Secondary School Adolescents' Perception of Risk in Sexual Behaviour in Rural Community Of Oyo State, Nigeria.

Background: Adolescents' low perception of risk associated with sexual behaviour has been identified as one of the reproductive health problems contributing to teenage pregnancy, unsafe abortion and sexually transmitted infections (STIs).Objective: The study aimed at involving adolescents in school-based health promotion activities as a strategy to improve their perception of risk in sexual behaviour.Method: A quasi-experimental design was adopted for this study using intervention and control groups. This was done during a six months school-based participatory peer-educators' health promotion activities in selected secondary schools in Oyo State, Nigeria. The schools were randomly allocated the intervention and control status. The intervention group was exposed to the health promotion activities, pre and post intervention data were analysed for comparison.Results: Results showed statistically significant improvement in the perception of risk in sexual behaviour among adolescents in the intervention group compared with the control group (P< .05). About 60% of the adolescents in the intervention group were able to perceive danger in having many sexual partners compared with 34% in the control group. There was no statistically significant effect of gender on perception of risk in sexual behaviour (P> .05). This implies that among the adolescents in the intervention group who perceived danger in having multiple sexual partners, level of perception was the same for both males and females.Conclusion: Based on the outcome of the study, it was recommended that adolescents' active participation in health promotion activities should be encouraged.Keywords: Adolescents, perception of risk, sexual behaviour, active participation, health promotion

Facility User's Preference between the Free and the Bamako Initiative (Drug Revolving Fund-Based) Health Services in Iwajowa Local Government, Oyo State

Background: The Drug Revolving Fund (DRF) was instituted in 1996 in Oyo State to ensure sustainable drug availability at primary health care level with a seed stock of drugs supplied by the Petroleum Trust Fund. This was discontinued in 1999 and replaced in January 2000, with free health service, which involves supplying free drugs from the state medical store to local government areas. This study aimed to determine which of these two was preferred by health facility users in terms of drug availability and health services provided during a 2-year period of implementation of each.Methodology: This cross-sectional study was conducted in the catchment areas of the health centres which were in existence prior to 1998 within Iwajowa LGA. A total sample of all community members aged 25years and above who had been using the health centres prior to or up to 1998 were enrolled in the study. A structured questionnaire was used to collect data on patronage and drug availability during both periods.Results: Respondents totaling 1882 were surveyed; 260 (14.0%) had stopped patronizing the health facilities after commencement of free health. Major reason among others was lack of drugs reported by 92 (39.4%) respondents. More facility users 1151 (62.6%) preferred the DRF scheme in terms of drug availability while 660 (36.0%) preferred free health; 375 (81.1%) of those who preferred free health did so because it was cheap. A sizeable percentage (36.6%) of respondents requested for continuation of free health.Conclusions: Findings showed that most users preferred the DRF to free health scheme. It is suggested that communities can set up their own DRF scheme at the health facility within their ward.Keywords: Bamako initiative, drug revolving fund, essential drugs, free health, Health care financing, drug availabilit

Job satisfaction and psychological health of medical doctors in Calabar, Southern Nigeria

Background: Employees should be happy at their work, considering the amount of time they devote to it throughout their working life. There is paucity of data on the job satisfaction and psychological health of medical doctors in Nigeria.Objective: To assess the level of job satisfaction and its relationship to psychological health among medical doctors in a southern city of Nigeria.Design: A cross-sectional descriptive survey.Setting: Three major public hospitals in Calabar, Nigeria.Subjects: Medical doctors who had worked for at least six months in the hospitals.Results: Response rate was 73.0%. More than half (56.7%) of the respondents expressed overall satisfaction with their job. Inadequate pay and work overload were the most commonly mentioned reasons for job dissatisfaction. About a fifth of the respondents were at increased likelihood of psychological disorder. There was a statisticallysignificant negative correlation between job satisfaction scores and GHQ scores. Satisfied respondents were least likely to have psychological disorder.Conclusion: Causes of job dissatisfaction among medical doctors should be addressed to improve their psychological health

Dental Services and Attitudes towards its regular Utilization among Civil Servants in Ibadan, Nigeria

