Setting

This survey was conducted in Anambra state in South-east Nigeria. The State is surrounded by five States, namely Delta state to the west, Imo and Rivers states to the south, Enugu state to the east, and Kogi state to the north. The major urban areas in Anambra state are Awka, Onitsha, and Nnewi. The indigenous ethnic groups are Igbo (98% of the population), and a small population of Igala (2% of the population) that live in the north-western part of the State (www.anambrastate.gov.ng/history/, 2020). It has a landmass area of 4,844 km², with coordinates between Latitude 6° 20′N and Longitude 7° 00′E. Anambra has tropical rain forest vegetation, humid climate with average temperature of about 30°C and rainfall of between 152cm – 203cm (www.anambrastate.gov.ng/history/, 2020).

Administratively, the State is divided into 21 Local Government Areas (LGA). The sampling and recruitment of participants for this survey were designed along the lines of these LGAs. Also, there are 330 wards, and 177 communities in the state, with the capital territory at Awka.

Anambra Bureau of Statistics provided the 2020 projected population of Anambra State to be 6,149,744; of which males are 3,124,070 (50^.8%) and females 3,025,674 (49^.2%) and a population growth rate of 2^.21% per annum (^{Anambra state ministry of health, 2017}). On the whole, about 70% of the State's population is below the age of 30 across the sexes. The sampling for this study and analysis of the findings took into account this population age-structure.