Access to postpartum tubal ligation services in Cape Town, South Africa - an observational study

Background: Many women receiving antenatal care in public health services in Cape Town choose bilateral tubal ligation as their preferred method of postpartum contraception during their antenatal course. If the sterilisation does not occur immediately, these women are discharged on an alternative form of contraception and, ideally, an interval date for bilateral tubal ligation is arranged. Objectives: To assess the access to tubal ligation services in the Metro West area of Cape Town, South Africa, in women who request permanent contraception following delivery, looking specifically at the number of women requesting bilateral tubal ligation who receive the procedure intrapartum, immediately postpartum or as an interval procedure. Other objectives included determining the reproductive outcomes if bilateral tubal ligation was not performed, investigating the alternative forms of contraception provided and to study the demographics of the population requesting bilateral tubal ligation as a form of contraception. Methods: The study was conducted as a cross-sectional observational study collecting data over a period of 3 months, from June 2019 to August 2019. Maternity case records for deliveries between June 2019 and August 2019 from four facilities were reviewed. The facilities, representing all levels of care, were Vanguard Midwife Obstetric Unit, Wesfleur Hospital (district hospital), New Somerset Hospital (regional hospital), Groote Schuur Hospital (tertiary hospital). Results: There were 260 women who requested tubal ligation as their choice of contraception. Only 50% of these received a tubal ligation. Of the 131 tubal ligations performed, 2 were interval sterilisations. Ninety-one percent (120/131) of the tubal ligations were done at the time of caesarean section. Of the 129 women who received alternative forms of contraception, 13 women had a recurrent pregnancy. Conclusion: The study suggests that only 50% of women requesting tubal ligation as form of contraception actually end up receiving the procedure. Alternative forms of contraception are widely used and relied upon, but not without risks of recurrent pregnancy. Interval tubal ligation was not easily accessed by those women who were referred for the procedure.

Implementation of maternal guidelines for gravid teenagers with hypertensive disorders in KwaZulu-Natal

Background: The worldwide phenomenon of teenage pregnancy among 13­9-year-olds is complicated by obstetric conditions. Among the top three causes of maternal mortality, hypertension is the third in South Africa. Quality maternal care is assured by obstetric practitioners (OPs) implementing guidelines specific for management of hypertension in pregnancy. Objective: The objective of this study was to investigate implementation of maternal guidelines for hypertension in pregnancy among teenagers. Methods: As a retrospective quantitative research design was used, 173 maternal records of pregnant teenagers from 13 to 19 years were sampled from six district hospitals and Community Health Centres (CHCs) between 01 January 2017 and 31 December 2019 to undergo systematic random sampling. A pretested structured checklist was used to record data from sampled maternal records. Statistical Package for Social Sciences (SPSS) version 26 was used for data analysis, and results were presented using simple descriptive statistics. Results: Research results indicated that teenagers who suffered from hypertension intrapartum and postpartum did not receive maternal care according to the guidelines for maternity care in South Africa. Blood pressure was not measured of six (3.47%) intrapartum and five (2.9%) postpartum teenagers. Seventeen (9.8%) hypertensive postpartum teenagers received their antihypertensives. Conclusion: Public health institutions (PHIs) compromised provision of quality maternal care among teenagers, evidenced by incomplete intrapartum and postpartum assessment, diagnosis and management of hypertensive disorders in pregnancy (HDP).

Syndrome de QT long découvert en postpartum: à propos d'un cas à Fianarantsoa, Madagascar / Long QT syndrome discovered in postpartum: about a case in Fianarantsoa, Madagascar

Le syndrome de QT long congénital est une canalopathie arythmogène rare mais grave pouvant être responsable d'une mort subite prématurée chez l'enfant et les sujets jeunes. La période du postpartum est particulièrement à risque de survenue d'évènement cardiaque chez la femme. Nous rapportons le cas d'une femme de 29 ans porteuse d'un syndrome de QT long congénitale probable déclenché avec trouble du rythme cardiaque déclenché par le postpartum dont le risque de mort subite à court terme a été imminent en absence de traitement

Devenir périnatal issu des grossesses rapprochées étude retrospective Marocaine / Perinatal outcome of closely spaced pregnancies: a Moroccan retrospective study

