Assessment of the role of traditional birth attendants in maternal health care in Oredo Local Government Area, Edo State, Nigeria

Background: Since the adoption of the Primary Health Care (PHC) approach in Nigeria in 1979, government has recognized the need for integrating traditional birth attendants (TBAs) into the PHC system and had consequently initiated TBAs training programmes. In spite of the high patronage of traditional birth attendants, many of their practices during childbirth have been found to adversely affect the health of mothers. This study aimed at assessing the role of TBAs in maternal health in Oredo Local Government, Benin City, Edo-State, Nigeria. Methodology: All the TBAs identified through snowball method within the LGA consented to providing information, through interviewer-administered questionnaires on their reproductive health practices. Results: Of the 45 TBAs interviewed, forty-four (97.8%) were female. The majority (62.2%) acquired their skills through apprenticeship with relation, while 8.9% had no training at all. The services provided by the TBAs ranged from ante-natal care provided by 53.3%, child delivery, 97.8%, treatment of infertility, 60.0%, management of threatened abortion, 13.3% and circumcision of babies, 28.9%. Preparations used in the treatment of cord stump included methylated spirit used by 42.2% of the respondents, herbal preparations, 28.9%, dry heated sand, 11.1% and engine oil, 6.7%. Some of the medications used (animal dung, flies, scarification marks, and cow urine) to treat patients could serve as sources of infection. Methods of risk assessment during ante-natal care, management of delivery complications, record keeping among TBAs were found to be poor. Infection prevention methods used were also found to be poor, with more than half (51.1%) not using any form of preventive measures during procedures. Conclusion: This study has revealed that the practices of these TBAs are not safe. There is need for improvement through a more holistic training programme including monitoring and supervision.Keywords: traditional birth attendants, role, maternal healthJournal of Community Medicine and Primary Health Care 2005, 17(1): 55-6

Risk Factors and Clinical Correlates of Hepatitits B Seroprevalence in Nigerian Children

Introduction: Establishing risk factors for a disease enables early identification of those with the disease (through screening) as well as targeted prevention and control measures. The significance and relative importance of such risk factors may differ based on geographic location and they may change over time with the institution of control measures. In this study we examined the association between HBsAg seropositivity, some risk factors and clinical features.Methodology: Consecutive children aged 2 months to 16 years who were admitted to a Children’s Emergency Room were recruited. Data on the presence / absence of risk factors such as previous blood transfusion, scarifications, receipt of unsafe injections and previous surgery were obtained. History to ascertain previous or present history of jaundice and pale coloured stool was obtained. Examination to detect hepatomegaly and spenomegaly was carried out. Blood samples were assayed for HBsAg.Results: Of the 150 children recruited 84(56%) were male. The mean (SD) age of the children was 33.0(39.1) months. HBsAg seropositivity was 13.9%. Circumcision, scarification, ear piercing, history of blood transfusion, receipt of unsafe injections, present/ past history of jaundice and malnutrition were not significantly associated with being seropositive (p>0.05).Conclusion: This study did not identify any pathognomonic clinical feature of hepatitis b seroprevalence. The lack of association between HBsAg seropositivity and the studied risk factors may represent a real improvement in infection control measures. Further research is required to ascertain if there are still some unidentified risk factors for hepatitis B transmission in Nigerian children.Keywords: Hepatitis B Virus, Infection, Risk Factor

Psychological morbidity and job satisfaction among teachers in private secondary schools

Background: Teachers are an inseparable corner stone of the society and their satisfaction will affect the quality of service they render. Poor job satisfaction could result in job stress and this could affect their psychological health. This study aims to ascertain the level, causes of job dissatisfaction, intentions to quit and psychological morbidity among teachers in private secondary schools in a developing country.Methods: A cross-sectional study was conducted among teachers (392) in private secondary schools in Benin-City, Edo-State Nigeria, between June 2003 to November 2003. A total population of 400 teachers who had spent at least one year in the service were included in the study. The respondents completed a self – administered designed questionnaire and a standard instrument – The General Health Questionnaire (GHQ 28)Results: The response rate was 98%. Fifty- eight (14.8%) of the respondents had psychological morbidity (GHQ score of 4 and above). One hundred and seventy - eight (45.4%) teachers were very satisfied or satisfied with their jobs. A significant number (45.9%) of teachers would want to quit their jobs. The proportion of teachers with GHQ score 4 and above increased with the level of dissatisfaction but this was not found to be statistically significant. Poor salary was found to be the main cause of job dissatisfaction and major reason for wanting to quit the job.Conclusion: This study shows a low level of job satisfaction among Nigerian teachers. Poor salary was the major cause of job dissatisfaction and intension to quit. Further work need to be done to ascertainthe association of psychological morbidity and job dissatisfaction

