Nigeria NARHS Plus is being undertaken to provide
information to address the needs of government and non-governmental organisation
programs addressing HIV/AIDS, and to provide programme managers and policy makers
with the information that they need to effectively plan and implement future interventions.
The overall objective of the survey is to collect high-quality and representative data on
knowledge, attitudes, and behaviours regarding HIV/AIDS and other STIs, and on the
prevalence of HIV infection among women and men.
The Specific objectives are to:
•
Determine the national HIV sero-prevalence of women and men of
4
The 2005/6 Nigeria sentinel Survey found the overall (national) HIV
prevalence rate for all adults age 15-49
years to be 4.4 percent (FMOH, 2006)
223
•
•
reproductive age;
Improve the understanding of the variation in sero-prevalence levels
with social and economic characteristics and behavioural risk factors;
and
Facilitate a comparison of HIV prevalence obtained in the 2007 Nigeria
NARHS Plus and prevalence from facility-based surveys such as the
sentinel surveillance system.
4.0
Survey Organisation and Methodology
The following summarises key aspects of the integration of HIV testing into the NARHS
Plus survey organisation and methodology. A detailed work plan and timetable for the
survey which provides additional information is included in Attachment A.
4.1
Organisational Structure
The Federal Ministry of Health (FMoH) is the arm of government authorizing the HIV
testing, and is involved in the design of the NARHS Plus survey instruments and in other
aspects of the implementation of the survey relating to the HIV testing. The NARHS Plus
will be implemented by the central Survey Management committee, which will be
responsible for general administrative management of the survey, including overseeing
day-to-day operations, recruiting and training field staff and data processing staff and
supervising field operations and office operations for the survey.
4.2
Sample
5
The 2007 Nigeria NARHS Plus will be conducted using a stratified national sample of
approximately 10,000 individuals residing in private households nationwide. All women
age 15-49 years and men age 15-64 years living permanently in the selected households
will be eligible to be interviewed in the NARHS Plus and for HIV testing. The sample
allows for HIV sero-prevalence estimates for women and men at the following levels:
national; urban/rural, and for state level estimates of prevalence.
4.3
Questionnaires
Two questionnaires will be used: 1) an individual questionnaire for each respondent and a
one page questionnaire for the biomarker component. Copies of the questionnaire are
included in Attachment B. These instruments are based on the questionnaires developed
by the NARHS national programme which was adapted from International standard
questionnaires such as the DHS and adapted to Nigeria’s specific data needs. The
questionnaires as well as all survey procedures including those relating to the HIV will be
translated and piloted prior to implementation of the main survey. Furthermore, all
instruments will be appropriately labelled for easy matching of results during data entry
process while all identification information will be removed prior to data entry in order to
ensure confidentiality.
4.4
Approach to HIV testing
There are various approaches used in population-based surveys
•
Unlinked anonymous (with informed consent)
•
Linked anonymous testing (informed consent but no tests result given)
•
Linked anonymous testing (informed consent and provision of tests results)
FMOH will use the linked anonymous testing approach with the provision of test results.
HIV testing will be done using blood samples as opposed to urine or saliva testing. Urine
and Saliva tests’ kits have not been validated in Nigeria; they do not distinguish HIV-1
from HIV-2, identify viral subtypes, and cannot assist in antiretroviral drug resistance
monitoring.
5
This was calculated based on appropriate formular and parameters
224
All eligible women and men will be asked for their voluntary consent to the blood testing
and to the storage and use of the blood specimens. In the case of never-married
adolescents’ age 15-17 years, consent will be sought from a parent before the adolescent
is asked for his/her assent. When there is no parent living in the household, consent will
be requested from the adult who is in charge of the youth’s health and welfare at the time
of the NARHS Plus visit and who makes decisions on his/her behalf.
In households in which eligible individuals will be requested to participate in the HIV
testing component of the survey only, the testing approach will involve the collection of
five blood spots from a finger prick on the same filter paper card and stored as dried blood
spots (DBS). DBS can be stored at room temperature for up to 30 days and can be
analysed to the same extent as serum or plasma for HIV serology, subtype determination
or molecular studies.
HIV testing will be done using national guidelines for rapid-test as outlined in the
UNAIDS/WHO guidelines (WHO, 2005). Therefore, for ethical reasons pre and post test
counselling will be conducted using Determine and Statpak or Determine and Bundi for
parallel testing. Individuals who test positive or whose tests are indeterminate will be
referred to the nearest HIV treatment facility for confirmatory testing and follow up.
A unique random identification number (bar code) will be assigned to each DBS and
labels containing that code affixed to the filter paper card, the questionnaire, and a field
tracking form at the time of the collection of the sample. After fieldwork is completed in a
sampled cluster, the questionnaires, dried blood spot and sample transmittal forms will be
sent to the central office of the technical Management committee for logging and checking
prior to data entry. DBS samples will be checked against the transmittal form and then
forwarded to designated testing laboratories. No identifier other than the unique
identification label affixed at the time of the collection of the samples will accompany the
specimen to the laboratory.
In order to protect the anonymity of the results during the processing phase, the master
survey data file will be kept at NASCP/FMOH; all hard copies and files will be stored in
locked cabinets. The data file will be kept on a separate network or will be protected
(usually with a password) so that only authorised survey staff will have access to the data
during the processing phase. No questionnaire or file including information from the
survey may be either copied or taken out of NASCP.
After the tabulation phase has been completed and it is determined that no additional
reconciliation of the interview results is necessary, all the sections of the NARHS Plus
questionnaires relating to the surveyed individuals’ personal identification (ID), such as the
name, the household number, the cluster number, the number of the administrative
subdivisions, and the part of the questionnaire containing the identification codes of the
blood samples will be destroyed.
A new data file will be created in which all of the personal identification of the persons
surveyed (household number, cluster number, etc.) will be replaced by randomly
generated codes. This process will maintain the integrity of the cluster and the household,
while making impossible all identification of the individuals, households, and clusters
surveyed. A series of checks will be carried out on this file in order to ensure that the
results were not affected by these changes. After it has been verified that this new file is
complete, all the data files containing the original cluster numbers and household numbers
will be destroyed.
Testing of the DBS samples will occur at the laboratory concurrently with the processing of
the survey questionnaires. However, no result will be reported to the survey implementing
agency during the period of questionnaire entry and editing and the creation of the final
225
data file from which all individual identifiers have been removed. After all materials
including the original IDs have been destroyed and the anonymous data file prepared, the
results of the HIV testing will be obtained from University College Hospital (UCH), Ibadan
and added to the new survey data file
The unique random identification number assigned to the samples and questionnaire will
serve as the means for merging the survey and testing files.
4.5
HIV Counselling and Testing Services
Because of the anonymous but linked nature of the testing approach in the NARHS Plus,
survey respondents will have access to the HIV test results. Mobile counselling and
testing services will be provided prior to providing the survey result. Information on the
availability of existing HCT centres in relation to NARHS Plus sample points will be
provided for the respondents.
Survey respondents will be offered written and verbal information describing HCT,
operating times of ART sites in their area, and a coupon that they can present when
obtaining services. Furthermore, any person (whether or not they have participated in the
NARHS Plus) approaching a NARHS Plus team with a request for a HCT coupon or
information will be provided with one, in an effort to increase HCT usage in Nigeria.
4.6
NARHS Plus Field Staff Composition, Recruitment and Training
The survey will be conducted by approximately 40 Field Working Groups. Each team will
be composed of a supervisor, a Quality Control officer, three female and three male
interviewers, three counsellor testers, SAPC, RHC and a laboratory scientist. Staff from
the FMoH, NPC UCH Virology, WHO and USAID IPs will participate in the field staff
training.
The training for field staff will include a detailed description of the content of the
questionnaire, how to fill the questionnaire, and interviewing techniques. Specifically with
respect to the biomarker data collection, Counsellors and testers are expected to receive
at least three days of classroom training plus additional field practice.
As part of the training, all the CTs will be given a thorough training in informed consent
procedures, how to take finger prick blood spot samples, and how to handle and package
the dried blood spots. At least two field staff involved in the interviewing on each team will
be trained testers who will receive thorough training in the collection of samples.
All staff will receive training in universal precautions and the disposal of hazardous waste.
They will test procedures on each other during the training as well as in the field practice
sessions. During the training, there will be special lectures on the HIV/AIDS epidemic.
These lectures will encompass the importance of getting counselling and testing for HIV; it
is expected that the better informed the interviewers are about the importance of
counselling and testing, the more effective they will be in conveying this information to
respondents.
4.7
Community Awareness
A mass media information campaign may be organised in order to raise awareness
among the general population especially in the localities that have been selected for the
survey. More importantly though, prior to the start of the survey in each area, the team
supervisors will hold meetings with local administration and community leaders about the
NARHS Plus and specifically on the purpose and procedures for blood collection and
anonymity of results.
226
At the conclusion of the interview in each household, informational brochures on HIV/AIDS
and the means of prevention will be offered in the surveyed households, regardless of
whether or not eligible respondents in the households provided blood specimens. These
brochures will contain the list and addresses of all HCT Centres as well as practical
information such as operating hours. These informational materials may also be made
available to other community members if they request them.
4.8
Quality Control Measures During Data Collection
Quality control during the period of the survey fieldwork will be ensured through effective
supervision of the interview teams during fieldwork. The first level of supervision will be
provided by the team supervisors. They will also observe the process of blood collection in
order to ensure that all informed consent and specimen collection procedures are being
correctly implemented. All positive samples and a random sample of 10% of all negatives
will be collected, processed and tested at the QC Laboratory.
SMOH teams will visit on a daily basis to ensure that all activities are carried out as
planned. Questionnaires, DBS from completed clusters will be picked up during these
visits. As a further quality control measure, central supervisory visit will be made by TC
and SMC members at the beginning of the survey. They will take part in the state level
trainings of the field teams to ensure that appropriate quality control procedures are being
taught and adhered to.
Finally, a monitoring of the “response rate” for HIV testing will be done at the field level.
Any problem that is identified during the review will be discussed with the appropriate
teams, and steps will be taken to address the problems.
4.9
Laboratory Testing
The HIV test algorithm calls first for each DBS specimen to be eluted and tested with one
fourth-generation HIV 1/2/O ELISA test, as recommended by international guidelines for
surveillance. All HIV positive samples then will be re-tested with a second HIV 1/2/O
ELISA test. For quality control purposes, a 10 percent random sample of HIV negative
specimens will be retested. All HIV positive and discordant samples will be retested using
the same algorithm with western blot as a tie breaker.
UCH Virologist will use a standard data entry programme supplied by NPC/WHO to record
the results of the blood analyses. This file shall contain only the unique identification code
for each sample and the results of the tests. In order to reinforce the measures protecting
the subjects’ anonymity, this file will be kept on a separate computer at UCH accessible
only with a password that will be known only by the person conducting the HIV testing for
the NARHS Plus and his/her assistant. Regular accounts will be provided to the NASCP
on the progress of the work (total number of samples received and analysed, and
aggregate number of positive cases). However, no coded individual result shall be
transmitted to FMOH until the NASCP indicates to the SMC that all the survey data have
been rendered anonymous by scrambling all the identifiers
4.10
Ethical Considerations
(a)
Physical Risk
Taking a finger stick blood sample poses minimal physical risk to the subject. Each
member of the STT responsible for taking finger stick capillary blood samples will use
disposable gloves, alcohol swabs, sterile gauze, and retractable, disposable lancets so as
to eliminate risk of contamination. As part of the informed consent procedure, all eligible
respondents will be told that the supplies that will be used will be clean and sterilize.
227
(b)
Informed Consent
Standard verbal informed consent procedures will be closely followed during any blood
sample collection. The statements used in obtaining respondent consent for the NARHS
Plus interview, HIV testing, and for the storage of blood specimens are included in
Attachment C.
The informed consent for blood collection will be requested only after the individual
interview is completed so as to establish better rapport with respondents and to allow
completion of the questionnaire by participants who refuse blood sample collection.
As part of the informed consent process, individuals who are eligible for the blood sample
collection would be advised of all the purposes for which the blood will be used (i.e. HIV).
They would be assured that the supplies used will be sterile and the physical risk is
extremely small. They will be told that the HIV test results will be available to them.
Respondents will be assured of the anonymity of the testing. In households where
adolescents ages 15-17 live with parents or guardians, the parents or guardians of
adolescents will be asked for permission to take blood spots from the adolescent before
assent of the adolescent is sought.
However, adolescents in this age group who live independently (this will be ascertained
during the interview process, or who are married or living with a sexual partner) will give
their own consent.
(c)
Confidentiality/Anonymity of HIV Data
As described above and summarised in Figure 1, the HIV test results will be processed at
a different location than the questionnaire data. The blood specimens sent to the
laboratory will contain only a bar code label and questionnaire data will be matched only
after the bar code link to possible personal identifiers on the questionnaire is destroyed
and cluster and personal identifier information is changed or removed from the data file.
These procedures have been implemented in other countries and have proven effective to
assure anonymity of the HIV test data.
228
Figure A.1: Summary of Processes for Maintaining
Anonymity/Confidentially of HIV Test Results in the NIGERIA NARHS Plus.
Fieldwork
Dried
Blood
Spots
Data/Blood Collection
CODE
CODE
CODE
Questionnaire
(DBS)
Transfer to:
DHS
IMPLEMENTING
ORGANIZATION
LABORATORY
TEST
Processing
DATA ENTRY
DATA EDITING
WEIGHTING
CLEAN WEIGHTED DATA FILE
PREVALENCE FILE:
•Test results
•Code
IDENTIFIERS ARE DESTROYED
FILES ARE LINKED
FINAL ANONYMOUS DATA FILE
FINAL ANONYMOUS
SURVEY FILE:
Survey Data + Prevalence
(d)
Facilitating HCT
This proposal calls for the collection of dried blood spot samples for HIV testing from
consenting adults and independent adolescents, for subsequent HIV testing at site, with
transmittal of results and eventual linkage with questionnaire data, after all identification
information has been eliminated from the latter. This is considered the preferred approach,
though on-site counselling and testing during the NARHS Plus interviews could pose
serious problems of confidentiality, counselling privacy and quality, and staffing and
logistics. Certain measures will be taken to reduce these risks. These will include
1.
2.
3.
Rapid test kits using non cold chain algorithms will be used
Confidential rooms will be used and in areas where confidentiality can not
be ensured, respondents will be advised to come to another site to receive
results.
Moreover, since the survey team is expected to be in any given sample
point for a maximum of 3 days, it would not be possible to provide follow-up
services but referrals will be made and vouchers given to appropriate sites.
229
Consideration was given to setting up a system where the test results would be provided
to the VCT sites closest to the participants’ home and participants informed that they could
obtain the results from that site (using the unique bar code identifier) after the survey
testing processing was completed. Several issues make this approach problematic. First,
the timeframe from collection of samples until the results will be available will be several
months, meaning that any negative result, even if they could be tracked back through
barcodes, would need reconfirmation due to time lapsed. Secondly, there exists the
potential of mismatched bar codes. In a survey of this magnitude it is likely, even with
vigilant supervision, that there will be a few mismatched bar codes and questionnaires. At
an aggregate level, this will have an insignificant effect on the results. However, it would
mean that the result provided to any individual survey respondent may not be accurate.
Finally, there is potential for additional errors to occur in the process of informing
individuals of their test results at the level of the HCT sites.
Given these issues, it was deemed more appropriate to provide results immediately but
advise patients to go for confirmatory follow up tests and secondary health facilities near
the patient’s communities.
In order to assess the impact of the NARHS Plus on facilitating VCT utilisation, the SMOH
will keep an accounting of the vouchers distributed during the course of the survey.
Furthermore, each VCT site will receive forms on which they will record the persons who
come for VCT with a NARHS Plus voucher. Team Counsellors will provide the necessary
referral vouchers. These forms will be collected from the providers approximately one
month after the NARHS Plus fieldwork is completed. Analysis of the information from
these ledgers is expected to be useful in assessing HCT service uptake in Nigeria and to
inform future efforts in general population sero-surveys.
The main components of the HIV testing protocol for the Nigeria NARHS Plus can be
summarised as follows. For participants who consent to the HIV testing, dried blood spot
specimens will be prepared by collecting blood from a finger prick onto special filter paper
cards. A unique random identification number will be assigned to each sample in the field
but will only be linked to survey data after all identifiers are destroyed. Free HIV
Counselling and Testing (HCT) services will be provided to all respondents who want to
know their status. This protocol is waiting for approval by the NIMR Research Ethics
Committee.
The protocol is in compliance with the standardized HIV Testing Protocol for NARHS Plus
surveys and is under review by the National IRB.
The US Office for the Protection from Research Risks (OPRR) guidelines require that
studies that collect personal identifiers and are supported by the US Government provide
results of HIV testing to all study participants with three exceptions: (1) where there is risk
of harm to an individual study participant; (2) where there is justification based on protocol
design, and, for sites outside the US; and (3) where there is justification based on cultural
norms, resource capabilities, and or official health policies.
The Public Health Service (PHS) Policy on informing those tested about their HIV serostatus applies to this foreign extramural PHS activity because the potential to link HIV test
results to specific individuals for reporting may exist during the conduct of the Nigeria
National Survey.
Exemption Category 2) Pertaining to protocol design. There are significant procedural and
methodological challenges that would not allow for the private and confidential return of
HIV test results to individuals. Since the interviews will be conducted in households rather
than a private setting, it is possible to ensure the return of HIV test results to the
230
participants in a confidential manner, but this has to be ensured by the counsellors/testers
during the survey. In addition respondents irrespective of status will be encouraged to get
confirmatory tests done at specific sites.
In regard to protocol and study design, requiring individuals to receive the results of their
HIV test may discourage certain individuals or groups from participating however certain
key benefits are obvious in providing results to respondents. These include increasing
access and acting as entry points to treatment and the opportunity to inform large
numbers of Nigerians of their HIV results.
4.11
Environmental Concerns Bio-hazards Disposal
The bio hazards disposal bags and sharp bins will be supplied to each STT. All the waste
from blood collection will be deposited in these bio hazard bags and sharp bins. Teams
will make arrangements with the health facilities (Clinic, Centres, or Hospitals) that will be
nearby to the clusters to properly dispose off these bio hazardous wastes in incinerators.
This process will be done weekly.
231
TABLE A.3 FINAL LOCALITIES SELECTED AND SAMPLE TO BE
INTERVIEWED BY CLUSTER
LGA
NAME
LOCALITY
ABA
SOUTH
ABA
SOUTH
LOCATION
ABA (CROWN
TOWN)
ABA (CROWN
TOWN)
ABIA
ABA
SOUTH
ABA
SOUTH
ABA
(NDIEGORO)
ABA(EZIUKWU
ABA)
ABIA
BENDE
NDIAGHO
R
ABIA
IKWUAN
O
OBEAMA
R
ABIA
ISIALAG
WA
NORTH
AGBURUIKE
R
ABIA
ISIALAG
WA
NORTH
AGBURUIKE
R
ABIA
OHAFIA
OHAFIA
(AMAEKOU
OHAFIA)
U
ABIA
OHAFIA
OHAFIA (ELU
OHAFIA)
U
ADAMAWA
GANYE
GANYE
U
ADAMAWA
GANYE
GANYE
U
ADAMAWA
LAMURD
E
GYAWANA
R
ADAMAWA
LAMURD
E
GYAWANA
R
CLUSTE
R CODE
252 CLIFFORD
ROAD
CLIFFORD
ROAD
NO 89
DEGEMA
STREET
NO38 JUBILEE
ROAD
JEREMIAH
OJIABO (NEAR
ST. MARRY'S
CATHOLIC
CHURCH)
CHIEF
REPHEAL
NWAGBARA
MR LAZARUS
ANUSIEM
(ACHARA
OKPULOR
HALL)
MR LAZARUS
ANUSIEM
(ACHARA
OKPULOR
HALL)
AMAEKPU
EKPE HOUSE
(NOT TOO FAR
FROM OHAFIA
GIRLS SEC
SCH)
HON. K.C.