Introduction: déterminer les complications périnatales associées aux grossesses rapprochées. Méthodes: une étude cas-témoin rétrospective menée du 1er juin 2020 au 1er juin 2021 au centre hospitalier provincial de Settat. Au total, 670 patients ont été recrutés. Six cent trente personnes ont été réparties en deux groupes. Un groupe de patientes avec des intervalles intergénésique <9 mois (N = 443) et un groupe témoin >9 mois (N = 187). Résultats: la prématurité, la dénutrition et l'anémie p<0,05 étaient les principales complications et les principaux facteurs de risque de grossesse imminente étaient l'âge >35 ans (OR = 19,079 (4,98; 73,06) p<0,005) et le milieu rural (OR = 0,468)) (0,28; 0,78) p<0,005), niveau socio-économique bas (OR = 3,465 (2,06; 5,81) p<0,005); absence de prescriptions contraceptives postnatales (OR = 15,77 [7,31; 33,99]; p<0,005); absence d´allaitement avant la grossesse (OR = 49,462 [15,78; 155,03]; p<0,05). Conclusion: des soins préventifs et ciblés sont nécessaires en matière de planification familiale pour éviter les complications périnatales.

Introduction: the purpose of this study is to provide Moroccan data, study maternal risk factors and identify perinatal complications related to closely-spaced pregnancies. Methods: we conducted a retrospective case-control study at the Provincial Hospital Center in the city of Settat since June 1, 2020 to June 1, 2021. A total of 1,200 patients were admitted, but only 630 were included in the study. They were divided into 2 groups: a group of patients whose interpregnancy interval was <9 months (N = 443) and a control group whose interpregnancy interval was >9 months (N = 187). Results: prematurity, hypotrophy and anemia p<0,05 were the main complications, the main risk factors for closely-spaced pregnancies were age >35 years (OR =19,079 (4,98; 73,06) p < 0,005), coming from a rural area (OR = 0,468 [0,28; 0,78] p < 0,005), having a low socioeconomic status (OR =3,465 [2,06; 5,81]; p < 0,005); the absence of contraceptive prescription in the postpartum period (OR =15,77 [7,31; 33,99]; p < 0,005); and breastfeeding breaks before getting pregnant (OR = 49,462 [15,78; 155,03]; p<0,05). Conclusion: prevention and specific family planning methods are necessary to avoid perinatal complications.

Planification familiale du postpartum à l'hôpital de district de la commune II de Bamako, Mali / Postpartum family planning at the district hospital of the commune II of Bamako, Mali

La planification familiale du postpartum est la prévention des grossesses durant les 12 mois qui suivent l'accouchement. Objectif : Etudier l'utilisation des méthodes contraceptives dans le postpartum dans le service de gynécologie obstétrique de l'hôpital de district de la commune II de Bamako. Matériels et Méthodes : Nous avons mené une étude transversale descriptive et analytique avec collecte prospective des données du 1er janvier 2019 au 31 décembre 2020. Ont été incluses, toutes les accouchées ayant choisi et bénéficié d'une méthode contraceptive. Le test statistique utilisé a été le test de Fisher avec un seuil de significativité fixé à 5%. Résultats : En 2 ans, la prévalence contraceptive dans le postpartum était de 26,1%. Plus des 2/3 des counselings (61%) ont été faits lors des consultations prénatales, 8% pendant la phase de latence, 26% dans le postpartum immédiat et 5% lors de la visite postnatale. Les méthodes les plus choisies ont été les implants (47,1%), le dispositif intra-utérin (29,6%), les pilules miro-progestatives (12,5%), les progestatifs injectables (8%) et les préservatifs (3,2%). Conclusion : La planification familiale du postpartum contribue à augmenter la prévalence contraceptive

An evaluation of challenges with the South African PMTCT HIV programme seen from the perspective of HIV-positive children admitted to the PICU

