Availability and utilization of emergency obstetric care public health facilities in Zaria, Northern Nigeria

Background: Maternal mortality rates continue to soar high in Northern Nigeria despite all sorts of interventions being put in place. This has necessitated the need to emphasize on Emergency Obstetric Care (EmOC) to tackle obstetric complications which are the largest direct causes of maternal mortality. The study was conducted to assess the availability of Emergency Obstetric Care facilities in Zaria Local Government Area (LGA) located in Northern Nigeria.Methods: This was a hospital based cross- sectional descriptive study carried out in Zaria LGA. Data was collected from seven public health facilities using a structured interviewer administered questionnaire.Results: The LGA met the WHO requirement for the population served while none of the designated BEOC met the UN criteria for such designation. Only 8% of births took place in the health facilities and 0.7% of deliveries were by caesarean section. The met need for EmOC in Zaria LGA was 25.1%. Human resources were lacking in number and skills. Some key drugs and equipment needed to carry out signal function were also absent.Conclusions: Public health facilities in Zaria did not meet the requirements of the United Nations (UN) process indicators. There is need to upgrade the health facilities with the necessary human resource, equipment and facilities to enable them perform their designated EmOC functions

The Profile and Significance of Listed Property Companies in Some Selected African Countries

This study investigates the significance and profile of Listed Property Companies (LPCs) in 10 African countries namely; Botswana, Egypt, Kenya, Mauritius, Morocco, Nigeria, South Africa, Tunisia, Zambia, and Zimbabwe respectively for the period of 10 years from 2006 to 2015., the profile and some key indicators of each respective country has been identified to determine the significance of each respective economy. The study uses secondary data obtained from Thompson Reuters DataStream to extract the number of companies in each country and their respective profiles. Descriptive statistics were used to analyze 64 Listed Property Companies using simple percentages. The study revealed that most of the African countries are Opaque with very few semi-transparent such as Kenya, Mauritius, and Botswana with the exception of South Africa which is the only transparent, the study further revealed that most of the companies are established between 2010 to 2015. Egypt has the highest number of property companies 29 represented by 45.31 % followed by South Africa with 16 Listed property Companies Represented by 25 % while Nigeria, Kenya and Zambia have the least number of companies with 1 each represented by 1.56%

An assessment of corporate social responsibility of property developers in Bauchi Metropolis, Nigeria

Purpose: The study aims to assess the corporate social responsibility of property developers in Bauchi metropolis with a view to examine the importance and effects of corporate social responsibility on property development in the study area. This study is limited to Bauchi metropolis. Research Methodology:The study uses descriptive and exploratory research design using quantitative research approach. Questionnaires were administered to 20 property developers within Bauchi metropolis using purposive sampling techniques. Reliability was investigated by an overall average Cronbach’s Alpha value of 0.81, the data obtained was analyzed using percentage computation, weighted mean, relative importance index (RII) and severity index (SI) were also used. Findings: The most important corporate social responsibility (CSR) to the property developers is environmental sustainability followed by a qualitative environment, the less important is the safety of houses. Furthermore, the highest CSR provided by the developers is environmental sustainability. Among the highest effects of neglecting corporate social responsibility is causing damage to the environment while the least is developing poor neighborhoods. Limitations: This study explored on only 20 property development firms within Bauchi metropolis, results might not necessarily apply to other firms within the metropolis. Contribution: This study will be of significant importance to the government and professional bodies in the built environment in terms of policy formulation, these can help checkmate the property development companies in carrying out corporate social responsibilities to the immediate environment they operate thereby becoming socially responsible and allowing the general public/community to enjoy projects that will enhance their lives. Keywords:Corporate social responsibility, Sustainable development, property developer

A randomized controlled trial of rectal diclofenac sodium and intramuscular pentazocine versus intramuscular pentazocine, diclofenac, and paracetamol analgesics for pain relief in the first 48 h after cesarean section

