Maternal health services uptake and its determinants in public primary health care facilities in edo state, Nigeria.

AIMS AND OBJECTIVE: To assess the uptake of maternal health services; its determinants and the perception of users about these services. MATERIALS AND METHODS: A descriptive cross sectional study was carried out in Edo North Senatorial Zone of Nigeria. Respondents were selected using a multi- stage sampling technique. A structured, interviewer administered questionnaire was used to collect data from the respondents. The data were analysed using SPSS version 17. Binary logistic regression model was used to identify predictors of utilization of these services. RESULTS: A total of 342 respondents participated in the study; with 171(50%) from the sub-urban communities and the other half from the rural communities. The utilization of the ANC services was 79% and 81% for the sub-urban and rural communities respectively. As for delivery services, it varied from 60.2% to 81.3% for the sub-urban and rural communities respectively. Family planning services uptake was about the same for both types of communities; being 43.7% for the sub-urban communities and 44.4% for the rural communities. Educational status and type of community were significantly associated with delivery service utilization. The predictors of the antenatal services utilization included: educational status, cost per illness, self assessment of health, clean environment and sources of information on maternal care. Marital status, average income and type of community were the predictors of family planning services utilization. CONCLUSION: The utilization of maternal services was good; being higher than the national average with the exception of postnatal service, which was completely absent. The major determinants of utilization of maternal health services included educational status and the average monthly income of the respondents. Services were perceived by more than half of the respondents to be generally good. There is need for the provision of the minimum service components of maternal health care services especially postnatal service at the PHC facilities.

Sanitary conditions of food vending sites and food handling practices of street food vendors in Benin City, Nigeria: implication for food hygiene and safety.

OBJECTIVE: To determine the sanitary conditions of vending sites as well as food handling practices of street food vendors in Benin City, Nigeria. METHODOLOGY: A descriptive cross-sectional study was done using an observational checklist and researcher-administered questionnaire. 286 randomly selected vending units were surveyed, and their operators interviewed on their food handling practices. RESULTS: A higher proportion, 259 (90.5%), of the observed vending sites appeared clean. The following sanitary facilities were observed in and around the respective food premises of the respondents: waste bin, 124 (43.4%), refuse dumpsite, 41 (14.3%), wash hand basin, 201 (71.2%), hand towel, 210 (73.4%), and soap, 220 (76.9%). There were also the presence of flies 118, (41.3%), and the presence of rats/cockroaches, 7 (2.4%). Respondents with tertiary education, 5 (38.5%), vended foods in environment with good hygiene status compared to those with secondary, 45 (31.7%), and primary education, 33 (27.3%). There was no statistically significant association between educational status and the hygiene status of food premise (P = 0.362). CONCLUSION: This study showed that street food vending sites in Benin City were sanitary and that food vendors had good food handling practices.

PERCEPTION OF EPIDURAL ANALGESIA FOR LABOUR AMONG PREGNANT WOMEN IN A NIGERIAN TERTIARY HOSPITAL SETTING.

BACKGROUND: Epidural anaesthesia is the preferred technique and gold standard for labour analgesia. However this technique is poorly utilized in our setting .This study is therefore aimed to assess the perception of this technique for labour analgesia among pregnant women in a Nigerian tertiary hospital setting in order to suggest ways of improving the utilization of same. AIM & OBJECTIVES: To assess the knowledge and percerption of women regarding epidural analgesia for labour in the antenatal clinics. SETTING: University of Benin Teaching Hospital, Benin, Southsouth Nigeria. METHODS: A total of 420 women attending the antenatal clinics of the University of Benin Teaching Hospital in South-south Nigeria were interviewed using semi-structured researcher-administered questionnaires. Respondents' socio-demographic characteristics, knowledge of epidural analgesia and its acceptance were obtained, documented and analyzed. RESULTS: Four hundred and five (94.6%) out of 420 gave complete responses to the questions asked. A majority of the respondents 322(79.5%) were not aware of epidural analgesia. Of the 83(20.9%) who were aware, 22.9% knew it was used to relieve labour pain and 20(24.1%) had first knowledge about epidural analgesia from health workers. A majority of the respondents 310(76.5%) would accept epidural analgesia if offered to them. The level of education and previous labour experiences were statistically significantly associated with awareness and acceptance of epidural analgesia respectively (p = 0.000). CONCLUSION: This study has shown that there is poor awareness and acceptance of epidural analgesia in labour in this environment which would be greatly improved by public enlightenment and counselling during ante-natal visits.