IMAGA (NEAR
NIPOST
SERVICES)
UMARU
HAMMAWA
(NEAR NEW
MARKET)
GABRIEL
SARGA (NOT
TOO FAR TO
ST.MARTINS
PRY SCH)
MATHEW
YERIMA (NEAR
C. A.C
GYAWANA)
MATHEW
YERIMA (NEAR
C. A.C
GYAWANA)
ADA-
MAYO-
WURO KIRI
R
WURO KIRI
ABIA
ABIA
ABIA
CLUSTER
LOCATION
U
U
U
U
232
Final
Males
to be
sampled
Final
Females
to be
sampled
351
11
11
22
352
11
11
22
350
11
11
22
349
11
11
22
357
20
18
38
358
20
18
38
355
20
18
38
356
20
18
38
354
3
3
6
353
3
3
6
131
5
5
10
132
5
5
10
135
26
23
49
136
26
23
49
134
26
23
49
Tota
l Eligibl
e
MAWA
BELWA
ADAMAWA
MUBI
SOUTH
MUDA
R
ADAMAWA
YOLA
NORTH
JIMETA
U
ADAMAWA
YOLA
NORTH
JIMETA
U
ADAMAWA
YOLA
SOUTH
YOLA
U
ADAMAWA
AKWAIBOM
YOLA
SOUTH
ETIM
EKPO
YOLA
URUK ATA IKOT
ISEMIN
U
R
AKWAIBOM
ETINAM
ETINAN URBAN
U
AKWAIBOM
ETINAM
ETINAN URBAN
U
IKOTEKPENE
IKOT IKPONG
URUK USO
R
ORON
EYO USO ATAI
R
ORON
EYO USO ATAI
R
UYO
IBOKO OFFOT
U
UYO
IBOKO OFFOT
U
UYO
IKOT UDOKO
OKU
U
AKWAIBOM
AKWAIBOM
AKWAIBOM
AKWAIBOM
AKWAIBOM
AKWAIBOM
AKWAIBOM
ANAMBRA
UYO
ANAMBR
A WEST
UYO OFFOT
U
UDA - NZAM
R
ANAMBRA
DUNUKOFA
MGBUKE
UMUNACHI
R
ANAMBRA
IDEMILI
SOUTH
UMUOGALI-OBA
U
ANAMBRA
IDEMILI
SOUTH
UMUOGALI-OBA
ANA-
ONI-
ONITSHA
JAURO ISHAKU
SARKI (NEAR
CENRAL
MOSQUE)
ALH. YAHYA
COMMISSIONE
R (NEAR
JIMETA
PRISONS)
JAURO
HAMMAN A.
MUSA (NEAR
NIGER
INSURANCE)
J.UMARU
MOH'D (NEAR
ADAMAWA
HOSPITAL)
J.UMARU
MOH'D (NEAR
ADAMAWA
HOSPITAL)
CHIEF JOHNNY
ETETE
AKPAN OKON
AKPAN (NEAR
SUNLIGHT
NUR PRI SCH
AND TOO FAR
FROM LGA
SECRETARIAT)
SUNDAY
JOHNNY
BASSEY (NEAR
ST.JOHN
AFRICAN
CHURCH)
EVANG.
FEDELIX E. J.
ETIM
PATRICK
OKUNG
PATRICK
OKUNG
22A NKEMBA
STR.
22A NKEMBA
STR.
25 IKOT
UDORO
STREET
32 UDO
UMANA STR.
133
26
23
49
127
5
5
10
128
5
5
10
129
5
5
10
130
5
5
10
336
28
27
55
333
4
3
7
334
4
3
7
335
28
27
55
337
28
27
55
338
28
27
55
331
3
3
6
332
3
3
6
330
3
3
6
329
3
3
6
385
13
20
33
386
13
20
33
383
34
19
53
U
EGODI PIT
PROF.ELOCHU
KWU
AMAUCHEAZI
CHRISTOPHER
EJEKALOM
(NEAR
COMM.PRI
SCH)
UCHENNA
IGBANGO (NOT
TOO FAR TO
GIRLS SEC
SCH OBA)
384
34
19
53
U
28 ISIOKWE
380
5
3
8
233
MBRA
ANAMBRA
ANAMBRA
ANAMBRA
TSHA
NORTH
ONITSHA
NORTH
ONITSHA
SOUTH
ONITSHA
SOUTH
ORUMBA
NORTH
ORUMBA
NORTH
BAUCHI
ALKALERI
YALO
R
BAUCHI
BAUCHI
BAUCHI
U
BAUCHI
BAUCHI
BAUCHI
U
BAUCHI
BAUCHI
BAUCHI
U
BAUCHI
BAUCHI
BAUCHI
U
BAUCHI
DAMBAM
DAGAUDA
R
BAUCHI
DAMBAM
DAGAUDA
R
BAUCHI
GAMAWA
GAMAWA
U
BAUCHI
GAMAWA
GAMAWA
U
ANAMBRA
ANAMBRA
(ISIOKWE II)
ROAD
ONITSHA
(UMUAROLI)
U
17 NKISI AROLI
STREET
379
5
3
8
ONITSHA
(FEGGE II)
U
25 ALOR
STREET
381
5
3
8
ONITSHA
(FEGGE II)
U
382
5
3
8
UMUDALA
R
387
13
20
33
UMUDALA
R
388
13
20
33
096
17
13
30
087
19
12
31
088
19
12
31
089
19
12
31
090
19
12
31
094
17
13
30
095
17
13
30
091
4
3
7
092
4
3
7
093
17
13
30
315
24
19
43
316
24
19
43
317
24
19
43
BAUCHI
BAYELSA
ZAKI
GAUYA
R
BRASS
BELETIEMA
R
BAYELSA
EKEREMOR
AYAMASSA
R
BAYELSA
EKEREMOR
AYAMASSA
R
26 ALOR
STREET
JOSEPH
OFORJEBE
JOSEPH
OFORJEBE
SARKIN YALO
MUHAMMADU
DR AHMED
GIDADO (NEAR
JAHUN II
PRIMARY
SCHOOL)
MAL. YUSUF
BABAN
IYATUWA
(NEAR KOFAR
DUMI PRI.
SCH.)
AUWALU
MAKAMA
(NEAR N T A
OFFICE)
AUWALU
MAKAMA
(NEAR N T A
OFFICE)
ALH.HALADU
AYUBA (NEAR
CENTRAL PRI
SCH)
ALH.HALADU
AYUBA (NEAR
CENTRAL PRI
SCH)
IBRAHIM MANU
(NEAR DAY PRI
SCH AND ALSO
NEAR POLICE
STATION)
D.P.O.
MAIDUNNA
(NEAR
MOHAMMED
BAKURAH'S
HOUSE)
SARKIN ASKA
ALI
RAMESY NAOH
CHF WALTER
KPIAYE (NEAR
CHERUBIM &
SERAPHIM
CHURCH)
CHF WALTER
KPIAYE (NEAR
CHERUBIM &
SERAPHIM
CHURCH)
234
BAYELSA
KOLOKU
MA/OPO
RUMA
ODI
R
BAYELSA
NEMBE
BASSAMBIRI
U
BAYELSA
NEMBE
BASSAMBIRI
U
BAYELSA
SOUTHE
RN IJAW
AMASSOMA
U
BAYELSA
SOUTHE
RN IJAW
AMASSOMA
U
BAYELSA
SOUTHE
RN IJAW
AMASSOMA
U
BAYELSA
AMASSOMA
U
BENUE
SOUTHE
RN IJAW
KATSINA
LA
MBAILIM
R
BENUE
KONSHI
SHA
AGBEEDE
R
BENUE
MAKURDI
MAKURDI
U
BENUE
MAKURDI
MAKURDI
U
BENUE
MAKURDI
MAKURDI
U
BENUE
MAKURDI
MAKURDI
U
BENUE
MAKURDI
MAKURDI
TOWN
U
BENUE
MAKURDI
MAKURDI
TOWN
U
PHILIP EDIDE
(NEAR
IMGBELA PRI
SCH)
CHF. OGBU
(NEAR G.G.S.S
BASSAMBIRI)
ANTHONY
FRANK (NEAR
COPM.
HEALTH
CENTRE)
JOHN
ATAGBORO
(NEAR
GENERAL
HOSPITAL)
EBIMOBOWEI
AMAGAO
(NEAR HRH C.
GRAHAM
NAINGBE)
MANSION
OKPOBA
(ALUMU PRY
SCH)
MANSION
OKPOBA
(ALUMU PRY
SCH)
RCM CHURCH
ASEN
TIMOTHY
ATUMAGA(NEA
R LGEA PRI.
SCH.
AGBEEDE)
N0. 1 NIGER
CRESCENT
(NEAR
CENTRAL
MOSQUE
WADATA)
CHIEF ASENYA
AWUNU (NEAR
NOMADI PRI
SCH
JANKWAKWA)
JAMES YAOR
(NEAR LGEA
PRI SCH
OWNERS
OCCUPIER)
JAMES YAOR
(NEAR LGEA
PRI SCH
OWNERS
OCCUPIER)
ZAKI
JONATHAN
ADEKE(NEAR
THE
SHEPHARD
ACADEMY)
ZAKI ATUM
AZANDE(NEAR
LGEA PRI.
SCH.
WALOMAYO)
BENUE
MAKURDI
MAKURDI(IKPA
WA)
U
CHIEF S.
ANULA(NEAR
235
318
24
19
43
313
13
10
23
314
13
10
23
309
5
5
10
310
5
5
10
311
5
5
10
312
5
5
10
151
29
26
55
939
29
26
55
147
6
5
11
148
6
5
11
149
6
5
11
150
6
5
11
935
7
6
13
938
7
6
13
936
7
6
13
RCM PRI SCH
AGBAIKYOR)
BENUE
MAKURDI
MAKURDI(KANS
HIO)
U
BENUE
OHIMINI
ATLO
R
BENUE
OBEGEDE
R
BENUE
OJU
VANDEIKYA
MBAAJI
R
BORNO
ASKIRAUBA
ASKIRA
R
BORNO
ASKIRAUBA
ASKIRA
R
BORNO
BAYO
TELLI
R
BORNO
DAMBOA
NJABA
R
BORNO
GUBIO
GAZABURE
R
BORNO
GWOZA
GWOZA.
U
BORNO
GWOZA
GWOZA.
U
BORNO
JERE
MAIDUGURI
U
BORNO
JERE
MAIDUGURI
U
BORNO
KUKAWA
DORON BAGA
U
BORNO
KUKAWA
DORON BAGA
U
BORNO
MAIDUGURI
MAIDUGURI
U
BORNO
MAIDUGURI
MAIDUGURI
(BOLORI I
U
BORNO
MARTE
ALA
R
CROSS
RIVER
BEKWARA
ANYIKANG
U
KUMBUR
KUMBA(NEAR
LAKE CHAD
HOTEL)
JUSTICE A.P.
ANYEBE
ANDREW
AGADA
ANYAKPA
ANUM
LAWAN MOH'D
GUDUSU
(NEAR EMIR'S
PALACE)
LAWAN MOH'D
GUDUSU
(NEAR EMIR'S
PALACE)
MAI ANGUWA
BAIYU
BULAMA GOJA
LAWAN
ALSAMI
ALH ABDUL
BELLO(NEAR
GSS GWOZA)
LAWAN
YAYA(NEAR
EMIR PALACE)
SHETTIMA
MUSTAPHA
(NEAR
RAILWAY
QTRS)
SHETTIMA
MUSTAPHA
(NEAR
RAILWAY
QTRS)
HON. MODU
KUR (CLOSE
TO
YAUCHIKASHA
RUWA)
MALLAM AUDU
MANOMI
(NEAR
USMANIYA PRI
SCH)
MOH'D A.
NAIRA (NEAR
OLD M/DURI
POLICE
STATION)
ALHAJI M. K.
MONGUNO
(NEAR BOLORI
I. MARKET
LAWAN
SHETTIMA
ALOMA (NEAR
ALA CENTRAL
PRI SCH)
CH. MARTIN
OJAR (NEAR
ODABUA
MODEL
COLLEGE)
236
937
7
6
13
152
29
26
55
153
29
26
55
154
29
26
55
125
21
19
40
126
21
19
40
928
21
19
40
123
21
19
40
927
21
19
40
925
5
5
10
926
5
5
10
119
10
8
18
120
10
8
18
121
6
6
12
122
6
6
12
117
10
8
18
118
10
8
18
124
21
19
40
957
3
3
6
BEKWARA
ANYIKANG
U
OBUBRA
EDONDON
R
ORIRA
R
CALABAR
TOWN (EDIMOTOP)
U
NO.36 EDIMOTOP STREET
CROSSRIVER
BIASE
CALABAR
MUNICIP
AL
CALABAR
MUNICIPAL
HON.
CLEMENT
AJOR(NEAR
ST. CELESTINE
P/SCHOOL)
CHIEF UTONG
OGEH(NEAR
COMMUNITY
HEALTH
CENTRE)
MR. MICHAEL
UMOH
CALABAR
TOWN
(NYAHASANG)
U
CROSSRIVER
CALABAR
SOUTH
CALABAR
TOWN(EFUTABUA)
U
CALABAR
SOUTH
CALABAR
TOWN(EFUTABUA)
U
OBUBRA
ABABENE
R
OBUBRA
ABABENE
R
OBUDU
OBUDU URBAN
U
OBUDU
OBUDU URBAN
ISHINDEDE NKUM
U
UBULUBU
R
CROSS
RIVER
CROSS
RIVER
CROSSRIVER
CROSSRIVER
CROSSRIVER
CROSSRIVER
CROSSRIVER
CROSSRIVER
CROSSRIVER
CROSSRIVER
DELTA
OGOJA
ANIOCHA
NORTH
R
DELTA
BURUTU
AGBODOBIRI
R
DELTA
BURUTU
OJOBO
R
DELTA
BURUTU
OJOBO
R
DELTA
ETHIOPE
EAST
EKREBUO
R
DELTA
IKA
NORTH
EAST
UMUNEDE
U
NO 7 NSAHA
EFFIOM
STREET
NO. 4 ESSIEN
STREET (NEAR
HRH ITA
OKOKON
EKPENYONG
NO. 4 ESSIEN
STREET (NEAR
HRH ITA
OKOKON
EKPENYONG
CHIEF AFRO
ENANG
CHIEF AFRO
ENANG
CAPT. JOHN
AKOMAYE
(NOT TOO FAR
TO
FEDERATION
SEC SCH)
CHIEF
AUGUSTINE A.
(NEAR ALL
SAINTS
CATHOLIC
CHURCH)
PATRICK
NGANG
CHIEF OKOLIE
CHARLES
PERE
KOKOIMUGBI
CHIEF ANDY
OMOKO
(CLOSE TO
GENERAL
HOSPITAL)
CHIEF ANDY
OMOKO
(CLOSE TO
GENERAL
HOSPITAL)
CHIEF
DICKSON
IGBEDE
MR. JULIUS
KARRIAH
(NEAR
KINGDOM
HALL OF
237
958
3
3
6
959
24
23
47
348
24
23
47
340
7
6
13
339
7
6
13
341
7
6
13
342
7
6
13
345
24
23
47
346
24
23
47
343
3
3
6
344
3
3
6
347
24
23
47
955
24
18
42
954
24
18
42
305
24
18
42
306
24
18
42
953
24
18
42
303
14
11
25
JEHOVAH
WITNESS)
DELTA
IKA
NORTH
EAST
ISOKO
SOUTH
NDOKW
A EAST
DELTA
OSHIMILI
NORTH
DELTA
DELTA
UMUNEDE
OWODOKPOKPO
U
R
UMUOLU
R
ASABA
U
ASABA
U
DELTA
OSHIMILI
NORTH
UGHELI
SOUTH
OLOTA
R
DELTA
WARRI
SOUTH
AGBASSA
(WARRI)
U
DELTA
WARRI
SOUTH
AJAMIMOGHA
(WARRI)
U
DELTA
WARRI
SOUTH
EDJEBA WARRI
U
DELTA
WARRI
SOUTH
IGBUDU
(WARRI)
U
DELTA
WARRI
SOUTH
IGBUDU
(WARRI)
U
DELTA
WARRI
SOUTH
IYARA (WARRI)
U
DELTA
WARRI
SOUTH
ODION (WARRI)
U
DELTA
WARRI
SOUTH
WARRI
U
EBONYI
ABAKALIKI
ABAKALIKI
URBAN
U
ABAKALIKI
ABAKALIKI
ABAKALIKI
ABAKALIKI
URBAN
ABAKALIKI
URBAN
ABAKALIKI
URBAN
DELTA
EBONYI
EBONYI
EBONYI
U
U
U
BAKWUNYE
PETER (NEAR
SACRED
HEART
SCHOOL)
BISHOP OYE
ORUTE
OKORO
GEORGE
CHIEF OLIKO
CHIKE(NEAR
IFY MEDICAL
CENTRE)
OGBUESHI
OKEY
OFILI(NEAR
POTTER
WHEEL
HOTEL)
MR. ORIKO
ESHEM
RTD MAJOR
A.O
EGHAGA(NEAR
OCEANIC
BANK)
CHIEF J.S.M
OMASIBOR(NE
AR
AJAMIMOGHA
HEALTH
CENTRE)
MR ALAJONU
MATTHEW(NEA
R EDJEBA PRY
SCH)
CHIEF F.E
BRISIBE (NEAR
IZISCO
INTERNATIONA
L HOTEL)
CHIEF F.E
BRISIBE (NEAR
IZISCO
INTERNATIONA
L HOTEL)
ABRAHAM
EYUBE(NEAR
MEROGUN
PRY SCH)
CHIEF MARK
OKORO (NEAR
OGEDEGBE
PRI SCH)
MAJOR A.O
EOHAGA
(NEAR ACB
INTERNATIONA
L BANK)
NO. 8
ONUEBONYI
STREET
NO. 7
NDIZUOGU
STREET
NO. 1 IBEME
STREET
NO. 1 IBEME
STREET
238
304
14
11
25
307
24
18
42
308
24
18
42
951
14
11
25
952
14
11
25
956
24
18
42
949
5
4
9
947
5
4
9
948
5
4
9
301
5
4
9
302
5
4
9
950
5
4
9
300
5
4
9
299
5
4
9
359
2
3
5
360
2
3
5
361
2
3
5
362
2
3
5
U
ULO OGO
AMAEKWU(NE
AR ST.
THOMAS
CATHOLIC
CHURCH)
PATRICK
OKO(NEAR
CICA COMP.
