Awareness and Availability of the National School Health Policy in Selected Rural and Urban Primary Schools in Oyo State, Southwest Nigeria.

BACKGROUND: The School Health Programme (SHP) is key in actualizing optimal health and education for school-age children. Its implementation in Nigeria has been described as ineffective. Some of the challenges with implementation might be related to end users' lack of familiarity with the National School Health Policy (NSHPo). This study was conducted to determine awareness and availability of the NSHPo in Oyo State. METHODS: A cross-sectional analytical study was carried out among teachers in selected rural and urban public and private primary schools in Oyo State. All consenting teachers from the schools from the purposively selected urban and rural local government areas in Oyo State participated. The questionnaire was divided into sections on sociodemographic characteristics, awareness, and availability of the NSHPo document. Summary statistics were computed as well as bivariate analysis using Chi-square test to explore the association between type of school and awareness of NSHPo at p<0.05. RESULTS: One thousand, one hundred and thirty-eight respondents (rural: 571; urban: 567) participated. In the rural primary schools, 49.4% of the respondents had ever heard of the NSHPo document. Of these, 24.1% had ever sighted a copy and 16.3% had ever seen a copy in the school office. None of the respondents owned a copy when verified during check listing. Awareness of the NSHPo document was higher among rural public-school respondents (52.2%) than rural private schools (43.5%), though not statistically significant (p=0.052). In the urban primary schools, 55.2% of the teachers had ever heard of the NSHPo document. Of these, 22.7% had ever sighted a copy and 18.2% had ever seen a copy in the school office. On verifying these claims, none of the respondents could produce a copy of the document. A significantly higher proportion (62.8%) of respondents in the urban public schools were aware of the NSHPo document compared with 42.1% of those in the urban private schools [p<0.001]. CONCLUSION: The NSHPo document was not sighted with any of the teachers in both rural and urban public and private schools visited.

CONTEXTE: Le programme de santé scolaire (PSES) est essentiel pour assurer une santé et une éducation optimales aux enfants d'âge scolaire. Sa mise en œuvre au Nigeria a été décrite comme inefficace. Certains des défis posés par la mise en œuvre pourraient être liés au manque de familiarité des utilisateurs finaux avec la politique nationale de santé scolaire (NSHPo). Cette étude a été menée pour déterminer la connaissance et la disponibilité de la NSHPo dans l'État d'Oyo. MÉTHODES: Une étude analytique transversale a été menée auprès d'enseignants d'écoles primaires publiques et privées, rurales et urbaines, sélectionnées dans l'État d'Oyo. Tous les enseignants consentants des écoles des zones de gouvernement local urbaines et rurales sélectionnées à dessein dans l'État d'Oyo ont participé à l'étude. Le questionnaire était divisé en sections sur les caractéristiques sociodémographiques, la connaissance et la disponibilité du document NSHPo. Des statistiques sommaires ont été calculées ainsi qu'une analyse bivariée à l'aide du test du chi carré pour explorer l'association entre le type d'école et la connaissance du NSHPo à p<0,05. RÉSULTATS: Mille cent trente-huit répondants (ruraux : 571; urbains: 567) ont participé à l'étude. Dans les écoles primaires rurales, 49,4% des personnes interrogées avaient déjà entendu parler du document NSHPo. Parmi eux, 24,1% en avaient déjà vu un exemplaire et 16,3% en avaient vu un dans le bureau de l'école. Aucune des personnes interrogées ne possédait d'exemplaire, comme cela a été vérifié lors de l'établissement de la liste. La connaissance du document NSHPo était plus élevée parmi les répondants des écoles publiques rurales (52,2%) que parmi ceux des écoles privées rurales (43,5%), bien que cela ne soit pas statistiquement significatif (p=0,052). Dans les écoles primaires urbaines, 55,2% des enseignants avaient déjà entendu parler du document NSHPo. Parmi eux, 22,7% avaient déjà vu une copie et 18,2% avaient déjà vu une copie dans le bureau de l'école. Lors de la vérification de ces affirmations, aucune des personnes interrogées n'a pu produire une copie du document. Une proportion significativement plus élevée (62,8%) des répondants des écoles publiques urbaines connaissaient le document NSHPo, contre 42,1% des répondants des écoles privées urbaines [p<0,001]. CONCLUSION: Le document NSHPo n'a été vu par aucun des enseignants des écoles publiques et privées rurales et urbaines visitées. Mots clés: Programme de santé scolaire, Politique nationale de santé scolaire, Sensibilisation, Disponibilité, Nigeria.