Prevalence of urinary schistosomiasis among school children in a rural community in South-South, Nigeria.

BACKGROUND: Schistosomiasis is a major health problems in tropical Africa with school age children being most affected. The study aimed to assess the prevalence of the disease among primary and secondary school children in a rural community in Edo State. STUDY DESIGN: A cross sectional study was carried out in a rural community in Etsako West local government area of Edo state. Respondents included all primary and secondary school students in the community. A structured administered questionnaire and urine microscopy were used for data collection. RESULTS AND CONCLUSION: Twenty-four percent of subjects reported passing blood in urine out of which 10.9% had ever sought medical attention for the haematuria. The overall prevalence of urinary Schistosomiasis, as confirmed by the presence of eggs of Schistosoma haematobium was 10.7% with males being almost 3 times as many as the affected females; 32 (74.4%) versus 11(25.6%). Prevalence of microhaematuria was 4.96 %, and protenuria 7.94% . There is need for an urgent mapping of communities served by the infested stream, as well as enlightenment campaigns to educate the rural populace on the disease and it's complications.

Assessment of noise levels generated by music shops in an urban city in Nigeria.

OBJECTIVE: To assess the level of noise generated by music shops in an urban city in Nigeria. STUDY DESIGN: Cross-sectional, descriptive study. METHODOLOGY: The study involved music shops in three out of eight identified clusters of market areas in Benin City. A semi-structured, researcher-administered questionnaire was also used to collect data from music shop owners. Noise levels generated by speakers in the music shops were measured using a sound level meter, and blood pressure measurements were taken with a mercury sphygmomanometer. RESULTS: Of the 250 music shops studied, more than 90.0% generated noise levels >85 dB, and 54.8% had a continuous pattern of noise. Longer duration of working years was significantly associated with decreased hearing (P = 0.01), shouting when talking (P = 0.04) and high blood pressure (P = 0.003). The position of music dealers in relation to the speakers was significantly associated with shouting when talking (P = 0.000). A significant association was found between higher levels of noise and high blood pressure (P = 0.004). CONCLUSION: This study found very high levels of noise in music shops, which could be a source of occupational noise exposure among music dealers. Enlightenment campaigns on the hazards of exposure to loud noise and periodic audiometry examinations are recommended for this occupational group.

Food contamination in fast food restaurants in Benin City, Edo State, Nigeria: Implications for food hygiene and safety.

OBJECTIVE: To determine the prevalence of food contamination in the fast food restaurants operating in Benin City, Edo State, Nigeria. METHODS: Three hundred and fifty food handlers were selected by means of a systematic sampling method and interviewed using a semi-structured researcher-administered questionnaire. One hundred and sixty-eight samples of ready-to-eat food and 45 stool samples were collected and analysed in the laboratory for the presence of bacteria (excluding anaerobic bacteria). RESULTS: More than half of the respondents (n=184, 52.6%) had no training in food hygiene and safety. Only 149 (42.6%) respondents knew that micro-organisms can contaminate food. The prevalence of food contamination in the fast food restaurants was found to be 37.5%. Bacillus cereus and Staphylococcus aureus were the most commonly isolated bacteria, while salad, meat pie and fried rice were the most commonly contaminated foods. CONCLUSION: There is need for the relevant local authorities to ensure that the food sold to consumers in fast food restaurants is safe, wholesome and fit for human consumption in order to prevent outbreaks of food-borne illnesses. Also, there should be regular training/retraining and health education of these food handlers in all aspects of food hygiene and safety.

Knowledge and practice of food hygiene and safety among food handlers in fast food restaurants in Benin City, Edo State.

OBJECTIVE: To assess the knowledge and practice of food hygiene and safety among food handlers in fast food restaurants in Benin City, Edo State. METHODOLOGY: A descriptive cross-sectional study was carried out among 350 respondents who were selected by means of a systematic sampling method and interviewed using a semi-structured researcher-administered questionnaire. An observational checklist was thereafter used to inspect their personal hygiene status. RESULTS: The mean age of the food handlers was 26.4 +/- 6.1 years. Two hundred and twenty eight (65.1%) were females while 34.9% were males. A majority (98%) of the respondents had formal education. There was good knowledge and practice of food hygiene and safety among the respondents. Knowledge was significantly influenced by previous training in food hygiene and safety (p = 0.002). Food handlers who had worked for longer years in the fast food restaurants had better practice of food hygiene and safety (p = 0.036). The level of education of respondents did not significantly influenced their practice of food hygiene and safety (p = 0.084). Although, 299 (85.4%) food handlers were generally clean, skin lesions was seen in 4 (7.3%) of them. CONCLUSION: This study showed good knowledge and practice of food hygiene and safety by food handlers in the fast food restaurants in Benin City, but there is need for improvement through training and retraining of food handlers by the management of the restaurants and the local government authorities.