Background. Mother-to-child transmissions (MTCT) accounts for 90% of the 370 000 new HIV-positive children, globally. Despite progress in the prevention of mother-to-child transmission (PMTCT) of HIV, children still acquire HIV infection. Objective. To identify and describe the prevalence of maternal, infant and/or health system-related risk factors gleaned from the literature for HIV transmission in HIV-positive children admitted to the paediatric intensive care unit (PICU) at Inkosi Albert Luthuli Central Hospital (IALCH), Durban, South Africa. Method. A retrospective electronic chart review identifying all HIV-positive children under 2 years admitted to the PICU at IALCH between January 2017 and December 2019 was undertaken. Individual patient records were analysed using a standardised template. Results. Of the 80 mothers and children with HIV enrolled in the present study, 38.8% (n=31/80) of mothers were diagnosed prior to pregnancy, 42.5% (n=34/80) were diagnosed during pregnancy (unsure when exactly transmission occurred), and 18.8% (n=15/80) of mothers were diagnosed after delivery. The median (range) time of antiretroviral treatment (ART) was 225 (30 - 365) days for mothers. More than half of mothers (56.3%, n=45/80) whose babies became HIV-positive had poor adherence to antiretroviral drugs (HIV viral load >1 000 copies/mL). An HIV-positive diagnosis in the children of these mothers occurred throughout infancy and early childhood, especially in the first 6 months (87.5%, n=70/80). A third of mothers practised mixed feeding. Health system deficiency, mainly via cancellation of tests without notifying healthcare workers, was typical in infants (33%; n=26/80) and mothers (68.8%, n=55/80). All others (100%) were not counselled about the importance of PMTCT and 93.8% of mothers were not counselled about the importance of follow-up. Almost all HIV-positive infants (95%, n=76) presented with severe respiratory illness, mainly severe acute respiratory distress syndrome (62.5%, n=50/80) and pneumonia with hypoxic respiratory failure (32.5%, n=26/80). The overall mortality of the cohort was 22.5% (n=18/80), and most deaths were associated with cytomegalovirus (CMV), Pneumocystis jirovecii pneumonia (PJP) or both (61.1%, n=11/18). Conclusion. This present study confirmed that a new diagnosis of HIV positivity occurs throughout pregnancy and early childhood in infants. Poor adherence to ART in mothers and their infants, poor counselling, failure to attend antenatal and postnatal care, mixed feeding, and challenged laboratory services were common modifiable factors that need addressing.

Sleep quality and new onset postpartum hypertension

Background: Chronic sleep deficiency is a stressful situation which has an association with high blood pressure. After delivery, mothers have disrupted sleep due to frequent awakenings by their infants. What is not known is how significant this relationship is in women during the postpartum period as well as other factors that may affect their Sleep quality. Sleep quality is a measure of duration and disruption. Aim and Objectives: Study is aimed at determining the relationship between Sleep quality and new onset postpartum hypertension. The specific objectives are; to determine the Sleep quality of mothers in the postpartum period using the Pittsburgh Sleep quality index (PSQI), identify factors that affect Sleep quality of mothers in the post-partum period and determine blood pressure patterns of mothers in the postpartum period. Materials and Methods: This was a longitudinal study. Using systematic random sampling, a sample size of 126 women were recruited between June and August 2016 in the Postnatal clinic of the 37 Military Hospital. Written consent was obtained from participants. Sitting blood pressure was checked and recorded and a modified form of the Pittsburgh Sleep quality index (PSQI) was used to assign a global score for Sleep quality. A global score of more than 5 indicated poor Sleep quality in that mother. Clients were first recruited at the 1st postnatal visit with follow-up at the 2nd routine postnatal visit (6weeks). Only mothers whose blood pressures were normal during pregnancy and upon discharge from hospital were included. For categorical data, Pearson's chisquare test was used for comparisons and logistic regression as used to determine significant factors that contribute to new onset hypertension in postpartum women. A P-value less than 0.05 was considered significant. Results: Majority of mothers (92.1% and 90.5% at first and second visits respectively) had poor Sleep quality. Mothers who slept away from their babies at the sixth week visit had better sleep. Mean global Sleep quality scores had no significant association with new onset hypertension but mean scores of some Age , p=0.001, OR =1.20 (C.I: 1.09-1.32) and some sleep components sleep disturbance, p=0.041, OR =1.86(C.I: 1.02-3.37), and use of sleep medicine, p=0.031, OR =1.54 (C.I:1.04- 2.29) were significantly associated with new onset postpartum hypertension. Conclusion: Global poor Sleep quality is not associated with increased odds of new onset hypertension but the Sleep quality components, sleep disturbance and increased use of sleep medicine, were significantly associated with new onset hypertension in mothers