SEXUAL RISK BEHAVIOURS AND COMPULSIVE SEXUAL BEHAVIOUR DISORDERS AMONG MILITARY PERSONNEL IN IBADAN.

Background: Military personnel (MP) are exposed to situations such as loneliness and alcohol use that lead to sexual risk behaviours (SRBs) with serious implications for the spread of sexually transmitted infections (STIs). Compulsive sexual behaviour disorder (CSBD) is a psychosexual condition that is characterized by a consistent failure to control sexual behaviour and continuation of the behaviour despite the consequences. The prevalence of CSBD is underreported due to the sensitive nature of the behaviour. This study thereby assesses SRBs and CSBD and associated factors among MP. Methods: A cross-sectional study among 406 MP in Ibadan using a convenient sampling method to select the personnel serving in the two military barracks in Ibadan. MP available on the days of data collection were interviewed. A semi-structured, interviewer-administered questionnaire was used to obtain information on SRBs and CSBD. Descriptive and inferential statistics were done and the Chi-Square test was used to test for association between independent and outcome variables at p < 0.05. Results: The mean age of respondents was 30.1±10.1 years. Above half (52.7%) were aged 20 - 30 years, 70.7% were males, and 56.6% were not living with a partner. The prevalence of SRBs among respondents was 79.6% while the prevalence of CSBD was 6.4%. Gender and marital status were predictors of SRBs. Conclusion: The majority of MP engaged in SRBs while less than one-tenth had CSBD. Gender and marital status were predictors of SRBs. Risk reduction counseling was recommended for MP.

PREVALENCE AND PREDICTORS OF EXCLUSIVE BREASTFEEDING AMONG MOTHERS IN A SEMI-URBAN NIGERIAN COMMUNITY: A CROSS-SECTIONAL STUDY.

Background: The uptake of exclusive breastfeeding (EBF) is low globally including Nigeria despite its benefits and interventions. This study aimed to assess the prevalence and predictors of EBF among mothers in a semiurban Nigerian community. Methods: We conducted a cross-sectional study among nursing mothers attending the immunization clinic at the Federal Medical Centre, Owo, Ondo State. A semi-structured questionnaire containing the World Health Organization's indicators for assessing breastfeeding practices was used for data collection. Results: A total of 386 mothers were recruited with a mean age of 30.8 ± 5.0 years. Among them, 149 (36.8%) were below 30 years, 345 (89.4%) have had ANC visit at least four times, and 259 (67.1%) had initiated breastfeeding immediately after delivery. The prevalence of EBF was 52.6%. Natural feeds were the common feeds introduced after 6 months among 159 (78.3%) mothers. One hundred and forty-four (62.1%) nursing mothers aged 30 years or older practiced EBF compared to 72 (48.3%) persons below 30 years (X2 = 6.290, p = 0.012). Also, 38 (70.3%) mothers who have delivered four or more children practiced EBF compared to 180 (54.2%) with fewer children (X2 = 5.437, p = 0.020). Nursing mothers aged 30 years or older had 36% higher odds of practicing EBF compared to younger persons (Adjusted Odds Ratio = 1.358, 95%CI = 0.886 - 2.081, p = 0.160). Conclusion: To achieve the WHO recommended target of ensuring that 90% of nursing mothers practice EBF, advocacy and health education must be intensified.

COVID-19 PANDEMIC AND ITS POTENTIAL IMPACT ON SEXUAL AND REPRODUCTIVE HEALTH INDICATORS IN NIGERIA.

