CONTRACEPTIVE METHOD CHOICE AND COMMODITY SOURCES AMONG WOMEN OF REPRODUCTIVE AGE CURRENTLY USING ANY FORM OF CONTRACEPTION IN COMMUNITIES IN IMO STATE, NIGERIA

Introduction: The choice and use of a particular contraceptive method and their sources varies globally. The common modern contraceptive methods used were; condoms, injectables, pills and Intra Uterine Contraceptive Devices (IUCD). Aim: The aims of this study was to determine the pattern of contraceptive method choice and commodity  sources among women of reproductive age who are currently using any contraception in communities in Imo State, Nigeria. Methodology: This study was a community based cross-sectional study carried out among 1123 women of reproductive age (15-49 years) living in communities in Imo State, Nigeria. Eligible participant were selected using a multistage random sampling technique and data was collected using a pretested, semi structured and interviewed administered questionnaire. Data was analyzed using a computer software (EPI-INFO Version 3.3.2). Results: The mean age of the women was 32.0±8.0 years. Out of the 1123 women studied, only 305 (27.2%) were current contraceptive users. About two-third of the users (18.2%) were using any form of modern contraceptive method. The common contraceptive methods used were; condoms, periodic abstinence, injections and pills. Contraceptive choice varies with age, marital status, religion and resident of women. Overall most women sourced their contraceptives from the private sector. Most of the barrier methods and pills were sourced from the chemist while the injections, IUCD tubal ligation and implants were sourced from the hospitals. Conclusion: Use of modern contraceptive method was low and the choice of a particular contraceptive type and source of the commodity varies with socio-demographic characteristics of the women. There is need to make contraceptives available and family services accessible to women in a way that will be culturally acceptable to them. Keyword: Contraceptive method, choice, commodity sources, communities, Imo Stat

of Solid Waste Management in Onitsha Metropolis, Nigeria

Abstract Background: Despite efforts at making municipal solid waste management (MSWM) effective, one key challenge faced by the state and local environmental protection agencies in Nigeria has been inconsistencies in the pattern of solid waste management by households. Objective: To determine the practice, pattern and challenges of solid waste management in Onitsha Metropolis. Materials and methods: A cross-sectional study of 425 households in Onitsha Metropolis, selected using multistage sampling technique was done. Quantitative data was collected by interview using a pretested semi-structured questionnaire and analysed using computer Graph Pad Prism version 5.3. Tests of statistical significance were carried out using ANalysis Of Variance followed by multiple comparison done using post hoc Tukey's HSD (honestly significant difference) test. A p value of < 0.05 was considered significant. Qualitative data was obtained using key informant interviews. Results: The mean age of the respondents is 36.84±12.21years. Whereas 244 (57.4%) use government facilities / services, 47 (11.1%) dump theirs on streets and drainages. Two hundred and ninety five (60.90%) practice some form of waste segregation. There were statistically significant differences between the areas of residence and household solid waste disposal personnel (p<0.05), patterns of solid waste disposal (p<0.05) and solid waste separation (p<0.05) respectively. Conclusions: The study revealed poor waste management practices as well as some relationship between area of residence and waste disposal personnel, pattern of waste disposal and waste separation respectively. Strategies for improving the MSWM in Onitshaare thus suggested

Perception of quality of maternal healthcare services among women utilising antenatal services in selected primary health facilities in Anambra State, Southeast Nigeria

