Sociodemographic Correlates of Integrated Maternal, Newborn, and Child Health Services Utilization Among Childbearing Mothers in Nigeria.

Background Some social and demographic factors might limit the ability of childbearing mothers (CBMs) to use healthcare services for themselves and their children, thereby exposing them to maternal, infant, and child morbidity and mortality. This study aimed to investigate the sociodemographic correlates of the utilization of integrated maternal, newborn, and child health (IMNCH) services by CBMs in Benue State, Nigeria. Methodology A community-based, correlational survey study was conducted among a random sample of 1,200 CBMs. Face-to-face interviews were conducted using a pretested, structured questionnaire, the Integrated Maternal, Newborn, and Child Health Services Utilization Questionnaire (IMNCHSUQ), and study participants were chosen using a multistage sampling procedure. Of the IMNCHSUQ issued, only 896 copies had complete data, which were used for the analysis. The data collected were analyzed using SPSS version 25.0 (IBM Corp., Armonk, NY, USA). The data were evaluated using the mean, standard deviation, and point-biserial correlation, and the null hypotheses were tested using linear regression at the 0.05 level of significance. Results The majority of the CBMs were married (79.7%) and unemployed (66.0%) while the predominant age group was between 15 and 24 years (42.7%). CBMs had a high level of utilization of IMNCH services (x= 3.30, SD = 0.94). The sociodemographic factors studied had little or no influence on the utilization of IMNCH services among CBMs. The most significant demographic predictor was the place of residence. Marital status, educational level, parity, and age were also found to be significant predictors in a few services. Conclusions Uneven distribution of IMNCH centers may be a major cause of the failure of CBM's lack of utilization of IMNCH services, especially in rural settlements with sparse distribution of facilities.

Suicidal ideation and attempts among Nigerian undergraduates: Exploring the relationships with depression, hopelessness, perceived burdensomeness, and thwarted belongingness.

Objective: The study investigated the prevalence of suicidal behavior and its association with depression, hopelessness, perceived burdensomeness, and thwarted belongingness in a sample of undergraduates in Nigeria. Introduction: Suicide is a leading cause of death among young adults globally. However, information about suicidal ideation, attempts, and relationships with psychiatric factors, perceived burdensomeness, and thwarted belongingness is sparse in Nigeria. The study investigated the prevalence of suicidal ideation and attempts and associated factors in a sample of undergraduates in Nigeria. Methods: We collected data from a cross-sectional survey of 625 undergraduate students primarily recruited from universities, colleges of education, and polytechnics in Adamawa Central Senatorial Zone, Adamawa State, northeast Nigeria. The Suicidal Behaviors Questionnaire-Revised, the 15-item Interpersonal Needs Questionnaire, the 9-item Patient Health Questionnaire, and the 20-item version of the Beck Hopelessness Scale were administered to the participants. We used descriptive statistics and binary and multivariate logistic regressions for data analysis. Results: A total of 616 students with a mean age of 21.41 ± 4.72 years completed the study. The prevalence of suicidal behavior was 34.9% (215/616). Having a female sex (adjusted odds ratio [AOR] = 8.37, 95% confidence interval (CI): 2.06, 34.03), depression (AOR = 45.15, 95% CI: 0.95, 5.11), hopelessness (AOR = 20.10, 95% CI: 5.56, 72.41), and perceived burdensomeness (AOR = 89.15, 95% CI: 29.63, 268.30) were associated with suicidal ideation. In addition, being a female (AOR = 1.69, 95% CI = 1.02, 2.83), being a 200-level student (AOR = 3.41, 95% CI = 1.46, 7.96), and being a 300-level student (AOR = 0.28, 95% CI = 0.11, 0.74) were associated with suicidal attempt. Conclusion: The study's findings show that suicidal behaviors (ideations and attempts) are prevalent among undergraduate students in northeast Nigeria. The findings underline the need for the development of mental health services and early identification and intervention for at-risk young people in Nigeria.

Influence of Cultural Beliefs on the Utilization of Integrated Maternal, Newborn, and Child Health Services in Benue State, Nigeria.

