Oral health seeking behaviour among patients attending outpatient clinic in University of Ilorin teaching hospital (UITH) Ilorin

Introduction: In sub ­ Saharan Africa, oral health services are greatly hampered by low availability and poor accessibility to health care and these are various interrelated factors responsible. This study determined the factors that influence oral health seeking behavior among patients attending outpatients' clinic. Methodology: A total of 460patients were selected into the study from the outpatients' clinic using systematic random sampling. Data was collected and was analyzed using SPSS 17. The significant level was set at 0.05 Results: Of the 97.3% of the respondents with awareness of oral health facility, 90.9% of them had oral health facility within 5km distance. The commonest complaint was toothache. Majority of the respondents (88.2%) accessed orthodox oral health services mostly for teeth extraction (61.3%). There was statistically significant difference between the awareness of Oral health facility and closeness to residence. Conclusion: Age, awareness and attitude have positive effect on health seeking behavior of patients.

Accessibility of maternal health information and its influence on maternal health preferences in rural Tanzania: A case study of Chamwino District

Background: The access to quality maternal health information amongst pregnant women plays an important role in determining woman's health behaviour during pregnancy. Yet, access to maternal health information remains a major challenge in Tanzanian rural communities especially for pregnant women leading to low utilisation of skilled maternal health services. Objectives: The study aimed at examining the accessibility of maternal health information amongst pregnant women in rural Tanzania. Methods: A qualitative phenomenological study involving 25 pregnant women, 5 skilled healthcare providers (SHPs) and 5 traditional birth attendants (TBAs) was carried out in Chamwino District, Dodoma Region, Tanzania for a period of 6 months. Data were analysed thematically using the six-stage guide to thematic data analysis with NVivo Software. Results: The acute shortage of healthcare personnel and traditional beliefs influenced pregnant women's access to quality maternal health information. The majority of women used mothers-in-law and TBAs as their primary source of maternal health information rather than skilled healthcare providers. Conclusion: Despite the acute shortage, healthcare providers need to play a leading role in providing maternal health information amongst the rural populations. Furthermore, skilled health providers need to work in collaboration with the TBAs to increase access to maternal health information and build a well-informed healthy society.

Information behaviour and medication adherence among hypertensive and diabetic patients in tertiary care Teaching Hospital in Lagos State, Nigeria

This paper examined the relationship between use of information and medication adherence among hypertensive and diabetic patients in tertiary care teaching hospital in Lagos State, Nigeria. It also explored the factors that influence hypertensive and diabetic patients' choice of information sources. The research is a descriptive survey that used a questionnaire to collect data. Purposive sampling technique was used in selecting four diabetic and hypertension clinics in University of Lagos Teaching Hospital. The convenience sampling technique was used in selecting the patients. Participants comprised 134 hypertensive and diabetic patients. Data were collected at the clinics. Result shows that majority of the respondents 52.3. % and 23.1% either very highly utilized or highly utilized healthcare personnel such as doctors, pharmacists and nurses as their major sources of information. While 16.4 % and 19.4% of the respondents either very highly utilized or highly utilized pharmacy stores as information sources. The main factors that influence their choice of information source were credibility and relevance of the source (70.9%) and easy access to information source (53.0%). Majority of the respondents (40.3%) reported that their level of adherence to medication was good while 32.1% reported that their level of adherence to medication was very good. The study also found that there is a strong positive relationship between information sources use and attitude towards medication adherence (rho=0.726, P (0.031) <0.05). The findings may enhance understanding of the influence of information source use and medication adherence. It can also assist medical professionals and medical librarians in meeting the information needs of hypertensive and diabetic patients.

Exploring the Health Belief Model and First-Year Students' Responses to HIV/AIDS and VCT at a South African University

The Health Belief Model (HBM) is a psychosocial framework that attempts to explain health behaviour. It is determined by an individual's personal beliefs or perceptions about a disease and the options available to decrease its occurrence. In the context of sexual risk behaviours; literature reveals that knowledge about HIV/AIDS and Voluntary Counselling and Testing (VCT) are key strategies in the management and prevention of HIV. This study was conducted in 2011; the same year the First Things First campaign was implemented in universities across South Africa to maximise opportunities for HIV testing among youth. It aimed to identify first-year students' responses to HIV/AIDS and VCT at the University of the Witwatersrand (WITS). The mixed research methods consisted of self-administered structured questionnaires with a sample population of 195 first-year students and 2 in-depth interviews with experts in the field of HIV/AIDS. Descriptive statistical analyses (frequencies and cross-tabulations) and thematic content analysis was carried out. The findings indicate that students are willing to know their status. The positive influence of peers is a motivation for those accessing VCT. However; some students do not access VCT due to personal fears while other students do not access VCT because of their low individual risk perception for HIV due to sexual abstinence. It concludes that university students' self-efficacy and cues to action might bring about a positive change in the future of the epidemic within a university context

