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Plantain is one of the most important staple crops in Nigeria and has the potential to contribute to food security and economic development of the country. There is inadequate information on competitiveness, comparative advantage and effects of government policies on the commodity. The study therefore analyzed competitiveness and effects of government policies on plantain production systems in Southwestern Nigeria. Primary data were collected using structured questionnaire from 260 producers randomly selected from major production areas in the zone. Secondary data on port charges and world prices were also utilized. Data were analyzed using Policy Analysis Matrix (PAM). Results indicated that plantain production was privately and socially profitable in all the productions systems. Domestic resource cost ratio of 0.16 - 0.19 and social cost benefit ratio of 0.20-0.23 revealed that southwestern Nigeria had comparative advantage in the production of the commodity. The policy indicators and incentives structure such as the nominal protection coefficient on output (0.31-0.42) and input (1.02-1.04), effective protection coefficient (0.26-0.37), profitability coefficient (0.21- 0.32), subsidy ratio to produces (-0.51 to -0.62) and producers subsidy estimate (-1.70 to -2.02) showed that the producers were taxed and there exists transfers of resources from the systems. The study recommends formulation of policies which are consistent with the country's goals of agricultural transformation, food security and economic development. [ABSTRACT FROM AUTHOR]

In a free maternity care setting the number of antenatal clients can be overwhelming for the obstetric staff. Using the World Health Organization (WHO) classifying form, most of the women can be triaged for the basic component of the new WHO antenatal care model. Our aim was to evaluate the risk status of pregnant women in a tertiary health institution providing free maternity care in Nigeria. We interviewed1022 randomly selected clients using the WHO classifying form at our booking clinic over a 12-month period. The analysis was performed using the epi info statistical program. Seven hundred and sixty-five clients (74.9%)were found eligible for the basic component of the new antenatal care model. The associated risk in pregnancy increased with increasing parity. The basic component of the new WHO antenatal care model can safely be implemented in centres such as ours. [ABSTRACT FROM AUTHOR]

One thousand and thirteen (1013) symphysiotomies were performed and 27 477 deliveries were conducted during the period. The symphysiotomy rate in the study period was 3.7%. Fifty-six per cent (56%) of the patients who had symphysiotomy were aged 39 years and below, and the mean age was 27.94 ± 7.16 years. Mothers with maternal age greater than 40 years were at a higher risk for symphysiotomy. Thirty-eight per cent (38%) of those who had symphysiotomy were nulliparae, 35% were multiparae, while grandmultiparae accounted for 27%. Cephalopelvic disproportion was the leading indication for symphysiotomy (88%), while arrest of the after-coming head of the breech and previous caesarean section with mild cephalopelvic disproportion were other indications for symphysiotomy. Transient post-operative pelvic and leg pain was the leading maternal complication in the study, while stress incontinence, para urethra/vagina lacerations and vesico-vagina fistula were the other complications highlighted. In the study, 69% of the symphysiotomies performed were for babies with birth weight between 3.0 and 3.9 kg. The record of one maternal death was available and was from massive pulmonary embolism on the third day postpartum. There were 104 perinatal deaths with a perinatal mortality rate of 108.7 per 1000 total births. [ABSTRACT FROM AUTHOR]

Background: Sugar-sweetened beverages (SSBs) have become a global health concern because of their adverse health effects and their association with the obesity pandemic. It has not received much attention in sub-Saharan Africa, including Nigeria, especially among pregnant women. The pattern, frequency and factors associated with SSBs among pregnant women in Ibadan, Nigeria, were investigated., Design: Data were from the Ibadan Pregnancy Cohort Study - a prospective cohort study investigating 1745 pregnant women from four comprehensive obstetric facilities in Ibadan. A qualitative food frequency questionnaire (FFQ) was used to assess the pregnant women's intake of food and drinks over the previous months. Sugar-sweetened beverage variable and scores were also generated using the principal component analysis with varimax rotation. Factors associated with high SSB scores were examined using multivariate logistics regression analyses at a 5% significance level., Results: The most commonly consumed SSBs were cocoa-sweetened beverages, soft drinks, malt drinks, and fruit juice. A quarter of the women (75th percentile) consumed SSB more than once weekly. The factors associated with high SSB on multivariate analysis were; being employed (AOR: 1.52, 95% CI 1.02-2.26), maternal obesity (AOR: 0.065, 95% CI 0.47-0.89), high fruit intake (AOR:3.62, 95% CI 2.62-4.99), high green vegetable consumption (AOR:1.99, 95% CI 1.06-3.74), high milk intake (AOR: 2.13, 95% CI 1.65- 2.74), frequent fast food outlet visit (AOR: 2.19, 95% CI 1.53-1.70), all of these remained significant after adjusting for confounding variables., Conclusion: SSBs were common among our study population. Factors associated with high SSBs intake are crucial for implementing locally relevant public health interventions., (© 2023. The Author(s).)

