Barriers to accessing health care in Nigeria: implications for child survival

PKBackground: Existing studies indicate that about one in every six children dies before age five in Nigeria. While evidence suggests that improved access to adequate health care holds great potential for improved child survival, previous studies indicate that there are substantial barriers to accessing health care in Nigeria. There has not been a systematic attempt to examine the effects of barriers to health care on under-five mortality in Nigeria. This study is designed to address this knowledge gap. Data and method: Data came from a nationally representative sample of 18,028 women (aged 15 49) who had a total of 28,647 live births within the 5 years preceding the 2008 Nigeria Demographic and Health Survey. The risk of death in children below age five was estimated using Cox proportional hazard models and results are presented as hazards ratios (HR) with 95% confidence intervals (CI). Results: Results indicate higher under-five mortality risks for children whose mothers had cultural barriers and children whose mothers had resource-related barriers to health care (HR: 1.44, CI: 1.32 1.57, pB0.001), and those whose mothers had physical barriers (HR: 1.13, CI: 1.04 1.24, pB0.001), relative to children whose mothers reported no barriers. Barriers to health care remained an important predictor of child survival even after adjusting for the effects of possible confounders. Conclusion: Findings of this study stressed the need for improved access to adequate health care in Nigeria through the elimination of barriers to access. This would enable the country to achieve a significant reduction in childhood mortality

Housing Tenure Effects on Child’s Educational Performance in Non-Residential Secondary Schools in Ogun State, Nigeria

This study examined the effects of housing tenure on child’s educational performance in non- residential secondary school system in Ogun State, Nigeria, and it provides vital information to aid families’ optimal decisions on pro-child’s educational performance school accommodation arrangement. The Null hypothesis (H0): there is no significant difference between home owner and non – home owner child’s educational performance in non – residential secondary schools in Ogun State, Nigeria was tested using , independent sample t-test statistic, and data gathered from two sets of questionnaire consisting of 391 and 170 copies administered to day students and parents respectively in nine selected secondary schools from three local government areas in Ogun State, Nigeria using random sampling technique. Frequency tables, mean item score statistics were also used for descriptive analysis.The study discovered that significant differences exist between home owner and non – home owner child’s educational performance in non – residential secondary schools in Ogun State, Nigeria with the students from home owner occupied families on one hand performing better (on a 5 points equidistant Likert Scale in which 1 = Very Poor, 2 = Poor, 3 = Average, 4 = Good, and 5 = Very Good, p < 0.001 @ 95% confidence level) in arts subjects (mean score = 4.51), science subjects (mean score = 4.35), and junior secondary school (mean = 3.98) than their colleagues from tenancy occupied homes that scored mean values of 2.31, 3.48, and 3.49 in the same subject areas respectively.  While on the other hand, students from tenancy occupied families performed better (mean score = 4.12) in commercial subjects than their colleagues home owner occupied families that obtained mean score value of 3.26 in the same subject area.This study has presented contextual knowledge on the linkages between child’s educational performance and housing tenure from the outcome of the data analysis, it however, did not consider the quality of school teachers, teaching methods used and the quality of the learning environment all of which could significantly contribute to child’s academic performance. The study expands the frontiers of knowledge on the benefits of home ownership as the findings could enable parents/guardians to relate better with secondary school day students in domestic chores as well as being conscious of the impact of involving day students in family business on academic performance in school. This paper is original and fills a gap in knowledge as it draws for the first time in Nigeria, the attention of parents/guardians to the impact of housing tenure on child’s educational performance especially in specific subject areas. Keywords: Home ownership, Housing Tenure, Child’s Academic Performance, Ogun State Nigeria DOI: 10.7176/DCS/10-12-06 Publication date: December 31st 202

Review on Different Beneficial Ways of Applying Alum Sludge in a Sustainable Disposal Manner

Disposal of waste from water treatment plant is one of the major issues most treatment plants seem not to overcome due to the constant generation of this waste as a result of meeting the demand of water and purification of water for human consumption. The effect of disposing sludge constantly in the environment has called for an economical and sustainable way of reusing alum sludge. However, this paper aimed at reviewing the possible literature on applying waste from water treatment plant in various ways, example; in building material; as brick and tiles, in concrete ; as replacement of cement and aggregate, in Geotechnics; as soil stabilizer and in agriculture; as soil fertilizer, in pottery; use as replacement of clay in flower pot production for sustainable disposal. All the above mentioned categories of uses have reviled an effective and efficient way in managing waste from water treatment plant (alum sludge), also a safer and economical manner of disposal.  However, the effects when used and the behaviour when it is incorporated with other materials were highlighted, other reuse and disposal options where discussed and the areas not covered (knowledge gap) was identified

Postnatal probiotic supplementation can prevent and optimize treatment of childhood asthma and atopic disorders: a systematic review of randomized controlled trials