Factors associated with postpartum health problems among married women of reproductive age in the Democratic Republic of the Congo: a cross-sectional study in Kenge City

Maternal mortality is attracting attention worldwide, but maternal health problems after delivery have received less attention. Most studies focus on prenatal maternal health problems. We aimed to identify factors associated with postpartum health problems among married women of reproductive age in Democratic Republic of the Congo. We employed a cross-sectional study design and randomly enrolled 700 married women of reproductive age in Kenge city. Data collection instrument was developed using the UNICEF Multiple Indicator Cluster Survey. T-test, chi-square test, and binary logistic regression analysis were performed using the SPSS version 24.0. Significant risk factors associated with postpartum health problems were initial postnatal care period; within 24 hours (Odds Ratio [OR]=2.197, 95% confidence interval [CI]: [1.156­4.174], p=.016); within 7 days (OR=1.972, 95% CI: [1.102­3.528, p=.022]; within 14 days (OR=2.124, 95% CI: [1.082­4.172], p=.029) among reproductive health and health service utilization characteristics. Health education by RECO (Relais Cmunataure) was associated with postpartum health problems including PCIME (Prise en Charge Integree des Maladies de l'Enfant; OR=1.845, 95% CI: [1.038­3.282], p=.037); hand washing (OR=1.897, 95% CI: [1.060­3.396], p=.031); malaria (OR=2.003, 95% CI: [1.192­3.366], p=.009) among Maternal and Child Health intervention characteristics. In conclusion, it is necessary to develop and promote health policies and educational programs focusing on PNC service within 24 hours, PNC services within 7 days, PCIME, hand washing, prevention of malaria

Practice of hot abdominal compression among parturient women at the University College Hospital, Ibadan, Nigeria

Background: The postpartum period is an important period of excitement with the arrival of the newborn. The body then starts physiological adaptations to revert to the pregnancy states. These physiological adaptations can be associated with some cultural practices like hot abdominal compress (HAC) which may have harmful effects such as hot water burns, abdominal wrinkling and darkening. This study assessed the practice of HAC among mothers seen at the postnatal clinic of the University College Hospital (UCH), Ibadan, Nigeria. Methods: This was a cross-sectional study among 290 postpartum women recruited consecutively at the postnatal clinic in UCH between 1st December 2015 and 29th February 2016. Data collection was by pretested self-administered questionnaire and was analyzed using SPSS version 22.0. p value was set at < 0.05. Results: The participants' mean age was 31.88 (SD+ 5.1 years), 97.2% of the women had ANC in formal setting and 53.8% had vaginal delivery. Of the 290 participants, 264 (91.0%) were aware of HAC and 51.7% practiced HAC. The return of uterus to normal size (34.7%) and mothers' encouragements (24.7%) were the commonest reason for practice of HAC. Mothers' and mothers-in-law' assisted with HAC in 46.2% and 36.6% of cases, respectively. More vaginally-delivered women practiced HAC (p < 0.001). Conclusion: This study showed that practice of postpartum HAC is high and the reasons for the practice are more of tradition and cultural beliefs. There is need for more studies to better understand this culturally deep-rooted practice

Knowledge and practice of essential newborn care among postnatal mothers in Addis Ababa City Health Centers, Ethiopia