Awareness and perception of maternal mortality among women in a semi-urban community in the Niger Delta of Nigeria.

BACKGROUND: Maternal mortality rates are very high in Nigeria. Increased level of awareness and perception will reduce maternal mortality rates. OBJECTIVE: The study was aimed at assessing the awareness and perception of maternal mortality among women in the reproductive age group at Ogunu community in Warri South Local Government Area of Delta State. METHODOLOGY: This was a descriptive cross-sectional study that was carried out in Ogunu town in Delta State. A simple random sampling technique was used to select 400 women, who gave consent to be enrolled in the study. They were assisted in filling a semi-structured questionnaire containing questions on awareness and perception of maternal mortality among women in the community. Information generated was recorded on a data collection sheet designed for the study. The coded data were fed into the computer using the SPSS program to determine the mean values and frequencies. RESULTS: A total of 400 questionnaires were distributed; of these, 349 were completely filled and returned. The mean age of the study subjects was 31.6 +/- 7.7 years. Among these subjects, 54.7% were married, while 32.7%, 28.7% and 26.5% had tertiary, secondary and primary education, respectively. The study revealed that 96.3% of the subjects felt that death can occur from pregnancy-related problems, while 69.1% were aware of maternal mortality. Majority of the subjects agreed that one or more forms of delay could be responsible for their death. This study shows that a good proportion of subjects was aware of maternal mortality and also had a good perception of it. CONCLUSION: Efforts should be directed towards educating women about the risk of delivering in homes of traditional birth attendants, maternity homes and health centers, and the concept of early referral of women to the hospital should be reinforced. Providing information to women on prevention of maternal mortality and community participation and mobilization will help prevent maternal mortality to some extent in Nigeria.

Health effects of night shift duty on nurses in a university teaching hospital in Benin City, Nigeria.

OBJECTIVE: This study is aimed at identifying the effects of night shift duty on the health and wellbeing of nurses in order to make recommendations on ways of ameliorating them. METHODS: The study was ofa cross sectional descriptive type using a total sample of nurses in the hospital. Data collection was by means of a semi-structured self-administered questionnaire and the analysis by the computer Programme for Epidemiologists (PEPI). RESULTS: The response rate was 79.3% with a total of 211 (68.1%) having one or more health complaints, which included muscle ache and pains (58.7%), frequent headaches (21.9%), lack of concentration (21.3%) and a negative effect on social life (66.1%). The younger nurses disliked night shift more than the older ones (2 = 57.5, df=6, p = 0.000) and 57.7% felt they were less productive during night shift. The shorter the period of sleep after the night shift, the lesser the level of productivity and the more the manifestation of health symptoms (2 = 45.5, df = 4, p = 0.000 and 2 = 29.0, df = 2, p = 0.000 respectively). CONCLUSION: Night shift duty caused both medical and psychological problems on the nurses. There is a need for medical surveillance, educational programme and the application of sleep hygiene techniques for shift working nurses.

Self-reported absenteeism among hospital workers in benin city, Nigeria.

SUMMARY BACKGROUND: Absenteeism is a major cause of loss in jobs, man-hours, productivity, and lives in the health sector. It also has grave consequences for global economies. OBJECTIVE: To determine the overall absenteeism rate and the factors that conduces to absenteeism among hospital workers. DESIGN: Cross sectional descriptive type. SETTING AND PARTICIPANTS: The entire staff in the hospital was enlisted in the study and data were collected through self-administered and semi-structured questionnaire. RESULTS: Fifty three percent of the 474 respondents reported at least one absence spell in the year. Absenteeism was highest among domestic staff (70.8%) and lowest among the doctors (46.9%). The average number of spells per absentee per year was 1.7 and the average duration of spells was 4.1 days while the incapacity rate was 7.2 days. The overall absenteeism rate was 1.7%. Absenteeism was significantly associated with increasing age (p=0.000), gender, [females

Knowledge of malaria and the practices towards its control among urban dwellers in Benin City.