Background: Although several randomized controlled trials (RCTs) published over the past 5 years show that prenatal or postnatal probiotics may prevent or optimize the treatment of childhood asthma and atopic disorders, findings from the systematic reviews and meta-analyses of these studies appear inconsistent. More recent RCTs have focused on postnatal probiotics, and linked specific probiotic strains to better disease outcomes. Objective: This systematic review aimed to determine if postnatal probiotics are as effective as prenatal probiotics in preventing or treating childhood asthma and atopic disorders. Methods: We searched the PubMed, Medline, Google Scholar, and EMBASE databases for RCTs published within the past 5 years (from 2017 to 2022). We included only full-text RCTs on human subjects published in or translated into the English language. We retrieved relevant data items with a preconceived data-extraction form and assessed the methodological quality of the selected RCTs using the Cochrane Collaboration's tool for assessing the risk of bias in randomized trials. We qualitatively synthesized the retrieved data to determine any significant differences in study endpoints of the probiotic and placebo groups. Results: A total of 1,320 participants (688 and 632 in the probiotic and placebo groups) from six RCTs were investigated. One RCT showed that early Lactobacillus rhamnosus GG (LGG) led to a reduction in the cumulative incidence rate of asthma. Another study demonstrated that mixed strains of Lactobacillus paracasei and Lactobacillus fermentum could support clinical improvement in children with asthma while one trial reported a significant reduction in the frequency of asthma exacerbations using a mixture of Ligilactobacillus salivarius and Bifidobacterium breve. Three trials showed that a combination of LGG and Bifidobacterium animalis subsp lactis, Lactobacillus rhamnosus alone, and a probiotic mixture of Lactobacillus LOCK strains improved clinical outcomes in children with atopic dermatitis and cow-milk protein allergy. Conclusions: Postnatal strain-specific probiotics (in single or mixed forms) are beneficial in preventing and treating atopic dermatitis and other allergies. Similarly, specific strains are more effective in preventing asthma or improving asthma outcomes. We recommend more interventional studies to establish the most useful probiotic strain in these allergic diseases

The Role of HIV/AIDS Prevention Campaigns on HIV Related Behavioural Changes in Ibadan, Nigeria

This study examined the impact of sources of AIDS education on HIV-related behavioural changes, and its implications for HIV prevention and service delivery in Nigeria. We analysed cross-sectional data obtained from a structured face-to-face interview with 1,373 respondents aged 15-50, who have ever had sex in Ibadan, Nigeria. Knowledge of HIV/AIDS, its route of transmission and prevention strategies was high.  About 20 % of the respondents were exposed to the AIDS prevention campaigns. A majority reported sexual behavioral changes, which included restriction of sex partners, use of condoms, sexual abstinence and avoidance of casual sex. Thirty-nine percent took some steps to reduce risk of infection by avoiding transfusion with unscreened blood and testing for HIV status.  Using multiple logistic regressions, the factors affecting the reported changes were identified. The application of health belief model shows that the model cannot wholly explain the changes in behavior. The role of female powerlessness in safer sex decision-making is noted. Despite the limitations of the study, the need for a sustained AIDS prevention campaign is stressed. The implications of the study for AIDS programs and research are highlighted

Teenage pregnancy in South Africa: Where are the young men involved?

Background. The level of unintended pregnancies among teenage girls in South Africa (SA) has remained a public health concern. However, studies and interventions generally do not consider young men’s involvement in teenage pregnancies. Objective. To investigate the sociodemographic and sexual behaviour characteristics of young men who have impregnated at least one teenage girl. Methods. The study used data from the Centre for Justice and Crime Prevention (2009), which included responses from young men (aged 12 - 22 years) across all SA provinces. Univariate and bivariate analyses and binary logistic regression were performed. Results. The results showed that 93.2% of the sample had ≥2 lifetime sexual partners, 22.4% rarely used condoms and 11.5% had never used condoms. Teenage pregnancy incidence was ≥35% in all provinces except Gauteng and the Western Cape. The likelihood of being involved in a teenage pregnancy was higher among respondents who reported having ≥2 lifetime sexual partners (odds ratio (OR) 2.510; 95% confidence interval (CI) 0.43 - 14.77). Respondents with a higher education were less likely to be involved in a teenage pregnancy (OR 0.819; 95% CI 0.36 - 1.84) than those with a lower education (OR 1.219; 95% CI 0.59 - 2.50). Conclusion. Engaging in multiple sexual partnerships could increase the vulnerability of young people to sexually transmitted infections or teenage pregnancies. Initiatives to create awareness among SA youth regarding the consequences of sexual behaviour are recommended, with a specific focus on addressing young men’s involvement in teenage pregnancy

Assessment of the Quality of Borehole Water Sample in Federal Housing Estate and Sites and Services Areas of Owerri, Imo State, Nigeria