Essential newborn care is a wide-ranging approach planned to improve the health of newborn through interventions after pregnancy. In Ethiopia, about 120,000 newborns die every year in the first weeks of life which accounts for 42% of all deaths of under-five mortality. Therefore this study is aimed to assess the knowledge and practice of essential newborn care practices among mothers in Addis Ababa, Ethiopia. A facility-based cross-sectional study was conducted amog the enroll 576 women in the first six weeks of post-partum who attending ANC in Addis Abeba Health facility. Written consent was obtained from each participated individuals before the actual data taken. Data were gathered by using pre tested standard questionnaire. The collected data were uploaded to computer using EpiData version 3.1. and the analysis was made through SPSS package version 21. Logistic regression was carried out to assess possible associations. The strength of association was measured at P<0.05 with 95% confidence interval. The study revealed that the level of essential newborn care practices was 38.8%. Education and advise about essential newborn care practices during and after birth by skilled birth attendants (OR=2.17, 95%, CI=1.42,3.31), home visit by health extension worker (OR=1.55, 95% CI=1.03,2.32) and place of delivery at health center (OR=7.69, 95% CI =1.32, 36.42), at private health facility (OR=9.18, 95% CI=1.32, 63.75) and government hospital (OR=6.68, 95% CI =1.32, 33.87) were found to have statistically significant association with essential newborn care practices. The result of this study has indicated that the level of essential newborn care practices was low. A home visit by health extension workers, the timing of postnatal care visit by skilled birth attendants, advice about essential newborn care practices during and after pregnancy and place of delivery were found to be independent predictors of essential newborn care practices in the study area. Government should take remedial action to improve newborn care practice

Étude de la satisfaction des soins du post-partum immédiat (SSOPPI) au centre de santé de référence de la commune V de Bamako

Les objectifs du travail étaient de mesurer le degré de satisfaction des femmes dans le post-partum et de déterminer la stabilité de l'échelle de mesure de la satisfaction des soins post-partum immédiat(SSOPPI). Matériel et méthode : La maternité du centre de santé de référence de la commune V a servi de cadre d'étude. L'étude était descriptive à visée évaluative portant sur les femmes en post-partum. Elle a couvert la période allant du 11juillet 2014 au 14 janvier 2015. Deux questionnaires d'entrevue (SSOPPI1) et (SF12 et SSOPPI2) ont été utilisés pour la collecte des données. L'analyse des données a été faite sur le logiciel EPI-info version 3.5.3. Résultats : L'étude a porté sur un total de 145 femmes en SSOPPI1 et SSOPPI2. L'âge moyen était de 25, 6ans±5,5ans. Le degré de satisfaction pour les deux phases de l'étude (SSOPPI1 et SSOPPI2) était fonction du niveau d'étude, la profession, le mode de déclenchement du travail, la voie d'accouchement, l'état du nouveau-né à la naissance. La satisfaction était de 98,6% en SSOPPI1 et de 98,5% en SSOPPI2 avec une différence statistiquement non significative (p=0,67). Conclusion : Le degré de satisfaction globale était fonction d'un certain nombre de facteurs. Cette satisfaction est restée stable pendant les deux phases de l'étude

Postpartum depression: the burden and determinants in resource constrained environments

Background: Depression occurring after delivery of a baby can be missed especially in resource constrained environments. Constraint in personnel and a low diagnostic index are probable reasons. A low diagnostic index or delay in diagnosis and treatment of postpartum depression (PPD) has adverse consequences on the family dynamics. Objective: The study aimed at determining the burden of postpartum depression that was missed after the first postnatal follow up visit at a tertiary hospital in Makurdi, Nigeria. Methods: A cross-sectional study of postpartum women at the immunization clinic at the Federal Medical Centre, Makurdi using the a semi-structured questionnaire containing the Edinburgh postnatal depression scale (EPDS) to assess for depression with a diagnostic cut off of 10 was done. Results: Three hundred and thirty postpartum women were assessed and the burden of PPD that was missed during a postnatal visit was 27.6%. No correlation was found between any social or economic demographics and PPD. Conclusion: The prevalence of missed PPD in Makurdi is high (27.6%), hence the need for high diagnostic index of suspicion and routine screening by the primary care physicians. Social or economic demographics alone should not be criteria for its suspicion

Connaissance des signes de danger de la grossesse, du postpartum et du nouveau-né par les gestantes et accouchées récentes du District sanitaire de Sig-Noghin, Ouagadougou, Burkina Faso