COLLEGE)
CHIEF ANYA
NKAMA (NEAR
EWA INYA'S
HOUSE)
CHIEF ANYA
NKAMA (NEAR
EWA INYA'S
HOUSE)
NWEZE
SUNDAY
(CLOSE TO
OBLECHI
COMM. PRI
SCH)
OYIBO
OKEREKWU
(NOT TOO FAR
FROM
OBULECHI
HEALTH
CENTRE)
R
EVERISTUS
NWELE
EBONYI
AFIKPO
NORTH
AMAEKWU
UNWANA
U
EBONYI
AFIKPO
NORTH
EGEBURU
OHAISU AFIKPO
U
EBONYI
AFIKPO
NORTH
AMURO - ITIM
R
EBONYI
AFIKPO
NORTH
AMURO - ITIM
R
EBONYI
EZZA
NORTH
UMUEZEALI
ORIUZOR
U
EBONYI
EZZA
NORTH
EBONYI
IKWO
EBONYI
OHAUKWU
UMUEZEALI
ORIUZOR
ENYIM
AMAINYIMA
OKPOITUMO
INYIMAGU
OKPOSHI
EHEKU
EDO
EGOR
BENIN CITY
(OKHORO)
U
EDO
ESAN
SOUTH
EAST
EWOHIMI
(OKAIGBEN)
U
EDO
ESAN
SOUTH
EAST
EWOHIMI
(OKAIGBEN)
U
EDO
ESAN
WEST
UJIOGBA
R
UJIOGBA
R
IRAOKHOR
R
U
HON. UBOCHI
FESTUS
ISAAC
FEDIYOR
HOUSE ( NEAR
ULTIMATE
SCHOOL)
CHIEF DAVID
OKONOBOH
(NEAR N E P A
SERVICE
STATION)
MR. BRAVO
HOUSE
(EWOHIMI
POLICE
STATION)
PA JOSEPH
UGUDAN
(NEAR
UKPATO PRI
SCH)
PA JOSEPH
UGUDAN
(NEAR
UKPATO PRI
SCH)
HON.
BERNARD
OSIREGBEMHE
PIUS ENIJE
HOUSE (NEAR
ADUWAWA
MARKET)
U
PIUS ENIJE
HOUSE (NEAR
EDO
ESAN
WEST
ETSAKO
CENTRAL
EDO
IKPOBAOKHA
BENIN CITY
(ADUWAWA)
EDO
IKPOBAOKHA
BENIN CITY
(ADUWAWA)
EDO
R
239
945
7
8
15
946
7
8
15
367
23
24
47
368
23
24
47
363
11
14
25
364
11
14
25
366
23
24
47
365
23
24
47
289
11
9
20
293
10
9
19
294
10
9
19
295
18
16
34
296
18
16
34
298
18
16
34
290
11
9
20
291
11
9
20
ADUWAWA
MARKET)
EDO
EDO
OREDO
UHONM
WODE
BENIN CITY
U
UHI
R
EKITI
ADO
EKITI
ADO-EKITI
U
EKITI
ADO
EKITI
ADO-EKITI
U
EKITI
ADO
EKITI
ADO-EKITI
U
EKITI
ADO
EKITI
ADO-EKITI
U
EKITI
EKITI
SOUTH
WEST
ILAWE EKITI
U
EKITI
EKITI
SOUTH
WEST
ILAWE EKITI
U
EKITI
EKITI
WEST
IPOLE ILORO
R
EKITI
EKITI
WEST
IPOLE ILORO
R
EKITI
EMURE
EMURE EKITI
U
EKITI
EMURE
EMURE EKITI
U
EKITI
IREPOD
UN/IFELODUN
IROPORA EKITI
R
EKITI
OYE
IJELU EKITI
R
EKITI
OYE
OSIN EKITI
R
ENUGU
IGBOETITI
OJIME UKEHE
NKPOLOGWU
U
P.O. AJERIO
(NEAR GLOBAL
HOTEL
BENDEL)
OSAYANDE
AGHO
PETER
ADEOLA
HOUSE (NEAR
AUD CENTRAL
MOSQUE)
ELIJAH OJO
HOUSE (NEAR
AP FILLING
STATION)
ELDER
AWODIGEDE
HOUSE (NEAR
OBADARE N/P
SCH)
ELDER
AWODIGEDE
HOUSE (NEAR
OBADARE N/P
SCH)
COL.
OLUGBADE(NE
AR ST. JOHN
CATHOLIC
SPECIAL)
CHIEF
AKOGUN(NEAR
SUNSHINE
HOTEL)
JEGEDE
AGBESA
(NEAR A U D
PRI SCH)
JEGEDE
AGBESA
(NEAR A U D
PRI SCH)
CH THOMAS
OLORO HOUSE
(NEAR AD
SECRETARIAT)
ALHAJI
FOLORUNSO
(NEAR
APOASTOLIC
FAITH
CHURCH)
CHIEF
OKUNATO
(CLOSE TO
IROPORA
TOWN HALL)
CH. OBALOFIN
IDOWU(NEAR
ELEJELU
PALACE)
CH. JOSEPH
AJAYI (NEAR
OLOSINS
PALACE)
ODO UKWUKIM
MASQ.HOUSE
(NEAR COMM.
HIGH SCH
240
292
11
9
20
297
18
16
34
215
4
4
8
216
4
4
8
217
4
4
8
218
4
4
8
942
11
10
21
944
11
10
21
223
19
18
37
224
19
18
37
219
20
18
38
220
20
18
38
222
19
18
37
943
19
18
37
221
19
18
37
373
11
11
22
NKPOLOGWU)
ENUGU
IGBOETITI
OJIME UKEHE
NKPOLOGWU
U
ENUGU
IGBOEZE
SOUTH
ALOR AGU
R
ENUGU
UZOUWANI
OGBOSUUMULOKPA
R
UZOUWANI
ENUGU
EAST
ENUGU
NORTH
ENUGU
NORTH
OGBOSUUMULOKPA
ENUGU (NIKEEMENE)
ENUGU (NEW
HEVEN ENUGU)
ENUGU (NEW
HEVEN ENUGU)
ENUGU
(AWKUNANAW
IDAW RIVER)
ENUGU
ENUGU
ENUGU
ENUGU
ENUGU
ENUGU
SOUTH
NKANU
WEST
FCT
ENUGU
R
U
U
U
U
R
AMAC
OZALLA
NYANYAN
AREA F
FCTABUJA
GWAGW
ALADA
GWAGWALADA
U
FCTABUJA
GWAGW
ALADA
GWAGWALADA
U
U
FCTABUJA
FCTABUJA
ABAJI
YABA
R
AMAC
GARKI AREA 2
U
FCTABUJA
AMAC
GARKI II
U
FCTABUJA
AMAC
GWAGWA
R
AMAC
JIWA
R
AMAC
MAITAMA
U
FCTABUJA
FCTABUJA
FCTABUJA
FCTABUJA
AMAC
WUSE (WUSE
ZONE 1)
U
KUJE
TOTON GABIYA
R
GOMBE
BILLIRI
BILLIRI
U
OZO IHEDIMA
UKEHE (NEAR
MBARA OBEGU
IDENYI HALL)
BONIFACE
UGWUOKE
(NEAR ST.
MARY'S
CATHOLIC
CHURCH )
JOHN
NWAFIACHA
(NEAR HRH
IGWE J.
IFEDIEGWU)
JOHN
NWAFIACHA
(NEAR HRH
IGWE J.
IFEDIEGWU)
NO 11 AGBANI
STREET
NO 1 IHEALA
AVENUE
NO 1 IHEALA
AVENUE
50 MONUT
STREET
NWANINTA
OKOYE
BLOCK 76/77
AREA F
ALH. SULE
HARUNA
AGUMA (NEAR
AGUMA'S
PALACE)
BLK A8
KONTAGORO
ESTATE
MOH'D S. INJI
(NEAR CHIEF
PALACE)
2 YENEGOA
STREET
MAMMAN
SARKI NOMA
(NEAR MR
BIGS
REASTURANT)
ALH.ALHASSA
N GWAGWA
(NEAR LEA
PRI. SCH)
HAKIMI JIWA
(NEAR PRI
HEALTH CARE)
F.H.A.
QUARTERS I
FED.MIN.AGRI
C & RD (NEAR
AMUSEMENT
PARK)
TOTONGABIA
POSTOR
SAMSO SABO
(NEAR ECWA
241
374
11
11
22
378
18
19
37
375
18
19
37
376
18
19
37
370
8
8
16
371
8
8
16
372
8
8
16
369
8
8
16
377
18
19
37
933
11
8
19
179
11
8
19
180
11
8
19
183
27
17
44
177
6
4
10
175
6
4
10
182
27
17
44
181
27
17
44
178
6
4
10
176
6
4
10
184
27
17
44
101
5
4
9
SEC SCH)
GOMBE
GOMBE
BILLIRI
FUNAKAYE
FUNAKAYE
GOMBE
GOMBE
GOMBE
(BOLARI)
U
GOMBE
GOMBE
GOMBE
(JAKADAFARI)
U
GOMBE
GOMBE
GOMBE
(SHAMAKI)
U
GOMBE
GOMBE
(SHAMAKI)
U
GWANDUM
R
KINAFA
UMUAGHARA
OGBE
UMUAGHARA
OGBE
R
R
IMO
GOMBE
SHOMGOM
YAMALT
U/DEBA
AHIAZUMBAISE
AHIAZUMBAISE
IMO
NJABA
UMUOKWARA
R
IMO
OKIGWE
OKIGWE
U
IMO
OKIGWE
U
IMO
ORSU
OKIGWE
OKWUROKWU
AMANACHI
R
IMO
OWERRI
MUNI.
OWERRI
U
IMO
OWERRI
MUNI.
OWERRI
U
IMO
OWERRI
NORTH
OWERRI
(OGBEKE
OBIEZENA)
U
IMO
OWERRI
WEST
OWERR
(UMUANUNU)
U
JIGAWA
BIRNINKUDU
BIRNIN KUDU
U
BIRNIN KUDU
U
Durbun Dawa
R
GOMBE
GOMBE
GOMBE
IMO
JIGAWA
JIGAWA
BIRNINKUDU
BRININ
KUDU
BILLIRI
U
KUPTO
R
KUPTO
R
R
PROF.
SANTAYA
(NEAR DR
JOSHUA
MAINA HOUSE)
CHIROMA
USMAN
CHIROMA
USMAN
CAPTAIN
GARBA (NEAR
LAGOS BAR)
ALHAJI YAHYA
UMAR HOUSE
(NEAR
JAKADAFARI
AREA COURT)
ALHAJI YARI
HOUSE (NEAR
IDI PRI SCH)
ALHAJI YARI
HOUSE (NEAR
IDI PRI SCH)
BAR. HANANIA
HAMMAH
BUBA MAI
GORO
CHIEF V.C
OBILOR
CHIEF V.C
OBILOR
GWAWACHI
STEPHEN
IKECHUKWU
KANU (NEAR
HRH EZE
C.UGOCHUKW
U 11)
CHIEF OKEY
OKPARA
(NEAR CHRIST
HOLY CHURCH
INT.)
CHIEF OBIORA
LAWRENCE
NO 10 B
OPARANOZIE
STREET
NO 10 B
OPARANOZIE
STREET
HILLARY
EGEJURU
(NEAR ESHIEDI
PRI SCH)
DR AJOKU F.A
(NEAR ELBON
PLAZA)
Dan Bala
Ibrahim (NEAR
GENERAL
HOSPITAL)
Alh.
Muhammadu
Mai Keke
(NEAR INEC
OFFICE)
Mai Ung.
Ibrahim Adamu
242
102
5
4
9
103
28
25
53
104
28
25
53
097
3
3
6
098
3
3
6
099
3
3
6
100
3
3
6
404
28
25
53
105
28
25
53
397
20
22
42
398
20
22
42
396
20
22
42
393
9
9
18
394
9
9
18
395
20
22
42
390
6
6
12
391
6
6
12
392
6
6
12
389
6
6
12
047
3
3
6
048
3
3
6
920
32
29
61
JIGAWA
GUMEL
GUMEL
U
JIGAWA
GUMEL
GUMEL
U
JIGAWA
GUMEL
GUMEL
U
JIGAWA
GUMEL
GWARAM
GUMEL
(DANTANOMA)
UNGUWAR
KUKA
JIGAWA
GWIWA
MALAMMADURI
UNG.DORAWA
SHAYYA
YAMMA
R
JIGAWA
RINGIM
KARSHI
R
JIGAWA
RINGIM
KARSHI
R
KADUNA
GIWA
RUHEWA
R
KADUNA
IGABI
RIGASA
U
KADUNA
IKARA
KURMIN KOGI
R
KADUNA
JAMA'A
ANTANG
R
KADUNA
KADUNA
CHIKUN
KADUNA
(BISHISHI
GWAGWADA)
U
KADUNA
KADUNA
CHIKUN
KADUNA
(BURUKU)
U
KADUNA
KADUNA
NORTH
KADUNA
(KABALA
CONSTAIN)
U
KADUNA
KADUNA
NORTH
KADUNA (UN
SHANU)
U
KADUNA
KADUNA
NORTH
KADUNA(RAFIN
GUZA KAWO)
U
KADUNA
KADUNA
SOUTH
KADUNA
(TELEVISION)
U
KADUNA
KADUNA
SOUTH
KADUNA
(KAKURI)
U
KADUNA
KAURA
KAGORO
U
JIGAWA
JIGAWA
U
R
R
TELA ZAKI
(NEAR
SPECIAL PRI
SCH)
TELA ZAKI
(NEAR
SPECIAL PRI
SCH)
MAL. MAGAJI
BASHIR (NEAR
AMINU KANO
HALL)
ALH USMAN
(NEAR LAUTAI
CINEMA)
Mal.Musa Liman
Musa Halilu
Kansila
Muhammadu
Galadima
ALH GARBA
TELA
ALH GARBA
TELA
ALH. MUNTARI
RILWANU
MAI UNG ALH
MOH D(UBE
PRY SCH)
HAKIMI ALHAJI
LAWAL IDRIS
MAI
UNG.YUSUF
SARKIN
BISHISHI
AYUBA (CLOSE
TO
CUMMUNITY
CLINIC)
TURAKI LADO
(NEAR G.S.S
BURUKU)
ALHAJI
HARUNA PAKI
(NEAR MEDINA
MOSQUE)
ALH
ABDULLAHI
IBRAHIM
(NEAR HIDAYA
ISLAMIC SCH
UNG SHANU)
ALHAJI
DALLADI(NEAR
NOMADIC PRI
SCH)
DAKACI WASA
YARI (NOT
TOO FAR
FROM LEA PRI
SCH 1
TELEVISION)
JOHN
ADEWUIYE
HOUSE (PETTY
HIGH SCH)
GWAMNA
AWAN (NEAR
WATER
BOARD)
243
043
2
1
3
044
2
1
3
046
2
1
3
045
2
1
3
050
32
29
61
919
32
29
61
049
32
29
61
051
32
29
61
052
32
29
61
083
32
26
58
922
7
7
14
084
32
26
58
086
32
26
58
080
13
10
23
079
13
10
23
076
13
10
23
075
13
10
23
921
13
10
23
078
13
10
23
077
13
10
23
081
7
7
14
KADUNA
KAURA
KAGORO (ZALI)
U
KADUNA
KUBAU
TAFIYAU
R
KADUNA
LERE
YARKASUWA
R
KADUNA
SANGA
R
KANO
AJINGI
KANO
ALBASU
WASA STATION
TSEBARAWA
GABAS
ALBASU UNG
JEMO
KANO
BICHI
SHATUMBI
R
KANO
DALA
KANO
U
KANO
DALA
KANO
(ADAKAWA)
U
KANO
DALA
KANO
(ADAKAWA)
U
KANO
DAMBATTA
DAMBATTA
(UNG. SANGO)
U
KANO
DAMBATTA
DOGUWA
KANO
DOGUWA
UNG. BARDE
DANBATTA
DOGUWAR
GINGIYA
DOGUWAR
GINGIYA
GABAS
R
KANO
FAGGE
KANO (DANRIMI
KWACIRI)
U
KANO
KANO
FAGGEE
GABASAWA
KANO(SABON
GARI WEST)
JUNGORON
KANAWA
KANO
GAYA
TANI
R
KANO
GWALE
KANO (GWALE)
U
KANO
MUNI
KANO
MUNI-
KANO(SHARAD
A BATA)
KANO
(TUKUNTAWA)
KANO
KANO
KANO
R
R
U
R
U
R
U
U
UNG JONAH
MUSA (NEAR
5TH ECWA
CHURCH)
UNGUWAR
BARDE
ALHAJI
IBRAHIM SARKI
HAUSAWA
MUH D .S.
BASHAYI
MAI UNGUWA
SALE.I.
SGRT LAWAN
HAJIYA DIJE
HARUNA
ALH. LABARAN
CHAIRMAN(NE
AR KOFAR
RUWA
MARKET)
COM. ALASAN
BALA IDRIS
(NEAR
ADAKAWA PRI
SCH)
ALH DALHAYU
DANKURMA(AD
AKAWA PRI
SCH)
HAJIYA LAURE
(NEAR
DAMBATTA
GEN
HOSPITAL)
TURAKI
LAWAN (NEAR
SANI AMINU
HOUSE)
MAL. BELLO
ALAR.
MAL. BELLO
ALAR.
ABDULRAHMA
N DANFULANI
(NEAR
DANRIMI
OUTPOST
POLICE
STATION)
ALH.
IBRAHIM(NEAR
QUEEN A.D PRI
SCH)
GALADIMA
ABDU
HARISU KANI
ALH LAWAN
GARBA (NEAR
GWALE
POLICE
STATION)
SEN. MASUD
DOGUWA(NEA
R GSS
SHARADA)
HAUWA MAI
MAGANI (NEAR
244
082
7
7
14
923
32
26
58
085
32
26
58
924
32
26
58
070
21
18
39
074
21
18
39
912
19
17
36
053
9
8
17
059
9
8
17
904
9
8
17
064
7
6
13
063
7
6
13
071
21
18
39
072
21
18
39
058
9
8
17
905
9
8
17
069
21
18
39
913
19
17
36
056
9
8
17
906
9
8
17
060
9
8
17
CIPAL
KANO
KANO
MUNICIPAL
KANO (GANDU
C/GARI)
U
KANO
KURA
KURA
U
KANO
KURA
KURA
R
KANO
MADOBI
KAFI AGURA
R
KANO
NASARAWA
KANO (GAMA)
U
KANO
NASARAWA
KANO (GAMA)
U
KANO
NASARAWA
KANO
(GIGINYU)
U
KANO
NASARAWA
KANO(GAMA)
U
KANO
ROGO
ZAMFARAWA
R
KANO
TARAUNI
KANO (GYADIGYADI)
U
KANO
KANO(MARADIN
U
JAJIRA
R
KANO
TARAUNI
UNGOGO
UNGOGO
R
KANO
WARAWA
JAJIRA
JUMA
GALADIMA
/UNG.
