Cablegate: Findings of the 2003 Demographic and Health

This record is a partial extract of the original cable. The full text of the original cable is not available.




E.O. 12958: N/A


1. Summary. The findings below on women's health and
their social status are from the executive summary of
the 2003 Nigeria Demographic and Health Survey. The
nutritional status of Nigerian women falls within the
internationally accepted normal range. The total
fertility rate is 5.7 children, high even by African
standards, and use of modern family planning methods is
low, only 8 percent for married women. Most births
occur at home in Nigeria, but most mothers receive pre-
natal care at least once during pregnancy. Although one-
fifth of Nigerian women are circumcised, the practice
is declining. Most working women decide alone what to
do with their earnings; generally, however, women
continue to be dominated by men in Nigeria,
particularly regarding family decisions, and continue
to be subject to beatings by husbands. End summary.


2. Nutritional Status of Women. The mean body mass
index (BMI) of Nigerian women at the time of the survey
was 22.3, which falls well within the internationally
accepted normal range (between 18.5 and 24.9). Almost
two-thirds of the women (64 percent) in the sample
population had BMIs falling in the normal range; 15
percent were thin, including 2 percent severely thin.
The youngest women were the most likely to be thin.
One-quarter of the women 15-19 years of age had a BMI
of less than 18.5. One-fifth of the Nigerian women
weighed more than they should have: 15 percent were
overweight and 6 percent obese.

3. Maternal Care. Almost two-thirds of mothers in
Nigeria (63 percent) had received antenatal care (ANC)
for their most recent live birth in the five years
preceding the survey. One-fifth of mothers (21 percent)
had received ANC from doctors; almost four in ten of
the women had received care from nurses or midwives (37
percent). Almost half the women (47 percent) had made
the minimum number of four recommended visits, but most
of the women who had received antenatal care had not
gotten care within the first three months of pregnancy.
Slightly more than half of the women who received
antenatal care said they had been informed of potential
pregnancy complications (55 percent). Fifty-eight
percent of the women had received iron tablets; almost
two-thirds had had urine or blood samples taken; and 81
percent had had their blood pressure measured. Almost
half (47 percent) of the women had not received tetanus
toxoid injections during their most recent birth.

4. Most births in Nigeria occur at home (66 percent).
Only one-third of the live births during the five years
preceding the survey occurred in a health facility.
Slightly more than one-third of the births were
attended by doctors, nurses, or midwives. A smaller
proportion of women had received postnatal care. Only
23 percent of the women who gave birth outside a health
facility had received postnatal care within two days of
the birth of their last child. More than seven in ten
women who delivered outside a health facility had
received no postnatal care at all.

5. All the data on maternal care showed that rural
women are disadvantaged compared to urban women, and
there are marked regional differences among women.
Women in the south, particularly the South East and the
South West, received better care than women in the
north, especially women in the North East and North

6. Female Circumcision. Almost one-fifth of Nigerian
women are circumcised, but the practice is declining.
The oldest women are more than twice as likely as the
youngest women to have been circumcised (28 percent
versus 13 percent). This practice is most widespread
among the Yoruba (61 percent) and Igbo (45 percent),
who traditionally reside in the South West and South
East. Half of the circumcised respondents could not
identify the type of procedure that had been performed.
Among the women who identified the procedure, the most
common involved cutting and removal of flesh (44
percent of all circumcised women). Four percent of the
women reported they had undergone infibulation.

7. Among the 53 percent of Nigerian women who had heard
of female circumcision, two-thirds (66 percent)
believed that it should be discontinued, while 21
percent wanted the practice to continue. Less than half
of circumcised women wanted the practice continued (42
percent). Continuation finds greater support among
southerners than northerners and among those who are
circumcised than the uncircumcised. Among men who had
heard of the practice, almost two-thirds were against
continuation of female circumcision, while about one-
fifth favored it.

8. Perceived Constraints to Use of Health Care. Almost
half of the women in the survey cited at least one
barrier to their accessing health care services. The
most commonly cited problem was getting money for
treatment (30 percent), followed by distance to a
health facility, and having transport (24 percent
each). One in ten women said getting permission to
access such services was a problem.

9. While most Nigerian women have had some education,
42 percent have never attended school. This is almost
twice the percentage of men who have never attended
school (22 percent).

10. Slightly over half of the women respondents
reported being employed (56 percent) during the time of
the survey. Eighty-four percent of working women had
earned cash only or cash in addition to in-kind
earnings. Almost three-quarters of the women who had
received cash earnings reported that they alone had
decided how their earnings had been used. Another 16
percent said they had decided jointly with their
husbands or someone else. Only 10 percent of the women
reported that someone else had decided how their
earnings would be used.

11. The 2003 NDHS recorded information on women's role
in different types of decisions in the household.
Almost half (46 percent) of the married women
participating in the survey reported they did not have
final say (either singly or jointly) in any decision.
Among the married couples, the husbands dominated
household decision-making.

12. The respondents were asked whether husbands can
justifiably beat their wives for specific reasons. Most
men and women (about six in ten) believed there are
occasions when a man is justified beating his wife.
About half the women respondents believed that husbands
can rightly beat their wives if the latter leave the
home without telling their husbands or if the wives
neglect the children. These were also the most common
justifications cited by men (50 percent and 47 percent,


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