Factors associated with high caesarean section rates in Bertha Gxowa Hospital

Thesis (M.Fam.Med.)--University of the Witwatersrand, Faculty of Health Sciences, 2014.BACKGROUND: Bertha Gxowa hospital, like other district hospitals in South Africa offers Caesarean section as an essential obstetric service to pregnant women. Caesarean section rates have been increasing worldwide, giving cause for concern because of increased maternal and perinatal morbidity and mortality associated with high Caesarean section rates. This study aims to describe factors associated with high Caesarean section rates in Bertha Gxowa hospital. The researcher hypothesized that associated factors could be identified, and if demographic obstetric and non obstetric factors are described in relation to the context in which the Caesarean sections took place, it should be possible to identify significant modifiable factors. It is hoped that the findings of this study will help to shape local obstetric policy and practice, and lead to improved maternal and perinatal health. METHODS: This study utilized a quantitative cross sectional descriptive design. Patient records were reviewed to obtain information on Caesarean deliveries performed between January and December 2011. Demographic, obstetric and non obstetric factors were described. Pearson’s Chi-square, Fisher’s exact and Student t tests were used as tests of association between independent variables and Caesarean section. A logistic regression model was used to describe risk factors associated with Caesarean section. RESULTS: The results show that increasing parity was associated with Caesarean section (P = 0.004). Eighty six percent of the Caesarean sections were emergency Caesarean sections and 65% were primary Caesarean sections. The commonest obstetric indications were fetal distress, previous Caesarean section, cephalopelvic disproportion, poor progress and malpresentation. Women belonging to Robson classes 1 and 5 had more Caesarean sections than other classes. There was a significant association between Medical Officers and Caesarean section (P=0.001). There was no significant association between patient’s demand, HIV status, Medical Officers’ experience and Caesarean section. CONCLUSION: Obstetric indications contributed more to the high Caesarean sections in Bertha Gxowa hospital than non obstetric factors. The Caesarean section rates may be reduced if obstetric protocols are implemented for certain classes of patients. LEVEL OF EVIDENCE: II

Exploring Career-related Strategies for Strengthening Poverty Reduction Programmes in Nigerian Communities: A Qualitative Study

This study was designed to explore career-related strategies for strengthening poverty reduction programmes in Nigerian communities. Using a phenomenological framework and interpretive paradigm, the study used a qualitative research design. The participants of this study consisted of five key officers working in the Federal Ministry of Humanitarian Affairs and Poverty Alleviation (FMHAPA) in Nigeria and five counsellors working in Nigerian secondary schools. The participants were selected through a purposeful sampling process. Data collection measures include interviews, focus group discussion, and document analysis. All participants were interviewed to collect data, which was analyzed using thematic analysis. To identify themes and patterns in the responses provided by the participants, the interviews were recorded and transcribed. In accordance with the findings of this study, career-related strategies for strengthening poverty reduction programmes in Nigerian communities include employability skills development, access to quality education, job creation and entrepreneurship, supportive networks, social justice and corporate responsibilities, and appropriate work policy. A major contribution of this study is the identification of career-related strategies to help strengthen poverty reduction programmes in Nigerian communities. Another contribution is the implications that can be drawn for career counselling

Purpose-Based Career Coaching as a Strategy for Increasing Employability of Graduates: A Survey Study

This study investigated teachers’ and counsellors’ perception of a purpose-based career coaching as a strategy for increasing employability of graduates in Nigeria. The design employed to conduct this study was a cross-sectional survey design that featured desk research and sensitivity workshop. The participants were 100 teachers and 100 counsellors from South-East region of Nigeria. Multi-stage sampling procedure was adopted in this study. Purpose-based Career Coaching and Employability Questionnaire" (PCCEQ) was used to collect data, while descriptive and inferential analysis were used to analyse data. The results obtained revealed that the knowledge level of the teachers and counsellors increased through the sensitivity workshop with respect to the use of purpose-based career coaching as a strategy for increasing employability of graduates. In addition, with a slight significant difference, the perception of both teachers and the counsellors was high in terms of application, workability and effectiveness of the purpose-based career coaching. Gender did not have any significant contribution or influence on the participants’ perceptions. Therefore, the conclusion reached in this study is that teachers and counsellors perceived purpose-based career coaching as effective, applicable and workable strategy for increasing employability of graduates in Nigeria

