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BackgroundSlums or informal settlements characterize most large cities in LMIC. Previous evidence suggests pharmacies may be the most frequently used source of primary care in LMICs but that pharmacy services are of variable quality. However, evidence on pharmacy use and availability is very limited for slum populations.MethodsWe conducted household, individual, and healthcare provider surveys and qualitative observations on pharmacies and pharmacy use in seven slum sites in four countries (Nigeria, Kenya, Pakistan, and Bangladesh). All pharmacies and up to 1200 households in each site were sampled. Adults and children were surveyed about their use of healthcare services and pharmacies were observed and their services, equipment, and stock documented.ResultsWe completed 7692 household and 7451 individual adults, 2633 individual child surveys, and 157 surveys of pharmacies located within the seven sites. Visit rates to pharmacies and drug sellers varied from 0.1 (Nigeria) to 3.0 (Bangladesh) visits per person-year, almost all of which were for new conditions. We found highly variable conditions in what constituted a “pharmacy” across the sites and most pharmacies did not employ a qualified pharmacist. Analgesics and antibiotics were widely available but other categories of medications, particularly those for chronic illness were often not available anywhere. The majority of pharmacies lacked basic equipment such as a thermometer and weighing scales.ConclusionsPharmacies are locally and widely available to residents of slums. However, the conditions of the facilities and availability of medicines were poor and prices relatively high. Pharmacies may represent a large untapped resource to improving access to primary care for the urban poor.

Introduction Many urban residents in low- and middle-income countries live in unfavorable conditions with few healthcare facilities, calling to question the long-held view of urban advantage in health, healthcare access and utilization. We explore the patterns of healthcare utilization in these deprived neighborhoods by studying three such settlements in Nigeria. Methods The study was conducted in three slums in Southwestern Nigeria, categorized as migrant, indigenous or cosmopolitan, based on their characteristics. Using observational data of those who needed healthcare and used in-patient or out-patient services in the 12 months preceding the survey, frequencies, percentages and odds-ratios were used to show the study participants’ environmental and population characteristics, relative to their patterns of healthcare use. Results A total of 1,634 residents from the three slums participated, distributed as 763 (migrant), 459 (indigenous) and 412 (cosmopolitan). Residents from the migrant (OR = 0.70, 95%CI: 0.51 to 0.97) and indigenous (OR = 0.65, 95%CI: 0.45 to 0.93) slums were less likely to have used formal healthcare facilities than those from the cosmopolitan slum. Slum residents were more likely to use formal healthcare facilities for maternal and perinatal conditions, and generalized pains, than for communicable (OR = 0.50, 95%CI: 0.34 to 0.72) and non-communicable diseases (OR = 0.61, 95%CI: 0.41 to 0.91). The unemployed had higher odds (OR = 1.45, 95%CI: 1.08 to 1.93) of using formal healthcare facilities than those currently employed. Conclusion The cosmopolitan slum, situated in a major financial center and national economic hub, had a higher proportion of formal healthcare facility usage than the migrant and indigenous slums where about half of families were classified as poor. The urban advantage premise and Anderson behavioral model remain a practical explanatory framework, although they may not explain healthcare use in all possible slum types in Africa. A context-within-context approach is important for addressing healthcare utilization challenges in slums in sub-Saharan Africa.

Background: Several interventions have been instituted to encourage smoking cessation among smokers. Many adults are currently working and spend several hours a day at work. Employers thus have a role to play in encouraging staff who smoke to quit. This study investigated the perception of drivers employed in the University of Ibadan, Nigeria on the role of their employers in facilitating smoking cessation among staff who smoke.Methods: All 176 drivers employed by the University and who were available on the days of the interviews were interviewed. A semi-structured questionnaire was used to obtain information on drivers’ opinion on the role of employers in facilitating smoking cessation among staff.Results: All the drivers were male and had a mean age of 51.2 ± 5.8 years. Five (2.8%) drivers were current smokers. One hundred and thirty-six (77.3%) drivers were of the opinion that their employers had a role to play in encouraging smoking cessation among staff who smoke. They felt this could be done by organizing workshops to sensitize staff on the dangers of smoking 73 (53.7%), educating staff about the health effects of smoking 26 (19.1%) and arresting staff caught smoking during official hours 20 (14.7%).Conclusions: Many of the drivers felt that their employers had a role to play in encouraging smoking cessation among staff. The University authorities should build on this and take specific steps to institute a comprehensive workplace antitobacco policy which includes smoking cessation interventions to assist staff whosmoke to quit.Keywords: Tobacco cessation, Workplace no-smoking policy, Workplace smoking cessation interventions

Intimate Partner Violence (IPV) is prevalent in Nigeria but a culture of silence exists, making it difficult to identify women at risk. A descriptive cross-sectional survey was employed to determine the prevalence and predictors of physical IPV in a low income, high density community in south west Nigeria. Among 924 interviews of everpartnered women aged 15-49 years, prevalence of lifetime experience of physical IPV was 28.2%. The significant predictors for physical IPV were previous experience of psychological abuse (adjusted OR: 4.71; 95% CI: 3.23-6.85); sexual abuse (aOR: 5.18; 3.21-8.36); having attitudes supportive of IPV (aOR: 1.75; 1.2-2.4); partner’s daily alcohol consumption (aOR: 2.85; 1.50-5.41); and previous engagement in a physical fight (aOR: 3.49; 1.87-6.50). Community based IPV prevention programmes targeted at breaking the cycle of abuse, transforming gender norms which support IPV and reducing alcohol consumption should be developed.Keywords: Intimate partner violence, women, predictors of physical violence, urban community, south west Nigeria.Afr J Reprod Health 2012; 16[1]:43-53).

This cross-sectional, community-based study was carried out among commercial motorcyclists in Igboora. All the commercial motor parks in Igboora were visited and all the commercial motorcyclists who consented to participate in the study were interviewed. Information on the respondents' socio-demographic characteristics, and the practice of road safety measures was collected using an interviewer administered questionnaire. A total of 299 motorcyclists were interviewed. All (100%) of them were males. The mean age of the respondents was 27.4 ± 7.4 years. One hundred eighty-two (60.7%) of the motorcyclists had the correct knowledge of the purpose of Highway Code. Only 70 (23.3%) could recognize more than half of the currently used road safety codes and 47 (15.7%) obey these road safety codes more than half of the time they see it. Only 183 (61.2%) of them had a driving license and 72 (24.1%) were able to produce these licenses on demand. All (100%) of the respondents did not use any protective helmet. Those who have longer years of working experience, higher level of education and higher knowledge of the safety codes practice it more regularly ( r = 0.198, p = 0.001, χ2 = 9.31, p = 0.025, and r = 0.28, p = 0.001 respectively). One hundred thirty-six (45.5%) have been involved in at least one accident in the preceding year. The overall incidence of road traffic accident was 2.16 per 1,000. There was however on statistically significant association between the practice of road safety codes and the occurrence of road traffic accidents (χ2 = 0.176, p = 0.916). The study shows that the practice of road safety measures was low in this rural Nigerian community and was not associated with the incidence of road traffic accidents. Introducing road safety education particularly targeted at educating the motorcyclists on the importance and practice of road safety measures would lead to an increase in the practice of the safety measures and hopefully a reduction in the incidence of road traffic accidents.