Maternal and child health interventions in Nigeria: a systematic review of published studies from 1990 to 2014

BACKGROUND: Poor maternal and child health indicators have been reported in Nigeria since the 1990s. Many interventions have been instituted to reverse the trend and ensure that Nigeria is on track to achieve the Millennium Development Goals. This systematic review aims at describing and indirectly measuring the effect of the Maternal, Newborn, and Child Health (MNCH) interventions implemented in Nigeria from 1990 to 2014. METHODS: PubMed and ISI Web of Knowledge were searched from 1990 to April 2014 whereas POPLINE® was searched until 16 February 2015 to identify reports of interventions targeting Maternal, Newborn, and Child Health in Nigeria. Narrative and graphical synthesis was done by integrating the results of extracted studies with trends of maternal mortality ratio (MMR) and under five mortality (U5MR) derived from a joint point regression analysis using Nigeria Demographic and Health Survey data (1990-2013). This was supplemented by document analysis of policies, guidelines and strategies of the Federal Ministry of Health developed for Nigeria during the same period. RESULTS: We identified 66 eligible studies from 2,662 studies. Three interventions were deployed nationwide and the remainder at the regional level. Multiple study designs were employed in the enrolled studies: pre- and post-intervention or quasi-experimental (n = 40; 61%); clinical trials (n = 6;9%); cohort study or longitudinal evaluation (n = 3;5%); process/output/outcome evaluation (n = 17;26%). The national MMR shows a consistent reduction (Annual Percentage Change (APC) = -3.10%, 95% CI: -5.20 to -1.00 %) with marked decrease in the slope observed in the period with a cluster of published studies (2004-2014). Fifteen intervention studies specifically targeting under-five children were published during the 24 years of observation. A statistically insignificant downward trend in the U5MR was observed (APC = -1.25%, 95% CI: -4.70 to 2.40%) coinciding with publication of most of the studies and development of MNCH policies. CONCLUSIONS: The development of MNCH policies, implementation and publication of interventions corresponds with the downward trend of maternal and child mortality in Nigeria. This systematic review has also shown that more MNCH intervention research and publications of findings is required to generate local and relevant evidence

Self-Assessed Health Status and Morbidity Experiences among College Students in Nigeria: A Study of Federal College of Education, Obudu

Self reported or self rated health is a situation of determining ones health status. Studies relating to it are scarce in Africa. The present study examined its prevalence and its relationship with actual experience of morbidity. From the study, it was found that self rated health status is not common in Nigeria. There was a significant relationship between self rated health status and actual experience of morbidity. Further study involving clinical testing is recommended to establish a policy framework for self accessed health status in order to reduce morbidity amongst college students in Nigeria and Obudu in particular

Patients’ knowledge and perceived reactions to medical errors in a tertiary health facility in Nigeria

BACKGROUND: Human errors in healthcare delivery pose serious threats to patients undergoing treatment. While clinical concern is growing in response, there is need to report social and behavioural context of the problem in Nigeria. OBJECTIVE: To examine patients' knowledge and perceived reactions to medical errors. METHODS: A cross-sectional survey was conducted using a semi-structured questionnaire was used to collect data from 269 in-patients and 10 In-Depth Interviews were conducted among health caregivers in the University of Calabar Teaching Hospital, Nigeria. RESULTS: Majority (64.5%) of respondents reported annoyance and disappointment with medical errors. Severity of error (88.5%) and the perception of negligence mediated intention to litigate. Voluntary disclosure significantly reduced patients' intention to litigate caregivers (chi(2)=3.584; df=1; P=0.053). Frustration/anger was not more likely to influence patient to litigate than feelings of resignation/forgiveness (chi(2)=2.156; df=1; P>.05). Financial difficulties arising from error had an important influence on litigation. Health caregivers admitted possibility of errors; and insisted that although notifying patients/relatives about errors is appropriate, disclosure was dependent on the seriousness, health implications and the causes. CONCLUSION: Voluntary disclosure and teamwork is very important in dealing with medical error. The role of medical social workers could be important in the discourse and disclosure of medical error

Patients’ knowledge and perceived reactions to medical errors in a tertiary health facility in Nigeria

Background: Human errors in healthcare delivery pose serious threats to patients undergoing treatment. While clinical concern is growing in response, there is need to report social and behavioural context of the problem in Nigeria. Objective: To examine patients’ knowledge and perceived reactions to medical errors. Methods: A cross-sectional survey was conducted using a semi-structured questionnaire was used to collect data from 269 in-patients and 10 In-Depth Interviews were conducted among health caregivers in the University of Calabar Teaching Hospital, Nigeria. Results: Majority (64.5%) of respondents reported annoyance and disappointment with medical errors. Severity of error (88.5%) and the perception of negligence mediated intention to litigate. Voluntary disclosure significantly reduced patients’intention to litigate caregivers (chi2=3.584; df=1; P=0.053). Frustration/anger was not more likely to influence patient to litigate than feelings of resignation/forgiveness (chi2=2.156; df=1; P>.05). Financial difficulties arising from error had an important influence on litigation. Health caregivers admitted possibility of errors; and insisted that although notifying patients/relatives about errors is appropriate, disclosure was dependent on the seriousness, health implications and the causes. Conclusion: Voluntary disclosure and teamwork is very important in dealing with medical error. The role of medical social workers could be important in the discourse and disclosure of medical error

Reproductive Decisions between Gender and Fertility Preferences among Urban Dwellers: The Case of Bette, Nigeria

Efforts at reducing fertility in developing areas have focused on women who are expected to determine fertility preferences, yet fertility has not reduced in these areas. This is because in most of these areas, especially in Africa, fertility preferences are rather determined by the man, culture and society. This study focused on how reproductive decision making between man and woman affects their fertility preferences. We found that the immediate household (husband and wife) provided the household needs and in the process influences the reproductive decision. The man as head of the family leads or dominates in almost all decisions. We suggest that women’s position in decision making be enhanced while the norms and values that undermine their authority on reproductive decision should be reviewed.Key Words: Reproductive decisions, fertility preferences, urban dwellers, gender