L'objectif était d'étudier la connaissance des signes de danger de la mère et du nouveau-né ainsi que les facteurs associés parmi les femmes du district sanitaire de Sig-Noghin. Il s'est agi d'une étude transversale analytique menée du 1er avril au 30 mai 2016. Elle a concerné un échantillon de 429 femmes. L'entretien a été la technique d'enquête utilisée. Pour l'identification des facteurs associés, une régression logistique fut réalisée. Parmi les participantes 16,5 % ; 11,1 % et 6,3 % ont pu citer au moins trois (3) signes de danger respectivement de la grossesse, du postpartum et du nouveau-né. L'âge de la femme (OR aj 6,14 [1,06-35,61]), le niveau d'instruction (OR aj 3,19 [1,59-6,38]), le nombre de grossesses (OR aj 3,30 [1,13-9,62]) et le nombre de consultations prénatales (OR aj 1,77 [1,09-3,46]) étaient les facteurs statistiquement associés à la connaissance des signes de danger de la mère. Aucun des facteurs étudiés n'était associé à la connaissance des signes de danger du nouveau-né. En somme, le niveau de connaissance des signes de danger de la mère et du nouveau-né reste faible. Il est impératif de promouvoir davantage la sensibilisation des femmes enceintes et accouchées tout en impliquant la communauté dans laquelle celles-ci vivent

Labor, delivery and postpartum complications in nulliparous women with female genital mutilation admitted to Karamara hospital

Objectives:To assess labor, delivery and postpartum complications in nulliparous women with FGM/C and evaluate the attitude of mothers towards elimination of FGM.Methods:A prospective hospital based study using structured questionnaire was conducted between January to March 2015 at Karamara hospital, Jijiga, Ethiopia. All nulliparous women admitted for labor and delivery were included. Data were collected regarding circumcision status, events of labor, delivery; postpartum and neonatal outcomes as well as attitude of mothers towards elimination of FGM/C. Results:Two hundred sixty four (92.0%) of the women had FGM/C with most (93.0%) undergoing Type III FGM. The mean age of the women was 22 yr. Failure to progress in 1st stage and prolonged 2nd stage of labor occurred in 165 (57.0%) and189 (65.6%) of the cases respectively. Caesarean section was performed in 17.0% and instrumental delivery in 23.0%. 64.5% required episiotomies, 83.3% had an anterior episiotomy, 29 % had perineal tears, 25.7%% experienced post-partum hemorrhage and 24% postpartum infection. Among the newborns, there were 6.4% perinatal deaths; 18.8 % low birth weight and 1.5% birth injuries. Almost all complications were more frequently seen in circumcised compared to non-circumcised women. Conclusions: The prevalence of FGM is high and it substantially increases the risk of many maternal complications. Health professionals should be aware of these complications and support/care of women with FGM should be integrated at all levels of reproductive health care provision. Capacity building of responsible health professional should be initiated in the area with intensification of FGM eradication activities

Hémorragie du post-partum immédiat : technique de méchage

Le Méchage intra-utérin (MIU) est une technique d'étape importante pour stopper l'Hémorragie du post-partum (HPP); il est pratiqué après l'inefficacité des moyens médicaux et avant l'étape chirurgicale. Les préalables pour une PEC efficace sont évoqués puis une description détaillée de la technique de méchage est faite, terminée par une étude portant sur 265 cas d'HPP sur 7 ans dont 119 cas de méchage. Avec 93,3% de taux de succès et un coût très faible, le MIU est très efficace dans la PEC de l'HPP. Aucune complication à court ou long terme n'est constatée dans la cohorte présentée. 58 cas de grossesses spontanées sont constatés par la suite

