Comparative study of sexual health knowledge and practices among sexually active adolescent girls in co-educational and girls-only secondary school in Calabar, Nigeria.

Introduction: there is little or no progress towards the attainment of sexual and reproductive health (SRH) targets of the Sustainable Development Goals (SDGs) in many developing country settings. Key SRH gap in these settings includes suboptimal knowledge-based safe sexual practices, especially among adolescent girls as a vulnerable subpopulation. Unique features of school environmental settings including gender segregation have not been harnessed for cost-effective sexual health education, perhaps due to the current paucity of literature. This study was aimed at comparing sexual health knowledge and practices, between sexually active adolescent girls in co-educational and girl-only secondary schools in Calabar, Nigeria. Methods: cross-sectional comparative study design was used. Sexually active adolescent girls were randomly recruited from co-educational and girl-only secondary schools in Calabar, Nigeria. Validated questionnaire developed by the United Nations Educational Scientific and Cultural Organization (UNESCO), was used to assess sexual health knowledge and behavioral practice. Factors associated with a satisfactory level of knowledge were assessed using the Chi-square test. Data analysis was done using SPSS version 24.0, with the p-value set at 0.05. Ethical approval was obtained before data collection. Results: one hundred and twenty respondents were studied, comprising an equal proportion of sixty (60) in co-educational and girl-only schools. Mean age and age at sexual debut were 16.4 ± 1.8 and 14.3 ± 2.2 years, respectively. Compared with group 1 (co-education), respondents in group 2 (girl-only) had significantly higher mean knowledge scores (26.1 vs. 30.4, p<0.05). Fifty respondents (41.7%) had a satisfactory level of knowledge of sexual health. There was no significant difference in mean practice scores comparing groups 1 and 2 (20.4 vs. 21.5, p>0.05). Internet use, unmarried parental status, and not living with both parents, were associated with unsatisfactory levels of knowledge on sexual health. Conclusion: compared with co-educational schools, girl-only schools have better sexual health knowledge, but a similar level of behavioral practices. There is a need for improvement in sexual health education efforts among adolescent girls, perhaps with more focus on coed schools, within the context of potential inherent disadvantage in the school environmental setting.

Potential barriers to and facilitators of civil society organization engagement in increasing immunization coverage in Odukpani Local Government Area of Cross River State, Nigeria: an implementation research.

BACKGROUND: Civil society organizations (CSOs) are important in health care delivery. They have the potential to play significant roles in immunization-related services, such as advocacy, health education, demand creation and resource mobilization. Their roles are often indispensable, diverse and beneficial in reducing infant morbidity and mortality due to vaccine-preventable diseases. This study explored the potential barriers to and facilitators of CSO engagement in increasing immunization coverage in Odukpani Local Government Area of Cross River State, Nigeria. METHODS: The study adopted qualitative data collection methods. Twenty-two focus group discussion (FGD) sessions, three in-depth interviews (IDIs) and 26 key informant interviews (KIIs) were conducted. Appropriate guides (FGD guide, IDI guide and KII guide) were used to conduct face-to-face interviews and the discussions. The FGDs, KIIs and IDIs were audio-recorded and transcribed. A framework analysis approach involving five key stages of analysis (familiarization with data, identification of thematic framework, indexing, charting, mapping/interpretation) was used for data analyses and presentation. RESULTS: CSOs encounter barriers in the course of their immunization advocacy, communication and social mobilization due to male child preference, leading to shielding of male children and not allowing them to be given immunization, as well as patriarchy, safety concerns, religious concerns, anti-vaccine misinformation and rumours, low perception of effectiveness and efficacy of vaccines, inaccessibility of localities, low health literacy and superstitious beliefs. Various community structures, such as the institution of the village head, elders' council and town crier (announcer), and the existence of change agents, act as facilitators of immunization advocacy and uptake. Factors such as traditional control mechanisms including masquerades and religion act as either barriers or facilitators depending on the community and the mode of deployment. CSO members are willing to overcome these barriers and leverage the facilitators. CONCLUSIONS: For successful engagement in immunization-related services, there are barriers in the study area that CSOs should overcome, such as male child preference and geographic inaccessibility, as well as facilitators that they should leverage such as traditional information dissemination systems and enforcement of compliance by the chiefs and elders' council.

Reported self-management of hypertension among adult hypertensive patients in a developing country: a cross-sectional study in a Nigerian tertiary hospital.

