Contraceptive Use: Implication for Completed Fertility, Parity Progression and Maternal Nutritional Status in Nigeria

The study identified socio-demographic factors influencing contraceptive use while using nutritional status, completed fertility and parity progression as key variables. NDHS, 2008 dataset on married women aged 45-49 was used. Chi-square, ordinary linear and logistic regression models were used for the analysis. The mean age of the women and CEB were 46.8±1.5 years and 6.9±3.1 respectively. About 26.0% of the women ever used contraception, while 9.0% of the women were underweight. Parity progression from parity 0 to 4 was consistently higher among never-users than women who ever used contraception. The tempo changes for all parities above four as ever-users now progress at lower rate during these periods. The completed fertility and the risk of undernourishment were significantly higher among never users of contraception than ever users. The level of risk persists even when the potential confounding variables were used as control

Hepatitis B immunization at the University College Hospital, Ibadan: an eight year review of vaccine administration records

Vaccination of health care workers (HCWs) against hepatitis (HBV) infection is highly necessary in Nigeria where the infection occurs in hperendemic proportions. We hereby determine the trends in the administration of HBV vaccine at the University College Hospital (UCH), Ibadan, Nigeria. The study reviewed the records for the administration of vaccine against HBV at the Staff Medical Services Department of UCH, Ibadan, Nigeria, from 1994 to 2001. A total of 1,437 subjects consisting of 686 (47.7%) males and 751 (52.3 %) females were vaccinated against HBV from 1994 to 2001. They were aged 16 to 64 years and consisted of 356 students (24.8%) and 1081 healthcare workers (HCWs) (75.2%) which comprised Doctors (30.9%), Dentists (1.9%), Paramedics (19.6%), Non-medics (14.6%) and subjects with undisclosed occupational category ((10.7%). About 11% to 100% of the subjects had annual prescreening for HBsAg sero-negativity from 1996 to 2001 but none had post vaccination assay of anti-HBs titre. All the subjects received 1st dose of 0, 1, 2 accelerated HBV vaccination schedule while on annual basis, 16.7% to 91.8% of the subjects received the 3rd dose of the vaccine. Despite the proportional participation of the different occupational groups was highest among the doctors and dentists but lowest among the paramedics, only 59.7% of all the vaccinees had three dose(s) of the vaccine during the 8 year period. In conclusion, although the HBV vaccination programme had shortcomings, it is an established practice at UCH, Ibadan and efforts should be made to improve on its prevailing standard.Keywords: Immunization, HBV, Healthcare Workers, Nigerians, UCH, Ibadan

Short CommunicationAttitude of Infertile Women to Child Adoption in Nigeria

Infertility has serious consequences especially in Africa where a high premium is place on child bearing. An interviewer-administered questionnaire was administered on 396 consenting women seeking infertility treatment at the gynaecological clinic of the University College Hospital, Ibadan in an attempt to assess the attitude of infertile women in Nigeria to child adoption and its acceptability as a management option for infertility. Most (64%) believed its culturally unacceptable and only 17% will try it as an option. Sustained advocacy, community mobilization and enactment of supportive laws were some of the suggestions made by respondents to improve its uptake.Keywords; Infertility, Adoption, Assisted ConceptionNig. J. Physiol. Sci. 25(2010) 47 – 4

Elimination of Leprosy as a public health problem by 2000 AD: an epidemiological perspective

