Determinants of use of insecticide treated bednets among caregivers of under five children in an urban local government area of Osun state, South-Western Nigeria.

In Sub Sahara Africa, the use of Insecticide Treated Nets (ITNs) is one of many strategies of Roll Back Malaria (RBM) initiatives to reduce malaria burden. This study therefore assessed the current use of insecticide treated nets and the determinants of its use among the caregivers of under five children in an urban local government area in Osun state, Nigeria. The study utilised a cross-sectional design among caregivers of under- five children selected from households by multistage sampling technique. The study collected quantitative data using pretested semi structured, interviewer administered questionnaire while factors that determine the current use of ITN were identified using multi linear logistic regression. The study revealed that 54.4% caregivers of under five children were aware of ITNs as one of the malaria preventive measures, 49.1% had good knowledge of ITN and 38% agreed with the use of ITNs. Thirty four percent had access to ITNs, 32.3% owned at least one ITN with 30.3% reported been given free in the health care facilities. Thirty three percent had ever used and the foremost reasons for non-use are not readily available and expensive. Only 18.5% currently used ITNs and challenges faced were not easy to treat, difficult to set up and no place to keep it. Marital status, knowledge of ITN, attitude towards ITN, ownership of ITN and free ITN were factors that determined the use of ITNs amongst the respondents. There is a need to ensure intensive awareness on ITNs through campaigns and embark on its mass distribution to the public to enhance use.

Impact of nutritional education on nutritional status of under-five children in two rural communities of south-west Nigeria.

OBJECTIVES: This study evaluated the impact of nutritional education on knowledge, attitude and practices (KAP) of mothers concerning infants and young children feeding and their children's nutritional status in two semi-urban communities of south-west Nigeria. MATERIALS AND METHODS: This is a community intervention study. We recruited 150 mothers of children aged 0-18 months independently from the intervention and control communities through a multi-stage sampling technique. We collected data with the aid of an interviewer-administered questionnaire at baseline and at six months after intervention from both communities to obtain information on feeding of infants and young children. In addition, we measured weights and heights of recruited children. Intervention involved group counselling of mothers and food demonstrations at designated health facilities. Data analysis for quantitative data was done using Epi-Info software, and for qualitative data, content analysis of major themes was used. RESULTS: Before intervention, recruited mothers and their children from the two communities were comparable in terms of all the parameters assessed (P>0.05 in all cases). After six months of intervention, mothers who had nutritional education demonstrated better knowledge and attitudes to key infant and young children feeding recommendations. There was also limited improvement in feeding practices. Mothers from the intervention community exclusively breastfed their infants longer with mean age at introduction of complementary foods at 5.3 months compared to 4.5 months in the control community (P<0.05), breastfed their children longer (P<0.05). However, there was no statistically significant improvement in the weight of their children. CONCLUSION: In this study, nutritional education of mothers only had positive impact on their level of KAP on infant and young children feeding.

Wait time and service satisfaction at Antenatal Clinic, Obafemi Awolowo University Ile-Ife.

OBJECTIVE: Antenatal care is an essential aspect of health care delivery for improving pregnancy outcome such that about two-thirds of maternal deaths can be prevented. The study was carried out with the aim to assess patient satisfaction on some aspects of antenatal care services (timeliness, courtesy, communication and competence of personnel in the clinic) and estimated time spent in clinic. METHODOLOGY: The study was a cross sectional survey of pregnant mothers attending antenatal clinic of the Obafemi Awolowo University Teaching Hospital Complex within the period of the study. The patients who were willing to participate in the study were recruited and interviewed with pretested questionnaire. Direct observation of the total time spent clinic was also conducted. RESULTS: Four hundred pregnant mothers were recruited and interviewed. 55% were satisfied with the quality of health talk, 72.6% were of the opinion that the services of the hospital are good and meet their needs and 87% agreed with the quality of health talk. 53.7% agreed with the competency of the hospital staff, 39.1% agreed with timely response of the staff and 20.5% were of the opinion that the staffs were friendly and polite. The socio-demographic factors that significant influenced the respondent's satisfaction of the antenatal services and time spent in clinic were educational and occupational status. The total time spent in the clinic was 2hrs 42 mins of which 1 hr 40 was spent at the nurse's desk, 13 minutes for consultation with the doctor and the rest for laboratory services, record services. The transit time before consultation with nurses and doctors were 51.2 minutes and 2 hr 29 mins respectively. CONCLUSION: Majority of respondents were satisfied with the care received, however long waiting times is the norm of antenatal care services

Incisional Hernia in Women: Predisposing Factors and Management Where Mesh is not Readily Available

