Determinants of contraceptive use among women attending antenatal care at Federal Teaching Hospital Abakaliki, Nigeria

Background: Contraception is of immense relevance in reproductive health. It is also one of the effective strategies towards improving maternal health. This study was designed to determine the awareness and use of contraceptives among women attending antenatal care at Federal Teaching Hospital Abakaliki, Nigeria.Method: A descriptive cross sectional study design was used. Systematic random sampling technique was used to select 415 women receiving antenatal care at the facility. Information was obtained using a pre-tested, interviewer- administered questionnaire. Data analysis was done using Statistical Package for Social Sciences statistical software version 22 and level of statistical significance was determined by a p-value <0.05.Results: The mean age of the respondents was 29.3±4.5 years. Majority of respondents, (288) 69.4% had attained tertiary education. Majority, (350)84.3% were aware of contraception and the male condom, (292)70.4% and the pill, (244) 58.8% were the most known methods. Source of information on contraception were mostly from television, (201)48.4% and health workers, (186)44.8%. Use of contraceptives was low among the respondents, (99)23.9% and the male condom, (52) 52.5% and natural method, (28)28.3% were the common methods used. Contraceptives were obtained mainly from pharmacy shops/patent medicine vendors, (50)50.5% and public health facilities, (21) 21.2%. Majority of those who used contraceptives had the support of their husbands, (94) 94.9% and majority also (83)83.8% were satisfied with the methods used. Predictors of contraceptive use among the respondents included being unmarried, (AOR=3.6; 95% CI: 1.3- 10.5), Nullipara, (AOR=0.09; 95% CI: 0.02-0.3) and having 1-4 children, (AOR=0.1; 95% CI: 0.05-0.4).Conclusion: Awareness of contraception was high, however utilization was low among the respondents in the study area. There may be the need for increased public enlightenment on the use of contraceptives. Health workers will have a role to play through counselling of clients. Changing the preference of the people for large family sizes may increase the use of contraceptives in Nigeria and there should be greater emphasis on female education.Keywords: Determinants, contraceptive, antenatal care, tertiary hospital, Nigeri

Hygiene practices in abattoir and slaughter slab, determinants and assessment of abattoir and slaughter slab facilities in Abakaliki, Ebonyi State South-East Nigeria

Background: Workers in slaughterhouses engaging in unhygienic practices create conducive environments for zoonoses and meat contamination. Knowledge of hygiene practices and their determinants provides evidence for the design of targetedinterventions.Objectives: We investigated knowledge and determinants of hygiene practices among workers in slaughterhouses and assessed slaughterhouse facilities in Abakaliki.Methods: Workers in the Central Meat Market abattoir and Slaughter slab Abakaliki were interviewed in a cross-sectional quantitative study to ascertain their knowledge and hygiene practices while abattoir facilities were assessed using a checklist. Associations were analysed with Chi-square while predictors were determined using binary logistic model.Results: We interviewed 188 workers 75.5% and 85.6% of whom had good knowledge and good hygiene practices respectively. However, hand-washing before and after handling meat (44.1%), cleaning work surfaces with soap and water (45.2%) and sanitary disposal of waste (6.9%) were suboptimal. Knowledge of good hygiene practice was a predictor of good hygiene practice (AOR: 4.6, 95% CI: 2.0-11.3, p=0.001). Well water and borehole were present in both slaughterhouses and cold rooms were available in Central Meat market abattoir.Conclusions: The level of good knowledge was high and this was a determinant of good hygienic practices. Training on hygiene practices is recommended to prevent meat contamination and zoonoses. Keywords: Knowledge; Hygiene Practices; Abattoir; Slaughter slab; Determinants; Ebonyi; Nigeria

Management staff’s perspectives on intervention strategies for workplace violence prevention in a tertiary health facility in Nigeria: a qualitative study

IntroductionHealth workers have increasingly become victims of workplace violence. However, negligible action has been given to developing workplace violence (WPV) prevention programs in hospital settings in low-middle-income countries. An effective workplace violence prevention program is crucial for preventing violence and managing the consequences of incidents. This study assessed management staff perspectives on intervention strategies for workplace violence prevention in a tertiary health facility in Nigeria.MethodsA qualitative study design was employed to explore the intervention strategies for preventing and managing workplace violence at a tertiary health facility in southeast Nigeria. Six focus group discussions were conducted with thirty-eight management-level staff. The interview transcripts were manually coded according to six predefined constructs of workplace violence: creating interdisciplinary harmony and WPV experiences, causes, prevention, program/policy contents, and implementation strategies. A manual thematic analysis approach was adopted, and the results were presented as narratives.ResultsThe findings revealed recognition, welfare, administrative control, and security as vital strategies for the WPV prevention program. The participants agreed that unanimity among staff could be promoted through respect for all cadres of staff and for people’s perspectives (creating interdisciplinary harmony). Assaults and staff intimidation/victimization (experiences), attributed to unethical/poor health workers’ behaviour and ethnic discrimination (causes), were viewed as preventable by ensuring patients’/caregivers’ welfare through respectful and timely care and staff’s welfare through incentives/remunerations and discouraging intimidation (prevention strategies). Furthermore, the staff expressed that the WPV program should employ administrative controls, including instituting WPV policy/unit, codes of ethics, and standard operating procedures across all workplace facets (program/policy contents), which should be implemented through awareness creation, enforcement of sanctions, and provision of appropriate and adequate security presence in the hospital (policy implementation strategies).ConclusionRespect, patient/staff welfare, administrative control, and security are strong mechanisms to prevent workplace violence in tertiary hospitals. Hospital management should institutionalize workplace violence prevention programs/policies and ensure compliance

