ABORTION PROCUREMENT AND POST-ABORTION CARE SERVICES: EXPERIENCES OF NIGERIAN ADOLESCENTS

ABSTRACT Introduction: The prevention of abortion-related complications and mortality is dependent on the availability, accessibility and usability of emergency post-abortion care (PAC) throughout the health care system. Unfortunately, Nigerian adolescents are often unable to obtain adequate post-abortion care services due to numerous challenges and barriers. This study attempted to explore experiences with abortion and post-abortion care services from the adolescents’ perspective which is the first step in enhancing optimal utilization of adolescents’ PAC services Methods: A qualitative exploratory research design was used. 20 semi-structured interviews were conducted with adolescent patients during hospitalization. The adolescent patients were duly counselled and informed consent obtained prior to the in-depth interview. The semi-structured interview guide was used for data collection and the data were analyzed using content analysis. Results: Findings from the interviews revealed that adolescents found it difficult to discuss issues of pregnancy and abortion with their parents or guardians due to fear, stigmatization or rejection. The adolescents experienced negligence of care, shame and stigma due to failure of health care providers to ensure privacy, as well as delay in treatment due to hospital protocol and non-availability of prescribed drugs which significantly affected the PAC care services they received Conclusion: The adolescents experienced fear, shame, and stigmatization, negligence of care and lack of access to adequate PAC services. These findings highlight the need to review health actions directed towards adolescents with abortion complications and plan interventions aimed at improving provision of adolescents’ friendly PAC services, in order to meet the reproductive health needs of these adolescents

PERCEPTION OF WOMEN OF CHILDBEARING AGE (15-45years) ON CAUSES AND CONSEQUENCES OF INFERTILITY IN OSOGBO LOCAL GOVERNMENT AREA OF OSUN STATE, NIGERIA

Infertility brings about low self-esteem, sense of powerlessness, discrimination and stigmatization as well as threatens the woman’s identity, status, marital and emotional security. This study examined the perception of women of childbearing age on causes and consequences of infertility. A descriptive non experimental research design was used. A sample frame of 40 respondents was selected using purposive sampling technique among women of childbearing age. Data were analyzed using descriptive and inferential statistics. Three null hypotheses were tested using student t-test at 5% level of significance. The study revealed that irregular sexual intercourse, irregular menstruation, untreated sexually transmitted diseases, late marriage especially above 30years of age, fibroid, low sperm count, unsafe abortion, and promiscuity were factors contribute immensely to increase infertility rate. Majority of the respondents opined that infertility could result in divorce or separation of couple which can lead to extinction of that family name, husband’s family inherit his property after his death, polygamy or polyandry, loss of hope, lack of joy and happiness in the family. The findings of this study revealed that there is no significant difference in the age religion of women under study and their perception on causes and consequences of infertility with t-calculated>t-tabulated (2.54 > 4.3); as well as, there is no significant difference was found between the age at marriage of women under study and their perception on causes and consequences of infertility with t-calculated>t-tabulated (2.56 > 4.3). The results also revealed that there is significant difference in the religion of women under study and their perception on causes and consequences of infertility with t-calculated<t-tabulated (7.64 < 4.3). It was concluded that sound family life education should be given to the public especially women and adolescents teenagers with emphasizes on causes, prevention and management of infertility

Documentation in labour among midwives in Madonna university teaching hospital elele, rivers state, Nigeria

Background: Documentation is a fundamental and vital communication tool among healthcare professionals. It is an essential part of midwifery that has clinical and legal implications for the client and midwife as well as the health care institution. This study assessed the knowledge, practice of and factors influencing documentation in labour among nurses in Madonna University Teaching Hospital, Elele Rivers State.Methods: This is a descriptive cross sectional study with a sample size of 102 nurses selected using purposive sampling technique. The instrument for data collection was structured questionnaire. Data collected were analysed using simple percentage and frequency table.Results: The findings of the study showed that midwives had good knowledge of documentation in labour, but their practices were poor. Factors influencing documentation includes; time, the attitude of the midwives (terming documentation to be unnecessary), and few number of midwives working in a shift.Conclusions: It was recommended that, the consequences of not documenting in labour should be emphasized and penalty is given to midwives who do not document properly. More staff should be assigned to client and the shift adjusted to shorter hours to prevent fatigue and tediousness

