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Background: Adolescent girls face numerous challenges which hinder their ability to manage menstruation in a healthy and dignified manner. Objectives: To examine the menstrual hygiene practices of adolescent girls schooling in rural Anambra communities. Study design: Cross-sectional descriptive study. Method: Participants were selected using multistage stratified random sampling technique and interviewed using self-administered semi-structured questionnaire. Data were analysed using Statistical Package for Social Sciences version 22.0. Results: Mean age of all, pre-menarche and post-menarche girls were 14.7 ± 1.84, 12.8 ± 1.09 and 15.1 ± 1.73 years, respectively. About 46% of the pre-menarche girls had not received any information on menstruation. Common sources of initial menstruation information were mother (87.3%), school (52.2%) and peers (20.0%). Among the 1091 (85.0% (1091/1283)) post-menarche girls, last menstrual period, last menstrual period duration and cycle length could not be recalled by 53.9%, 34.4% and 39.3%, respectively. Majority (98.3%) who could recall last menstrual period had a cycle length of ⩽30 days and the mean duration of menses was 4.4 ± 0.84 days. Disposable sanitary pad was mostly (60%) cited as recommended product, but cloth/rags (40.6%) or tissue paper (32. 3%) were predominantly used. Majority (88.6%) took their bath ⩾twice/day, 50.9% changed sanitary product ⩽twice/day while 72.5% exhibited poor hand washing. Sanitary products were mostly discarded by burning (45.4%). Fifty-one percent could not change in school predominantly due to lack of functional toilets/changing rooms (84.2%) while 72.5% of those who changed did so in bushes or unused spaces. Challenges faced during menstruation include restriction from holy places (38.9%), waist pain (74.9%), blood stains (36.1%) and lack of money to buy pad (27.0%). Factors significantly associated with using commercial pads were age (p = 0.047), class (p = 0.006), mother's educational status (p < 0.001), social class (p < 0.001), ability to recall last menstrual period date (p = 0.029) or duration (p = 0.001). Conclusion: Menstrual hygiene management was unsatisfactory among studied adolescents. Continuous education of adolescent girls on menstrual hygiene management and advocacy for adequate menstrual hygiene management support are imperative. [ABSTRACT FROM AUTHOR]

Aim: This study was carried out to determine the knowledge and utilization of hepatitis B infection preventive measures and influencing factors among primary health care workers in Ibadan. Background: Exposure of healthcare workers to sharps, blood and body fluids makes them vulnerable to blood borne infections like human immunodeficiency virus (HIV), hepatitis C and hepatitis B to mention a few. There has been an increase in the prevalence of hepatitis in the under developed countries including Nigeria while Hepatitis B preventive measures are not practiced by some health workers. Methods: This descriptive survey utilized a quantitative approach. Two hundred and ten workers were selected from primary health care centers within four local governments of Oyo state using multi stage sampling technique. Data were collected, coded and analyzed using Statistical Package of Social Sciences (SPSS) version 15. Results: Majority of the health care workers had heard of hepatitis B transmission before while many (68.1%) had experienced needle stick injury. Many (65.2%) had good knowledge of preventive measures of hepatitis B while only 37.6% put the measures into practice. Conclusion: Although they claimed high practice of preventive measures, the findings were to the contrary. Hypotheses tested showed that knowledge did not significantly influence practice of preventive measures of hepatitis B. It is recommended that primary health care workers should attend sponsored seminars /conferences targeted at improving practices of preventive measures of hepatitis B. Necessary resources for prevention of blood borne infections should be made available to the health care workers. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to examine the determinants of catastrophic household health expenditure in Nigeria, with particular focus on Out-of-Pocket (OOP) health expenditure. Payments for healthcare through OOP are the major means of channeling funds to healthcare providers in many developing countries including Nigeria. It has great consequence on household well-being, especially when it is difficult for household to meet up with spending on other necessity goods. Design/methodology/approach: The demand for health theory provided the theoretical framework. The study used data from 2018/2019 Nigeria Living Standard Survey (NLSS) with catastrophic thresholds of 10 and 25%. A logistic regression model was used, while Pearson chi-squared test was used for models' goodness of fit. Findings: Based on the obtained result using Pearson chi-squared, at 10% threshold of total non-food expenditure, the likelihood of experiencing catastrophic health expenditure increased with secondary education, for those without health insurance and for severely ill or injured by 1.48, 2.57 and 8.70, respectively. It fell for those who consulted patent medicine vendors/chemists for illness or injury by 0.63 compared to orthodox practitioners. Enhancement of post-secondary education and widening the coverage of the available social health insurance would minimise the financial burden on many households. Originality/value: This paper fulfills the need to examine the determinants of catastrophic household health expenditure on two catastrophic thresholds and two forms of household expenditure. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate household food security (access) level and the dietary diversity of households in the Nsukka Local Government Area in South‐eastern Nigeria. From 20 local communities of Nsukka, 390 women were randomly sampled from the women's group and asked to complete a survey that determined the Household Food Insecurity Access Scale scores and the Household Dietary Diversity Scores (HDDS). The descriptive results indicated a high level of food insecurity with 82.6% households reporting various degrees of food insecurity. Over half of the sampled population experienced insufficient food quality. They either ate unwanted food (65.9%), limited variety (63.1%), or unpreferred food (64.6%). Some households experienced insufficient food intake by going a whole day without food (38.2%), go to sleep hungry (45.1%), or have no food of any kind (49%). The analysis of variance showed no significant difference (p = 0.428) in the food security level of households headed by males as compared with those headed by females. Approximately 53.6% of households fell at or below the average HDDS; males headed 48% of these households, while females headed 64%. The chi‐square test indicated factors associated with household food security including age, education, work status and income, whereas the gender of the household head, household size and marital status were not significantly associated. Public–private partnerships, nutrition orientation and food intervention programs could improve food security in this area. Key messages: This study found a high level of household food insecurity in Nsukka Local Government Area (NLGA) at 82.6%, with 60.3% of households being severely food insecure and 13.3% and 9% mildly and moderately food insecure, respectively, resulting in anxiety for most households.The majority ate limited variety, unwanted and unpreferred food, with more households consuming starchy foods than protein‐rich foods. About 53.6% households fell at or below average dietary diversity.There was no difference in household food security based on the gender of the household head.Food security was associated with education, age, income and work status.Rural households within NLGA require food intervention programs to alleviate food insecurity. [ABSTRACT FROM AUTHOR]

Background: Client satisfaction is a multidimensional construct focusing on clients' perceptions and evaluations of the treatment and care received. It is one of the factors affecting the outcomes of healthcare and the use of health services. Therefore, we aimed to assess clients' satisfaction with PHC services in Kaduna State, Northwest Nigeria. Methodology: A cross–sectional descriptive study was conducted in Kaduna State, Northwest, Nigeria which evaluate the satisfaction of clients and caregivers accessing healthcare in PHC centres. A sample size of 217 was determined using Fisher's formula, with a multi-stage sampling technique used to randomly select eligible respondents, who have accessed at least a PHC service in any of the PHCs in the State were included in the study, A semi-structured, interviewer-administered questionnaire was administered, and the data collected was analyzed using SPSS version 23.0. Appropriate statistical tests were used to examine the association between dependent and independent variables, while predictor variables that showed significant association with the outcome variables were further subjected to logistic regression analysis, to determine factors that affect clients' satisfaction with PHC services. Statistical significance was determined at an alpha level set at 0.05 at a 95% confidence interval. Results: Thirty-one percent of the respondents were satisfied with PHC services in Kaduna State with a mean composite satisfaction score of 3.78 ± 0.67. Age, ethnicity, level of education, and occupational status were factors affecting clients' satisfaction with PHC services among the respondents. On multivariate analysis, age, ethnicity, educational status, and occupational status were significant factors affecting clients' satisfaction with PHC services. Clients of Hausa/Fulani extraction are one and a half times less likely to be satisfied with PHC services when compared to clients from other tribes [aOR = 1.5, 95% CI (1.21–4.67); p = 0.003]. In terms of educational status, clients with formal education are one and a one-third times more likely to be satisfied [aOR = 1.3, 95% CI (0.17–0.94)] with PHC service when compared with their counterparts with informal education (p = 0.034). Conclusion: Clients' satisfaction with PHC services in Kaduna State, Northwest Nigeria was sub-optimal. Healthcare providers were recommended to improve their attitude bearing in mind clients' peculiarities. [ABSTRACT FROM AUTHOR]

