Assessment of the implementation of respectful maternity care charter in North Central Nigeria (Federal Capital Territory and Kwara State): study protocol

Respectful Maternity Care (RMC) charter is one of the tools for ensuring quality of care in maternity services. Nigeria is a signatory to RMC charter; therefore, the charter is expected to be the standard of care. However, in Nigeria and other countries, reports of disrespectful maternity care abound; this discourages women from accessing facility-birth. Therefore, to improve the quality of care towards increase in uptake, it is expedient to assess the level of implementation of the RMC charter by key stakeholders for sustainability, impact and scale-up of charter-compliant maternity care in Nigeria. The study aims to assess the implementation of RMC charter in North-central Nigeria. The study is a mixed-method, cross-sectional study; the expected participants are key stakeholders in healthcare (Healthcare workers, Healthcare Administrators, Project Managers, Policy makers) in North-Central Nigeria (Federal Capital Territory and Kwara state). A multistage sampling technique would be used to enroll participants from 18 healthcare facilities (Primary, Private, Secondary and Tertiary) in rural and urban areas and Ministries of Health officials at local and state government levels. Expected outcomes: The study is expected to provide information on the current status of knowledge and implementation of the RMC charter in Nigeria. It would also identify the enablers and barriers to the implementation process and provide evidence for effective scale-up of the process in Nigeria. The outcomes will be widely disseminated to healthcare workers, health administrators and decision-makers in healthcare services through post-study meetings, conference presentations, journal publications and policy briefs for effective RMC charter implementation in Nigeria.

Attitudes to female genital mutilation/cutting among male adolescents in Ilorin, Nigeria

Background. The central role of males in female reproductive health issues in patriarchal societies makes them an important group in the eradication of female genital mutilation/cutting (FGM/C).Objective. To determine knowledge about and attitudes to FGM/C among male adolescents; and their preparedness to protect their future daughters from it.Methods. A cross-sectional survey among male adolescent students in Ilorin; Nigeria. Participants completed a self-administered questionnaire after consent had been obtained from them or their parents. Statistical analysis was with SPSS version 20.0 (IBM; USA). A p-value of 0.05 was taken as significant.Results. Of 1 536 male adolescents (mean age 15.09 (standard deviation 1.84) years; range 14 - 19); 1 184 (77.1%) were aware of FGM/C; 514 (33.5%) supported female circumcision; 362 (23.6%) would circumcise their future daughters; 420 (27.3%) were of the opinion that FGM/C had benefits; mostly as a necessity for womanhood (109; 7.1%); and 627 (40.8%) perceived it as wickedness against females; 546 (35.5%) were aware of efforts to eradicate FGM/C; and 42.2% recommended education as the most important intervention to achieve thisConclusion. Education and involvement in advocacy may transform male adolescents into agents for eradication of FGM/C

Spontaneous abortions (miscarriages): analysis of cases at a tertiary center in North Central Nigeria

Background: Spontaneous abortion (miscarriage) is a source of pregnancy loss globally. Its management; especially in low resource countries remains hampered by inadequate facilities for evaluation. Objectives: To assess the clinical presentation; diagnosis; and treatment of cases of spontaneous abortion at a tertiary hospital in Ilorin; Nigeria. Methodology: A descriptive study of all spontaneous abortions (miscarriages) managed at the University of Ilorin Teaching Hospital; Ilorin; Nigeria between January 1; 2007 and December 31; 2011. The records were retrieved from the medical records department and necessary information retrieved. Results: There were 603 miscarriages with a prevalence of 4.2; incomplete miscarriage was the most common 254 (42.1); 356 (59.0) had no identifiable risk factor; 434 (72) of the women were 35 years; 361 (59.9) had first trimester miscarriages; 272 (45.1) were of low parity (Para 0-1) and 223 (37) were having a repeat miscarriage. Of the 141 managed for threatened miscarriage; pregnancy was salvaged in 90 (63.8); 244 (40.5) had surgical evacuation with 100 success rate while 218 (36.2) had medical management with 90.8 success rate. The mean duration of admission was shortest with surgical management (2.03 ? 1.1 days) and post-abortion infection rate was 11 (2.6 success rate. The mean duration of admission was shortest with surgical management (2.03 ? 1.1 days) and post-abortion infection rate was 11 (2.6). Histology confirmed product of conception in 98 and molar gestation in 2 of the samples; no mortality was recorded in this study. Conclusion: More than half of women with miscarriages had no identifiable risk factors mainly due to limitation in facilities for evaluation; there is a need to improve facilities for investigating women with spontaneous abortions in developing countries to identify the causes of the losses