Prevalence, Pattern and Effect of Intimate Partner Violence against Women in Abeokuta, South West Nigeria.

BACKGROUND: The world over, women are victims of violence in close and intimate relationships where they are expected to be safe and protected. Intimate partner violence (IPV) significantly impacts the physical and mental well-being of those affected. This study assessed the prevalence, pattern and effects of IPV amongst women in Abeokuta South Local Government Area (LGA) of Ogun State, South West Nigeria. MATERIALS AND METHODS: This community-based cross-sectional study was carried out in Abeokuta - South LGA in Ogun State. Data were collected from 339 women in intimate relationships using a structured interviewer-administered questionnaire. Ethical approval (HPRS/381/471) was obtained from the Ogun State Ministry of Health Ethical Review Committee. Analysis was done using IBM® SPSS version 23, and results were presented in frequencies and proportions using tables and charts. RESULTS: About three-quarters (73.2%) of the 339 respondents had experienced one form of IPV. Psychological/emotional violence, 224 (66.1%), and physical violence, 161 (47.5%), were the study's most commonly reported forms of violence. Amongst those affected, 186 (54.9%) were 'insulted', 87 (25.7%) were 'embarrassed in public' and another 124 (36.6%) were slapped. The effects of IPV reported were bruises/lacerations, unwanted pregnancies, sexually transmitted infections and attempted suicide. CONCLUSION: The prevalence of IPV of all forms were high in the studied population. Therefore, the government needs to create more awareness of the problem and promote investments in women's empowerment to reverse this trend.

Vaccine Safety: Assessing the Prevalence and Severity of Adverse Events Following COVID-19 Vaccination amongst Healthcare Workers in Tertiary Health Facilities in Nigeria.

BACKGROUND: Vaccines, including COVID-19 vaccines, are known to be cost-effective interventions for disease prevention and control. However, adverse events following immunisation (AEFI) may challenge the acceptance of these vaccines. This study assessed the prevalence and severity of COVID-19-related AEFI amongst healthcare workers at tertiary health facilities in Nigeria. MATERIALS AND METHODS: This descriptive, cross-sectional study was conducted among healthcare workers who had received the COVID-19 vaccine. A multi-stage sampling technique was used to select participants from six Tertiary Health Facilities in Nigeria. Ethical approval (NHREC/01/01/2007-19/07/2021) was obtained from NHREC. Data were analysed using IBM® SPSS version 25 and categorical variables were presented in tables/charts using frequencies and proportions. RESULTS: A total of 2130 respondents participated in the study, with a mean age of 37.4 ± 9.1 years. Most of the respondents, 1674 (78.6%), had two doses of the vaccine, and the overall prevalence of AEFI was 813 (38.2%). Common among the AEFI reported following the administration of the first dose of the vaccine were fever 649 (30.5%) and pain at the injection site 644 (30.2%), while it was pain at the injection site 216 (10.1%) and fever 173 (8.1%) for second dose. The higher proportions of AEFI were mostly mild to moderate. CONCLUSION: The study observed a relatively low prevalence of AEFI, with the commonly reported ones being fever and injection site pain. It is crucial that countries continuously collect the data on AEFI and establish causality as a way to improve quality and guarantee vaccine safety.

Assessment of the implementation of respectful maternity care charter in North Central Nigeria (Federal Capital Territory and Kwara State): study protocol

Respectful Maternity Care (RMC) charter is one of the tools for ensuring quality of care in maternity services. Nigeria is a signatory to RMC charter; therefore, the charter is expected to be the standard of care. However, in Nigeria and other countries, reports of disrespectful maternity care abound; this discourages women from accessing facility-birth. Therefore, to improve the quality of care towards increase in uptake, it is expedient to assess the level of implementation of the RMC charter by key stakeholders for sustainability, impact and scale-up of charter-compliant maternity care in Nigeria. The study aims to assess the implementation of RMC charter in North-central Nigeria. The study is a mixed-method, cross-sectional study; the expected participants are key stakeholders in healthcare (Healthcare workers, Healthcare Administrators, Project Managers, Policy makers) in North-Central Nigeria (Federal Capital Territory and Kwara state). A multistage sampling technique would be used to enroll participants from 18 healthcare facilities (Primary, Private, Secondary and Tertiary) in rural and urban areas and Ministries of Health officials at local and state government levels. Expected outcomes: The study is expected to provide information on the current status of knowledge and implementation of the RMC charter in Nigeria. It would also identify the enablers and barriers to the implementation process and provide evidence for effective scale-up of the process in Nigeria. The outcomes will be widely disseminated to healthcare workers, health administrators and decision-makers in healthcare services through post-study meetings, conference presentations, journal publications and policy briefs for effective RMC charter implementation in Nigeria.