MAGAJIYA
KANO
WUDIL
WUDIL ABUJA
U
KANO
WUDIL GARI
U
KATSINA
WUDIL
BINDAWA
GOZAWA
R
KATSINA
DAURA
DAURA
U
FASKARI
FASKARI
(S/GARI
FASKARI)
U
KANO
KATSINA
R
GANDU PRI
SCH)
GIDAN YARIN
KANO (NEAR
WAKILIN
RIJIYA
MOSQUE)
IDI YAU (BY
LGA STAFF
QTRS)
A.YAHAYA
JUNAIDU
(GIDAN
ZANGO)
DANLAMI
KWALWA
BASHIR
COUNCILOR
(NEAR
GWAGWARWA
POLICE
STATION)
LATE ALI
ADAMU BABAN
ABBA (NEAR
GWAGWARWA
POLICE POST)
HAJIYA
MARIYA (NEAR
TARAUNI SEC
SCH)
BASHIR
COUNCILOR(N
EAR GAMA
MINI STADIUM)
MAL. KABIRU
USMAN
MAL. IBRAHIM
UMAR KABO
(NEAR POST
OFFICE)
ABUBAKAR
INUWA(NEAR
NDE HEAD
OFFICE)
GIDAN
BARBELU
GIDAN
BARBELU
USMAN BOSS
M. USMAN
INDABO(NEAR
ALHAZAI
HOSPITAL)
AHMAD
BEGE(WUDIL
SPECIAL PRI)
M ABDU LIMAN
MAIGARI
MAMMAN(NEA
R MAZOJI PRI
SCH)
ALH SANI
ALLAH KSK
(NEAR
CENTRAL
MOSQUE)
245
061
9
8
17
065
7
6
13
066
7
6
13
914
19
17
36
055
9
8
17
062
9
8
17
054
9
8
17
907
9
8
17
073
21
18
39
057
9
8
17
908
9
8
17
067
21
18
39
068
21
18
39
911
19
17
36
910
7
6
13
909
7
6
13
917
26
25
51
916
7
7
14
037
12
12
24
FASKARI
(YANKARA)
U
ISAH IBRAHIM
(NEAR
YANKARA
MARKET)
038
12
12
24
R
TALLERI DAHE
918
26
25
51
R
042
30
29
59
033
7
7
14
034
7
7
14
035
7
7
14
036
7
7
14
KATSINA
FASKARI
KATSINA
JIBIA
KATSINA
KAFUR
GANGARA
UNGWAR
MAIRIGA
KATSINA
KATSINA
(DUTSIN
AMARE)
U
KATSINA
KATSINA
KATSINA
(DUTSIN
AMARE)
U
KATSINA
KATSINA
KATSINA
(KOFAR SAURI)
U
KATSINA
KATSINA
KATSINA
(SHARARRAR
PIPE)
U
KATSINA
KATSINA
KATSINA
(KOFAR SAURI)
U
LAWAL LAGOS
ALH. SANI
KERAU (NEAR
MAMMAN
BARDA PRI
SCH)
ALH. SANI
KERAU (NEAR
MAMMAN
BARDA PRI
SCH)
ISIYAKU C.D.K
(NEAR GOVT
COLLEGE
KASTINA)
ALH. RABE
DAN LAMI
(NEAR
SHUKURA
BREAD OR
KABIR WATER
BOARD)
SHEHI M. SANI
ZAGUNA(NEAR
GOVT.
COLLEGE
KATSINA)
915
7
7
14
KATSINA
KAIKAI
R
RUGA B.
041
30
29
59
MAIDANIA
R
M. ISAH LIMAN
039
30
29
59
KATSINA
KUSADA
MAIDUWA
MAIDUWA
MAIDANIA
R
040
30
29
59
KEBBI
ALIERO
GUNTULU
R
032
28
26
54
KEBBI
BAGUDO
LAFAGU
R
031
28
26
54
KEBBI
BIRNINKEBBBI
BIRNIN KEBBI
U
023
2
2
4
KEBBI
BIRNINKEBBBI
BIRNIN KEBBI
U
024
2
2
4
KEBBI
BIRNINKEBBBI
BIRNIN KEBBI
U
025
2
2
4
KEBBI
BIRNINKEBBBI
BIRNIN KEBBI
U
026
2
2
4
KEBBI
SHANGA
YARBESSE
R
029
28
26
54
KEBBI
SHANGA
YARBESSE
R
030
28
26
54
ZURU
ZURU (RAFIN
ZURU CENTRE
GABAS)
U
M. ISAH LIMAN
ALH. UMARU
FARI
SARKIN FAWA
MUHD
HAKIMI ALU
(NEAR PRI SCH
& ALSO NEAR
KABIRU
TANIMU
HOUSE)
ALH. SALA
ILLO (NEAR
SIR YAHAYA
HOSPITAL)
ABDULLAHI
FODIO (NEAR
FED. MED.
CENTRE)
ABUBAKAR
MAITANDU
(NEAR EMIR'S
PALACE OR
EQUITY
PLAZA)
MAL.HARUNA
KAKA
MAL.HARUNA
KAKA
UMARU
MOHAMMED
ZURU (NEAR
PHC ZURU)
027
6
5
11
KATSINA
KATSINA
KEBBI
246
KEBBI
ZURU
ZURU (RIKOTO)
U
KOGI
DEKINA
ITAMA
R
KOGI
KABBA
BUNU
(OYI)
KABBA
U
KOGI
KABBA
BUNU
(OYI)
KABBA
U
KOGI
KOGI
GIRINYA
R
KOGI
KOGI
GIRINYA
R
KOGI
OFU
OFABO
R
KOGI
OFU
OFAKAGA I
R
KOGI
OKENE
OKENE (MIKE)
U
KOGI
OKENE
OKENE
(OBEHIRA)
U
KOGI
OKENE
OKENE
(OBEHIRA)
U
KOGI
OKENE
OKENE
(OTUTU)
U
KWARA
EDU
LAFIAGI
U
KWARA
LAFIAGI
OFFARESE &
OTHERS
U
KWARA
EDU
IFELODUN
KWARA
ILORIN
EAST
ILORIN
U
KWARA
ILORIN
SOUTH
ILORIN (FATE
BASIN)
U
R
SARKI MOH'D
D/ALKALI
(NEAR
BAHAGO
GOMO
SEC.SCH.)
028
6
5
11
ALOEI ABBA
PA OKOMODA
(NEAR
CENTRAL
MARKET)
CHIEF
ADEKUNLE
(NEAR OWOLOWO
PETROLEUM)
MAGAJI
MANZO
BAKERU
MAGAJI
MANZO
BAKERU
ALFRED
AKAWE
TORKULA(NEA
R ARMY
CHILDREN
SEC. SCH
N/BANK)
203
21
20
41
199
13
13
26
200
13
13
26
201
21
20
41
202
21
20
41
934
21
20
41
IBRAHIM ETU
ALH. IDRIS
KING (NEAR
LGEA PRI
SCHOOL)
ENGR. SULE
ALIU (NEAR
GOSPEL
ASSEMBLIES
CHURCH)
ABUBAKAR
JANAKU (NEAR
LGEA PRI SCH)
PROF.
SHUAIBU
BEITA (NEAR
OTUTU
CENTRAL
MOSQUE)
MOHAMMED
MANZUMA
(NEAR OLD
CENTRAL
MOSQUE)
ALH.
NDAMARIA
JIBRIL (NEAR
LAFIAGI AREA
COURT)
MR JAMES
OGUNDIRAN
AROWOLO S
HOUSE (NEAR
GOVT DAY
SEC SCH)
MR ODEDINA
J. OJOA
(NEAR
COMMON
FAITH
MINISTRIES
204
21
20
41
197
5
5
10
195
5
5
10
196
5
5
10
198
5
5
10
209
6
6
12
210
6
6
12
212
19
17
36
207
12
10
22
208
12
10
22
247
OR RCCG)
KWARA
ILORIN
WEST
ILORIN
U
KWARA
ILORIN
WEST
ILORIN
U
KWARA
IREPODUN
ILALA
R
KWARA
IREPODUN
ILALA
R
KWARA
KAIAMA
ADERAN
R
LAGOS
OKO-OBA
U
AJEGUNLE
U
AKOWONJO
U
EGBE
U
LAGOS
AGEGE
AJEROM
I/IFELODUN
ALIMOS
HO
ALIMOSHO
AMUWO
ODOFIN
FESTAC TOWN
U
LAGOS
APAPA
IJORA BADIA
U
LAGOS
BADAGRY
BADAGRY
U
LAGOS
LAGOS
LAGOS
ALHAJI SALIU
IYANDA (NEAR
ERUDA LGEA
SCH)
ALHAJI
BELLO (KUNTU
CENTRAL
MOSQUE AND
ADETA PRI
SCH)
ALH. AKANDE
BELLO (NEAR
ILALA
CENTRAL
MOSQUE)
ALH. AKANDE
BELLO (NEAR
ILALA
CENTRAL
MOSQUE)
MALLAM
UMAR MUSA
Oladoje Street /
Agege Market
Road (Z PLACE
HOTEL)
61A Olayinka
Street
28, Iwajowa
Street
4, Abbey Street
5th Avenue/J
Close 512 Road
No 6 - 18 A
Baale Street
Onilude
Compound
(NEAR
BADAGRY
GRAMMAR
SCH 1)
205
12
10
22
206
12
10
22
213
19
17
36
214
19
17
36
211
19
17
36
269
19
15
34
272
19
15
34
283
19
15
34
276
19
15
34
275
19
15
34
278
19
15
34
285
7
7
14
LAGOS
EPE
ORIBA
R
Oriba I
287
4
4
8
LAGOS
EPE
ORIBA
R
288
4
4
8
LAGOS
ETI-OSA
IFAKO/IJ
AYE
IKOYI
U
270
19
15
34
ALAKUKO
U
271
19
15
34
IKEJA
IKORODU
ALAUSA
U
273
19
15
34
IKORODU
U
286
7
7
14
ALAPERE
U
274
19
15
34
ISALE EKO
U
279
19
15
34
LAGOS
KOSOFE
LAGOSISLAND
LAGOSMAIN
LAND
Oriba VII
Obudu / Ibadan
(NEAR IKOYI
CLUB)
38, Adenekan
Adeniyi Street
Sunday Adigun
Street / Ajeni
fuja Street
7, Ebunwawa
street
Kazeem /Ajibike
Street
30 Ajayi Bembe
Street
YABA
U
280
19
15
34
LAGOS
MUSHIN
MUSHIN
U
281
19
15
34
LAGOS
OJO
ABULE-AKA
U
Falodun Street
35B
19/21 Dakobiri
Street
2 EBOLO
STREET
LAGOS
OSHODI-
MAFOLUKU
U
Ogunsiji Street
LAGOS
LAGOS
LAGOS
LAGOS
LAGOS
248
282
19
15
34
277
19
15
34
ISOLO
LAGOS
SHOMOLU
SHOMOLU
U
NASARAWA
AKWANGA
ANDAHA
R
NASARAWA
AKWANGA
ANDAHA
R
NASARAWA
DOMA
DOMA
U
DOMA
DOMA
U
KEANA
KWARA
R
KEFFI
SAURA
R
NASARAWA
LAFIA
LAFIA
U
NASARAWA
LAFIA
LAFIA
U
NASARAWA
LAFIA
LAFIA
U
NASARAWA
LAFIA
LAFIA
U
NIGER
BORGU
YUMU
R
NIGER
CHANCH
AGA
MINNA
U
NIGER
CHANCH
AGA
MINNA
U
NIGER
CHANCH
AGA
MINNA
(NKANGBE)
U
NIGER
CHANCH
AGA
MINNA
(NKANGBE)
U
NIGER
CHANCH
ANGA
NASARAWA
NASARAWA
NASARAWA
NIGER
NIGER
GBAKO
MAGAMA
MINNA (WEST)
U
BATAGI
R
MATANDI
R
(NEAR ECWA
CHURCH)
4, Okesuna
Street
T. Y.
DANJUMA
(NEAR
CENTRAL
MOSQUE)
T. Y.
DANJUMA
(NEAR
CENTRAL
MOSQUE)
ALH ALI JIKAN
ARI (NEAR
YOUTH
CENTER
DOMA)
LIMAN GARI
(NEAR PAKASA
CLINIC)
ADASHO ADI
SAURAN
HAUSAWA
SABON
KAYARDA
HOUSE (NEAR
LGEA PRI SCH)
SABON
KAYARDA
HOUSE (NEAR
LGEA PRI SCH)
SEN. HARUNA
FAMILY HOUSE
(NEAR EMIR'S
PALACE)
ALH. YAHAYA
MAIKEFFI
(NEAR NAMU
CLINIC)
MOHAMMED
BUHARI
Alh. Adamu
Barde (NEAR
NEPA HEAD
OFFICE)
Alh.Jafaru
Mariga (NEAR
HASKE CLINIC
& MATERNTY)
Alh. Yusuf K.
Paiko (NEAR
OBASANJO
SHOPING
COMPLEX)
Alh. Yusuf K.
Paiko (NEAR
OBASANJO
SHOPING
COMPLEX)
Alh. Yusuf K.
Paiko(NEAR
OBASANJO
SHOPING
COMPLEX)
BATAGI LAZHI
UNGUWAN
SALKAWA
249
284
19
15
34
173
25
22
47
174
25
22
47
169
4
4
8
170
4
4
8
172
25
22
47
171
25
22
47
165
7
6
13
166
7
6
13
167
7
6
13
168
7
6
13
931
26
22
48
185
5
4
9
186
5
4
9
187
5
4
9
188
5
4
9
929
5
4
9
194
26
22
48
932
26
22
48
NIGER
MASHEGU
NASSARAWA
R
NIGER
MOKWA
MOKWA
U
NIGER
MOKWA
MOKWA
U
NIGER
RAFI
MAIKUJERI
R
NIGER
RAFI
MAIKUJERI
R
NIGER
SULEJA
SULEJA
(TUNGAN)
U
OGUN
ABEOKUTA
SOUTH
ABEOKUTA
U
OGUN
ABEOKUTA
SOUTH
ABEOKUTA
U
OGUN
ABEOKUTA
NORTH
ABEOKUTA
U
OGUN
ABEOKUTA
NORTH
ABEOKUTA
U
OGUN
IFO
IFO
U
OGUN
IFO
IFO
U
OGUN
IFO
IFO
U
OGUN
IPOKIA
IHUNBO
R
OGUN
ORILE-ILUGUN
R
OGUN
ODEDA
ODOGB
OLU
IBEFUN
R
OGUN
OGUN
WATER
SIDE
IBIADE
R
AUDU MAI
UNGUWAN
SARKIN
HAUSAWA
(NEAR
NNATSU PRI.
SCH)
CAPT. ISAH
ABUBAKAR
(NEAR ALH
NDAWANGWA)
Alh. Shehu-m
Bako (Near Mai
Haruna Islamic
School)
Alh. Shehu-m
Bako (Near Mai
Haruna Islamic
School)
JIBRIN
BAKO(NEAR
AWWAL
IBRAHIM
STADIUM)
OGUNYOMI S
HOUSE (NEAR
ALAKE
PALACE)
JUSTICE
KUFORIJI
(NEAR
NIGERIAN
PRISON)
LAHAOLA
HOUSE (NEAR
ABEOKUTA
NORTH
MATERNITY
CENTRE)
LAHAOLA
HOUSE (NEAR
ABEOKUTA
NORTH
MATERNITY
CENTRE)
HON. SESAN
OKEWUNMI
(ISTIJAB
CENTRAL
MOSQUE)
BALOGUN IFO
HOUSE (NEAR
EGUN-NLA
MOSQUE)
ABIARA S
HOUSE(NEAR
ROYAL INT.
SCHOOL)
HON. G.G.
ADELEYE'S
HOUSE
JOFAX FOTOS
CHIEF IMAM
ATUPA
ALHAJI
ANDREW
BELLO (NEAR
LIBERTY
CHURCH OF
CHRIST)
250
193
26
22
48
189
8
7
15
190
8
7
15
191
26
22
48
192
26
22
48
930
8
7
15
259
8
8
16
260
8
8
16
261
8
8
16
262
8
8
16
263
13
12
25
264
13
12
25
940
13
12
25
266
19
16
35
941
19
16
35
265
19
16
35
267
19
16
35
IBIADE
R
ONDO
OGUN
WATER
SIDE
AKOKO
NORTH
WEST
IGASI AKOKO
R
ONDO
AKURE
SOUTH
AKURE
U
ONDO
AKURE
SOUTH
AKURE
U
ONDO
AKURE
SOUTH
AKURE
U
ONDO
AKURE
SOUTH
AKURE
U
ONDO
ILAJE
AYETORO
R
ONDO
ILAJE
AYETORO
R
ONDO
ILE
OLUJI
OKEIGBO
OKE IGBO
U
OKE IGBO
U
EPE TOWN
R
OGUN
ONDO
ILE
OLUJI
OKEIGBO
ONDO
EAST
OSUN
ATAKUM
OSA
WEST
KAJOLA I
R
OSUN
BOLUWA
DURO
IRESI
R
IRESI
OMIDIRE
ONIPETESI
R
OSUN
BOLUWA
DURO
IFE
SOUTH
R
OSUN
ILA
ILA ORANGUN
U
ONDO
OSUN
ALHAJI
ANDREW
BELLO (NEAR
LIBERTY
CHURCH OF
CHRIST)
MR. ADEDEJI
OJO
BABA ARABA
(NEAR C.A.C
OKE IBUKUN)
CHIEF S F
OLOWOKERE
(NEAR
CATHOLIC
BISHOPS
COURT)
PA AYO
ADEGBITE
(NEAR ST.
THOMAS PRI
SCH ISINKAN)
PROF.ENIOLA
S O (NEAR
OMOLUOROGB
O GRAMMAR
SCH)
APEDE
ENIKUOMEHIN
(NEAR BASIC
HEALTH
CENTRE)
APEDE
ENIKUOMEHIN
(NEAR BASIC
HEALTH
CENTRE)
LATE OBA
SIJUWADE
FAROTADE
(NEAR POST
OFFICE)
CHIEF BODE
ADEOYIN
(NEAR
AIYETORO
MOSQUE)
ALHAJI
KAREEM
ALHAJI SIMBA
HOUSE(NEAR
KINGS
PALACE)
BAYO
ABOSEDE
(NEAR IRESI
CENTRAL
MOSQUE)
BAYO
ABOSEDE
(NEAR IRESI
CENTRAL
MOSQUE)
LEMONU
IBRAHIM
PROF.
AJIBOYE
(NEAR
BRIGHTER
FUTURE INT'L
251
268
19
16
35
231
21
18
39
225
6
5
11
226
6
5
11
227
6
5
11
228
6
5
11
233
21
18
39
234
21
18
39
229
14
13
27
230
14
13
27
232
21
18
39
243
14
13
27
241
14
13
27
242
14
13
27
244
14
13
27
239
23
22
45
COLLEGE)
OSUN
ILA
ILA ORANGUN
U
OSUN
OSOGBO
OSOGBO
U
OSUN
OSOGBO
OSOGBO
U
OSUN
OSOGBO
OSOGBO
U
OSUN
OSOGBO
OSOGBO
U
OYO
AFIJIO
IWARE
R
OYO
IWARE
R
OYO
AFIJIO
IBADAN
(CENTRAL)
IBADAN
(AREMO)
U
OYO
IBADAN
(CENTRAL)
IBADAN(BASOR
UN)
U
OYO
IBADAN
N.W
IBADAN (ABEBI)
U
OYO
IBADAN
NORTH
IBADAN
(SANGO)
U
OYO
IBADAN
S.E
IBADAN
(OWODE
ACADEMY)
U
OYO
IBADAN
S.W
OYO
IREPO
OYO
ISEYIN
IBADAN
(APATA)
KISHI (ISALE
ODO)
ISEYIN (OKE
OLA)
OYO
ITESIWAJU
BUDO ARE
R
OYO
KAJOLA
AYETORO OKE
R
OYO
KAJOLA
AYETORO OKE
R
U
U
U
ADEJENGBE
(NEAR
ORANGUN
PALACE)
LAWANI ADISA
(ST. MICHEAL
PRI SCH)
ALH.
