The prevalence of domestic violence among pregnant women in Nigeria: a systematic review.

To identify, appraise, and synthesize research evidence on the prevalence of domestic violence (DV) among pregnant women in Nigeria. We conducted a systematic review of all published studies between April 2004 and June 2016. Comprehensive searches were conducted on electronic databases such as PubMed, CINAHL, Global Health, MEDLINE, PsycINFO, Directory of Open Access Journals, Google Scholar, and electronic libraries of the authors' institution. Identified articles were screened in two stages against the inclusion criteria with titles and abstract screened first followed by full-text screening. Selected articles were assessed using the "guidelines for evaluating prevalence studies," and findings were synthesized narratively. Among 19 studies that met the inclusion criteria, two articles were excluded due to low methodological quality and 17 articles were included in the review. The prevalence of DV during pregnancy in Nigeria ranged between 2.3% and 44.6% with lifetime prevalence rates ranging between 33.1% and 63.2%. Physical, sexual, psychological, and verbal abuses were the most frequent types of DV reported in this review. The most common perpetrators were husbands, as reported in 11 of the 17 studies. Pregnant women between the ages of 20 and 30 years were the most common victims of DV. Our review suggests high prevalence of DV in pregnancy among women in Nigeria and higher lifetime prevalence. However, determining an overall, synthesized accurate prevalence rate of DV within this population based on existing evidence presents a challenge. The findings have important implications for stakeholders such as planners, policy makers, maternity care providers, and researchers in public health and social policy at national, regional, and international levels toward combating the issue. OBJECTIVE METHOD RESULTS CONCLUSIO

Uptake of Antenatal Care Among Pregnant Women in Plateau State Nigeria

Background-Antenatal care offers pregnant women promotive, preventive and curative services. Despite this, some pregnant women still donrsquot access ANC at all while others donrsquot have access to ANC by skilled health care professionals. This increases the risk of maternal morbidity and mortality. This study therefore aims to determine the predictors of ANC attendance among in Plateau State. Methodology-A community based cross sectional study,400 study participants across six communities in the three senatorial zones in Plateau State were selected. Focused Group Discussion was conducted among study participants. Data was analysed using SPSS version 23. Results- 90.8% of respondents booked their last pregnancy out of which 55.8% had more than four ANC visits. Only 52.9% of the women had ANC by skilled health care providers. 69.7% of women who did not book their pregnancy delivered at home. Educational status, marital status and marital setting were predictors of ANC attendance among the study population. Women who had formal education were 1.7 times more likely to attend ANC compared to those with non-formal or no education at all. (P-value lt0.001 CI 1.267-2.321). Also, women in monogamous settings were more likely to attend ANC compared to those in polygamous setting (P-value 0.015 CI 0.162-0.822). Conclusion-Many of the respondents did not have the required number of ANC visits.nbsp More targeted interventions should be implemented in order to ensure that women have access to skilled care during pregnancy as this will reduce the risk of complications in pregnancy and delivery

Assessment of the Birth and Emergency Preparedness Level of Pregnant Women Attending Antenatal Care in a Primary Health Care Centre in Jos, Plateau State, Nigeria

Birth preparedness helps ensure that women can access professional delivery care when labor begins and reduces the delay that occurs when women experience obstetric complications. This cross sectional study was aimed at assessing the birth and emergency preparedness level of 250 pregnant women attending Antenatal Care (ANC) in a Primary Health Care (PHC) in Jos North Local Government Area of Plateau State, Nigeria. The subjects were selected through a systematic sampling technique and the data was analyzed using SPSS version 17 statistical software, and the results were presented in tables. The results showed that 161(64.4%) identified a place of delivery, 210(84%) said they wanted to deliver in the hospital, while 40(16%) choose home as their preferred place. 135 (54%) made arrangement for transportation, while 115(46%) did not. Only 58(23.2%) of the pregnant women made arrangements for blood donation, while majority (83.6%) of the women saved money for the purchase of delivery items. The finding s of this study suggests therefore, that a large proportion of the pregnant women did not prepare for childbirth and emergencies especially the prior arrangement for transportation and blood donation.Key words: Birth, emergency, preparedness, danger signs, pregnant wome