The menace of human papillomavirus (HPV) infections among low- and middle-income countries with no access to a free HPV vaccine is a public health concern. HPV is one of the most common sexually transmitted infections (STIs) in Nigeria, while the most known types of HPV genotypes being transmitted are the high-risk HPV-16 and 18 genotypes. In this study, we explored the predictors of self-reported HPV infections and HPV genital warts infection among a population of students, non-academic staff, and academic staff of Ibrahim Badamasi Babangida (IBB) University located in Lapai, Nigeria. We also assessed their knowledge about HPV infections and genotypes, and sexual behaviors. An online cross-sectional study was conducted by setting up a structured questionnaire on Google Forms and it was distributed to the university community via Facebook and other social media platforms of the university. The form captured questions on HPV infection, and knowledge about HPV infection and genotypes, as well as the sexual health of the participants. All variables were described using frequencies and percentage distribution; chi-squared test statistics were used to explore the association between HPV infection (medical records of HPV infection) and the participants' profile, and a logistic regression analysis was performed to examine the factors associated with HPV genital warts infection among the population. This study reveals those participants between the ages of 26–40 years (81.3%) and those currently not in a sexually active relationship—single/divorced (26.4%)—who have self-reported having the HPV-16 and -18 genotypes. Moreover, participants between 26–40 years of age (OR: 0.45, 95%CI: 0.22–0.89) reported themselves to be carriers of HPV genital warts. Therefore, this study reveals the factors associated with HPV infection and genital warts peculiar to IBB university students and staff. Hence, we suggest the need for HPV awareness programs and free HPV vaccine availability at IBB university. [ABSTRACT FROM AUTHOR]

The culture of a people is their identity as it affords them due recognition. This paper therefore is aimed at examining the causes and consequences of rapid erosion of cultural values in nigeria. Social change theory was used in this paper. This study was carried out in ado-odo/ota lga, with a sample size of 203. Simple statistics like frequency distribution, percentile were used. Chi-square statistics was used in testing the hypotheses. The study found out that there is a positive relationship between social forces such as colonialism, westernization and erosion of cultural values. Also, it was found that there is a positive relationship between the local family structure and the foreign culture. The study concludes that forceful imposition of foreign culture should be discouraged. [ABSTRACT FROM AUTHOR]

Objectives: To determine the prevalence and contributing factors of depression and suicidal ideations among stroke survivors in Nigeria. Methods: This was a cross-sectional study comprising 75 consenting stroke survivors who were purposively recruited from 2 tertiary hospitals. Suicidal ideations and depression were measured using standard questionnaires. Obtained data was analyzed with appropriate statistical tools. Results: 9.3% of the participants had depression while 4% reported suicidal ideations. Significant correlation existed between suicidal ideations and depression (ρ =.31, P =.01), and levels of depression and suicidal ideations (χ2 = 85.76; P <.01). Depression had a significant relationship with gender and marital status, while suicidal ideations had a significant relationship with marital status. Females were significantly more depressed than their male counterparts (U = 512.50, P =.04) and also had a higher score on suicidal ideations. The widowed/divorced recorded the highest scores on depression (χ2 = 8.77, P =.01) and suicidal ideations (χ2 = 6.62; P =.04). Conclusion: A worrisome prevalence of depression was reported among the study participants. The level of suicidal ideations was quite low. Depression and suicidal ideations were higher among females and those who lost their life partners (either by divorce or death). [ABSTRACT FROM AUTHOR]

Background: The implementation of the country-wide comprehensive sexuality education (CSE) curriculum among in-school adolescents remains abysmally low and mHealth-based interventions are promising. We assessed the effect of a mHealth-based CSE on the sexual and reproductive health (SRH) knowledge, attitude and behaviour of in-school adolescents in Ilorin, northcentral Nigeria. Methods: Using schools as clusters, 1280 in-school adolescents were randomised into intervention and control groups. Data was collected at baseline (T0), immediately after the intervention (T1) and 3 months afterwards (T2) on SRH knowledge, attitude and practice of risky sexual behaviour (RSB). Data analysis included test of associations using Chi-square, independent t-test and repeated measures ANOVA. Predictors were identified using binary logistic regression. Results: In the intervention group, there was a statistically significant main effect on mean knowledge score (F = 2117.252, p = < 0.001) and mean attitude score (F = 148.493, p = < 0.001) from T0 to T2 compared to the control group which showed no statistically significant main effects in knowledge (p = 0.073), attitude (p = 0.142) and RSB (p = 0.142). Though the mean RSB score declined from T0 to T2, this effect was not statistically significant (F = 0.558, p = 0.572). Post-intervention, being female was a positive predictor of good SRH knowledge; being male was a positive predictor of RSB while being in a higher-class level was a negative predictor of RSB. Conclusion: The mHealth-based CSE was effective in improving SRH knowledge and attitude among in-school adolescents. This strategy should be strengthened to bridge the SRH knowledge and attitude gap among in-school adolescents. Trial registration Retrospectively registered on the Pan African Clinical Trial Registry (pactr.samrc.ac.za) on 19 October 2023. Identification number: PACTR202310485136014 Plain Language Summary: In Nigeria, the implementation of a nationwide sex education programme for adolescents going to schools is below expectation but using mobile health (mHealth) interventions could help. In this study, we looked at how a mHealth-based sex education programme affected the sexual and reproductive health (SRH) knowledge, attitude, and behaviour of in-school adolescents in Ilorin, Nigeria. We divided 1280 students into two groups, one received the mHealth-based intervention and the other did not receive it. We collected data before the intervention, right after it, and 3 months later to see any changes in SRH knowledge, attitudes, and risky sexual behaviours. We used various statistical tests to analyze the data and find patterns. The results showed that the group that received the mHealth intervention had significant improvements in their knowledge and attitudes about SRH from the start of the study to 3 months after the intervention. However, the control group, which didn't get the intervention, didn't show these improvements significantly. While the risky sexual behaviour score decreased slightly in the intervention group, this change was not significant. After the intervention, we found that being female was associated with better SRH knowledge, while being male was linked to more risky sexual behaviours. Also, being in a higher class level was associated with low risky behaviour. In conclusion, using mHealth for sex education helped improve the SRH knowledge and attitudes of students. This approach could be scaled to fill the gap in SRH knowledge and attitudes among adolescents in schools. [ABSTRACT FROM AUTHOR]

Introduction: While practice guidelines support clinical decision-making for optimal patient outcomes, there is often nonadherence to practice guidelines in implementing evidence-based interventions. Objectives: This article aimed to assess adherence to practice guidelines in emergency obstetric and newborn care (EmONC) and the outcome of pregnancy in cases of obstetric complications in referral hospitals. Method: The study employed a descriptive design. A purposive sampling technique was used to select the three tertiary hospitals and six out of nine state hospitals in Osun State. A data extraction form developed based on a fidelity framework was used to collect data on Adherence from 264 cases of obstetric complications. Descriptive statistics, such as frequency and percentage, and inferential statistics, such as chi-square, were done with the significance level set as p <.05. Results: Findings showed low adherence to practice guidelines in 70.8% of hemorrhage care, 52.0% of fetal distress care, 60.0% of prolonged obstructed labor care, and 44.4% of preeclampsia/eclampsia care. The study's findings also showed that 64.3% of cases of prolonged/obstructed labor, 54.9% of cases of fetal distress, and 46.7% of all cases of obstetric complications were referred out at the state hospitals. Neonatal mortality in state and tertiary hospitals was 3.7% and 21.7%, respectively, which was significantly different (p <.001). Conclusion: There was low adherence to practice guidelines for the implementation of EmONC in state and tertiary hospitals, and a significant number of cases of obstetric complications were referred out in the state hospitals. The low adherence to practice guidelines and numerous referrals truncate the successful implementation of EmONC and hinder women and newborns from receiving optimal care for obstetric complications. There is a need to develop strategies that promote adherence to practice guidelines in implementing EmONC. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: A mismatch between school furniture dimensions and anthropometric parameters has been well documented in adolescents, but there is a paucity of data on the impact of these mismatches on the students' spinal health in Nigeria. This study therefore investigated the relationship of spinal deformities with selected anthropometric parameters and furniture dimensions of adolescents in secondary schools. Methods: This study involved 540 apparently healthy students between the ages of 10 and 19 years from 9 public and private secondary schools in Lagos state, Nigeria. The furniture dimensions, anthropometric parameters, and spinal curvature disorders were evaluated using standard protocol. Data was analyzed using SPSS version 20.0 with a level of significance set at p < 0.05. Results: Two hundred two (37%) of the participants had abnormal spinal curvatures in varying types and degrees. There was a significant association at p ≤ 0.05 between the presence of spinal deformities and popliteal height to seat height mismatch (X2 = 175.67, p = 0.001), hip breadth to seat width mismatch (X2 = 293.14, p = 0.00), and shoulder height to backrest height mismatch (X2 = 788.16, p = 0.001). Conclusion: Anthropometric parameters to furniture dimensions mismatch are significantly associated with the presence of spinal deformities among the students. The main cause of mismatch is using a homogeneous size of furniture for all students in addition to non-consideration of the students' dimensions during furniture manufacturing. [ABSTRACT FROM AUTHOR]

