Factors influencing the choice of child delivery location among women attending antenatal care services and immunization clinic in Southeastern Nigeria

BACKGROUND AND OBJECTIVE: In Nigeria, most deliveries take place at home or with traditional birth attendants (TBAs). This study examined the factors that influenced or determined utilization of healthcare facility delivery services among women who attended antenatal care (ANC) services. METHODS: A cross-sectional survey was conducted with 220 women who registered for ANC at a hospital and delivered within 18 months. Associations between independent variables and choice of healthcare facility delivery were analyzed. Multiple logistic regression was also used to identify the predictors of choice of delivery among women. RESULTS: Of the 220 women who registered for ANC, 75% delivered at a healthcare facility while 15% delivered with a TBA or at home. In the final model, number of children, having planned to deliver at a hospital, labor occurring at night, and labor allowing time for transportation were significant predictors of child delivery location among the women. CONCLUSION AND GLOBAL HEALTH IMPLICATIONS: Utilization of the health facilities for childbirth may increase if pregnant women are encouraged to book early for ANC and if during ANC, pregnant women were counseled to detect labor signs early. In addition to focused and intensified counseling for women with more children, support should be provided that includes financial provisions for transportation to the healthcare facility

Conditioning film deposition on ureteral stents after implantation

Background: Vulvovaginal candidiasis (VVC) is one of the major urogenital infections for which women seek medicaltreatment or use self-prescribed antifungals. The objective of this study was to investigate whether probiotic lactobacilli canbe used as an adjunctive treatment in the management of VVC in Nigerian women. Patients and methods: Fifty-ninepremenopausal women attending health clinics were diagnosed with vaginal yeast infection by both clinical assessment and standard laboratory culture techniques. After informed consent, they were randomized blindly to receive a conventional single oral dose of fluconazole (150 mg) and a daily probiotic capsule containing Lactobacillus hamnosus GR-1 and Lactobacillus reuteri RC-14 or placebo for 3 months (90 days). Results: At day 7, 47 of the 59 patients attended for follow-up.Seven of the 33 on probiotics (23%) and 2 of 14 on placebo (14%) had evidence of yeast infection by culture on day 7 ( p 0.1), indicating a cure rate of approximately 80% with single dose fluconazole. However, of the 26 subjects who reported at day 90, 79% who received probiotics were free of yeast infection compared with 43% on placebo ( p 0.1490). PCR confirmed this finding, as 75% in the probiotics group were negative for heat shock protein specific for Candida albicans at day 90. A PCR primer set specific for L. rhamnosus GR-1 and L. reuteri RC-14 revealed the presence of the Lactobacillus strains on day 90 in 25% of the subjects who took probiotics. All the patients in the placebo group (100%) had two or three recurrences during the 90 day follow-up, while 53% of the probiotics group had one to two recurrences ( p 0.05). Conclusion: The study shows that adjunctive treatment of VVC with probiotic L. rhamnosus GR-1 and L. reuteri RC-14 did not impact the cure rate at day 7, but did lead to fewer vulvovaginitis recurrences. Problems with patients returning for follow-up appointments suggest the need for a more active education programme in Nigeria on clinical trials per se and probiotics in particular. Clinical Trial Registration Number: