Sexual dysfunction among female patients of reproductive age in a hospital setting in Nigeria.

Although sexual dysfunction is an important public-health problem in Nigeria, little research has been conducted on this topic in Nigeria. This cross-sectional study was conducted to determine the prevalence of sexual dysfunction and their correlates among female patients of reproductive age using a questionnaire. Respondents were recruited from the out-patients clinics of a teaching hospital setting in Ile-Ife/ Ijesa administrative health zone, Osun State, Nigeria. Of 384 female patients interviewed, 242 (63%) were sexually dysfunctional. Types of sexual dysfunction included disorder of desire (n=20; 8.3%), disorder of arousal (n=l 3; 5.4%), disorder of orgasm (n=154; 63.6%), and painful coitus (dyspareunia) (n=55; 22.7%). The peak age of sexual dysfunction was observed among the age-group of 26-30 years. Women with higher educational status were mostly affected. The reasons for unsatisfactory sexual life mainly included psychosexual factors and medical illnesses, among which included uncaring partners, present illness, excessive domestic duties, lack of adequate foreplay, present medication, competition among wives in a polygamous family setting, previous sexual abuse, and guilt-feeling of previous pregnancy termination among infertile women. The culture of male dominance in the local environment which makes women afraid of rejection and threats of divorce if they ever complain about sexually-related matters might perpetrate sexual dysfunction among the affected individuals. Sexual dysfunction is a real social and psychological problem in the local environment demanding urgent attention. It is imperative to carry out further research in society at large so that the health and lifestyles of affected women and their partners could be improved.

Unavailability of essential obstetric care services in a local government area of south-west Nigeria.

This paper reports the findings at baseline in a multi-phase project that aimed at reducing maternal mortality in a local government area (LGA) of South-West Nigeria. The objectives were to determine the availability of essential obstetric care (EOC) services in the LGA and to assess the quality of existing services. The first phase of this interventional study, which is the focus of this paper, consisted of a baseline health facility and needs assessment survey using instruments adapted from the United Nations guidelines. Twenty-one of 26 health facilities surveyed were public facilities, and five were privately owned. None of the facilities met the criteria for a basic EOC facility, while only one private facility met the criteria for a comprehensive EOC facility. Three facilities employed a nurse and/or a midwife, while unskilled health attendants manned 46% of the facilities. No health worker in the LGA had ever been trained in lifesaving skills. There was a widespread lack of basic EOC equipment and supplies. The study concluded that there were major deficiencies in the supply side of obstetric care services in the LGA, and EOC was almost non-existent. This result has implications for interventions for the reduction of maternal mortality in the LGA and in Nigeria.

Clinical versus sonographic estimation of foetal weight in southwest Nigeria.

A prospective study was conducted at Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria, between 3 January and 31May 2004, to compare the accuracy of clinical and ultrasonographic estimation of foetal weight at term. One hundred pregnant women who fulfilled the inclusion criteria had their foetal weight estimated independently using clinical and ultrasonographic methods. Accuracy was determined by percentage error, absolute percentage error, and proportion of estimates within 10% of actual birth-weight (birth-weight of +10%). Statistical analysis was done using the paired t-test, the Wilcoxon signed-rank test, and the chi-square test. The study sample had an actual average birth-weight of 3,255+622 (range 2,150-4,950) g. Overall, the clinical method overestimated birth-weight, while ultrasound underestimated it. The mean absolute percentage error of the clinical method was smaller than that of the sonographic method, and the number of estimates within 10% of actual birth-weight for the clinical method (70%) was greater than for the sonographic method (68%); the difference was not statistically significant. In the low birth-weight (<2,500 g) group, the mean errors of sonographic estimates were significantly smaller, and significantly more sonographic estimates (66.7%) were within 10% of actual birth-weight than those of the clinical method (41.7%). No statistically significant difference was observed in all the measures of accuracy for the normal birth-weight range of 2,500-<4,000 g and in the macrosonic group (> or =4,000 g), except that, while the ultrasonographic method underestimated birth-weight, the clinical method overestimated it. Clinical estimation of birth-weight is as accurate as routine ultrasonographic estimation, except in low-birth-weight babies. Therefore, when the clinical method suggests weight smaller than 2,500 g, subsequent sonographic estimation is recommended to yield a better prediction and to further evaluate foetal well-being.