Introduction: Diarrhoea disease is one of the commonest under-five children's diseases with increasing prevalence rate in our communities. Complication of the disease may lead to death however; the diseases as well as its complications are preventable when proper measures are put in place by the mothers of under-five children. Objective: The study was designed to assess maternal strategies in the prevention of under-five's diarrhoea in two selected communities in Ibadan. Methods: Community based descriptive design was adopted. Study population included 246 mothers of under-five in the two communities. Data on patient's demographic characteristics, mother's knowledge about diarrhoea and maternal strategies in diarrhoea prevention were recorded using structured questionnaire. The data was analysed using descriptive analysis and Chi-square was used to test the set hypotheses. Results: Mean age of the 243 mothers, who participated in the study is 30 years (± SD 6.4). Overall, 89.3% of mothers had adequate knowledge of diarrhoea; however, there were deficiencies in some areas, 71.6% of mothers acknowledged teething as causes of diarrhoea, 39.9% and 33.3% did not know that rotavirus vaccine and exclusive breast feeding may reduce diarrhoea incidence respectively. In addition, 55.6% of participants' children had incidence of diarrhoea. Also, 94.2% of mothers had appropriate maternal strategies in the prevention of diarrhoea. Mothers always practice exclusive breastfeeding for the first six months of life (62.6%) and always wash hands with soap and water (68.3%). Only 11.5% mothers received rotavirus vaccine. Conclusion: The study findings indicated low uptake of rotavirus vaccine and high incidence of diarrhoea among the respondent's children. Therefore, effort should be made to provide information about rotavirus vaccine and prevention of diarrhoea disease. [ABSTRACT FROM AUTHOR]

Introduction: The primary obligation of healthcare professionals is the well-being of patients. Inter-professional conflict can prevent the achievement of this goal, thereby potentially putting patients in peril. This study aimed at articulating contextual strategies to mitigate and prevent inter-professional conflict among healthcare workers in Nigeria. Methods: A cross sectional study was undertaken in various health facilities in Nigeria. Questionnaires were administered to healthcare professionals. Completed questionnaires were analysed using Statistical Package for Social Sciences. Descriptive and inferential statistical analyses were undertaken. Results: A total of 2207 valid responses were included for analysis. Findings revealed that almost all the respondents (92.9%) indicated that the Ministry of Health has a key role in resolving conflict in the healthcare sector. Close to three quarters (70.4%) of the study participants disagreed that leadership of hospitals and health agencies be limited to a particular profession. Almost all the participants (90.15%) indicated that cognate administrative expertise and experience are critical for leadership. A strong majority of the sample (93.5%) opined that reforms are required in the leadership selection process of hospital and other healthcare agencies. Conclusion: Due to the criticality of this issue to patients' access to healthcare, findings from this study can underpin a proactive evidence based strategy that can comprehensively address inter-professional conflict among healthcare workers in Nigeria. [ABSTRACT FROM AUTHOR]

Background: Despite concerted global efforts to reduce the burden of maternal anemia, it remains a major public health issue. Over 40% of pregnant women worldwide are anemic; low- and middle-income countries (especially those in sub-Saharan Africa) make a disproportionately higher contribution to the global burden. The condition can lead to undesirable outcomes for the mother and child. This study was conducted to determine the prevalence of anemia in pregnancy among women attending antenatal clinics in Chikun LGA, Kaduna. Methods: This study was conducted among 145 women attending antenatal clinics in Chikun LGA. Data were collected using a pretested, semi-structured interviewer-administered questionnaire. Hemoglobin (Hb) level was determined and anemia was defined using the World Health Organization-recommended cutoff of <11 g/dl. The results were presented in frequency tables. Data were analyzed using IBM SPSS Statistics version 26. Statistical significance was set at P < 0.05. Results: Fifty-five (37.9%) of the respondents were between the ages of 25 and 29 years. The mean age of the respondents was 28.61 ± 5.5 years. The majority, 107 (73.8%), had a household size of 2–4. Only 16 (11.0%) respondents were aware of anemia. Pregnant women were identified by half (50.0%) of the respondents as being more at risk of anemia. Only a quarter (25.0%) of respondents had good knowledge of anemia. Over two-fifth (42.8%) of the respondents were anemic. There was a statistically significant relationship between household size and anemia in respondents. Conclusion: A large proportion of the respondents were anemic; this underscores the need to strengthen the nutritional counseling and routine hematinics given during the antenatal period. Social drivers should also be addressed in terms of favorable public policies. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: In Nigeria, private for-profit health facilities present an opportunity to achieve the UNAIDS 95-95-95 HIV targets because of their reach and patronage. However, little is known about determinants of outcomes in these facilities. This study describes patient outcomes and the patient and health facility characteristics associated with these outcomes in adults receiving HIV treatment in private facilities in the Federal Capital Territory (FCT), Benue and Nasarawa states in north-central Nigeria. Methods: A retrospective longitudinal analysis of program data collected between 2013 and 2019 was done. Patient attributes and outcomes were compared across the two states and FCT. Incidence rates were determined for all cause exit, mortality and loss to follow up (LTFU). Cox proportional hazard models were used to identify associations between patient and facility attributes and these outcomes. Bivariate and multivariate logistic regression models were used to determine the factors associated with viral suppression among the study participants. Results: Of the 22,010 study subjects, 42.7%, 22.2% and 35.1%, respectively, were in Benue, FCT and Nasarawa. Almost a third (31.8%) had received antiretroviral treatment (ART) for less than a year at censoring. Incidence rates for all-cause exit, mortality and loss to follow up (LTFU) were 17.2 (95% CI 16.8, 17.5), 2.1 (95% CI 2.0, 2.2), and 11.2 (95% CI 10.8, 11.8) per 100 person years respectively. Males had higher risks of death (HR = 1.47, 95% CI 1.25–1.73), and LTFU (HR = 1.08, 95% CI 1.00–1.16). Age at ART start showed a dose–response association with both mortality and LTFU. Care at model facilities (OR = 2.16, p < 0.001), Zidovudine (AZT)-based regimens (OR = 2.00, p < 0.001), and lowest quartile baseline CD4 + count (OR = 2.40, p < 0.001) were associated with regimen switch. 75.6% of subjects were viral suppressed. Male gender (OR = 0.84, p = 0.025); AZT-based regimen (OR = 0.72, p < 0.001), age in the bottom quartile (OR = 0.71, p = 0.002) were associated with virally suppression. Conclusion: Private for-profit facilities are a major provider of HIV and other health services in Nigeria. With appropriate technical support and engagement, they can help accelerate efforts to achieve epidemic control of HIV in Nigeria, and contribute to achievement of UNAIDS 95-95-95 target by 2030. [ABSTRACT FROM AUTHOR]

Background: The risk of contracting sexually transmitted infections (STIs), including human immunodeficiency virus (HIV) is related to women's sexual attitudes, beliefs, and power dynamics within marriages in developing countries. Despite the interventions towards improving women's sexual health and well-being, women are disproportionately affected by the risk of STIs transmission compared with their male counterparts in most sub-Saharan African countries including Nigeria. This study examined the roles of family structure and decision-making autonomy on women's attitudes towards negotiating safe sexual practices in Nigeria.Methods: The study involved analyses of data from a nationally representative and weighted sample size of 28,219 ever-married/cohabiting women aged 15-49 years from the 2018 Nigeria Demographic and Health Survey. Descriptive and statistical analyses were carried out, including frequency tables, Pearson's chi-square test, and multivariable binary logistic regression model.Results: The overall prevalence of having positive attitudes towards negotiating safe sexual practices were 76.7% and 69.6% for a wife justified in asking the husband to use a condom if he has an STI and refusing to have sex with the husband if he had sex with other women, respectively. The results further showed that polygamous unions negatively influenced urban and rural women's attitudes towards negotiating safe sexual practices, but women's decision-making autonomy on how to spend their earnings was found to be a protective factor for having positive attitudes towards negotiating safe sexual practices with partners. Surprisingly, there were significant variations in attitudes towards negotiating safe sexual practices among urban and rural women who enjoyed decision-making autonomy on their healthcare (aOR 1.70; CI 1.32-2.18 and aOR 0.52; CI 0.44-0.62, respectively). Plausibly, such women might have constrained them to compromise their sexual relationships for fear of being neglected by partners.Conclusion: The outcomes of this study have some policy implications for both maternal and child health. There is the need to intensify programmes aimed at improving women's sexual health and rights towards achieving sustainable development goals of preventing deaths of newborns, ending STIs and creating gender in Nigeria. [ABSTRACT FROM AUTHOR]