Midwives’ knowledge and utilization of non-pneumatic anti shock garment in reducing complication of postpartum haemorrhage in selected health care facilities in Bayelsa state Nigeria

Background: Non-pneumatic anti-shock garment (NASG) is a first-aid lower-body pressure device that reverses hypovolaemic shock and decreases obstetric hemorrhage thereby decreasing maternal morbidity and mortality due to post-partum haemorrhage (PPH).This study assessed the knowledge and utilization of non-pneumatic anti shock garment in the management of postpartum hemorrhage among midwives in selected health care facilities in Bayelsa state.  Methods: This is a descriptive cross-sectional study in which a sample size of 112 nurses were selected using purposive sampling technique. The instrument for data collection was questionnaire and data collected were analyzed using descriptive and inferential statistics.  Results: The study revealed that majority of the respondents regardless of their educational level had good knowledge of the description, mechanism of action, and uses of NASG. It was also revealed that majority of the respondents do not use NASG in their centers and its application in management of post-partum hemorrhage was not part of the protocols in these centers, which was a clear indication of underutilization of the NASG in the primary health care centers. There was no significant association found between years of working experience of respondents and their utilization of NASG with (X2 = 8.577, df = 2, P = 0.114) as well as between the level of knowledge of midwives and their utilization of the NASG with (X2 = 0.387, df = 1, P = 0.534).Conclusions: It was recommended that non-pneumonic antishock garment should be made available by government and its utilization should be included in all health care centers policy as a management protocol for post-partum hemorrhage.

Knowledge of Postpartum Depression and its Associated Risk Factors Among Nurse-Midwives in a Nigerian Tertiary Hospital

Postpartum depression (PPD) is a global childbirth-related problem that affects many women and if ignored can have long-term adverse consequences, for both mother and child. Timely identification of its risk factors requires a good knowledge base for the care provider A descriptive cross sectional study was used to assess the knowledge of PPD and its associated risk factors among nurse-midwives in a tertiary hospital in Bayelsa State. A systematic random sampling technique was used to select a sample size 114 nurse-midwives respondents. A well-structured questionnaire was used to collect data from the participants. The same were analysed using descriptive and inferential statistics with level of significance set at 0.05(5%).Despite the fact that majority of nurse-midwives rated their information level on postpartum depression as moderate, most of them still maintained that cigarette smoking, unwanted pregnancy, poor economic status cannot predispose a woman to PPD. Furthermore, majority affirmed that Edinburg Postnatal Depression Scale (EPDS) can be used to screen for PPD yet only about half of the respondents opined that PPD tendency can be detected during pregnancy and less than half of them affirmed that a score of &gt; 10 using the EPDS indicates depression. The study also found significant relationship between educational qualification and level of information about PPD and its associated risk factors.The level of knowledge of nurse-midwives is not at the expected level since majority still have knowledge deficit regarding risk factors and how to detect PPD. Hence, it was recommended that periodic suitable training programs on PPD should be developed for healthcare professionals especially for nurse-midwives who are the first point of contact during antenatal, labour and post natal period

Methods employed in the prevention and treatment of malaria among pregnant women in a riverine community in Bayelsa State, Nigeria

