Premarital sex and condom use among trainee healthcare workers: an exploratory study of selected healthcare training institutions in Enugu State, Nigeria.

INTRODUCTION: To assess the prevalence and causes of premarital sex and condom use among trainee healthcare workers in selected healthcare institutions in Enugu State, Nigeria; and to proffer solution to challenges identified. METHODS: We used a mixed study approach with qualitative and quantitative components. Informed consent was obtained from participants and data collected using self-administered structured questionnaires. Epi info® was used for data analysis. RESULTS: A total of 362 respondents (309 unmarried) from four healthcare training institutions participated in the study. Among unmarried respondents, 141 (45.8%) were sexually active. Premarital sex was more common among Pentecostals and sexual activity increased with age (r=0.78; p <0.05). Premarital sexual activity was more common among males and trainee nurses (p <0.005). Although knowledge of condom use was high, actual use was poor (20.1%), with lowest rates among females, Catholics and age-group 30-35 years. Breakages, high failure rates and reduced sexual satisfaction were cited as major factors responsible for poor use. Use of non-specific terms such as "casual sex" and "casual or regular sex partners" hindered consistent, correct condom use. CONCLUSION: There is a significant gap between knowledge of and actual use of condoms, despite high premarital sexual activity amongst healthcare workers. Furthermore, non-specific terminologies hinders appropriate condom usage. We propose the term: Committed Spousal Partner (CSP) defined as "a sexual partner who commits to fidelity (one sexual partner per time) and whose current HIV status is known through medical testing and is properly documented" in place of all non-specific terminology.

Assessment of the performance of community-directed treatment with ivermectin strategy for the control and elimination of onchocerciasis in Edo State, Nigeria.

BACKGROUND: Community-directed treatment with ivermectin (CDTI) was developed in the mid 1990's as a solution for the control and elimination of onchocerciasis. It requires that ivermectin be administered continuously over a period of at least 14 years with community involvement before elimination can be achieved. OBJECTIVES: The objective of this study is to assess the performance of CDTI strategy for control and elimination of onchocerciasis in endemic Local Government areas of Edo State. METHODS: A descriptive evaluation in a cross-sectional, descriptive study design was conducted among 720 community members selected from six communities using multistage sampling technique, 11 Community directed distributors (CDDs), and 17 health workers involved in the implementation of the CDTI strategy in Edo State. Primary data were collected using an interviewer's administered questionnaire while secondary data were obtained from the State Ministry of Health. IBM SPSS version 21 software was used for data analysis. RESULTS: The highest therapeutic coverage (95.5%) was observed in Aden II community while the least therapeutic coverage (56.6%) was observed in Imeke community. Regarding the performance indicators, ivermectin supply, work of CDDs, training, monitoring and supervision, finances by communities had scores ≥2.5 and were therefore considered as having satisfactory performance. However, community participation and ownership and health education and mobilization had scores <2.5 and as such considered as having unsatisfactory performance. CONCLUSION: Sustainability of the CDTI program in the study area is likely but not guaranteed as there is need for improvement in areas regarding community mobilization, participation, and ownership.

What experts think about integrating mobile health into routine immunization service delivery in Nigeria.

BACKGROUND: Routine immunization (RI), like other essential health services, could benefit from mobile telephony and especially from the current trend of their increased use in health service delivery. SMS text messages have been recorded to be highly effective in many settings around the world and could be used for reminders and recalls to improve RI performance in Nigeria. This qualitative study assessed the state of RI services, obtained expert opinion on integration of mobile health (mHealth) into RI, and also identified potential threats to such an initiative. METHODS: In-depth Interviews were held with experts in RI and Primary Health Care from different arms of the health sector in Edo State Nigeria. Their responses were summarized and coded to allow for easy synthesis and interpretation of information. RESULTS: Among the experts, there was widespread support for the adoption of mHealth services into RI delivery but with a caution on threats to its success, including inconsistent supply of electricity, poor mobile telephone networks, and the possibility of a lack of political will and funding support from the government. CONCLUSIONS: Although RI performance appears fairly satisfactory in the study setting, adoption of mHealth is highly encouraged to sustain the gains. User-friendliness, interoperability and adaptations to fit peculiar financial and health care models must be kept in view while customizing software solutions for this setting. Also, the store and forward system for handling health information appears more appropriate in this setting to maximize the effectiveness of mHealth despite the shortfall in infrastructure.