Introduction: The lack of continuous training of maternal and child healthcare providers has been identified as one of the factors contributing to the poor quality of maternal and child healthcare services in Nigeria. Objectives: The study aimed to evaluate the level of postnatal care-related knowledge among healthcare workers in Osun State and the impact of a structured training program on their learning. Method: A quasi-experimental research design using pre-test and post-test control groups was utilized in this study. One hundred and sixty-one healthcare workers were recruited from six Local Government Areas (LGA) and randomized into intervention and control groups. The healthcare workers in the intervention group (n =82) were exposed to a 3-day structured training program. A structured questionnaire was used to collect data before, immediately, and 3-months after the training. Data were analyzed using descriptive statistics, multiple linear regression, t-test, and repeated measure analysis of variance (ANOVA) with posthoc pairwise comparison. Results: The mean ages of healthcare workers in the intervention and control groups are 40.96±6.91 and 42.52±7.58, respectively. At baseline, the mean knowledge score of the intervention and control groups were 60.0±11.6 and 63.7 ± 10.4, respectively. There is a significant difference in the mean knowledge score of healthcare workers in the intervention group compared with those in the control group immediately after the training (t=12.04, p < .001) and after 3-months of data collection training (t =5.92, p < .001). A multivariate linear regression confirmed the positive effect of group membership (intervention vs. control) on the post-test knowledge among respondents (p < .001). Conclusion: An educational training significantly improved the knowledge of healthcare workers on the recommended postnatal care. [ABSTRACT FROM AUTHOR]

This study investigated the views of students on e-assessment used by the University of Ilorin, Nigeria. In order to achieve the objectives, a researcher designed questionnaire was the instrument used to gather data from randomly selected 400 students of the institution. The data collected were analyzed using frequency counts, percentages and chi-square was used to analyze the only hypothesis generated. The findings showed that all the students involved in the study did not prefer on-line registration of their courses, most of them disagreed that females consider e-assessment stressful and there was a significant difference between the views of male and female students on e-assessment in the University of Ilorin. It was recommended among others that the University should assist students by creating more cyber cafes on the campus so that the students can register with fewer difficulties, provide more computers and the need to help the students to be more computer literate. [ABSTRACT FROM AUTHOR]

Background: There are conflicting reports on the impact of highly active antiretroviral therapy (HAART) in resolving hematological complications. Whereas some studies have reported improvements in hemoglobin and other hematological parameters resulting in reduction in morbidity and mortality of HIV patients, others have reported no improvement in hematocrit values of HAART-treated HIV patients compared with HAART-naïve patients. Objective: This current study was designed to assess the impact of HAART in resolving immunological and hematological complications in HIV patients by comparatively analyzing the results (immunological and hematological) of HAART-naive patients and those on HAART in our environment. Methods: A total of 500 patients participated, consisting of 315 HAART-naive (119 males and 196 females) patients and 185 HAART-experienced (67 males and 118 females) patients. Hemoglobin (Hb), CD4+ T-cell count, total white blood count (WBC), lymphocyte percentage, plateletes, and plasma HIV RNA were determined. Results: HAART-experienced patients were older than their HAART-naive counterparts. In HAART-naive patients, the incidence of anemia (packed cell volume [PCV] <30%) was 57.5%, leukopenia (WBC < 2.5), 6.1%, and thrombocytopenia < 150, 9.6%; it was, significantly higher compared with their counterparts on HAART (24.3%, 1.7%, and 1.2%, respectively). The use of HAART was not associated with severe anemia. Of HAART-naive patients, 57.5% had a CD4 count < 200 cells/?L in comparison with 20.4% of HAART-experienced patients (P < 0.001). The mean viral load log10 was significantly higher in HAART-naive than in HAART-experienced patients (P < 0.001). Total lymphocyte count < 1.0 was a significant predictor of

In Nigeria, freshmen constitute a risk group of adolescents and young adults capable of engaging in unsafe sexual practices. This study documents the associated factors to sexual risk behaviours practices of University of Ibadan, Nigeria freshmen. Eight hundred and forty one (841), freshmen who attended a routine orientation program were asked to respond to a questionnaire. Results showed that 30.8% were sexually active and 47% did not use condom in their last sexual episode. Associated with sexual risk behaviours include: being a male freshman increasing age; lower tendency for violence; increase sexual compulsivity; alcohol abuse; history of rape and a history of Child Sexual Abuse (CSA). Three variables: alcohol abuse; history of CSA and increasing age remained significant in a multiple regression analysis. The paper presents the first evidence of vulnerability of freshmen to sexual risk practices in a Nigerian University. [ABSTRACT FROM AUTHOR]

Background. In recent times, it has become a common practice to discharge a woman early after an uncomplicated caesarean section (CS), to satisfy their wishes, reduce cost, and maximize efficient use of healthcare system resources. Objective. To conduct a comparative analysis of maternal and neonatal outcomes following day two hospital discharge versus day 5 or 7 discharge after an uncomplicated CS. Materials and Methods. Eligible parturient (228) who met the inclusion criteria were randomized into two groups between 1st October 2018 and 30th September 2019 in two different maternity centers in Ebonyi state. The study group (114) was discharged two days after an uncomplicated CS while the control group (114) was discharged on the 5th or 7th postoperative day. Their satisfaction, cost, morbidities, and breastfeeding practices were evaluated using a pretested questionnaire. Data were analyzed using IBM SPSS version 22. Results. Day 2 discharge was not associated with a higher rate of readmission as compared with day 5-7 discharge ( χ 2 = 0.95 , P = 0.329). There were no statistically significant differences in cost incurred by patients discharged on day 2 after uncomplicated CS compared to the control group ( χ 2 = 1.65 , P = 0.649). Maternal satisfaction was high following day 2 discharge compared with day 5-7 discharge ( χ 2 = 16.64 , P = 0.0001 , OR = 0.857 , 95 % CI = 0.59 – 1.25). The majority of mothers (79.6%) discharged on day 2 were able to initiate and sustain breastfeeding with no statistically significant difference in the initiation and sustenance of breastfeeding with those discharged on days 5-7 ( χ 2 = 4.45 , P = 0.108). Early hospital discharge did not have any significant negative impact on neonatal health ( χ 2 = 1.063 , P = 0.303). Conclusion. Early discharge of patients after an uncomplicated CS is not associated with increased rate of readmission. It is associated with good maternal satisfaction, adequate initiation and sustenance of breastfeeding, and good neonatal wellbeing. We advocate early discharge of women following uncomplicated CS. [ABSTRACT FROM AUTHOR]

Objective. The objective of this study was to investigate the extent stroke survivors who attended an herbal center knew of stroke risk factors and whether significant sex differences existed. Study Design. This was a cross-sectional study conducted from January to June 2018 at Bebe Herbal Center, and it involved two well-trained assistants who interviewed 149 first-time stroke survivors after consent and ethical approval were obtained. The survivors self-reported their knowledge, attitude, and beliefs on risk factors before and after stroke. Statistical Analyses. Means of continuous variables were compared using Student's unpaired t -test, while categorical variables between males and the females were analyzed using Pearson's chi-square test. P < 0.05 was taken as significant. Results. Mean age of men (64.81 ± 1.24 yrs) was significantly higher than that of women (61.39 ± 1.42 yrs) (F = 0.096 , t = 1.79 , df = 147 ; P < 0.05). More men than women were 60 years and above while more women than men were below 60 years. Pearson's chi-square test showed significant association of sex with education ( χ 2 = 12.31 ; df = 3 , P < 0.006), occupation ( χ 2 = 23.65 ; df = 4 , P < 0.001), alcohol intake ( χ 2 = 24.23 ; df = 1 ; P < 0.001), and smoking ( χ 2 = 9.823 ; df = 1 ; P < 0.001). The commonest risk factor suffered was hypertension (73.1%), followed by alcohol intake (59.1%), smoking (31.5%), and diabetes mellitus (26.7%); these affected men more than women. Male survivors unaware of their hypertensive status were more likely to have stroke than females, and age had a significant effect on the likelihood of developing a stroke; the same was occupation. Conclusions. These survivors suffered mainly from hypertension, triggered by psychosocial problems and diabetes mellitus; their stroke seemed fueled by unrecognized hypertension, unrecognized diabetes mellitus, ignorance of hyperlipidemia, and wide-scale belief in witchcraft as risk factor. Awareness programs in the third world should take these observations into consideration. [ABSTRACT FROM AUTHOR]