Assessment of the quality of borehole water samples from Federal Housing Estate and Sites and Services areas of Owerri, Imo State, Nigeria was conducted to determine the suitability of these borehole water samples. Six samples of borehole water gotten from six different families living in these areas were analyzed for microbial, chemical and physicochemical parametersusing standard analytical method of National Agency for Food and Drug Administration and Control (NAFDAC). The result of microbial analysis revealed that all the water samples (samples D, E, F, G, H, and M) had total coliform count of 64.0cfu/100ml, 5.0cfu/100ml, 41.0cfu/100ml, 16.0cfu/100ml, 124.0cfu/100ml and 0.0cfu/100ml respectively. This showed that sample D, F, G, and H exceeded the standard of 10 coliform counts/100ml. The entire samples resulted at 0 counts for Escherichia coli. Samples D, F, G and M tested negative for pseudomonas test, whereas samples E and H did not. The chemical analysis showed that all the samples did not meet up with the recommended standard of pH (6.5-8.5).However, there was significant difference (p<0.5) between samples D and E. samples F and J were significantly the same, also as samples G and M. Sample M was the least significant while sample D was the most significant at pH 4.6 and 6.4 respectively. The temperatures were all significantly the same and did not exceed standard limit of 370C. The total dissolved solid also did not exceed the limit of 500ppm and the conductivity limit was not exceeded. All the samples did not exceed limits for zinc, copper, lead, magnesium, cadmium and iron which are 3mg/l, 1mg/l, 0.01mg/l, 0.02mg/l, 0.03mg/l and 0.3mg/l  respectively except for calcium, where samples D, E, G and H were beyond standard of 0.4mg/l. All the samples were significantly different for each parameter except for lead of which the entire sample were all the same. The depth of the borehole in relation to the distance of septic tank, distance of neighbor’s septic tank and distance of refuse dump as obtained from these families revealed that sample M had the highest distance and was the least contaminated, whereas sample H had the closest distance and the greatest microbial contamination. The depth of Sample G borehole was according to the regulatory standard of 150 ft., and from the analysis the entire parameters were within standard except for pH. Keywords: Water, Standards, Microbial analysis, Total Dissolved Solid, Metals, Septic tan

A New Source of Elemol Rich Essential Oil and Existence of Multicellular Oil Glands in Leaves of the Dioscorea

Dioscorea species is a very important food and drug plant. The tubers of the plant are extensively used in food and drug purposes owing to the presence of steroidal constituent’s diosgenin in the tubers. In the present study, we report for the first time that the leaves of Dioscorea composita and Dioscorea floribunda grown under the field conditions exhibited the presence of multicellular oil glands on the epidermal layers of the plants using stereomicroscopy (SM) and scanning electron microscopy (SEM). Essential oil was also isolated from the otherwise not useful herbage of the plant, and gas chromatographic-mass spectroscopy analysis revealed confirmation of the essential oil constituents. Out of the 76 compounds detected in D. floribunda and 37 from D. composita essential oil, major terpenoids which are detected and reported for Dioscorea leaf essential oil are α-terpinene, nerolidol, citronellyl acetate, farnesol, elemol, α-farnesene, valerenyl acetate, and so forth. Elemol was detected as the major constituent of both the Dioscorea species occupying 41% and 22% of D. Floribunda and D. composita essential oils, respectively. In this paper, we report for the first time Dioscorea as a possible novel bioresource for the essential oil besides its well-known importance for yielding diosgenin

Gender-related power differences, beliefs and reactions towards people living with HIV/AIDS: an urban study in Nigeria

<p>Abstract</p> <p>Background</p> <p>Although there are an increasing number of studies on HIV-related stigma in Nigeria, very little research has focused on how power differences based on gender perpetuate the stigmatization of people living with HIV/AIDS (PLWHA) and how these gender differences affect the care that PLWHA receive in health care institutions. We explore gender-related beliefs and reactions of society, including health care professionals (HCPs), with regard to PLWHA, using Connell's theoretical framework of gender and power (1987). With Connell's structural theory of gender and power (financial inequality, authority and structure of social norms), we can describe gender differences in stigmatization of PLWHA.</p> <p>Method</p> <p>We conducted in-depth semi-structured interviews, lasting 60 to 90 minutes, with 100 persons (40 members of the general public, 40 HCPs and 20 PLWHA) in Port Harcourt, Nigeria. The interviews were tape-recorded and transcribed verbatim. The Nvivo 7 computer package was used to analyze the data.</p> <p>Results</p> <p>There are similarities and differences between the general public and HCPs towards PLWHA in gender-related beliefs and reactions. For instance, although association with promiscuity and power differences were commonly acknowledged in the different groups, there are differences in how these reactions are shown; such as HCPs asking the female PLWHA to inform their partners to ensure payment of hospital bills. Women with HIV/AIDS in particular are therefore in a disadvantaged position with regard to the care they receive.</p> <p>Conclusion</p> <p>Despite the fact that men and women with HIV/AIDS suffer the same illness, clear disparities are apparent in the negative reaction women and men living with HIV/AIDS experience in society. We show that women's generally low status in society contributes to the extreme negative reactions to which female PLWHA are subject. The government should create policies aimed at reducing the power differences in family, society and health care systems, which would be important to decrease the gender-related differences in stigma experienced by PLWHA. Interventions should be directed at the prevailing societal norms through appropriate legislation and advocacy at grassroots level with the support of men to counter laws that put women in a disadvantaged position. Furthermore, development of a policy that encourages equality in access to health care for all patients with HIV/AIDS by applying the same conditions to both men and women in health care institutions is recommended. There is a need to protect women's rights through implementing support policies, including paying attention to gender in the training of HCPs.</p