The impact of the novel corona virus disease (COVID-19) pandemic cuts across all sectors and has brought to the fore the true realities and status of health systems globally, revealing the gaps and cracks even in seemingly perfect health systems. The fragile and weak health system in the country is also riddled with a lot of sub-optimal health indicators including reproductive health. It is important to anticipate and look out for these effects in order to plan for and ensure early detection and necessary intervention to mitigate such. This paper discusses the potential effect of COVID-19 on reproductive health indicators in Nigeria. The reproductive health indices of a population have far and wide reaching impact on the health status of the population. However, reproductive health indicators are usually among the worst hit during health emergencies or disasters as seen in the Ebola pandemic in sub-Saharan Africa. Interventions must be put in place so that the pandemic does not set Nigeria back from the marginal gains made in reproductive health over the years.

Morbidity Pattern and Choice of Care in an Urban Slum of a Metropolitan State, Southwestern Nigeria.

BACKGROUND: An increased population growth has led to the proliferation of slums in urban areas. Urban slum dwellers are susceptible to ailments which may be worsened from reduced access to health facilities or weak institutional capacity. Understanding the pattern of morbidity and choice of care among slum dwellers can inform appropriate health interventions among this group. This study was conducted to investigate and document the morbidity patterns and choice of care within an urban slum community of South-western Nigeria. METHODS: The study was a descriptive cross-sectional survey involving 480 respondents selected through a random sampling technique in Idikan community of Southwestern Nigeria. The survey was conducted using a pre-tested semi-structured interviewer administered questionnaire on morbidity pattern and choice of care. Data were analyzed using SPSS Vs version 13 to generate frequencies and association between independent variables and choice of care using Chi-square at 5% level of significance. RESULTS: Among those that were ill, slightly over half of the respondents, 254 (52.9%) used self-medication while only 226 respondents (47.1%) sought medical care Majority of the respondents that sought care did so from Christian based health facilities (66.8%). A significantly higher proportion, (74.3%) of those in the higher occupational class compared with those of low occupational class (55.1%) (p = 0.001) sought care in a health facility. Also, a significantly higher proportion of those with tertiary education (69.0%) sought care in facilities compared to other cadres (p = 0.033). CONCLUSION: Disparities in morbidity patterns and access to care still persists in the surveyed community which requires urgent attention in the urban slums. This is evidently linked to educational and socio-economic status. Re-distribution of national funds to educational institutions and creation of jobs in the slums are advocated to improve the health seeking behaviours of slum dwellers in Ibadan and Nigeria at large.

Teachers' Training and Involvement in School Health Programme in Oyo State, Southwest Nigeria.

School Health Programme (SHP) currently lacks effective implementation in Nigeria. Lack of training/orientation of teachers in the programme may have contributed to this. Developing an appropriate training intervention may require prior situation analysis to know teachers' current level of training and involvement in the programme, as there is paucity of information on such study in Oyo State. Thus, this study was carried out to assess primary school teachers' training and involvement in the SHP in Oyo state, Nigeria. A descriptive cross-sectional study was conducted using a 2-stage cluster sampling method to select 2 out of the 33 Local Government Areas (LGAs) in Oyo State. A semi-structured self-administered questionnaire was used to obtain information on respondents' characteristics and previous training and involvement in the SHP. The major variable for assessing teachers' involvement in the SHP was "ever been involved in health inspection of pupils". Level of involvement was categorized into "never, "once", "occasionally", "frequently", and "very regularly". These options were further re-categorized into "never", "infrequently" (once and occasionally) and "frequently" (frequently and very regularly) for the purpose of inferential statistics. Data were analyzed using descriptive statistics and Chi-square test at p=0.05. A total of 811 respondents participated in the study. Twenty-eight percent of the respondents reported previous training in the SHP out of whom 44.7% received the training on-the-job. Forty-seven percent were regularly involved in health inspection of pupils. Teachers who taught health education (92.3%) were involved in health inspection of pupils compared with counterparts who did not (74.4%) (p<0.001). Similarly, 85.3% of teachers trained on-the-job were frequently involved in the SHP compared with 73.6% of those trained during undergraduate years (p=0.026). Training and involvement of public primary school teachers in the SHP in Oyo State were suboptimal. Efforts at building the capacity of teachers through on-the-job training in SHP may be necessary to improving the current level of implementation in the State.

