Experience of domestic violence among pregnant women in rural and urban areas of Niger Delta Region of Nigeria: risk factors, help-seeking resources and coping strategies

Background: Risk factors and coping strategies employed for domestic violence across rural and urban locales remains a topical public health concern. Geographic locations experiencing other forms of violence may contribute additional risk factors to domestic violence.Methods: A cross-sectional study design was used to determine and compare the risk factors, help-resources and coping strategies employed by survivors of domestic violence living in rural and urban areas of the Niger-Delta region of Nigeria. Altogether 461 (225 rural, 236 urban) pregnant women participated. Statistical analysis was carried out with SPSS version 21 with p <0.05.Results: Predictors of violence identified were: geographical location, residing in a rural area (OR 2.052 95% C.I. 1.349 - 3.122) and alcohol intake by pregnant women (OR 1.691; 95% C.I. 1.022 - 2.798) increased the risk of domestic violence while intimate partner’s occupation, being a professional was a protective factor (OR 0.513 95% C.I. 0.327 - 0.806). Less than half of the respondents in bothlocations (rural 44.0% versus urban 35.2%) sought for help following incidents of violence. Fewer rural (3.1%) than urban (10.7%) of them sought for formal help from the police. The main coping strategy used was ‘keeping silent’ by 69.4% rural compared to 46.4% urban survivors and the main reason given, was to avoid family disharmony.Conclusion: There is urgent need for relevant stakeholders to institute measures to reduce domestic violence especially in rural areas of developing countries and establish well-linked help resource centres across both rural and urban localities. Keywords: Rural-urban, Pregnant women, Domestic violence, Niger-Delt

Quality assurance of HIV counselling and testing for the prevention of mother-to-child transmission of HIV in Rivers State, Nigeria

As the HIV/AIDS pandemic continues especially in the developing countries, the evaluation of quality and effectiveness of interventions aimed at its control remains very critical. A descriptive, cross-sectional study was carried out among HIV/AIDS counsellors providing counselling services to pregnant women attending antenatal clinics in all the 34 secondary health care facilities in Rivers State between September and December 2009 to assess the quality of HIV counselling services offered by these counsellors. A semi-structured, self-administered questionnaire was used to elicit relevant information on counsellors' performances and extent of compliance with the national guidelines on pre-and post test counselling for PMTCT. Data was analyzed using the Epi-Info version 6.04d statistical software package. Confidence limit of 95% was set at a significance level at P=0.05. The average duration of counseling was twenty minutes, with only one or two counsellors in attendance. Most of the counsellors, 228 (59.4%) out of the 384 (95%CI=53.0-65.8) said they were only supervised occasionally. Majority of the counsellors 369(96.1%) did not have access to copies of the national guidelines for VCT counselling for PMTCT and the checklist for providing counselling services. Similarly, other resources for counselling such as television and video sets, posters and banners were in short supply. Important issues in post-test counselling such as information about assessing ongoing emotional and social support services, making plans for the future and future fertility, information on delivery options, nutrition and the need for follow up and adherence counselling were often left out. Counsellors' motivation and the institutionalization of supportive supervision are advocated to enhance the quality of HIV counselling at PMTCT centres in Rivers StateKey words: HIV/AIDS, counselling quality assurance, PMTCT services, Rivers State Nigeria

Health Care Workers Contribution to Missed Immunization Opportunities in Children

This study was aimed at identifying the health workers' knowledge and inappropriate practices that potentially contribute to missed immunization opportunities in children. A cross-sectional survey was conducted in August 2007 among Primary Health Care workers in Khana Local Government Area of Rivers State, Nigeria on the knowledge and practices of childhood immunization. It focused on their knowledge and practices of the national immunization schedule and false contraindications to childhood immunization. All data generated was analyzed using Epi Info version 6.04d statistical package. Most of the primary health care workers, 285 (76.0%) had adequate knowledge of the National Immunization Schedule for children with accurate knowledge of vaccine dosages, routes of administration and intervals between doses. However, their knowledge of false contraindications to immunization was low. Two-thirds of the health care workers, 65.9% [95%CI=60.0-70.8] had poor knowledge of the importance of routine screening of children for immunization when they presented to the health facilities for other curative services. Similarly, less than a quarter of the health care workers, 50 (13.3%) knew that HIVpositive status of women was not a contraindication for the immunization of their children. In the same vein only about a quarter of the health care workers 85 (22.7%) immunized severely malnourished children (p=0.0000). Also, less than half of the health care workers, 145 (35.7%) immunized children with mild feverish conditions (t