Factors influencing maternal health choices among women of reproductive age in Hausa communities in Ibadan, Nigeria: an exploratory study.

INTRODUCTION: decision making is a vital aspect of women's reproductive life. In an attempt to fulfil the desire to procreate, women's lives are lost especially in developing countries where medical care is still inadequate. The researchers sought to explore the Hausa people's culture as regards maternal health choices concerning modern family planning methods, delivery places and parity. METHODS: a cross-sectional study using mixed methods was conducted among women of reproductive age (N=253) in three Hausa communities in Ibadan. Based on the objectives, semi-structured questionnaire and in-depth interview guide were used for data collection. Quantitative data were analysed using Chi-square and the level significance set at 0.05 while qualitative data were analysed thematically. RESULTS: over fifty percent respondents had more than 3 children and about one third (33.9%) preferred having more than 4 children. Nearly all participants (94%) were aware of modern family planning methods but only 49.0% used them. The most widely used methods are injectables (22.0%) and condoms (20.6%). Almost half of the study population (46.5%) delivered their babies at home with assistance from other residents with most preferring home delivery for various reasons. CONCLUSION: although the level of awareness about family planning methods is quite satisfactory, however, the level of contraceptive uptake is still sub-optimal. Most Hausa women prefer home delivery which predisposes them to associated complications. Findings further identified various reasons for maternal health choices and provided insights on viable nursing interventions that can be adopted to promote skilled birth delivery to reduce maternal morbidity and mortality.

Determinants of maternal health service utilisation among pregnant teenagers in Delta State, Nigeria.

INTRODUCTION: the prevailing high maternal mortality and morbidity rate among pregnant adolescents in Nigeria underscores all efforts said to have been made to tackle maternal deaths among this population. Not much research has been done to ascertain the reasons associated with the poor utilisation of Maternal Health Services (MHS) by pregnant teenagers. This study, therefore, explored the extent and determinants of MHS utilisation among pregnant teenagers in Delta State. METHODS: this study made use of a mixed cross-sectional study design. Multi-stage sampling technique was adopted in selecting eight communities while snowballing was used in identifying pregnant teenagers. A structured interviewer-administered questionnaire was used for the data collection from 212 pregnant teenagers and an interview guide was further used to interview 16 pregnant teenagers randomly selected from the communities. Descriptive and inferential data analyses were done using SPSS version 22. Hypotheses were tested using Chi-square test at P≤0.05 level of significance. RESULTS: seventy per cent of the participants stated that they utilised MHS by visiting an antenatal care centre (ANC) centre at least once during their pregnancy but only 28.3% had ANC attendance that was appropriate with their gestational age. A grand mean ± SD of 3.4714 showed that there is a high level of perception of stigmatisation among pregnant teenagers. Also, married teenagers [86%] were found to utilise MHS more than their single counterparts [67.1%]. A statistically significant association (Chi-square) was found between utilisation of MHS and maternal education [P=0.024], utilisation of MHS and availability/accessibility of MHS facilities [P=0.002], utilisation of MHS and cost of MHS [P=0.001] and utilisation of MHS and coercion/violence from partner [P=0.000]. CONCLUSION: the level of utilisation of MHS by pregnant teenagers is low with main determinants of use being stigmatisation of pregnant teenagers, availability of health personnel, accessibility to MHS facilities, permission from significant others and cost of MHS.

Instant messaging and nursing students' clinical learning experience.

BACKGROUND: Although learning in clinical settings is a key element of nursing education, for many learners these are challenging developmental contexts often marked by isolation and a lack of belongingness. Despite the massive appropriation of mobile instant messaging (MIM) platforms and the connective properties attendant to them, very little is known about their role in and impact on nursing students' clinical learning experiences. APPROACH AND METHODS: To address this gap, the study, which was part of a multinational research project on the use of mobile social media in health professions education in developing countries, examined the use of the instant messaging platform WhatsApp by nursing students during placements and potential associations with socio-professional indicators. The survey involved a total number of 196 nursing students from 5 schools in Oyo State, Nigeria. RESULTS: The findings suggest that students used WhatsApp relatively frequently and they perceived that this platform strongly enhanced their communication with other students and nurses. WhatsApp use during placements was positively associated with students' maintained social capital with peer students, the development of a professional identity, placement satisfaction and with reduced feelings of isolation from professional communities. The determinants that influenced WhatsApp use during placements were perceived usefulness and perceived ease of use. No associations were found between WhatsApp use during placement and age, attitude, subjective norms and placement duration. CONCLUSION: This study is one of the first of its kind that points to the relevance of mobile instant messaging as part of nursing students' (inter)personal learning environments in clinical settings and, particularly, in the development setting under investigation. Further research is needed to corroborate these findings, to enhance the understanding of the impact mechanisms, and to evaluate a more systematic use of MIM in clinical learning contexts.

