Experiences and perceptions of menopause among women in Ibadan South East Local Government Area, Nigeria

Menopausal experiences and perceptions of menopausal women in Ibadan South East Local Government Area were determined. A three-stage sampling technique was used to select the LGA, wards, and participants for the study. Eight Focus Group Discussions (FGDs) were conducted and a validated questionnaire was used to interview 240 participants aged between 46 to 69 years. Five questions were used to assess participants' knowledge with each question attracting 1 point thus culminating to a maximum of 5 points. Data from the FGD were recorded on audio-tapes, transcribed and subjected to content analysis. Descriptive and Chi-square test statistics were used to analyze the quantitative data. The mean age of participants was 56.9 ± 6.2 years. The mean age at menopause was 46.1 ± 2.5 years. Eighty-five percent of participants had ever heard about menopause and the participants' major source of information included close relatives (75.5%). The mean knowledge score for menopause using a 5-point scale was 2.8 ±1.0. Only 28.0% of the participants could state at least one symptom of menopause and 4.1% could list the risks associated with it. Fifty-four percent who scored above the mean knowledge score had positive attitude towards menopause regarding it as a natural occurrence. Seventy percent had the belief that sexual intercourse causes sickness for menopausal women. The belief of 60.8% of the participants was that women should not tell anyone about their menopausal experiences. Eighty-three percent had experienced at least one out of the 19 common symptoms of menopause. Discomforting experiences attributed to menopause included dryness of the vagina (81.3%), pain during intercourse (76.7%) and joint pains (74.2%). Only 32.9% took action to alleviate the discomforts. Actions taken included self-medication (47.4%), adoption of sexual abstinence (13.0%) among others. Illnesses perceived to be associated with menopause included: fibroid (34.4%), weakness of the body (30.0%) and protruding stomach (18.0%). FGD revealed that many of the participants were of the opinion that sex should be avoided by menopausal women in order to prevent adverse effects associated with menopause. There are gaps in knowledge, wrong perceptions and use of inappropriate palliative measures regarding menopause among the participants. Public enlightenment and community-based patient education interventions are needed to address these challenges

Participatory action research: community diagnosis and intervention in controlling urinary schistosomiasis in an urban community in Ibadan, Nigeria.

Schistosomiasis is second only to malaria and is endemic in Nigeria. It has been reported that the infection is more prevalent, irrespective of gender, in the age group 5 to 14 years. It is least among the age group 26 and 55 and occurs mostly in the rural areas in the country. The infection is spreading from the rural areas to various urban communities, particularly the agricultural and fishing populations. In Ibadan, capital of Oyo State in southwestern Nigeria where the focus of this study is made, the infection has been reported among children and adolescents in six Local Government Areas. Students of Advanced Diploma in Health Education (ADHE) of the Department of Health Promotion and Education, during a community diagnosis exercise among primary schools in two communities in Ibadan, met with this problem. The purpose of this study is to mobilize the affected communities, with both internal and external resources through a participatory-action process, to combat the infection which is one of their major problems. Since the providence of schistosomiasis in target communities is age related, investigations were concentrated in 17 Primary Schools in the two communities. The investigation involved laboratory confirmation by collecting 147 urine samples from a total population of 676 children and examining them microscopically for the schistosoma ova. In addition, the quality of stream water and their vector presence were assessed. The key intervention strategy used was community mobilization of both internal and external resources of targeted communities. The striking outcome of the intervention study is that the outbreak of schistosomiasis in the communities was formally reported to the Federal Ministry of Health and the Oyo State Ministry of Health. All infected pupils were treated, the long awaited water scheme to replace the broken pipes was completed, and two new water supply schemes were implemented by the communities. Further, the communities displayed sign boards prohibiting community members from fetching water from "Dandaru" river for daily domestic needs. It is concluded that the combined efforts of all the actors helped the community to enjoy improved water supply and reduced their exposure to infection from the stream, which was the source of the infection.

Reproductive health knowledge and use of contraceptives among adolescent mothers in a sub-urban community in Oyo State, Nigeria.

This survey explored the reproductive health knowledge and use of contraceptives among 316 young mothers in Ogbere, a sub-urban community in Oyo State, Nigeria. A cluster sampling technique was used to recruit the respondents and data were collected from them through face-to-face interviews using questionnaires. The ages of the respondents ranged from 17-20 with a mean of 18.9. The majority (76.9%) of the respondents were married and had primary school education (72.8%). Fivepercent had lost a pregnancy due to abortion, miscarriage or still birth. Forty-three percent had fair, 34.5% poor, and 22.5% good knowledge of contraceptives; 53% did not know any of the routes for HIV transmission. A large majority (70%) had never used any contraceptives, 29% had done so. Eighty percent of those who had ever used any contraceptive were using one at the time of the survey. The most popular contraceptives used were condoms (44.4%) and pills (16.1%). Interventions to improve the economic status and promote use of contraceptives are recommended for this population.