BACKGROUND: Sustained control of blood pressure, is dependent on degree of self-management, which includes self-integration, self-regulation, self-monitoring and adherence to regimen. We assessed the pattern of self-management of hypertension among adult hypertensive patients in a developing country. METHODS: Cross-sectional study design and convenience sampling, was used to recruit adult hypertensive patients, attending Lagos State University Teaching Hospital, Lagos, Nigeria. Interviewer-administered questionnaire was used to obtain data on self-management components. SPSS version 21.0 was used to analyze data, with p-value set at 0.05. RESULT: One hundred and seven (107) respondents, had mean age of 49.0 ± 12.0 years. Mean value for self-management was 3.15 ± 0.55, comprising self-integration (3.06 ± 0.36), self-regulation (3.32 ± 0.63), self-monitoring (3.29 ± 0.84) and adherence to regimen (3.15 ± 0.55). Most components of self-management, had high levels of mean score. Respondents that were less than 40 years, compared with those that were more than 40 years, had greater mean values for self-integration (3.37 vs 3.05), but significantly lesser values for all other components (p < 0.05). CONCLUSION: Young hypertensives had poor levels of most components of self-management. There is urgent need for health educational programs on self-management of hypertension among young people in sub-Saharan Africa.

Knowledge and practice of COVID-19 prevention among community health workers in rural Cross River State, Nigeria: implications for disease control in Africa.

INTRODUCTION: in developing countries, community health workers (CHWs) are essential, for provision of behaviour change communication towards prevention of coronavirus 2019 (COVID-19) infection at rural grassroots level. We aimed at assessing their level of knowledge and practice of preventive measures in a developing country setting. METHODS: total enumeration of all CHWs in a rural local government area in southern Nigeria was carried out, using cross-sectional descriptive study design. Pretested self-administered 15-item questionnaire was used to assess knowledge of COVID-19 including basic epidemiology, virology, preventive measures and use of personal protective equipment (PPE). Practice of preventive measures was also assessed. Each correct response to knowledge question contributed one unit to the total score which was converted to percentage. Total knowledge score of 50% or greater was considered satisfactory. RESULTS: complete data was obtained from eighty-six (86) respondents with mean age of 36.3±8.9 years (18-54 years). Mean total knowledge score was 28.14±12.8% (6.7 to 53.3%), and 9.3% (n=8) had score of at least 50%. Correct responses to appropriate sequence of putting on and removing personal protective equipment (PPE) were 5.8% (n=5) and 8.1% (n=7), respectively. Regular practice of use of face masks, goggles, gloves, and hand hygiene was found to be 50% (n=43), 12.8% (n=11), 30.2% (n=26), and 56.4% (n=48), respectively. CONCLUSION: community health workers are grossly underprepared for provision of health education on COVID-19, due to their poor level of knowledge. Their capacity building through workshops and effective continuing education program are urgently needed.

Is evidence-based medicine a mirage in resource-constrained settings? A survey among resident doctors in selected teaching hospitals in Nigeria.

AIM: The study aimed to assess the self-rated knowledge, attitude toward, and practice (KAP) of evidence-based medicine (EBM) among resident doctors in Nigeria. METHODS: This was a cross-sectional web-based survey among 238 resident doctors in four selected teaching hospitals in southern Nigeria. Survey questionnaire contained items assessing the KAP of EBM, familiarity with and understanding of key EBM terms, the use of EBM in decision making, barriers militating against EBM and ways to improve EBM adoption. Proportions and summary statistics were reported for the distribution of survey items. RESULTS: Mean number of years in clinical practice was 9.3 ± 4.5 years. Respondents were uniformly distributed in major clinical specialties. The majority (70.5%) were senior registrars. Respondents' understanding of EBM components included; current best clinical evidence (98.3%), clinical expertise (65.5%), and patients' choices (36.6%). Self-rated familiarity with EBM terms was high while perceived understanding of the terms was lower. The least understood concept was heterogeneity (20.6%). The attitude toward EBM was generally positive. Only about half (53.6%) had used medical bibliographic databases within the last 6 months prior to the survey. Barriers against EBM included lack of time (47.1%) and lack of requisite skills (32.4%). Suggestions to improve EBM adoption included training (58.1%), provision of free Wi-Fi, and free access to bibliographic databases (25.2%) and increased political will (23.1%). CONCLUSION: A further understanding of the EBM concept, provision of enabling infrastructure, regular clinical audit and advocacy to hospital management and clinical consultants, may improve the level of adoption of EBM.