Parents and caregivers’ perceptions on content and channels of communication on immunization service messages in Anambra state, Nigeria implication for action

Background: Effective communication is key to ensuring that barriers to childhood vaccination are tackled. Most times the source and content of information fails to deliver the necessary information needed to make proper decision children’s vaccination. This study explored the perception of communication messages and the different channels used in delivering messages on vaccination among parents/caregivers in Anambra State, Nigeria. Methods: A descriptive cross-sectional study was conducted in Anambra State, Nigeria among parents/caregivers with children aged 0-59 months. A multistage sampling method was used. Questionnaire was used for data collection and analyzed using IMB SPSS version 23. Chi square test was used for association at p<0.05. Results: Findings show that the overall awareness and knowledge was very high 306 (95.6%). Majority 216 (67.50%) of the respondents only receive the key immunization messages during campaigns. Most preferred channel of delivery was through religious groups 273 (85.3%). followed by town announcers 270 (84.4%). Overall, 175 (54.7%) were positive on messages given during Immunization campaigns. Higher proportion agreed that immunization messages are better reinforced if both parents are targeted 309 (98.6%). There were statistically significant association of overall awareness and knowledge with age p=0.043, gender p=0.006, educational level <0.001 and occupation p=0.001. There were no statistically significant association of overall perception with characteristics of respondents. Conclusions: Parents/caregivers’ perceptions of immunization messages can influence social change and increase immunization uptake. Both parents of the children should be targeted whenever immunization messages are to be disseminated

Short term outcome and predictors of survival among birth asphyxiated babies at a tertiary academic hospital in Enugu, South East, Nigeria

Background: Birth asphyxia (BA) is a preventable cause of cerebral insults in newborns. It is associated with high morbidity and mortality. Of the 120 million babies born in third world countries annually, it is estimated that about 3.6 million will develop BA.Objectives: We aimed to determine the short term outcome and predictors of survival among birth asphyxiated babies using Apgar score.Methods: This study was carried out in the Newborn Unit of Enugu State University Teaching Hospital. In-hospital deliveries (Inborn) and those from other centers (Out-born) with one minute Apgar score ≤ 6 were included. Interviewer administered questionnaire was used to collect data from caregivers. Information sought included gestational age (GA), birth weight (BW), Apgar score, place of delivery and outcome. Data was analyzed using SPSS. Bivariate and multivariate logistic regressions were done.Results: Of the 150 neonates, 61.3% survived. Majority of the dead were out-born. The difference was statistically significant (p < 0.001). The inborn were about 1.2 times (AOR = 1.22; 95% CI: 1.06-1.78) more likely to survive BA. Among low birth weights (LBWs), 73.9% died, 23.7% of normal weights and 14.3% of macrosomics died. The difference was statistically significant (p < 0.001). The normal weights were about 2 (AOR = 2.23, 95% CI: 1.76-6.25) and the macrosomics about 5 times more likely to survive BA than LBWs. Regarding GA, 78.8%, 17.2% and 18.2% of the pre-terms, term and post-dates died respectively. The difference was statistically significant (p < 0.001). The term babies were about 11 (AOR = 11.27; 95% CI: 4.02-31-56) and post -dates about 9 (AOR = 8.79; 95% CI: 1.43-54.04) times more likely to survive BA than preterms. Other significant factors were degree of asphyxia (p = 0.003), and parental education (p < 0.001).Conclusion: BW, GA, degree of asphyxia, place of delivery and parental education all predicts survival among birth asphyxiated newborns.Keywords: Newborn, birth asphyxia, Hypoxic Ischemic Encephalopathy (HIE) outcomes, predictors of survival

Family planning use: prevalence, pattern and predictors among women in an urban slum in Enugu, Nigeria