A Comparative Assessment of the Epidemiology of Malnutrition among Pupils in Public and Private Primary School in Jos North Local Government Area of Plateau State

Background: Majority of school children lack adequate amount of food, thereby inducing malnutrition, which now poses a serious threat to education, particularly in developing countries, including Nigeria. The importance of good nutrition in the proper and optimal development in childhood is indispensible because children are at a stage in life when all the tissues and cells are rapidly growing and organs are developed for specific functions in the child's life.Methodology: A descriptive cross sectional study was conducted among pupils of selected Public and Private schools in Jos North Local Government Area of Plateau state, Nigeria. A multistage sampling method was used to recruit the calculated sample size of 500 pupils; an interviewer administered questionnaires, weighing scale, measuring tape meter were the instrument used for data collection.Results: The socio demographic data of 290 and 210 pupils of the public and private schools respectively were compared. The pupils' ranged between 5-17years with majority between 6-10 years in all the schools. Pupils in the private school were more nourished and had an appropriate weight-for-age more than 90% of the normal range with an ideal height-for-age of 48.0% more than those in the public school.Conclusion: Nutritional imbalance can affect the educational outcome of the children amongst many other things. Measures such as school feeding should be introduced on a national scale in order to alleviate any deficiency state of the pupils

Review Article: Clinical risk management: time for a paradigm shift in medicare in Nigeria?

Introduction: Medical practice In Nigeria is faced with a myriad of challenges to patients, medical practitioners and the institutions that they render services in. These include but are not limited medical errors and malpractice that can lead to litigation, exposure to highly infectious diseases when medical practitioners interface with patients and the attendant liabilities that government and private health institutions may have to pay out.Objectives: To describe the role of clinical risk management in health care management and evaluate risk management practice policies in medical care in NigeriaMethodology: A systematic review of literature on risk management, policy that concern medical risks/management documents and articles was conducted. Keywords used in the search were clinical guidelines, and risk management in Nigeria. Reviewed documents contained information on risk management internationally and where available, in Nigeria. Searches were conducted on the Cochrane Library, PubMed and African Journals On line. Publications were also sourced from cited references and reports. The search engine used was Google.Results: NationalPolicies that provide direction in clinical risk management in Nigeria are lacking even against the background of medical errors that lead to mortalities and morbidities.Conclusion: There is a need for leadership to be provided by healthcareKeywords: Clinical risk management, Medical risk management, Health car

Does mid upper arm circumference identify all acute malnourished 6–59 month old children, in field and clinical settings in Nigeria?

Objectives: To determine the utility of mid-upper arm circumference (MUAC) in identifying acutely malnourished children compared with weight-for-height (WHZ), body mass index (BMI) for age (BAZ) and MUAC z-score (MUACZ) in clinical and field practice.Design: Cross-sectional study.Setting: Children from immunisation and paediatric outpatient clinics of Jos University Teaching Hospital and two schools in Jos, Plateau state, Nigeria.Subjects: Children 6–59 months with parental consent, and no chronic medical condition or pedal oedema. Outcome measures: MUAC, height and weight were measured. The WHZ, BAZ and MUACZ were determined using the World Health Organisation (WHO) Anthro software 3.0. Prevalence of acute malnutrition was compared between these data and those given by MUAC. The World Health Organisation (WHO) z-score cut-off of < -3 and < -2 and MUAC of ≤ 11.5 cm and 11.6 –12.5 cm was used to define severe acute malnutrition (SAM) and moderate acute malnutrition (MAM), respectively. Stata 12SE was used to determine frequency distribution, means and significance.Results: The mean age of subjects was 22.4 ± 15.5 months. The mean MUAC was 14.7 ± 1.5 cm. The MUAC differed between males and females in the age-groups of 6–11 (p = 0.02) and 36–47 (p = 0.006) months. The prevalence of SAM by WHZ was 3.4%, MUAC was 1.5%, BAZ was 4.3% and MUACZ was 1.0%. When compared, WHZ and BAZ were concordant in 77.8% (p = 0.001) of SAM subjects. MUAC and MUACZ indicated that none of the subjects were classified as SAM by WHZ and BAZ.Conclusion: Neither WHZ or MUAC as a single parameter identifies all children with acute malnutrition. A re-definition of MUAC criteria for malnutrition or consistent application of both parameters is required.Keywords: acute malnutrition, BAZ, field and clinical setting, MUAC, MUACZ, WH