OLORUNKOSE
BI (NEAR
EXCELLENT
N/P SCH OR T
& K N/P SCH)
CHIEF
ADETUNJI
ADETOLA
(NEAR WHITE
HOUSE
HOTEL)
CHIEF
ADETUNJI
ADETOLA
(NEAR WHITE
HOUSE
HOTEL)
OGUNRINDE
(ISALE OSUN
AJEGUNLE)
OKE LEMOMU
ALH OLADITI
HOUSE (NEAR
I.M.G PRI SCH)
AJABE
POPOOLA
(NEAR B.C.O.S
IBADAN)
CHIEF
LADAPO J.O
(NEAR UNITED
ANGLICAN
CHURCH)
AKEDE ONA
IYE (NEAR
SANGO
MARKET)
ALHAJI SAKA
SHITTU (NEAR
ABOSEDE
MEMORIAL
COLLEGE)
ALH. (DR) S.
OLUWA (NEAR
GOVT
COLLEGE 2)
TIAMIYU
OYINWOADE
YEKINI
OLULOKAN
OMO ALADE
SAKI (CITY
IMOKORO)
REV
GBADEGESIN
GBADAMOSI
AJETUNMOBI
(NEAR
AYETORO
CENTRAL
252
240
23
22
45
235
7
7
14
236
7
7
14
237
7
7
14
238
7
7
14
257
25
13
38
258
25
13
38
246
9
7
16
245
9
7
16
248
9
7
16
249
9
7
16
247
9
7
16
250
9
7
16
252
9
7
16
251
9
7
16
253
25
13
38
254
25
13
38
255
25
13
38
MOSQUE)
OYO
ORI IRE
ILUJU
R
PLATEAU
JOS
NORTH
JOS (ANGUWAN
ROGO)
U
PLATEAU
JOS
NORTH
JOS (FUDAWA)
U
PLATEAU
JOS
NORTH
JOS (FUDAWA)
U
PLATEAU
PLATEAU
JOS (JISHEGESSE
T/WADA)
U
DANYE
R
PLATEAU
PLATEAU
PLATEAU
JOS
NORTH
JOS
SOUTH
LANGTA
NG
NORTH
QUANPAN
QUANPAN
SHILUR
R
KADAURA
R
KADAURA
R
PLATEAU
SHENDAM
YELWA
U
PLATEAU
SHENDAM
YELWA (ANG
MURTALA)
U
RIVERS
ANDONI
OKOLOILE
R
RIVERS
EMUOHA
OBELLE
R
RIVERS
EMUOHA
OBELLE
R
RIVERS
OKRIKA
IBAKA TOWN
R
RIVERS
OYIGBO
OYIGBO
U
RIVERS
OYIGBO
OYIGBO
U
ILE ALAKASU
ALH. GAMBO
ABUBAKAR
(CLOSE TO
ASSASUL N/P
SCH AND NOT
TOO FAR
FROM
UNIVERSITY)
ADA AGWOM
YAKUBU.I.ATS
EN (NEAR
REDEEMED
CHRIS.
CHURCH
FUDAWA B)
ADA AGWOM
YAKUBU.I.ATS
EN (NEAR
REDEEMED
CHRIS.
CHURCH
FUDAWA B)
ADAGWOM
PETER NYAM
(NEAR
GOSPEL FAITH
MISSION)
REV. DANLADI
IDONG
GALADIMA
LADIP
ANGWAN
DANJUMA
ANGWAN
DANJUMA
USMAN SARKI
GALABI (NEAR
AL-AIMN
RAHAWA
HOSPITAL)
DOCTOR
YILWADA
(NEAR ISLAMIC
SCH)
H.R.H J.O.
IKWUT
CHIEF DANIEL
WEKUL (NEAR
COMM. SEC
SCH)
CHIEF DANIEL
WEKUL (NEAR
COMM. SEC
SCH)
HON. SAMUEL
OKPOKO
(NEAR IBAKA
MARKET)
BENJAMIN
EREKE (NEAR
CHIEF DANIEL
OLOKO
HOUSE)
CHIEF H
WAGBARA
(NEAR
253
256
25
13
38
157
7
7
14
155
7
7
14
156
7
7
14
158
7
7
14
161
24
23
47
164
24
23
47
162
24
23
47
163
24
23
47
159
3
3
6
160
3
3
6
327
29
23
52
325
29
23
52
326
29
23
52
328
29
23
52
323
11
9
20
324
11
9
20
BORIKIRI
(ALASE-AMA)
U
JOBINNA
HOTEL)
PROF
OKUJAGU
(NEAR
FOUNDATION
FAITH
CHURCH)
ELEKAHIA
U
NO 1 ODUM
STREET
319
9
7
16
ELEKAHIA
U
NO 1 ODUM
STREET
320
9
7
16
MGBUNDUKWU
U
30 OKWELE ST
322
9
7
16
KARANGIUA
R
17
14
31
DARBABIYA
R
TUNAU BOKA
IBRAHIM
MASHAL
902
SOKOTO
GADA
GORON
YO
007
19
16
35
SOKOTO
ILLELA
RANGANDAWA
R
MALAN NUHU
005
19
16
35
SOKOTO
ILLELA
RANGANDAWA
R
006
19
16
35
SOKOTO
SILAME
GANDE
R
008
19
16
35
SOKOTO
SILAME
GANDE
R
009
19
16
35
SOKOTO
SOKOTO
NORTH
SOKOTO
U
001
6
5
11
SOKOTO
SOKOTO
NORTH
SOKOTO
U
002
6
5
11
SOKOTO
SOKOTO
SOUTH
SOKOTO
U
003
6
5
11
SOKOTO
SOKOTO
SOUTH
SOKOTO
U
004
6
5
11
SOKOTO
SOKOTO
SOUTH
SOKOTO
U
900
5
5
10
SOKOTO
U
901
5
5
10
CHAKAI
R
010
19
16
35
MASU
R
MALAN NUHU
MOHD LUMU
DAN IYA
MALLAM
UMMARU
DANTUWO
ALH BELLO
KWARE (NEAR
RUMRUKAWA
PRI SCH)
LATE ALKALI
LADAN (NEAR
SULTAN
PALACE)
PROF BASHAR
(NEAR
NAGARTA
COLLEGE)
PROF BASHAR
(NEAR
NAGARTA
COLLEGE)
ALH ADILI MAI
FATA(NEAR
KWANNI
POLICE
STATION)
ALH SODANGI
SHUNI (NEAR
POST OFFICE)
DAN GARA
BUBA
ABUBAKAR
LIMAN
Samson Bako
(by Union Bank)
ALH. MAMUDA
ABUBAKAR
(NEAR
CENTRAL
MOSQUE)
VENDAGA
NYOMGBA
HON. ABOKI
ALI ( NEAR
NULGE
OFFICE)
903
17
14
31
144
19
18
37
145
19
18
37
143
19
18
37
137
4
4
8
RIVERS
RIVERS
RIVERS
RIVERS
SOKOTO
PORTHARCOURT
PORTHARCOURT
PORTHARCOURT
PORTHARCOURT
SOKOTO
SOKOTO
SOUTH
TAMBU
WAL
TAMBU
WAL
TARABA
BALI
BALI
R
TARABA
BALI
BALI
R
TARABA
GASSOL
DOUBELI
R
TARABA
JALINGO
JALINGO
U
SOKOTO
SOKOTO
254
321
9
7
16
TARABA
JALINGO
JALINGO
U
TARABA
JALINGO
JALINGO
U
TARABA
JALINGO
JALINGO
U
TARABA
LAU
ABBARE
R
TARABA
LAU
ABBARE
R
TARABA
USSA
ALAHA A
R
YOBE
GEIDAM
GEIDAM
U
YOBE
GEIDAM
GEIDAM
U
YOBE
GULANI
GARIN TUWO
R
YOBE
GARIN TUWO
R
YOBE
GULANI
JAKUSKO
KALULUWA
R
YOBE
POTISKUM
POTISKUM
U
YOBE
POTISKUM
POTISKUM
U
YOBE
POTISKUM
POTISKUM
U
POTISKUM
U
BERA KURA
R
RAMFASHI
R
RAMFASHI
R
ALH. YUSUFU
KOLEKOLE
(NEAR G.D.S.S
MAGAMI)
DR. ABDUL
YAKI (NEAR
S/GARI PRI
SCH)
DR. ABDUL
YAKI (NEAR
S/GARI PRI
SCH)
JAURO
ABDULMUMINI
Alh. Inuwa
aminu
YOBE
ZAMFARA
ZAMFARA
POTISKUM
YUNUSARI
BUKKUYUM
BUKKUYUM
ZAMFARA
GUNMI
GUMMI
U
ZAMFARA
GUNMI
GUMMI
U
ZAMFARA
GUSAU
GUSAU
(GALADIMA)
U
ANDEZE ANDE
ALHAJI YUSUF
ABBA (NEAR
CENTRAL PRI
SCH)
SHEEIK BELLO
(NEAR G.S.T.C
GEIDAM)
ALH
ALARAMMA M.
MUSA (NEAR
GARIN TUWO
MARKET)
ALH
ALARAMMA M.
MUSA (NEAR
GARIN TUWO
MARKET)
ALHASSAN A.
GAYYA
RTD LT.
USMAN
YAHAYA (NEAR
JAMA'A CLINIC)
ALH. AUDU MAI
BREAD (NEAR
HITECH
COMPANY)
RUWAN SAMA
(NEAR SABON
LAYI PRI SCH)
MAL.MUSA
UMARU (NEAR
OLD PRISON
YARD)
BULAMA
SHUWARI
MALAM SHEHU
LIMAN
MALAM SHEHU
LIMAN
ALH. SHEHU
GYARE (NEAR
GENERAL
HOSPITAL)
ALH. NA ALLAH
GOJE (NEAR
JUMMA'AT
MOSQUE II)
ALH. BUBA MAI
GORO (NEAR
ABBATOAR)
GUSAU
GUSAU
(MADA)
U
SARKIN ASKI
ANGO (NEAR
YOBE
ZAMFARA
255
138
4
4
8
139
4
4
8
140
4
4
8
141
19
18
37
142
19
18
37
146
19
18
37
111
4
3
7
112
4
3
7
115
25
23
48
116
25
23
48
114
25
23
48
107
7
6
13
108
7
6
13
109
7
6
13
110
7
6
13
113
25
23
48
017
19
18
37
018
19
18
37
015
4
4
8
016
4
4
8
011
3
3
6
012
3
3
6
CENTRAL
MOSQUE)
ZAMFARA
ZAMFARA
ZAMFARA
ZAMFARA
ZAMFARA
ZAMFARA
GUSAU
(MAYANA)
U
GUSAU
(MAYANA)
U
KWARE
R
KWARE
R
LATE WAKILI
AYYUKA (NEAR
ANSAR
UDDEEN
CENTRAL
MOSQUE)
LATE WAKILI
AYYUKA (NEAR
ANSAR
UDDEEN
CENTRAL
MOSQUE)
TSOHUWAR
KASUWA
SHIYAR
DANGALADIMA
TSAFE
MALLAMWA
R
TSAFE
MALLAMWA
R
GUSAU
GUSAU
SHINKAFI
SHINKAFI
013
3
3
6
014
3
3
6
019
19
18
37
020
19
18
37
HAKIMI ALIYA
021
19
18
37
HAKIMI ALIYA
022
19
18
37
256
APPENIDX 2: State Level Figures
Percent distribution of selected indicators of all respondents by states
State
State
BENUE
KOGI
KWARA
NASSARAWA
NIGER
PLATEAU
ABUJA-FCT
NORTH
CENTRAL
ADAMAWA
BAUCHI
BORNO
GOMBE
TARABA
YOBE
NORTH EAST
JIGAWA
KADUNA
KANO
KATSINA
KEBBI
SOKOTO
ZAMFARA
NORTH WEST
ABIA
ANAMBRA
EBONYI
ENUGU
IMO
SOUTH EAST
AKWA IBOM
BAYELSA
CROSS RIVER
DELTA
EDO
RIVERS
SOUTH SOUTH
EKITI
LAGOS
OGUN
ONDO
OSUN
OYO
SOUTH WEST
NIGERIA
Feel the
right s of
PLWHAs
are
Have
protected
heard of
in Nigeria
AIDS
Feel
people
talk
openly
Feel
about
that
AIDS in
AIDS
Nigeria
has a
cure
Feel state
Feel local Know
governme
governme any FP
nt supports
nt supports method
HIV/AIDS
HIV/AIDS
Know that
Have complete
Thractivities
activities
AIDS is
knowledge of
ough
transHIV prevention
use of
mitted
(UNAIDS
sharp
through
indicator)
objects
sex
Know
Use
Use
any
any FP
modern
modern
method FP
FP
method
Through
Know a
method
blood tranhealthy
sfusion
looking
person can
be HIV
positive
97.3
93.9
96.9
93.7
84.3
95.8
90.7
92.9
8.4
10.8
9.4
7.5
7.6
9.7
12.3
9.3
94.9
89.8
96.4
89.2
74.6
94.1
86.2
88.7
71.2
38.9
72.4
67.5
32.2
58.8
58.7
56.1
90.5
80.1
90.5
86.1
62.4
92.0
81.8
82.4
90.8
60.5
92.5
84.5
54.1
90.7
76.9
77.3
76.1
55.4
80.7
77.4
26.8
85.7
78.1
66.3
96.2
98.4
90.1
98.8
92.8
92.0
94.5
96.9
98.8
95.2
83.7
74.6
67.7
77.5
87.5
96.4
98.9
98.9
99.6
98.0
98.4
99.2
98.4
97.4
97.1
94.8
98.4
97.6
97.9
96.0
94.6
98.0
96.8
98.3
96.9
93.8
9.3
8.2
9.6
7.5
3.6
5.2
7.3
19.0
12.0
15.2
11.0
5.2
8.8
6.8
12.2
4.8
6.4
3.2
11.8
2.8
5.8
10.1
16.3
4.8
10.8
7.4
8.4
9.6
4.8
11.8
9.4
16.9
4.0
7.0
9.2
9.4
88.1
97.6
88.1
98.8
92.5
81.2
90.7
95.1
96.3
91.2
78.6
68.9
57.7
70.7
82.8
91.5
97.7
97.8
97.9
97.2
96.7
91.4
93.6
97.1
93.3
87.9
93.1
93.1
94.6
91.8
90.5
95.7
93.6
96.6
93.7
90.0
48.7
61.3
45.7
61.8
54.2
17.2
48.0
45.3
47.5
35.2
25.1
24.2
16.6
16.1
31.9
53.4
71.2
60.2
38.6
61.7
57.2
65.1
62.3
78.8
59.2
58.7
64.6
64.8
77.9
69.3
56.9
59.4
59.2
76.4
67.8
52.5
84.3
95.3
74.2
92.9
87.2
54.8
81.1
84.1
91.5
89.3
66.6
52.8
53.8
60.6
75.3
85.5
95.9
94.7
91.4
95.5
92.7
88.3
85.4
89.4
88.5
83.9
90.6
88.0
91.1
89.2
88.4
88.2
89.6
91.0
89.7
83.8
79.2
84.8
68.5
83.9
86.0
61.6
77.0
83.6
83.6
82.2
61.4
56.5
46.9
60.6
70.9
82.8
95.9
92.1
94.9
93.9
91.9
81.4
67.5
90.0
84.9
77.9
89.0
82.6
84.4
88.7
76.1
83.1
84.0
89.3
85.1
79.5
75.8
87.5
46.4
68.0
62.2
52.4
64.7
47.7
73.3
64.0
54.8
31.0
33.8
23.3
51.7
80.3
72.0
85.7
89.8
80.2
81.6
79.5
72.6
65.9
79.1
68.7
86.7
75.9
69.0
82.7
64.5
83.1
72.4
88.5
77.7
67.7
257
BENUE
KOGI
KWARA
NASSARAWA
NIGER
PLATEAU
ABUJA-FCT
54.2
29.5
23.2
57.2
25.3
53.5
49.2
92.5
54.7
48.0
91.5
49.0
87.7
73.8
86.7
66.2
91.7
81.7
64.1
85.7
85.1
83.4
61.8
85.8
77.0
61.1
83.6
83.6
89.9
88.2
87.4
84.9
68.4
92.4
78.4
88.0
75.0
86.6
84.1
58.9
90.8
76.2
29.3
18.2
26.0
14.3
8.9
28.6
23.8
21.5
10.1
23.2
13.1
5.9
18.5
20.4
NORTH
CENTRAL
ADAMAWA
BAUCHI
BORNO
GOMBE
TARABA
YOBE
41.5
71.0
79.3
75.8
83.6
79.0
21.0
15.7
36.6
65.9
26.8
85.3
47.6
33.9
68.3
94.4
52.6
91.6
87.1
68.3
79.7
84.0
59.9
76.3
84.9
57.2
79.7
82.4
61.6
62.2
82.5
56.8
60.2
90.6
59.6
81.3
67.3
56.4
60.2
87.1
54.0
77.6
59.0
42.8
4.7
15.6
6.3
12.9
10.4
0.4
4.2
5.9
2.6
6.6
9.2
0.4
NORTH EAST
49.2
76.7
73.2
70.6
69.0
63.2
8.3
4.8
JIGAWA
KADUNA
KANO
KATSINA
KEBBI
SOKOTO
ZAMFARA
54.3
52.9
36.7
41.1
43.2
21.4
45.1
58.1
79.9
56.8
63.7
57.8
45.5
72.5
56.3
85.8
57.8
45.0
49.6
50.2
41.0
47.4
85.8
48.8
42.7
42.7
49.2
36.5
74.0
80.6
72.1
39.3
56.9
40.2
33.7
61.7
80.4
63.5
38.6
42.3
33.2
33.3
1.3
13.5
4.0
1.9
0.0
2.1
0.8
0.8
11.8
3.2
1.5
0.0
1.8
0.0
NORTH WEST
42.4
62.1
56.4
51.4
59.7
53.6
3.8
3.1
ABIA
ANAMBRA
EBONYI
ENUGU
IMO
41.7
69.3
56.9
70.4
32.5
79.2
85.4
84.8
95.3
88.9
65.5
83.0
94.3
95.3
72.2
64.3
79.9
82.1
94.5
70.6
71.1
88.6
91.8
89.8
88.7
65.9
83.7
89.2
86.2
86.3
15.7
25.8
24.4
18.1
31.0
12.0
18.6
21.1
15.4
14.5
SOUTH EAST
54.6
86.7
82.4
78.4
86.2
82.5
23.0
16.5
AKWA IBOM
BAYELSA
CROSS RIVER
DELTA
EDO
RIVERS
51.6
40.7
66.0
40.5
42.2
53.5
77.3
82.3
91.4
77.3
68.8
73.9
86.4
82.5
77.5
75.3
85.2
78.2
82.6
62.7
76.8
72.2
84.8
72.1
90.3
92.5
96.5
93.5
84.8
88.6
86.8
87.7
93.2
90.6
84.3
86.7
27.9
37.7
31.5
30.7
27.4
10.1
20.2
29.0
26.4
23.3
25.2
8.8
SOUTH SOUTH
49.1
78.8
80.1
74.8
91.4
88.6
27.4
21.9
EKITI
60.1
91.5
93.7
93.1
94.9
94.3
32.8
30.7
LAGOS
43.4
63.1
81.8
80.0
86.9
86.4
21.6
20.7
OGUN
49.0
75.5
69.2
64.5
84.4
83.3
24.3
23.6
ONDO
78.7
95.2
93.7
87.8
89.0
86.6
15.0
13.8
OSUN
72.3
82.2
89.2
83.6
67.6
66.8
10.4
9.6
OYO
41.7
84.3
95.5
94.4
95.5
89.9
27.0
23.3
SOUTH WEST
54.7
79.7
86.9
84.0
87.3
85.5
22.6
21.0
NIGERIA
47.9
74.4
74.6
70.6
77.9
73.6
16.5
13.1
258
State Level Figures
Percent distribution of selected indicators of all respondents by states
Know that HIV can be transmitted from mother to
child
During
During
delivery
breastfeeding
State
During
pregnancy
Ever had an
HIV test
Have
never
had an
HIV test
but
desire
BENUE
KOGI
KWARA
NASSARAWA
NIGER
PLATEAU
ABUJA-FCT
73.6
54.4
70.9
59.1
43.8
69.3
70.3
72.6
52.0
68.9
54.8
39.7
71.4
69.9
NORTH
CENTRAL
ADAMAWA
BAUCHI
BORNO
GOMBE
TARABA
62.4
46.2
62.5
36.8
63.5
51.4
Will buy food
from an HIV
infected
shopkeeper
80.6
72.5
69.7
84.2
71.4
83.6
74.8
If family
member is
infected,
would want
AIDS in the
family kept
secret
58.4
43.2
41.1
39.8
40.7
38.2
38.9
77.7
56.1
70.1
66.3
38.6
83.6
72.9
17.4
13.9
9.8
19.8
5.9
21.4
36.1
60.5
65.2
55.5
68.8
32.8
52.7
56.6
59.3
66.8
37.4
68.5
51.0
17.1
76.3
43.8
26.4
8.9
15.2
5.0
13.3
4.0
86.7
61.3
75.9
81.6
86.5
62.1
59.9
65.4
49.2
52.8
46.7
73.0
50.4
59.7
54.1
22.1
11.9
19.1
36.0
26.3
39.0
36.1
YOBE
45.6
44.4
43.2
2.0
70.4
37.0
27.0
NORTH EAST
50.5
51.2
53.7
7.9
77.0
54.8
52.1
JIGAWA
KADUNA
KANO
KATSINA
KEBBI
SOKOTO
ZAMFARA
57.6
69.4
56.0
42.0
32.7
39.0
37.3
50.5
62.0
55.3
34.2
32.7
37.5
38.6
