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BackgroundCivil society organizations (CSOs) are important in health care delivery. They have the potential to play significant roles in immunization-related services, such as advocacy, health education, demand creation and resource mobilization. Their roles are often indispensable, diverse and beneficial in reducing infant morbidity and mortality due to vaccine-preventable diseases. This study explored the potential barriers to and facilitators of CSO engagement in increasing immunization coverage in Odukpani Local Government Area of Cross River State, Nigeria.MethodsThe study adopted qualitative data collection methods. Twenty-two focus group discussion (FGD) sessions, three in-depth interviews (IDIs) and 26 key informant interviews (KIIs) were conducted. Appropriate guides (FGD guide, IDI guide and KII guide) were used to conduct face-to-face interviews and the discussions. The FGDs, KIIs and IDIs were audio-recorded and transcribed. A framework analysis approach involving five key stages of analysis (familiarization with data, identification of thematic framework, indexing, charting, mapping/interpretation) was used for data analyses and presentation.ResultsCSOs encounter barriers in the course of their immunization advocacy, communication and social mobilization due to male child preference, leading to shielding of male children and not allowing them to be given immunization, as well as patriarchy, safety concerns, religious concerns, anti-vaccine misinformation and rumours, low perception of effectiveness and efficacy of vaccines, inaccessibility of localities, low health literacy and superstitious beliefs. Various community structures, such as the institution of the village head, elders’ council and town crier (announcer), and the existence of change agents, act as facilitators of immunization advocacy and uptake. Factors such as traditional control mechanisms including masquerades and religion act as either barriers or facilitators depending on the community and the mode of deployment. CSO members are willing to overcome these barriers and leverage the facilitators.ConclusionsFor successful engagement in immunization-related services, there are barriers in the study area that CSOs should overcome, such as male child preference and geographic inaccessibility, as well as facilitators that they should leverage such as traditional information dissemination systems and enforcement of compliance by the chiefs and elders’ council.

Background: With maternal mortality ratio of 2,000/100,000 live births and perinatal mortality rate of 40/1,000 total births, Cross River State is one of the states with the highest maternal and perinatal deaths in Nigeria. One of the causes of these poor health indices is low utilization of facility-based maternal and child healthcare services during pregnancy and childbirth. Objective: To assess the predictors of utilization of antenatal care and delivery services in Akpabuyo, a rural community in Cross River State of Nigeria. Method: This was an analytical cross-sectional survey. Data were collected from 370 pregnant women between June and July, 2013 and analyzed using SPSS version 25. Results: Binary logistic regression showed that compared with women with tertiary education, women with non-formal education were less likely to attend antenatal clinic (AOR=0.510, 95% CI=0.219-1.188) although the difference was not statistically significant. Also, compared with farmers, full-time housewives were less likely to deliver in a health facility (AOR=0.650, 95% CI=0.305-1.389) while civil servants were nearly five times more likely to deliver in the health facility (AOR=4.750, 95%CI=1.616-13.962). Conclusion: The predictors of antenatal care and facility delivery services utilization identified by the study were educational status and occupation. This raises the need for policies and programmes to ensure girl child education and the economic empowerment of women. Keywords: Maternal; Perinatal; Mortality; Child healthcare; Antenatal care; Delivery.

Background: Ebola virus disease has a high case fatality rate. Health care providers have a key role to play in its management and prevention. Objectives: The aim of this study was to determine the knowledge, attitude and practice regarding Ebola virus disease (EVD) among students of Nursing in the University of Calabar, Calabar, Nigeria. Methods: This was a descriptive cross-sectional study. A semi-structured,self-administered questionnaire was administered to 178 nursing students. The respondents were selected using systematic random sampling. Results: Lecturers were the commonest source of information regarding EVD as reported by 84.5% of the respondents followed by television (76.3%). Nearly 27% of respondents indicated that the fear of EVD had dampened their interest and enthusiasm in the nursing profession. Nearly 12 % indicated that they would not take part as theatre nurses in the surgical operation of a patient who had been certified cured of EVD. A similar proportion indicated their unwillingness to attend to a woman in labour even if she had been certified cured of EVD. Conclusion: Majority of the students were knowledgeable about EVD. Although majority of them had favorable attitude towards EVD patients, there was evidence of stigmatizing and discriminatory attitude that needs to be addressed. Keywords: Ebola, infection, virus, disease, haemorrhagic, fever, Nigeria.