Abstract : Child marriage represents a fundamental violation of human rights, nonetheless, several societies accept and practice this. This practice is life in Becheve, in Obanliku Local Government, Cross River State despite its implications to people involved, their communities and the world at large. It has received less attention from policymakers and health researchers. This study is to assess the betrothing of young girls into marriage in this area. Methods A descriptive cross-sectional study design was adopted among adults using questionnaires. Data was analysed using IBM SPSS version 23.0. Chi square test was used to ascertain the association between socio-demographic characteristics and agreement to betrothed/child marriage at significance level of p < 0.05. Binary Logistic Regression was used for predictors for variable with p value of ≤ 0.2 Result: High proportion of the respondents 222(53.9%) were currently in betrothed/child marriage, 184 (44.7%) had female children and 319(77.4%) have relatives or know anyone in such marriage. Only 82(19.9%) were happy and agree with such marriage. Key perceived reasons for such marriage were poverty 412(100%), tradition 412(100%), lack of education 410(99.5%), gender inequality 404(98.1%) and rural/urban area residence 402(97.6%). Psychological effects include; personality problems 410 (99.5%) and worries 402 (97.6%). Socioeconomic effects include; large family size 410 (99.5%), low education 409 (99.3%) and lack of decision making 408 (99.0%). Medical effects include; malnutrition 410 (99.5%), poor health seeking behavior 408 (99.0%), increased maternal and child mortality 400 (97.1%) and increased risk of STD 396 (96.1%). Identified predictors were age 35 - 50 years (AOR 6.34; 95% CI 3.55 – 75.23), ≥ 51 years (AOR 12.37; 95% CI 8.86 – 138.88), Widowed/Divorced/Separated (AOR 4.06; 95% CI 1.23 – 18.35), Islam religion (AOR 40.36; 95% CI 4.54 – 358.84), secondary education (AOR 0.23; 95% CI 0.15 – 0.45), tertiary education (AOR 0.060; 95% CI 0.014 – 0.495) and farming (AOR 24.12; 95% CI 15.41 – 37.56). Conclusion: This practice is still common in the study area. Lack of education, tradition, religion, lack of family support and insecurity fuel this practice. The consequences are manifold, overlapping and the impact trans-generational. There is need for concerted effort by all to end this menace

Keyword : Betrothing, early child marriage, Becheve, culture, Nigeria

Abstract : Introduction Prevention of Mother-to-Child Transmission of HIV (PMTCT) is a critical component of HIV control and if well implemented drastically reduces transmission to a child. However, Mother-to-Child Transmission of HIV (MTCT) remains a huge burden. Health facility-based antenatal care is still the main vehicle used for PMTCT services in Nigeria, when less than 40% patronize them. In view of shortages of qualified health personnel globally, engaging TBAs will improve the coverage of PMTCT services as it has the potential of bridging the gap. The aim of this study is to provide evidence to inform engagement of TBAs for PMTCT service delivery scale-up in Nigeria. Methods A cross-sectional survey was conducted among TBAs using questionnaires. Total study was done involving 409 TBAs. Data collected was analyzed using IBM SPSS version 25. Chi-square test was used for association of characteristics of TBAs with knowledge and practice on HIV as well as factors influencing willingness to collaborate in the PMTCT programme at < 0.05. Predictors were ascertained using Binary Logistic regression. Ethical Consideration were duly observed. Results In all, 241(58.9%) had overall good knowledge on HIV. The main source of knowledge was Healthcare workers 336 (82.2%). Majority correctly identified ways of HIV transmission and how transmission from infected mother to child can be prevented (>75%). The overall practice on HIV was poor 264 (64.5%) even though the majority 341 (83.4%) refer their HIV clients to health facility. Practices on personal protection was good (>70%). About 378 (92.4%) agree that they have a role in PMTCT for their clients and babies, however only 99 (24.2%) were willing to collaborate in the PMTCT programme. Identified predictors for good practice were; aged ≤ 45 years (AOR 2.66; 95% CI 1.08– 18.46), had primary education and below (AOR 0.68; 95% CI 0.05 – 0.75) and good knowledge (AOR 12.62; 95% CI 8.33 – 44.17). Identified predictors for agreeing to collaborate in the PMTCT programme were good knowledge (AOR 6.34; 95% CI 3.55 – 41.27) and good practice (AOR 3.15; 95% CI 1.74 – 13.35). Conclusions The attainment of PMTCT treatment targets for Nigeria is crucial to that of the world. TBAs are an important but currently underused resource for PMTCT scale-up. There is need to involve TBAs in PMTCT service delivery in Nigeria as if effectively engaged could bridge the gap in HIV control in Nigeria.

Keyword : Prevention of Mother-to-Child Transmission of HIV services, Traditional Birth Attendants, Engaged, Nigeria