Factors Underlying Taking a Child to HIV Care: Implications for Reducing Loss to Follow-up among HIV-Infected and Exposed Children

Objective: With the aim of reducing pediatric loss to follow-up (LTFU) from HIV clinical care programs in sub-Saharan Africa; we sought to understand the personal and socio-cultural factors associated with the behavior of caregivers taking HIV-infected and -exposed children for care in western Kenya.Methods: Between Mayand August; 2010; in-depth interviews were conducted with 26 purposively sampled caregivers caring for HIVinfected(7); HIV-exposed (17) and HIV-unknown status (2) children; documented as LTFU from an urban and rural HIV care clinic. All were women with a majority (77) being biological parents. Interviews were audio-recorded; transcribed and content analyzed.Results: Thematic content analysis of the women's perceptions revealed that their decision about routinely taking their children to HIV care involved multiple levels of factors including: (1) intrapersonal: transport costs; food availability; time constraints due to work commitment; disclosure of HIV status for both mother and child; perception that child is healthy and religious beliefs; (2) interpersonal: unsupportive male partner; stigma by the family and family conflicts; (3) community: cultural norms; changing community dynamics and perceived stigma; (4) health care system: clinic location; lack of patient-centered care; delays at the clinic and different appointment schedules (mother and child). Furthermore; the factors across these different levels interacted with each other in a complex way; illustrating the challenges women face in taking their children to HIV care.Conclusion: The complexity and interconnectedness of the factors underlying retention of children in HIV care perceived by these women caregivers suggests that interventions to reduce pediatric LTFU need to be holistic and address multiple socio-ecological levels. Patient-centered care that integrates a family-centered approach to HIV pediatric care is recommended

A Decade of Research Involving Men who have Sex with Men in Sub-Saharan Africa: Current Knowledge and Future Directions

It has been just over 10 years since the first large behavioral survey of men who have sex with men (MSM) was implemented in Senegal in 2001. Since then; behavioral and/or HIV prevalence surveys have been conducted in over 14 other countries in sub- Saharan Africa. Current available evidence and review have established that HIV prevalence among MSM in these countries are significantly higher than corresponding general populations; that MSM engage in sexual risk behaviors that place them and sexual partners at higher risk; and that issues of discrimination and stigmatization inhibit HIV interventions for MSM. This paper summarizes the existing knowledge; describes limitations of this evidence; and proposes new and enhanced research approaches to fulfill needed gaps to inform national HIV responses for MSM populations

Behavioural problems among schoolchildren in Nigeria

Background: Behavioural problems among schoolchildren can pose a burden on families and society. Objective: To determine the prevalence and pattern of behavioural problems among children living in Uyo, a town in South-South Nigeria. Methods: A cross-sectional study was carried out among 572 pupils from six primary schools selected randomly from private and government schools in Uyo. Pupils with a normal IQ were selected using a systematic sampling method. The Rutter behavioural scale for teachers (B2) was completed by their teachers, and that for parents (A2) was completed by the parents. Student's t-test was used to compare pairs of means, frequencies were compared using the chi-square test, and p<0.05 was taken as significant. Results: According to the teachers' scale 132 pupils (23.1%) had scores within the range indicating behavioural problems, compared with 103 pupils (18.0%) on the parents' scale. This was statistically significant (χ2=19.8, p=0.001). Pupils in government and private schools had mean scores of 7.4 (standard deviation (SD) 6.41) and 5.12 (SD 6.26) and 7.29 (SD 5.84) and 6.96 (SD 5.76), respectively. Behavioural problems were more common among children in government schools and among those in the lower socio-economic class. Boys had significantly higher mean scores than girls, and both scales showed more boys to be disturbed. Antisocial behaviour was commonest among boys and older children. Conclusion: There is a high prevalence of behavioural problems among primary school children in Uyo, with a predominance of antisocial behaviour. The government needs o provide appropriate services to deal with this state of affairs

