FUNDING STRATEGIES AND SUSTENANCE OF EARLY CHILDHOOD EDUCATION IN NIGERIA: THE WAY FORWARD

This paper examined the existing funding strategies of Early Childhood Education (ECE) in Nigeria with a view to suggesting strategies for its better funding and sustenance. The paper recognised the commitment of the Nigerian Governments and the support of the community, individuals and foreign sponsors in funding ECE programmes. The paper however submitted that much more still needs to be done towards providing adequate funds for quality teachers/caregivers, supply of appropriate facilities and stimulating learning materials as well as supervision of ECCD programmes. Towards this end, increased government allocations, sustained international support, financial allocation to ECE teacher training institutions, equity funding and cost-sharing strategies were recommended

Randomised Trial of Oral Misoprostol Versus Manual Vacuum Aspiration for the Treatment of Incomplete Abortion at a Nigerian Tertiary Hospital

Objectives: This study aimed to compare the efficacy of oral misoprostol with manual vacuum aspiration (MVA) in first trimester incomplete abortions. Methods: This randomised controlled trial study was conducted at the University of Ilorin Teaching Hospital, Ilorin, Nigeria between April 2014 and November 2015. Pregnant women who presented with clinical features of incomplete abortion at a gestational age of 13 weeks or less were included. Patients who had profuse vaginal bleeding, an intrauterine device in situ, signs of pelvic infections or who were younger than 18 years old and had no accompanying adults to give informed consent were excluded. A total of 200 participants were randomly and equally allocated to either the MVA or misoprostol treatment group. The treatment group were given 600 μg of misoprostol orally. The primary outcome measure was complete uterine evacuation, while secondary outcome measures included the need for additional surgical evacuation for failed treatment, adverse effects/complications, acceptability of and satisfaction with the treatment. Results: Both misoprostol and MVA had high complete evacuation rates, yet MVA was significantly higher (99% versus 83%, relative risk [RR]: 0.84, confidence interval [CI]: 0.766–0.918; P <0.001). Significantly more women in the misoprostol group required additional MVA for failed treatment than in the MVA treatment group (17% versus 1%, RR: 16.67, CI: 2.260–12.279; P <0.001). No significant difference was found between the misoprostol and MVA treatment groups in terms of satisfaction (92.7% versus 89.8%, RR: 1.04, CI: 0.946–1.127; P = 0.473). Conclusion: Treatments with misoprostol and MVA had high complete uterine evacuation rates, as well as high rates of acceptability and satisfaction. However, MVA had a significantly higher complete evacuation rate than misoprostol. Keywords: Misoprostol; Abortion Techniques; First Trimester; Incomplete Abortion; Nigeria

Female adolescents and the future of female genital mutilation/cutting: a report from an endemic area

Background: Despite collaborative efforts aimed at its eradication, Female Genital Mutilation/Cutting (FGM/C) continuesin endemic areas. Objective: To evaluate the experience and preparedness of female adolescents to protect their future daughters from FGM/C. Methods: A cross-sectional survey involving adolescent secondary school girls in North Central Nigeria. Participants were secondary school students who completed the study’s self-administered questionnaire after informed parental or participant’s consent. Data management was with SPSS 20.0 (IBM, USA), P-value &lt;0.05 was significant. Results: There were 2000 participants aged 13-19 years (mean 15.56±1.75), prevalence of FGM/C was 35.0%, awareness was 86.1%, mutilation was performed between infancy and eight years of age (mean 3.85±3.24 years), 644(32.2%) desire to mutilatetheir future daughters, 722(36.1%) expressed support for FGM/C and 63.1% of victims of FM/C reported adverse post-mutilation experiences. Support for FGM/C was associated with low social class (P0.0010), opinion that FGM/C has benefit (P0.001) and desire to mutilate future daughters (P0.001) while awareness of efforts to eradicate FMG/C was 813(40.7%). Conclusion: FGM/C remains prevalent with potential support for its continuation among female adolescents despite reported adverse post-mutilation experiences. The multi-pronged approach to eradicate FGM/C should prioritize re-orientation for adolescent girls, rehabilitation of mutilated girls and girl child formal education. Keywords: Female genital mutilation/cutting; female circumcision, harmful traditional practices, adverse childhood experiences

Determinants of the decision-to-delivery interval and the effect on perinatal outcome after emergency caesarean delivery: a cross-sectional study

