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Background: Although much is known about the rapidly spreading COVID-19 disease, a lot of knowledge is still evolving. The knowledge, attitude and practice (KAP) of healthcare workers (HCWs) towards COVID-19 remain key in protecting themselves and in fighting the “war” against the disease. This study assessed the KAP of HCWs in Kano, northern Nigeria. Methodology: A cross-section of different cadre of healthcare workers was recruited online via google forms. Using a link, the participants completed an adapted from a similar study, pre-tested questionnaire on KAP regarding COVID-19. Predictors of KAP were assessed using logistic regression modelling. Results: Among the 651 HCWs invited to participate, 233 respondents responded giving a response rate of 35.8%. Of these, 195 (83.7%) had good knowledge, 183 (78.9%) had a positive attitude and 180 (77.6%) had good practice towards prevention of COVID-19. The odds of having good knowledge were significantly lower among Community Health Officers/Community Health Extension workers (aOR=0.2, 95% CI: 0.1-0.6;p

Haemoglobinopathies is a collective term used for inherited disorders of haemoglobin synthesis. Individuals with sickle cell disease can be homozygote SS (HbSS), heterozygotes SC (HbSC) and heterozygotes S-beta thalassaemia (HbS beta thalassaemia). The homozygous state (HbSS) is referred to as sickle cell anaemia (SCA). Worldwide, SCD is one of the most common inherited single gene autosomal recessive genetic disorders. Approximately, 150,000 Nigerian babies with HbSS are born yearly, one of the highest in the world. Pregnancy in SCD is a high-risk pregnancy especially in homozygous HbSS which may be associated with adverse maternal and foetal outcome. This chapter describes the pathophysiology of SCD. Additionally, it describes the complications and management of SCD in pregnancy as well as preventive measures. Management of sickle cell disease in pregnancy in low and middle resource countries like Nigeria is saddled with a lot of challenges, as a result of which it is associated with high morbidity and mortality for both the mother and the foetus. Preconception care, quality antenatal, intrapartum, postpartum and family planning services, using a multidisciplinary approach, are all essential in ensuring improved outcomes for both mother and baby.

Breech presentation is defined as polar alignment of fetus in which the fetal buttocks or feet present at the maternal pelvic inlet. Breech is the most common malpresentation in pregnancy, incidence is high before term but occur in 3-4% of term pregnancies. There is increased perinatal morbidity and mortality with breech presentation which has been linked to the prematurity, birth asphyxia due to cord accidents, congenital abnormalities, birth trauma and mode of delivery. This study was aimed at determining the incidence and outcome of breech deliveries at Aminu Kano Teaching Hospital, Nigeria. It was a retrospective analysis of breech deliveries at Aminu Kano Teaching Hospital over a 2-year period. Information was obtained from the labor ward register, theatre register and the case notes of the mothers. There were 6658 deliveries during the period of the study, out of which 154 had breech deliveries. The incidence of breech deliveries during the period under study was 2.31%. The age of the patients ranged from 17-45 years. Parity ranged between 0-11. There were more breech deliveries in the multipara (59.5%) than in primigravidae (14.9%) and primipara (25.6%).However, there was no significant difference in the perinatal outcome between the groups (P=0.054). Deliveries were mostly through caesarean section (62%), while 38% were through assisted vaginal breech. There were 113 live births and 8 still births. This study has shown that the incidence of breech is slightly lower than in many studies, and breech deliveries were mostly unplanned and more among multiparae. The neonatal outcomes in the planned breech deliveries were excellent. Birth asphyxia and stillborn were found more in the unplanned and unbooked cases with breech.

A crucial element in the delivery of high-quality health care is patient safety. The rate of adverse events among hospital patients is an indication of patient safety. A systematic review of in-hospital adverse events revealed the median incidence of adverse events as 9.2%; 7.4% were lethal and 43.5% preventable. All the studies in the systemic review were from developed countries, as research is lacking from developing countries. In 2012, data from 10 developing countries reported adverse events ranging from 2.5 to 18.4% per country; 30% were lethal and 83% preventable. This study places patient safety as one of the major concerns of the health policy agenda in developing countries. Human resources for health deficits in developing countries constitute a major structural constraint for ensuring patient safety. The key to reducing adverse events in health care is system-based interventions rather than clinical interventions or technologies. Patient safety skills training, effective communication, and good team work are essential in improving patient safety in developing countries. Research on patient safety is needed to address the knowledge gap in developing countries.

The study investigated the effectiveness of sublingual misoprostol when used as primary treatment of primary post-partum hemorrhage (PPH) in a low-income country.Maternity care providers in three Nigerian hospitals administrated 800 μm sublingual misoprostol to women experiencing PPH. The outcome variables were estimated blood loss and the need for additional uterotonic drugs after initial treatment with misoprostol. Entry criteria included women in term spontaneous labor, while exclusion criteria were women with operative delivery and those experiencing PPH not due to atonic uterus.One hundred and thirty-one women with PPH were treated over 6 months. Estimated blood loss ranged 500-2500 mL. Twenty women (15.3%) required additional uterotonic drugs to control continuing blood loss. There were no maternal deaths, while seven perinatal deaths were recorded.We conclude that although sublingual misoprostol is effective in reducing blood loss due to PPH, it does not effectively treat all forms of PPH. Additional uterotonics and other ancillary treatments would be required.

Nigeria is a huge African country, home to 20% of Africans, with a population of about 140 million people (National Population Commission 2006). It also has a high fertility rate, although the 2003 Nigerian Demographic and Health Survey (NDHS 2001) shows a slight decline in the total fertility rate. Fertility also varies by region. In the South women have 4.1 children on average, compared to 7.0 children in the Northeast and 6.7 in the Northwest (NDHS 2003). In spite of this high premium given to childbirth in Nigeria, it is still a challenge for the majority of our women, with an unacceptably high maternal and neonatal mortality rate. The maternal mortality rate is estimated to be 800/100,000 live births (NDHS 2001). While this is lower than the sub-Saharan Africa average of 910/100,000, wide variation exists across the geopolitical zones.