Job satisfaction and psychological health of medical doctors in Calabar, Southern Nigeria

Background: Employees should be happy at their work, considering the amount of time they devote to it throughout their working life. There is paucity of data on the job satisfaction and psychological health of medical doctors in Nigeria.Objective: To assess the level of job satisfaction and its relationship to psychological health among medical doctors in a southern city of Nigeria.Design: A cross-sectional descriptive survey.Setting: Three major public hospitals in Calabar, Nigeria.Subjects: Medical doctors who had worked for at least six months in the hospitals.Results: Response rate was 73.0%. More than half (56.7%) of the respondents expressed overall satisfaction with their job. Inadequate pay and work overload were the most commonly mentioned reasons for job dissatisfaction. About a fifth of the respondents were at increased likelihood of psychological disorder. There was a statisticallysignificant negative correlation between job satisfaction scores and GHQ scores. Satisfied respondents were least likely to have psychological disorder.Conclusion: Causes of job dissatisfaction among medical doctors should be addressed to improve their psychological health

Stress and psychological health of medical students in a Nigerian University

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Neonatal jaundice and its management: Knowledge, attitude, and practice among expectant mothers attending antenatal clinic at University of Benin Teaching Hospital, Benin City, Nigeria

Introduction: Neonatal Jaundice (NNJ) is a common disorder worldwide and one of the important contributors to the high neonatal morbidity and mortality in Sub-Saharan Africa. Severe neonatal jaundice leads to brain damage or even death in otherwise healthy newborns. The objective of the study was to assess the knowledge, attitude and practice of expectant mothers about neonatal jaundice and its management.Materials and Methods: The study was descriptive cross-sectional, carried out among 389 expectant mothers who were attending the antenatal clinic at the University of Benin Teaching Hospital. A structured, Pre-tested, researcher administered questionnaire was used to interview the respondents. Data was analysed using SPSS version 15.Results: The mean age of the expectant mothers was 30.5 (SD 4.9) years. Fifty-five (14.1%) of respondents had previous experience with NNJ, 8 (2.1%) lost babies due to NNJ. 334 (85.9%) were aware of the condition, 381 (77.4%) knew how to recognize the symptoms of NNJ, 279 (71.7%) knew a correct method of treatment of NNJ. A large proportion ofthe expectant mothers 261 (67%) knew some complications of NNJ. Two hundred and five (52.7%) did not know any danger sign of complications of NNJ. Three hundred and fifty five (91.3%) had good attitude towards its management. Majority of expectant mothers whose previous babies had NNJ took the babies to the hospital for treatment. A large proportion also expressed their willingness to seek medical attention if their babies were to develop the condition. Their knowledge of neonatal jaundice was significantly influenced by their level of education and the number of theirprevious babies who had NNJ.Conclusion: This study revealed that expectant mothers attending antenatal clinic at UBTH had good knowledge of the treatment and complications of NNJ but inadequate knowledge of the causes and danger signs of the condition. Their attitude and practice towards the management of NNJ was good. It is therefore recommended that Health care providers should give more health education on NNJ to the expectant mothers during antenatal visits.Key words: Neonatal jaundice, expectant mothers, antenatal clinic, Benin Cit