BackgroundPreventing prolongation of the decision-to-delivery interval (DDI) for emergency caesarean delivery (CD) remains central to improving perinatal health. This study evaluated the effects of the DDI on perinatal outcome following emergency CD. MethodsA prospective cross-sectional study involving 205 consenting women who had emergency CD at a tertiary hospital in Nigeria was conducted. The time–motion documentation of events from decision to delivery was documented; the outcome measures were perinatal morbidity (neonatal resuscitation, 5-minute Apgar score, neonatal intensive admission) and mortality. Data analysis was performed with IBM SPSS Statistics version 20.0, and P&lt;0.05 was considered significant.ResultsThe overall mean DDI was 233.99±132.61 minutes (range 44–725 minutes); the mean DDI was shortest for cord prolapse (86.25±86.25 minutes) and was shorter for booked participants compared with unbooked participants (207.19±13.88 minutes vs 249.25±12.05 minutes; P=0.030) and for general anaesthesia compared with spinal anaesthesia (219.48±128.60 minutes vs 236.19±133.42 minutes; P=0.543). All neonatal parameters were significantly worse for unbooked women compared with booked women, including perinatal mortality (10.8% vs 1.3%; P=0.012). Neonatal morbidity increased with DDI for clinical indications, UK National Institute of Health and Care Excellence (NICE) and Robson classification for CDs; perinatal mortality was 73.2 per 1000 live births, all were category 1 CDs and all except one occurred with DDI greater than 90 minutes. Severe preeclampsia/eclampsia, obstructed labour and placenta praevia tolerated DDI greater than 90 minutes compared with abruptio placentae and umbilical cord prolapse. However, logistic regression showed no statistical correlation between the DDI and neonatal outcomes. ConclusionPerinatal morbidity and mortality increased with DDI relative to the clinical urgency but perinatal deaths were increased with DDI greater than 90 minutes. For no category of emergency CD should the DDI exceed 90 minutes, while patient and institutional factors should be addressed to reduce the DDI

Non-fistulous urinary leakage among women attending a Nigerian family planning clinic

Urinary leakage is an important gynecological challenge, which has a substantial impact on quality of life. The aim of this study was to determine the prevalence and types of non-fistulous urinary leakage among women attending the family planning clinic of the University of Ilorin teaching hospital, Ilorin, Nigeria. The study was a cross-sectional study carried out between January 3 and April 25 2009. One hundred and two women experienced urinary leakage out of 333 women interviewed, giving a prevalence rate of 30.6%. Stress incontinence was the most common urinary leakage (prevalence rate 12.0%). This is followed by urge incontinence (10.8%), urinary incontinence (4.8%), and overflow incontinence (3.0%). None of the women afflicted sought medical help. Conclusively, this study has demonstrated that non-fistulous urinary leakage is a common problem among women of reproductive age in this environment

OVERCOMING THE CHALLENGES OF INSECURITY IN NIGERIA

Insecurity constitutes an existential challenge and remains a scourge that undermines Nigeria's march to progress. Various dimensions of insecurity have plagued Nigeria since independence in 1960. It is notable that in the Fourth Republic (1999-2023), insecurity has reached unprecedented heights, with gross implications for national development. It is more disturbing that it has become more widespread and regionalised with Nigeria rated by Global Terrorism Index (GTI, 2022) as the third most insecure country in the world, after Afghanistan and Iraq. Although the Federal Government has embarked upon various measures to curb insecurity in the country, they have proved largely unworkable due to poor conceptualisation and ineffective implementation, among other factors. Thus, this chapter investigates the root causes of insecurity and provides strategic policy options towards overcoming its challenge in Nigeria

Determinants Of The Right Of Access To Food In Sub-Saharan Africa

Food is one of the most important basic needs of human beings since it provides the energy for the physiological functioning of the body. The right to food is thus the right of all individuals alone or in community with others to enjoy physical and economic access to adequate food or the means for its procurement. Adequate food also implies the availability of food in sufficient quantity and quality to satisfy the dietary needs of all individuals and the accessibility of food in ways that are sustainable. Generally, a number of factors are considered important in the determination of the right of access to food. Key among these factors are availability of agricultural resources such as land, water, energy and fertilizer; increase in the demand for food as a result of the increase in population, increase in personal income, development of transportation and storage facilities, macroeconomic stability, socio-political stability; seasonal fluctuation in availability of food due to natural disaster, access to safe water, access to health care services, access to sanitation facilities and many others. This paper examines the extent to which these factors have impacted on the ability of the people in Sub-Saharan Africa to have access to food, using a set of cross-country data and a multiple regression analysis. The results obtained indicate that factors like the increase in population, access to sanitation facilities, access to safe water, access to health care services, access to information and increase in the price of food have to some extent impacted on the right of the people to have access to food in the sub-region. Food supply, income of the people, the presence of democratic values, access to education and access to transport play little or no significant role in determining the right of the people to access food. Given these results, measures, such as, the provision of stable macroeconomics policies, reduction in income poverty, provision of basic social services and good governance were suggested as possible solutions to the right of access to food in Sub-Saharan Africa