Sexual behaviour and negotiation of the male condom by female students of the University of Ibadan, Nigeria.

This study explored the sexual behaviour of unmarried female students of the University of Ibadan, Nigeria, and assessed the extent to which those who were sexually active negotiated and used the male condom. Four focus group discussions were conducted followed by a survey of 354 students. The results show that the mean age of the students was 22.5 years 55.1% had had sexual intercourse; the mean age at first intercourse was 16.5 years. The number of lifetime sexual partners ranged from 1 to 20 with a mean of 3.4; 75% of those who had had sex reported ever using condom; 16.9% and 39% used it during their first and last sexual episodes respectively; only 34.3% used it consistently. Seventy-three per cent had ever negotiated condom use with a partner, but only 41% did so during their last sexual encounter. A significant association was found between condom negotiation and number of sexual partners: Students with fewer life time partners (3.2) had less frequently negotiated condom use than those with more partners (4.3) (P<0.05). Condom negotiators also scored significantly higher (4.6) on a 6-point AIDS Knowledge Score than those who had never done so (4.0) (P<0.05). About a quarter (26.7%) had ever bought a condom, while 38.5% had ever carried it. We conclude that although many female students had sometimes used a condom only a few used it consistently and are therefore at risk of the unintended outcomes of unprotected sex. We propose appropriate interventions to address the problem.

Diarrhoea in children of Nigerian market women: prevalence, knowledge of causes, and management.

A cross-sectional survey was carried out among mothers of children aged less than five years in two markets in Ibadan, one with poor environmental sanitation and the other clean and well maintained. The study took place between September 1996 and March 1997. The questionnaire used for this survey sought information about the occurrence of diarrhoea among children aged less than five years, their mothers' knowledge about the management of diarrhoea and their practices, including care-seeking practices, and the use of oral rehydration solutions. Two hundred and sixty-six mothers were interviewed in the first market (Bodija) and 260 in the other (Gbagi). Thirty-seven percent of the children in the cleaner market (Gbagi) were said to have had diarrhoea within the last 3 months compared to 33% of the children in the unhygienic Bodija market (p > 0.05). These results suggest that environmental sanitation may not be a major determinant of diarrhoea among children of the two groups of market women. When their children had diarrhoea, 44% (Bodija) and 40% (Gbagi) of the mothers attended health centres, 33% (Bodija) and 32% (Gbagi) gave ORT at home, and 12% (Bodija) and 19% (Gbagi) purchased drugs at a chemist. The study further showed that, while only one-third of all respondents resorted to home-treatment of diarrhoea with ORS, more than 80% of them knew the components and composition of ORS solution. There is a need to continue to encourage mothers to use ORS and, thus, bridge the knowledge-practice gap in mothers' management of diarrhoea at home.

PIP: A large proportion of lower socioeconomic status women in Nigeria are petty traders, with many selling their products in markets with poor environmental conditions. Therefore, the children who often accompany their mothers to the market are constantly exposed to health hazards, especially contaminated food and water. Child diarrhea is an important cause of morbidity and mortality in this environment. Findings are presented from a cross-sectional survey conducted among mothers of children under 5 years old in Bodija and Gbagi markets, Ibadan, the former market with poor environmental sanitation and the latter with a clean and well maintained market. The study took place between September 1996 and March 1997. The survey investigated the occurrence of diarrhea among children under age 5 years, their mothers' knowledge about the management of diarrhea, and their practices, including care-seeking practices and the use of oral rehydration solutions (ORS). 266 mothers were interviewed in Bodija and 260 in Gbagi. 33% and 37% of the children in Bodija and Gbagi markets, respectively, were reported to have had diarrhea within the previous 3 months. These results suggest that environmental sanitation may not be a major determinant of diarrhea among the children of these 2 groups of market women. When their children had diarrhea, 44% of mothers in Bodija and 40% in Gbagi attended health centers, 33% and 32% gave ORS at home, and 12% and 19%, respectively, bought drugs at a chemist. Although only approximately 33% of the women treated diarrhea at home with ORS, more than 80% knew the components of ORS solution. Mothers need to be encouraged to use ORS when their children have diarrhea.

Environmental and personal hygiene practices: risk factors for diarrhoea among children of Nigerian market women.