Background: The COVID-19 pandemic has impacted the world negatively with huge health and socioeconomic consequences. This study estimated the seasonality, trajectory, and projection of COVID-19 cases to understand the dynamics of the disease spread and inform response interventions., Method: Descriptive analysis of daily confirmed COVID-19 cases from January 2020 to 12 th March 2022 was conducted in four purposefully selected sub-Saharan African countries (Nigeria, Democratic Republic of Congo (DRC), Senegal, and Uganda). We extrapolated the COVID-19 data from (2020 to 2022) to 2023 using a trigonometric time series model. A decomposition time series method was used to examine the seasonality in the data., Results: Nigeria had the highest rate of spread (β) of COVID-19 (β = 381.2) while DRC had the least rate (β = 119.4). DRC, Uganda, and Senegal had a similar pattern of COVID-19 spread from the onset through December 2020. The average doubling time in COVID-19 case count was highest in Uganda (148 days) and least in Nigeria (83 days). A seasonal variation was found in the COVID-19 data for all four countries but the timing of the cases showed some variations across countries. More cases are expected in the 1 st (January-March) and 3 rd (July-September) quarters of the year in Nigeria and Senegal, and in the 2 nd (April-June) and 3 rd (October-December) quarters in DRC and Uganda., Conclusion: Our findings show a seasonality that may warrant consideration for COVID-19 periodic interventions in the peak seasons in the preparedness and response strategies., (© 2023. The Author(s).)

Background: Unprescribed and herbal medicines use among pregnant women is a public health concern in low and middle-income countries because of the potential teratogenic effects, insufficient safety and weak drug regulatory systems. Unprescribed and herbal medicines are common among pregnant women in Nigeria, and only a few researchers have documented the prevalence and the risk factors. However, evidence on the associated pregnancy outcomes is still lacking. We assessed the prevalence, predictors and pregnancy outcomes of unprescribed and herbal medicines use among pregnant women in Ibadan, Nigeria., Methods: This study was a component of the Ibadan Pregnancy Cohort Study, a prospective cohort study, among pregnant women in Ibadan, Nigeria, who were enrolled at ≤ 20 weeks gestation at their first antenatal visit and followed up till delivery. In all, 571 women participated in the maternal drug use assessment during the third trimester using a pretested interviewer-administered questionnaire. The primary outcomes were unprescribed and herbal medicines use and pregnancy outcomes, secondary outcomes, were abstracted from medical records. The predictors assessed included sociodemographic, obstetric, antenatal care utilization, and lifestyle characteristics. Bi-variate logistic and Poisson regression analyses were used to evaluate the predictors and relative risk for the pregnancy outcomes of unprescribed and herbal medicines at 5% significance., Results: The prevalence of unprescribed and herbal medicine use was 31.9% and 21.7%, respectively. On bivariate analysis, the significant predictors of unprescribed medicine (which were protective) were tertiary education, increasing income, adequate antenatal care (≥ 4 visits), and at least two doses of sulfadoxine-pyrimethamine. However, high parity and having an antenatal admission increased the risk. However, after adjusting for confounders, the significant factors associated with unprescribed medicines were; tertiary education (AOR) = 0.23; 95% CI: (0.06 - 0.95); p-value: 0.043] and obtaining at least two doses of sulfadoxine-pyrimethamine [AOR = 0.33; 95% CI: (0.29 - 3.60); p-value: 0.048]. For herbal medicines, the predictors were similar to unprescribed drugs. However, after adjusting for confounders, none was significant for herbal medicines. Unprescribed and herbal medicines were not significantly associated with pregnancy outcomes., Conclusions: Unprescribed and herbal medicines use were common among pregnant women in Ibadan, Nigeria, particularly among women with low economic status and those with poor utilization of antenatal care services. These significant predictors can be targeted for public health intervention. Specifically, health education that discourages the use of unprescribed and herbal medications to pregnant women during antenatal care., (© 2023. The Author(s).)

