Obstetric mortality in a Nigerian general hospital.

BACKGROUND: The aim of the study was to evaluate the progress towards achieving a 50% reduction in maternal mortality by the year 2000 at a referral hospital. METHODS: A retrospective review of births and maternal deaths over an 18-year period from 1981 to 1998. RESULTS: There was a 30% reduction among booked women in the period 1990-1998 compared to 1981-1989 while only 8% reduction was achieved among referred women. Infection and hypertensive disorders remained the leading causes of death but the contribution of haemorrhage declined due to improved blood transfusion services. CONCLUSION: Further improvement in maternal survival can be achieved by training health personnel involved in maternity care to recognise or anticipate complications early and refer.

Knowledge, attitude, and practice of female health professionals regarding cervical cancer and Pap smear.

BACKGROUND: The objectives of this paper was to determine what female health professionals knew and felt about cervical cancer and Pap smear and their uptake of Pap smear. METHODS: A questionnaire survey of 144 female health professionals at two referral hospitals with facilities for Pap smear. RESULTS: Nurses constituted 52.8% of respondents followed by laboratory scientists (18.8%), doctors (14.6%) and pharmacists (13.9%). One hundred and thirty two (91.7%) respondents had heard of cervical cancer and 80.6% knew it was associated with vaginal bleeding. Twenty two percent could not list any risk factor A significantly greater proportion of doctors (100%) knew the purpose of a Pap smear compared to 59.2% of nurses, 50% of pharmacisits and 48.1% of laboratory scientists (p = 0.003). Only 13 respondents (9%) had everhad a Pap smear with doctors (p = 0.003) and divorced/separated women (p = 0.005) significantly more likely to have done so. Perceived non-availability of Pap smearservice was the main reason (51.3%) for not having had a Pap smear. However, 30.3% had not thought of it or did not consider themselves at risk of cervical cancer. CONCLUSION: Health professionals themselves need to be properly informed about cervical cancer and Pap smears because of their own needs as women and also to improve their effectiveness in educating and encouraging other women to have Pap smears. Available Pap smear services should be publicized and made more affordable.