Does maternal education impact infant and child care practices in African setting? The case of Northern Nigeria

Background: In many African settings, infant and child care practices are dictated by long-established social norms and cultural values, some of which may be disastrous to the health of the baby. To determine how maternal education is related with child health and rearing practices in Kano. Materials and Methods: Using a descriptive cross-sectional design, 386 randomly selected mothers of under-five children and their babies were examined. Data were analyzed using IBM SPSS Statistics for Windows, version 22 (IBM Corp., Armonk, NY, USA). Children's weight-for-height, height-for-age, and weight-for-age Z-scores were obtained. Infant and child care, feeding and weaning practices were assessed and scored based on a system adapted from past study. Results: The mean ± standard deviation of the mothers was 27.3 ± 5.2 years, 69.7% had at least secondary school education. The mothers had 4 ± 2 children, and 79.3% were ≥12 months old. More than half of the children (58.2%) had suffered one or more of the common childhood diseases within the previous month, 60.3% had a form of malnutrition and less than half (42.5%) were fully immunized for age. Varying infant and child care, feeding and weaning practices were observed. Overall, half (49.2%) of the mothers had good care practices, 42.2% had good feeding practices and 57.6% had good weaning practices. Interestingly, neither the mothers' care practices nor the feeding practices were statistically associated with their educational status. However, the proportion of the mothers with good weaning practices was higher among those with no secondary education (59.7%). Conclusion: The finding suggests that cultural beliefs are specific areas of focus in campaigns for improving infant and child care and rearing practices of mothers, and eventually for reducing the high infant and child morbidity and mortality in the Northern Nigeria

Determinants and effect of girl child marriage: a cross sectional study of school girls in Plateau State, Nigeria

Background: Child marriage is a major problem contributing to maternal morbidity and mortality in Nigeria. It has effect on both social and health of not only the girl child but the children born to these young mothers. Aim: This study aimed at assessing the determinants of early marriage among secondary school girls in Plateau State and its effect especially on their health and education. Methods: The study was a cross sectional study of young girls in 21 secondary schools across the three geopolitical zones in Plateau state, selected through a simple random sampling technique after obtaining consent from the JUTH ethical committee and permission from the State ministry of education and the principals of the various schools.Results: The study found that while must marriages among girls are forceful marriages, the factors that influenced early marriage was poor educational level of parents, poverty and place of residence. The girls who married among them reported having had some health challenges and educational backwardness as a result of early marriage. Conclusion: This study found that poverty and poor education are the underlying cause of child marriage and child marriage is usually against the will of the girls who desire to be educated.Key words: Early marriage, maternal and childhood morbidity and mortality, Child Right Act, girl child education, puberty, teenage pregnanc

Domestic Refuse Handling Practices Among Adult Females in a Nigerian Metropolitan City: Are there Challenges

Domestic refuse are solid household wastes that are predominantly  handled by adult females. This study determines the domestic refuse-handling practices/associated factors in a Nigerian metropolitan city. It was an interventional/community-based study involving a total of 436 adult females selected by the multi-stage sampling method. They were  subdivided into two groups: control group (n=218) and intervention group (n=218). Using a semi-structured, interviewer-administered questionnaire, a baseline assessment was made in both groups. Health education was given on domestic refuse handling and reinforcement by trained  community-based health educators. Three months later, the same respondents were re-assessed using the same questionnaire. Data was analysed using EPI info software. Post-intervention results showed that 137 (62.8%) of the females in the intervention group had good domestic refuse-handling practices compared to 55 (25.2%) of the females in the control group, while 163 (74.8%) had bad practices. Majority of females suggested collective efforts as a solution to the various challenges faced by them particularly the absence of community sanitation members. Also, community-based health education was found to be effective in enhancing good domestic refuse-handling practices, though there is a need for morecommunity effort as regards the proper handling for enhanced  sustainability.Key words: Solid waste, practices, female adults, obstacles