Background: Cesarean section is one of the most commonly performed operations in obstetric practice. A multimodal approach to post‑cesarean  pain management has been shown to be more effective than a unimodal approach, though the most effective combination and preferred route of administration are still unknown. Aim: To compare the effectiveness of rectal diclofenac sodium and intramuscular pentazocine versus intramuscular pentazocine, paracetamol, and diclofenac analgesics for pain relief in the first 48 h after cesarean section at Federal Medical Centre, Katsina. Methods: This was a prospective single‑blind, randomized controlled trial, in which 120 booked women planned for cesarean section were recruited  and randomly allocated to the study or control group. The study group received 100 mg rectal diclofenac sodium 12 h and intramuscular pentazocine 60 mg 6 h, while the control group received intramuscular diclofenac 75 mg 12 h, pentazocine 60 mg 6 h, and paracetamol 600 mg 8 h for the first 48 h postoperatively. Pain perception, maternal satisfaction, and preferred route of drug administration were compared between the two groups. Results: The study group had significantly lower mean visual analog scale pain scores and higher maternal satisfaction in the first 48 h (P < 0.05).  There were no significant differences in the maternal and newborn side effects of the analgesics. The rectal route of drug administration was more preferred (P < 0.05). Conclusion: The study showed that rectal diclofenac sodium and intramuscular pentazocine post‑cesarean section analgesic efficacy and maternal satisfaction were superior to that of intramuscular pentazocine, diclofenac, and paracetamol. Key words: Cesarean section; intramuscular pentazocine; postoperative pain relief; rectal diclofenac sodium

Evaluating Health Workers’ Knowledge Following the Introduction of Clinical Mentoring in Jigawa State, Northern Nigeria.

Clinical mentoring is work-based training for the capacity building of health care workers. This study determined if there were benefits and increases in knowledge levels for 33 selected health workers across 5 health facilities in Jigawa State following the introduction of clinical mentoring. Questionnaires were used to determine biodata and knowledge scores of mentored health workers and also key departmental activities before and after a 6 months period of introduction of clinical mentoring. Data was analyzed with SPSS version 20. Over 90% of the 33 mentored health workers showed an increase in their knowledge scores. The mean percentage score of the health workers increased significantly from 56.3 ± 2.1 before the start of clinical mentoring to 74.7 ± 1.7 (p<0.001) six months later. Mortality review meetings were also introduced. This study has shown that clinical mentoring is beneficial for improving the clinical knowledge of mentored health workers. (Afr J Reprod Health 2015; 19[3]: 118-125). Keywords: Health workers, clinical mentoring, capacity building, northern Nigeria Le mentorat clinique est la formation en milieu de travail pour le renforcement des capacités du personnel de la santé. Cette étude a déterminé s’il y avait des avantages et des augmentations dans les niveaux de connaissances pour les 33 membres du personnel de la santé sélectionnés à travers 5 Centres de santé de l'Etat de Jigawa suite à l'introduction de mentorat clinique. Des questionnaires ont été utilisés pour déterminer un curriculum vitae et des notes de connaissances du personnel de la santé qui sont passés par le mentorat et aussi des activités clés du ministère avant et après une période de six mois de l'introduction du mentorat clinique. Les données ont été analysées avec la version SPSS 20. Plus de 90% des 33 des membres du personnel de la santé qui ont subi le mentorat ont montré une augmentation dans leurs scores de connaissance. Le score moyen de pourcentage du personnel de la santé a augmenté considérablement de 56,3 ± 2,1 avant le début de mentorat clinique à 74,7 ± 1,7 (p <0,001) six mois plus tard. Les réunions pour l’examen de la mortalité ont été également introduites. Cette étude a montré que le mentorat clinique est bénéfique pour améliorer la connaissance clinique du personnel de la santé qui a subi le mentorat. (Afr J Reprod Health 2015; 19[3]: 118-125). Mots-clés: personnel de la santé, mentorat clinique, renforcement des capacités, nord du Nigeri

Persistent hypertension up to one year postpartum among women with hypertensive disorders in pregnancy in a low-resource setting:A prospective cohort study

BACKGROUND: Hypertensive disorders in pregnancy (HDPs) are associated with lifelong cardiovascular disease risk. Persistent postpartum hypertension in HDPs could suggest progression to chronic hypertension. This phenomenon has not been well examined in low- and middle-income countries (LIMCs), and most previous follow-ups typically last for maximally six weeks postpartum. We assessed the prevalence of persistent hypertension up to one year in women with HDPs in a low resource setting and determined associated risk factors. METHODOLOGY: A prospective cohort study of women conducted at eight tertiary health care facilities in seven states of Nigeria. Four hundred and ten women with any HDP were enrolled within 24 hours of delivery and followed up at intervals until one year postpartum. Descriptive statistics were performed to express the participants’ characteristics. Univariable and multivariable logistic regressions were conducted to identify associated risk factors. RESULTS: Of the 410 women enrolled, 278 were followed up to one year after delivery (follow-up rate 68%). Among women diagnosed with gestational hypertension and pre-eclampsia/eclampsia, 22.3% (95% CI; 8.3–36.3) and 62.1% (95% CI; 52.5–71.9), respectively, had persistent hypertension at six months and this remained similar at one year 22.3% (95% CI; 5.6–54.4) and 61.2% (95% CI; 40.6–77.8). Maternal age and body mass index were significant risk factors for persistent hypertension at one year [aORs = 1.07/year (95% CI; 1.02–1.13) and 1.06/kg/m(2) (95% CI; 1.01–1.10)], respectively. CONCLUSION: This study showed a substantial prevalence of persistent hypertension beyond puerperium. Health systems in LMICs need to be organized to anticipate and maintain postpartum monitoring until blood pressure is normalized, or women referred or discharged to family physicians as appropriate. In particular, attention should be given to women who are obese, and or of higher maternal age

