Publications by authors named "Michael Kunnuji"

Background: Global re-emergence of the zoonotic viral disease, Mpox (Monkeypox) has drawn global attention, leading to its declaration as a Public Health Emergency of International Concern (PHEIC) by World Health Organisation (WHO) in July 2022. Nigeria is a spotlight identified for the viral disease outbreak, with attention drawn on its transmission to non-endemic nations. With the country's healthcare challenges, care seeking practices particularly amongst low-income urban informal settlement populations are diverse - presenting challenges to both case identification and management during an outbreak.

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Millions of people have been displaced within or outside their countries. Disruptions associated with displacement often lead to transactional sex with dire social, sexual and reproductive health implications. A common driver of transactional sex is food insecurity among refugees and internally displaced persons (IDPs), yet IDP/refugee settings offer an opportunity for females to challenge and renegotiate gender norms and exercise greater control over their lives and sexuality.

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Mpox (formerly known as monkeypox) was declared a Public Health Emergency of International Concern (PHEIC) by the World Health Organization on 23rd July 2022, however cases of the disease have been detected in Nigeria since the 1970s and more recently since it began spreading in more urban areas of the country from 2017 onward. Nigeria has a strong track record of epidemic preparedness and response, spearheaded by the Nigeria Centre for Disease Control. Despite being somewhat separate architectures on paper, epidemic response (in particular, integrated disease surveillance and response) relies on a foundation of primary health care, which is inadequately funded not only in Nigeria, but globally.

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In Northeastern Nigeria 600,000 internally displaced girls and women need sexual and reproductive health and rights (SRHR) services. We examined the relationships between contraceptive use, menstrual resumption, and pregnancy and birth experiences among girls (ages 15-19) and young women (ages 20-24) in an IDP camp. Data are from a cross-sectional survey collected using three-stage cluster sampling; the analytic sample is 480.

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Recent calls for global health decolonization suggest that addressing the problems of global health may require more than 'elevating country voice'. We employed a frame analysis of the diagnostic, prognostic, and motivational framings of both discourses and analyzed the implications of convergence or divergence of these frames for global health practice and scholarship. We used two major sources of data-a review of literature and in-depth interviews with actors in global health practice and shapers of discourse around elevating country voice and decolonizing global health.

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Background: 'Resilience', 'self-reliance' and 'increasing country voice' are widely used terms in global health. However, the terms are understood in diverse ways by various global health actors. We analyse how these terms are understood and why differences in understanding exist.

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In humanitarian settings, ~35 million girls and young women of reproductive age (15-24) are in urgent need of sexual and reproductive health (SRH) information and services. Young women and girls in humanitarian contexts are particularly vulnerable to unwanted pregnancies, unsafe abortion, gender-based violence, and early and forced marriage. We sought to understand girls' and young women's experiences with unwanted pregnancy, abortion, contraception, sexually transmitted infections (STIs), gender-based violence (GBV), and forced marriage in an IDP camp in Northeastern Nigeria.

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Background: Nigeria has one of the highest under-five mortality rates in the world. Identifying the causes of these deaths is crucial to inform changes in policy documents, design and implementation of appropriate interventions to reduce these deaths. This study aimed to provide national and zonal-level estimates of the causes of under-five death in Nigeria in the 2013-2018 periods.

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Background: Nigeria's under-five health outcomes have improved over the years, but the mortality rates remain unacceptably high. The qualitative component of Nigeria's 2019 verbal and social autopsy (VASA) showed that caregivers' health beliefs about causes of illnesses and efficacious treatment options contribute to non-use/delay in use of facility-based healthcare for under-five children. This study explored how these health beliefs vary across zones and how they shape how caregivers seek healthcare for their under-five children.

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Background: Nigeria's child health profile is quite concerning with an infant mortality rate of 67 deaths per 1000 live births and a significant slowing down in progress towards improving child health outcomes. Nigeria's 2018 Demographic and Health Survey (DHS) suggests several bio-demographic risk factors for child death, including mother's poor education, poverty, sex of child, age of mother, and location (rural vs urban) but studies are yet to explore the predictive power of these variables on infant survival in Nigeria.

Methods: The study extracted data for all births in the last 12 months preceding the 2018 Nigeria DHS and used the Cox proportional hazard model to predict infant survival in Nigeria.

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Background: The persistently high and stalled total fertility in Sub-Saharan Africa, including in Nigeria, calls for new efforts towards fertility reduction. Most efforts on fertility desire in sub-Saharan Africa have focused either on individual men or women with little focus on couples as a unit of analysis. Moreover, the influences of different types of marriages in which couples reproduce have not been adequately explored.

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Background: There is mixed evidence and lack of consensus on the impact of economic development on stunting, and likewise there is a dearth of empirical studies on this relationship in the case of sub-Saharan Africa. Thus, this paper examines whether economic growth is associated with childhood stunting in low-income and middle-income sub-Saharan African countries.

Methods: We analysed data from 89 Demographic and Health Surveys conducted between 1987 and 2016 available as of October 2018 using multivariable multilevel logistic regression models to show the association between gross domestic product (GDP) per capita and stunting.

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Background: Early childbearing comes at high health costs to girls, the children they bear, their future life chances and the larger society. Nationally representative data suggest variation in onset of childbearing across regions and states of the country. Yet, there is need for strong evidence on how background characteristics explain time to first birth among young females across regions in Nigeria.

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Background: Proponents have promoted sexuality education as a means of empowering adolescents, yet it has been thwarted in many low and middle-income countries. Nigeria represents an exception. Despite social opposition, the government in 1999 unexpectedly approved sexuality education policy.

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Mississippi and Nigeria are two socially conservative places unlikely to prioritise sexuality education. Nonetheless, Mississippi passed a bill in 2011 mandating all school districts to offer sexuality education, and Nigeria approved a national sexuality education curriculum in 2001. To identify the factors that drove the process of prioritisation of sexuality education in each context, we conducted more than 70 semi-structured interviews with nongovernmental organisations/nonprofits, donor organisations and federal and state ministries involved in the prioritisation and implementation of sexuality education in Mississippi and Nigeria.

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In 2003, Nigeria adopted the Family Life and HIV Education (FLHE) sexuality education curriculum. Our analysis interrogates variation in sub-national implementation. We conducted 52 interviews with persons knowledgeable about the curriculum in three states-Kano, Lagos, and Niger-and reviewed publications on FLHE.

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This study set out to document the prevalence and predictors of sexual intercourse with persons below the age of consent (statutory rape) and outright sex without consent (rape) among out-of-school adolescents in an urban slum in Lagos, Nigeria. Data gathered from a survey of 480 participants were employed. About 14% and 35% of the participants had been victims of rape and statutory rape respectively.

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Gender-based domestic violence (DV) comes at great costs to the victims and society at large. Yet, many women hold the view that intimate partner violence (IPV) against women is appropriate behavior. This study aimed at exploring the nexus of experience of different forms of DV and acceptance of IPV as appropriate behavior.

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Research has shown that in countries such as Nigeria many urban dwellers live in a state of squalour and lack the basic necessities of food, clothing and shelter. The present study set out to examine the association between forms of basic deprivation--such as food deprivation, high occupancy ratio as a form of shelter deprivation, and inadequate clothing--and two sexual outcomes--timing of onset of penetrative sex and involvement in multiple sexual partnerships. The study used survey data from a sample of 480 girls resident in Iwaya community.

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Reproductive health is an essential aspect of the wellbeing of adolescents. Therefore reproductive health knowledge and sexual behaviour deservedly attract the attention of researchers, programme planners and policy implementers working with young people. Yet in Nigeria, little is known about the effect of migration status on reproductive health knowledge and sexual activities of young people in general and out-of-school adolescent girls in particular.

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As internet penetration surges in different parts of the world, access to a wide range of subject matters also increases. Matters of sexuality are no exceptions. While there is ample empirical evidence that youths seek knowledge about sexuality, and get involved in sexually stimulating and/or gratifying activities on the internet, the relationship between involvement in these online sexual activities (OSAs) and real life sexual behaviour remains a matter of polemic.

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