Behaviour change and motivational interviewing in the patient with diabetes

Motivational Interviewing (MI) is designed to motivate people to change by helping them to recognise and resolve the difference between a behaviour problem and personal goals and values. There are several challenges of health behaviour change in MI; as well as traps that the health care provider and patient can easily fall into. During the MI approach; a patient should be guided through the change model; providing him the chance to participate. There are several general principles in the MI approach as well as different interaction techniques. The efficacy of MI has been widely published in the literature

Understanding self-appraisal of HIV-infection risk among young adults in Nigeria: Evidence from a National Survey

A major component of HIV prevention is to encourage individuals to appreciate their personal risk of contracting the virus with the aim of encouraging them to take steps to reduce the risks. This article addresses the accuracy of an individual's risk assessment by matching this with individual's reported risk behaviours in order to assess possible congruence. Although the relationship between risk perception and risk behaviours has been studied by previous authors using cross-sectional studies; this has not been extensively studied using a large nationally representative data set; such as in Nigeria. In our attempt to address this; we classified HIV-risk behaviour into low-risk and high-risk behaviour. We considered both descriptive and inferential approaches in our analyses. The findings were triangulated with qualitative studies using focus group discussions conducted among members of the target group in Nigeria. Dependence of risk perception on some selected background characteristics; HIV/AIDS-knowledge indicators; experience of sexually transmitted infections (STIs); as well as exposure to the Society for Family Health (SFH) radio campaigns in Nigeria were investigated through multiple logistic regression models. Among the respondents with risk behaviours; being single; Christian; male; and listening to the SFH radio campaigns were associated with a higher perception of risk of contracting HIV

Some Behavioural Risk Factors for Intestinal Helminthiasis in Nursery and Primary School Children in Enugu; South Eastern Nigeria

The objective of this study was to determine some common behavioural risk factors for intestinal helminthiasis in nursery and primary school children in Enugu. Design: A cross-sectional survey on 460 children attending nursery and primary schools in Enugu was carried out in 2003 with a view to determine some behavioural risk factors for intestinal helminthiasis. Setting: This study was carried out in the research laboratory of the Federal Ministry of Health; National Arbovirus and Vector Research Centre; Enugu. Method: Intestinal helminthiasis was diagnosed using the kato-katz method in analysing fresh stool samples collected from nursery and primary school children in Enugu. These fresh stool samples were collected into appropriately labeled clean containers. Questionnaires were administered by the researchers to obtain data from the children and their parents or guardians as regards some behavioural risk factors for intestinal helminthiasis . Results: The results from this study showed that the prevalence of intestinal helminthiasis was significantly affected by various behavioural risk factors. The rate of helminthic infection varied significantly with hand washing habits after defeacation (X2 = 75.77; df = 2; p = 0.001) and with different habits of washing fruits before eating ( X2 = 52.79; df = 2; p = 0.001) among the pupils. Also; the rate of helminthic infection varied significantly with the source of drinking water (X2 = 55.12; df = 3; p = 0.01); water boiling habits (X2 = 40.89; df = 2; p = 0.001); use of footwear after school hours (X2 = 30.72; df = 2; p = 0.001). Sites utilized for defeacation by the pupils (X2 = 80.25; df = 3; p = 0.001) also significantly influenced the rate of helminthic infection. Conclusion: Various behavioural factors which significantly affect the rate of helminthic infection abound in children living in Enugu. The government should give attention to the control of these behavioural risk factors. A lot of health education will be needed to curb the poor personal hygienic habits which are obvious risk factors for intestinal helminthiasis

Factors Influencing the Health Behaviors of International Students at a University

Purpose: Each year; college campuses in America welcome an increasing and diverse population of international students. While the health status of these students is as diverse as the countries they come from; the shared experience of coming from different cultures; different backgrounds and different systems could lead to differences in health behavior. This study aimed to identify key patterns in nutrition; exercise and use of health care services and make recommendations for health promotion interventions. Methods: Online questionnaires were distributed to all international students enrolled in classes for the Spring 2007. Results: The majority of international students believed healthy behaviors were important: good nutrition habits (91); regular exercise (74); and use of health care services (60). Forty-four percent of the students reported they never exercise and 56reported not to have used any health care services within the past year. Conclusion: Although international students of Western Kentucky University; USA believe in healthy behaviours; majority often do not use the health care services. University wellness programs should be designed to identify target areas for health promotion interventions among international students. In addition; orientation programs provided to these students should be comprehensive and must include perceived academic; health; social and cultural issues and how to overcome them