Tuberculosis treatment outcomes and interruption among patients assessing DOTS regimen in a tertiary hospital in semi-urban area of south-western Nigeria.

BACKGROUND: Tuberculosis remains one of the most infectious diseases worldwide especially with the HIV pandemic. It is a cause of high morbidity and mortality in developing countries including Nigeria. Reasons contributing to high morbidity and mortality include high defaulting rate and treatment interruption. Several studies had evaluated the treatment outcome of tuberculosis but there is paucity of published literature on the outcome of treatment interruption especially in this environment. This study thus assessed the outcome of treatments and interruption among patients assessing DOTS regimen in a tertiary hospital located in asemi urban area in south-western Nigeria. METHODOLOGY: The study was a review of TB register of the federal medical centre, Owo from its inception in 2008 to 2011. All the patients that have completed at least one course of chemotherapy (defined as 8 months of anti-tuberculosis treatment- 2 months intensive phase and 6 months continuation phase) were included. Treatment outcome and interruption were defined in accordance with World Health Organisation (WHO) recommendations. Data were analysed with SPSS version 17. RESULTS: A total of 400 patients were included. The mean age of patients was 36.8 +/- 16.8 years and 56.3% were male. Majority, (79.7%) were adults aged 19-64 years, 12.5% were in the paediatric age group and 7.8% were elderly. Less than half, 45.3% had TB/HIV co-infection. Regarding treatment outcome of tuberculosis, 75.5% were cured, 14.8% died, 4% relapsed and 3% defaulted. A little above one-fifth, 21 (5.3%) had treatment interruption among whom 9 (42.9%) were successfully traced and completed treatment. Significantly, higher proportion of those that had treatment interruption died, 54.1% compared with their counterpart, 14.9%, (p < 0.001) and had relapse. (14.3% versus 3.4%, p = 0.01). CONCLUSION: A high rate of tracking failure among patients with treatment interruption was found in the study. In addition, mortality and morbidity were higher among patients with treatment interruption. A more concerted effort is needed in tracking/tracing patients with treatment interruption in orderto reduce morbidity and mortality among TB patients assessing treatment.

Sanitary conditions of abattoirs in Ibadan, Southwest Nigeria.

BACKGROUND: The environment in the abattoir is of public health concern because of its implications on the quality of meat sold in the markets. The poor sanitary states of abattoirs have been reported in the literature. Very few studies have provided a comprehensive assessment of the sanitary conditions in the abattoir premises. This study sought to assess the compliance of abattoirs in Ibadan, Southwest Nigeria with standards set by Federal Ministry of Environment. METHODOLOGY: A descriptive cross-sectional study was conducted in Ibadan using an observational checklist adapted from Policy guidelines on market and abattoir sanitation by the Federal Ministry of Environment. Twelve (12) abattoirs in Ibadan metropolis were assessed. Data obtained were analyzed using descriptive statistics. RESULTS: Concerning general inspection, only one (8.3%) of the abattoirs had adequate access route, potable water supply and functional drainage system. Many had poor solid waste management practices as heaps of refuse littered the surroundings. Internal inspection of the abattoirs revealed that two (16.7%) had adequate space and facilities. Ten (83.3%) had first aid posts even though they were not equipped with materials. Eleven (91.7%) abattoirs had toilet facilities that were either poorly kept or abandoned. CONCLUSION: This study showed that most of the abattoirs in Ibadan metropolis were operating under unhygienic and sub-standard conditions and lacked basic requirements for a good abattoir as stipulated in the Policy Guidelines on Market and Abattoir Sanitation. There is an urgent need to enforce the minimum standards as stipulated in the policy guidelines.

Ownership and utilisation of insecticide-treated mosquito nets among caregivers of under-five children and pregnant women in a rural community in southwest Nigeria.

