Reasons and experiences of home and hospital deliveries among women in Kano, North Western Nigeria

Background: In developing countries most women deliver at home for some reasons and such deliveries are not attended by a skilled birth attendant. In Nigeria 63% of births occurred at home. Objective: To determine the reasons and experiences of home and hospital deliveries among women in Kano, Nigeria. Methods: The study was a comparative cross-sectional study. The study employed a mixed method study. A total of 614 women were selected by multistage sampling technique and enrolled for the study. Focus group discussions with a group of women and husbands as well as key informant interviews with health care workers were conducted in the communities. Quantitative data was analysed using Minitab V17 software. Thematic content analysis was performed for the qualitative data. Data was gathered and analysed using triangulation methods. Results: The questionnaires response rate was of 96.7%. The mean age of respondents was 32.6 ± 6.5 years for home delivery group, and 28.1 ± 5.6 years for the hospital delivery group. Reasons for home deliveries were custom (24.5%), unfriendly attitude of health workers (17.5%), financial barriers (15.5%), and safety was the main reason for hospital delivery (56.7%). Determinants of choice of place of delivery were lower age at first pregnancy AOR=4.06 95%CI (1.633-10.076) and higher education AOR=2.70 95%CI (1.927-3.792) respectively. Conclusion: Mothers have different reasons and experiences with regard to choice of delivery location. Hospital deliveries should be encouraged

Occupational Hazard Perception and Utilization of Protective Measures by Welders in Kano City; Northern Nigeria

Background: Little is documented on welders' awareness of health hazards associated with welding in developing countries including Nigeria. This study assessed the perceived occupational hazards and adherence to safety measures among welders in Kano; northwestern Nigeria. Methods: A structured interview questionnaire was administered on a cross-section of 194 welders in Kano metropolis; and the data was analysed using SPSS 12.0 statistical software. Results: Overall; 58.8of the welders were aware of one or more workplace hazards. This was positively influenced by educational attainment; age and work experience. Of the 194 respondents; 86.1had experienced one or more work-related accidents in the preceding year. Only 34.5of welders used one or more types of protective device. Conclusions: The level of awareness of occupational hazards was high with low utilization of protective measures against the hazards. There is therefore need for safety education and legislation for the use of protective measures to safeguard workers health and increase productivity

Perception and Predictors of Insecticide-Treated Net Use in a Rural Northern Nigerian Community

"Background: Sub-Saharan Africa carries a high burden of malaria. Despite evidence of the effectiveness of insecticide treated nets (ITNs); utilization rates are still low. Methods: We assessed community perception of malaria and determinants of ITN use among 158 households in rural northern Nigeria using interviewer administered structured questionnaires. Results: Nearly all respondents 157(99.4) were familiar with the term ""malaria"" and attributed it to mosquito bite. Other mentioned causes of malaria included unclean environment (74); heat (7); overwork (1.9); and contaminated water (0.6). The symptoms mentioned included fever (95); headache (52.5); body weakness (41.1) and vomiting (25.9). Most respondents (84.0) were aware of ITNs but only 34.8used them. Willingness to buy at current market price; health workers as source of information and the use of mosquito coils were significant predictors of ITN use. Conclusion: High awareness of ITNs did not translate into its utilization. Public health education in malaria including free ITN use should be delivered by health workers."

Magnitude and Leading Causes of In-Hospital Mortality at Aminu Kano Teaching Hospital

Background: Population based mortality data are scarce especially in developing countries including Nigeria. Despite its limitations; hospital mortality analysis assesses the quality of health-care delivery and provides a proximate measure of mortality. We reviewed the magnitude and causes of death among in-patients in a tertiary hospital in northern Nigeria. Methods: Analysis of mortality rate and causes of death for the period 20052008 (inclusive) in Aminu Kano Teaching Hospital. Causes of death were prospectively entered on a database and classified according to the International Classification of Diseases (ICD-10). Results: Out of 51;975 patients admitted to the hospital; 4;029 of them died. This gives a mortality rate of 7.8(95Confidence Interval of 7.5to 8.0). Specifically; of the 15;484 males admitted; 2;361 died giving a mortality rate of 15.2while of the 36;491 females admitted; 1;668 died giving a mortality rate of 4.6. The median age for all patients that died was 32.4 years (range: less than 1 day to 101 years); but 36.1 years (range: less than 1 day to 101 years) for the male and 29.3 (range: less than 1 day to 87 years) for the female subsets. The ten most common causes of mortality were HIV/AIDS (8.3); Septicaemia (6.8); cerebrovascular disease (6.3); chronic renal failure (3.9) chronic liver disease (3.3); diabetes mellitus (3.2); neonatal jaundice (2.9); severe birth asphyxia (2.6); prematurity (2.5) and bronchopneumonia (2.4). Conclusion: The mortality rate and causes of death are comparable to similar centres. Regular mortality audits could identify management errors and prevent recurrence of avoidable deaths