Background: The introduction of the COVID-19 vaccine necessitates the assessment of individual perception regarding the vaccine. This study aimed to assess the perception of community members and willingness to pay for the prospective COVID-19 vaccine in Ibadan, Nigeria. Methods: A descriptive cross-sectional study design was used. Data were collected using an interviewer-administered questionnaire in September 2020. We studied community members aged 15 years and above using a multi-stage sampling technique. The perceptions of respondents about the COVID-19 vaccine were assessed on eight questions using the five-point Likert scale with a score point of "1" assigned for "Strongly Agree", "2" for "Agree", "3" for "Not decided", "4" for "Disagree", and "5" for "Strongly disagree". During analysis, we reverse-coded the options by assigning a point of "1" for "Strongly disagree", "2" for "Disagree", "3" for "Not decided", "4" for "Agree", and "5" for "Strongly disagree". However, questions asked in the negative directions were not reverse-coded during analysis. Eight questions were used to assess the perception of community members regarding the prospective COVID-19 vaccine, and overall, the maximum point was 40. Points greater than or equal to 32 points (80%) implied positive perception. Descriptive statistics were done. Chi-square tests were used for the assessment of associations between sociodemographic characteristics and willingness to pay for the prospective COVID-19 vaccine. We conducted logistic regression tests on statistically significant variables at p-values <0.05. Results: The mean age of the 440 respondents studied was 37.22 ± 15.36 years, 193 (49.00%) were males, and 292 (67.30%) of the respondents had heard of the prospective COVID-19 vaccine. Among them, 232 (79.50%) respondents had positive perception regarding COVID-19 vaccine. Individuals in the fifth wealth quintile were ten times more likely to be willing to pay for the prospective COVID-19 vaccine compared to those in the first wealth quintile (Adjusted Odds Ratio = 9.57, 95% CI [2.88-31.82], p = <0.01). Conclusion: The prospective COVID-19 vaccine should be subsidized or made freely available to everyone. [ABSTRACT FROM AUTHOR]

Objective This study assessed the progress, opportunities and challenges in scaling up of HIV testing for pregnant women in Nigeria. Methods Data were retrieved from the 2016–2017 fifth multiple cluster survey. Adjusted and unadjusted logistic regression models were used to examine demographic factors associated with HIV testing while controlling for geopolitical zones. Results At the population level, the coverage of HIV testing among pregnant women increased by 10% points from 32.8 to 42.7% between 2013 and 2017. Also, the coverage of antenatal HIV testing grew by 20 points, from 50.1 to 70.5% over the period. However, women were still more likely to be tested for HIV during pregnancy if they were older than 24 years [adjusted odds ratio (AOR) 1.33, 95% CI 1.04–1.69], had higher education [AOR 6.94, 95% CI 5.07–9.49], resided in urban areas [AOR 1.26, 95% CI 1.07, 1.50] and belong to richest wealth quintile [AOR 7.43, 95% CI 5.72–9.66]. Conclusion Our findings suggest that progress has been made in scaling up of antenatal coverage of HIV testing. However, the level of HIV testing during pregnancy remains low and far below the 95% national target. Appropriate interventions are needed in resource-poor communities where antenatal care utilization is very low. [ABSTRACT FROM AUTHOR]

The study investigated the influence promotion and prompt salary payment on job performance of library personnel in university libraries in Nasarawa State. Two (2) specific objectives with corresponding research questions guided the study and two hypotheses were formulated and tested at 0.05 level of significance. The study adopted a survey research design and was carried out in Nasarawa State, Nigeria. The population of the study was 150 library personnel in the University libraries in Nasarawa State which were made up 44 library personnel in federal university Lafia, 66 library personnel in Nasarawa State University Keffi and 40 library personnel in Bingham University Karu, Nasarawa State. The total of 150 library personnel in the universities were used. The instrument for data collection was a self-developed structured questionnaire. The questionnaire was subjected to face and content validation by three experts. To ensure internal consistency of the instrument, the instrument was trial tested on thirty (30) Library personnel in Benue State university library Makurdi and Francis Idachaba library, federal university of Agriculture Makurdi who were not part of the main study but considered to have similar characteristics with the subject under study. The reliability of the instrument was calculated using Cronbach Alpha method and a reliability coefficient of 0.87 was obtained. The data collected were analyzed using Means and Standard Deviation to answer the research questions and Chi-Square statistic to test the null hypotheses at 0.05 level of significance. Findings of the study revealed that promotion and regular salary payment have influence on job performance of library personnel in university libraries in Nasarawa State. Conclusion and recommendations were made based on the findings of the study. [ABSTRACT FROM AUTHOR]

Background. Mental health disorders have received little attention amongst people living with HIV/AIDS (PLWHA). Depression is the most common psychiatric consequence of HIV/AIDS diagnosis. Its prevalence is higher among PLWHA than the general population. Objectives. To determine the prevalence of depression, to identify its associated factors and, lastly, to determine its association with treatment outcome measures among PLWHA on antiretroviral therapy (ART) aged ≥ 18 years receiving care at the HIV clinic of General Hospital, Lagos. Material and methods. A cross-sectional study was conducted using the systematic random sampling method to select participants over a period of 14 weeks. An interviewer-administered questionnaire was designed to capture socio-demographic, behavioural, psychosocial, HIV and health-related information, as well as the clinical data of the participants. The Patient Health Questionnaire (PHQ-9) was used to assess depression. The relationships between depression and other participants’ characteristics were tested with Pearson’s chi-squared (χ2 ) test. Logistic regression analysis was used to minimise confounding, and the level of statistical significance was set as a p-value of ≤ 0.05. Results. The total of 279 respondents, with a mean age of 43.1 ± 10.3 years, were predominantly females (67.7%). The prevalence of depression among the participants was 24%. Factors such as occupation (p = 0.041; 95% CI, 0.43 to 3.63), alcohol intake (p = 0.036; 95% CI, 0.62 to 3.82), cohabitation (p = 0.025; 95% CI, 1.43 to 3.82), stigmatisation (p = 0.008; 95% CI, 0.92 to 3.70) and personal history of depression (p < 0.001; 95% CI: 1.75 to 6.38) showed statistically significant relationships with depression. Conclusions. The burden of depression is high among PLWHA. Identifying and unravelling factors associated with depression among PLWHA and advocacy against stigmatisation will play a significant role in reducing this burden. [ABSTRACT FROM AUTHOR]

Substance abuse is a common global phenomenon and has invaded human society as the most important social damage. The study aim was to evaluate factors influencing substance abuse among commercial motorcycle operators in Akure Metropolis Ondo State. A descriptive cross-sectional design was adopted to examine the factors influencing substance abuse among commercial motorcycle operators in Akure Metropolis. A total of 384 respondents were sampled with a multistage sampling method, data were collected from the respondents through a well-structured validated questionnaire. Data collected were summarized using frequency and percentages to answer research questions. The hypotheses were analyzed using Chi-square and Analysis of Variance (ANOVA) at 0.05 level of significance. Findings revealed that commercial motorcycle operators in Akure Metropolis engaged in substances use and abuse due to frustrations, to boost energy and get fit for the work, to avoid problems and to think more clearly. Respondents were found to use the substance on a daily basis. Statistically, a significant difference was found between the level of respondents' education and factors influencing substance abuse, F (3, 380) = 54.746, ρ < .001. In conclusion, it is clear now that commercial motorcycle operators in Akure metropolis engaged in substance abuse due to availability and affordability of the substance, frustration, boosting energy and low level of education. It is therefore recommended that nurses, most especially psychiatric nurses should intensify campaign on the risk associated with substances use and abuse with the respondents. [ABSTRACT FROM AUTHOR]

Background. Birth preparedness and complication readiness (BP/CR) concept is based on the premise that preparing for birth and being ready for complications reduce all three phases of delay to a bad obstetric outcome. Objectives. To determine the knowledge of BP/CR with its determinants and BP/CR index among pregnant women in Abakaliki, southeast Nigeria. Methods. A cross-sectional survey was done between 1st March 2019 and 31st July 2019 among 450 randomly selected antenatal attendees at Mile Four Hospital, Abakaliki, Nigeria. The data were obtained using a pretested interviewer-administered structured questionnaire adapted from the maternal and neonatal health program handbook of the Johns Hopkins Program for International Education in Gynaecology and Obstetrics (JHPIEGO). The data obtained were analyzed using percentages, chi-square, and odds ratios. The level of significance is at P value < 0.05. Results. The birth preparedness and complication readiness index was 41.9%. Only 44.9% and 36.9% of the study population had adequate knowledge of birth preparedness (BP) and complication readiness (CR), respectively. Upper social class, lower educational level, urban residence, and less than 30 years of age were associated with increased odds of respondents having adequate knowledge of BP and CR (P > 0.05). However, only booking in the 1st or 2nd trimester was a significant determinant of the respondent's adequate knowledge of BP (AOR = 0.63 , 95% CI 0.40-0.98) and CR (AOR = 0.62 , 95% CI 0.39-0.97). Identification of transport and saving of money was the commonest birth plan while the commonest danger sign known to the participants was bleeding. Conclusion. This study revealed that knowledge of BP/CR is suboptimal. The determinant of this knowledge is antenatal booking. It is recommended that women should have adequate antenatal care education to improve their knowledge of BP/CR. This will help to increase the low BP/CR index seen in our study. [ABSTRACT FROM AUTHOR]