Introduction: High fertility,high birth rates and low family planning prevalence rate is a common feature in developing countries with consequent rapid population growth. Family planning has saved the lives and protected the health of millions of women and children. This study aims to ascertain prevalence, pattern and predictors of family planning use among women living in an urban slum.Methodology: It was a Community based, descriptive cross sectional study using questionnaire. Chi square test was used to assess associations of socio-demographics characteristics with ever used and currently using family planning. Binary logistic regression was used to determine the predictors of family planning use.Result: Of the 281 women studied, 50.5% of respondents have used family planning method before and 35.6% still using. Commonly used methods include;withdrawal (30.2%),condom (26.7%) and abstinence (26.7%) while the least used were sterilization (1.1%) and BTL (1.4%).About 79.7% of non-users cited fear of side effects as the major reason and 9.3% discontinued due to side effects. There were statistically significant association of age, marital status, occupation and number of children with ever used family planning (all p < 0.001).Those aged 25-34 years were 0.22 (95% CI: 0.10-0.48) times likely and those aged ≥ 35 years 0.32 (95% CI: 0.122-0.83) likely to have ever used family planning than those aged 24 years and below. Equally those with 1-3 children were 0.25 (95% CI: 0.08-0.80) likely and those that had> 3 children 0.22 (95% CI: 0.06-0.81) likely to have ever used family planning than those with no children.Conclusion: Prevalence of family planning is poor. Fear of side effects, inconvenience and religion played a major role in the reduction of use of family planning. Identified predictors were age and number of children. There is need to increase access, reduce cost and improve promotion on services like counselling to enable informed choices which will ultimately increase family planning uptake.Keywords: Prevalence, pattern, predictors, family planning, urban slu

Short term outcome and predictors of survival among birth asphyxiated babies at a tertiary academic hospital in Enugu, South East, Nigeria

Background: Birth asphyxia (BA) is a preventable cause of cerebral insults in newborns. It is associated with high morbidity and mortality. Of the 120 million babies born in third world countries annually, it is estimated that about 3.6 million will develop BA. Objectives: We aimed to determine the short term outcome and predictors of survival among birth asphyxiated babies using Apgar score. Methods: This study was carried out in the Newborn Unit of Enugu State University Teaching Hospital. In-hospital deliveries (Inborn) and those from other centers (Out-born) with one minute Apgar score 64 6 were included. Interviewer administered questionnaire was used to collect data from caregivers. Information sought included gestational age (GA), birth weight (BW), Apgar score, place of delivery and outcome. Data was analyzed using SPSS. Bivariate and multivariate logistic regressions were done. Results: Of the 150 neonates, 61.3% survived. Majority of the dead were out-born. The difference was statistically significant (p < 0.001). The inborn were about 1.2 times (AOR = 1.22; 95% CI: 1.06-1.78) more likely to survive BA. Among low birth weights (LBWs), 73.9% died, 23.7% of normal weights and 14.3% of macrosomics died. The difference was statistically significant (p < 0.001). The normal weights were about 2 (AOR = 2.23, 95% CI: 1.76-6.25) and the macrosomics about 5 times more likely to survive BA than LBWs. Regarding GA, 78.8%, 17.2% and 18.2% of the pre-terms, term and post-dates died respectively. The difference was statistically significant (p < 0.001). The term babies were about 11 (AOR = 11.27; 95% CI: 4.02-31-56) and post-dates about 9 (AOR = 8.79; 95% CI: 1.43-54.04) times more likely to survive BA than preterms. Other significant factors were degree of asphyxia (p = 0.003), and parental education (p < 0.001). Conclusion: BW, GA, degree of asphyxia, place of delivery and parental education all predicts survival among birth asphyxiated newborns. DOI: https://dx.doi.org/10.4314/ahs.v19i1.29 Cite as: Uleanya ND, Aniwada EC, Ekwochi U, ND U. Short term outcome and predictors of survival among birth asphyxiated babies at a tertiary academic hospital in Enugu, SouthEast, Nigeria. Afri Health Sci. 2019;19(1). 1554-1562. https://dx.doi.org/10.4314/ahs.v19i1.2

Perception and willingness of medical students towards working in rural communities