Prevalence of hypertension among teenage students in Kano, Nigeria

BACKGROUND: Hypertension has been reported among young people worldwide. It is known to track from youth to adulthood, which makes it a useful predictor of essential hypertension in adulthood. This study determined the prevalence of hypertension and associated cardiovascular risk factors among secondary school teenagers in Kano, Nigeria. METHODS: A questionnaire was administered on a cross section of 1000 teenage students to inquire about cardiovascular risk factors. Participants' blood pressure, height and weight were measured. Relevant investigations were done for those with raised blood pressure.RESULTS: The participants' ages ranged from 13 to 19 years with a mean of 15.91.62 years. Seventy of the students had systolic blood pressure 140mmHg and/or diastolic blood pressure 90mmHg giving a prevalence rate of hypertension of 7.2% [95% CI = 5.6-8.9%]. Specifically, 32 (6.7%) of the 476 males were hypertensive compared to 38 (7.7%) of the 492 female participants. This difference was not statistically significant (2 =1.6 df = 1 p > 0.05). The prevalence rate of hypertension rose from 4.3% (among the younger participants) to 11.8% among the oldest students. Of the 70, a majority (88.5%) had grade 1 hypertension, 10.0% had Grade 2 hypertension and 1.5% had Grade 3 hypertension. The hypertensives were about twice more likely to have a family history of hypertension compared to their normotensive counterparts. This difference was statistically significant [OR = 2.1, 95% CI = 1.12-3.83] (2 = 6.4 df = 1 p = 0.01). CONCLUSION: Hypertension exists among teenage students in Kano, Nigeria. Early detection can reduce risk of cardiovascular changes and end organ damage

Community Leaders' Perception of Reproductive Health Issues and Programmes in Northeastern Nigeria

Context: A faith-based NGO wanted to expand its reproductive health programmes to Northeastern Nigeria in view of its poor reproductive health indices compared to the other parts of the country. In order to make the programme more acceptable; accessible and successful; a rapid needs assessment was conducted. Objective: To assess the perception and acceptability of the various components of reproductive health among community and religious leaders in northeast Nigeria. Study Design. Setting and Subjects: A community-based qualitative study. One community leader and one Islamic religious leader each were interviewed in Ganjuwa; Dass and Shira local government areas of Bauchi state. Similarly; a community leader and a religious leader each were interviewed in Maiduguri; Konduga and Gwoza local government areas of Borno state. In Yobe state; one religious and one community leader were interviewed. Results: The community/religious leaders perceived reproductive health problems as prevalent and contributing to maternal morbidity and mortality. They believe women should seek healthcare services for preventive and curative care preferably from female providers. They suspect reproductive health programmes as Western agenda for population control. They have very strong feelings against the provision of elective abortion services. The only acceptable indications for elective abortion include death of the fetus in utero; gross congenital anomaly incompatible with life and serious maternal health risk. A committee of trusted; and preferably Muslim; Godfearing; doctors should assess and confirm these indications. They accept that women with complications of spontaneous abortion should seek care. The provision of contraceptive services to adolescents or married couples is not acceptable. In case of married couples; the only acceptable indication is on serious maternal health grounds. Even then; only harmless methods of contraception may be used specifically coitus interruptus or calendar method with prior spousal consent. The use and promotion of condoms as a barrier method or for the prevention of STIs is not acceptable. The prevention and care of those with HIV/AIDS is acceptable with emphasis on pre-marital abstinence and faithfulness among couples. Conclusion: The varied perceptions; cultural and religious barriers to reproductive health services need to be articulated in order to structure appropriate strategies that will inform and sensitize people about reproductive health programmes and services. Advocacy; monitoring and involvement in programme planning; implementation and social mobilization are useful strategies for addressing this issue