Social work practice with childbirth-injured women in Nigeria.

Nigerian social workers in health care settings have been actively involved in the treatment of women in northern Nigeria who suffer from childbirth injury during obstructed labor. The patient population studied suffers from vesicovaginal fistula (VVF), a debilitating and chronic condition whereby a woman leaks urine uncontrollably and experiences grave social consequences. Crisis intervention, social rehabilitation, fighting stigma, and discharge planning similar to the American professional model were functions of the social workers in addressing the needs of this patient population. Implications for practice and the universality of social work skills are discussed.

The medical ethics of the 'father of gynaecology', Dr J Marion Sims.

Vesico-vaginal fistula (VVF) was a common ailment among American women in the 19th century. Prior to that time, no successful surgery had been developed for the cure of this condition until Dr J Marion Sims perfected a successful surgical technique in 1849. Dr Sims used female slaves as research subjects over a four-year period of experimentation (1845-1849). This paper discusses the controversy surrounding his use of powerless women and whether his actions were acceptable during that historical period.

Women's access to health care in developing countries.

Women in developing countries are frequently confronted with a myriad of socio-cultural factors which negatively impinge upon physical well-being and accessibility to appropriate health care services. Institutional, economic, and educational barriers effect and lowers their standard of living when compared to their male counterparts. Women must become agents of change to improve their situation. Factors such as access to income, legal rights, social status, and education may prove far more important in determining women's access to health care than technology distribution and governmental strategies.

Preventing birth injury among women in Africa: case studies in northern Nigeria.

Among the most serious maternal injuries from childbirth in Africa is vesicovaginal fistula (VVF). Case studies of 55 VVF patients in northern Nigeria showed them to be poor, underage village women without sufficient access to modern health facilities at the time of the injury. Suggestions for short-term and long-term preventive measures are presented and discussed.

Kaduna beggar children: a study of child abuse and neglect in northern Nigeria.

Kaduna State, Nigeria serves as an example of a third world state that in the wake of rapid change and the weakening of traditional forms of welfare has created an underclass of beggars, many of whom are children. Lack of a comprehensive welfare system in general, and more specifically, protective services for minors, has resulted in the neglect of some children who are exploited by poor families for street begging. Although laws exist to protect minors and prevent street begging by children, they are seldom enforced. Perhaps this is due to the absence of a governmental agency solely responsible for child welfare. In light of the need to assist beggar children, the following measures are recommended: Establish a Bureau for the Protection of Beggar Children. Establish a Division of Protective Services in the Ministry of Social Development. Establish advocacy programs for street children by voluntary agencies.

Typology of health care consumers in Nigeria.

Against the background of two highly competitive systems of medicine in Nigeria four types of health care consumers are identified in this paper. Health Consumer I utilizes either the traditional or scientific system exclusively. Health consumer II utilizes the traditional system and when dissatisfied turns to the scientific system: while health consumer III utilizes the scientific system first and later turns to the alternative system. Health consumer IV utilizes both systems simultaneously. Illness behaviour as exhibited by these consumers has negative consequences on the successful delivery of medical services in Nigeria in that scarce resources are wasted through duplication of services and personnel. Furthermore competition between both systems is heightened by the defection of patients to the alternative system. A solution to these problems is offered through the reorganization of the governmental health services to include the traditional sector. It is suggested that an intregrated governmental medical services may result in stabilizing the health consumer and producing an economically more viable system of medicine for the country.

The attitudes of medical and traditional doctors toward integration of the governmental health services in the western states of Nigeria.

It seems that there may be some benefits to be derived from the integration of traditional practitioners into the government health delivery system. The adoption of such a policy may serve to solve several of the major health problems, the most apparent being: the shortage of government medical manpower; the high mortality and morbidity resulting from preventible disease; the lack of adequate medical government care in rural areas; and a general distrust by the people of scientific medical care possibly due to their close adherence to the treatment given by traditional doctors.