Healthcare workers’ knowledge and attitude towards prompt referral of women with postpartum haemorrhage in Nigeria: a community-based study

Background: Postpartum Haemorrhage (PPH) is a major contributor to maternal mortality in developing countries most especially in the rural areas where Emergency Obstetric Care (EmOC) are not available. Delay in referring women from rural health facilities to settings where EmOC services are available have been reported. This study assessed community-based healthcare workers’ (CHWs) knowledge and attitude towards the prevention, early recognition and prompt referral of women with Post-Partum Haemorrhage (PPH) for Emergency Obstetric Care (EmOC).Methods: Descriptive cross-sectional design was used. Structured questionnaire was used to collect data from 200 CHWs recruited from community-based healthcare. Data analysis was done in SPSS version 20 at significance level of 0.05.Results: Findings show that 86.5% (n=173) of the respondents had good knowledge while 12% (n=24) and 1.5% (n=3) had moderate and poor knowledge respectively. Negative attitude towards prompt referral of women affected with PPH was found among 51% (n=102) of the respondents. Unavailability of blood drapes to estimate blood loss [χ2 (1, n=200) = 4.51, p=0.03], lack of ambulance [χ2 (1, n=200) = 4.46, p=0.03], and poor state of the roads [χ2 (1, n=200) = 4.44, p=0.03] were factors linked to poor attitude of CHWs towards prompt referral of affected women.Conclusions: The study concluded that there is a need for intervention that can help improve community healthcare workers’ attitude towards prompt referral of women affected with postpartum haemorrhage. There is also a need for general overhaul of community-based facilities to effectively support prompt referral

Breastfeeding profile and practice of Nigerian mothers: a cross-sectional survey

Background: Breastfeeding patterns in the developing world are still below the recommended levels and the potential to improve child survival remains untapped. This study investigated the breastfeeding profile and practices of Nigerian nursing mothers.  Methods: This cross-sectional survey involved women at attending selected baby-friendly facilities in Ile-Ife, South-West, Nigeria who had breastfed their most recent baby for a minimum of six months. A self-administered questionnaire was used to obtain data on demographics, infant-maternal characteristics and breastfeeding practices. 383 mothers volunteered for this study, yielding a response rate of 95.7%. Data were analyzed using descriptive and inferential statistics at 0.05 alpha level.Results: The mean age of the respondent was 29.0 ± 4.96 years. Exclusive breastfeeding (EBF) rate was 86.2%. Breastfeeding initiation time of less than 1 hour after delivery and 24 hours rooming-in practice rate was 78.3% and 79.1% respectively. Daily breastfeeding time and total breastfeeding duration was 8.06 ± 2.33 hours and 18.3 ± 4.82 months respectively. The mean onset time for water supplementation was 4.74 ± 1.77 months with a rate of 30.3% within 1-3 months. Weaning initiation time was mostly (43.9%) within 12 to 18 month of infant’s age.  There was significant association between EBF practice and each of maternal education (X2 = 6.554; P = 0.038) and Socio-Economic Status (SES) (X2 = 19.32; P = 0.031) with most of the respondents in the lower SES (56.1%) subscribing to EBF.Conclusions: Exclusive breastfeeding (EBF) rate for the first six months among Nigerian mothers attending baby-friendly clinics was high. Breastfeeding initiation time after delivery was early, water supplementation to breastfeeding was before 5 months of the infant’s life and weaning practice was late. Maternal educational level and socio-economic status significantly influenced EBF practice.