Safety and Protection Practices in the Early Childhood Education Centres

A safe and secure environment is an essential part of the early childhood development of any child. This study aims to investigate the safety and protection practices of early childhood centers in the Anambra state, Nigeria, and to determine if any improvements can be made to them. This study analyzed data collected from 60 Early Childhood Care Centers (ECCE Centers) and 60 Pre-Primary Schools (Preprimary School) in Anambra State using the Evaluation of ECCE Implementation Kit (KEIEP), direct observation, and unstructured interviews, all of which were conducted using the evaluation tool. Using descriptive statistics, chi-squares, and student t-statistics, the data were analyzed. According to the results of this study, 28.0% of the private ECCE centers were in compliance with the requirements for enough space for children to play, fenced facilities, a standard first aid box, a splint bandage and an antiseptic. It is important to note that the majority of public early childhood education centers (62.0%) comply with the requirements for fencing, a first aid box, splint bandages, cotton wool, antiseptic, scissors, methylated spirit, liniment, analgesics, and thermometers, whereas 31% of those centers do not have the remaining seven practices. A conclusion of the study was that both private and public ECCE centers in Anambra State comply with the safety and protection provisions and practices in place

Influence of sex, self esteem and locus of control on perceived job tension

No Abstract Available African Journal for the Psychological Study of Social Issues Vol.5(2) 2000: 227-24

Reproductive Knowledge, Sexual Behaviour and Contraceptive Use among Adolescents in Niger State of Nigeria

Eight hundred and ninety six adolescents aged 11–25 years were recruited into this study using a multi-stage random sampling method. Overall, about 33% of them had already had first sexual experience but more males than females reported having experienced first sexual encounter. Only 3.6% of the respondents were married. Half of the sexually experienced adolescents had more than one sexual partner at the time of the study. Majority of the respondents (91.9%) had heard information about HIV/AIDS and at least a STD. A wide disparity was found in knowledge and use of the contraceptive methods studied, ranging from 41.9% to 63.8% for knowledge and from 0.7% to 12.5% for use. Knowledge and use of condom was highest. For prevention of HIV/AIDS, more males than females thought condom was useful. More Gwari and Hausa respondents claimed that they did not use any family planning method during their first sexual relationship than Yoruba and Igbo respondents. There is need for reproductive health programmes to intensify efforts towards improving adolescents\' attitudes to risky sexual behaviours and motivate them to undertake behaviours that would limit such risks. (Afr J Reprod Health 2003; 7[1]: 37–48) Résumé Les comportements reproductifs, sexuels et contraceptifs des adolescents dans l\'Etat de Niger au Nigéria. Huit cent quatre-vingt-seize adolescents âgés de 11–25 ans ont été recrutés pour faire partie de cette étude qui a été effectué à l\'aide de la méthode d\'échantillonnage à multiples étapes. D\'ensemble, environ 33% d\'eux avaient déjà eu un premier rapport sexuel, mais il y avaient plus des hommes qui avaient déclaré avoir eu une première expérience du rapport sexuel. Seuls 3,6% des interrogés étaient mariés. La moitié des adolescents qui étaient sexuellement expérimentés avaient plus d\'un partenaire sexuel au moment où l\'étude a été menée. La majorité des interrogés (91,9%) étaient au courant de l\'existence du VIH/SIDA et au moins d\'une MST. Il y avait un grand écart entre la connaissance et l\'emploi des méthodes contraceptives, qui allait de 41,99% jusqu\'à 63,8% pour la connaissance et de 0,7% à 12,5% pour l\'emploi. La connaissance et l\'emploi du préservatif étaient les plus élevés. Quant à la prévention du VIH/SIDA, il y avait plus des hommes que des femmes qui ont pensé que le préservatif était utile. Plus des interrogés d\'origine gwari et haoussa que les interrogés d\'origine yorubas et ibo ont déclaré qu\'ils n\'avaient pas employé la méthode de planification familiale au cours de leurs premiers rapports sexuels. Il faut que les programmes de la santé reproductive intensifient leurs efforts vers l\'amélioration des attitudes des adolescents envers les comportements sexuels à risque et de les motiver de façon à ce qu\'ils puissent se comporter de manière à réduire de tels risques. (Rev Afr Santé Reprod 2003; 7[1]: 37–48) Key Words: Adolescents, contraception, sexual behaviour, Nigeri

Reproductive knowledge, sexual behaviour and contraceptive use among adolescents in Niger State of Nigeria