Introduction: Hepatitis B virus (HBV) infection is hyper-endemic in Nigeria. Prisons are high-risk environments for the spread of infectious diseases. Worldwide, seroprevalence of HBV infection is substantially higher among individuals in correctional facilities when compared to general population. We determined the seroprevalence and risk factors associated with HBV infection among Kuje prison inmates, Nigeria., Material and Methods: We conducted a prison facility based cross-sectional study. Interviewer administered questionnaires were used to obtain information on participants socio-demographic characteristics, HBV risk factors, previous HBV test and vaccination history. Blood samples collected from participants were analysed for HBsAg, HBsAb, HBcAb, HBeAg and HBeAb markers using rapid lateral chromatographic immunoassay kit. Univariate, bivariate, and multivariate analysis were performed., Results: A total of 271 inmates (63 convicts and 208 awaiting trial inmates) were recruited into the study as participants. The mean age of the participants was 32.7 SD±9 years. HBV seroprevalence (HBsAg) of 13.7% (95% CI: 9.8-18.3) was found. 55.4% (95% CI: 49.2-61.4) of inmates were susceptible to HBV infection, 20.7% (95%CI; 16.0-26.0) had past HBV infection while 10.3% (95% CI: 7.0-14.6) had acquired natural or artificial HBV immunity. Factors found to be associated with current HBV infection (HBsAg) include age-group ≤25years (aOR = 8.0,95% CI: 2.9-22.3), being ever married (aOR = 4.2, 95% CI: 1.7-10.4) and history of alcohol consumption (aOR = 3.4, 95% CI: 1.3-8.4)., Conclusion: This study reveals a high seroprevalence of HBV infection among Kuje Prison inmates, hence the need to introduce prison-focused health intervention initiatives such as HBV screening, vaccination and care to reduce the transmission of HBV infection among inmates and ultimately the general population., Competing Interests: The authors have declared that no competing interests exist.

Objectives: The aim of this study was to compare the success rates of transvaginal retropubic urethropexy with fascia lata pubovaginal sling (PV sling) for treatment of postrepair urinary incontinence at a fistula center in Nigeria., Methods: This was a retrospective review of 60 patients who had transvaginal retropubic urethropexy and 46 patients who had PV sling on account of postrepair incontinence at National Obstetric Fistula Centre, Abakaliki, Nigeria, between January 2014 and December 2016. Data were retrieved from the hospital records. Success was defined as negative urinary stress test at 3 months after repair. Data were analyzed with SPSS version 20, and P value <0.05 was taken as statistically significant. χ was used to determine the association between the procedures and success rate., Results: The success rate of transvaginal retropubic urethropexy versus PV sling was 53.3% versus 82.6% (χ = 9.95, P = 0.02). Complications occurred in 13.2%., Conclusions: In conclusion, the efficacy of the fascia lata PV sling was more than that of transvaginal retropubic urethropexy for postrepair urinary incontinence. Urodynamic assessments need to be incorporated into management of these women for better patient's selection for each procedure.

Introduction and Hypothesis: Management of a recurrent urogenital fistula is very challenging and requires experienced surgeons. The aim of this study was to describe the characteristics, success rates, and associated factors related to surgical repairs of patients with recurrent urogenital fistulas by an experienced team at a fistula centre in Nigeria., Methods: This was a retrospective cohort study of 154 patients that had repeat urogenital fistula repairs at the National Obstetric Fistula Centre, Abakaliki, Nigeria, between January 2014 and December 2016. Information was retrieved from their hospital records. Successful repair was defined by continent status at 3 months after repair. Data were analyzed with SPSS version 20 by IBM Inc., and p < 0.05 was taken as statistically significant. Chi-square test was used to determine the association between the factors and successful repair., Results: The mean age was 36.27 ± 12.96 years. Obstetric fistula occurred in 92.2% of the patients. The success rates for the first, second, third, and fourth repeat repairs were 68.8%. 56.2%, 50%, and 0% respectively. Significant factors were the number of previous attempts at repair (χ 2  = 20.44, p = 0.002), age group (χ 2  = 16.95, p = 0.03), Waaldijk's classification (χ 2  = 13.31, p = 0.04), duration of fistula (χ 2  = 19.6, p = 0.03), surgeons' experience (χ 2  = 7.11, p = 0.04), and place of previous attempt at repair (χ 2  = 6.35, p = 0.02). There were no complications in 86.4%., Conclusions: The success rate was good. Patients who had previous failed repairs at the fistula centre had better outcomes after the repeat surgeries. Centralizing fistula care will enhance optimal outcomes. It may also boost training and research in this specialty.