Introduction: The preference for the place of practice plays a vital role in the distribution of human resources for health. Research evidence points at specific medical student characteristics and preferences that can predict their practice preferences. This study aims to ascertain medical students' perception and willingness to practice in rural areas after graduation.Methods: The study was carried out among 400-600 level undergraduate medical students at University of Nigeria Enugu Campus in Enugu metropolis, Enugu state. Nigeria. An analytical cross sectional study design involving use of questionnaire was done. Chi Square test and Binary logistic regression were used to ascertain socio-demographic factors associated with willingness to practice in rural areas.Results: Majority of respondents were aged 21-25 years 134(67.0%), males 133(66.5%) and parents lives in urban area 166(83.0%),. About 6(3.0%) were satisfied on current status of rural health service, 132(66.0%) stated that medical training for rural practice were adequate while 67(33.5%) were willing to work in rural area. There was statistically significant association of father's occupation with willingness to practice in rural area (p=0.017). Determinant identified was fathers being farmers 1.4 times (AOR 1.143; 95% CI 1.27-1.84).Conclusion: Perception of working in rural areas was good, while the willingness was poor. The major reasons for not willing to work in rural area includes; low standard of living and poor educational opportunities for children Giving doctors special allowances and changing duration of rural postings will encourage them to look forward to working in rural areas.Keywords: Perception, willingness, practice, rural are

Socio‑demographic Characteristics and Workplace Safety Practices of Panel Beaters: A Comparative Study of Roadside and Organized Sectors in Enugu State, Nigeria

Background: Human resources and their safety are central to occupational health practices. Understanding the sociodemographic characteristics and safety practices of workers helps in workplace interventions. This study aimed at comparing the sociodemographic characteristics and safety practices among roadside and organized panel beaters in Enugu metropolis, Enugu State, Nigeria. Methodology: This was a comparative cross-sectional study. Amultistage sampling method was used to select 428 panel beaters in Enugu metropolis. A semi-structured interviewer-administered questionnaire was used for data collection. Data was entered and analyzed using the Statistical Package for the Social Sciences 20. Comparative analysis was done using Chi‑square and the level of significance was set at 5%. Results: The mean ages (standard deviation) were 31.1 ± 10.3 years and 37.9 ± 12.1 years for roadside and organized panel beaters, respectively. The majority of respondents, (70.6%) and (56.5%), from the roadside and organized sectors, respectively, had secondary education. About 59.8% of the roadside panel beaters were single compared to about two-thirds (63.1%) of organized panel beaters who were married. More than two-thirds (72.9%) of roadside workers earn more than N 35,000 monthly, while half of the organized workers earn more than N 35,000. The differences in sociodemographic characteristics and monthly income were statistically  significant. Environmental sanitation was the most common safety and hygiene practices engaged by respondents. Very few   respondents, more among the organized sector, noted that their workplaces were monitored or checked. The use of personal protective equipment was found to be generally deficient, in addition to poor health and safety training. Conclusion: There was a statistically significant difference in the sociodemographic characteristics between the roadside and organized sectors panel beaters with poor safety practices. Routine and improved health education and safety training on basic preventive measures would be necessary to prevent occupational hazards in the workplace. Keywords: Panel beaters, sociodemographic characteristics, workplace safety measure

Utilization of Tertiary Institutions Social Health Insurance Programme (TISHIP) among undergraduate students in Enugu State

Introduction: Utilization of Health Insurance Scheme services varies for a variety of reasons but it appears that the determining factors are universal.TISHIP was developed to counteract the detrimental effects of user fees which sometimes lead to catastrophic health expenditures. This study aimed to ascertain level of awareness and utilization of TISHIP in tertiary institution in NigeriaMethods: The study was carried out among full time undergraduate studentsEnugu State University of Science and Technology, Enugu state. Nigeria. Analytical cross sectional study design involving use of questionnaire was done. Chi Square test and Binary logistic regression were used to ascertain socio-demographic factors influencing utilization of TISHIP.Results: Majority of respondents were aged 21-25 years 149(48.7%) and lived off-campus 267(87.3%). About 137(44.8%) were aware of TISHIP with major source of awareness from friends/relatives 82(59.8%). Also 60% had positive attitude, 88(28.8%) has registered for the programme and 46(52.3%0 registered >1 year ago.Major factors influencing TISHIP includes; long waiting time 195(63.7%) and poor attitude of the medical staff 186(60.8%). There were statistical significant associations between use of TISHIP with address, education and occupation of both parents. (p< 0.05). Identified predictors were being females (AOR 0.74; 95% CI 0.35-0.96), living in hostel (AOR 3.24; 95% CI 1.52-6.77), father being civil/public servant (AOR 2.34; 95% CI 1.66-5.61) and mother being civil/public servant (AOR 3.13; 95% CI 1.02-7.54).Conclusion: The study showed that knowledge on TISHIP was poor, Also utilization of TISHIP was poor However, majority had positive attitude on TISHIP. There is need for improvement especially as regards sensitization and dissemination on availability of TISHIP to achieve the set objective of the programme.Key words: Tertiary, Health, Insurance, Student

