Although efforts have been made towards improving the health of children across the globe with notable results, neonatal tetanus (NNT) remains a major contributor to the neonatal death rates in Nigeria. This problem calls for a concerted effort by the government to achieve the revised global NNT elimination deadline of 2015. The purpose of this cross-sectional quantitative study using secondary data was to establish the prevalence of NNT in Nigeria's northeast region and to ascertain if there was any significant difference in frequency of antenatal care (ANC), trained traditional birth attendants (TBAs), and umbilical cord treatments, using single sample proportions test and chi-squared tests of independence. The framework for this research was the theory of planned behavior. The participants (N = 312) were mothers of NNT babies. In spite a continual decline in the NNT cases between 2010 (26%) and 2013 (9%), the prevalence rate of NNT was unacceptably high at 28.815%. Also, significant differences existed as mothers who gave birth to NNT babies received significantly fewer or no ANC (p < 0.001), received significantly fewer or no attention from TBAs (p < 0.001), and reported significantly fewer incidences of proper umbilical cord treatments (p < 0.001). The chi-squared tests of independence resulted in significant differences in the frequencies of mothers who received ANC between Nigerian provinces (p < 0.001) and mothers who had their baby's umbilical cord treated (p = 0.005). This study will contribute to social change by guiding health care policy makers and immunization program managers on maternal and newborn health care services and indicate ways to build capacity of the TBAs for safe home delivery/hygienic handling of umbilical cord of newborns.

MPH / Department of Public Health / See the attached abstract below

Over the past two decades there has been an upsurge in interest in structural equation modelling (SEM). Applications abound in the social sciences and econometrics, but the use of this multivariate technique is not so common in public health research. This dissertation discusses the methodology, the criticisms and practical problems of SEM. We examine actual applications of SEM in public health research. Comparisons are made between multiple regression and SEM and between factor analysis and SEM. A complex model investigating the utilization of antenatal care services (ANC) by migrant women in Belgium is analysed using SEM. The dissertation concludes with a discussion of the results found and on the use of SEM in public health research. Structural equation modelling is recommended as a tool for public health researchers with a warning against using the technique too casually. / Mathematical Sciences / M. Sc. (Statistics)

Over the past two decades there has been an upsurge in interest in structural equation modelling (SEM). Applications abound in the social sciences and econometrics, but the use of this multivariate technique is not so common in public health research. This dissertation discusses the methodology, the criticisms and practical problems of SEM. We examine actual applications of SEM in public health research. Comparisons are made between multiple regression and SEM and between factor analysis and SEM. A complex model investigating the utilization of antenatal care services (ANC) by migrant women in Belgium is analysed using SEM. The dissertation concludes with a discussion of the results found and on the use of SEM in public health research. Structural equation modelling is recommended as a tool for public health researchers with a warning against using the technique too casually. / Mathematical Sciences / M. Sc. (Statistics)