Respectful Maternity Care and Midwives' Caring Behaviours During Childbirth in Two Hospitals In Calabar, Nigeria

All women deserve humane, considerate, sensitive and respectful care in childbirth. Respectful maternity care (RMC) is human right and standard midwifery practice. However there have been general public complaints about lack of respectful behaviour by midwives. To determine clients' experience of respectful maternity care and midwives' caring behaviour, two hospitals in Calabar, Nigeria were selected for this study. This descriptive study collected data from 83 purposively selected postnatal women who had spontaneous vaginal delivery, and 51 midwives caring for them. Ethical clearance was obtained from the HREC of Cross River State Ministry of Health and informed consent from participants. Clients and midwives identified respectful maternity care received/practiced from the RMC checklist. Data were analyzed using SPSS version18.0. RMC was reported by 58 (69.9%) clients while 25 (30.1%) reported lack of it in different categories. Non-respectful care reported included lack of privacy, lack of information about progress of labour, denying preference and choice of childbirth position, lack of sensitivity towards clients' pain and culture, verbal abuse, detention in facility for non-payment of bill. Attending midwives confirmed not adequately screening or draping women (because of lack of screens and drapes); restricting women to deliver in the dorsal position and detaining women if they cannot pay the bill (because of hospital policy). Common acts of disrespectful care experienced by women in this study fit into some of the categories identified in literature. Appropriate maternity care must be respectful and rights-based in order to enhance utilization of maternity services and access to skilled care

A Participatory Evaluation of the Outcome of Actions Taken Toward the Prevention of Maternal Mortality in a Rural Community in Nigeria

While there has been worldwide focus on improving maternal mortality, in sub-Saharan Africa this is a challenge because of limited healthcare resources, inadequate health literacy and traditional beliefs. National and international policies emphasise better emergency maternal care, skilled birth attendants, better health education and community mobilization to ameliorate the situation. Evidence demonstrates the effect of skilled attendants, better education and emergency services but little about the impact of empowering local communities to take action to prevent maternal mortality. This concluding phase of a participatory action research project aimed to evaluate the actions of a rural community in southern Nigeria following mobilization towards prevention of maternal mortality. Twelve volunteers from the community directly or indirectly involved with pregnancy and childbirth were recruited through purposive and snowball sampling as co-researchers. They undertook participatory data collection from 8 focus groups and 12 individual interviews to evaluate actions previously undertaken by them to raise awareness about maternal mortality and its prevention. Data were thematically analysed. Findings presented in themes included: reported revised understandings of causes of maternal mortality rather than previous beliefs of attributing maternal complications/deaths to evil spirits; more appropriate behaviour to prevent maternal mortality such as preference of skilled birth attendants to traditional birth attendants. Conclusion is that through action research, the community appeared to have been mobilized by showing signs of empowerment to take action in collaboration with skilled birth attendants towards reduction of maternal mortality. Therefore, community members should be involved in actions that help to prevent maternal deaths

An Exploratory Study of Menstruation and Menstrual Hygiene Knowledge Among Adolescents in Urban and Rural Secondary Schools in Cross River State, Nigeria

Menstruation and menstrual hygiene knowledge is fundamental to the health and well-being of adolescent females, however little attention is paid to the acquisition of the right knowledge about this important aspect of adolescent reproductive health in developing counties, Nigeria inclusive. The study was aimed at determining menstruation and menstrual hygiene knowledge among secondary school students as a basis for planning an appropriate health promotion intervention. A cross-sectional study conducted in selected urban and rural secondary schools in Cross River State, Nigeria. Using a semi-structured questionnaire, 1,006 adolescent female students from junior secondary to senior secondary in eight schools were surveyed. The research protocol was approved by the Ethical Review Board of the Cross-River State, Ministry of Health. Of the 1,006 respondents, 600(59.6%) were urban-based while 406 (40.4%) were rural-based. Most 556 (55.3%) were from public schools while 450(44.7%) were from private schools. Mean age was 14.2±2.71 while age at menarche was 10.95±4.10. Age at menarche in urban schools was 11.1±0.157 while that of rural schools was 10.71±0.239. On knowledge, 230(56.7%) rural-based adolescent female students had a significantly poor knowledge of menstruation and menstrual hygiene practices compared with their urban-based counterparts 253 (42.2%). Majority 435(72.5%) in urban and 327(80.5%) in rural schools obtained information about menstruation from their mothers. Similarly, 407(67.8%) in urban schools and 318 (78.3%) from rural schools were informed about menstrual hygiene by their mothers. There is an urban-rural gap in knowledge of menstruation and menstrual hygiene. Parental role in menstrual hygiene education is critical

Personal characteristics and compliance to health education among pregnant women attending antenatal clinic in University of Calabar Teaching Hospital, Nigeria

This study investigated personal characteristics (individual factors) associated with compliance to health education among pregnant women attending antenatal clinic in University of Calabar Teaching Hospital, (UCTH) Calabar, and Cross River State, Nigeria. Level of Knowledge, educational status, age, parity and time’ of pregnant  women were isolated and examined. Three research questions and one hypothesis  were formulated to guide the study. Literature was conceptually, empirically and  theoretically reviewed based on the variables under study. Descriptive design was adopted, and using the convenience sampling technique, a sample size of 140  pregnant women who attended antenatal care from May 2016 to November 2016 was used. A validated and reliability certified (with a correlation coefficient of 0.79) structured questionnaire was used to generate data from respondents.  Questionnaire was administered through face to face interaction and on the spot  collection of completed questionnaire. Data were presented using frequency tables, pie-charts and bar-chart, while chi-square (X2) analysis at 0.05 level of  significance was used to test the hypothesis. The results of the study showed that  individual factors that facilitated compliance were level of knowledge and level of education of the pregnant women; 72.9% of the study participants had adequate knowledge about health education and a greater proportion (62.9%) complied with health education. Chi-square analysis of the hypothesis showed a statistically significant association between level of education and compliance towards health education (X2 cal = 31.56, X2 crit = 7.815, P = 0.05, df = 3). Number of children (parity) and lack of time were the individual factors that hindered compliance. It was therefore recommended that Midwives should intensify efforts in awareness creation on family planning and its benefits, to reduce number of children to give mothers time to take care of themselves. Government of Nigeria and Cross River State in particular should reduce the high cost of education thereby encouraging every  citizen to have basic education thus reduce illiteracy level of women and of its citizens in general.Keywords: Pregnant women, Antenatal Care Services, Individual factor