Health Risk Behaviors of High School Learners and their Perceptions of Preventive Services offered by General Practitioners

"Background: Adolescence spans nearly a decade in which young people may initiate health risk behaviors like unsafe sexual practices and alcohol; tobacco and other drugs use (ATOD use). Most adolescent mortality and morbidity; attributable to such health risk behaviors; are preventable. Managing the consequences of health risk behaviors is costly and does not reduce the number of young people initiating these unhealthy lifestyle choices. The emphasis needs to shift towards the provision of adolescent primary and secondary preventive services. Overseas efforts involve national health risk behavior screening; the application of national guidelines for primary health care workers in all contexts and continuing evaluation so that appropriate region specific policies can be instituted. With the completion of our second South African National Health Risk Behavior survey and the implementation and evaluation of the National Adolescent Friendly Clinic Initiative in government clinics; we lack national guidelines for the primary health care worker to administer adolescent preventive services. Furthermore; the NAFCI initiative does not involve the general practitioner in the private sector. The aim of the research is to assess how the economically disadvantaged youth from public schools access the private sector general practitioner for preventive services related to health risk behaviors. Methods: This cross-sectional descriptive study was conducted among senior high school learners (Grades 10; 11 and 12) from 18 randomly selected secondary public; co-educa -tional schools with an ordinary curriculum in the Johannesburg educational districts; during the first three school terms of 2002. A self administered research questionnaire was used to ascertain learners self reported involvement in health risk behaviors and their interaction with their GP in dealing with these health risk behaviors. Results: 1139 learners completed the research questionnaires. 1. Learners reported a high prevalence of health risk behaviors: 65for alcohol use; 57for sexual activity; 39for tobacco use and 15for drug use. 2. The predominant pattern of substance use was the experimental pattern of having tried these substances: 40for cigarette use; 53for alcohol use; 54for injected drug use and 57for other drug use. The majority of sexually active adolescents were practicing unsafe sex (55had multiple partners; 52without condoms and 28without family planning). 3. Learners reported a high prevalence of coexisting health risk behaviors: 44for alcohol use and sexual activity; 36for tobacco and alcohol use and 26for tobacco use and sexual activity. 4. Risk perception was lower for sexual activity (25felt in danger and 5felt affected) than for substance use (an average of 82felt in danger and 40felt affected). Of the 1139 learners; only 271 learners (24) had a GP in private practice. 1. The adolescent-GP interaction was favorable for preventive service delivery: 70of learners had medical aid cover; 41were seeing their GP for more than five years; 92were the ""family?? doctor; 80had visited their GP in the past 6 months and 60had consulted on their own at least once. 2. Primary preventive service delivery to those not involved in health risk behaviors was poor: 28for sexual activity; 24for drug use; 23for alcohol use and 19for tobacco use. 3. Uncovering of health risk behaviors occurred to varying degrees: 40for sexual activity; 18with alcohol use; 18with tobacco use and 11with drug use. 4. Secondary preventive service delivery to those involved in health risk behaviors was better: averages of 89for sexual activity; 84for drug use; 54for tobacco use and 38for alcohol use. Statistically significant learner and general practitioner demographics highlighted the complex dynamics involved in this interaction. Conclusions: The study showed that adolescents from economically disadvantaged backgrounds have a high prevalence of health risk behaviors but utilize the general practice resource to a limited degree. Despite the interaction between adolescent and general practitioner being conducive to the receipt of primary and secondary preventive services; this was not optimal"

The Demographic Characteristics and Health Seeking Behaviour of Unbooked Patients in Irrua Specialist Teaching Hospital

Background: The Obstetric outcome of the patients who receive antenatal care and deliver at the Irrua Specialist Teaching Hospital is reasonably satisfactory. Our major challenges arise from unbooked emergencies. The aim of this study was to determine the frequency of unbooked patients in the Irrua Specialist Teaching Hospital; their clinical presentation; their demographic characteristics as well as their obstetric outcome. Methods: A structured proforma was used to collect relevant information over a one-year period from patients' case notes; theatre records and labour ward records. Results: During the study period; unbooked patients constituted 14.7of all deliveries. They had a higher proportion of teenagers (p

