Caesarean delivery rate and indications at a secondary healthcare Facility in Ibadan, South Western Nigeria: a five-year review.

BACKGROUND: Caesarean delivery is an essential surgical skill within the primary care setting aimed at reducing maternal morbidity and mortality. OBJECTIVES: To determine the rate and indications for caesarean deliveries with a view to improving on the service delivery in the study area. METHODS: A retrospective review of all caesarean deliveries over a five-year period, January 1st, 2012 to December 31st, 2016. RESULTS: A total of 2321 deliveries were recorded during the study duration and 481 of them were through caesarean section (CS) giving a caesarean section rate of 20.4%. The rate was higher in the multigravida 255 (53.1%). The commonest indication for caesarean section was previous caesarean section 131 (27.2%). Emergency caesarean delivery accounted for 278 (57.8%). Only 16 (3.3%) stayed more than five days postoperatively while the rest, 465 (96.7%), stayed less than five days. There was a gradual yearly increase in rate from 12.1% in 2012 to 19.5% in 2016. CONCLUSION: The rate of CS in this study has shown a gradual yearly increase with emergency CS having a higher percentage. Early diagnosis and referral of high-risk pregnancies from peripheral hospitals could reduce emergency CS among the study population.

Effect of malaria preventive education on the use of long-lasting insecticidal nets among pregnant females in a Teaching Hospital in Osun state, south-west Nigeria.

BACKGROUND: Malaria in pregnancy is a major public health problem in Nigeria. Long-Lasting Insecticidal Nets (LLINs) have been advocated as an effective tool against malaria transmission. However, success of this intervention largely depends on the knowledge and practices regarding malaria and its prevention. Unfortunately, few studies have been done on effect of malaria preventive education on use of LLIN in pregnancy. OBJECTIVE: To assess the knowledge of malaria and determine the effect of malaria preventive education on the use of LLINs among pregnant females in a Teaching Hospital in Osun state. METHOD: It was a one group pre-test post-test quasi - experimental hospital based study involving pregnant females attending Ante-Natal Clinic (ANC) of the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC). A total of 200 respondents were recruited for this study by 2-stage sampling technique. Data was collected using a pretested questionnaire to elicit information on socio-demographic characteristics, use of LLIN in pregnancy, knowledge of malaria and its preventive measures. The data collected was analysed using descriptive and inferential statistics. The descriptive statistics comprised frequency, percentage, means and standard deviations. Bivariate analysis comprised Chi-square test on knowledge of malaria before and after intervention while correlation test assessed strength of relationship between knowledge of malaria preventive education and use of LLINs before and after intervention. Multivariate analysis determined the predictors of LLINs use. Analytical statistics of cross tabulation was conducted considering a p < 0.05 to be statistically significant. RESULTS: There was an increase in the scores of knowledge on malaria transmission after the intervention and this was statistically significant (χ2 = 8.862, p < 0.01). Similarly, the scores of knowledge on malaria prevention increased after the intervention and this was statistically significant (χ2 = 10.023, p < 0.01). Respondents' age, marital status and gravidity were predictors of LLINs use. Biserial correlation showed a statistically positive relationship between knowledge of malaria preventive education and use of LLINs after intervention (r = 0.036, p < 0.01). CONCLUSION: The use of malaria preventive education was found to be effective in increasing the use of LLIN in this study. These findings highlight a need for educational intervention in implementation of LLINs. There is therefore a need to strengthen the policy of malaria prevention education as an integral component with distribution of free LLIN in health care setting to enhance its utilization.

Determinants of Quality of Life of Elderly Patients Attending a General Practice Clinic in Southwest Nigeria.