Introduction: Access to skilled maternal health services has been recognized as a panacea to poor maternal health outcome. However, poor access to skilled maternal health services prevail and this is worrisome because of the corresponding poor maternal health outcomes. This study examined women's status and access to maternal health services in primary healthcare facilities of North Ukelle. Methods: A cross sectional survey design was adopted for this study while a validated questionnaire with a reliability coefficient of 0.67 was administered to obtained data. A multistage sampling technique was used to select 390 women who had been pregnant within twenty four (24) months prior to the survey. Both descriptive and Chi square techniques were applied to analyze data using SPSS 21.0. Result: Findings from this study showed low access, as only 176(45.1%) accessed maternal care in the primary healthcare facilities. Decision for care was taken by husbands alone for 152(39%) respondents and the influence of low decision autonomy was conspicuous as husband's decision determined place of registration for maternal care in 254 (65.1%) respondents. Access to health facility based care increased with higher level of education. Interestingly, women involved in trading 72(18.5%) accessed care more than civil servants 43(11.0%). Chi square analysis showed no significant association between occupation and access. Conclusion: Based on these findings, free secondary education for the girl-child is suggested, as this will empower her to take healthcare decisions and negotiate care options. Flexible maternal care periods such as evenings and weekends should be adopted to accommodate working class women with tight time schedule. [ABSTRACT FROM AUTHOR]

Introduction: The occurrence of hypertension in people living with human immunodeficiency virus/ acquired immunodeficiency syndrome (PLWHA) on antiretroviral therapy (ART) is increasing. In Nigeria, where the national human immunodeficiency virus (HIV) prevalence is 1.4%, an estimated 700,000 PLWHA are on ART. We investigated the prevalence of hypertension and associated factors among adults on ART in Owo, Ondo State. Material and methods: A retrospective study with 300 PLWHA on ART in Federal Medical Centre, Owo, was conducted. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mm Hg and/or diastolic blood pressure (DBP) ≥ 90 mm Hg. Descriptive statistics were performed. Chi-square tests were used to identify associations between sociodemographic/clinical parameters and hypertension. Odds ratio and adjusted odds ratio were used to examine risk factors associated with hypertension. Results: The mean age of PLWHA was 38.3 years (SD, 10.4) and 33.7% were males. Median duration on ART was 6 years (range, 0.5-15). The prevalence of hypertension was 20.3%, with 25.7% in males and 17.5% among females. The prevalence of hypertension before commencing ART was 14.7% and 20.3% after ART was commenced (p = 0.043). Mean SBP was 110 ± 16 mm Hg before ART use and 118 ± 18 after utilization of ART (p < 0.001). Hypertension before commencing ART was associated with age of 38 years and above (OR: 2.7; 95% CI: 1.3-6.8). Amongst PLWHA, hypertension after commencing treatment was associated with being previously hypertensive (AOR: 9.2; 95% CI: 4.5-18.6). Conclusions: HIV treatment programs should include screening and management of hypertension. Screening and assessment of risk factors were directed at PLWHA diagnosed with hypertension before commencing ART, while routine check of blood pressure was evaluated at subsequent visits. [ABSTRACT FROM AUTHOR]

Background: Rivers State is among the states with high HIV prevalence in Nigeria. Occupational exposure to HIV through blood or body fluids of HIV/AIDS patients is a recognised risk factor of HIV infections among healthcare workers. We identified the determinants of occupational exposures to HIV among healthcare workers in Prevention of Maternal to Child Transmission (PMTCT) sites within Port Harcourt metropolis in Rivers State.Methods: A descriptive cross-sectional study was conducted and multi-stage sampling technique was used to select 341 healthcare providers from 22 public and 22 private health facilities in PMTCT sites in Port Harcourt metropolis. The data collected were analysed using descriptive statistics, Chi-square and logistic regression models (p-value = 0.05).Results: Respondents' mean age was 35.9 ± SD8.4 years, 270 (80.1%) and 171(50.7%) were females, and from public health facilities respectively. Prevalence of occupational exposure of healthcare workers to HIV in the past 12 months was 153 (45.0%), and 96 (63.3%) experienced such exposure more than once. Contacts with potentially infectious body fluid accounted for the largest proportion 51 (33.3%); followed by needle stick prick 49 (32.6%). About 189 (56.1%) had safety information at their disposal and this serves as a reminder on safety precautions. The likelihood of occupational exposure was significantly higher among doctors (AOR = 2.22, 95% C.I = 1.16-4.25,) but lower among environmental health workers (AOR = 0.10, 95% C.I = 0.02-0.46,) than nurses/midwives when other factors were included in the model.Conclusion: Occupational exposure to blood and body fluids remains a frequent occurrence among healthcare workers; highest among doctors in PMTCT sites in the study area. Provision of protective safety materials, training and enforcement of adherence to universal precaution strategies are highly recommended. [ABSTRACT FROM AUTHOR]

Background: In Nigeria, health maintenance organizations (HMOs) are the purchasers of health insurance with a social National Health Insurance Scheme for civil servants. However the roles of HMOs in implementation of social health insurance are not clear. This study determined the roles of HMOs in implementation of the national social health insurance scheme in Enugu, Southeast Nigeria. Methods: A partially mixed sequential dominant status design was employed in the study. Quantitative data were collected from 613 Federal Government employees that are registered with the National Health Insurance Scheme (NHIS) as part of the Formal Sector Social Health Insurance Program (FSSHIP) using an interviewer-administered questionnaire. Test for sampling adequacy was ensured (KMO, 0.701) and likewise the sphericity of the data using Bartlett's test (Chi [1] 796.72, p-value < 0.001). For the qualitative study, there was document review and in-depth interviews. A total of 28 in-depth interviews were conducted with key stakeholders comprising of managers of HMOs, NHIS manager, providers of health care and personnel in the State Ministry of Health among others. Thematic analysis was used for the qualitative data. Results: One-third (31.5%) of respondents said that roles of HMOs were very important, while 23% said that their roles were not important. More than half (57.70%) ranked HMOs very low in their roles, while 24.10% ranked them highest. Concentration index shows that the poor were satisfied (−.10), while the rich were highly satisfied (0.13) with roles of HMOs. The qualitative data analysis showed that most of the respondents were not satisfied with the roles of HMOs based on the themes that were developed and analyzed. Conclusion: There is clear understanding of the functions of HMOs among respondents in the study although they generally think that HMOs are not meeting the expectations of the scheme. There is need for the Federal Government through the National Health Insurance Scheme to provide more effective guidelines for HMOs, supervise and monitor the implementation of such guidelines for HMOs to improve on their roles. [ABSTRACT FROM AUTHOR]

Background: Maternal death remains a public health burden in the developing countries including Nigeria and the major causes are pregnancy related. Lack of male involvement in pregnancy related care is one of the contributing factors. Previous studies on male involvement focused on family planning services and were majorly targeted at women. This study, therefore, was carried out to assess the knowledge, perception and involvement of male partners in pregnancy related care among married men in Ibadan, Nigeria. Methods: A cross sectional study was conducted using a four-stage sampling technique to select 367 married men in an urban community in Ibadan. A semi-structured, interviewer-administered questionnaire was used to obtain information on the knowledge, perception and involvement of respondents regarding pregnancy related care. Responses to questions on knowledge of pregnancy related care were converted to a 33-point scale. Scores greater than or equal to the mean knowledge score (26.2) were categorized as good knowledge of pregnancy related care. Similarly, responses to involvement in pregnancy related care questions were converted to a 24-point scale with scores greater than or equal to the mean (15.1) classified as good involvement in pregnancy related care. Data were analyzed using descriptive statistics and association between qualitative variables was established using Chi-square test at p < 0.05. Results: Sixty-three percent had good knowledge of pregnancy related care. Majority believed that they had roles to play in their partners' care during pregnancy (89.9%), labor and delivery (92.9%), and in newborn care (97.5%). Overall, 56.9% had good involvement in pregnancy related care. About 20% followed their partners to antenatal care (19.6%) and postnatal (19.9%) clinics. A significantly higher proportion of respondents with good knowledge accompanied their partners for antenatal care (p = 0.008) and postnatal care clinic (p = 0.014); participated in birth preparedness (p < 0.001) and assisted with newborn care (p < 0.001). Job demands, social stigma and long waiting time at the health facilities were reasons highlighted for non-involvement in pregnancy related care. Conclusions: The study revealed gaps in knowledge and involvement in pregnancy related care. There is a need for reproductive health policy review to strongly emphasize the need for involvement of male partners in reproductive health issues including pregnancy related care. [ABSTRACT FROM AUTHOR]