Coronavirus disease 2019 risk assessment of adults and geospatial mapping in selected communities of Southwest Nigeria.

Background: Coronavirus disease 2019 (COVID-19) remained a worldwide public health problem. Risk assessment and mapping can be deployed to assist in the control and management of disease outbreaks. Aim: The aim of this study was to conduct COVID-19 risk assessment and mapping in selected communities of Southwest Nigeria. Methods: This was a cross-sectional study of adults, 18 years and above, involving the use of multi-stage sampling. Data collection was done with a pre-tested, structured, interviewer-administered questionnaire. The Statistical Package for the Social Sciences version 23 and Environmental Systems Research Institute ArcGIS desktop version 10.5 were used for data analysis and spatial mapping, respectively. The threshold for statistical significance was set at P < 0.05. Results: The respondents' mean age was 40.6 ± 14.5 years. Self-reported vulnerability factors identified included hypertension, diabetes mellitus, working in hospital facility, cigarette smoking and age ≥60 years amongst others. About a quarter (20.2%) had a high risk of COVID-19 following risk quantification. The risk cuts across geographical locations and socio-economic status. Education was significantly associated with COVID-19 risk. The spatial interpolation map revealed that the farther a community was from the high-burden area, the lower the risk of COVID-19. Conclusion: There was a high prevalence of self-reported COVID-19 risk. Identified communities with COVID-19 high-risk burden in the risk mapping and those with stratified proximity to these areas need to be targeted by the government for a public health awareness campaign.

Caregiving in a tertiary health institution in North Central Nigeria: Support types and financial burden.

Background: Caregivers play an important role in informal patient management. Identification of the support types and the financial challenges faced by caregivers will provide information on strategies to ease this burden. This study aimed to describe the support types and financial burden amongst caregivers in a tertiary hospital in North Central Nigeria. Methods: This was a cross-sectional study conducted amongst caregivers of inpatients in a tertiary hospital in North Central Nigeria. Data were collected using a pre-tested interviewer-administered questionnaire and were analysed using the Statistical Package for the Social Sciences package version 23. Results were reported in frequencies and proportions and presented in prose, tables and charts. Results: A total of 400 caregivers were recruited. The mean age was 38.32 ± 12.82 years and most (66.0%) were females. Caregivers supported their patients by running errands (96.3%) and 85.3% reported caregiving as stressful. The reported errands were purchase of medications (92.3%), supply of non-medical needs (63.3%), submission of laboratory samples and collection of results (52.3%) and service payment (47.5%). About two-thirds (63.2%) reported loss of income while caregiving and about half (50.8%) provided financial support to the patients. Conclusion: This study suggests that majority of caregivers experience significant physical and financial burden while caregiving. This burden can be eased off by the simplification of payment and laboratory processes and employment of more staff to support patients admitted to the wards. The financial burden experienced by caregivers reinforces the need to encourage more Nigerians to enrol in a health insurance scheme.

Psychological and stigma profiles of HIV patients in a North-Central city of Nigeria.

Background: The World Health Organization defines health as a state of complete physical, mental, and social well-being and not merely the absence of infirmity and disease. Researchers and clinicians have mainly focused on health outcomes that are physically or laboratory measured. These, however, do not reflect how the affected individual feels and functions in daily life. This study assessed the psychological and stigma profiles of patients attending HIV clinics in a North-central State of Nigeria. Methods: The study design was descriptive cross-sectional. A total of 384 HIV-positive patients who were systematically recruited at 5 public service delivery sites in Ilorin, Kwara State, North-central Nigeria participated in the study. Data was analyzed using SPSS software version 20.0. Level of significance was pre-determined at P value < 0.05 at a confidence level of 95%. Results: Fifty-nine percent of respondents reported being anxious about their condition and 25.5% felt depressed. Eighty-six percent received adherence counselling and 82.3% received psychological care from support groups. In the psychological domain, majority (74.5%) of the respondents had high health-related quality of life (HRQoL). There was a statistically significant association between employment status and psychological domain of HRQoL. As regards stigma, majority experienced high stereotype stigma (73.7%) and 67.2% experienced high stigma as pertains disclosure. Conclusion: Health workers should promote psychological support of HIV patients, for example, in form of support groups and adherence counseling. Efforts by government and corporate bodies should be geared towards employment empowerment of PLWHA which may help improve quality of life.