Introduction: open excisional breast biopsy is a known modality for treatment of breast lumps especially in developing countries. Other sophisticated methods are available for management of breast lumps in more advanced nations. Our aim in this study was to review the outcome of open excision breast biopsies in our setting with a view to improving patient management., Methods: this study was conducted at the National Obstetric Fistula Centre, Abakaliki, South East Nigeria among women who had excision breast biopsy between January 2015 and December 2016. Data was analysed using Statistical Package for Social Sciences (SPSS), version 21., Results: a total of 107 case folders were reviewed in this study. The mean age of the women was 27 ± 10 years. Overlying breast incision was the preferred route in 78(72.9%), periareolar incision in 28(26.2%), and Gillard Thomas's method (infero-lateral submammary sulcus incision) used in one patient with bilateral multiple breast lumps (0.9%). The complications recorded in this study were haematoma in 3(2.8%), wound infection in 5(4.7%) and wound breakdown in 1(0.9%). Hypertrophic scar was found in 2(1.8%) patients at follow-up. Overall, most patients were satisfied with the aesthetic outcome of their surgery., Conclusion: open excision breast biopsy is a useful modality for management of breast diseases in our setting. Complication rates are minimal. Both overlying and periareolar breast incisions results in aesthetically satisfactory scar in our practice. Inferior-lateral sub mammary sulcus skin incision is useful when the lumps are multiple and located at different quadrants of the breast. Appropriate use of drain helps to reduce the incidence of haematoma., Competing Interests: The authors declare no competing interests.

Introduction: Ureteric fistula is one of the major morbidities that can arise from pelvic surgeries. It mainly results from gynaecological and obstetric procedures. Intravenous urography is an imaging modality for the upper urinary tract. Its features may be suggestive of ureteric fistula and it is of great value when medicolegal issues arise. It is however expensive and requires expertise. There are other useful and cheap methods for evaluating ureteric fistula including the use of dye test. There is need to determine if IVU (Intravenous urography) should be recommended for women with this disease. The aim of this study was to determine the features of intravenous urography among women with ureteric fistula and therefore determine its relevance in the management of such patients., Methods: This was a retrospective study conducted at the National Obstetric Fistula Centre, Abakaliki between January 2012 and March 2017. All patients with ureteric fistula during the study period who were assessed with intravenous urography before surgery were included in this study., Results: The mean age was 38 ± 16 years. Twelve (92.3%) were Christians. IVU showed hydroureters in 46.15% hydronephrosis in 53.85%, non-functioning kidney in 46.15% and ureteric stricture in 7.69%. IVU gave an insight into the side with ureteric fistula except in one who had normal result., Conclusion: Hydronephrosis, hydroureters and silent (non-functioning) kidneys are features of IVU in women with ureteric fistulas, however these features are not pathognomonic for the disease.

Diabetes Mellitus (DM) is one of the diseases of public health concerns of the 21st century with rising burden in developing countries. The evaluation of care for diabetes from patients' perspective an important indicator of measuring quality of health services and improving treatment approaches but data of the nature are scarce in Nigeria. The study therefore investigated Patients' Evaluation of the Quality of Diabetes care (PEQD) in Ibadan. This descriptive cross-sectional study recruited 384 diabetic patients from three hospitals where specialised services are offered in Ibadan. A semi-structured pre-tested questionnaire was used to collect data. A 42-point PEQD questionnaire scale was used to collect data and a score of >21 was rated as good Perceived Quality of Care (PQC). Data were analysed using descriptive statistics, chi-square test and logistic regression set at 5% level of statistical significance. Mean age of respondents was 62.5 + 10.8 years and mean diabetes duration was 8.4 + 7.6. Majority (58.3%) of the respondents didn't know the type of diabetes they had. Patients aged less than 60 years were less likely to PQC received as good (OR: 0.21; CI: 0.05 - 0.91) compared to those who were above 60 years. More than half (55.0%) of the respondents perceive quality of care as good. Patients' assessment of the quality of diabetes care received was perceived good. There is need to sustain current satisfactory services in diabetic care and institutionalize periodic survey patients' satisfaction to provide feedback for future quality improvement.