Background The maternal mortality ratio in Nigeria is high at 576 per 100,000 live births. The health policy is in favor of health advocacy programs that promote the utilization of integrated maternal newborn and child health (IMNCH) services in local primary health centers by childbearing mothers. Cultural factors, however, have been shown to limit the widespread adoption of these services. The purpose of this study was to investigate the influence of cultural beliefs on the utilization of IMNCH services by child-bearing mothers (CBMs) in Benue state. Methods A community-based correlational survey research was conducted on a random sample of 1,200 CBMs. A multistage sampling technique was used to select the study participants and a pretested, structured questionnaire was used to collect data through face-to-face interviews. Only 896 copies of the distributed Integrated Maternal Newborn and Child Health Services Utilization Questionnaire (IMNCHSUQ) had complete information and were used for analysis. The collected data were managed and analyzed using SPSS version 25 (IBM Corp., Armonk, NY). Mean, standard deviation, and point-biserial correlation were used to answer the research questions while linear regression was used to test the null hypotheses at a 0.05 level of significance. Results The majority of the CBMs were married (79.7%) and unemployed (66.0%) while the predominant age group was between 15 and 24 years (42.7%). CBMs had a high level of utilization of IMNCH services (X ®=3.30, SD=0.94); there was a positive moderate relationship between IMNCH utilization and cultural factors (rbp=.43, ρ= 0.000). Results also suggest that cultural factors were significant predictors of IMNCH services utilization in Benue State, Nigeria. Conclusion Any health education program for maternal and child health in Benue State should take cognizance of the cultural values, beliefs, and norms of the people to sustain positive ones while discouraging values and norms detrimental to the health and well-being of CBMs and their children.

Psychological distress, burnout, and coping strategies among Nigerian primary school teachers: a school-based cross-sectional study.

BACKGROUND: The teaching profession is highly stressed job. A high level of stress is associated with poor health outcomes, such as burnout and psychological distress. Therefore, teachers' use of coping styles becomes imperative. However, relatively little is known about primary school teachers' psychological distress, burnout, coping strategies, and associated factors in Nigeria. The study investigated psychological distress, burnout, coping strategies among primary schools, and associated factors in Nigeria. METHODS: A total of 264 teachers aged 20-59 years participated in the study between May 2019 to October 2019. Questionnaires on psychological distress, burnout, coping strategies, and demographic profile form were used for data collection. Factors associated with psychological distress, burnout, and coping strategies were identified using t-test, univariate ANOVA, Pearson's correlation, Chi-square test, and hierarchical linear regression analysis. RESULTS: Of 264 participants enrolled for the study, 253 responded, giving a response rate of 95.8%. The prevalence of psychological distress and burnout was 69.9% (176/253) and 36.0% (91/253), respectively. Sex (ß = 0.158), a high level of emotional exhaustion (ß = 0.193) and reduced personal accomplishment (ß = 0.358), adoption of problem-focused strategies (ß = 0.904), and dysfunctional strategies (ß = 0.340) were positively associated with psychological distress. Age (ß = - 0.338), academic qualification (ß = - 0.210), and income level (ß = - 0.146) were inversely associated with psychological distress, which together explained 51.5% of the total variance. Psychological distress (ß = 0.275 vs. ß = 0.404) was significantly associated with emotional exhaustion (EE) and reduced personal accomplishment (PA) and explained 11.4 and 24.2% of the variance in EE and reduced PA, respectively. CONCLUSIONS: The high prevalence of psychological distress and burnout among teachers should receive urgent attention. Teachers' training curricula should include developing interpersonal skills, stress management abilities, and resilience to equip them for the job. Also, teacher training curricula should integrate mental health promotion interventions.

Adverse childhood experiences and psychological distress among higher education students in Southeast Nigeria: an institutional-based cross-sectional study.