Willingness to pay for highly active antiretroviral (HAART) drugs and HIV treatment monitoring tests among People Living with HIV/AIDS

BackgroundThe HIV treatment programme in Nigeria is from international donors and this may come to an end soon. AimsTo assess the willingness to pay for antiretroviral drugs and HIV treatment monitoring test among people living with HIV/AIDS in Enugu state, Nigeria.Methods A descriptive cross sectional study design was used. A two stage sampling technique was used to select 400 people who were receiving antiretroviral treatment in two of eight comprehensive treatment centres in Enugu, Nigeria. Willingness to pay was elicited via the contingent valuation method. Results Mean age of respondents was 36.6±10.0 years and male, female ratio of 1:1.2. The median willingness to pay for antiretroviral drugs and HIV treatment monitoring test was 500 Naira (USD 3.1) per month. Majority, 85.3 per cent were willing to pay however only a minor proportion, 1.8 per cent were willing to pay the actual amount for the services Predictors of respondents willingness to pay included being in low socio-economic group, (AOR 0.3, 95 per cent CI:0.2-0.7) and being on salaried employment, (AOR 3.0, 95 per cent CI:1.1-8.9). ConclusionMajority of people living with HIV/AIDS were willing to pay for antiretroviral drugs and HIV treatment monitoring tests but only a minor proportion were willing to pay the actual cost of services. This may adversely affect continuity of treatment and enrolment of new patients into the treatment programme. In-order to sustain the gains of the HIV treatment programme and achieve optimal treatment outcomes for patients on treatment in Nigeria there may be the need to subsidize antiretroviral treatment services for people living with HIV/AIDS

Comparison of knowledge of occupational hazards of lead exposure and blood lead estimation among roadside and organized panel beaters in Enugu metropolis, Nigeria

Introduction: occupational practices continuously exposes workers to hazards of lead. This study aimed to compare the knowledge of occupational hazards associated with lead exposure, and blood lead estimation among roadside and organized panel beaters in Enugu metropolis, Nigeria. Methods: this was a cross-sectional study. Multistage sampling method was used to select 428 panel beaters in Enugu metropolis. Samples were analyzed using Atomic Absorption Spectrometer at 283.3 wavelengths. Data were entered and analyzed using Statistical Package for Social Science 20. Comparative analysis were done using chi - square, T-test, Mann-Whitney U-test, Kruskal-Wallis test, logistic regression and level of significance was set at 5%. Results: the majority of respondents on both roadside (59.8%) and organized (73.4%) sectors had poor knowledge of hazards of lead exposure. The difference was significant using χ² (P<0.05). The median blood lead levels were 3.0µg|dl and 16.0µg|dl for roadside and organized panel beaters respectively. The difference was significant with Mann-Whitney U test (P<0.001). The prevalence of elevated blood lead at 10µg|dl were 36.9% (roadside sector) and 64.5% (organized sector). The duration of working hours (OR = 4.34, CI = 1.729 – 10.338) was found to be the predictor of elevated blood lead levels. Conclusion: there were general poor knowledge of hazards of lead exposure and high prevalence of elevated lead levels which were more among organized panel beaters. Advocacy on standard organizational structures that support improved occupational health practices is needed and routine outreach by research institutions for health education and safety training