Contraceptive methods awareness and use among women of reproductive age in an urban district of Lagos, Nigeria

Background: Contraceptive use can reduce maternal morbidity and mortality and improves the socio-economic status of families, communities and the nation. The objectives of this study are to assess contraceptive awareness, attitude and pattern of use among women aged 15-49 years in a Local Council Development Area (LCDA) of Lagos, Nigeria.Methodology: This is a descriptive cross-sectional study design. A community survey was done using multi-staged sampling technique to select 220 women of reproductive age from the LCDA. Information on the awareness of contraceptive methods and use was obtained using an interviewer administered semi-structured questionnaire. Data analysis was done using Epi InfoTM statistical software.Result: Most respondents were educated up to secondary school (85.5%), married (57.3%), and less than half had no children (42.7%) and still in school (36.4%). Majority of respondents are aware of contracepetive methods (86.0%), Condoms and injectables are the most known. Few respondents are currently using any form of contraceptive method (31.8%), and had ever used them before (36.4%). The commonest contraceptive method used are condoms ([24.3% for currently using]; [47.5% for ever used]); oral pills ([28.6% for currently using]; [41.3% for ever used]) and injectables ([18.6% for currently using]; [26.35% for ever used]). The commonest side effect reported is irregular menstruation (31.4%). There was no positive association between contraceptive use and marital status, education and occupation of respondents (p > 0.05 in all).Conclusion: The study concludes that despite the high level of awareness of contraceptive methods, the level of use is low among women studied.Keywords: Contraceptives methods, awareness, use, maternal mortality, women, reproductive age, Urban District, Lag

Lack of effective communication between communities and hospitals in Uganda: a qualitative exploration of missing links

<p>Abstract</p> <p>Background</p> <p>Community members are stakeholders in hospitals and have a right to participate in the improvement of quality of services rendered to them. Their views are important because they reflect the perspectives of the general public. This study explored how communities that live around hospitals pass on their views to and receive feedback from the hospitals' management and administration.</p> <p>Methods</p> <p>The study was conducted in eight hospitals and the communities around them. Four of the hospitals were from three districts from eastern Uganda and another four from two districts from western Uganda. Eight key informant interviews (KIIs) were conducted with medical superintendents of the hospitals. A member from each of three hospital management boards was also interviewed. Eight focus group discussions (FGDs) were conducted with health workers from the hospitals. Another eight FGDs (four with men and four with women) were conducted with communities within a five km radius around the hospitals. Four of the FGDs (two with men and two with women) were done in western Uganda and the other four in eastern Uganda. The focus of the KIIs and FGDs was exploring how hospitals communicated with the communities around them. Analysis was by manifest content analysis.</p> <p>Results</p> <p>Whereas health unit management committees were supposed to have community representatives, the representatives never received views from the community nor gave them any feed back from the hospitals. Messages through the mass media like radio were seen to be non specific for action. Views sent through suggestion boxes were seen as individual needs rather than community concerns. Some community members perceived they would be harassed if they complained and had reached a state of resignation preferring instead to endure the problems quietly.</p> <p>Conclusion</p> <p>There is still lack of effective communication between the communities and the hospitals that serve them in Uganda. This deprives the communities of the right to participate in the improvement of the services they receive, to assume their position as stakeholders. Various avenues could be instituted including using associations in communities, rapid appraisal methods and community meetings.</p

Maternal and child health interventions in Nigeria: a systematic review of published studies from 1990 to 2014

BACKGROUND: Poor maternal and child health indicators have been reported in Nigeria since the 1990s. Many interventions have been instituted to reverse the trend and ensure that Nigeria is on track to achieve the Millennium Development Goals. This systematic review aims at describing and indirectly measuring the effect of the Maternal, Newborn, and Child Health (MNCH) interventions implemented in Nigeria from 1990 to 2014. METHODS: PubMed and ISI Web of Knowledge were searched from 1990 to April 2014 whereas POPLINE® was searched until 16 February 2015 to identify reports of interventions targeting Maternal, Newborn, and Child Health in Nigeria. Narrative and graphical synthesis was done by integrating the results of extracted studies with trends of maternal mortality ratio (MMR) and under five mortality (U5MR) derived from a joint point regression analysis using Nigeria Demographic and Health Survey data (1990-2013). This was supplemented by document analysis of policies, guidelines and strategies of the Federal Ministry of Health developed for Nigeria during the same period. RESULTS: We identified 66 eligible studies from 2,662 studies. Three interventions were deployed nationwide and the remainder at the regional level. Multiple study designs were employed in the enrolled studies: pre- and post-intervention or quasi-experimental (n = 40; 61%); clinical trials (n = 6;9%); cohort study or longitudinal evaluation (n = 3;5%); process/output/outcome evaluation (n = 17;26%). The national MMR shows a consistent reduction (Annual Percentage Change (APC) = -3.10%, 95% CI: -5.20 to -1.00 %) with marked decrease in the slope observed in the period with a cluster of published studies (2004-2014). Fifteen intervention studies specifically targeting under-five children were published during the 24 years of observation. A statistically insignificant downward trend in the U5MR was observed (APC = -1.25%, 95% CI: -4.70 to 2.40%) coinciding with publication of most of the studies and development of MNCH policies. CONCLUSIONS: The development of MNCH policies, implementation and publication of interventions corresponds with the downward trend of maternal and child mortality in Nigeria. This systematic review has also shown that more MNCH intervention research and publications of findings is required to generate local and relevant evidence

Determinants of neonatal mortality at Wesley Guild Hospital, Ilesa, Nigeria

No Abstract. Nigerian Journal of Medicine Vol. 15(3) July-September 2006: 271-27

Effect of prolonged birth spacing on maternal and perinatal outcome

Background: Researchers have held varied opinions on the effect of prolonged birth spacing on maternal and perinatal outcome. Objectives: To determine the reasons for prolonged birth spacing and to compare the maternal and perinatal outcome compared to shorter normal birth spacing. Design: Comparative case - controlled study between January 1st, 2001 to December 31st, 2002. Setting: Obstetric Unit of Obafemi Awolowo University Teaching Hospital Complex, Ile- Ife, Nigeria. Subjects: Fifty cases consisted of multiparae with prolonged birth spacing (³6 years) and controls consists of similar number of multiparae with shorter normal birth spacing (2 - 5 years) matched for age, parity and socio-economic status. Main Outcome Measures: Labour outcome, Apgar scores, operative and vaginal delivery rates, perinatal and maternal outcome, reasons for prolonged birth spacing. Results: There was no significant difference observed with respect to spontaneous onset of labour, induction or argumentation of labour, duration of labour, spontaneous vaginal delivery rates, Caesarean section rates, instrumental vaginal deliveries, analgesic requirement, postpartum haemorrhage, and Apgar scores in both groups. There were no perinatal or maternal deaths. The commonest reason adduced for prolonged birth spacing is failed contraception (56%), followed by secondary infertility (24%) and to a lesser extent re-marriage, improved income and sheer desire. Conclusion: There was no significant difference in maternal and perinatal outcome in pregnancy between women with prolonged birth spacing and those with normal shorter birth spacing. East African Medical Journal Vol.81(8) 2004: 388-39