Background: High nurse-patient ratios are burdensome for nurses and seem to be associated with shift work disorder. This study determined nurses' workload using nurse-patient ratios as indexes and examined the influence of workload burden on shift work disorder (SWD) among nurses. Methods: An ex-post facto design was utilized and was conducted in selected tertiary hospitals in Southwestern Nigeria. A multistage sampling technique was used to select 422 respondents. A structured questionnaire was used to collect data. Data was analyzed with SPSS Version 20. Results Mean of respondents working on the wards was 13 ±5.1; the average nurse-patient ratio was 1: 8 ± 6.4. Prevalence of symptoms predictive of SWD was (49.6%). More than half of the nurses (55.9%) had high workload, while (44.1%) had low workload. Workload was significantly associated with insomnia (χ² = 7.07, p = 0.001), and sleepiness (χ²= 5.77, p = 0.01) among nurses. Conclusion: The study concluded that nurses who had more patients to care for had more symptoms predictive of shift work disorder. [ABSTRACT FROM AUTHOR]

Objective: This project evaluated the outcomes of training high school students to deliver consumer health information to their peers. Methods: A total of 120 students selected from 7 high schools in Oyo state, Nigeria, received 8 hours of training on consumer health literacy and peer education, which is a process of training volunteers to deliver health information to their peers. The training included hands-on activities using the students' own mobile phones. After the training, peer educators distributed leaflets, showed consumer health information (CHI) websites to others, counseled and referred fellow students, and submitted forms describing these activities. All peer educators completed pre- and post-tests, and 10 were interviewed 4 months after training. Results: After the training, the authors found improvement in the trainees' knowledge of CHI resources and understanding of their roles as peer educators. Most peer educators (72.5%) delivered CHI to their peers after the training, primarily through sharing websites on teen health and other CHI resources. In the interviews, all peer educators reported direct benefits from participating in the project, and many stated that they knew where to find reliable health information. Conclusion: Volunteer high school students can be trained to deliver CHI to their peers using mobile phones. [ABSTRACT FROM AUTHOR]

In this study, a cross-sectional design was used to evaluate the prevalence of smoking and educational intervention on the knowledge of hazards of smoking among secondary school students in Ibadan. A multi-stage stratified sampling method involving stratification of the eleven Local Government Areas (LGA) in Ibadan into two; urban and semi-urban LGA. One LGA was selected from each stratum. Two secondary schools (one private and public) were selected from each LGA. A total of 516 registered Senior Secondary Schools (SSS) students in each school were selected for the study. A questionnaire consisting of modified core Global Youth Tobacco Survey (GYTS) and additional questions for assessment of knowledge of smoking in relation to chronic diseases were administered on the students. Participants were graded as poor or good knowledge on smoking. Educational intervention on hazards of smoking was carried out in the public school with highest prevalence and poorest knowledge of smoking. Data was entered into SPSS version 23 and analyzed using frequencies, means and Chi square test to evaluate difference between knowledge of health hazard of smoking among; smokers and non-smokers as well as between private and public schools. P-value < 0.05 was considered statistically significant. Prevalence of smoking among participant was 8.0%. The average age of initiation of smoking was 12.0 ± 3.9 years. Prevalence of smoking was significantly (p<0.001) higher (31, 75.6%) in male than female (10, 24.4%) and prevalence in public school (37, 90.2%) was found to be significantly (p <0.001) higher than private (4, 9.8%). Overall, 404 (78.3%) of respondents had poor knowledge of health hazard of smoking. The private schools' students showed good knowledge of the health hazards of smoking 106 (52.7%) compared to 143 (45.4%) students in public schools. There is a significant difference (p<0.05) in the level of knowledge of health hazard of smoking among smokers and non-smokers. Majority of the smokers are in public schools 37 (90.2%). The knowledge of health hazard of smoking among the students after the educational intervention showed that those with good knowledge improved by 10.6%. The study showed a high prevalence of smoking, poor knowledge of health hazard of smoking and a positive impact of an educational intervention on students' knowledge on health hazard of smoking. More awareness program and teaching of the students on health hazard of smoking is required. [ABSTRACT FROM AUTHOR]

Objective: The study determined the prevalence of flatfoot and also compared the foot anthropometric variables of both flatfooted and non-flatfooted primary school Children. Subject and Method: The study utilized a descriptive crosssectional research design and involved 1071(526 males and 545 females) public school pupils above six years. Foot anthropometry variables were obtained using measuring tape (foot length, ball girth, foot instep and heel circumference) and vernier caliper (forefoot width, mid-foot width and heel width). Flatfoot was diagnosed using Staheli Plantar Index, where values >1.15 indicates flatfoot. The prevalence of flatfoot was obtained using Chi-Square analysis, ANOVA was used to compare body anthropometry (weight, height and body mass index) with side of flatfoot (unilateral, bilateral and no flatfoot), while independent t-test was used to compare the foot anthropometric variables of children with flatfoot and those without flatfoot. Result: The prevalence of flatfoot was 14.75%. 64.3% of males and 71.6% of females have unilateral flatfoot while 30% of males and 41% of females have bilateral flatfoot. There was a significant association between higher prevalence of flatfoot and age with 6 and 7year old group showing the highest prevalence. There was a significant difference in foot length, forefoot width, heel width and heel Circumference on the right foot and significant difference in foot length and heel Circumference on the left foot between flatfoot and non-flatfoot children. Conclusion: Footwear manufacturers should consider anthropometric data of different foot types while manufacturing foot wears so as to minimizing foot pain, injuries and deformities. [ABSTRACT FROM AUTHOR]

Background The current trend of withdrawal of donor support for HIV/ AIDS treatment in Nigeria may require that the cost of antiretroviral drugs be borne in part by infected people and their families. Objective This study was conducted to determine the economic value for free antiretroviral drugs ( ARVs) expressed by clients receiving treatment for HIV/ AIDS in a tertiary hospital. Study method The contingent valuation method was used to elicit the values attached to free ARVs from people living with HIV/ AIDS that were receiving care in a public tertiary hospital in south-east Nigeria. Exit poll using a pre-tested questionnaire was undertaken with adult clients on treatment. The bidding game technique was used to elicit their willingness to pay ( WTP) for ARVs for themselves and members of their households. Ordinary least squares ( OLS) multiple regression analysis was used to test the construct validity of elicited WTP amounts. Results About a third of the respondents were willing to pay for a monthly supply of ARVs for themselves and household members. The mean WTP for monthly supply of ARVs for self was US$15.32 and for household member was US$15.26 (1 US$=₦160). OLS regression analysis showed that employment status and higher socio-economic status were positively associated with higher WTP. OLS showed that age and transport cost per clinic visit were negatively related to WTP. Knowing the risks of not adhering to treatment protocol was positively related to WTP. Conclusion The respondents positively valued the free ARVs. This calls for greater financial support for the sustainable provision of the treatment service. However, holistic financing mechanisms should be explored to ensure sustained funding in the event of complete withdrawal of donor support. [ABSTRACT FROM AUTHOR]

Background: Most of the recent reports on acquired heart diseases (AHDs) among Nigerian children are either retrospective or cover a short period of time with fewer subjects. The last report on AHDs among children in Lagos was about a decade ago; it was, however, not specific to children with AHDs but was part of a report on structural heart diseases among children in Lagos. The present study was carried out to document the prevalence and profile of different AHDs in children and to compare the findings with those previously reported. Methods: We conducted a quantitative, nonexperimental, prospective, and cross-sectional review of all consecutive cases of AHDs diagnosed with echocardiography at the Lagos State University Teaching Hospital between January 2007 and June 2016. Comparisons between the normally distributed quantitative data were made with the Student t test, while the χ² test was applied for the categorical data. Results: The subjects with AHDs were 73 males and 52 females, with a male-to-female ratio of 1.4:1. The children were aged 15 days to 14 years, with a mean of 6.61 ± 4.26years. Rheumatic heart disease was the most common AHD, documented in a quarter of the children, followed by dilated cardiomyopathy and pericardial effusion in 20.8% and 17.3%, respectively. Less common lesions encountered were Kawasaki disease, mitral valve prolapse, hyperdynamic circulation, and supraventricular tachycardia. Conclusion: Rheumatic heart disease was still the most common AHD in the children in the present study. Dilated cardiomyopathy and pericardial effusion are on the increase as has been reported earlier. [ABSTRACT FROM AUTHOR]

