Factors influencing contraceptives use among grandmultipara in Ile-Ife, Nigeria

Objective: To determine modifiable factors that influence contraceptive usage among grandmutiparas in a South-Western Nigerian setting.Methodology: A prospective survey was done among antenatal attendees in OAUTHC from January toDecember 2006. Using interviewer administered semi-structured questionnaire data were collected from all  grandmultiparous attendees on sociodemographic characteristics, contraceptive awareness and usage, contraceptive intentions and the role of men on contraceptives usage. Data were analysed with SPSS 11.0 and result presented in descriptive statistics.Results: The prevalence of grandmultiparity was 9.04% in the studied population, and their mean age was 36.73 + 4.7years: Eighty-one percent attended secondary school, and 65% were monogamous. Despite high level of awareness (51.6-100%) contraceptive usage was low (5.9 to 40.8%). About 90% agreed that family planning improve quality of family life. While 80% had no intention for further childbearing only 36% intended to use BTL. Sex preference was the only motivation for further childbearing in all (100%) of them.Conclusion: High literacy rate in this group did not impart positively in reducing the unmet need. Increased awareness on permanent  contraception and the role of men need to be promoted. Health education that will break the negative strongholds of cultural factors has to be introduced gradually at the primary school levels.Keywords: Contraceptive usage, Grandmultiparity, Cultural factors

New paradigm old thinking: the case for emergency obstetric care in the prevention of maternal mortality in Nigeria

<p>Abstract</p> <p>Background</p> <p>The continuing burden of maternal mortality, especially in developing countries has prompted a shift in paradigm from the traditional risk assessment approach to the provision of access to emergency obstetric care services for all women who are pregnant. This study assessed the knowledge of maternity unit operatives at the primary and secondary levels of care about the concept of emergency obstetric care (EmOC) and investigated the contents of antenatal care (ANC) counseling services they delivered to clients. It also described the operatives' preferred strategies and practices for promoting safe motherhood and averting maternal mortality in South-west Nigeria.</p> <p>Methods</p> <p>The study population included all the 152 health workers (doctors, midwives, nurses and community health extension workers) employed in the maternity units of all the public health facilities (n = 22) offering maternity care in five cities of 2 states. Data were collected with the aid of a self-administered, semi-structured questionnaire and non-participant observation checklist. Results were presented using descriptive statistics.</p> <p>Results</p> <p>Ninety one percent of the maternity unit staff had poor knowledge concerning the concept of EmOC, with no difference in knowledge of respondents across age groups. While consistently more than 60% of staff reported the inclusion of specific client-centered messages such as birth preparedness and warning/danger signs of pregnancy and delivery in the (ANC) delivered to clients, structured observations revealed that less than a quarter of staff actually did this. Furthermore, only 40% of staff reported counseling clients on complication readiness, but structured observations revealed that no staff did. Only 9% of staff had ever been trained in lifesaving skills (LSS). Concerning strategies for averting maternal deaths, 70% of respondents still preferred the strengthening of routine ANC services in the health facilities to the provision of access to EmOC services for all pregnant women who need it.</p> <p>Conclusion</p> <p>We concluded that maternity unit operatives at the primary and secondary care levels in South-west Nigeria were poorly knowledgeable about the concept of emergency obstetric care services and they still prioritized the strengthening of routine antenatal care services based on the risk approach over other interventions for promoting safe motherhood despite a global current shift in paradigm. There is an urgent need to reorientate/retrain the staff in line with global best practices.</p

Rural-urban differences on the rates and factors associated with early initiation of breastfeeding in Nigeria: further analysis of the Nigeria demographic and health survey, 2013