A Cross-sectional survey was carried out to determine the environmental and personal hygiene practices of mothers of children aged less than five years in two markets in Ibadan--one with poor sanitary conditions (Bodija) and the other one with better sanitation facilities (Gbagi). The study sought to identify the risk factors for diarrhoea among these children. Two hundred and sixty-six mothers in Bodija and 260 in Gbagi were interviewed. A questionnaire was used for collecting information on social and demographic characteristics, personal and environmental hygiene practices, including sources of food and water for their children, waste-disposal practices and occurrence of diarrhoea among their children aged less than five years. The educational status of the women in Bodija was lower than that of the women in Gbagi (p < 0.001). Sixty (23%) women of the Bodija market mentioned that tap water was the source of drinking water for their children, while 91 (34%) brought water from their homes, and 45 (17%) bought it from vendors in the market. The corresponding figures for women of the Gbagi market were 41 (16%), 98 (38%) and 19 (7%). Two hundred and thirty-four (90%) women in Gbagi prepared breakfast at home for their children compared to 216 (81%) women in Bodija. This difference was statistically significant (p < 0.05). Waste disposal and personal hygiene practices were poorer among the women in Bodija. Yet the occurrence of diarrhoea was not significantly different in both the markets. Risk factors for diarrhoea identified in this study were water and food bought from vendors, child defaecation practices, mothers' cleaning up practices after child's defaecation, and refuse-disposal practices. The inherent risk of sale of unwholesome food and water by vendors is a great concern for public health authorities in Nigeria. Efforts to control diarrhoea must not only be focused on improving mothers' knowledge about food hygiene but also on environmental hygiene practices within the community.

Sexual behavior and knowledge of AIDS among female trade apprentices in a yoruba town in South-Western Nigeria.

This exploratory study was carried out among unmarried female trade apprentices in Ikorodu, a Yoruba town in south-western Nigeria, to identify sexual risk behaviors, assess knowledge on HIV/AIDS, and recommend an appropriate AIDS education program. Four focus groups were conducted to gain insight into the social-cultural and economic factors influencing sexual risk behaviors, followed by a survey involving 280 randomly selected respondents. Findings showed that many group discussants approved of premarital sex and believed that sex with multiple partners occurred mainly because of the economic difficulties encountered by female apprentices. Most of the survey respondents (70.9%) were sexually experienced, with age of first sexual intercourse ranging from eleven to twenty-two years. One hundred and fifty-five (78.2%) were sexually active; of these, 37.4 percent said that their last sexual encounter occurred because they could not resist the pressure put on them by their male partners, were under the influence of alcohol, were in need of money, and raped. Sixty percent of the sexually active respondents did not take any action to prevent STD or pregnancy during their last sexual encounter. Of the fifty-eight who did, 37.9 percent used the condom. Of those sexually experienced (45.3%) have had at least one STD symptom in the year before, half of them did not do anything about their condition; 37 percent practiced self-medication or received injections from quacks. Although 70.9 percent had heard about AIDS, many had limited knowledge about the non-sexual routes of HIV transmission. Appropriate intervention strategies were recommended to educate the apprentices.

Focusing on women for water and sanitation: the case of mapo community in ibadan, Nigeria.

Geographical and topographic limitations have hindered community efforts to get wholesome water for domestic purposes. In response to this expressed need of the people an educational intervention using women as unit of practice and solution as water purification and management in order to reduce water-borne infections was embarked upon. Health talks, motivation of the participants, seminar/workshop for professional health providers, and laboratory sessions for water purification methods and techniques were some of the components of the learning process to achieve the goal. During and at the end of the project, participants showed interest and enthusiasm and demonstrated behavioral changes as far as making sure that the water they use is clean and kept so in clean receptacles. It is hoped that the process set up will continue through the Community Development Health Committee and the Mapo Zonal Health Office, Ibadan.

Profession-specific training in health education.

In 1975, the African Regional Health Education Centre (ARHEC) inaugurated two training programmes in health programmes in health education: a two-year postgraduate course leading to a master's degree, and a one-year course preparing for a non-graduate diploma. The purpose of the latter was to give advanced training and updating to experienced health personnel who had either received a diploma in health education some years before or had been functioning as health educators. This was intended to be a temporary course, to phase out in three years. However, due to its popularity, it was extended in spite of certain negative aspects, mainly the fact that new graduates often return to their former positions with little opportunity to utilize fully their new skills. Those who succeeded best tried to merge health education with their basic professional practice (for example, nursing with patient education). ARHEC decided therefore to modify the programme of its advanced diploma course, which now provides for the teaching of a basic core of health education subjects to all students, and includes three modules to which students are assigned according to their previous training and their future professional activities: community health education and primary health care; hospital-based patient and family health education; and school health education. The practical field work, which is an essential aspect of the course, is tailored to the interests of students in each module. Preliminary evaluation indicates that this programme provides a better response to the needs of students and their employers and eliminates the problem of two categories of health educators (diploma and masters level). It is intended to create other modules dealing with the media, occupational health, and so on.