BACKGROUND: Exposure to adverse childhood experiences (ACEs) constitutes public health problems linked to adverse mental outcomes such as psychological distress during adulthood. This study examines the prevalence of ACEs and psychological distress and explores the association between ACEs and psychological distress and demographic factors among young adults. METHODS: We conducted a cross-sectional study of 330 students from May 2018 to July 2018. The participants completed the Adverse Childhood Experiences International Questionnaire (ACE-IQ), Kessler Psychological Distress Scale (K10), and the sociodemographic profile scale. We used descriptive statistics to describe the prevalence of ACEs and psychological distress in our sample. After adjusting for the demographic covariates, ACEs' association with psychological distress was determined using binary and multivariate logistic regressions. RESULTS: A total of 203 students with a mean age of 20.76 ± 2.73 years completed the study. The total mean ACE score was 4.58 ± 1.59, and the total mean psychological distress score was 20.76 ± 6.31. Most of the participants (86.7%) experienced ACEs, 14.8% reported experiencing one ACE, 30.5% reported experiencing 2-3 ACEs, and 41.3% reported experiencing 4+ ACEs. Further, about 85% of the youth have experienced at least one form of sexual abuse during childhood, and females reported a higher number of ACEs than males. Sexual abuse (OR = 2.36; 95% CI: 2.36, 7.65), physical neglect (OR = 2.87; 95% CI: 1.57, 5.31), overall ACE exposure (OR = 6.66; 95% CI: 2.41, 18.42), having 1 ACE (OR = 4.40; 95% CI: 1.32, 14.70), having 2-3 ACEs (OR = 4.13; 95% CI: 1.39, 12.29), and having 4+ (OR = 11.67; 95% CI: 3.95, 34.45) were significantly associated with psychological distress. CONCLUSIONS: ACEs are prevalent among young adults and are associated with psychological distress in adulthood. Furthermore, parental factors are associated with ACEs and psychological distress. Thus, implementation of school, community-and facility-based routine mental health screening programs is essential for prompt identification, prevention, and treatment of youth with childhood adversities and poor mental health outcomes.

Workplace gender-based violence and associated factors among university women in Enugu, South-East Nigeria: an institutional-based cross-sectional study.

BACKGROUND: Exposure to workplace gender-based violence (GBV) can affect women's mental and physical health and work productivity in higher educational settings. Therefore, this study aimed to examine the prevalence of GBV (workplace incivility, bullying, sexual harassment), and associated factors among Nigerian university women. METHODS: The study was an institutional-based cross-sectional survey. The multi-stage sampling technique was used to select 339 female staff from public and private universities in Enugu, south-east Nigeria. Data was collected using the Workplace Incivility Scale (WIS), Modified Workplace Incivility Scale (MWIS), Negative Acts Questionnaire-Revised (NAQ-R), and Sexual Experiences Questionnaire (SEQ). Descriptive statistics, independent samples t-test, Pearson's Chi-square test, univariate ANOVA, bivariate, and multivariable logistic regression analyses were conducted at 0.05 level of significance. RESULTS: The prevalence of workplace incivility, bullying, and sexual harassment (SH) was 63.8%, 53.5%, and 40.5%. The 12-month experience of the supervisor, coworker, and instigated incivilities was 67.4%, 58.8%, and 52.8%, respectively. Also, 47.5% of the participants initiated personal bullying, 62.5% experienced work-related bullying, and 42.2% experienced physical bullying. The 12-month experience of gender harassment, unwanted sexual attention, and sexual coercion were 36.5%, 25.6%, and 26.6%, respectively. Being aged 35-49 years (AOR 0.15; 95% CI (0.06, 0.40), and ≥ 50 years (AOR 0.04; 95% CI (0.01, 0.14) were associated with workplace incivility among female staff. Having a temporary appointment (AOR 7.79, 95% CI (2.26, 26.91) and casual/contract employment status (AOR 29.93, 95% CI (4.57, 192.2) were reported to be associated with workplace bullying. Having a doctoral degree (AOR 3.57, 95% CI (1.24, 10.34), temporary appointment (AOR 91.26, 95% CI (14.27, 583.4) and casual/contract employment status (AOR 73.81, 95% CI (7.26, 750.78) were associated with workplace SH. CONCLUSIONS: The prevalence of GBV was high. There is an urgent need for workplace interventions to eliminate different forms of GBV and address associated factors to reduce the adverse mental, physical, and social health outcomes among university women.

Nonadherence to tuberculosis treatment and associated factors among patients using directly observed treatment short-course in north-west Nigeria: A cross-sectional study.

