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

Disabling Hearing Loss In Two Industries In Lagos, Nigeria

Objective: To determine the prevalence of disabling hearing loss (> 40 dBA) inn two industries in Nigeria Methods: Cross – sectional survey conducted in a textile and a booting industry in Lagos, Nigeria amongst 217 noise – exposed and 155 non –noise exposed subjects. Data collection included use of a questionnaire, ontological examination, audiometric and noise level measurements. Result: The prevalence of disabling hearing loss was significantly higher in exposed subjects (17 %) compared with non- noise exposed subjects (7%, P = 0.008), while the attributable fraction was 58%. In the textile industry , hearing loss was significantly higher amongst exposed subjects (36%) compared with non- noise exposed group ( 11% p = 0.0001 ) but the prevalence was similar amongst the group in the bottling industry ( p > 0.05 ) Furthermore , a significantly proportion of all subjects in the textile company ( 23%) had hearing loss compared with the bottling industry (2 % p = 0.0000) . Hearing loss was significantly associated with age older than 35 years (p= 0.009) and duration of employment greater than 5 years ( p = 0.02 ). Conclusion: Disabling hearing loss was significantly higher in the noise – exposed subjects and indicates the need for a hearing conservation programme amongst these workers. Key Words: Disabling hearing loss, noise, audiometry, industry. Nigerian Journal of Clinical Practice Vol.7(1) 2004: 4-