OBJECTIVE: To determine the knowledge of malaria and its control methods among urban dwellers in Benin City, Edo State with a view to making recommendations on its prevention. METHODS: The study was of a cross-sectional descriptive type, using multi-stage sampling technique. Semi-structured questionnaires were researcher-administered and data analysed by means of the Computer Programme for Epidemiologic Research (CPER). RESULTS: The indices of the knowledge of malaria were generally high. 92.5% had correct knowledge about the symptoms, 98.0% its mode of transmission, all the respondents knew at least one method of its preventive measures and 87.0% knew about therapy with chloroquine and other drugs. There was however, poor knowledge of the new artemisinin-based combination therapy (10.6%) and the Roll Back Malaria Initiative (31.5%). In spite of the positive findings on the knowledge, the practice of preventive measures were poor with only 27.8% using door and window nettings, 0.8% using insecticide treated mosquito nets and 25.6% using insecticides. CONCLUSION: Despite the availability of extensive sources of health information, there is the need for appropriate health education to stimulate positive changes in both knowledge and practice of malaria control. In addition, the campaign to " Roll Back Malaria" requires intensification.

Environmental sanitation in an urban community in benin city, edo state.

OBJECTIVES: To assess the sanitary conditions in an urban community in Benin City, Edo State. METHODS: A cross-sectional descriptive study using multi-staged sampling method. Data collection was by means semi-structured researcher-administered questionnaires. Intervention in the form of health education was carried out among the respondents on various environmental sanitation issues. Data was analysed using the Computer Programme for Epidemiologists (PEPI). RESULTS: A majority 213(50.4%) of the respondents obtained their water from private boreholes while 93(22.0%) obtained irregular pipe-borne water supplies from the public utility board, with only 160(37.8%) having adequate supplies and 291(68.8%) not using any form of water purification methods. 321(75.8%) of the respondents used the water closet for sewage disposal though these toilets were not flushed after every use in 70.7% of cases. The commonest methods of refuse disposal were open dumping (59.0%) and burning (26.4%). Indices of personal hygiene practices were high (average 87.8%), though the proportions of respondents who used soap for hand washing were all lower than those of hand washing without soap. Vector and pest control were mainly by the use of mosquito nettings of doors and windows (30.4%) and fumigation (18.8%). CONCLUSION: The overall level of sanitation is unsatisfactory. There is therefore need for intensive and continued health education to address these deficiencies.

Prevalence of byssinosis and other respiratory problems among textile mill workers in Asaba, Nigeria.

OBJECTIVES: This study was conducted to determine the distribution and severity of byssinosis and other respiratory problems in the different operation sections in a textile mill industry in Asaba. PATIENTS AND METHODS: This is a cross-sectional and analytic study in which workers directly exposed to cotton dust are compared with those not directly exposed to cotton dust at one point in time. RESULTS: A total of 735 workers were interviewed and 437 workers had respiratory examinations carried out on them. Byssinosis was diagnosed in 8 out of 405 workers (prevalence of 1.98%) who were not directly exposed to cotton dust, and 21 out of 330 workers (prevalence of 6.36%) who were directly exposed to cotton dust. The difference was found to be statistically significant (chi2 =9.25; df=1; 0.01

Job satisfaction and psychological health of doctors at the University of Benin Teaching Hospital.

BACKGROUND: Studies on job satisfaction and health have mainly been carried out among Caucasian populations. Similar studies are lacking in Nigeria. AIM: To investigate the level of job satisfaction and its relationship to psychological disorder amongst Nigerian doctors. METHODS: All 190 doctors at the University of Benin Teaching Hospital were invited to participate in a cross-sectional study. The respondents completed two self-administered questionnaires, a specifically designed (25-item) questionnaire and a standard instrument--the General Health Questionnaire (GHQ 28). RESULTS: One hundred and fifty-two doctors responded, giving a response rate of 80%. Twenty-one (14%) doctors had a GHQ score of 4 and above, and were at increased likelihood of having a psychological disorder. Fifty-four per cent were either very dissatisfied or dissatisfied with their jobs, while 30% were very satisfied or satisfied with their jobs. The proportion of doctors with GHQ scores of 4 or above increased with the level of dissatisfaction although this was not statistically significant. The crude odds ratio of psychological disorder (GHQ score 4 and above) in dissatisfied respondents compared to satisfied respondents was 2.2 (95% confidence interval = 0.6-8.4). The odds ratio remained non-significant after controlling for the presence of adolescent children, stress outside work and length of service. CONCLUSION: This study showed a high rate of job dissatisfaction among Nigerian doctors compared to their European and North American counterparts. The reason for this is not altogether obvious. Further research is needed to determine the causes of job dissatisfaction amongst Nigerian doctors.