53.4
75.0
57.1
41.8
35.5
35.3
45.4
8.6
14.0
10.6
2.8
2.8
4.5
2.4
61.7
64.8
52.8
52.1
75.3
59.3
59.5
61.0
43.4
72.6
51.8
67.6
49.6
42.5
47.6
36.2
36.4
31.0
42.7
31.3
30.6
NORTH WEST
50.2
46.6
51.2
7.4
58.7
58.1
36.7
ABIA
ANAMBRA
EBONYI
ENUGU
IMO
63.5
79.2
87.5
73.6
75.0
61.4
73.9
78.5
73.2
73.0
61.4
76.1
80.6
72.8
61.7
38.2
28.4
17.2
26.0
30.2
66.7
81.1
81.6
64.5
78.9
40.4
68.6
46.0
64.0
39.9
20.4
37.2
45.3
53.0
37.9
SOUTH EAST
76.0
72.2
70.9
27.7
75.2
52.0
39.0
AKWA IBOM
BAYELSA
CROSS RIVER
DELTA
EDO
RIVERS
76.4
50.0
62.7
75.8
68.7
65.9
72.5
42.1
64.3
63.3
57.4
55.8
75.2
58.3
65.9
68.8
68.7
71.8
29.8
19.8
15.8
11.8
24.8
18.2
86.0
68.2
98.8
76.6
60.0
78.9
47.3
39.1
49.5
42.0
50.0
38.6
33.6
31.5
37.6
28.9
47.2
37.0
SOUTH
SOUTH
EKITI
LAGOS
OGUN
ONDO
OSUN
OYO
SOUTH WEST
NIGERIA
67.3
59.7
66.9
19.0
79.2
44.1
35.2
81.5
76.9
60.1
70.1
72.0
78.1
74.1
62.1
75.5
73.5
55.8
70.1
68.8
77.2
71.1
58.9
77.0
75.6
60.5
70.9
69.2
74.4
72.2
62.3
16.1
20.9
15.2
12.6
8.8
9.8
14.8
14.6
65.6
71.3
73.5
84.7
82.6
85.6
76.6
72.4
47.9
50.6
35.2
61.0
32.6
39.1
45.1
49.8
29.6
35.2
11.1
39.4
19.0
13.1
25.6
35.0
259
State
Personally
support FP
Ever
hear
d of
condom
Ever
used
condo
m
Heard
of
STIs
Wife beating is
justified if
Wife
Food
neglects
is not
the
ready
children
on
time
BENUE
KOGI
KWARA
NASSARAWA
NIGER
PLATEAU
ABUJA-FCT
NORTH
CENTRAL
ADAMAWA
BAUCHI
BORNO
GOMBE
TARABA
YOBE
NORTH EAST
JIGAWA
KADUNA
KANO
KATSINA
KEBBI
SOKOTO
ZAMFARA
NORTH WEST
ABIA
ANAMBRA
EBONYI
ENUGU
IMO
SOUTH EAST
AKWA IBOM
BAYELSA
CROSS RIVER
DELTA
EDO
RIVERS
SOUTH
SOUTH
EKITI
LAGOS
OGUN
ONDO
OSUN
OYO
SOUTH WEST
NIGERIA
62.8
52.4
71.7
61.5
21.6
67.6
51.7
53.9
85.9
75.3
83.9
77.4
50.5
83.2
81.8
75.8
38.8
28.9
39.2
25.7
9.8
26.3
42.4
29.7
83.7
66.2
80.3
76.2
56.2
85.3
72.5
73.6
32.1
26.7
32.7
22.6
40.5
47.9
12.3
31.0
46.2
42.6
15.9
43.2
37.8
8.0
31.6
13.5
44.9
27.2
15.7
4.8
15.7
8.4
21.1
42.6
77.3
70.3
69.3
50.4
62.4
71.3
75.8
62.7
63.5
71.3
53.2
65.5
64.4
80.9
52.0
73.0
53.4
32.0
59.0
49.0
74.5
53.7
34.6
27.8
28.1
28.1
45.4
75.1
91.3
88.9
86.2
87.1
85.9
87.2
86.5
92.9
88.0
80.9
90.6
88.1
23.7
5.1
7.8
9.2
15.7
1.9
10.3
1.4
19.0
6.2
1.4
0.6
3.4
0.5
5.3
34.1
33.5
45.5
38.7
39.2
38.2
39.2
42.0
40.7
38.9
43.2
38.7
40.3
58.1
77.0
64.2
67.2
57.8
32.0
59.6
59.4
67.4
65.6
39.5
37.9
42.0
23.3
51.8
77.1
86.4
96.4
87.0
83.9
86.4
82.2
86.9
84.9
83.9
70.9
77.6
81.5
72.8
73.5
52.5
53.1
61.2
71.6
66.1
47.7
91.6
94.4
81.5
85.4
84.4
88.5
88.8
71.3
48.7
48.7
39.6
34.7
35.0
42.9
43.1
26.6
87.5
77.5
67.8
57.1
75.6
81.7
75.8
69.4
16.6
14.9
21.7
7.9
27.8
28.2
5.2
17.8
Listen
to
radio
at least
once a
week
63.9
67.9
72.8
80.2
43.5
68.9
65.0
64.7
29.4
43.0
49.6
37.7
26.2
27.3
64.7
38.7
16.5
13.7
20.5
25.3
13.5
11.2
16.9
39.8
31.1
16.5
51.8
41.5
24.2
7.6
29.9
17.7
29.9
25.4
20.1
5.6
20.0
24.0
44.8
33.8
25.7
38.7
7.5
28.1
11.4
3.1
11.3
14.9
9.6
12.4
10.4
22.9
20.3
13.1
39.3
23.8
19.0
5.2
20.7
12.9
20.9
15.1
10.6
2.0
12.4
12.0
32.1
16.1
14.1
18.7
5.8
15.9
68.6
84.8
37.7
65.1
49.8
33.2
55.9
62.5
72.3
77.2
55.4
43.1
52.6
56.6
63.3
59.0
70.8
71.3
66.1
80.7
69.7
65.3
81.7
62.0
62.8
69.6
68.1
67.7
42.3
53.6
31.5
15.8
21.9
9.2
29.2
14.8
45.6
37.0
23.2
16.6
21.7
17.2
27.6
47.8
54.6
30.1
37.8
81.0
49.8
45.7
73.4
37.3
57.1
66.1
65.9
57.0
36.4
18.4
52.9
27.2
45.6
12.9
29.6
26.9
19.4
12.5
36.2
11.4
23.2
3.1
16.4
16.4
83.3
64.6
61.9
85.4
93.6
75.6
75.5
66.1
54.9
78.6
51.9
63.4
74.4
53.3
64.1
43.3
260
Watch
TV at
least
once a
week
State level figures
HIV prevalence and 95% Confidence Intervals of all
respondents by state
State
BENUE
KOGI
KWARA
NASSARAWA
NIGER
PLATEAU
ABUJA-FCT
NORTH CENTRAL
ADAMAWA
BAUCHI
BORNO
GOMBE
TARABA
YOBE
NORTH EAST
JIGAWA
KADUNA
KANO
KATSINA
KEBBI
SOKOTO
ZAMFARA
NORTH WEST
ABIA
ANAMBRA
EBONYI
ENUGU
IMO
SOUTH EAST
AKWA IBOM
BAYELSA
CROSS RIVER
DELTA
EDO
RIVERS
SOUTH SOUTH
EKITI
LAGOS
OGUN
ONDO
OSUN
OYO
SOUTH WEST
NIGERIA
HIV Prevalence
8.8
4.5
3.2
6.8
5.4
4.6
5.3
5.7
5.6
3.1
3.0
2.5
3.6
2.8
3.4
2.5
6.3
2.8
2.3
1.0
3.2
1.8
2.9
1.6
1.8
6.3
1.3
4.1
2.9
8.8
1.1
4.2
1.4
1.1
3.2
3.3
4.5
3.1
8.5
0.9
1.3
3.0
3.5
3.6
261
95% Confidence Interval
5.5 – 12.1
1.8 – 7.2
0.9 – 5.5
3.5 – 10.1
2.6 – 8.2
1.7 – 7.5
2.3 – 8.7
4.6 – 6.8
2.5 – 8.7
0.8 – 5.4
0.8 – 5.2
0.3 – 4.7
1.1 – 6.1
0.6 – 5.0
2.4 – 4.4
0.7 – 4.3
3.5 – 9.1
1.3 – 4.2
0.5 – 4.1
0.4 – 2.4
1.0 – 5.4
0.1 – 3.5
2.2 – 3.6
0.2 – 3.4
0.0 – 3.6
3.0 – 9.6
-0.1 – 2.7
1.1 – 7.1
1.9 – 3.9
5.1 – 12.5
-0.4 – 2.6
1.8 – 6.6
0.2 – 2.6
-0.4 – 2.6
1.0 - 5.4
2.4 – 4.2
1.9 - 7.1
1.5 – 4.7
4.8 – 12.2
-0.4 – 2.2
-0.2 – 2.8
1.1 – 4.9
2.6 – 4.4
3.2 – 4.0
Acute Infection of HIV from all respondents tested by states
State
HIV Recent Infection/1000
Respondents
0.0
8.9
4.6
0.0
38.8
10.2
0.0
9.3
4.0
0.0
0.0
0.0
4.5
14.0
3.7
7.2
11.2
5.6
7.2
0.0
11.8
12.9
7.8
0.0
0.0
23.4
3.9
0.0
5.3
0.0
0.0
3.2
8.9
5.5
4.0
4.3
12.1
4.3
53.8
0.0
0.0
6.6
11.3
7.3
BENUE
KOGI
KWARA
NASSARAWA
NIGER
PLATEAU
ABUJA-FCT
NORTH CENTRAL
ADAMAWA
BAUCHI
BORNO
GOMBE
TARABA
YOBE
NORTH EAST
JIGAWA
KADUNA
KANO
KATSINA
KEBBI
SOKOTO
ZAMFARA
NORTH WEST
ABIA
ANAMBRA
EBONYI
ENUGU
IMO
SOUTH EAST
AKWA IBOM
BAYELSA
CROSS RIVER
DELTA
EDO
RIVERS
SOUTH SOUTH
EKITI
LAGOS
OGUN
ONDO
OSUN
OYO
SOUTH WEST
NIGERIA
262
National Trends on Knowledge, Attitude and Behaviour-2003-2007
Indicators
Age at first Marriage (years)
Use of Psychoactive drugs (%)
Ever had sex (%)
Age at first sex (years)
Sex in exchange for gift or favour
(%)
Knowledge about/heard of HIV
and AIDS (%)
Knowledge of no cure for AIDS
(%)
Personal risks perception of
contracting HIV(%) - no risk at all
Knowledge of Routes of HIV
Infection (%)-knew all routes
Misconception about HIV
Transmission: sharing toilets
Knowledge of HIV prevention
methods (condom use and one
uninfected partner)
Knowledge of Routes of Mother to
Child transmission of HIVPregnancy (%)
Knowledge of Routes of Mother to
Child transmission of HIVDelivery (%)
Knowledge of Routes of Mother to
Child transmission of HIVbreastfeeding (%)
Knowledge about HIV
transmission – sexual intercourse
Awareness of male condom
Females
2003
17.0
Males
2007
17.0
0.5
82.9
16.0
4.5
2003
24.0
83.4
16.9
6.9
2005
17.0
0.2
80.9
17.4
4.1
76.4
19.8
8.7
2005
24.0
4.2
72.7
20.1
10.8
2007
25.0
2.7
73.0
17.0
8.2
83
90.4
92.1
92.4
96.2
95.3
77.4
87.1
74.8
83
84
75.0
75.2
67.7
60.4
68.8
66.8
59.6
56.1
60.3
53.6
62.7
63.5
55.0
25.2
23.1
20.3
21.3
22.4
17.8
42.2
44.6
44.9
59.9
59.4
63.1
65.1
71
60.6
70.7
72.1
63.5
55.8
62.3
57.5
55
62.7
60.1
55.1
62.3
62.3
57.0
65.2
62.4
77.7
87.2
87.3
89.9
94.8
92.3
55
62.4
79.9
75.9
82.3
61.5
Efficacy of male condomProtects against unplanned
pregnancy
Efficacy of male condomProtects against HIV
Efficacy of male condomProtects against STI
Ever use of male condom
Current use of male condom
Use of male condom in last
sexual act with boyfriend/girlfriend
Awareness of Female condom
Knowledge of where to get an
HIV test
42
48.9
45.0
63
67.9
67.3
39.7
44.5
42.7
60.4
63.4
64.7
40.7
45.6
42.6
62.4
65.7
65.1
13.3
8.1
33.7
18.6
10.8
42.1
16.6
8.3
34.8
32.6
23
48.7
38.0
25.3
62.1
36.4
23.8
53.8
N/A
13.4
10.9
N/A
20.6
14.0
43.1
51.7
48.9
54.1
59.1
55.7
Desire for HIV test
Ever been tested for HIV
Received HIV test result
36.2
6.0
84.7
37.3
10.8
78.8
70.1
14.4
72.1
45.0
7.6
85.5
47.0
11.5
75.3
74.3
14.7
73.3
Awareness and Knowledge of
sexually transmitted Infections
Health seeking behaviour of
respondents with STI symptomsGovt/health facility
Attitude towards male family
members living with HIV and
AIDS (male relatives)
Attitude towards female family
members living with HIV and
AIDS
60.8
69.9
59.1
82.1
85.3
78.3
22.4
18.7
24.2
28.2
24.5
27.4
48.1
61.1
64.5
61.6
68.9
76.0
48.7
61.5
64.9
60
67.6
73.8
263
Attitude towards non –family
members who are infected with
HIV: willing to work with HIV
infected colleague
Rights of people with HIV and
AIDS are protected in Nigeria (%)
35.7
50.7
58.2
43.0
50.9
66.3
32.3
39.2
45.5
34.8
47.3
49.9
Received Antenatal care (%)
61.6
59.1
63.4
Breast feeding
30.5
32.7
44.2
Maternal mortality-household that
recorded death of a woman within
1 year
General knowledge of
contraceptive methods-any
method
General knowledge of
contraceptive methods-Modern
-
8.3
7.4
68.1
77.2
73.4
78.7
87.1
81.9
63.8
71.4
67.9
76.5
84.2
78.6
Affordability of family planning
methods: Daily pills
Accessibility of family planning
methods: Daily pills
Current use of contraceptives:
sexually active unmarried (any
method)
30.1
30.3
24.3
22.6
28.0
19.5
32.9
32.9
26.5
25.9
30.4
20.9
12.0
15.6
13.4
18.5
22.8
18.4
Decision- making about family
planning: husband
15.6
20.2
17.1
24.7
28.6
22.7
Domestic violence: wife refusal to
have sex
Awareness of Female
circumcision
Awareness of cancer of the
breast
34.4
32.6
25.3
19.1
23.1
21.2
55
57.1
49.0
60.6
60.6
52.2
51.4
60.4
60.1
58.2
56.4
57.7
-
Awareness of cancer of the womb
17.8
22
19.3
25
19.9
23.1
Awareness of cancer of the male
reproductive organ
Sexual rights: wife knows her
husband have sex with other
women
Community support for modern
methods of family planning:
religious leaders
10.4
12.5
12.1
21.9
19.1
20.6
62.0
63.6
53.3
62.3
65.9
56.8
34.2
39.3
29.4
37.1
40.5
35.0
264
State level figures
Map of Nigeria showing prevalence of HIV in Nigeria (NARHS Plus, 2007)
2007 HIV Prevalence
265
APPENDIX 3: FIELD PERSONNEL
State Teams on Fieldwork (Behavioural Interview Team)
Lagos Team I
Name
Ayokunle Samuel
Taiwo Afolabi
Saka Seun
Sade Oyedotun
Osoba Kunle
Uzor Ahamba
Tunde Fashiku
Shogbesan Adeola
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Lagos Team II
Name
Dayo Okufadi
Tunde Adesoga
Tope Akinwande
Ope Adesoga
Francis Oyefia
Bukola Arigbabuwo
Leye Okedara
Adeola Rasheed
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Ogun
Name
Marcus Adekunle
Kehinde Soremekun
Kazeem Lawal
Yemi Adebayo
Tope Ogunsola
Olumide Ojelade
Ranti Ogunsola
Kehinde Akanbi
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Edo
Name
Philomena Olie
Kate Osegbuwa
Muomijlite Cythia
Freeman Okoye
Akhigbe Stanley
Adepoju Mutiu
Iyhayere Akhigbe
Otasowie Nancy
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
266
Oyo
Name
Ayeleru Tajudeen
Adyeye Kunle
Tunji Rasaki
Beatrice Adegboyega
Florence Odunlami
Lanre Akintunde
Omobayo Adewale
Remi Azeez
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Osun
Name
Akin Olatoye
Soyika Samson
Adenekan Omobola
Rasaq Hammed
Adebayo Mary
Taiwo James
Adenike Olagunju
Azeez Muritala
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Kwara
Name
Romoke Okegbemi
Shina Yusuf
Wale Adeyemi
Sarah Ogunlola
Olufemi David
Agbona Bola
Femi Olajide
Yetunde Olayemi
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Ondo
Name
Akindare Kayode
Niran Kayode
Mabounje Peter
Idoboiwa Stella
Alabi Johnson
Omojowa Abiodun
Faduji Tayo
Alake Tosin
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
267
Ekiti
Name
Prudence Kupakin
Omolola Omoyeni
Ope Adeniyi
Adelugba Yemisi
Abdul Tunde
Ojo Agnes
Akomolede Tonia
Morakinyo Mayowa
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Enugu
Name
Beatrice Chukwujekwu
Comfort Odionyenma
Nnamani Charity
Edna Onyeye
Ogadimma Okpara
Angela Ogbanna
Uzoamaka Ugwu
Onyinyemara Obiagwu
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Anambra
Name
Ekemezie Ifeyinwa
Okoye Amaka
Ogochukwu Ekwenugo
Sonia Anakor
Aloysious Muorah
Nwozor Emmanuel
Ojekwu Ifeoma