Introduction: Leprosy is caused by Mycobacterium leprae and manifests as damage to the skin and peripheral nerves. The disease is dreaded because it causes deformities, blindness and disfigurement. Worldwide, 2 million people are estimated to be disabled by leprosy. Multidrug therapy is highly effective in curing leprosy, but treating the nerve damage is much more difficult. The World Health Assembly targeted to eliminate leprosy as a public health problem from the world by 2000. The objective of the review was to assess the successes of the leprosy elimination strategy, elimination hurdles and the way forward for leprosy eradication. Methods: A structured search was used to identify publications on the elimination strategy. The keywords used were leprosy, elimination and 2000. To identify potential publications, we included papers on leprosy elimination monitoring, special action projects for the elimination of leprosy, modified leprosy elimination campaigns, and the Global Alliance to eliminate leprosy from the following principal data bases: Cochrane data base of systematic reviews, PubMed, Medline, EMBASE, and the Leprosy data base. We also scanned reference lists for important citations. Key leprosy journals including WHO publications were also reviewed. Results: The search identified 63 journal publications on leprosy-related terms that included a form of elimination of which 19 comprehensively tackled the keywords including a book on leprosy elimination. In 1991, the 44th World Health Assembly called for the elimination of leprosy as a public health problem in the world by 2000. Elimination was defined as less than one case of leprosy per 10000-population. Elimination has been made possible by a confluence of several orders of opportunities: the scientific (the natural history of leprosy at the present state of knowledge), technological (multi-drug therapy and the blister pack); political (commitment of governments) and financial (support from NGOs for example the Nippon Foundation that supplies free multi-drug therapy) opportunities. Elimination created the unrealistic expectation that the leprosy problem could be solved by 2000. First, the elimination goal was not feasible in several areas which had high incidence of leprosy. Even if elimination was to be attained, significant numbers of new cases of leprosy would continue to occur and many people with physical imperfections, severe psychological, economic and social problems caused by leprosy would need continuous assistance. Extra-human reservoirs of Mycobacterium leprae, the relationship between leprosy and poverty, prevention of disabilities, lack of a reliable laboratory test to detect subclinical infection and a vaccine are also challenging issues. Conclusion: The evidence base available to inform on leprosy elimination is highly positive with the availability of multi-drug therapy blister packs. There are concerns that leprosy was not the right disease to be targeted for elimination as there are no reliable diagnostic tests to detect subclinical infection including the lack of a vaccine, extra-human reservoirs (monkeys and armadillos), increase in the burden of child cases, no good epidemiological indicator as prevalence instead of incidence is used to measure elimination. Multi-drug therapy treats leprosy very well but there is no proof that it concurrently interrupts transmission. The high social stigma, prevention of disabilities, and the relationship between leprosy and poverty are still major concerns.Key words: Leprosy, elimination, multi-drug therapy, public health, eradication, epidemiolog

Profile and professional expectations of medical students in Mozambique: a longitudinal study

<p>Abstract</p> <p>Introduction</p> <p>This paper compares the socioeconomic profile of medical students registered at the Faculty of Medicine of Universidade Eduardo Mondlane (FM-UEM), Maputo, for the years 1998/99 and 2007/08.</p> <p>Case study</p> <p>The objective is to describe the medical students' social and geographical origins, expectations and perceived difficulties regarding their education and professional future. Data were collected through questionnaires administered to all medical students.</p> <p>Discussion and evaluation</p> <p>The response rate in 1998/99 was 51% (227/441) and 50% in 2007/08 (484/968).</p> <p>The main results reflect a doubling of the number of students enrolled for medical studies at the FM-UEM, associated with improved student performance (as reflected by failure rates). Nevertheless, satisfaction with the training received remains low and, now as before, students still identify lack of access to books or learning technology and inadequate teacher preparedness as major problems.</p> <p>Conclusions</p> <p>There is a high level of commitment to public sector service. However, students, as future doctors, have very high salary expectations that will not be met by current public sector salary scales. This is reflected in an increasing degree of orientation to double sector employment after graduation.</p

The training and professional expectations of medical students in Angola, Guinea-Bissau and Mozambique

<p>Abstract</p> <p>Background</p> <p>The purpose of this paper is to describe and analyze the professional expectations of medical students during the 2007-2008 academic year at the public medical schools of Angola, Guinea-Bissau and Mozambique, and to identify their social and geographical origins, their professional expectations and difficulties relating to their education and professional future.</p> <p>Methods</p> <p>Data were collected through a standardised questionnaire applied to all medical students registered during the 2007-2008 academic year.</p> <p>Results</p> <p>Students decide to study medicine at an early age. Relatives and friends seem to have an especially important influence in encouraging, reinforcing and promoting the desire to be a doctor.</p> <p>The degree of feminization of the student population differs among the different countries.</p> <p>Although most medical students are from outside the capital cities, expectations of getting into medical school are already associated with migration from the periphery to the capital city, even before entering medical education.</p> <p>Academic performance is poor. This seems to be related to difficulties in accessing materials, finances and insufficient high school preparation.</p> <p>Medical students recognize the public sector demand but their expectations are to combine public sector practice with private work, in order to improve their earnings. Salary expectations of students vary between the three countries.</p> <p>Approximately 75% want to train as hospital specialists and to follow a hospital-based career. A significant proportion is unsure about their future area of specialization, which for many students is equated with migration to study abroad.</p> <p>Conclusions</p> <p>Medical education is an important national investment, but the returns obtained are not as efficient as expected. Investments in high-school preparation, tutoring, and infrastructure are likely to have a significant impact on the success rate of medical schools. Special attention should be given to the socialization of students and the role model status of their teachers.</p> <p>In countries with scarce medical resources, the hospital orientation of students' expectations is understandable, although it should be associated with the development of skills to coordinate hospital work with the network of peripheral facilities. Developing a local postgraduate training capacity for doctors might be an important strategy to help retain medical doctors in the home country.</p