INTRODUCTION: Tuberculosis is a public health problem in Nigeria. One of the most effective ways of controlling tuberculosis is the directly observed treatment short-course. However, some factors influence tuberculosis patients' treatment nonadherence via directly observed treatment short-course. The study objective was to assess medication nonadherence and associated factors among tuberculosis patients in north-west Nigeria. METHODS: A cross-sectional study enrolled tuberculosis patients using directly observed treatment short-course in public health facilities in Kano and Kaduna States from January 2015 to June 2016. The sample selection was conducted via a multistage sampling procedure. Data were collected using tuberculosis patients' demographic and clinical characteristics forms, well-validated structured instruments, and medical records. SPSS version 20 was used for data analysis. Logistic and multivariable logistic regression analyses to determine factors of medication nonadherence (P < 0.05). RESULTS: Complete responses from 390 patients out of the 460 patients recruited for the study were used for data analyses. The mean age was 51.5 (standard deviation = ±13.8) years. The mean tuberculosis medication adherence questionnaire score was 4.35 ± 1.12. The prevalence of nonadherence to tuberculosis medication was 30.5%. Multivariable logistic regression analysis showed that having a monthly income between #100,000 and #199, 000 (adjusted odds ratio = 0.01; 95% confidence interval: 0.00-0.13), being widowed (adjusted odds ratio = 26.74, 95% confidence interval: 2.92-232.9), being married (adjusted odds ratio = 120.49, 95% confidence interval: 5.38-271.1), having a distance <5 km to directly observed treatment short-course center from home (adjusted odds ratio = 0.06, 95% confidence interval: 0.00-0.01), having a tuberculosis/HIV co-infection (adjusted odds ratio = 0.01, 95% confidence interval: 0.12-0.35), use of antiretroviral treatment and cotrimoxazole prophylaxis therapy medications (adjusted odds ratio = 24.9, 95% confidence interval: 19.6-304.3) were associated with tuberculosis medication nonadherence. CONCLUSION: Tuberculosis medication nonadherence was high among the patients. Thus, patient-specific adherence education, attenuation of potential factors for tuberculosis medication nonadherence, and continual resource support for tuberculosis patients are needed to improve treatment outcomes.

Prevalence of loneliness and association with depressive and anxiety symptoms among retirees in Northcentral Nigeria: a cross-sectional study.

BACKGROUND: Retirees face numerous challenges, including disassociation from persons in their social networks in Nigeria. Perceived social isolation or loneliness could impair the quality of life in old age, and lead to mental disorders. However, it is uncertain whether perceived loneliness has an independent association with depressive and anxiety symptoms and comorbid conditions in Nigerian retirees. Therefore, we aimed at examining the association between perceived loneliness, depressive and anxiety symptoms, including comorbid conditions among retirees in Northcentral Nigeria. METHODS: This community-based cross-sectional study enrolled retirees aged 60 years and above in different pension zones from February 2019 to August 2019. A two-stage sampling procedure was used to select the study participants. Data on perceived loneliness, depressive, and anxiety symptoms were collected using the 8-item University of California, Los Angeles Loneliness Scale (ULS-8), and the DASS 21-depression and anxiety subscales, respectively. We collected information on the demographic characteristics using a well-validated structured questionnaire. Descriptive statistics, binary and multivariable logistic regression were used to examine the independent associations between loneliness, depression, anxiety, and anxious depression. P-values below 0.05 were considered statistically significant. RESULTS: The mean age of participants was 71.3 (± 6.01) years, and 54.4% were men. The prevalence of loneliness, depression, anxiety, and anxious depression was 21.8, 52.0, 27.7, and 20.5%, respectively. Retirees with depression or anxiety symptoms perceived that they were lonelier than those without depression or anxiety. The multivariable logistic regression model showed that female gender (AOR 1.49; 95% CI (1.09, 2.00), having secondary education (AOR 2.24, 95% CI (1.40, 3.57) and having higher education (AOR 3.82, 95%CI (2.37, 6.16) were significantly associated with depression. Also, lonely retirees are 1.19 times (AOR 1.19; 95% CI (0.84, 1.69) more likely to be depressed compared to retirees that are not lonely, and the anxious depressed retirees are 314.58 times (AOR 314.58; 95% CI (508.05, 1941.70) more likely to be depressed than those without anxious depression. CONCLUSION: The prevalence of loneliness, depression, anxiety, and anxious depression were relatively high among the older retirees. Female gender and advanced age were significantly associated with perceived loneliness, depression and anxiety.