Background:Aim: Incisional hernia is still relatively common in our practice. The aim of the study was to identify risk factors associated with incisional hernia in our region. The setting is the Obafemi Awolowo University Teaching Hospitals Complex; Ile-Ife; Nigeria during a period when prosthetic mesh was not readily available. Patients and Methods: All the women who presented with incisional hernia between 1996 and 2005 were prospectively studied using a standard form to obtain information on pre-hernia (index) operations and possible predisposing factors. They all had open surgical repair and were followed up for 18-60 months. Results: Forty-four women were treated during study period. The index surgeries leading to the hernias were emergency caesarian section 26/44 (59.1); emergency exploratory laparotomy 6/44 (13.6); and elective surgeries 12/44 (27.3). Major associated risk factors were the use of wrong suture materials for fascia repair; midline incisions; wound sepsis; and overweight. Conclusion: For elective surgeries; reduction of weight should be encouraged when appropriate; and transverse incisions are preferred. Absorbable sutures; especially chromic catgut; should be avoided in fascia closure. Antibiotics should be used for complicated obstetric cases

Sexual behaviour and contraceptive use among secondary school students in Ilesha south west Nigeria.

Data from several parts of Nigeria point to increasing sexual activity among single adolescents of both sexes with progressive decreasing age at initiation and poor contraceptive use. This paper investigates the sexual behaviour and contraceptive use among teenage secondary school students in Ilesha, southwest Nigeria. This is a cross-sectional population survey of 300 male and female secondary school students within the age group of 13-19 years. The setting is secondary school coaching classes in Ilesha, southwest Nigeria. The outcome measures include prevalence of sexual activity, age at first sexual debut, circumstances leading to first sexual debut, number of sexual partners and family planning use. The result shows that out of the 300 studied, 50% were sexually active, the predominant age at first coitus was 15-19 years, and circumstances leading to sexual debut included mutual agreement, coercion and curiosity. Predominant proportion of sexually active teenagers (86.7%) did not use contraception at the time of first coitus and most of them had more than one sexual partner. The conclusion from this study is that 50% of teenage secondary school girls in this part of Nigeria are sexually active; 68.7% whom, have multiple sexual partners, and 86.7% of them did not use contraception at sexual debut. This unsafe sexual behaviour therefore put them at a great risk of acquiring STDs including HIV infection, and unwanted pregnancy. This study therefore recommends sex education/family life education for young people to encourage them to delay sexual activity as much as possible and practice safe sex when it eventually commences. There is also the need to sensitise the young people, parents, teachers, the community and all stake holders on the magnitude of the problem and to open up dialogue that will break the social, cultural and other mysteries hindering adolescents and youth reproductive health education and services in Nigeria.

Introduction of sex education into Nigerian schools: the parents', teachers' and students' perspectives.

To assess parents', teachers' and students' knowledge of sex education and their level of acceptance of its introduction into the school curriculum in Nigeria, questionnaires were sent to teachers, students and parents of eight secondary schools located within Ile-Ife town. The responses of individual groups were collated, analysed and compared. A total of 1000 respondents (400 students, 400 parents and 200 teachers) returned the completed questionnaires. All the teachers and parents and 60% of the students had heard of sex education. A majority of the parents (92%), teachers (90%) and students (78%) supported its introduction into the school curriculum and believed that it would prevent unwanted pregnancies, enhance healthy relationships between opposite sex, prevent transmission of HIV infections and STDs, provide the knowledge of sexual interactions, consequences and responsibilities and to educate the students on the basic processes of human reproduction. One hundred and fifty-four (15.4%) of the respondents opposed the introduction of sex education because they believed that it would corrupt the students, it might lead to experimentation and that it should be the responsibility of the parents at home. Adolescent sex education should be incorporated into Nigerian schools. It is probably the most cost-effective intervention that could be made to ensure the future reproductive health of the Nigerian community.

Liberalisation of abortion laws in Nigeria: the undergraduates' perspective.

Nothing in the field of health care generates more controversy than does the issue of abortion. The views of 396 undergraduates of Obafemi Awolowo University, Ile-Ife, Nigeria concerning the liberalisation of abortion laws were investigated in May 2001. Ninety respondents (22.7%) supported the liberalisation of abortion laws in Nigeria because they believed that it would lead to reduction in associated morbidity and mortality, encourage more qualified personnel to perform it, encourage women to request abortion openly and encourage accurate statistics on abortion. However, the majority of the respondents (59.6%) opposed the liberalisation of abortion laws due to the fear that it would increase promiscuity, sexually transmitted diseases and abortion rates. Religious opposition and the belief that liberalisation would not reduce the level of poverty, ignorance and poor reproductive health facilities were the common factors leading to unwanted pregnancy and unsafe abortion in Nigeria. Support for the liberalisation of abortion laws shows significant relationship with increasing age (P = 0.001), male sex (P = 0.001) and a science-orientated faculty (P<0.05), but not religion. There is every indication that the issue of abortion is one that will continue to be unresolved for the forseeable future.