Social Support and Health Behaviour in Women Living with HIV in KwaZulu-Natal

The article explores the relationship between social support and health behaviour of rural and urban women who are living with HIV in South Africa. Our study was a descriptive survey of a group of pregnant and non-pregnant women living with HIV. The sample size was 262 women; 165 from urban area and 97 from rural area. Data were collected using 3 instruments; namely a demographic questionnaire; the health behaviour schedule and the Medical Outcomes Study (MOS) Social Support Survey. Significant findings indicate that in the urban area 71 of women had disclosed their HIV status to someone; while in the rural area 49 had done so.A total of 77 of the women indicated that they were sexually active - 21 had 2 partners and 20 indicated that they had at least one episode of a sexually transmitted disease since finding out their HIV status. A total of 16 said that they currently received counselling; which was significantly more frequent in the rural sample (27) than the urban (11).The membership of support groups is at 12 among the participating women; and social support as well as membership of a support group was higher in the rural group than the urban group. Good social support showed an association with condom use; support group attendance and taking vitamins. However; receiving counselling as well as membership of a support group showed stronger association with positive health behaviour than social support on its own. The higher social support was not associated with increased disclosure

Structured observations of hygiene behaviours in Burkina Faso: validity, variability, and utility

The use of observation techniques has been promoted for the study of hygiene practices; however, questions still remain about the validity and repeatability of such techniques. In this article we compare data on hygiene behaviours obtained from questionnaires with data obtained using a structured observation approach and examine the repeatability of structured observations of behaviours and spot observations of environmental conditions. Poor agreement between questionnaire responses and observations was found for child defecation and stool disposal practices (kappa statistic: 0.25 and 0.28, respectively). There was evidence of over-reporting of "good" behaviours (P < 0.0001). Repeated observations of child defecation and stool disposal behaviours showed better agreement (kappa statistic: 0.76 and 0.62, respectively) based on small sample sizes. These findings suggest that our questionnaire data are less valid than data obtained by direct observation. However, different approaches to questioning may be less prone to over-reporting of "good" behaviours than our approach. Further research into the validity of different forms of question is warranted. Behaviours and conditions related to hygiene vary. Observations may be useful in determining the frequency of different behaviours/conditions in the community. However, individual practices may be too variable to assign individuals to exposed and non-exposed groups for the purpose of identifying links with health outcomes. Further studies on the variability of behaviours and the repeatability of observations are therefore needed

Behaviour Change: The Way Forward for the Youth

"Human Immunodeficiency Virus (HIV) is primarily transmitted through sexual intercourse and because of this; AIDS strikes selectively at the young and middle-aged adults; who are the most socially and economically productive members of the population. But while the youths are the most vulnerable group to HIV infection; they are also the most promising agents of behaviour change. about half the people who contract HIV are under the age of 25. Knowledge on people's beliefs; behaviour; attitude and practice are of fundamental importance in determining the steps people are likely to take (or not to take) to protect themselves; and their sexual partners against infection with HIV. So are social networks; peer groups; community norms and friendship networks. Objectives: To justify behaviour change as the way forward in the reduction of HIV/AIDS prevalence among the youth. Risk behaviour include: 1. Peer groups 2. Poor health seeking behaviour especially as far as STDs are concerned 3. Unprotected sexual intercourse 4. Excessive alcohol consumption 5. Multiple sexual partners and others. Conclusion: There 's no cure for AIDS as yet! Behaviour change must be emphasised and practiced now if we are to stop HIV infections especially as far as the youth are concerned. For this to be effective; it should involve the youth themselves in the generation of appropriate messages and should address socio-economic and cultural realities that influence sexual behaviour. Recommendations: 1. Active involvement of members of the target audience in the intervention project activities (e.g. as peer educators; interviewers; project staff); youth clubs. 2. Parents should create time to discuss ""sex"" with their feelings about relationships; and areas of risk situations. 4. Negotiating sex e.g. say No to sex convincingly. 5. Practicing safer sex e.g. always have condoms ready. 6. Seek treatment in case of STIs."

HIV and the Youth; Behaviour Change as a Future for HIV Infection

The who estimates that half of the people infected with HIV acquired the infection between the ages of 15 and 24. One in 20 adolescents world wide contracts an STD every year. But the long latency of HIV obscures the fact that people sick now were infected during their teens