Mutant Prevention Concentrations of Some Aminoglycoside Antibiotics for Fecal Isolates of Escherichia coli under different Growth Temperatures

For optimal efficacy, an antibiotic must achieve and sustain at the site of infection, a concentration that can inhibit growth of the bacteria. However, a bacterial infection may contain subpopulations of mutant variants with reduced susceptibility to the antimicrobial agent. There is a great need to periodically evaluate the mutant prevention concentration (MPC) of antibiotic to provide a basis for altering dosing regimens such that the growth of resistant organisms could be curtailed. To evaluate the mutant prevention concentrations (MPCs) of streptomycin, gentamicin and amikacin for fecal Escherichia coli isolates under different growth temperatures and determine the extent of recovery of resistant mutants at such temperatures. Fifty (50) isolates of E. coli were isolated from stools of patients attending Nasarawa State University Keffi Health Centre in Keffi, Nigeria and identified using standard protocol. Antibiotic minimum inhibitory concentrations (MICs) were determined using macro-broth dilution method of the Clinical and Laboratory Standards Institute (CLSI) with incubation for 24 h at 37°C and 41°C. MIC for 50% (MIC50) and 90% (MIC90) of isolates were then generated from the plot of cumulative frequency curve. MPCs were measured by spreading a series of agar plates containing known aminoglycoside concentrations with approximately 1010 CFU of E. coli culture and incubated for 48 h at 37°C and 41°C. The lowest aminoglycoside concentration that prevented the growth of resistant colonies was taken as the MPC. MPCs for 50% (MPC50) and 90% (MPC90) of isolates were then generated from the plot of cumulative frequency of the MPCs obtained. MPC/MIC ratios for 50% (MPC50/MIC50) and 90% (MPC90/MIC90) of isolates were also determined. Bacteria surviving (persisting) at MPC were isolated and quantified after 48 h. Statistical analyses of data were done by one-way Analysis of Variance (ANOVA). For each of the drugs, MPC50 and MPC50/MIC50 were the same at both 37°C and 41°C. MPC50 values were: streptomycin (44.2 ?g/ml [?32.0 ?g/ml]); gentamicin (44.2 ?g/ml [?32.0 ?g/ml]); and amikacin (37.4 ?g/ml [?32.0 ?g/ml]); and MPC50/MIC50 ratios for each drug at both temperatures were ? 3. MPC90 and MPC90/MIC90 were the same for each drug at both 37°C and 41°C. MPC90 values were: streptomycin (253.2 ?g/ml [?256.0 ?g/ml]), gentamicin (209.0 ?g/ml [?256.0 ?g/ml]), and amikacin (128.0 ?g/ml); and MPC90/MIC90 ratios for each drug at both temperatures were ? 4. Mutant recoveries at the MPCs of the drugs for 50% of the isolates were significantly (P < 0.05) different both at 37°C (P = 0.0089) and 41°C (P = 0.0011). However, mutant recoveries at the MPCs of the drugs for 90% the isolates were insignificantly (P >0.05) different at 37°C (P = 0.0055) but significantly (P > 0.005) different at 41°C (P = 0.0080). Whether at normal body temperature or at a higher body temperature usually obtained during fever, E. coli selects and enrich for resistant mutants less easily against streptomycin than gentamicin or amikacin. The extent of recovery of mutants however, is higher at the higher temperature, justifying the common practice of administering high dosage of antimicrobial agent at high body temperature during therapy of bacterial disease. Keywords: Mutant Prevention Concentration, Escherichia coli, Aminoglycosid