Prevalence and indications for caesarean section in Enugu state, Nigeria

Background: Caesarean section (C/S) is one of the commonly performed surgical procedures in obstetrics. This procedure has been on the increase in the past decade, creating a public health concern. The objective of this study was to determine the prevalence and predictors of C/S delivery in a tertiary health facility in Nigeria.Methods: A prospective cohort study conducted at a tertiary health facility in Nigeria. Data was retrieved from the delivery cards of the mothers. Data was analysed using SPSS version 25 and variables were presented as frequencies, percentages, means, and standard deviation. Chi-square test was performed with the level of significance set at p≤0.05. Binary logistic regression was used to determine factors that predicted C/S delivery.Results: The prevalence of C/S was 48.3%. Commonest indication for C/S was 2 or more previous C/S. Mothers aged >30 years, employed, higher educational level, higher parity and delivered preterm predicted C/S delivery on logistic regression.Conclusions: The prevalence of C/S was high. Higher maternal age, employment, higher educational level, higher parity and preterm delivery were positively associated with C/S delivery

Still birth in a tertiary health facility in Enugu state South-East Nigeria: a hidden tragedy

Background: Stillbirth is one of the common adverse outcomes of pregnancy that occur worldwide. The prevalence differs in different continents of the world and even within different localities in the same country. The objective of this study was to determine the prevalence and social determinants of health that affect still birth in Enugu state, Nigeria.Methods: The study was a prospective hospital-based study conducted at the obstetrics and gynecology department of a tertiary health facility in Nigeria. All the data were retrieved from the ante natal and delivery card of all the women that delivered at the unit within the time of data collection. Data was analyzed using SPSS version 25 and variables were presented as frequencies, percentages, means, and standard deviation. Bivariate analysis was done using chi-square test. The level of significance was set at p value≤0.05.Results: The mean age of the mothers was 29.76±4.69 while most of them were aged 21-30 years 431(56.0%). Majority of them were employed 529 (68.7%) and had tertiary education 484 (62.9%). The prevalence of still birth was 40.3 per 1000 births. Maternal age, marital status, educational levels and booking status affected the prevalence of still birth.On logistic regression, un-booked mothers had 25 times odds of having still birth when compared to those that booked after 28 weeks gestationConclusions: The prevalence of still birth is high in Enugu state with un-booked mothers contributing about 88.6%. Early booking helps to detect possible complications early with timely interventions

Exploring actors roles in formulation of the human resources for health policy in Nigeria

BACKGROUND: Most policies in Nigeria are deliberate choices based on political mechanism, oversight, and lack of appropriate information. However in recent times there has been a global shift towards evidence based policy making. Thus Actors' views on evidence and their role in policy development appear critical to the use of evidence.OBJECTIVE: This study aimed to examine how actors' perception, roles and levels of power influenced Human Resources for Health policy development in Nigeria.METHOD: The research was conducted using a case study approach. Systematic reviews of relevant policy documents and reports, in-depth interviews of twelve respondents comprising government policymakers, academia, civil society organizations, health-workers and development partners were done. Interviews were analysed using NVivo 10 software for qualitative analysis.FINDINGS: Most respondents perceived evidence to be factual and concrete to support a given decision. The government policymakers wielded a high level of power and spearheaded the policy process. Development partners were major decision makers because they had financial and technical power. Civil society groups had the power of advocacy and generated evidence. The academia had medium power level of power and also generated evidence.CONCLUSION: The actors' with the highest level of power greatly influenced policy use and type of evidence used in formulating the Human Resources for Health policy. Stakeholders with coercive, financial or group power influenced the type of evidence finally used in formulating the Human Resources for Health policy.KEY WORDS: Human Resource for Health; Health policy making; Role of actors in policy makin

Standard Precautions among HealthCare Workers in a Tertiary Health Facility in Enugu Metropolis, South-East Nigeria

BackgroundThe work environment of Health Care Workers (HCWs) can be described as a potential risk zone due to numerous hazards endemic to the environment. The hospital is not just only a place where the sick people recover from their illness, but also where the healthy get infected.ObjectivesTo assess the knowledge, attitude and practice of Standard Precautions (SP) among HCWs in a tertiary government health facility in Enugu Metropolis, Nigeria.MethodsA descriptive cross-sectional design that used mixed method approach. Qualitative data was collected using an in-depth interview. The quantitative data instrument was a semi-structured, self-administered questionnaire. Manual content analysis was done for the qualitative data. Quantitative data was analysed using SPSS version 22.ResultsSixty-four (32.0%), 131(65.5%) and 5(2.5%) had good, fair and poor knowledge of SP respectively while 117(58.5%), 70(35.0%) and 13(6.5%) had good, fair and poor attitude to SP respectively. Fifty-nine (29.5%), 140(70.0%) and 1(0.5%) had good, fair and poor practice of SP respectively.ConclusionThere was fair knowledge and practice of SP among the studied HCWs while attitude was good.Rwanda J Med Health Sci 2021;4(3):366-37

Patients treatment seeking for manifestations.

<p>Patients treatment seeking for manifestations.</p

Average monthly cost of productivity loss by SES.

<p>Average monthly cost of productivity loss by SES.</p

Average monthly SES differences in the number of work days lost due to illness.

<p>*missing 1 response</p><p>** missing 3 responses</p><p>Average monthly SES differences in the number of work days lost due to illness.</p

Exploring Consumer Perceptions and Economic Burden of Onchocerciasis on Households in Enugu State, South-East Nigeria

<div><p>Introduction</p><p>Onchocerciasis or river blindness constitutes a major burden to households especially in resource-poor settings, causing a significant reduction in household productivity. There has been renewed interest from policy makers to reduce the burden of Neglected Tropical Diseases (NTDs) such as onchocerciasis on individuals and households. This paper provides new information on the patient’s perceptions of onchocerciasis and its economic burden on households in South-eastern Nigeria. The information will be useful to health providers and policy makers for evidence-informed resource allocation decisions.</p><p>Methods</p><p>Information was generated from a cross-sectional household survey conducted in Achi community, Oji River Local Government Area (LGA) of Enugu State, Southeast Nigeria. A pre-tested interviewer-administered questionnaire was used to collect data. A total of 747 households were visited randomly and data were collected using pre-tested interviewer administered questionnaire from 370 respondents. The respondents’ knowledge of the cause of symptoms of the disease, costs incurred for seeking treatment and productivity losses were elicited. Data were analyzed using tabulations and inferential statistics. A socio-economic status (SES) index was used to disaggregate some key variables by SES quintiles for equity analysis.</p><p>Results</p><p>Many people had more than one type of manifestation of onchocerciasis. However, more than half of the respondents (57%) had no knowledge of the cause of their symptoms. Male respondents had significantly more knowledge of the cause of symptoms than females (P = 0.04) but knowledge did not differ across SES (P = 0.82). The average monthly treatment cost per respondent was US$14.0. Drug cost (US$10) made up about 72% of total treatment cost. The per capita productivity loss among patients was US$16 and it was higher in the poorest (Q1) (US$20) and the third SES quintiles (Q3) (US$21). The average monthly productivity loss among caregivers was US$3.5.</p><p>Conclusion</p><p>Onchocerciasis still constitutes considerable economic burden on patients due to the high cost of treatment and productivity loss. Prioritizing domestic resource allocation for the treatment of onchocerciasis is important for significant and sustained reduction in the burden of the disease. In addition, focused health promotion interventions such as health education campaigns should be scaled up in onchocerciasis-endemic communities.</p></div

Socio-demographic characteristics of respondents.

<p>i Missing 4 responses</p><p>ii missing 15 responses</p><p>iii missing one response</p><p>Socio-demographic characteristics of respondents.</p

Types of symptoms experienced and patient’s knowledge of manifestations.

<p>Types of symptoms experienced and patient’s knowledge of manifestations.</p