Okechuwu Okonkwo
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Ebonyi
Name
Patience Ebiem
Ekechukwu Nkechi
Nkiru Nweke
Naomi Nwite
Elom Chinyere
Frank Inyan
Awoke Sunday
Okechukwu Iro
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
268
Delta
Name
Sarafa Akibu
Evans Osakwe
Henry Aniogbe
Anthonia Ofutalu
Obaroakpo Jane
Nelson Uguru
Ifeagachukwu Amorha
Peter Egwuenu
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Rivers
Name
Sunny Uzoechi
Ijeoma Chukwumezie
Iyinyechi Chukwumezie
Edwin Jinko
Mene Ruth
Womene Didi
Umorani Godspower
Stanley Onyekwere
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Bayelsa
Name
Tonye Ayamah
Chidi Alozie
Etolumo Amungo
Bomowei Bomiegha
Dieumo Ogbara
Owen Ockya
Anthony Godday
Romeo Kaiza
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Abia
Name
Sonia Eze
Ogwumike Chidozie
Okeugo Ijeoma
Obiechefu Vivian
Eze Jessica
Emenike Onwumere
Alozie Peters
Ikenna Egbenuka
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
269
Imo
Name
Onyirika Ikechukwu
Jerry Chukwuemeka
Onyirika Chikadibia
Chidinma Violet
Onyirika Uchnna
Sylialine Eke
David Emeka
Ekwerike Ikechukwu
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Akwa-Ibom
Name
Godwin Antia
Ntekpere Frank
Edidiong Archibong
Mayen Udoh
Francis Ubak
Tony Bassey
Ita Nkom
Enamibem Effiong
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Cross River
Name
Imoh Emmanuel
Tony Etuk
Ability Emmanuel
Matthew Oney
Bassey Effiom
Patience Okon
Eno John
Effa Emmanuel
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
FCT Abuja
Name
Kunle Ipins
Anthony Julius
Collins Okiotor
Patience Francis
Anna Eromobor
Basirat Aliyu
Felix Maigari
Tabat Elkoza
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Nasarawa
Name
Millicent Shaset
Ijeoma Chukwumezie
Ustaz Yakubu
Veronica Micheal
Wulnan Shedrach
Suzan Audu
Akolo Tsaku
George Shaset
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
270
Benue
Name
James Ethan
Solomon Kambai
Jeremiah Yange
Benjamin Ode
Victor Awen
Helen Kaan
Radiya Annas
Vivian Osagie
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Kogi
Name
King Yahaya
Kayode Collins
Rufus Babatunde
Funmi Olukoye
Awolusi Bolanle
Idiko Ufedo
Elesho Fisayo
Grace Ozioh
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Niger
Name
Mohammed Danfarida
Abu Abdul
Rukayat Yusuf
Eli James
Patrick Bolari
Abraham Gana
Nnena Okoro
Abigail Yisa
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Plateau
Name
Esther Useni
Silas Samuel
Mary Yakubu
Hussaina Kiman
Franca Dallong
Ishaya Izam
Dunka Dinget
Danlami Useni
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
271
Kano
Name
Comfort Bidokwo
Mohammed Kassim
Salisu Dawud
Shamsudeen Sani
Bala Usman
Nasiru Salau
Rakiya Mohammed
Christy Peter
Mimi Barwa
Sani Abubakar
Maryam Salihu
Abdulateef Salau
Aishstu Yunusa
Mustapha Abubakar
Fauziyyat Alhassan
Surojo Iliyasu
Designation
Supervisor
Supervisor
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Jigawa
Name
Suleiman Mshelia
Sulieman Sulieman
Amina Yaya
Hanatu Suleiman
Rose Daniel
Mohammed Yahaya
Ahmed Sani
Aminu Mohammed
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Kebbi
Name
Alex Abioye
Mohammed Yusuf
Yusuf Idris
Nura Abdulahi
Ibrahim Besse
Hannah Aliyu
Shafa’atu Tamba
Asma’u Umar
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Sokoto
Name
Mary Dauda
Kabiru Hassan
Tijanni Mohammed
Huse Mode
Maryam Kende
Sani Bala
Shehu Mohammed
Faith Augustine
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
272
Katsina
Name
Andrew Joshua
Adedara Samuel
Aminu Abdullahi
Danladi Hussaini
Ladi Alexander
Rahila Boyi
Salomi Adamu
Basir Nasir
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Zamfara
Name
James Esotu
Hassan Yusuf
Umar Gusau
Sabo Sulieman
Mustapha Nahuche
Hafsat Abdullahi
Sim Danlandi
Zainab Abubakar
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Kaduna
Name
Sadiq Hadi
Grace Ogbeta
Handan Wilson
Naptitali Atuk
Mercy Susan
Gladys Wilson
Sanchez Sambo
R.S Salawu
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Adamawa
Name
Mogan Ochewo
Danbaba Tahiru
Emmanuel Gabriel
Juliet Justin
Aisha Halidi
Stephen Danboyi
Auwal Marafa
Linda Eze
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Gombe
Name
John Akaya
Mary David
John Jauro
Saint Labi
Molly Aaron
Gloria Sunday
Gladys Dickson
Hannatu Aaron
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
273
Borno
Name
Peter Gaberiel
Alex Jerome
Zainab Modu
Hajja Kanumbu
Musa Abdullahi
Benjamin Fabian
Maryam Duwa
Abdlrahaman Usman
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Yobe
Name
Deborah Samaila
Paul Peter
Baba Sidi
Kauna Samaila
Nanchi Tanko
Abdubakar Alkali
Ruth Bala
Mattthew Ola
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Bauchi
Name
Maimuna Mohammed
Patience Achi
Benny Jonathan
Aliyu Garba
Habiba Mudi
Comfort Maikarfi
Job Jonathan
Halima Dauda
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Taraba
Name
Tijani Garba
Abdullahi Usman
Elizabeth Joshua
Puma Bulus
Joshua Madaki
Piyan Hassan
Habiba Faruq
Kyani Kyani
Designation
Supervisor
Supervisor
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
Interviewer
274
List of State Field Teams Sero-Testing Team
SOUTH SOUTH
Rivers State
S/N
NAME
DESIGNATION
1.
DR. DAVID FUBARA
SAPC
2.
JULIA S. THOMPSON
RH CO-ORDINATOR
3.
MR. JAJA R.F.
4.
MRS. CHRISTAINA W. DAGOGO
STATE LAB SCIENTIST
COUNSELOR-TESTER
5.
MRS. TAMUNO-OMIE ROBERTS
COUNSELOR-TESTER
6.
MRS. ADA IYALLA
COUNSELOR-TESTER
7.
MRS. MERCY MOMOH
COUNSELOR-TESTER
Edo State
S/N
NAME
DESIGNATION
1.
C.A. AGBADUA
SAPC
2.
SARAH OJO-EDOKPAI
RH CO-ORDINATOR
3.
MRS M.K. AYANLERE
STATE LAB SCIENTIST
4.
MRS. KURANGA
COUNSELOR-TESTER
5.
UBARU R.
COUNSELOR-TESTER
6.
MRS K.TONGO
COUNSELOR-TESTER
7.
MISS. IFEOMA
COUNSELOR-TESTER
Cross River State
S/N
NAME
DESIGNATION
1.
DR O. OJAR
SAPC
2.
VERONICA O. NKU
RH CO-ORDINATOR
3.
MRS MAGDALENE NKANG
STATE LAB SCIENTIST
4.
MRS EKAETTE OBASE
COUNSELOR-TESTER
5.
MRS REGINA ODEY
COUNSELOR-TESTER
6.
MRS RITA HENSHEW
COUNSELOR-TESTER
7.
MR OROK EFFIONG OKON
COUNSELOR-TESTER
Delta State
S/N
1.
NAME
DESIGNATION
DR. C.O. OKUGUNI
SAPC
2.
DR. EJIRO OGHENEAGA
RH CO-ORDINATOR
3.
MR JOHNSON ETAGHENE
STATE LAB SCIENTIST
275
4.
MR STANLEY NWABUNWANNE
COUNSELOR-TESTER
5.
MISS EBELE ESSIEN
COUNSELOR-TESTER
6.
MRS C.T.AGOINZOR
COUNSELOR-TESTER
7.
MRS J.E. EMAGUN
COUNSELOR-TESTER
8.
MISS CHARITY OKEREH
COUNSELOR-TESTER
9.
MISS FLORENCE OKOH
COUNSELOR-TESTER
10. MR KENNETH OBAJERE
COUNSELOR-TESTER
Bayelsa State
S/N
1.
NAME
DESIGNATION
CAROLINE ORUKARI
SAPC
2.
VICTORIA E. EPEH
RH CO-ORDINATOR
3.
MR SOLOMON E.A.
STATE LAB SCIENTIST
4.
ASSAYAMO EBIKABOWEI
COUNSELOR-TESTER
5.
BIENAGHA AYEBANEGHIYEFA
COUNSELOR-TESTER
6.
DAMINEGBE INIENA
COUNSELOR-TESTER
7.
DORIS A. IBE
COUNSELOR-TESTER
Akwa Ibom State
S/N
NAME
DESIGNATION
1.
DR. JOHN A.MARKSON
SAPC
2.
MRS BASSEY E. AKPAN
RH CO-ORDINATOR
3.
OKON L. AKPAN.
STATE LAB SCIENTIST
4.
LUCY E. EKPO
COUNSELOR-TESTER
5.
MRS MARY ETETIM UDO
COUNSELOR-TESTER
6.
ELIZABETH IME JEREMIAH
COUNSELOR-TESTER
7.
MRS IDONGESIT S. UDOH
COUNSELOR-TESTER
SOUTH WEST
Lagos State
S/N
NAME
DESIGNATION
1.
DR. TOLU AROWOLO
SAPC
2.
MRS FUNMI ADEYEMI
RH CO-ORDINATOR
3.
MR. JENROLA OLANREWAJU
STATE LAB SCIENTIST
4.
MRS MOTUNRAYO MARTINS
COUNSELOR-TESTER
5.
MRS YOMI NEWTON
COUNSELOR-TESTER
6.
MR BANJO
COUNSELOR-TESTER
7.
MR IGE MONSURU
COUNSELOR-TESTER
276
8.
MISS OLUSANYA
COUNSELOR-TESTER
9.
MISS JAMES RACHAEL
COUNSELOR-TESTER
10. MR JACOB OLUWOLE
COUNSELOR-TESTER
11. MR PELUMI ADEYEMI
COUNSELOR-TESTER
Ekiti State
S/N
NAME
DESIGNATION
1.
OLUWASOLA E.O.
SAPC
2.
OLORUNSANMI O.B.
RH CO-ORDINATOR
3.
OJO ABIODUN AKINYEYE
STATE LAB SCIENTIST
4.
KAYODE JEGEDE
COUNSELOR-TESTER
5.
BOLAJI OLAGUNJU
COUNSELOR-TESTER
6.
ESAN KUNLE
COUNSELOR-TESTER
7.
ADELEYE KOLADE
COUNSELOR-TESTER
Ondo State
S/N
NAME
DESIGNATION
1.
ADEMODI J.O.
SAPC
2.
OKE-ADEAGBO F.A..
RH CO-ORDINATOR
3.
H.O. ADEGBOLA
STATE LAB SCIENTIST
4.
MRS OLADUMIYE B.B.
COUNSELOR-TESTER
5.
MRS ABIONA F.B.
COUNSELOR-TESTER
6.
MISS FAROMO Y.
COUNSELOR-TESTER
7.
MRS ADEYEMI B. A.
COUNSELOR-TESTER
Ogun State
S/N
1.
NAME
DESIGNATION
DR E. A. OGUNSOLA
SAPC
2.
DR. K. M. LAWAL
RH CO-ORDINATOR
3.
MR OGUNKOLA M. O.
STATE LAB SCIENTIST
4.
MR. A. B. BUSARI
COUNSELOR-TESTER
5.
MRS C. O. AKINTUNDE
COUNSELOR-TESTER
6.
MRS B.A. DUROSOMO
COUNSELOR-TESTER
7.
MRS. O.A.OGUNTADE
COUNSELOR-TESTER
277
Oyo State
S/N
1.
NAME
DESIGNATION
DR.O. AKINTUNDE
SAPC
2.
DR O. OYELAKIN
RH CO-ORDINATOR
3.
MR OSUNTADE A.A.
STATE LAB SCIENTIST
4.
MRS M. A. OLADEPO
COUNSELOR-TESTER
5.
DR V.K. OYEDIJI
COUNSELOR-TESTER
6.
MR.M.O. AYANYEMI
COUNSELOR-TESTER
7.
MRS. ADENEYE
COUNSELOR-TESTER
Osun State
S/N
NAME
DESIGNATION
1.
OROLAKIN A.Y.
SAPC
2.
MRS AKINLADE J.M.
RH CO-ORDINATOR
3.
MRS AKINBOLADE A.A.
STATE LAB SCIENTIST
4.
MRS I. A. ISAMOT
COUNSELOR-TESTER
5.
MR. Y. A. KOSAMOT
COUNSELOR-TESTER
6.
MRS. L I KOLAWOLE
COUNSELOR-TESTER
7.
MRS OREKOYA M.A.
COUNSELOR-TESTER
SOUTH EAST
Enugu State
S/N
NAME
DESIGNATION
1.
DR IGWEAGU CHUKWUMA
SAPC
2.
MRS CARITY NNAMANI
RH CO-ORDINATOR
3.
MR. OSUM EMMANUEL
STATE LAB SCIENTIST
4.
MRS NWOBODO J.
COUNSELOR-TESTER
5.
ANEKE HERBERT
COUNSELOR-TESTER
6.
ENE SYLVESTER
COUNSELOR-TESTER
7.
AJAH EMMANUEL
COUNSELOR-TESTER
278
Anambra State
S/N
1.
NAME
DESIGNATION
DR O.E EZEAKU
SAPC
2.
ECHEZONA PATRICIA O.
RH CO-ORDINATOR
3.
EVAN. SAM E. ORJI
STATE LAB SCIENTIST
4.
EKWEOZOR VIVIAN
COUNSELOR-TESTER
5.
AKPATI ROSE
COUNSELOR-TESTER
6.
OBIDIEWU CECILIA N
COUNSELOR-TESTER
7.
MBELU MARY N
COUNSELOR-TESTER
Imo State
S/N
NAME
DESIGNATION
1.
DR O.E ANYANWU
SAPC
2.
ONUOHA CLARA.
RH CO-ORDINATOR
3.
OPARA ONYEDIKA ALEX
STATE LAB SCIENTIST
4.
MAUREEN OKERE
COUNSELOR-TESTER
5.
TONY NKWOCHA
COUNSELOR-TESTER
6.
BARNABAS OBASI
COUNSELOR-TESTER
7.
CHINYERE OSUOHA
COUNSELOR-TESTER
Ebonyi State
S/N
1.
NAME
DESIGNATION
DR PETER ELOM
SAPC
2.
MRS JOY EZE (JP)
RH CO-ORDINATOR
3.
ONWE JULIET
STATE LAB SCIENTIST
4.
MR VINCENT AZU
COUNSELOR-TESTER
5.
MRS ELIZABETH OKOUWA
COUNSELOR-TESTER
6.
MRS SABINA MBAM
COUNSELOR-TESTER
7.
MR PIUS NKWEGU
COUNSELOR-TESTER
Abia State
S/N
NAME
DESIGNATION
1.
OGUJIOFOR INNOCENT C.
SAPC
2.
UDOKWU EUPHEMIA IFEOMA
STATE LAB SCIENTIST
3.
GODIN UMAHI
COUNSELOR-TESTER
4.
OGBENYEALU G.
COUNSELOR-TESTER
5.
AHUWA THOMPSON
COUNSELOR-TESTER
6.
EKESON ELIZABETH
COUNSELOR-TESTER
279
NORTH WEST
Kano State
S/N
NAME
DESIGNATION
1.
DR. ASHIRU RAJAB
SAPC
2.
AISHATU LAWAN
RH CO-ORDINATOR
3.
SANI ABDU FAYGE
STATE LAB SCIENTIST
4.
ABBA AMINU
COUNSELOR-TESTER
5.
YAHUZA MUHAMMED
COUNSELOR-TESTER
6.
SADISU M NABARUMA
COUNSELOR-TESTER
7.
JIBRIN HUSSAUN YAKASAI
COUNSELOR-TESTER
8.
AMINU IBRAHIM MINJIBIR
COUNSELOR-TESTER
9.
ZAINAB DANJUMA
COUNSELOR-TESTER
10. HADIZA IBRAHIM
COUNSELOR-TESTER
11. USMAN IBRAHIM SHARIFAI
COUNSELOR-TESTER
Katsina State
S/N
NAME
DESIGNATION
1.
DR ISMAILA BUHARI
SAPC
2.
HINDATU MUSTAPHA
RH CO-ORDINATOR
3.
IBRAHIM M. KAITA
STATE LAB SCIENTIST
4.
FATIMA YUSUF GALADANCHI
COUNSELOR-TESTER
5.
RUQAYYA YAKUBU
COUNSELOR-TESTER
6.
MANNIR BALIYU KANKIA
COUNSELOR-TESTER
7.
IBRAHIM TSANNI
COUNSELOR-TESTER
8.
UMMA KANKIA
COUNSELOR-TESTER
Kaduna State
S/N
NAME
DESIGNATION
SALIHU A. HUNKUYI
SAPC
2.
MELE SOLOMON
STATE LAB SCIENTIST
3.
FELICIA FRANCIS
COUNSELOR-TESTER
4.
BILIKISU UMAR
COUNSELOR-TESTER
5.
AMOS ISUWA
COUNSELOR-TESTER
6.