Objective: To examine the occurrence of bladder spasms following surgical repair of urogenital fistula., Methods: The present retrospective study included data from patients who underwent surgical repair of urogenital fistula at the National Obstetric Fistula Centre, Abakaliki, Nigeria, between June 1, 2015, and May 31, 2016. Patients who underwent rectovaginal fistula repair and those who experienced persistent postoperative pain requiring high doses of analgesia were excluded. Bladder spasm was defined as the sudden onset of intermittent pain in the region of the bladder lasting for short periods of time in patients who were previously comfortable with routine postoperative analgesia. The incidence of bladder spasm was calculated and the presence of an association between repair outcome and bladder spasms was investigated., Results: There were 133 patients included in the present study with a mean age of 36 ± 11 years. Bladder spasms were experienced by 60 (45.1%) patients during the study period; of these patients, failed fistula repair was recorded for 13 (22%). Good surgical outcome (closed fistula) was associated with not experiencing postsurgical bladder spasms (P=0.044)., Conclusion: The incidence of bladder spasm following surgical repair of urogenital fistula appeared high. The occurrence of bladder spasms could influence repair outcomes., (© 2017 International Federation of Gynecology and Obstetrics.)

Background: Duration of bladder catheterisation after female genital fistula repair varies widely. We aimed to establish whether 7 day bladder catheterisation was non-inferior to 14 days in terms of incidence of fistula repair breakdown in women with simple fistula., Methods: In this randomised, controlled, open-label, non-inferiority trial, we enrolled patients at eight hospitals in the Democratic Republic of the Congo, Ethiopia, Guinea, Kenya, Niger, Nigeria, Sierra Leone, and Uganda. Consenting patients were eligible if they had a simple fistula that was closed after surgery and remained closed 7 days after surgery, understood study procedures and requirements, and agreed to return for follow-up 3 months after surgery. We excluded women if their fistula was not simple or was radiation-induced, associated with cancer, or due to lymphogranuloma venereum; if they were pregnant; or if they had multiple fistula. A research assistant at each site randomly allocated participants 1:1 (randomly varying block sizes of 4-6; stratified by country) to 7 day or 14 day bladder catheterisation (via a random allocation sequence computer generated centrally by WHO). Outcome assessors were not masked to treatment assignment. The primary outcome was fistula repair breakdown, on the basis of dye test results, any time between 8 days after catheter removal and 3 months after surgery. The non-inferiority margin was 10%, assessed in the per-protocol population. This trial is registered with ClinicalTrials.gov, number NCT01428830., Findings: We randomly allocated 524 participants between March 7, 2012, and May 6, 2013; 261 in the 7 day group and 263 in the 14 day group. In the per-protocol analysis, ten (4%) of 250 patients had repair breakdown in the 7 day group (95% CI 2-8) compared with eight (3%) of 251 (2-6) in the 14 day group (risk difference 0·8% [95% CI -2·8 to 4·5]), meeting the criteria for non-inferiority., Interpretation: 7 day bladder catheterisation after repair of simple fistula is non-inferior to 14 day catheterisation and could be used for management of women after repair of simple fistula with no evidence of a significantly increased risk of repair breakdown, urinary retention, or residual incontinence up to 3 months after surgery., Funding: US Agency for International Development., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: A vaginal fistula is a devastating condition, affecting an estimated 2 million girls and women across Africa and Asia. There are numerous challenges associated with providing fistula repair services in developing countries, including limited availability of operating rooms, equipment, surgeons with specialized skills, and funding from local or international donors to support surgeries and subsequent post-operative care. Finding ways of providing services in a more efficient and cost-effective manner, without compromising surgical outcomes and the overall health of the patient, is paramount. Shortening the duration of urethral catheterization following fistula repair surgery would increase treatment capacity, lower costs of services, and potentially lower risk of healthcare-associated infections among fistula patients. There is a lack of empirical evidence supporting any particular length of time for urethral catheterization following fistula repair surgery. This study will examine whether short-term (7 day) urethral catheterization is not worse by more than a minimal relevant difference to longer-term (14 day) urethral catheterization in terms of incidence of fistula repair breakdown among women with simple fistula presenting at study sites for fistula repair service., Methods/design: This study is a facility-based, multicenter, non-inferiority randomized controlled trial (RCT) comparing the new proposed short-term (7 day) urethral catheterization to longer-term (14 day) urethral catheterization in terms of predicting fistula repair breakdown. The primary outcome is fistula repair breakdown up to three months following fistula repair surgery as assessed by a urinary dye test. Secondary outcomes will include repair breakdown one week following catheter removal, intermittent catheterization due to urinary retention and the occurrence of septic or febrile episodes, prolonged hospitalization for medical reasons, catheter blockage, and self-reported residual incontinence. This trial will be conducted among 512 women with simple fistula presenting at 8 study sites for fistula repair surgery over the course of 24 months at each site., Discussion: If no major safety issues are identified, the data from this trial may facilitate adoption of short-term urethral catheterization following repair of simple fistula in sub-Saharan Africa and Asia., Trial Registration: ClinicalTrials.gov Identifier NCT01428830.