Eight hundred and ninety six adolescents aged 11–25 years were recruited into this study using a multi-stage random sampling method. Overall, about 33% of them had already had first sexual experience but more males than females reported having experienced first sexual encounter. Only 3.6% of the respondents were married. One half of the sexually experienced adolescents had more than one sexual partner at the time of the study. Majority of the respondents (91.9%) had heard about HIV/AIDS and at least a STD. A wide disparity was found in knowledge and use of the contraceptive methods studied, ranging from 41.9% to 63.8% for knowledge and from 0.7% to 12.5% for use. Knowledge and use of condom was highest. For prevention of HIV/AIDS, more males than females thought condom was useful. More Gwari and Hausa respondents claimed that they did not use any family planning method during their first sexual relationship than Yoruba and Igbo respondents. There is need for reproductive health programmes to intensify efforts towards improving adolescents' attitudes to risky sexual behaviours and motivate them to undertake behaviours that would limit such risks. (Afr J Reprod Health 2003; 7[1]: 37–48) RÉSUMÉ Les comportements reproductifs, sexuels et contraceptifs des adolescents dans l'Etat de Niger au Nigéria. Huit cent quatre-vingt-seize adolescents âgés de 11–25 ans ont été recrutés pour faire partie de cette étude qui a été effectué à l'aide de la méthode d'échantillonnage à multiples étapes. D'ensemble, environ 33% d'eux avaient déjà eu un premier rapport sexuel, mais il y avaient plus des hommes qui avaient déclaré avoir eu une première expérience du rapport sexuel. Seuls 3,6% des interrogés étaient mariés. La moitié des adolescents qui étaient sexuellement expérimentés avaient plus d'un partenaire sexuel au moment où l'étude a été menée. La majorité des interrogés (91,9%) étaient au courant de l'existence du VIH/SIDA et au moins d'une MST. Il y avait un grand écart entre la connaissance et l'emploi des méthodes contraceptives, qui allait de 41,9% jusqu'à 63,8% pour la connaissance et de 0,7% à 12,5% pour l'emploi. La connaissance et l'emploi du préservatif étaient les plus élevés. Quant à la prévention du VIH/SIDA, il y avait plus des hommes que des femmes qui ont pensé que le préservatif était utile. Plus des interrogés d'origine gwari et haoussa que les interrogés d'origine yorubas et ibo ont déclaré qu'ils n'avaient pas employé la méthode de planification familiale au cours de leurs premiers rapports sexuels. Il faut que les programmes de la santé reproductive intensifient leurs efforts vers l'amélioration des attitudes des adolescents envers les comportements sexuels à risque et de les motiver de façon à ce qu'ils puissent se comporter de manière à réduire de tels risques. (Rev Afr Santé Reprod 2003; 7[1]: 37–48

Enhancement of Intestinal Motility and Transit Time in Streptozotozin-Induced Diabetic Rats Treated with Ocimum gratissimum

Aims: Acute changes in the blood glucose concentration have a substantial effect on intestinal motility in both diabetic and healthy subjects. This research work was therefore designed to assess the effect of DM on GIT motor activity and the impact of treatment with OG on same. Methodology: The phytoconstituents and median lethal dose of the plant extract was determined before administration. Eighteen rats were used; the animals were divided into three groups of six rats each. Group 1 served as the control which was fed with normal feed. Group 2 was diabetic untreated rats (DM) while group 3 was OG treated diabetic rats (DMT). At the end of 28 days, the intestinal transit and motility were determined using graded doses of acetylcholine, adrenaline and atropine. Results: The DMT intestine showed greater increase in contraction with increase in concentration of acetylcholine, application of adrenaline showed that the ileum of the DMT had a significantly lower (P=.001) percentage change in relaxation when compared to control or DM groups but there was no significant difference between DM and control group. While atropine caused a significant increase (P=.001) in percentage change in relaxation in the DMT group when compared to control and DM groups. There was no significant difference between the DM and control group. DM and the DMT groups had significantly higher (P=.05) percentage transit than the control group. There were no significant differences between DM and DMT groups. Conclusion: These results demonstrate that impaired intestinal motor activity in type I STZ-induced diabetic rats is enhanced by treatment with OG, this may be possibly due to its hypoglycemic effect and its concomitant impact on related biochemical and neuroendocrine interplay that affect GI motor function