Background: This is a cross-sectional descriptive study aimed at assessing antenatal care service attendees′ perception of quality of maternal healthcare (MHC) services in Anambra State, southeast Nigeria. Materials and Methods: A total of 310 pregnant women utilising antenatal care (ANC) services in three purposively selected primary health centres (PHCs) in rural communities in Anambra State were studied. Reponses were elicited from the participants selected consecutively over a 4-month period, using a pre-tested, semi-structured interviewer-administered questionnaire on socio-demographic characteristics, utilisation and perception of MHC services. Data collected were analysed using SPSS version 17. Results: Findings showed that utilisation of facility for both antenatal (97.0%; 95% CI, 94.4-98.4%) and natal services (92.7%; 95% CI 89.2-95.2%) were quite high. Generally, most of the women were satisfied with MHC services (89.7%). Most of them were satisfied with the staff attitude (85.1%), waiting time (84.1%) and cost of services (79.5%). Being ≥30 years (X2 = 4.61, P = 0.032), married (X2 = 9.70, P = 0.008) and multiparous (X 2 = 9.14, P = 0.028), as well as utilisation of formal health facility for antenatal (X2 = 26.94, P = 0.000) and natal (X2 = 33.42, P = 0.000) services were associated with satisfaction with maternal health services. Conclusions: The study showed high level of satisfaction with quality of maternal health services among antenatal attendees and highlights the need to strengthen interventions that increase uptake of formal MHC services

Knowledge and Compliance with Standard Precaution Among Healthcare Workers in A South-East Nigerian Tertiary Hospital

Background: Adherence to standard precautions (SP) is critical to reducing the burden of nosocomial infections. Objective: We assessed the knowledge and practice of SP among healthcare workers (HCWs). Methodology: A cross-sectional study was conducted among HCWs in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi Anambra State, Nigeria using self-administered questionnaire and key informant interview. Results: Mean age and employment duration of subjects were 33.4±11.9 and 6.0 ± 6.7 years, respectively. Majority of the 341 HCWs had heard about SP (82.1%) and agreed that it should be applied to all patient care (78.0%). Only 45.7% of them correctly cited ≥2 components of SP. Two-third of participants reported that SP was poorly practiced in their unit mainly due to inadequate supply of materials (63.1%), inadequate staff training/retraining (62.2%), inadequate support by management (51.4%) and unavailable standard operating procedures (SOPs) on SP (37.8%). Compliance with SP and specifically, personal protective equipment (PPE) use were 65.1% and 76.2%, respectively. Profession (p=0.023), awareness about SP (p<0.001), SOP display in prominent places (p<0.001) and regular supply of running water (p<0.001) were significantly associated with SP compliance. Key informant interview revealed lack of written SP policies or its communication to HCWs, lack of training/retraining of HCWs and lack of materials required for SP practice. Conclusion: Knowledge of basic concept and practice of SP was not satisfactory among HCWs. Major barriers to SP were lack of materials, training and active support by hospital management. Awareness, SOP display in prominent places and regular supply of running water positively influenced SP compliance. Having written policies and communicating such to all HCWs, consistent supply of necessary materials, intensified training, and regular supervision are recommended Keywords: Universal precautions, Nosocomial infections, Tertiary hospitals, Health Personnel, Nigeri

An evaluation of innovative community-based approaches and systematic tuberculosis screening to improve tuberculosis case detection in Ebonyi State, Nigeria

Background: National tuberculosis (TB) programmes globally rely heavily on passive case finding for detecting TB in the community as advocated by the World Health Organization (WHO). TB case detection is low in Nigeria despite improvement in TB services and coverage. Methods: A retrospective evaluation of an active case-finding intervention utilizing community-based approaches and targeted systematic TB screening in Ebonyi State, Nigeria was done. The analysis was performed using Epi Info. Results: Using community-based and health-facility-based systematic screening strategies, 218,751 persons were screened, with 19.7% of them being presumptive TB cases. Among these, 23,729 (55.1%) submitted sputum samples for microscopy, and 764 (3.2%) had smear-positive TB. In addition, 683 individuals were diagnosed with other forms of TB using X-ray and clinical evaluation giving a total of 1447 all forms of TB cases. The overall number needed to screen (NNS) to find one person with all forms of TB through the project was 151. The NNS was 53 for general outpatients, 88 through contact tracing, and 110 among HIV-infected persons. Conclusions: Active case-finding strategies achieved good yields though early loss to follow-up was high. Active case finding is recommended for integration into national TB control policy and practice