A Comparative Analysis of Fertility Differentials in Ghana and Nigeria

Nigeria and Ghana are the most densely populated countries in the West African sub-region with fertility levels above world average. Our study compared the two countries’ fertility levels and their determinants as well as the differentials in the effect of these factors across the two countries. We carried out a retrospective analysis of data from the Nigeria and Ghana Demographic Health Surveys, 2008. The sample of 33,385 and 4,916 women aged 15-49 years obtained in Nigeria and Ghana respectively was stratified into low, medium and high fertility using reported children ever born. Data was summarized using appropriate descriptive statistics. Factors influencing fertility were identified using ordinal logistic regression at 5% significance level. While unemployment significantly lowers fertility in Nigeria, it wasn’t significant in Ghana. In both countries, education, age at first marriage, marital status, urban-rural residence, wealth index and use of oral contraception were the main factors influencing high fertility levels. (Afr J Reprod Health 2014; 18[3]: 36-47)Keywords: Fertility differential, Educational level, ordinal logistic regression, Nigeria, Ghan

Determinants of use of insecticide-treated nets among pregnant women in Nigeria

Onoriode Ezire,1 Samson B Adebayo,2 Omokhudu Idogho,3 Elijah A Bamgboye,4 Ernest Nwokolo5 1Research and Evaluation Division, Society for Family Health, Abuja, 2National Agency for Food and Drug Administration and Control, Abuja, 3Enhancing Nigeria&rsquo;s Response to HIV &amp; AIDS, Abuja, 4Medical Statistics, University of Ibadan, Ibadan,&nbsp;5Society for Family Health, Abuja, Nigeria Background: Malaria in pregnancy is still a major health issue in Nigeria, accounting for about 33% of cause of maternal death. Despite massive efforts to make insecticide-treated net (ITN) available to pregnant women in Nigeria, the use is still low. This study was conducted to identify facilitators and inhibitors for the use of ITN/long-lasting insecticidal net (LLIN) among pregnant women in Nigeria.Methods: Data were obtained from the 2011 State-Specific HIV &amp; AIDS, Reproductive and Child Health Survey conducted in 18 states of Nigeria. The survey was a population-based study among men and women of reproductive age living in households in rural and urban areas of Nigeria. Multistage cluster sampling technique was used to select eligible respondents. The sample size per state was 960 respondents. Data were collected between October and November 2011. The analysis was done using Statistical Package for Social Sciences (SPSS) version 20.Results: A total of 11.5% of the respondents were pregnant at the time of the survey of which 73.2% lived in rural location and approximately 70% were either not educated or attained at most a primary school education. A total of 93.2% of respondents have heard of net, 82.6% were confident that they can hang or use a net, and 64.6% owned an ITN/LLIN in their household while the actual use was just 19.2%. We found education, location (urban&ndash;rural), confidence to use a net, and knowledge that the use of a net can protect a pregnant woman from malaria to be significant at 5% level. The number of nets owned per household, the length of time the net is owned, age, and marital status were not significant. Multiple logistics regression shows that pregnant women who are confident to hang or use a net were almost ten times more likely to use a net than those who do not know, while those who know that the use of an ITN/LLIN can protect a pregnant woman from malaria were almost two times more likely to use a net than those who do not know.Conclusion: In general, while owning a net facilitates its use, ownership does not necessarily translate to usage. Owning more than one ITN/LLIN per household was not significant in the use of an ITN/LLIN by pregnant women in this study, neither was the length of time the net was owned. This study shows that increasing the number of nets owned per household might not be a critical decider on whether the net will be used or not. We recommend massive education on the use of ITN. Skill building on use and increasing knowledge on the benefits of using nets may contribute to improving ITN use among pregnant women in Nigeria. Keywords: net use in pregnancy, long-lasting insecticidal nets, education, skill building, massive distribution of net

Acceptability of child adoption as management option for infertility in Nigeria: Evidence from focus group discussions

Infertility remains a global health challenge with devastating psycho-social consequences in many African communities. Adoption that may serve as an alternative strategy for the affected couples is not widely practiced. This study was conceptualized to assess the acceptability of child adoption as a management option by Nigerians. Twelve focus group discussions were held involving three communities stratified into inner core, transitory and peripheral, within Ibadan metropolis, South-Western Nigeria from May to July 2008. The participants were purposively selected based on gender and age group. The barriers mentioned were cultural practices, stigmatization, financial implications, and procedural bottle-necks. Measures suggested to curb these negative attitudes were advocacy, community mobilization and enactment of supportive law that willprotect all parties involved (Afr J Reprod Health 2009; 13[1]:79-91)