Background This study investigates and compares the rates and factors associated with early initiation of breastfeeding (EIBF) within one hour of birth in rural and urban Nigeria. Methods Data from the 2013 Nigeria Demographic and Health Survey (NDHS) were analyzed. The rates of EIBF were reported using frequency tabulation. Associated factors were examined using Chi-Square test and further assessed on multivariable logistic regression analysis. Results The rates of EIBF were 30.8% (95% confidence interval [CI] 29.0, 32.6) and 41.9% (95% CI 39.6, 44.3) in rural and urban residences, respectively (p < 0.001). The North-Central region had the highest EIBF rates both in rural (43.5%) and urban (63.5%) residences. Greater odds of EIBF in rural residence were significantly associated with higher birth order (Adjusted Odds Ratio [AOR] 1.29, 95% CI 1.10, 1.60), large birth size (AOR 1.33, 95% CI 1.10, 1.60), and health facility delivery (AOR 1.46, 95% CI 1.23, 1.72). Rural mothers in the rich wealth index, not working and whose husbands obtained at least a secondary school education had significantly higher odds of early initiation of breastfeeding. Regardless of residence, greater odds of EIBF were significantly associated with non-cesarean delivery (Rural AOR 3.50, 95% CI 1.84, 6.62; Urban AOR 2.48, 95% CI 1.60, 3.80) and living in North-Central (Rural AOR 1.84, 95% CI 1.34, 2.52; Urban AOR 4.40, 95% CI 3.15, 6.15) region. Also, higher odds of EIBF were significantly associated with living in North-East (Rural AOR 1.48, 95% CI 1.05, 2.08; Urban AOR 3.50, 95% CI 2.55, 4.83), South-South (Rural AOR 1.51, 95% CI 1.11, 2.10; Urban AOR 2.84, 95% CI 2.03, 3.97) and North-West (Urban residence only AOR 2.08, 95% CI 1.54, 2.80) regions. Conclusions Rural-urban differences in the rates and factors associated with EIBF exist in Nigeria with rural residence having significantly lower rates. Intervention efforts which address the risk factors identified in this study may contribute to improved EIBF rates. Efforts need to prioritize rural mothers generally, (particularly, those in rural North-West region) as well as mothers in urban South-West region of Nigeria

Contraceptive awareness and use among sexually active breast feeding mothers in Ile-Ife, Nigeria

Objective: To assess the level of awareness and correlates of use of family planning services among sexually active breastfeeding mothers attending an infant welfare clinic. Design: Cross-sectional descriptive design. Setting: Infant welfare clinic of the urban comprehensive health centre, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria. Subjects: Mothers of breast feeding infants aged 8-11 months attending the infant welfare clinic. Results: Awareness of family planning was quite high (95.5%) while current family planning use was quite low (13%). Although the proportion of women who planned for future use of family planning in the sample was high (64%), all current non-users (86.6%) met the criteria for unmet need for family planning. Parity and the number of living children were the only socio-demographic correlates of the respondents that significantly influenced family planning acceptance (

Men's knowledge of and attitude with respect to family planning in a sub-urban Nigerian community

No Abstract. Nigerian Journal of Medicine Vol. 15(3) July-September 2006: 260-26

Knowledge and performance of the Ethiopian health extension workers on antenatal and delivery care: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>In recognition of the critical shortage of human resources within health services, community health workers have been trained and deployed to provide primary health care in developing countries. However, very few studies have investigated whether these health workers can provide good quality of care. This study investigated the knowledge and performance of health extension workers (HEWs) on antenatal and delivery care. The study also explored the barriers and facilitators for HEWs in the provision of maternal health care.</p> <p>Methods</p> <p>In conducting this research, a cross-sectional study was performed. A total of 50 HEWs working in 39 health posts, covering a population of approximately 195,000 people, were interviewed. Descriptive statistics was used and a composite score of knowledge of HEWs was made and interpreted based on the Ethiopian education scoring system.</p> <p>Results</p> <p>Almost half of the respondents had at least 5 years of work experience as a HEW. More than half (27 (54%)) of the HEWs had poor knowledge on contents of antenatal care counseling, and the majority (44 (88%)) had poor knowledge on danger symptoms, danger signs, and complications in pregnancy. Health posts, which are the operational units for HEWs, did not have basic infrastructures like water supply, electricity, and waiting rooms for women in labor. On average within 6 months, a HEW assisted in 5.8 births. Only a few births (10%) were assisted at the health posts, the majority (82%) were assisted at home and only 20% of HEWs received professional assistance from a midwife.</p> <p>Conclusion</p> <p>Considering the poor knowledge of HEWs, poorly equipped health posts, and poor referral systems, it is difficult for HEWs to play a key role in improving health facility deliveries, skilled birth attendance, and on-time referral through early identification of danger signs. Hence, there is an urgent need to design appropriate strategies to improve the performance of HEWs by enhancing their knowledge and competencies, while creating appropriate working conditions.</p