Factors associated with the knowledge, practice and perceptions of contraception in rural southern Nigeria

Background: Significant proportion of maternal deaths in Nigeria is due to complications of unsafe abortions, and these abortions are responses to unwanted pregnancies that could have been prevented by effective contraceptive programming. Despite intense programmatic efforts by the Nigerian government and various non-governmental agencies toreverse the trend, there has been little evidence to suggest a systematic improvement in these indicators. Methodology: A household random survey of 1,528 women aged between 15-49 years was undertaken at Amukpe community in Nigeria, to determine theirknowledge, practice and perceptions of contraception. Results: The results showed that 86.2% of the respondents had secondary or less level of education and 19.2% of the respondents were single parents. The level of contraceptive awareness was high (92.3%) and88% of the respondents became aware of contraception in the last 14 years. Friends/relatives (40.6%), followed by nurses (31.7%) and then doctors (17.3%) were the common sources of contraceptive awareness. The most  widely known contraceptive methods were injectables,condoms, POP and OCP. The specific knowledge of emergency contraception was poor. The factors associated with low contraceptive usage were poor level of training and ineffective conveyance of relevant information to clients by health personnel, low literacy levels,extremes of reproductive age and extremes of parity. Others were fear of side effects, lack of knowledge, and lack of spousal consent.Conclusion: Contraceptive usage remain poor despite high level of awareness. Effective educational and counseling interventions are likely to improve providers’ and consumers’ knowledge and subsequent uptakeof contraceptive usage

Perceptions and attitudes of a rural community to abortion in the Niger-delta region of Nigeria

To determine the perceptions and beliefs relating to unwanted pregnancy, family planning and abortion, and identify issues that can be leveraged to initiate positive attitudes towards family planning and abortion in the area. Focus group discussions (FGDs) and in-depth interviews (IDIs) were conducted in Amukpe, Delta State, Nigeria. A highly motivated and well-trained team versed in the local language and culture conducted the FGDs and IDIs. Therewas unanimity that unwanted pregnancies was quite common amongstwomen of reproductive age group and constitute a significant problemin the community.Abortion, particularly in the hands of quacks was amajor option to handling an unwanted pregnancy.Almost all agreed that their culture and religion abhors abortion, yetwidely practiced because of the odium associatedwith an unwanted pregnancy in the community. The knowledge of the Nigeria National abortion law even amongst the health workers and teachers was generally poor. The participants agreed that there were problems and complications (often severe) including death associatedwith abortion in the community. Itwas largely agreed that contraceptive knowledge and usage was poor. The reasons adduced for this include lack of knowledge, lack of spousal consent, socio-cultural taboos andmisconceptions, aswell as economic reasons. Itwas suggested that imbibing positive family values by parents in theirwards and government leveraging the socio-economic status of the communitywill go a long way to stemming the tide. Unwanted pregnancy, unsafe abortion and abortion complications are reported to be commonamongst women of reproductive age group inAmukpe community, whilst contraceptive awareness and usage is poor.Keywords: Perception and attitudes, rural community,Abortio

Factors associated with the knowledge, perception and practice of Pap smear screening for cervical cancer in Southern Nigeria

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Antenatal determinants of oro-facial clefts in Southern Nigeria

Objectives: Cleft lip with or without cleft palate, is the most common serious congenital anomaly that affects the orofacial regions. The management and care of the cleft patient constitutes a substantial proportion of the workload of the Nigerian maxillofacial surgeon and allied specialties. Yet, there are no specific programmes targeted at this group. We believe that the findings of this study is capable of identifying useful interventions for designing programs that will lead to a reduction in the burden of orofacial cleft in Nigeria. Methods: It was a transverse cross-sectional study that was undertaken at the Maxillofacial Units of the University of Benin Teaching Hospital and the Central Hospital, Benin City respectively. The prevalence and antenatal determinants of cleft lip and palate were determined. Results: Cleft lip and palate were often encountered in clinical practice in Benin City with a prevalence of 1.35%. The results showed that orofacial clefts were commoner in females and that the combined unilateral cleft lip and palate was the commonest entity encountered amongst the cases. The following risk factors were associated with the risk of development of cleft lip and palate: Paternal age >40years, maternal age >35years, genetic/family history, low socio-economic status, alcohol consumption and indulgence in the intake of herbal medications in pregnancy. Conclusion: Public health education programmes and advocacy activities geared towards raising awareness of the identified risk factors for the development of cleft lip and or cleft palate would go a long way to obviate the occurrence and reduce the burden

Prevalence and determinants of utero-vaginal prolase in southern Nigeria

Background: Utero-vaginal (u-v) prolapse is primarily a disease of the parous and often elderly post-menopausal women. The number of ageing women appears to be increasing in proportion due to the increasing life expectancy. Methods: This was a retrospective review of the service delivery records (case notes, ward and Theater records) of 21 women who presented with u-v prolapse at the gynaecological unit of University of Port Harcourt Teaching Hospital over a 5-year period. Results: The incidence of u-v prolapse is 1.6% per total number of patients who underwent major gynecological surgeries. The leading determinants of u-v prolapse were – multiparity, difficult delivery, menopause, ageing and physically exerting occupations. Others were no formal education or low levels of education and diet. Conclusion: We recommend that there is a need for public health education geared towards enlightening the populace on the need for antenatal care and supervised hospital delivery, reduced family size, improved nutrition, and the need for hormone replacement therapy for post-menopausal women particularly high parity individuals. Finally, female education should be given priority attention.Key words: Determinants, utero-vaginal prolapse, SouthernNigeri