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National HIV&AIDS and Reproductive Health Survey (NARHS Plus II, 2012)

National HIV&AIDS and Reproductive Health Survey (NARHS Plus II, 2012). FEDERAL MINISTRY OF HEALTH , ABUJA, NIGERIA December 2013. Overview of Survey Protocol. Brief Introduction Survey Objectives Methodology Sample size Conduct of the survey Analysis of data and report writing.

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National HIV&AIDS and Reproductive Health Survey (NARHS Plus II, 2012)

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  1. National HIV&AIDS and Reproductive Health Survey(NARHS Plus II, 2012) FEDERAL MINISTRY OF HEALTH, ABUJA, NIGERIA December 2013

  2. Overview of Survey Protocol • Brief Introduction • Survey Objectives • Methodology • Sample size • Conduct of the survey • Analysis of data and report writing

  3. Introduction (1) • NARHS – is a population-based survey conducted in the 36 states of Nigeria and the FCT since 2003. • In 2007, it was called NARHS Plus because of the inclusion of a serological (HIV testing) component to estimate the prevalence of HIV in the general population. • It was a biennial survey but now redesigned to hold every 5 years starting with that of 2012.

  4. Introduction (2) • NARHS Plus 2012 was the second wave in its series that included serological component. • NARHS Plus 2012 also included new questions to track variables on Food and Drugs, and more questions on maternal and child health.

  5. Objectives of 2012 NARHS Plus (1) • To obtain HIV Prevalence estimates and information on various factors related to HIV infection at the National, Zonal; and to some extent at State levels. • To collect quantitative data on key sexual and reproductive health indicators among females 15 – 49 years and males 15 - 64 years in Nigeria.

  6. Objectives of 2012 NARHS Plus (2) • To track the change in HIV prevalence and associated behavioural factors in the general population between the last NARHS Plus 2007 and 2012. • To produce data that will be used to review and re-programme HIV/AIDS and reproductive health interventions in the country and to inform policy decisions.

  7. Methodology (1) • Study Population: Nigerian population in all the 36 States & FCT • Sampling: Probability random sampling using a multistage cluster sampling technique • A nationally representative sample of Females aged 15 – 49 years and Males aged 15 – 64 years

  8. Sample Size • Minimum Sample size: 35,520 • Valid responses Behavioural: 31,235 (87.94%) • Valid responses Serologic : 24,115 (77.2%)

  9. Conduct of the Survey (1) • Completely managed by a Central Management Committee appointed by the FMOH responsiblefor serological and behavioural national survey • Methodology was facilitated by the National Population Commission and other members of the Technical committee

  10. Conduct of the Survey (2) • Methodology was reviewed by local and international experts and IRB approval secured • Confidentiality maintained and informed consent of all participants received • Adequate advocacy contributed to the success of the survey

  11. Conduct of the Survey – State Level • Survey at State level carried out by • SAPCs, RHCs and SLS, • NPC cartographers (EAs demarcation and listing, and selection) • Well trained supervisors, Interviewers and Counsellor testers • Laboratory confirmation of HIV positives confirmed at Department of Virology, University of Ibadan

  12. Results and FindingsBehavioral

  13. Survey Population - Rural & Urban

  14. Survey Population: Male : Female Ratio

  15. Age Distribution Of Study Sample

  16. Awareness of HIV&AIDS

  17. Knowledge of How to Prevent Against HIV/AIDS (2 methods)

  18. Median Age of Sexual Debut (15 – 24 Yrs)

  19. Condom Use With Non-marital Partners

  20. HIV Counselling and Testing

  21. Reasons for Refusing an HIV Test

  22. Ever Tested for HIV

  23. Stigma & Discrimination Against PLWHA

  24. Extracts of The National HIV/AIDS & Reproductive Health Survey, 2012

  25. Safe Motherhood • One of the strategies to improve safe motherhood is to increase the access and use of quality reproductive health services • The NARHS showed the status of access and use of such services in 2012

  26. Use of Antenatal care Services In Nigeria • Among women who had given birth in the last five years, 65.3% received ANC during their last pregnancy. The proportion that received ANC was higher among urban (82.0%) compared to rural dwellers (56.8%). • SE had the highest proportion (85.5%), while the lowest proportion (48.6%) was recorded in the NW. • Less than half (40.3%) of pregnant adolescents (15-19 years) received ANC

  27. Post Natal Care • Proportion of pregnant women that received PNC) for their last pregnancy out of women that gave birth within the last 5 years preceding the survey was about 41% nationally. • The proportion of women that received PNC was higher in urban (61%) than rural locations (31%),

  28. Breastfeeding • Only 41% of the mothers commenced breastfeeding immediately after delivery, • 43% commenced breastfeeding within a day of the delivery and 15% commenced breastfeeding days after the delivery. • A few (7%) of the women indicated that they did not breastfeed their babies at all.

  29. Knowledge & Beliefs on Family Planning

  30. Trends in Contraceptive Usage

  31. Cancers of the reproductive system • Awareness of cancer of the breast (54%) was higher than awareness of cancer of the womb (21%) and cancer of male reproductive organs (19%). • Half of the respondents (55%) knew of self breast examination, • knowledge about other procedures for detecting cancers was generally low. • Only 24% knew about blood test, 14% knew about examination of male reproductive organs, 10% knew of mammography and 9% knew of Pap smear.

  32. Vesico-Vaginal Fistula (VVF)

  33. HIV Sero-Prevalence

  34. Overall Prevalence • The national HIV prevalence was 3.4% • Male 3.3% and female 3.4% • Lower in Urban:3.2%, Rural : 3.6% • Comparable with 2007 figures:Urban:3.8% , Rural area: 3.5%. • Highest in South South zone: 5.5% , least in the South East:1.8% • Highest in Rivers State : 15.2% and least in Ekiti State : 0.2%

  35. HIV Prevalence by Sex and Zones in Nigeria

  36. HIV Prevalence by age group and Sex

  37. HIV Prevalence By States

  38. HIV Prevalence By Intake of Drinks Containing Alcohol • Highest HIV prevalence among those that took alcohol everyday (4.9% ); higher among females (7.1%) than males (4.1%). • HIV prevalence of 4.4% among those who take alcohol at least once a week compared to 2.1 % among those who never took alcohol.

  39. HIV Prevalence Respondents Who Were Sexually Active • Higher prevalence among male respondents who were sexually active (3.6%) than those not sexually active(2.4%) • Higher prevalence among female respondents who were sexually active (3.7%) than those not sexually active(2.5%) • Lower prevalence among male respondents who had sex in the last 12 months prior survey (3.1%) than those who did not have sex (3.4%)

  40. HIV Prevalence Among Respondents Who Have Ever Had Sex in Exchange for Gifts or Favours

  41. Perceived Risk of HIV and Prevalence

  42. HIV Prevalence By Condom Use Last Non Marital Sex Act

  43. Regulatory Activities on Foods and Drug

  44. Awareness of NAFDAC Overall, • 53.7% are aware of NAFDAC • 43.5% in rural areas vs. 72.6% in urban areas • 29.8% in the NE vs. 77.3% in SE Of those that are aware, • 57.0% have heard/seen advert on NAFDAC • 47.9% in rural areas vs. 67.1% in urban areas • 68.1% in the SW vs. 44.8% in SE • 18.8% bought drugs with scratch numbers • 16.2% in rural areas • 19.8 in urban areas

  45. Pharmacovigilance • Overall, • 6.6% have bought suspected fake drugs/food items. • 5.4% in rural areas vs. 8.8% in urban areas • 39.0% have checked NAFDAC Reg. no before buying products. • 59.6% in urban areas vs. 27.9% in rural areas. • Of these, • 27.4% were aware of programmes to report adverse reactions to food/drugs. • 17.9% in rural areas vs. 36.8% in urban areas. • 5.7% have ever experienced any adverse reaction from food/drugs.

  46. Source of Purchase of fake drugs/food Products Findings suggest that • 35.9% bought fake drugs from pharmacies • 31.9% from patent medicine stores • 28.9% from open market • 2.0% from traditional healers • From SW • 42.8% bought from pharmacies • 41.7% from patent medicine stores • From NW • 55.7% bought from Government health facilities. • While XX% those from NE bought from

  47. Indicator for Genuineness of Drug/Food Product • When asked the possible signs for suspecting fake drugs, • 48.4% did not get the desired effect of drug/product • 32.2% from mere looking at the products; and • 17.3% lack of NAFDAC Reg. No. • No remarkable difference was noticed according to gender

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