Background: Malaria remains a major public health problem in Nigeria and is the most common cause of hospital attendance in all age groups, of which children and pregnant women are the major risk groups; therefore this study was designed to explore various methods of prevention and treatment of malaria among pregnant women in riverine community in Bayelsa State, Nigeria.Method: A descriptive cross-sectional survey was used for the study and a pre-tested structured questionnaire was administered to 180 respondents’ selected using purposive sampling technique. Results were presented as tables and charts.Results: The study revealed that majority of the respondents were within 16-25years, with a minimum age of 16yrs, maximum age of 45yrs and a mean of 30yrs. More than half of the respondents agreed that malaria can be transmitted to the fetus and can lead to intrauterine fetal death. Most of the respondents used more than one preventive measures and the most commonly used methods employed in the prevention of malaria by the respondents were window and door nets (83.3%); clearing of bushes (72.2%), insecticide treated nets (ITNs) (67.2%) snapper(66.7%); insecticide spray (66.7%). Despite the fact that a good number of the respondents (91.7%) claimed to use drugs when they have malaria, most of which were prescribed by medical practitioners; only few of the respondents (31.7%) used prophylactic anti-malaria drugs during pregnancy.Conclusion: Findings above revealed that, majority of the respondents had adequate knowledge of malaria and its consequences in pregnancy, and also employed good methods in the prevention and treatment of malaria. However, some of the respondents still used crude methods such as pouring kerosene in stagnant water, burning of bushes, and use of herbs, native chalk and broom etc in the prevention and treatment of malaria which may be detrimental to healthand often ineffective. Therefore, there is need to concentrate on health education of these women on the hazards associated with the crude methods as well as importance of intermittent preventive treatment (IPT) during pregnancy so as to achieve effective control of malaria among pregnant women.Keywords: Malaria prevention, Malaria treatment, Pregnant wome

Student nurses’ practices and willingness to teach relatives breast self-examination in Nigeria

Background: Breast cancer is the most common cancer and the leading cause of cancer-related death for women worldwide. Breast self-examination (BSE) is an essential, low-cost, and simple tool for detecting breast cancer early. Employing the idea of ‘charity begins at home’ by involving student nurses in teaching BSE to relatives will improve early detection. Aim: To assess nursing students’ practice and willingness to teach BSE to their relatives. Setting: A college of nursing and midwifery in one state under North-Central Nigeria. Methods: A cross-sectional descriptive design was employed. Through incidental sampling technique 197 respondents were selected from the first to the third year. Data were collected using a structured questionnaire. Descriptive and inferential analyses, with a p-value of 0.05 were conducted. Results: Respondents indicated where they learned about BSE. There were 98.5% respondents who had heard about BSE, and 89.8% of them had good practice of BSE. However, a quarter did not teach BSE to relatives. There were no statistically significant associations noted. Conclusion: Most of the nursing students were aware of BSE and knew how to perform it, although a quarter did not teach BSE to their relatives. Therefore, it may be necessary to sensitise nurses to cultivate the habit of teaching BSE to relatives and women in the community. Contribution: It is crucial to provide nurses with the skills and knowledge required to carry out BSE effectively, as well as teach women how to perform it on themselves, to improve breast cancer detection rates in Nigeria

Adolescents’ Knowledge, Attitude and Utilization of Emergency Contraceptive Pills in Nigeria’s Niger Delta Region

Background and Objective: Risky sexual activity among adolescents is on the increase and contraceptive prevalence rate is low which is evidenced by high rate of teenage pregnancy in Bayelsa state, Nigeria. This study assesses the adolescents’ knowledge, attitude and utilization of emergency contraceptive pills (ECP) in Amassoma Community, Bayelsa State, in the Niger Delta region of Nigeria. Methods: The study was a descriptive cross-sectional research design. A purposive sampling technique was used to select a sample of 220 respondents from the target population. Data were collected using a self-structured questionnaire. Descriptive and inferential statistics were used to analyze the data generated. Results: Majority of the respondents had high level of knowledge and positive attitude towards emergency contraceptive pills but had low level of utilization. Concerns about what others may say, parental attitude, contraceptive availability, contraceptive accessibility, and peer infl uences were the major factors that infl uenced the utilization of contraceptive pills. There was no signifi cant relationship between knowledge and utilization of emergency contraceptive pills, as well as level of knowledge and their utilization of emergency contraceptive pills. Conclusions and Global Health Implications: Adolescents in the study were more likely to use emergency contraceptive pills, if parents and others reaction to adolescents’ contraceptive use were positive about those. Health care professionals, especially nurses, should organize enlightenment programs to educate adolescents, parents and the public on the benefi ts of adolescents’ contraceptives use, especially ECP. Key words: Knowledge • Family Planning • Attitude • Utilization • Adolescents • Emergency Contraceptive Pills Copyright © 2016 Onasoga et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited