Experience with norplant at a Nigerian Teaching Hospital

Objectives: To determine the acceptance of Norplant implants while it was in use and share our experience with other Norplant providers.Design: Retrospective descriptive study.Setting: The family planning clinic of the Jos University Teaching Hospital, Jos, Nigeria.Results: During the 21-year period, January 1985 to December 2005, a total of eighteen thousand, two hundred and ninety one (18,291) new clients accepted various modern contraceptive methods in the family planning clinic of Jos University Teaching Hospital, Nigeria. Norplant was accepted by 1,333 clients (4.9%) as against the intrauterinedevices (IUDs) 25.4%, and Oral Contraceptive Pills (OCP) 22.9%. Female sterilisation was a contraceptive method of choice in 21.2%, the injectables in 13.9%, and the male condom in 9.3%. Failure rate was 0.37% and continuity rate was high among users. The Norplant contraceptive implant was accepted by women of mean age of 29.6 years and women of all parity. The acceptance pattern demonstrated a multi-nodalpattern from the time of introduction in 1985 to December 2005 when supply came to an abrupt stop. The greatest barriers to Norplant use were non- availability and high cost of the commodity.Conclusion: Norplant implants provided contraceptive protection with high reliability, safety, independence from user compliance, rapid return of pre-existing fertility after removal, good tolerability, and relatively simple and quick insertion and removal. The capsules will definitely be used as a reference for similar contraceptive products in the contraceptive market

Psychosocial implications of tubal ligation in a rural health district: A phenomenological study

<p>Abstract</p> <p>Background</p> <p>Tubal ligation is the most popular family planning method worldwide. While its benefits, such as effectiveness in protecting against pregnancies, minimal need for long-term follow-up and low side-effects profile are well documented, it has many reported complications. However, to date, these complications have not been described by residents in Congo. Therefore, the study aimed at exploring the experience of women who had undergone tubal ligation, focusing on perceptions of physical, psychological and contextual experiences of participants.</p> <p>Methods</p> <p>This qualitative study used a semi-structured questionnaire in a phenomenological paradigm to collect data. Fifteen participants were purposefully selected among sterilized women who had a ligation procedure performed, were aged between 30 and 40 years, and were living within the catchment area of the district hospital. Data were collected by two registered nurses, tape-recorded, and transcribed verbatim. Reading and re-reading cut and paste techniques, and integration were used to establish codes, categories, themes, and description.</p> <p>Results</p> <p>Diverse and sometimes opposite changes in somatic symptoms, psychological symptoms, productivity, ecological relationships, doctor-client relationships, ethical issues, and change of life style were the major problem domains.</p> <p>Conclusions</p> <p>Clients reported conflicting experiences in several areas of their lives after tubal sterilization. Management, including awareness of the particular features of the client, is needed to decrease the likelihood of psychosocial morbidity and/or to select clients in need of sterilization.</p

Maternal death review and outcomes : an assessment in Lagos State, Nigeria

Strong political will by hospital management and supervising government agencies are a prerequisite for effectively addressing the human and infrastructural deficits that predispose to maternal mortality in Lagos State. Failure to address the patients and facility-related causes of maternal mortality could account for the persistently high maternal mortality ratio (MMR) in the hospitals. Interventions aimed at redressing all causes identified in the reviews will likely reduce MMRs. The study investigates results of Maternal and Perinatal Death Surveillance and Response (MPDSR) conducted in three referral hospitals in Lagos State, Nigeria over a two-year period and reports outcomes and lessons learned

Factors influencing nurses' compliance with Standard Precautions in order to avoid occupational exposure to microorganisms: A focus group study

<p>Abstract</p> <p>Background</p> <p>Nurses may acquire an infection during the provision of nursing care because of occupational exposure to microorganisms. Relevant literature reports that, compliance with Standard Precautions (a set of guidelines that can protect health care professionals from being exposed to microorganisms) is low among nurses. Additionally, high rates of exposure to microorganisms among nurses via several modes (needlesticks, hand contamination with blood, exposure to air-transmitted microorganisms) occur. The aim of the study was to study the factors that influence nurses' compliance with Standard Precaution in order to avoid occupational exposure to pathogens, by employing a qualitative research design.</p> <p>Method</p> <p>A focus group approach was used to explore the issue under study. Four focus groups (N = 30) were organised to elicit nurses' perception of the factors that influence their compliance with Standard Precautions. The Health Belief Model (HBM) was used as the theoretical framework and the data were analysed according to predetermined criteria.</p> <p>Results</p> <p>Following content analysis, factors that influence nurses' compliance emerged. Most factors could be applied to one of the main domains of the HBM: benefits, barriers, severity, susceptibility, cues to action, and self-efficacy.</p> <p>Conclusions</p> <p>Changing current behavior requires knowledge of the factors that may influence nurses' compliance with Standard Precautions. This knowledge will facilitate in the implementation of programs and preventive actions that contribute in avoiding of occupational exposure.</p

Maternal Weight Gain Biosocial Characteristics And Perinatal Outcome In Jos Nigeria

Objective: Maternal weight gain in pregnancy can offer a good means of assessing the well being of the pregnant mother and by inference, her baby. The cross – sectional prospective study was carried out carried out between November 1996 and December 1997, in Jos University Teaching hospital to assess the influence of biosocial characteristics on maternal weight gain and the effect of weight gain on perinatal outcome Methods: 210 informed healthy pregnant women average age 25.2± 5.1 (mean ± SD) were recruited form the antenatal clinic over a fourteen - month study period. Variables such as maternal age, parity, social class, booking weight gestational age were studied in relation to maternal weight gain and perinatal outcome. The student t- test was used to calculate significant difference between the mean and the level of significance was set at 5% Result: The mean maternal weight gain in pregnancy was 8.58± 3.61kg. The rate of weight gain was about 0.25kg per week between the gestational ages of 6 and 40 weeks. Young mothers gained more weight than older ones though the difference was not statistically significant. The primigravida statistically gained more weight than para 1-4 (P< 0.05) and the grandmultiparous patient (

Health care workers' knowledge on HIV and aids: universal precautions and attitude towards PLWHA in Benin-City, Nigeria

Objective: Health care workers are at risk of becoming infected with blood-borne pathogens, including HIV. The study was designed to test health care workers knowledge about HIV transmission, universal precautions and their attitude towards people living with HIV and AIDS.Design: A cross-sectional study.Setting: University of Benin Teaching Hospital, Benin-City, Nigeria.Participants: 120 Health Care Workers (HCWs) who were occupationally exposed to patient's blood and body fluids completed a self administered structured questionnaire between March and May 2004. The HCWs consisted of 50 doctors drawn from obstetrics and gynaecology (25) and surgery departments (25). 70 nurses from accident and emergency unit (23), labour ward (18), labour ward theatre (4), main surgical theatre (22) and family planning clinic (3).Results: The mean age of the health care workers and duration of practice were 39.8 ± 8.0years and 14.0 ± 8.2years respectively. Though many of the respondents demonstrated good knowledge about HIV transmission, more than 25% of them thought that HIV could be transmitted through saliva, vomit, faeces and urine. They over estimated their risk of acquiring HIV infection following needle stick injury, exposure of mucocutaneous membrane and intact skin to infected blood and body fluids. There was poor adherence to universal precautions which was attributed to lack of knowledge and availability of materials in 48% and 60% of the workers respectively. Over 40% of the health care workers exhibited discriminatory attitude towards people living with HIV and AIDS. There was no statistical significant difference (p>0.05) in the knowledge of HIV and AIDS transmission and infection prevention practices amongst the doctors and nurses. Similarly there was no significant difference in their discriminatory attitude towards PLWHA.Conclusion: We recommend that seminars, workshops should be organized on a continuous basis for health care workers on universal precautions, stigma and discrimination reduction. Those trained should train others on the job. The institution should also make available materials needed to protect workers against the risk of acquiring pathogenic infection in the course of providing health services to their patients. Keywords: HCW'S knowledge, HIV & AIDS, universal precautions, attitude towards PLWHA Nigerian Journal of Clinical Practice Vol. 8(2) 2005: 74-8

Evaluation of Cardiovascular Morbidity in Nigerian Women after 3 Years of Norplant® Contraception

This study was conducted to determine any cardiovascular morbidity with Norplant® use by electrocardiography. Thirty Nigerian women seeking long-term reversible contraception were recruited. The clients had baseline blood pressure checks and electrocardiography (ECG) tracings. These were repeated at the 12, 24 and 36 months follow-up visits and the results were analysed. The mean age of subjects was 32.4± 3.98 years. The mean weight at pre-insertion and at the 12, 24 and 36 months follow-up visits showed a statistically significant rise after 2 years (

How safe is motherhood in Nigeria?: the trend of mammal mortality in a tertiary health institution

Objective: To determine the magnitude and trend of maternal mortality in Jos University Teaching Hospital, Jos, Nigeria.Design: Retrospective study.Setting: Jos University Teaching Hospital, Jos, Nigeria.Subject: AN women dying in pregnancy, labour and puerperium.Main outcome measures: Maternal mortality ratio, trend of maternal mortality, age, antenatal booking status, educational status, main causes of maternal death, factors contributing to maternal deaths.Results: The maternal mortality ratio was 739/100,000 total deliveries and trend rose from 450/100,000 in 1990 to 1,060/100,000 total deliveries in 1994. About 33% of all maternal deaths occurred among teenagers. The risk factors for maternal deaths included adolescence, grand multiparity, illiteracy and non-utilisation of antenatal services. The main causes of maternal mortality were haemorrhage (28.1%), sepsis (21.3%) and eclampsia (15.7%). The contributions of complicated induced abortion and anaesthetic deaths in this study are worthy of mention.Conclusion: The maternal mortality ratio is unacceptably high in Jos University Teaching Hospital more particularly because of the rising trend. Socio-cultural and economic factors contributed immensely to the high maternal mortality in Jos. The objective of the World Health Organisation(WH0) to reduce maternal mortality by 50% by the year 2000 will not be achieved in this part of Nigeria. Nonetheless, improvement of the nation's economy coupled with a stable policy and provision of intrastructural facilities will assist to sigdicantly reduce maternal mortality

How safe is motherhood in Nigeria?: the trend of mammal mortality in a tertiary health institution

Objective: To determine the magnitude and trend of maternal mortality in Jos University Teaching Hospital, Jos, Nigeria.Design: Retrospective study.Setting: Jos University Teaching Hospital, Jos, Nigeria.Subject: AN women dying in pregnancy, labour and puerperium.Main outcome measures: Maternal mortality ratio, trend of maternal mortality, age, antenatal booking status, educational status, main causes of maternal death, factors contributing to maternal deaths.Results: The maternal mortality ratio was 739/100,000 total deliveries and trend rose from 450/100,000 in 1990 to 1,060/100,000 total deliveries in 1994. About 33% of all maternal deaths occurred among teenagers. The risk factors for maternal deaths included adolescence, grand multiparity, illiteracy and non-utilisation of antenatal services. The main causes of maternal mortality were haemorrhage (28.1%), sepsis (21.3%) and eclampsia (15.7%). The contributions of complicated induced abortion and anaesthetic deaths in this study are worthy of mention.Conclusion: The maternal mortality ratio is unacceptably high in Jos University Teaching Hospital more particularly because of the rising trend. Socio-cultural and economic factors contributed immensely to the high maternal mortality in Jos. The objective of the World Health Organisation(WH0) to reduce maternal mortality by 50% by the year 2000 will not be achieved in this part of Nigeria. Nonetheless, improvement of the nation's economy coupled with a stable policy and provision of intrastructural facilities will assist to sigdicantly reduce maternal mortality