College of Behavioral & Social Sciences

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    Modeling spatial access to cervical cancer screening services in Ondo State, Nigeria
    (Springer Nature, 2020-07-21) Stewart, Kathleen; Li, Moying; Xia, Zhiyue; Adewole, Stephen Ayodele; Adeyemo, Olusegun; Adebamowo, Clement
    Women in low- and middle-income countries (LMIC) remain at high risk of developing cervical cancer and have limited access to screening programs. The limits include geographical barriers related to road network characteristics and travel behaviors but these have neither been well studied in LMIC nor have methods to overcome them been incorporated into cervical cancer screening delivery programs. To identify and evaluate spatial barriers to cervical cancer prevention services in Ondo State, Nigeria, we applied a Multi-Mode Enhanced Two-Step Floating Catchment Area model to create a spatial access index for cervical cancer screening services in Ondo City and the surrounding region. The model used inputs that included the distance between service locations and population centers, local population density, quantity of healthcare infrastructures, modes of transportation, and the travel time budgets of clients. Two different travel modes, taxi and mini bus, represented common modes of transit. Geocoded client residential locations were compared to spatial access results to identify patterns of spatial access and estimate where gaps in access existed. Ondo City was estimated to have the highest access in the region, while the largest city, Akure, was estimated to be in only the middle tier of access. While 73.5% of clients of the hospital in Ondo City resided in the two highest access zones, 21.5% of clients were from locations estimated to be in the lowest access catchment, and a further 2.25% resided outside these limits. Some areas that were relatively close to cervical cancer screening centers had lower access values due to poor road network coverage and fewer options for public transportation. Variations in spatial access were revealed based on client residential patterns, travel time differences, distance decay assumptions, and travel mode choices. Assessing access to cervical cancer screening better identifies potentially underserved locations in rural Nigeria that can inform plans for cervical cancer screening including new or improved infrastructure, effective resource allocation, introduction of service options for areas with lower access, and design of public transportation networks.
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    The Roots of Political Instability Amongst Indigenous Nationalities and in the 'Nigerian' Supra-National State, 1884-1990: A Longitudinal and Comparative Historical Study
    (2004-11-30) Ejiogu, Emmanuel Chinenyengozi; Hage, Jerald; Gurr, Ted R.; Sociology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    The 'Nigerian' supra-national state was built by British colonialism in West Africa's Niger basin. Its supra-national status derives from its multi-national composition. It attracts the attention of scholars who want to account for its continuing poor political performance. Our inquiry into the roots of its continuing poor political performance was conducted from the perspectives of Harry Eckstein's congruence theory and the derivative framework from it that we called the E-G scheme. We found a high degree of social, economic, and political heterogeneity amongst the diverse nationalities that were compelled to constitute it. In the three nationalitiesthe Igbo, Yoruba, and Hausa-Fulanithat we sampled, that heterogeneity is evident in their governmental and non-governmental authority patterns. We found that the British formulated and implemented state building policies that preferentially favored the Hausa-Fulani but not the Igbo, the Yoruba, and others. We found that the British were impressed by the inherent autocratic traits of the Hausa-Fulani, but not the obviously democratic traits of the indigenous Igbo, and Yoruba authority patterns. Thus, while there emerged tremendous resemblances between the authority patterns of the 'Nigerian' supra-national state and those of the Hausa-Fulani, there emerged deep-seated disparity between them and indigenous Igbo, and Yoruba authority patterns. We established that the resultant state of affairs created and promotes commensurate bases of legitimacy for the authority of the supra-national state only in core Hausa-Fulani society but not in Igbo and Yoruba societies. During colonial rule high political performance in the 'Nigerian' supra-national state was region-specific. In spite of the resemblances shared by the authority patterns of the supra-national state and indigenous Hausa-Fulani authority patterns, their common incongruence and inconsonance with the indigenous authority patterns of the Igbo, Yoruba, and others constitute sufficient ground for the continuing poor political performance in the 'Nigerian' supra-national state.