Male contribution to infertility in Ile-Ife, Nigeria.

This is a retrospective study of 350 cases of male partners of infertile couples who presented at the gynaecological and urological units of Ife State Hospital branch of Obafemi Awolowo University Teaching Hospital complex Ile-Ife, Nigeria within a five year (1993-1997) period. Of the 350 cases reviewed, 200 (57.6%) had normal seminal fluid parameters while 27.7% had oligozoospermia and 15.2% had azoospermia. The age and past history of sexually transmitted diseases (STDs) had significant effect on the result of seminal fluid analysis (p < 0.05 respectively) while the occupational status had no significant effect (p > 0.05). Most of the infertile couple presented with secondary infertility (62%) with a significant past history of sexually transmitted diseases (STDs) (p < 0.05). Efforts directed to the prevention of STDs should be pursued vigorously by health care providers. Education of the populace on responsible sexual habits cannot be overemphasized.

Utilization of approved health facilities for delivery in Ile-Ife, Osun State, Nigeria.

This was a cross-sectional population survey carried out to determine utilization of approved health facilities for delivery by mothers in Ile-Ife and factors influencing the observed utilization. A total number of 117 mothers who had delivered once or many times were selected using the systematic sampling method. Information was collected using pretested structured interview administered questionnaire. Data collected was analyzed using frequency tables and statistical test of significance. Of the 117 mothers interviewed, 70 (59.8%) booked in approved health facilities while 51 eventually delivered in the approve health facilities. The prominent reasons given for non utilization of health facilities were time of occurrence of labor, difficulty with transportation, fear of surgical operation, husband/family influence and delivery assistance by TBA's and relatives. Educational status of the mother, religious beliefs, distance from approved health facilities more than 5 km and attitude of health workers were amongst factors significantly influencing choice of place of delivery by the mothers.

Sociocultural practices influencing under five nutritional status in an urban community in Osun State, Nigeria.

Three hundred and forty four preschool children from Ilare district of Ife Central Local Government Area of Osun State, Nigeria were assessed for nutritional status using selected and sensitive anthropometric techniques. The sociocultural practices of the parents were also examined. Approximately 53.8% and 54.7% of the children were identified to be malnourished and stunted respectively. The socioeconomic situation of the family was identified to have a significant influence on the child's nutritional status. Female children were observed not to be as adequately nourished as their male counterparts. However parity and food taboo had no significant influence on the child's nutritional status. The need for improvement in the socioeconomic status of the family and education of the community on the importance of female nutrition are discussed.

Promotion of exclusive breastfeeding (EBF): the need to focus on the adolescents.

This study was designed to assess the knowledge and attitude towards exclusive breast feeding among 377 female students of School of Health Technology, Ilesha and to compare their responses with 60 primigravidae attending antenatal clinic in Ile-Ife, Nigeria. The ages of the subjects ranged from 15 to 34 years. Data were collected using pretested structured questionnaire. Approximately 47% of the total population were grouped under low level of knowledge of exclusive breastfeeding. There was no significant relationship in terms of knowledge between the two groups. There was, however, a significant relationship between the age of subjects and increased level of knowledge about EBF. Seventy percent of the primigravidae were graded as having poor attitudes as compared with 18% of the female students. About 42% of the total population would give water and glucose D water to neonates within 72 hours after delivery. These findings further suggest that planners of the Baby Friendly Initiative need to focus more on adolescents and the primigravidae in the promotion of breastfeeding.

Breast feeding practices in urban and rural health centres: impact of baby friendly hospital initiative in Ile-Ife, Nigeria.

The present study was carried out to assess the impact of the Baby Friendly Hospital Initiative (BFHI) on breast feeding practices. The variables used to evaluate the BFHI centre included time of initiation of breastfeeding (BF) after delivery, intended duration of BF, adoption of exclusive breastfeeding (EBF) in relation to educational status, location of health centre, and knowledge and practice of positioning the child at the breast. Observation, questionnaire and interview techniques were employed to collect the data among 217 and 214 nursing mothers (NMs) from Urban and Rural Health Centres. Of the 228 NMs who initiated BF within 30 minutes after delivery, 140 (61%) were from a designated BFHI Centre and 88 (39%) were from an undesignated BFHI rural health centre. There was a significant relationship between the practice of EBF and designation of BFHI centre (P = 0.0001). The higher the level of education of the NMs, the higher the present of NMs subscribing to EBF (P = 0.0001). The present study has also confirmed that EBF which was once considered to be less than 3%, has increased significantly to 61%. The success was not unconnected with the inauguration of BFHI. The BFHI is recording huge success in the urban area but the impact is still to be felt in the rural areas.