Metabolic syndrome following hypertensive disorders in pregnancy in a low-resource setting:A cohort study

Objectives: Hypertensive disorders in pregnancy (HDPs) are associated with risk of future metabolic syndrome. Despite the huge burden of HDPs in sub-Saharan Africa, this association has not been adequately studied in this population. Study design: This was a prospective cohort study on pregnant women recruited between August 2017 - April 2018 and followed up to one year after their deliveries and evaluated for presence of metabolic syndrome at delivery, nine weeks, six months and one year. Main outcome measures: Prevalence of metabolic syndrome Results: A total of 488 pregnant women were included: 410 and 78 with HDPs and normotensive, respectively. None of the normotensive had metabolic syndrome until one year (1.7% = 1 out of 59 observations), while among those with HDPs were 17.4% (71 of 407), 8.7% (23 of 263), 4.7% (11 of 232) and 6.1% (17 of 278), at delivery, nine weeks, six months and one year postpartum, respectively. High BMI and blood pressure were the drivers of metabolic syndrome in this population. The incidence rate in HDPs versus normotensive at one year were, respectively, 57.5/1000 persons’ year (95%CI; 35.8 – 92.6) and 16.9/1000 persons’ years (95%CI; 2.4-118.3), with incidence rate ratio of 3.4/1000 person's years. Only parity significantly predicted the presence of metabolic syndrome at one year [(aOR= 3.26/delivery (95%CI; 1.21-8.79)]. Conclusion: HDPs were associated with a higher incidence of metabolic syndrome up to one year postpartum. Women with HDPs should be routinely screened for metabolic syndrome within the first year postpartum to reduce cardiometabolic risks.</p

Facilitators and barriers to seasonal malaria chemoprevention (SMC) uptake in Nigeria: a qualitative approach

BACKGROUND: SMC was adopted in Nigeria in 2014 and by 2021 was being implemented in 18 states, over four months between June and October by 143000 community drug distributors (CDDs) to a target population of 23million children. Further expansion of SMC is planned, extending to 21 states with four or five monthly cycles. In view of this massive scale-up, the National Malaria Elimination Programme undertook qualitative research in five states shortly after the 2021 campaign to understand community attitudes to SMC so that these perspectives inform future planning of SMC delivery in Nigeria. METHODS: In 20 wards representing urban and rural areas with low and high SMC coverage in five states, focus group discussions were held with caregivers, and in-depth interviews conducted with community leaders and community drug distributors. Interviews were also held with local government area and State malaria focal persons and at national level with the NMEP coordinator, and representatives of partners working on SMC in Nigeria. Interviews were recorded and transcribed, those in local languages translated into English, and transcripts analysed using NVivo software. RESULTS: In total, 84 focus groups and 106 interviews were completed. Malaria was seen as a major health concern, SMC was widely accepted as a key preventive measure, and community drug distributors (CDDs) were generally trusted. Caregivers preferred SMC delivered door-to-door to the fixed-point approach, because it allowed them to continue daily tasks, and allowed time for the CDD to answer questions. Barriers to SMC uptake included perceived side-effects of SMC drugs, a lack of understanding of the purpose of SMC, mistrust and suspicions that medicines provided free may be unsafe or ineffective, and local shortages of drugs. CONCLUSIONS: Recommendations from this study were shared with all community drug distributors and others involved in SMC campaigns during cascade training in 2022, including the need to strengthen communication about the safety and effectiveness of SMC, recruiting distributors from the local community, greater involvement of state and national level pharmacovigilance coordinators, and stricter adherence to the planned medicine allocations to avoid local shortages. The findings reinforce the importance of retaining door-to-door delivery of SMC