BACKGROUND: Aging is associated with change in health status and decreasing functional capacity affecting the general well-being of individuals with increase in the prevalence of chronic noncommunicable diseases. OBJECTIVE: This study aimed to assess the quality of life (QoL) and its determinants in elderly patients attending a general practice clinic in Southwest Nigeria. METHOD: Descriptive cross-sectional study of consenting elderly patients completed an interviewer-administered questionnaire on QoL and its determinants. Data were analyzed using descriptive and inferential analysis. Logistic regression was done to identify predictors of QoL. RESULTS: A total of 216 older adults were interviewed. Only 25% had good QoL with majority having multiple morbidities which was associated with poorer QoL. Predictors of QoL were family support (odds ratio = 0.249, 95% confidence interval [0.079, 0.850], p = .026) and socioeconomic class (odds ratio = 3.66, 95% confidence interval [1.47, 7.87], p = .004) of the respondents. CONCLUSION: QoL was found to be poor among the study population and worst in those with multiple morbidities. There is a need for policy direction to advocate for preventive strategies for risk of chronic diseases as well as provide better access to primary care through National Health Insurance Scheme (NHIS).

AIDS care in Nigeria: are nurses comfortable performing procedures?

Nurses' feeling of comfort during care is important to stay on the job and for their choice of specialty of care. This study aimed to assess nurses' level of comfort in providing care to patients living with AIDS and to determine the sociodemographic variables that influence nurses' comfort. Nurses in four hospitals in Nigeria (n = 277) were surveyed using a questionnaire that elicited information on their demographic characteristics, previous AIDS encounter, and their comfort taking vital signs, casually handling, administering enema and mouth-to-mouth resuscitation, and in recommending exercise and physical therapy to patients living with AIDS. Nigerian nurses were uncomfortable with resuscitation and also showed discomfort not wearing gloves while handling these patients. Being single and male gender influenced nurses' comfort with vital signs and enema administration. Special orientation to include analysis of common tasks and procedures for new nurses assigned to AIDS units is suggested.

Knowledge and utilization of Information Technology among health care professionals and students in Ile-Ife, Nigeria: a case study of a university teaching hospital.

BACKGROUND: The computer revolution and Information Technology (IT) have transformed modern health care systems in the areas of communication, teaching, storage and retrieval of medical information. These developments have positively impacted patient management and the training and retraining of healthcare providers. Little information is available on the level of training and utilization of IT among health care professionals in developing countries. OBJECTIVES: To assess the knowledge and utilization pattern of information technology among health care professionals and medical students in a university teaching hospital in Nigeria. METHODS: Self-structured pretested questionnaires that probe into the knowledge, attitudes and utilization of computers and IT were administered to a randomly selected group of 180 health care professionals and medical students. Descriptive statistics on their knowledge, attitude and utilization patterns were calculated. RESULTS: A total of 148 participants (82%) responded, which included 60 medical students, 41 medical doctors and 47 health records staff. Their ages ranged between 22 and 54 years. Eighty respondents (54%) reportedly had received some form of computer training while the remaining 68 (46%) had no training. Only 39 respondents (26%) owned a computer while the remaining 109 (74%) had no computer. In spite of this a total of 28 respondents (18.9%) demonstrated a good knowledge of computers while 87 (58.8%) had average knowledge. Only 33 (22.3%) showed poor knowledge. Fifty-nine respondents (39.9%) demonstrated a good attitude and good utilization habits, while in 50 respondents (33.8%) attitude and utilization habits were average and in 39 (26.4%) they were poor. While 25% of students and 27% of doctors had good computer knowledge (P=.006), only 4.3% of the records officers demonstrated a good knowledge. Forty percent of the medical students, 54% of the doctors and 27.7% of the health records officers showed good utilization habits and attitudes (P=.01) CONCLUSION: Only 26% of the respondents possess a computer, and only a small percentage of the respondents demonstrated good knowledge of computers and IT, hence the suboptimal utilization pattern. The fact that the health records officers by virtue of their profession had better training opportunities did not translate into better knowledge and utilization habits, hence the need for a more structured training, one which would form part of the curriculum. This would likely have more impact on the target population than ad hoc arrangements.