Effects of a health education intervention on hypertension-related knowledge, prevention and self-care practices in Nigerian retirees: a quasi-experimental study.

BACKGROUND: Education is vital to increasing knowledge, improving prevention and self-care practices for hypertension in older adults. This study aimed to determine the effectiveness of a health education intervention in improving hypertension (HT) knowledge, prevention and self-care practices among retirees in Enugu State, South-east, Nigeria. METHODS: In this quasi-experimental study, we enrolled 400 participants in Enugu and Nsukka cities in Enugu State, south-east Nigeria. Participants were assigned to the treatment and control groups. Participants in the intervention/treatment group (T-group) received the intervention provided by public health experts and nurses and participants in the control group (C-group) received health talk without the intervention. Data collected at baseline (before intervention), 16 weeks (4th month) and follow-up (5th month) included demographic variables, knowledge about hypertension, prevention and self-care practices. We used paired samples t-test, Chi-square test and one-way ANOVA repeated measures for data analyses. RESULTS: The mean age of the participants was 65.9 (± 8.9) years, the mean SBP and DBP were 136.5 (± 13.3) and 87.9 (± 9.1) respectively. More than half of the participants were (50.3%) were males, and the mean BMI was 23.9 (± 5.1) kg/m2. The paired comparison analysis showed that the mean HT knowledge score significantly increased in the T-group between baseline and 1 month (4th month) post-intervention compared to those in the C-group (P < 0.0001). Also, PA (P = 0.007), sleep pattern and quality (P = 0.003), substance use abstinence (P = 0.000), healthy diet (P = 0.000), and medication adherence (P = 0.000) improved significantly in the T-group compared to the control between baseline and 1 month after intervention. The repeated measures analyses showed statistically significant effects (between-groups analysis) for all outcomes with small to large effect sizes. Similarly, the repeated measures ANOVA analyses showed significant time-by-group interaction effects (within-groups) for all the outcomes with small to large effect sizes. CONCLUSION: Community-based health education intervention targeted at older adults can increase HT knowledge, improve prevention and self-care practices of hypertension at the population level.

Depressive and anxiety symptoms and associated factors among postnatal women in Enugu-North Senatorial District, South-East Nigeria: a cross-sectional study.

BACKGROUND: Postnatal depression (PND) and anxiety (PNA) among women are prevalent and impairing health problems, with adverse outcomes for mothers and their infants. This study assessed the prevalence of depression, anxiety and associated factors in a sample of postnatal women. METHOD: A community-based cross-sectional study was conducted on 270 postpartum women attending public health facilities in the study area. Postnatal depression was measured using the Edinburgh Postnatal Depression Scale (EPDS) and anxiety was measured using the Hospital Anxiety and Depression Scale (HADS-A). Data on maternal demographics, health characteristics, pregnancy-related characteristics, labor and birth characteristics, were collected via structured questionnaire. Binary Logistic and multinomial logistic regression analyses were carried out to identify the factors associated with depressive and anxiety symptoms in women. RESULTS: The EPDS identified 92 women (34.6%) as possibly depressed (using a cut-off ≥13) while the HADS-A identified 89 women (33.3%) with anxiety symptoms (using a cut-off + 8). A total of 69 women were identified with symptoms of anxiety and depression (anxious-depression). The multinomial regression analysis (MLA) showed that the history of depression (AOR = 0.12, 95% (CI 0.02, 0.76), and being a mother aged 15-29 years (AOR = 10.31, 95% (CI 1.13, 94.11) had a significant effect on the development of anxiety symptoms in women. Although not significant, mother's income level (AOR = 1.53, 95% (CI 0.72, 3.25), and being a younger mother (AOR = 1.06, 95% (CI 0.21, 5.26) were more likely to predict depressive symptoms in postnatal women. Attendance at postnatal care services in the PHCs (AOR = 0.14, 95% CI (0.04, 0.48) was significantly associated with anxious-depressed in the studied postnatal women. CONCLUSION: The findings of this study showed a direct association between depressive symptoms, anxiety and younger maternal age, rural residence, and low income. The higher prevalence of depressive and anxiety symptoms in this study is a call for postnatal care that is culturally sensitive, patient-centered, accessible and affordable by women, most importantly poor and rural women.