Knowledge and adherence to isoniazid preventive therapy among people living with HIV in multilevel health facilities in South-East, Nigeria: baseline findings from a quasi-experimental study

Introduction: isoniazid preventive therapy is a crucial component of TB/HIV collaborative program and patient good knowledge and adherence to this preventive treatment are essential in improving implementation. The aim of this study was to determine the knowledge and adherence to isoniazid preventive therapy among patients receiving HIV care. Methods: this is a baseline result of a quasi-experimental study which was carried out among 200 patients receiving HIV care in six high patient load health facilities providing comprehensive HIV care in Ebonyi State. This included a tertiary health facility and five secondary level health facilities. We used structured interviewer-administered questionnaire to collect information from the participants. Adherence was assessed by self-reports. Descriptive, bivariate and multivariate logistic regression analyses were conducted using SPSS version 20 at 5% level of significance. Results: majority (65%) of the respondents were between 30 and 49 years and most (73.5%) were females. Majority (85%) had been on antiretroviral therapy (ART) for more than one year. More than half of the respondents had ever received and had been counselled on IPT (55%, 62% respectively) while only 17.5% were on IPT during the study. More than half (60.5%) of the respondents had low level of knowledge. Marital status was the only predictor of knowledge. Unmarried respondents were 2 times more likely to have knowledge of IPT compared with the married (AOR = 2.11, CI = 1.10-4.06). Among the 35 patients who were on IPT, 32 (91%) reported good adherence in the 30 days preceding the survey. Conclusion: there was poor knowledge of IPT among the respondents however self-reported adherence was high. We recommend intensification of general and personalized education of PLHIV on IPT by health workers

Patients' satisfaction with HIV and AIDS care in Anambra State, Nigeria.

INTRODUCTION:HIV and AIDS care requires frequent visits to the hospital. Patient satisfaction with care services during hospital visits is important in considering quality and outcome of care. Increasing number of patients needing treatment led to the decentralization of care to lower level hospitals without documented patient perception on the quality of services. The study determined and compared patient satisfaction with HIV and AIDS care services in public and private hospitals and identified the factors that influence it. METHOD:This was a cross-sectional comparative study of patients receiving antiretroviral treatment in public and private hospitals in Anambra State. The sampling frame for the hospitals consisted of all registered public and private hospitals that have rendered antiretroviral services for at least one year. There were three public urban, nine public rural, eleven private urban and ten private rural hospitals that met the criteria. One hospital was selected by simple random sampling (balloting) from each group. Out of a total of 6334 eligible patients (had received ART for at least 12 months), 1270 were recruited by simple random sampling from the hospitals proportionate to size of patient in each hospital. Adapted, validated and pretested Patient Satisfaction Questionnaire (PSQ18) was interviewer-administered on consenting patients as an exit interview. A Chi-square test and logistic regression analysis were conducted at 5% level of significance. RESULT:There were 635 participants each in public and private hospitals. Of the 408 patients who had primary education or less, 265(65.0%) accessed care in public hospitals compared to 143(35.0%) who accessed care in private hospital (p<0.001). Similarly, of the 851 patients who were currently married, 371 (43.6%) accessed their care in public compared to 480 (56.4%) who accessed care in private (p<0.001). The proportion of participants who were satisfied were more in public hospitals (71.5%) compared to private hospitals (41.4%). The difference in proportion was statistically significant (χ2 = 116.85, p <0.001). Good retention in care [AOR: 2.3, 95%CI: 1.5-3.5] was the only predictor of satisfaction in public hospitals while primary education [adjusted odds ratio (AOR); 2.3, 95%CI: 1.5-3.4], residing in rural area [AOR: 2.0, 95%CI: 1.4-2.9], and once-daily dosing [AOR: 3.2, 95%CI: 2.1-4.8] were independent predictors of patient' satisfaction among private hospital respondents. CONCLUSION:Satisfaction was higher among patients attending public hospitals. Patient's satisfaction was strongly associated with retention in care among patients in public hospitals. However, in private hospitals, it was influenced by the patient's level of education, place of residence, and antiretroviral medication dosing frequency