INTRODUCTION: Malaria still constitutes a serious public health problem in Nigeria despite control efforts. The use of Insecticide Treated Net (ITN) has been proven to be an effective preventive modality in the control of malaria but its utilisation has been shown to be low. This study assessed the ownership and utilisation of ITN in Igbo-Ora, a rural community in Ibarapa Central Local Government Area (LGA) of Oyo State, Southwest Nigeria. METHODS: A descriptive cross-sectional survey among female caregivers of under-five children and pregnant women was conducted using semi-structured interviewer-administered questionnaire. Data were analyzed using SPSS version 16. RESULTS: Among 631 respondents that participated, 84.9% were caregivers of under-five children. Mean age was 27.7 ± 6.3 years with 53.4% between 20-29 age group. Majority, 91.1% had at least primary education, 60.2% were traders and 69.7% were married. Most respondents, 71.8% had at least one type of mosquito nets. Among those that had, 85.4% had window/door net, 25.2% untreated mosquito net while only 15.5% had ITN. Overall, 11.1% of the respondents had ITN among which 78.6% had ever slept under an ITN. Among those that had ever slept under an ITN, slightly less than half 49.1% slept under an ITN the previous night. Less educated respondents were five times more likely to use ITN (95% CI = 1.24-21.28). CONCLUSIONS: This study revealed very low ownership and utilisation of lTNs. There is need to improve on the knowledge of community members of the relevance of ownership and utilisation of ITN in malaria prevention.

Effect of safety education on knowledge of and compliance with road safety signs among commercial motorcyclists in Uyo, Southern Nigeria.

OBJECTIVE: Compliance with road safety signs is important in the reduction of motorcycle accidents. The aim of this study was to implement health education intervention and assess its impact on the knowledge of and compliance with road safety signs among commercial motorcyclists in Uyo, Southern Nigeria. METHOD: This was an intervention study among motorcyclists in Uyo, Southern Nigeria, with a control group from a similar town. The instrument of data collection was a semi-structured interviewer administered questionnaire. Subjects were selected through multistage sampling method. Baseline data on compliance to road safety signs was collected from both groups. Motorcyclists in the intervention group were given education on the importance of compliance to road safety signs. Data was subsequently collected from both groups 3 months post intervention and analysed using the Statistical Package for the Social Sciences version 11. RESULT: A total of 200 respondents participated in the study, 100 from each group. Following intervention, respondents with good knowledge score increased from 21% at baseline to 82% at 3 months post intervention in the intervention group (p<0.05) and from 19% to 21% in the control group. Compliance score in the intervention group increased from 15% to 70% (p<0.05) and from 12% to 18% in the control group. CONCLUSION: A significant increase in compliance to road safety signs was recorded among motorcyclists in the intervention group after safety education. All motorcyclists should therefore be given education on road safety signs as this will improve compliance and lead to safer road use among them.

Making a case for community screening services: findings from a medical outreach in ibadan, Nigeria.

BACKGROUND: Currently, population based medical check up is yet to be explored as a veritable tool for assessing the burden of non-communicable diseases in Nigeria. OBJECTIVES: This study aimed to assess the prevalence of selected lifestyle related diseases during a free medical rally in an urban community. METHODS: General medical examinations of all participants at a free medical rally in a middle class community in Ibadan, Oyo State was conducted. Body Mass Index (BMI), blood pressure and random blood sugar measurements were done using standardised instruments. BMI classification for children was done using the CDC guidelines for males and females aged 2-20 years. RESULTS: Of the 302 participants examined, 33.1% were males and 32.1% were less than 18 years. Of those aged 2 to 20 years, 22.9% were underweight, while 5.2% were overweight/ obese. In adults 3.6% were underweight and 43.2% were overweight/ obese. Adults were significantly more likely to be overweight/obese (P<0.001). Prevalence of high blood pressure was 29.3% and 9.4% of adults had elevated random blood glucose levels. A higher proportion of obese people (P=0.259), males (P= 0.327) and those older than 40 years (P<0.001) had elevated blood pressure. A weak correlation (spearman rho= 0.3) was found between blood pressure and BMI (P<0.001) and also between BMI and blood sugar level (spearman rho= 0.2) P=0.05. CONCLUSION: There is a need for greater emphasis on community based screening programmes to aid early diagnosis and treatment of non communicable diseases in the country.