Determinants of health and nutritional status of rural Nigerian women.

This study was undertaken to determine the effects of socioeconomic and cultural factors on the health and nutritional status of 300 women of childbearing age in two rural farming communities in Enugu State, Nigeria. The women were engaged in farming, trading, and teaching. A cross-sectional survey was conducted using both qualitative and quantitative data-collection methods. The study involved focus-group discussions (FGDs), interviews using a questionnaire, measurement of food/nutrient intake, assessment of activity patterns, anthropometry, and observations of clinical signs of malnutrition. The better-educated women had higher incomes than those with little or no education. Poor education was mainly attributed to lack of monetary support by parents (34%), marriage while in school (27%), and sex discrimination (21%). The teachers had significantly (p < 0.05) better health status, health and nutrition knowledge, food habits, nutrient intake, and self-concept, and adhered less to detrimental cultural practices. However, none of the women met their iron, riboflavin and niacin requirements. More cases of chronic energy deficiency were observed among the farmers (16%) and traders (13%) than among the teachers (5%). Generally, the women worked long hours with reported working hours (6-7 hours) being lower than the observed working hours (11 hours) for the traders and teachers. Income had a significant (p < 0.05) positive correlation with all nutritional variables, except vitamin C, age-at-marriage (r = 0.719), and nutrition knowledge (r = 0.601). Age-at-marriage had a positive correlation with body mass index (BMI) and all nutritional variables but was significant (p < 0.05) for protein (r = 0.362), calcium (r = 0.358), iron (r = 0.362), riboflavin (r = 0.364), and vitamin C (r = 0.476). Workload was negatively correlated with protein intake (r = 0.346; p < 0.05). Meal frequencies for more than 70% of the farmers and petty traders and 42% of the teachers were dependent on the availability of food in the household. Food taboos had no effect on their nutrient intake, since only 5-11% of women adhered to taboos. Although most women gave their children and husbands preference in food distribution, not much difference was found in the amount of food consumed by these women. The ratio of wife's portion to husband's was 1:1.4 for the farmers, 1:1.3 for the traders, and 1:1.2 for the teachers. FGDs revealed that sex discrimination in education prevailed where resources were limited. The results of the study suggest that the basic determinants of health and nutritional status of women are socioeconomic and cultural, education having a mediating or modifying influence on cultural practices.

Bacteriological quality of weaning food and drinking water given to children of market women in Nigeria: implications for control of diarrhoea.

Bacteriological quality of weaning food and drinking water given to 2 groups of children aged < or = years was evaluated by estimating bacterial cell count. One group consisted of those taken to market and the other of those left at home in the care of older siblings or house-helps. Bacterial counts (geometric mean) ranged from 5.02 +/- 1.82 to 8.70 +/- 1.0 log10 cfu per g or mL of food, and from 1.15 +/- 1.67 to 6.53 +/- 0.81 log10 cfu per g or 100 mL of water. Analysis of variance showed no significant difference in counts between types of food and between meals (breakfast and lunch). Bacterial contamination increased significantly with storage time, and was, in all circumstances except the water samples, significantly higher in foods given to children left at home. Reheated leftover foods also had significantly higher bacterial load than the freshly-cooked food. Coliform count varied significantly with source of drinking water. Poor hygiene standard (inferred from bacterial contamination) was generally observed among mothers weaning < or = 2-year-old children, while they were engaged in trading activities in the market, thus exposing their children to high risk of diarrhoea. Hygiene was significantly poorer in weaning of children left at home in the care of older siblings or house-helps. This implies that, in spite of their trading activities in the market, mothers still take better care of their babies than the older siblings or house-helps who may be inexperienced. These mothers may need education on childcare and food hygiene to suit to their trading activities, for example, during their monthly meetings. There is also a need to establish ORT (oral rehydration therapy) corners in the markets as part of the municipal services. This can be used not only for efficient and quick management of diarrhoea in the market but also for reinforcing hygiene education.

Perceived causes and management of diarrhoea in young children by market women in Enugu State, Nigeria.

The aim of the study was to determine the perceptions of mothers regarding the causes and management of diarrhoea of their children aged 0-24 months. In Enugu State, Nigeria, 80 market women whose children had diarrhoea during last 6 months were interviewed fortnightly. When possible, the children were observed to determine the types of diarrhoea and treatments given. Fifty-three of the women brought their children to market, and 27 left their children at home. Seventy-one percent of the mothers perceived that diarrhoea was caused by teething. The most common types of diarrhoea occurring in these children were watery diarrhoea (59%) and the so-called teething diarrhoea (29%). Dysentery (6%) and jedi jedi or frothy and mucoid stools (4%) occurred less frequently. In 68% of the cases, drugs were used alone or in conjunction with salt-sugar solution (SSS) or other forms of treatment. These drugs were prescribed by medical personnel (40%), patent medicine dealers (23%), or mothers themselves (30%). About 26% and 39% of the mothers treated, respectively, watery and teething diarrhoeas with drugs only, while 23% used SSS alone. The drugs used were mainly antimicrobials (34%) and a combination of antimicrobial, antimalarial, antacid, analgesic, and some local herbal preparations (21%). The results of the study showed the evidence of unnecessary use of drugs and ignorance about their potential adverse effects. These underscore the need for appropriate primary care education among the market women in Nigeria.