ABSTRACT
Persisting sociocultural beliefs have continued to significantly influence the adoption of recommended newborn care practices by women in Sub-Saharan Africa. This study aimed at identifying the sociocultural practices, beliefs, and myths surrounding newborn cord care by women residing in Bayelsa State, Nigeria. This was a qualitative study that involved 24 women and 3 traditional birth attendants (TBAs) in three focus group discussions and three in-depth interviews respectively. Interview guides were used to lead the discussions and the interviews which were audiotaped, translated and then transcribed. Thematic analysis was done using NVivo QSR version 12.2 Pro. Several themes describing various sociocultural practices, beliefs, and myths surrounding cord care were uncovered. Most women preferred to be delivered by a TBA who usually cuts the infant's cord with a razor blade and ties the stump with hair or sewing thread. Substances used for cord care included methylated spirirt, "African never-die" leaf, and "Close-Up" toothpaste. All the participants agreed that methylated spirit was a potent antiseptic for cord care but none of them had heard about nor used chlorhexidine gel. It was a common belief that abdominal massage and the application of substances to the cord were solutions to common cord-related problems. Mothers, TBAs and relatives were influential regarding choices of cord care practices. Sociocultural practices, beliefs, and myths are still major barriers to the adoption of recommended cord care practices by women in Bayelsa State. Interventions should be targeted at improving delivery in health facilities and educating women in the community on good cord care practices.
ABSTRACT
Background: Several efforts have been put in place to reduce the global burden of malaria especially in children and in sub-Saharan Africa. The study aimed to evaluate the impact of malaria control activities on the trend of childhood malarial diseases at a tertiary hospital in South-south Nigeria. Methodology: A retrospective review of the case records of all malaria diagnoses including in-patient, out-patient, and emergency room, seen in the Department of paediatrics at the University of Port Harcourt Teaching Hospital from January 2006 to December 2018 was conducted. Results: There were 41, 863 malaria cases diagnosed over the 12 years with a decline in yearly diagnosis and admissions, from the year 2006 through 2018. Total malaria admissions were 578, (44.5/ year), giving a severe malaria incidence of 1.26%, and there were 164 malaria death cases, with a yearly average of 12. The causes of death in the children with malarial parasitaemia were severe anaemia in 75 (45.7%), hypoglycaemia in 14 (8.5%), cerebral malaria in 17 (10.4%), and prostration with other co-morbidities, 22 (13.4%). Thirty-six children (22%) were convulsing and died soon after admission, with a compounding diagnosis of aspiration and respiratory failure. Conclusion: There is a gradual reduction in childhood malaria disease, admission, and death, though this is slower than anticipated based on efforts and strategies put in place by the Nigerian government and various organizations.
ABSTRACT
Background Youth friendly services, an evidence based approach to overcome the barriers experienced by youths in accessing care, is poorly implemented. The Medical Women's Association of Nigeria (MWAN) Rivers State chapter, was supported by Ford Foundation to mainstream youth-friendly health services (YFHS) into existing primary health care facilities in two hard-to-reach communities. This paper presents the interventions, findings, challenges and recommendations. Methods This study project was implemented in stages: design, baseline survey, interventions and evaluation, between 2014 and 2016. Interventions included facility modifications, health worker capacity building, school and community outreaches, peer group activities, and interpersonal communication. Pre-and-post-intervention surveys were carried out among in- and out-of-school youths to determine the effects of the interventions. Results The most commonly stated barriers to uptake of youth friendly health services included: unavailability of services (154; 33.1%), unavailability of health care workers (167; 38.9%), unaffordability of services (108; 45.8%) and difficulty in communicating with health workers (85; 36.0%). Post-intervention, utilization improved across all services while the perception of barriers to utilization of services reduced (p < 0.05). The interventions implemented increased the odds of youths utilizing YFHS 1.81 times (95% CI = 1.39-2.37). Conclusion Facility modifications, capacity building of health workers, school and community outreaches, peer group activities, and interpersonal communication improved utilization across all services while the perception of barriers to utilization of services reduced. Implementation of YFHS is impacted by external factors often beyond the control of project implementers. Innovative solutions outside of routine health care delivery systems are critical for success. Further evaluation to explore the effect of these interventions is needed. Strengthening of health systems remains a vital strategy for scale-up of YFHS.