Job Satisfaction and Psychological Health of Long Distance Drivers in Benin City

This cross-sectional analytical study was designed to assess the level of and factors affecting job satisfaction andpsychological health among long distance drivers in Benin City, Edo, Nigeria. A 21-item Job satisfaction questionnaire and the Golberg’s General Health Questionnaire (GHQ 28) were used for data collection from 168 consenting drivers. Data was analysed with SPSS version 15. Results showed that an appreciable number of drivers were satisfied with their job (85%). Factors linked with satisfaction included flexibility of periods designated as resting hours (91.6%), company administration and management (84.6%), self- perception of being valued by the company (79.7%), and remuneration (74.1%). Sources of dissatisfaction included lack of training on the job (82%) and frequent  arassment by law enforcement officers (77%). Psychological morbidity was rare. Overall, the drivers showed high level satisfaction towards their job, though there were areas of dissatisfaction that need to be addressed in the interest and safety of passengers and other road users.Keywords: Drivers, Health, Job Satisfaction, Long distance, Psychologica

Incidence of blood-related work accidents among health workers in a government hospital in Benin City, Nigeria

Accidents are hazards to which health workers are exposed. Hazards may be physical, chemical, biological, mechanical or psychosocial. Mechanical hazards are very common in the health industry because of the frequent use of pointed and sharp instruments such as needles, scalpel and knives. This six-month (June 1999 and June 2000) longitudinal incidence study was carried out at the Central Hospital, Benin City, Nigeria, as a follow-up on a previous cross-sectional study on frequency of blood-related work accidents in the same hospital. All the doctors, laboratory workers and 50% of nurses were included in the study. The nurses were selected using stratified random sampling method. Two hundred and fourteen health care workers started the follow-up study, out of which 146 were left at the end of the six-month period, giving an attrition rate of 31.8%. Results shows that contact with patients' blood with ungloved hands, blood splashes on the face and other parts of the body, needle pricks, cuts from drug ampoules and glove perforation during surgery were the major work-related accidents/injuries during the six-month follow-up. This is similar to findings from the retrospective study. The frequencies of various accidents were higher during the six-month follow-up (incidence study) than the six months prior to the study (retrospective study). Combining all the health workers, the incidence densities of these five major work-related accidents were between 3.6 per person years (ppy) to 9.5ppy. These incidence densities were all significantly higher for doctors than nurses or laboratory workers. There is an urgent need to reduce the incidence of these work-related accidents/injuries in order to reduce the chances of health workers developing occupationally acquired diseases

Specialist training in Fiji: Why do graduates migrate, and why do they remain? A qualitative study

<p>Abstract</p> <p>Background</p> <p>Specialist training was established in the late 1990s at the Fiji School of Medicine. Losses of graduates to overseas migration and to the local private sector prompted us to explore the reasons for these losses from the Fiji public workforce.</p> <p>Methods</p> <p>Data were collected on the whereabouts and highest educational attainments of the 66 Fiji doctors who had undertaken specialist training to at least the diploma level between 1997 and 2004. Semistructured interviews focusing on career decisions were carried out with 36 of these doctors, who were purposively sampled to include overseas migrants, temporary overseas trainees, local private practitioners and public sector doctors.</p> <p>Results</p> <p>120 doctors undertook specialist training to at least the diploma level between 1997 and 2004; 66 of the graduates were Fiji citizens or permanent residents; 54 originated from other countries in the region. Among Fiji graduates, 42 completed a diploma and 24 had either completed (21) or were enrolled (3) in a master's programme. Thirty-two (48.5%) were working in the public sectors, four (6.0%) were temporarily training overseas, 30.3% had migrated overseas and the remainder were mostly in local private practice. Indo-Fijian ethnicity and non-completion of full specialist training were associated with lower retention in the public sectors, while gender had little impact. Decisions to leave the public sectors were complex, with concerns about political instability and family welfare predominating for overseas migrants, while working conditions not conducive to family life or frustrations with career progression predominated for local private practitioners. Doctors remaining in the public sectors reported many satisfying aspects to their work despite frustrations, though 40% had seriously considered resigning from the public service and 60% were unhappy with their career progression.</p> <p>Conclusion</p> <p>Overall, this study provides some support for the view that local or regional postgraduate training may increase retention of doctors. Attention to career pathways and other sources of frustration, in addition to encouragement to complete training, should increase the likelihood of such programmes' reaching their full potentials.</p