We aimed to compare plotting accuracy and interpretation of weight gain patterns in average and small infants on road-to-health (RTH) and the new World Health Organization (WHO) growth charts in Enugu, Nigeria. Child health staff plotted standard weights on both formats. Twelve plotted charts were created, permutating three different weight trajectories (fast, steady, and slow) ending at two attained weights (average and small), with each plotted on both chart formats. Respondents were shown four of these charts and asked to describe the weight gain pattern shown and what action this pattern would prompt. There were 222 respondents, of whom 78% were hospital based; 54% were nurses, 32% medical doctors, and 13% nutritionists. Plotting accuracy was good on both the WHO and RTH charts, but rating of weight gain was generally poor. On the RTH chart, slow weight gain was correctly recognized in only 19% average and 35% small infants, and responses were not significantly associated with the pattern shown. On the WHO charts, slow weight gain was correctly recognized in 40% average and 65% small infants ( p = .002 and <.001), but they were also more likely to rate small children with normal growth as slow weight gain. In a logistic regression model, final weight predicted a slow weight gain rating more strongly (OR = 2.4; 1.8-3.2) than an actual slow weight gain pattern (OR 1.8; 1.1-1.6). Health staff seemed unable to recognize slow weight gain and were influenced more by current weight than actual weight gain pattern, though the new WHO format improved recognition. [ABSTRACT FROM AUTHOR]

The article discusses the correlation of gender difference in the prevalence and sociodemographic factors of mobility disability among older adults in Nigeria. It examines the gender differences in mobility disability among older people and factors associated with gender differences in mobility disability in later life. It notes that the marginal effects of sociodemographic and health factors were stronger for women than for men.

Background: Majority of the oral diseases in children are preventable. The paediatricians owing to the unique position they occupy in child care are invaluable in achieving standard oral and dental healthcare in children. This study was aimed at assessing the paediatricians' views on basic oral healthcare in children in Nigeria. Methods: This was a cross sectional descriptive study. Respondents were paediatricians attending the 2015 Annual General Meeting and Scientific Conference of the Paediatric Association of Nigeria. Relevant information sought from the respondents included: socio- demographic characteristics, duration and location of practice; specific questions on knowledge of basic oral health care in children and recommendations for improvement in knowledge of oral and dental health among paediatricians based on standard clinical guidelines. Data was analyzed using the SPSS version 20.0 and presented in simple frequencies and percentages. Test of associations was done using chi- square while logistic regression analysis was used to determine significantly associated variables (p < 0.05). Results: A total of 121 paediatricians were recruited. 108 (89.3 %) reported that children should be referred to dental health care when caregivers/older patients report dental problems (χ² = 9.377; p = 0.02). 53.7 % felt that examination of the oral cavity should be routine while 61 (50.4 %) of them reported that health education should be given to caregivers/mothers about nursing caries starting early in life. Majority of the respondents 66 (54.5 %) disapproved gum pad cleaning of young infants. 32 (26.4 %) suggested starting tooth brushing in infants as soon as a tooth appear in a child while 112 (92.6 %) recommended the disapproval of pacifiers in infants/younger children. 93 (76.9 %) were of the opinion that the paediatrician is competent in identifying and handling of basic oral health care in children. However, 108 (89.3 %) recommended that the current postgraduate curriculum in paediatrics should incorporate knowledge of basic oral health care in children. Conclusion: Majority of the paediatricians were found to have limited knowledge about some basic oral health care in children. It is recommended that the current postgraduate training curriculum in paediatrics in our setting should incorporate knowledge of basic oral healthcare in children. [ABSTRACT FROM AUTHOR]

Suboptimal complementary feeding practices have a detrimental impact on a child's growth, health and development in the first two years of life. They lead to child malnutrition, which contributes to the high prevalence of stunting (38%) and underweight (28%) reported for children <5 years of age in Sub- Saharan Africa. This study analysed complementary feeding practices in four anglophone West African countries ( Ghana, Liberia, Nigeria and Sierra Leone) using the most recent Demographic and Health Surveys. The study covered 12 623 children aged 6-23 months from four anglophone West African countries ( Ghana: 822 children: Liberia: 1458 children, Nigeria: 8786 children and Sierra Leone: 1557 children). Four complementary feeding indicators were examined against a set of individual-, household- and community-level factors, using multiple regression analysis. Multivariate analyses found that lack of post-natal contacts with health workers, maternal illiteracy and geographical region were common determinants of delayed introduction of solid, semi-solid or soft foods across all four countries. Predictors for minimum dietary diversity, minimum meal frequency and minimum acceptable diet included children aged 6-11 months, administrative/geographical region, poorer household income and limited access to media. The authors recommend that the four anglophone West African countries studied should prioritise efforts to improve complementary feeding practices in order to reduce child morbidity and mortality. Interventional studies on complementary feeding should target those from poor and illiterate households. [ABSTRACT FROM AUTHOR]

E-wallet-powered Growth Enhancement Support Scheme was designed by the Nigerian Government to facilitate and improve farmers' prompt access to agricultural information and input services. An assessment of the pilot phase of the scheme becomes necessary for an effective implementation. The study therefore assessed the attitude of crop farmers towards the e-wallet platform of the Growth Enhancement Support Scheme. A total of 120 crop farmers across the study area were sampled through a simple random sampling method. Data were collected through a well-structured interview schedule, and analysed using percentages, PPMC and Chi-square. Farmers' mean age was 47 years. Majority were males, married and have an average of 15 years farming experience. Maize and cassava were the most grown crops. Majority indicated non commitment of the ADP and long distance to redemption centre as major constraints to use of e-wallet. More than half had favourable attitude towards the e-wallet platform of the Scheme. There is significant relationship between the years of farming and educational level with farmers' attitude towards the e-wallet. Constraints faced also had negative influence on attitude to the scheme. Establishment of more redemption centres to stop the rigor of long queues and reduce long distance covered before accessing the centres will make prompt access to information targeted by e-wallet achieve desired end. [ABSTRACT FROM AUTHOR]

Background: According to UNICEF, 40% of all under-5 deaths occur within the first month of life and half of these within the first few days of life. Many of these deaths are related to late recognition of neonatal illness, delays in decision to seek care at household level and subsequent late intervention at healthcare facilities. Knowledge of mothers about the danger signs in newborn is imperative to reduce these delays and preventable deaths. Aim: This study aimed to assess the perception of mothers and/or care givers of danger signs in newborns and their knowledge of the WHO recognized danger. A secondary aim was to explore the socio-demographic factors of mothers that influence knowledge of the WHO recognized danger signs and the health seeking behaviors of these mothers and/or care-givers. Methods: This was a community based descriptive and analytical study which used a multistage sampling technique to select 376 mothers and/or care-givers from four communities in 4 of the 17 Local Government Areas (LGA) of Enugu State. Logistic regression and chi-square was used in testing associations between variables. Results: Knowledge of more than three of the nine WHO recognized danger sign was poor (0.0-30.3%). Majority of the mothers had knowledge of one (i.e. fever) WHO recognized danger sign (95.2%). Knowledge of the WHO signs was not significantly associated with maternal socio-demographic variables considered in this study. Healthcare seeking behaviour was significantly determined by knowledge of at least one WHO recognized danger sign (OR 4.6 CI 1.1-18.7, P = 0.032). Cough, diarrhea and the excessive crying were the most perceived and experienced non-WHO recognized dangers signs among respondents. Conclusion: There is urgent need to strengthen the teaching and training of expectant mothers across all maternal socio-demographic variables on these danger signs and the most appropriate measures to take when they occur. [ABSTRACT FROM AUTHOR]

Background: This study aimed to identify the prevalence of oral co-morbidities in 8 to 16 years old children with Molar Incisor Hypomineralisation (MIH) and compare this with the prevalence of same oral lesions in children without MIH. Method: Study participants were selected through a multi-staged sampling technique. The children were asked if they had dentine hypersensitivity or any concerns about their aesthetics. Children were examined for MIH, caries, traumatic dental injury and their oral hygiene status. The association between MIH and each of the independent variables was determined. Results: Only children with MIH had aesthetic related concerns and dentine hypersensitivity. The differences in the oral hygiene status (p < 0.001) and caries prevalence (p < 0.001) of children with and without MIH were statistically significant. The prevalence of traumatic dental injury did not differ statistically between children with MIH and those without MIH (p = 0.24). Conclusion: Children with MIH had more oral pathologies than children without MIH. These co-morbidities (dentine hypersensitivity, aesthetic concerns, caries and oral hygiene) are capable of impacting negatively on the quality of life of the children. Screening for children with MIH may help facilitate prompt access to treatment. [ABSTRACT FROM AUTHOR]