Background: Regular utilization of dental services is key to the attainment of optimal oral health state, an integral component of general health and well being needed for effective productivity by working personnel.Objective: This study assessed the rate and pattern of dental service utilization among civil servants and their attitudes towards its regular use.Methodology: A multi-stage sampling technique was used to select participants from the Federal Secretariat in Ibadan, Nigeria. A structured, standardized, pretested and self-administered questionnaire was utilized to elicit responses on dental services and attitudes towards their regular utilization. Responses to knowledge and attitude questions were scored and categorized. Chi-squared test was used to test associations between variables at 5% level of significance.Results: A total of 400 civil servants participated in the study. Their mean age was 44.0 ±7.3years. Many 291(72.8%) were well informed about dental health care and services, but few 156 (39%) had ever utilized it. Of the utilizers, 32 (20.5%) visited within the previous one year period, while others last visited in more than one year period. Few 17 (10.9%) of the utilizers visited for routine dental checks, 103 (66%) for acute pain relief, while the rest had other dental health care needs. The majority 312 (78.0%) showed positive attitude towards regular dental service utilization and this improved with higher educational attainment, improved level of income, being aware of dental services and having ever utilized it (all p<0.05).Conclusion: Despite the awareness and positive attitude towards regular dental service use, their utilization rate was relatively low, episodic and problem driven. Appropriate oral health promotion strategies to enhance utilization of preventive dental services are strongly recommended for them.Keywords: Dental services, Attitude, Utilizatio

Socio-demographic characteristics of street children in rural communities undergoing urbanization

Background: The concept of the street child in rural communities has received little attention. This study describes the sociodemographic characteristics of the street children found in a group of rural communities.Method: This descriptive study is nested in a cross sectional analytical study of street children in a group of rural communities undergoing urbanization. A cluster sample of street children as defined by the United Nations was taken in the seven chosen political wards.Results: Majority of the street children (88.9%) were within the age group 15-17 years with more males (58.3%) than females  (41.7%). Up to 64.7% had attained secondary level education while only 3.9% had no formal education. A high percentage, (61.4%) were still attending school and 15.8% had no work. Of those who work on the streets, being an apprentice (16.4%), petty trading (15.0%), part-time driving (9.5%) and car washing (5.0%) were the commonest types of work. Of those still schooling, 41.6% had no form of part-time work on the streets. None of the street children lived on the street with 65% still living with parents.However, 75% had been involved in the street life for 1-2 years with a median time of 2 years. More than 30% of their parents work outside town.Conclusion: The street child in rural communities differs from the urban perception which often has to do with those living rough and existing outside the family framework. More studies would be needed on the driving factors for street life in rural communities undergoing urbanization.Keywords: Street children, rural communities, socio-demographic  characteristic

Relationships as determinants of substance use amongst street children in a local

Background: Unrestrained exposure to street life often makes the street child vulnerable to psychoactive substances. In other settings, the social relationships of the substance user with those around him or her and family norms of parenting have been docu-mented to modulate use. However, there is a dearth of literature on the role of relationships in substance use in Nigeria. Methods: A cross-sectional analytical study of street children was conducted in a local government area of south-western Nigeria between November 2004 and March 2005, with data analysis being undertaken in April 2005 and November 2006. A cluster sampling method was used to recruit 360 consenting street children into the study. Information was collected on socio-demographic characteristics, parental and friend connectedness, familial stress and current psychoactive substance use. Results: The mean age was 16.2 ± 1.3 years, and there were more males (58.3%) than females. Most of the respondents (65%) were still living with their parents. Fifty-three per cent of the respondents were current psychoactive substance users and the five commonest substances used were kola nut (58.6%), alcohol (43.6%), tobacco (41.4%), marijuana (25.4%) and “sokudaye” (24.9%). Of the respondents who live alone and of those whose fathers work outside of the town, 84% and 57.9% respectively were more likely to be current users at P < 0.05. Similarly, low connectedness with mother and friends and low parental presence were significantly associated with current substance use (75.7%, 77.5% and 58.3% respectively at P < 0.05). On logistic regression, only low con- nectedness with mother (OR 2.4, 95% CI 1.194.98) and friend (OR 3.1, 95% CI 1.705.72) predicted current substance use. Conclusion: The study documented the important role of positive relationships between street children and their friends/mothers in preventing psychoactive substance use South African Family Practice Vol. 50 (5) 2008: pp. 47-47

Drug availability and health facility usage in a Bamako Initiative and a non-Bamako Initiative Local Government Areas of Akwa Ibom State, South -South Nigeria

Background: The availability of drugs on a continuous basis is paramount to the success of any health care system. The Bamako Initiative (BI) had provision of essential drugs as one of its key thrusts in order to improve the utilization of health facilities. This study compared the perceived availability of essential drugs and patronage of health facilities in a BI and non-BI Local government areas (LGA) of Akwa Ibom State in south-south Nigeria.Methodology: This was a cross sectional comparative descriptive study that used an interviewer administered semi-structured questionnaire as an instrument for data collection. Data collected was analyzed using SPSS software version 11.Results: A total of 154 respondents in each LGA were interviewed. Up to 135 (88.8%) opined that drugs were always available in the BI LGA as against 103 (66.9%) in the non-BI LGA (p &lt;0.001). Similarly, 133 (86.3%) said drugs were usually available in the required formulation for BI LGA compared to 115 (74.7%) in the non-BI LGA (p &lt;0.05). More respondents in the BI facilities, 45 (45%) reported using the facilities often compared to 39 (35.8%) in the non-BI facilities (p = 0.03). A total of 116 (75.3%) respondents in the BI LGA felt drugs were not costly compared to 50 (32.7%) in the non-BI LGA (p &lt;0.001). Up to 11 (7.2%) respondents in the non-BI LGA were not satisfied with the drug services in the health centers, compared to 1(0.6%) in the BI LGA (p = 0.01).Conclusion: Availability of essential drugs therefore seemed to contribute to patients' usage of health facilities.Keywords: Bamako Initiative, Essential Drugs, Availability, Patronage, Health Facilities, Utilizatio

Comparative Analysis of Patient Satisfaction Levels in HIV/AIDS Care in Secondary and Tertiary Health Care Facilities in Nigeria

Background: Continuous quality improvement is linked to the use of timely and useful feedback from clients in HIV care. HIV experts and care professionals agree that consumer involvement, such as patient satisfaction survey, is an essential part of HIV care and policy making today. The introduction of Antiretroviral Drugs (ARTs) services in Nigeria has significantly impacted positively on the overall well being of people living with HIV/AIDS (PLWHAs). However, there is little understanding of their satisfaction and perception of quality of care provided. Objective: This study comparatively assessed patients' satisfaction with ambulatory HIV/AIDS care in secondary and tertiary health facilities in Anambra State. Methods: This was a descriptive comparative crosssectional study of 300 PLWHAs conducted at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi (150) and at St. Charles Borromeo Catholic Hospital (SCBH), Onitsha (150). Sample selection was by systematic sampling technique whereby every 3rd patient registered to see the doctor each day was recruited. Data was collected using a structured interviewer-administered questionnaire and analyzed using SPSS version 13. Results: Patients in Nnewi were more likely to spend more 2 money on transport (÷ = 33.36, p=0.0001), while those in Onitsha were more likely to incur more expenses on non-HIV 2 tests (÷ = 5.73, p=0.017). Patients visiting the tertiary health facility were significantly more satisfied with access to care than those visiting the secondary health care facility were, (

Determinants of good oral hygiene among pregnant women in Ibadan, south-western Nigeria.

Background and objectives: The need to attain and maintain good oral hygiene among pregnant women cannot be over emphasized as periodontal diseases in pregnancy have been linked with poor pregnancy outcomes. This study assessed the variables that affect oral hygiene status among pregnant women in a south-western Nigerian locality. Methodology: Four hundred and five pregnant Nigerian women were assessed for their oral hygiene status using the Oral Hygiene Index-Simplified. Demographic and pregnancy statistics were also obtained and the relationships between these and oral hygiene status were determined. Results: The mean age was 25.35 &plusmn; 5.02 years. Most of the women (96.0%) had never visited a dentist or any other oral health care provider and only 12.5% of those who had been attended by dental care givers have ever had professional dental cleaning. The oral hygiene status appeared to worsen as parity increased (p=0.047) while the use of the toothbrush and paste was associated with good oral hygiene (p=0.007). Higher education was associated with use of the tooth brush and paste (p=0.046) and good oral hygiene (p=0.001). Conclusion: The positive effect of education on oral hygiene practices is highlighted in this study. However there is still need for proper health enlightenment in this population with regards to use of the available oral health care facilities.Keywords: Oral hygiene, Pregnancy, Nigeria

Incidence of blood-related work accidents among health workers in a government hospital in Benin City, Nigeria

Accidents are hazards to which health workers are exposed. Hazards may be physical, chemical, biological, mechanical or psychosocial. Mechanical hazards are very common in the health industry because of the frequent use of pointed and sharp instruments such as needles, scalpel and knives. This six-month (June 1999 and June 2000) longitudinal incidence study was carried out at the Central Hospital, Benin City, Nigeria, as a follow-up on a previous cross-sectional study on frequency of blood-related work accidents in the same hospital. All the doctors, laboratory workers and 50% of nurses were included in the study. The nurses were selected using stratified random sampling method. Two hundred and fourteen health care workers started the follow-up study, out of which 146 were left at the end of the six-month period, giving an attrition rate of 31.8%. Results shows that contact with patients' blood with ungloved hands, blood splashes on the face and other parts of the body, needle pricks, cuts from drug ampoules and glove perforation during surgery were the major work-related accidents/injuries during the six-month follow-up. This is similar to findings from the retrospective study. The frequencies of various accidents were higher during the six-month follow-up (incidence study) than the six months prior to the study (retrospective study). Combining all the health workers, the incidence densities of these five major work-related accidents were between 3.6 per person years (ppy) to 9.5ppy. These incidence densities were all significantly higher for doctors than nurses or laboratory workers. There is an urgent need to reduce the incidence of these work-related accidents/injuries in order to reduce the chances of health workers developing occupationally acquired diseases