Prevalence and determinants of stress of informal caregiving: A cross-sectional study among informal caregivers of hospitalised patients in a tertiary hospital in Nigeria.

BACKGROUND: Caring for patients in the hospital can cause a lot of stress for the caregivers, especially those who are involved with informal caregiving such as family members. Little is known in Nigeria on the stress of informal caregiving in the hospital environment. This study assessed the informal caregivers' stress level and their determinants in a tertiary hospital in Ilorin, Nigeria. METHODOLOGY: This was a hospital-based cross-sectional study. Between September and October 2019, using a simple random sampling method, data were collected from 400 informal caregivers of patients in University of Ilorin Teaching Hospital with interviewer-administered questionnaire which included socio-demographic characteristics, Caregivers Strain index (CSI) and caregivers' stress from institution and other factors index (CSIOI). Analysis was performed, and prevalence and determinants of stress of informal caregiving were presented using descriptive statistics and logistic regressions. P < 0.05 was considered statistically significant. RESULTS: The majority, 381 (95.2%) of the informal caregivers, reported great stress levels using CSI, while 227 (56.7%) experienced a great level of stress with the CSIOI. Predictors of caregiver stress were perception that staying around was stressful (odds ratio [OR] - 17.5, P < 0.001), felt their patients will not be well cared for if not around (OR - 6.1, P < 0.001), staying at the hospital for >30 days (OR - 2.6, P = 0.001). CONCLUSION: The informal caregivers experienced a great level of stress taking care of their patients on admission in the hospital. It is, therefore, expedient that issues surrounding the comfort of the informal caregivers as they care for their patients should be included in hospital policies.

Disclosure Pattern and Its Determinants among Patients Attending Anti-Retroviral Clinics in a North Central Capital City in Nigeria.

Background: It has been observed that contributory factors such as unprotected sexual intercourse and vertical transmission of HIV to the unborn child during childbirth still occur among women living with HIV.HIV status disclosure has also been found to lead to improved access to HIV prevention and treatment programmes. Methodology: The study was a descriptive cross sectional study using quantitative and qualitative data collection tools. Four hundred patients were recruited for the study and systematic sampling was used to select respondents at each treatment centre. Data was collected using a semi-structured interviewer administered questionnaire and a patient focus group discussion (FGD) guide. Results: The age of the respondents ranged from 20 to 70 years and 75.5% of the respondents were females. More than three-quarters of respondents (77%) had disclosed their status to their partners. Status disclosure to sexual partners was higher among respondents who were currently living with their partners (87.1%, p=<0.001). Conclusion: The study recommended that Government, partners and multilateral agencies needs to consider establishing empowerment schemes for women and men living with HIV to enable them live economic viable lives and avoid using economic means as a determinant of status disclosure.

What medicines do households keep in their cabinets? Understanding the possession and use of medicines at home and the role of health insurance in Nigeria.

BACKGROUND: Globally, the possession of medicines stored at home is increasing. However, little is known about the determinants of possessing medicines, their usage according to clinical purpose, which we term 'correct drug match', and the role of health insurance. METHODS: This study uses data from a 2013 survey evaluating a health insurance program in Kwara State, Nigeria, which upgraded health facilities and subsidized insurance premiums. The final dataset includes 1,090 households and 4,641 individuals. Multilevel mixed-effects logistic regressions were conducted at both the individual level and at the level of the medicines kept in respondents' homes to understand the determinants of medicine possession and correct drug match, respectively, and to investigate the effect of health insurance on both. RESULTS: A total of 9,266 medicines were classified with 61.2% correct match according to self-reported use, 11.9% incorrect match and 26.9% indeterminate. Most medicines (73.0%) were obtained from patent proprietary medicine vendors (PPMVs). At 36.6%, analgesics were the most common medicine held at home, while anti-malarial use had the highest correct match at 96.1%. Antihistamines, vitamins and minerals, expectorants, and antibiotics were most likely to have an incorrect match at respectively 35.8%, 33.6%, 31.9%, and 26.6%. Medicines were less likely to have a correct match when found with the uneducated and obtained from public facilities. Enrolment in the insurance program increased correct matches for specific medicines, notably antihypertensives and antibiotics (odds ratio: 25.15 and 3.60, respectively). CONCLUSION: Since PPMVs serve as both the most popular and better channel compared to the public sector to obtain medicines, we recommend that policymakers strengthen their focus on these vendors to educate communities on medicine types and their correct use. Health insurance programs that provide affordable access to improved-quality health facilities represent another important avenue for reducing the burden of incorrect drug use. This appears increasingly important in view of the global rise in antimicrobial resistance.