Assessment of health of senior executives in a developing country.

In a study of 202 senior executives, aged 25-64 y, in Benin City, Nigeria, the prevalence rate of hypertension was found to be 34.7%. Blood pressures increased with age for both sexes; however, the men had higher mean systolic and diastolic blood pressure and body mass indices (BMI) than the females. Contributing to this was a high level of inactivity, and diets high in carbohydrate and fat. High-risk social behaviour such as smoking and alcohol consumption was observed. It is recommended that management of the companies concerned put programs into place to assist this group of their workers to maintain a good health status, which will, in turn, improve their productivity.

Drug use profile in a Nigerian city hospital.

The newly introduced WHO Drug Use Indicators enable the delineation of drug use patterns, identification of inappropriate use and evaluation of interventional strategies. This study highlights the drug use pattern in a city hospital and further identifies areas of inappropriate use that need to be addressed. Records of 614 patient encounters (January-December 1993) were obtained by systematic random sampling at the Central Hospital, Benin City. The WHO prescribing indicators were calculated and detailed review in various therapeutic categories was carried out. The average number of drugs per encounter was 3.7. The percentage of encounters with injection and antibiotics were 37.0% and 54.2% respectively. Forty-eight per cent of drugs were prescribed by generic name and 94.4% of all prescribed products were in the National Essential Drug List. Drugs were not prescribed in 2.8% of encounters. Of injections, 74.1% were for treatment of febrile illness, usually presumed to be malaria. Analgesics/antipyretics, mainly paracetamol, were prescribed in 72.3% of encounters. In 57.8% of encounters vitamin preparations were prescribed. Certain differences were observed between children and adults with children receiving more vitamins and antimalarials. These findings suggest some inappropriate use of drugs which may in turn reflect current practice throughout Nigeria. Proper case management of febrile illness is likely to promote more rational use of drugs.

Occupational health services in manufacturing industries in Nigeria.

The provision of adequate health care facilities to cater for the health of workers is an important consideration in the management of manufacturing industries, since productivity is dependent on the health status of the workers. There are very few studies evaluating the health care provision in Nigerian industries. This study elucidates such health care services in Edo and Delta States of Nigeria. One hundred and thirty-five (56%) of the 241 registered manufacturing industries in Edo and Delta States of Nigeria were randomly selected and investigated. The response rate was 91.1% and the result showed that the medical staff comprised 2.5% of the total workforce, with the large scale industries contributing the highest proportion of these. Four point five per cent of the medical staff had formal training in occupational health and 15.6% of them visited the factory shop floor. The doctor:staff ratio in the medium and large scale industries were 1:819 and 1:618 respectively. It was found that all the industries used the health care facilities provided by the government, there were no clinics in all the small scale industries and group practice was not used by any of the industries studied. Pre-employment medical examinations were carried out in each of the groups of industries (100%, 39.4% and 5%) respectively, as were periodic medical examinations during employment, although to a lesser extent (100%, 13.2%, 0%) for the large, medium and small scale industries respectively. These finding suggest the availability of a reasonable standard of health care provision for large scale industries and somewhat less availability for medium and small scale industries. Health education of both the employers of labour, and the employees and the enforcement of existing laws are needed to improve the existing standard of occupational health services.

Schistosoma haematobium in rural school children in Nigeria.

A survey of Schistosoma haematobium infection was carried out in 722 rural school children in Emu, Edo State of Nigeria. The ages of the children ranged from 5-19 years with those between the age-group 10-14 years constituting the highest percentage 317 (43.9%). There were more males 383 (53.0%) than females 339 (47.0%) in the study population. Urine analysis of these children showed that 254 (35.2%) of them were excreting Schistosoma haematobium ova and of these 196 (27.2%) had haematuria. The prevalence of the disease was highest in the younger children with 43.1% for haematuria and 55.3% for S. haematobium ova among the age-group 5-9 years. The corresponding figures were 21.4% and 24.7% for age-group 10-14 years and 14.9% and 27.7% for 15-19 years old children. The sex-specific prevalences of haematuria and Schistosoma haematobium ova were higher for females than for the males.