Purpose: This analysis attempts to highlight the varied presentations, diagnostic difficulties, management and subsequent obstetric performances of women managed for advanced abdominal pregnancy., Methods: A retrospective analysis of all 20 cases of abdominal pregnancies between 1976 and 2006, at the Mater Misericordiae Hospital, Afikpo, southeastern Nigeria was performed., Results: There were 20 cases of abdominal pregnancy out of 58,000 deliveries, giving an incidence of 0.34 per 1,000 deliveries. The diagnoses were missed in 10 cases and there was one maternal death. There were four live births, two early neonatal deaths and four cases of lithopedion. The placenta was removed in 11 cases. Though the duration of hospital stay was longer in women in whom the placenta was left in situ compared to those in whom the placenta was removed, the observed difference was, however, not statistically significant (p value, 0.538). The majority of the women were lost to follow-up over the years; however, of the five women successfully followed up, only two (40%) had subsequent childbirth., Conclusion: The rate of 50% missed diagnosis in this study highlights the need for a high index of suspicion in the diagnosis of abdominal pregnancies as the clinical features are varied. It calls for vigilance on the part of the obstetrician. The maternal and fetal outcomes relate to early diagnosis and skilled management.

This study aimed at determining the knowledge and perception of physicians in Nigeria on abortion related deaths, and also to find out if they will support the liberalization of abortion as a means of reducing deaths from unsafe abortion. Physicians' willingness to offer abortion services was also explored. A self-administered questionnaire was distributed to a convenience sample of physicians in Delta state of Nigeria. Physicians were equally divided on whether legal liberalization of abortion would significantly reduce maternal mortality in Nigeria. Only 13.4% of the doctors were willing to offer abortion services if legally liberalized. The majority of the doctors considered promoting abstinence from pre-marital sex and contraceptive use as best effective strategies for reducing abortion-related deaths. However, liberalization of abortion law in Nigeria was not considered a very effective strategy.

Objectives: This study is aimed at determining the pattern of abnormalities in the Hysterosalpingograms of patients who attended the Radiology Unit of Ebonyi State University Teaching Hospital, Abakaliki., Method: The 188 hysterosalpingograms conducted between January 2002 to December 2005 were analysed.., Results: The mean age in this study was 31 years. Forty-one (21.8%) Hysterosalpingograms were normal. Abnormality of the Fallopian tubes constituted 54.6% of all abnormalities recorded, uterine 33.6% and cervical 11.8%. Cornual occlusion and hydrosalpinx were the leading abnormalities of the Fallopian tube, 32.2% and 20.3% respectively, while beading of the Fallopian tubes was the least tubal abnormality recorded in 1.4%. Uterine fibroid was the leading uterine abnormality in the study (44.5%), and uterine unicornis unicollis and bicornuate uterus were the least abnormalities of the uterus recorded with 0.8% respectively. Cervical synechiae was the only cervical abnormality recorded in the study (11.8%)., Conclusion: Hysterosalpingogram is relevant in outlining abnormalities of the fallopian tube and uterus especially in patients with infertility. The study suggests that abnormalities of the Fallopian tube are probably still a prominent contributor to infertility in our community.

Context: The recommended WHO antenatal focused visits with reduced number of visits and tests is yet to be implemented in many communities in rural Nigeria., Aim: This paper evaluated the attitude of antenatal clients in a rural mission hospital to the new antenatal model., Study Design: Focus group discussions were carried out bi-weekly for 12 weeks with consenting booked antenatal clients. The topic guide was developed following interactions with prenatal clients at a referral tertiary center., Results: One hundred and forty-four clients were interviewed. Prior to discussion, none had heard of the new antenatal care model. More than half of them will prefer the traditional policy with multiple visits to the new model. The traditional visit was said to be more reassuring and provides the clients time away from their routine chores/occupations and afford them the opportunity to interact with other expectant mothers and get acquainted with the health care providers., Conclusion: To realize the goals of the new WHO recommended antenatal model in rural Nigeria, mass enlightenment and education must precede its gradual and cautious introduction.