USMAN MUSA
COUNSELOR-TESTER
1.
280
Jigawa State
S/N
1.
NAME
DESIGNATION
MAGAJI ABDULHAMID
SAPC
2.
ZAINAB SAMBO
RH CO-ORDINATOR
3.
LAWAL S.YAKUBU
STATE LAB SCIENTIST
4.
SAIFULLAHI AMINU
COUNSELOR-TESTER
5.
ALI USMAN
COUNSELOR-TESTER
6.
TASIU MOHD
COUNSELOR-TESTER
7.
ABDULLAHI ISMAIL
COUNSELOR-TESTER
Sokoto State
S/N
NAME
DESIGNATION
1.
HALIRU YUSUFU
SAPC
2.
AMMA LADA
RH CO-ORDINATOR
3.
UMAR BELLO
STATE LAB SCIENTIST
4.
AMINU UMAR AHMED
COUNSELOR-TESTER
5.
SANI S.Y.
COUNSELOR-TESTER
6.
HAJIA MUTIAT DIKKO
COUNSELOR-TESTER
7.
SARATUBELLO
COUNSELOR-TESTER
Zamfara State
S/N
NAME
DESIGNATION
1.
MUSTAPHA MARAFA
SAPC
2.
BILIKISU MAFARA
RH CO-ORDINATOR
3.
ISAH BALA AUNA
STATE LAB SCIENTIST
4.
DR YINKA POPOOLA
COUNSELOR-TESTER
5.
HAUWA ALIYU
COUNSELOR-TESTER
6.
NASIRU ISA
COUNSELOR-TESTER
7.
BARA’ATU SHEHU
COUNSELOR-TESTER
Kebbi State
S/N
NAME
DESIGNATION
1.
DR. AMINU BUNZA
SAPC
2.
HAFSAH RASHEED
RH CO-ORDINATOR
3.
AHMED U. B.
STATE LAB SCIENTIST
4.
HAJANA HARUNA
COUNSELOR-TESTER
281
NORTH EAST
Adamawa State
S/N
NAME
DESIGNATION
1.
ABDULRAHMAN ALIYU
SAPC
2.
JAMIMA JUTA
RH CO-ORDINATOR
3.
JOHN T. JOSEPH
STATE LAB SCIENTIST
4.
RAHAB S. STEPHEN
COUNSELOR-TESTER
5.
SALOMI N EWEH
COUNSELOR-TESTER
6.
DAMARIS A. JODA
COUNSELOR-TESTER
7.
MRS MARTHE V. MECHELIA
COUNSELOR-TESTER
8.
MRS KWANYE TAYINE
COUNSELOR-TESTER
Borno State
S/N
NAME
DESIGNATION
1.
DR I. KUDA
SAPC
2.
KALTUM AHMED
RH CO-ORDINATOR
3.
O.K. WHYTE
STATE LAB SCIENTIST
4.
MOH’D IDRIS LAWAN
COUNSELOR-TESTER
5.
NDREW JAMES
COUNSELOR-TESTER
6.
AISHATU GARBA
COUNSELOR-TESTER
7.
MODU SALE
COUNSELOR-TESTER
Bauchi State
S/N
1.
NAME
DESIGNATION
SAIDU ABUBAKAR
SAPC
2.
MARIYA H. ZAKARI
STATE LAB SCIENTIST
3.
MARYAM SANI
COUNSELOR-TESTER
4.
ABDULAZIZ A. SALEH
COUNSELOR-TESTER
5.
SABARATU ADAMU
COUNSELOR-TESTER
6.
AMAR MUHAMMED
COUNSELOR-TESTER
282
Yobe State
S/N
1.
NAME
DESIGNATION
FATIMA M. B. HASSAN
SAPC
2.
FATSUMA ALKARI
RH CO-ORDINATOR
3.
ALIKIME A.D
STATE LAB SCIENTIST
4.
ALIKO ALH IDRISA
COUNSELOR-TESTER
5.
BALA A. ADAMU
COUNSELOR-TESTER
6.
PAULINE U. IWUH
COUNSELOR-TESTER
7.
GLORIA N. OSHIKE
COUNSELOR-TESTER
Gombe State
S/N
NAME
DESIGNATION
1.
HASSAN I BRAHIM
SAPC
2.
NDE MARGARET
RH CO-ORDINATOR
3.
LILIAN S. MAINA
STATE LAB SCIENTIST
4.
ISUWA JOHNNY
COUNSELOR-TESTER
5.
ADAMU YILA
COUNSELOR-TESTER
6.
FLORENCE DAVID
COUNSELOR-TESTER
7.
RUTH ZAIDAN
COUNSELOR-TESTER
Taraba State
S/N
NAME
DESIGNATION
1.
DR MADAKI M.
SAPC
2.
MARY J. HASSAN
RH CO-ORDINATOR
3.
AMAMRA TAWUN
STATE LAB SCIENTIST
4.
PETER GAMBO
COUNSELOR-TESTER
NORTH CENTRAL
Kwara State
S/N
NAME
DESIGNATION
1.
MRS S.O. LAWAL
SAPC
2.
HAJIA I. A. SALAMI
RH CO-ORDINATOR
3.
J. F. OLANREWAJU
STATE LAB SCIENTIST
4.
A. S. AHMED
COUNSELOR-TESTER
5.
M.T MOHAMMED
COUNSELOR-TESTER
6.
R.O.ADIO
COUNSELOR-TESTER
7.
A.K.AKINTOLA
COUNSELOR-TESTER
283
FCT, Abuja
S/N
1.
NAME
DESIGNATION
DR YAKUBU MOHAMMED
SAPC
2.
MARIA MOMOH
RH CO-ORDINATOR
3.
EKPEYONG UYOK.
STATE LAB SCIENTIST
4.
MRS AISHA GADU
COUNSELOR-TESTER
5.
MRS`ELIZABETH ACHUMIE
COUNSELOR-TESTER
6.
MR PRAISE
COUNSELOR-TESTER
7.
MALLAM BASHIR SULEIMAN
COUNSELOR-TESTER
Benue State
S/N
NAME
DESIGNATION
1.
GRACE MENDE
SAPC
2.
DR CHESHE TERVERI
RH CO-ORDINATOR
3.
UDOUDOH L. F.
STATE LAB SCIENTIST
4.
MRS KYENGE HANNY
COUNSELOR-TESTER
5.
MRS`AGNES KWAGHDZER
COUNSELOR-TESTER
6.
MR CHIMBIV P.TSAV
COUNSELOR-TESTER
7.
MR OWUNA REUBEN
COUNSELOR-TESTER
Kogi State
S/N
NAME
DESIGNATION
COMFORT ABU
SAPC
2.
AISHA MOHAMMEDI
RH CO-ORDINATOR
3.
CHRISTIAN AMODU.
STATE LAB SCIENTIST
4.
RACHEAL OLUBIYO
COUNSELOR-TESTER
1.
5.
MR SIMON AMEH
COUNSELOR-TESTER
6.
MR SAMUEL ISUZU
COUNSELOR-TESTER
7.
MR IBRAHIM AMUSA
COUNSELOR-TESTER
Nasarawa State
S/N
NAME
DESIGNATION
1.
ROSELINE EIGEGE
SAPC
2.
MARIAM BUBA
RH CO-ORDINATOR
3.
KYARI S. H.
STATE LAB SCIENTIST
4.
SAMBO U. MUHAMMED
COUNSELOR-TESTER
5.
ZAINAB AG BILAL
COUNSELOR-TESTER
6.
ESTHER ANZEGHA
COUNSELOR-TESTER
7.
KURE SUNDAY
COUNSELOR-TESTER
284
Niger State
S/N
1.
NAME
DESIGNATION
SHEHU MAIRIGA
SAPC
2.
DR A.M SHAGANUWAN
RH CO-ORDINATOR
3.
ADAMU BABA
STATE LAB SCIENTIST
4.
NDAGI A.ODZUKOGI
COUNSELOR-TESTER
5.
UMAR A. UMAR
COUNSELOR-TESTER
6.
HELEN CEBAWASA
COUNSELOR-TESTER
7.
VICKY JIYA
COUNSELOR-TESTER
Plateau State
S/N
NAME
DESIGNATION
1.
MR MOSES DAKAS
2.
MRS TABITHA DASHE
RH CO-ORDINATOR
3.
PATIENCE AMANGAM
STATE LAB SCIENTIST
4.
MRS JULIANA ZWALNAN
COUNSELOR-TESTER
5.
MRJOSHUA GOMWALK
COUNSELOR-TESTER
6.
MRS MAGDALENE DAKYEN
COUNSELOR-TESTER
7.
SAPC
MR PETER ADAMS
COUNSELOR-TESTER
285
SURVEY MANAGEMENT COMMITTEE MEMBERS
NAME
ORANIZATION
1.
Prof. Babatunde Osotimehin
2.
Prof. Abdulsalam Nasidi
3.
Dr Jonathan Yisa Jiya
4.
Dr. Shehu Sule
5.
Dr. Ngozi Njepuome
6.
Dr. E.B.A. Coker
7.
8.
9.
10.
11.
12.
Alhaji Mohammed Alfa
Dr. Moji Odeku
Christina Chappell
Dr. Peter Eriki
Mr. Bright Ekweremadu
Prof. E.A. Bamgboye
Honourable Minister of Health/Former
Director General of NACA, Abuja
Director, Public Health Department,
FMOH, Abuja
Head, Family Health Department,
FMOH, Abuja
Former Head, Family Health
Department , FMOH, Abuja
Head, HIV/ AIDS/TB Division, FMOH,
Abuja
National Coordinator, HIV / AIDS
Division, FMOH
Director, Cartography NPC
DD, Reproductive Health, FMOH
USAID
Country Representative, WHO
Managing Director, SFH
Deputy Vice Chancellor, University of
Ibadan
UCH Ibadan
Chairman, Nat RH Working Group/ARFH
Former Director‐ General, NIMR, Yaba,
Lagos
Chief of Party, FHI/GHAIN
Chief of party, CDC
Country Representative, UNAIDS, Abuja
South East (AIDS Zonal Manager,
FMOH, Enugu)
North East (AIDS Zonal Manager,
FMOH, Gombe)
MEASURE Evaluation
Chief of Party, ENHANSE
CIDA
UNICEF
UNFPA
UNDP
IHVN
World bank
Country Director, SNR
13. Prof. D.O. Olaleye
14. Prof O.A. Ladipo
15. Dr. Oni Idigbe
16.
17.
18.
19.
Dr. Christoph Hammelman
Nancy Knight
Dr. Warren Naamara
Dr. Tony Eloike
20. Mr. Hassan Ibrahim
21.
22.
23.
24.
25.
26.
27.
28.
29.
Dr Kola Oyediran
Dr Jerome Mafeni
Dr E. Emedo
Dr Suomi Sakai
Coulibally Sidiki
Alberic Kacou
Dr. Patrick Dakum
Jo Nicholls
Christy Laniyan
286
NARHS TECHNICAL COMMITTEE MEMBERS
NAME
ORANIZATION
1.
Dr. E.B.A. Coker
2.
Dr. Annette Akinsete
3.
Dr. Henry Akpan
4.
5.
Dr Nkiru Onukweusi
Dr. Moji Odeku
6.
Prof. E. Bamgboye
7.
8.
Prof D.O. Olaleye
Dr. Aderemi Azeez
9.
Dr. Issa B. Kawu
National Coordinator, HIV /AIDS Programme,
FMOH, Abuja
Former National Coordinator, HIV /AIDS
Programme, FMOH, Abuja
Former National Coordinator, HIV /AIDS
Programme, FMOH, Abuja
Head, Child Health Division, FMOH, Abuja
Deputy Director, Reproductive Health Division,
FMOH, Abuja.
Deputy Vice Chancellor/Dept of Epidemiology
and Statistics, UCH, University of Ibadan
Dept. of Virology, UCH Ibadan
Head, Strategic Information, HIV/AIDS Division,
FMOH, Abuja
Head, Surveillance, HIV/AIDS Division FMOH,
Abuja
NARHS Focal Officer, Strategic Information
(Surveillance) HIV/AIDS Division, FMOH, Abuja
Family Health Department, FMOH, Abuja
Reproductive Health Division, FMOH
Former Deputy Managing Director, Society for
Family Health
Deputy Managing Director, Society for Family
Health
USAID Abuja
HIV/ADIS Division Society for Family Health
Research & Evaluation, Society for Family
Health
Research & Evaluation, Society for Family
Health
Society for Family Health
Head, Public Health Laboratory, FMOH.
Asst Director, HCT, HIV /AIDS Division, FMOH.
Consultant, Dept of Community Medicine,
University of Lagos
National Population Commission, Abuja
National Population Commission, Abuja
Consultant Physician, Dept of Medicine UNIJOS
10. Dr. Ade T. Bashorun
11. Mr.Olugbenga Ajagun
12. Dr. Manuel Oyinbo
13. Pastor Zacch Akinyemi
14. Dr. A. Ankomah
15. Dr. Kalada Green
16. Dr. O. Ladipo
17. Dr. Jennifer Anyanti
18. Dr. Samson B. Adebayo
19.
20.
21.
22.
Mr. Ali Buba Vaganda
Dr. Abel Adedeji
Mrs. N.C.R Nwaneri
Dr. Kofo Odeyemi
23. Mr. M.K. Usman
24. Mr. Taiwo Adekanmbi
25. Dr. E. Isamade (Late)
287
26. Dr. B.O. Adedokun
27. Mr. J.O. Omidiji
28. Dr. K. Sabitu
29. Dr. K.S.O. Oyedeji
30.
31.
32.
33.
34.
35.
36.
37.
38.
Dr. Kayode Ogungbemi
Dr. Greg Ashefor
Dr. Tony Eloike
Dr. Niyi Ogundiran
Tessy Ochu
Dr Olusola Odujinrin
Dr. Wole Fajemisin
Mr Adeyinka Ashogbon
Mr Gabriel Ikwulono
39. Alex Onwuchekwa
40. Mrs Mercy C. Morka
41. Mr. G. Akinbiyi
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
Dr A. Dawodu
Dr. Femi Amoran
Dr. G. Odaibo
Dr. Henri Damisoni
Laura Arnston
Karla Fossand
Susan Mshana
Dr. Pat Matemilola
Dr. Mike Merrigan
Dr. K. Nyamuryekunge
Dr. M. Oduwole
Dr Abimbola Williams
Mr Osareti Adonri
Nancy Nelson – Twakor
Ado Abubakar
Dept of Epidemiology and Medical Statistics,
UCH, University of Ibadan
Dept of Epidemiology and Statistics, UCH,
University of Ibadan
ABU Teaching Hospital, Zaria
Nigerian Institute of Medical Research (NIMR),
Yaba
NACA Abuja
NACA Abuja
South East AIDS Zonal Coordinator, Enugu
W.H.O. Abuja
ENHANSE project
RH Adviser, WHO
MEASURE Evaluation
National Bureau of Statistics
Strategic information, HIV /AIDS Division,
FMOH, Abuja
Strategic information, HIV /AIDS Division,
FMOH, Abuja
Strategic information, HIV /AIDS Division,
FMOH, Abuja
Strategic information, HIV /AIDS Division,
FMOH, Abuja
Family Health Department, FMOH, Abuja
Consultant, ENHANSE/NASCP
Dept. of Virology, UCH Ibadan
UNAIDS
USAID, Abuja
USAID, Abuja
DFID
NEPWHAN
FHI/GHAIN
W.H.O. Abuja
UNAIDS, Abuja
RH/PATHS/DFID, FMOH
UNFPA
SNR (Strengthening Nig. response) Abuja
Trinitron Biotech, Abuja
288
NARHS REPORT WRITING TEAM
NAME
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
Dr. N. Njepuome
Dr. E.B.A. Coker
Prof E. A. Bamgboye
Dr. Kofo Odeyemi
Dr. A. Azeez
Dr. Issa B. Kawu
Dr. Ade T. Bashorun
Mr. Olugbenga Ajagun
Dr. Jennifer Anyanti
Dr. O. Ladipo
Dr. Samson B. Adebayo
Dr. Tony Eloike
Dr. KSO Oyedeji
Dr. Oyinbo Manuel
Mr. Taiwo Adekanmbi
Mr. M.K. Usman
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
Mr. J.O. Omidiji
Ali Buba Vaganda
Gabriel Ikwulono
Dr. B.O. Adedokun
Dr. L. Uzono
Mr. Alex Onwuchekwa
Mrs Mercy C. Morka
Tessy Ochu
Dr. Femi Amoran
Dr. Uchenna Onyebuchi
ORGANISATION
FMOH
FMOH
Data analysis Consultant
Report writing Consultant
FMOH
FMOH
FMOH
FMOH
SFH
SFH
SFH
TC
TC
FMOH
Data entry Consultant
Sampling, Mapping and Listing
Consultant
TC
SFH
FMOH
TC
FMOH
FMOH
FMOH
ENHANSE
(Consultant) FMOH/ENHANSE
NACA
289
OTHER CONTRIBUTORS/ CENTRAL SUPERVISORS
NAME
ORGANISATION
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
FMOH
ABU Zaria
NASCP, FMOH
NASCP, FMOH
FMOH
FMOH
NASCP
NACA
SFH
SFH
SFH
SFH
SFH
SFH
SFH
SFH
University of Ibadan
NAUTH, Nnewi
Dept of Virology, UCH., Ibadan
Dept of Virology, UCH., Ibadan
USAID
SFH
UNFPA
SFH
Technical Advisor/PATH
NACA
World Bank
FHI/GHAIN
NASCP, FMOH
NIMR, Yaba
NIMR, Yaba
NIMR, Yaba
University of Abuja
SFH
Dr. M. Arene
Johnbull Ogboi
Dr. N. Chukwukaodinaka
Dr. Aishat Yusuf
Mrs G. Bassey
Mrs Adenike Etta
Rose Iwueze
Louis Edema
Chinazor Ujuju
Joshua Awoleye
Mr Ibrahim
Jemila Jantabo
Dayo Arogundade
Richard Fakolade
Mr Ibrahim
Godpower Omoregie
Dr Kayode Osungbade
Dr. Goz Ifeadike
Dr A.S. Bakarey
Omoruyi Chuks
Akin Atobatele
Abdulsamad Salihu
Mrs. Aderonke Are‐Shodeinde
Chukwumeka Chima
Dr K. Babs Sagoe
Adeogun Adewale
Toyin Jagha
Samson Bamidele
Mrs Ima John‐Dada
Dr N. Idika
Dr Rosemary Audu
Mr S. T. Abolarinwa
Abubakar Jamda
Oladipupo B. Ipadeola
290
SUPPORT STAFF
NAME
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Mrs Caroline Osahon
Salihu Mohammed
Nike Okunade
Bunmi Ogungbesan
Mrs Adesanwo
Mr John Ata Ekong
Mrs B. Odekunle
Kassim Amodu
Mr Amos Bada
Felicia Ekpeyong
Yemisi Ogundare
Desmond Iriaye
Blessing Nzene
Mr Audu Salif
ORGANISATION
NASCP, FMOH
NASCP, FMOH
NASCP, FMOH
RH, FMOH
RH, FMOH
RH, FMOH
NASCP, FMOH
NASCP, FMOH
RH, FMOH
NASCP, FMOH
SFH
SFH
SFH
NASCP, FMOH
291