Mobile Instant Messaging (MIM) to support teaching practice: Insights from a nurse tutor program in Nigeria.

Aim: To determine the feasibility of using the Mobile Instant Messaging (MIM) platform, WhatsApp, to provide supervision and support for student nurse tutors during a teaching practice placement in Nigeria. Methods: A descriptive qualitative method was used to design and evaluate a six-week WhatsApp group discussion intervention among 19 student nurse tutors. Two pre-intervention focus group sessions (n=9 and n=10) and a workshop were conducted to assess the students' content needs and media usage, and to develop a short online supervisory curriculum. To evaluate the intervention, two focus group sessions (n=9 and n=9) were carried out, transcribed verbatim, and analysed together with the actual WhatsApp conversations using thematic content analysis. Findings: The participants found the WhatsApp-enabled learning space valuable, in particular for the transfer and application of knowledge in their day-to-day teaching practice and, more generally, for their professional development. There were rich and multifaceted indicators of learning and professional development in evidence which were mostly triggered by specific facilitation techniques. The four themes from the WhatsApp conversations are: (1) sharing and discussing "tricks of the trade"; (2) providing direction and triggering reflective (teaching) practice; (3) sparking professional discussions and announcing professional development opportunities; and (4) maintaining a continuous moderating and teaching "presence". Conclusion: Despite some technical challenges centred mainly on the accessibility of the MIM space, the study identified indicators of good supervision practice and the results point to the feasibility and value of MIM to enhance supervision during teaching practice.

Assessment of Perinatal Care Satisfaction Amongst Mothers Attending Postnatal Care in Ibadan, Nigeria.

INTRODUCTION: Patient satisfaction has been identified as a major index in the assessment of quality of healthcare globally. Mothers judge the quality of perinatal care received based on their satisfaction with the services provided, thus influencing their utilization of the available health facilities. There is currently a dearth of literature on users' satisfaction of services rendered at the primary level of care, which is the first port of call to the health system aimed at serving majority of the populace. OBJECTIVES: The study was set out to investigate maternal satisfaction with perinatal care received in selected primary health centres in Ibadan. METHODS: The study was a cross-sectional survey involving 66 women receiving postpartum care from five randomly selected primary health centres in Ibadan north-west local government using a 72-itemed questionnaire with p < 0.05. FINDINGS: The majority of the respondents (98.5%) perceived the perinatal care they received as high quality, and 94% and 98% were satisfied with services and facilities used for their care, respectively. Identified causes of dissatisfaction included dirty hospital environment, inadequate water supply and hospital facilities, distance of hospital location, cost of materials, time wasting, inadequate staffing and poor attitude, and verbal and physical abuse. An association exists between maternal satisfaction with quality of care and future intention for subsequent utilization (χ2 = 13.306; p = 0.0001). CONCLUSION: The overall maternal satisfaction on the perinatal care provided was perceived as very good. However, few domains of dissatisfaction were identified that would need to be addressed by healthcare professionals and policymakers to sustain and improve utilization of orthodox health care services amongst mothers, thereby contributing to achieving the third Sustainable Development Goal.

Health care utilization among rural women of child-bearing age: a Nigerian experience.

INTRODUCTION: Despite the availability of primary health care services in virtually every community and village in Nigeria, clients travel long distances to reach secondary and tertiary health care institutions. Against this backdrop, the researcher sought to find the factors that influence choice of health institutions among pregnant women. METHODS: A descriptive study was carried out across three levels of health care institutions with a total sample size of 160 clients who were randomly selected. A thoroughly validated 45- item questionnaire was used to explore clients' perceptions about what factors influence where they access health care services. RESULTS: Major findings revealed that level of education, proximity to place of residence, affordability and quality of services rendered, spousal and significant other's influences were active determinants of choice for health institutions among pregnant women in Nigeria. CONCLUSION: This study elicited information on why some types of institutions were preferred. The study has implications for community health nurses and policy makers on what should be done to make health institutions appropriately utilized by community in Nigeria.