Home Births and Postnatal Practices in Madagali; North-Eastern Nigeria

Background: Home births are common in resource poor countries and postnatal practices vary from one community to the other. Objective: To determine the proportion of home births; reasons for home delivery; and evaluate postnatal practices in Madagali; north-eastern Nigeria. Materials and Methods: This was a cross-sectional descriptive study of 400 women of reproductive age; who had put to birth in the past 1 year. The study was carried out over a period of 8 weeks from April to June 2010. The multistage method of sampling was used to select respondents. In the first stage; four of the five health districts were chosen randomly; namely; Gulak; Madagali; Sukur; and Duhu. The questionnaires were evenly distributed among the four health districts. In the second stage; from each district; two villages were chosen by simple random sample. In the third stage; two wards were selected in each village by simple random sampling. Result: Of the 400 respondents interviewed; 289 (72.2) were aged between 20 and 39 years; and most; 374 (93.5) were married. Only 14 (3.5) had tertiary education. Most respondents; 224 (56.0) were farmers and grandmultiparae; 187 (46.7). A total of 196 (49.0) women delivered at home; whereas 204 (51.0) delivered at the hospital. Of the 196 respondents who delivered at home; the bedroom 142 (72.4); was the preferred place of birth. The most common reason for home birth was short duration of labor in 71 (36.3) cases. Delivery was conducted by untrained persons in 50; (25.4); whereas 99 (50.8) and 31 (15.5) deliveries were supervised by Traditional Birth Attendants (TBAs) and Midwives/Nurses; respectively. Postpartum; the majority; 235 (58.7) respondents used sanitary pads to stanch lochia; whereas 140 (35) used rags. Conclusion: A significant number of births take place in the home and supervised by unskilled persons. Against the backdrop of poor education and low socio-economic status of respondents; perineal hygiene can be adjudged satisfactory. There is the need to increase on the number of hospital birth and also trained TBA who conduct most of home deliveries

Teething Myths among Nursing Mothers in a Nigerian Community

"Many symptoms had been associated with teething in children with the possibility of overlooking potentially fatal condition. Symptoms that had been associated with teething include diarrhoea; fever; vomiting and cough. The possibility that any of these symptoms could have been due to other causes call for thorough investigation of the child before concluding that it is only ""teething"". Objectives: The study was carried out to assess the beliefs of nursing mothers concerning symptoms that are associated with teething among children and to identify those that would seek medical treatments in case of their children having such symptoms during teething. Materials and Methods: Two hundred and ninety nursing mothers whose children had erupted at least a tooth were interviewed in the immunisation clinics of the University College Hospital and Adeoyo Maternity Teaching Hospital; both in Ibadan; Nigeria; on their beliefs and practice concerning teething in children. Results: One hundred and eighty-eight (64.8) of the mothers associated symptoms such as fever; cough; catarrh and diarrhoea with eruption of teeth in their children. Over half of the women agreed that a child having either fever (51.0); ear infection (57.6) or cough (50.3) should be promptly taken for medical consultation and not be tagged ""teething""; while for other symptoms such as gum pain (74.5); sleepless night (56.6); vomiting (51.4) and diarrhoea (51.7); over half of the mothers believed that the symptoms will resolve following the eruption of the teeth. Conclusion: The study demonstrated that mothers in the study attributes several symptoms to teething; which could be detrimental to the survival of their children as the symptom could have been due to other causes. There is; therefore; need for public enlightenment to create awareness on the possible effect of presumptuous belief that childhood diseases are due to teething process."

Impact of Health Education Intervention on Malaria Prevention Practices among Nursing Mothers in Rural Communities in Nigeria

Malaria is the most prevalent parasitic endemic disease in Africa; which is preventable; treatable and curable. This study aims to assess the effect of health education intervention on the knowledge; attitude; and prevention practices amongst mothers of under-five children in a rural area of Ogun State; Nigeria. Materials and Methods: The study design was a quasi-experimental study carried out in Ijebu North Local Government Area of Ogun State. A multistage random sampling technique was used in choosing the required samples and a semi-structured questionnaire was used to collect relevant information. A total of 400 respondents were recruited into the study with 200 each in both the experimental and control groups and were followed up for a period of 3 months. Results: There was no statistically significant differences observed between the experimental and control groups. Knowledge of indoor spraying increased from 14.7 to 58.2 (P 0.001) and window and door nets increased from 48.3 to 74.8 (P 0.001). The proportion of those with ITN use increased from 50.8 to 87.4 (P 0.001) while those with practice of maintaining clean environment also increased from 40.4 to 54.5 (P 0.001). There were no significant changes in all the practice of malaria prevention methods in the control group. Conclusion: This suggests that malaria control can be significantly improved in rural areas; if the caregivers are adequately empowered through appropriate health education intervention though change in attitude and belief may require a longer and persistent effort