ABSTRACT
Schools have the responsibility to educate their students and encourage them to live healthy and hygienic behavior. This descriptive cross-sectional study aimed to determine the status of the school health instruction in 56 randomly selected schools in Nnewi North Local Government area of Anambra state using the school health program evaluation scale. It also assessed the extent of implementation of provisions of school health instruction in these schools. Forty six (78.6%) of the 56 schools surveyed had adequate implementation of school health instruction. The proportion of school that met the requisite score (16) for adequate implementation of school health instruction was not significantly different between private and public schools [24(73%) vs. 20(87%), P=0.389]. There was also no significant difference in mean scores attained for school health instruction between private and public schools (17.6±4.4 vs. 17.6±3.6; P=0.939). Private school had more non classroom related heath activity compared to public schools (75.8% vs. 21.7%, P=0.000) while public schools, had significantly more qualified health instructors, ten (43.5%) compared to private schools six (18.2%), P=0.040. Training and retraining of primary school teachers coupled with effective school health policies would be essential in ensuring adequate and optimal implementation of school health instructions in primary schools.
ABSTRACT
Background: Infection accounts for 13% of the approximately three million newborns deaths that occur globally every year. Poor umbilical cord hygiene in the first week of life is a well documented risk factor that increases the likelihood of neonatal infections. To curb this trend in developing countries, the World health Organization in 2013 enlisted the use of antiseptic solution as an essential medicine for cord care. Aim: This study aims to describe umbilical cord care practices among mothers in Nigeria and its association with development of fever in newborns in the first month of life. Methods: This is a population based descriptive study using nationally representative data from the 2013 edition of the Nigeria Demographic and Health survey (NDHS). For this study, 12113 women aged 15-49 years were randomly selected from households using a stratified two-stage cluster design. Logistic regression and chi-square was used in data analysis. Results: Unhealthy umbilical cord care was practiced by 27.8% of the respondents. The World Health Organization and national policy recommendation of cord care was significantly practiced by older women (P=0.002), literate mothers (P=0.001), mothers with higher educational attainment (P=0.001), mothers in the higher wealth class (P=0.001), those with access to print and electronic media (P=0.001), mother who uses hospital based postnatal check-up (P=0.001) and mothers resident in urban areas (P=0.001). Compared to newborns whose mothers applied nothing to their umbilical stumps, the odds of developing fever in the first month of life was higher in newborns whose mothers applied Oil (OR 1.79 CI 0.39-8.87); Ash (OR 3.37 CI 0.09-29.51); Toothpaste (OR 4.10 CI 1.01-16.68); Animal dung (OR 11.01 CI 1.11-111); and Other concoction (OR 2.58 CI 0.30- 22.22) to the umbilical stump and lower in newborns whose mothers applied Methylated spirit or Chlorhexidine solutions (OR 0.68 CI 0.10-5.6) to the umbilical stump. Conclusion: The need for proper hygiene of the umbilical cord using the recommended antiseptic solution must be re-emphasized among health care providers particularly targeting traditional birth attendants in rural settings. Female education and empowerment which has long been designated as one of the child survival strategy and also highlighted in this study as a strong determinant of healthy cord care practices is needed to promote this low cost and highly effective practices amongst mothers.