Sexual and health behaviour of commercial sex workers in Benin City, Edo State, Nigeria.

In this paper, examined are the sexual and health behaviours of commercial sex workers in Nigeria, a high-risk group in this era of the acquired immune deficiency syndrome (AIDS) and human immunodeficiency virus (HIV) epidemic. The aim is to provide in-depth knowledge of their sexual networking and the prevalence rate of sexually transmitted diseases (STDs). This analysis is intended to highlight their implications in the spread and control of AIDS and HIV infection. The results of the study show the extensive sexual networking of these commercial sex workers, the health implications, and the utilisation of nonorthodox health services in diagnosing STDs. The implications of these results are the likely drain on the limited health resources of the Nigerian government and the harmful effects on the women, fetuses, children, and other sexual partners of clients of these commercial sex workers.

Assessment of health services for treatment of sexually transmitted infections among Nigerian adolescents.

BACKGROUND: The available evidence indicates that Nigerian adolescents use various health practitioners for the treatment of sexually transmitted diseases (STDs). However, the quality of the STD treatment used by adolescents has not been investigated previously. GOAL OF THIS STUDY: To investigate the quality of services provided by health practitioners for the treatment and prevention of STDs among adolescents in Benin City, Nigeria. STUDY DESIGN: In-depth interviews were conducted with 48 formal and informal sector health practitioners who were identified by key informants as being the main providers of STD treatment in the city. Their facilities were visited to evaluate the quality of services they provide for STD treatment. RESULTS: Health providers in the informal sector showed inadequate knowledge of the appropriate treatment methods for STDs. Although providers in the formal sector had better knowledge, they lacked appropriate management guidelines and were poorly oriented to the problems of STDs in adolescents. There was consensus among the health providers that adolescents most frequently use informal treatment for STDs. Nevertheless, among all providers, there was evidence of inadequate counseling of adolescents, a poor attitude toward the promotion of condom use, and inadequate use of referral opportunities. CONCLUSIONS: Comprehensive public health measures are needed to address these problems in Nigeria. These include the provision of reproductive health education for adolescents, the retraining of health providers, and the consolidation of services for the prevention and treatment of STDs.

Women's perceptions of the complications of pregnancy and childbirth in two Esan communities, Edo state, Nigeria.

The high prevalence of maternal mortality and its causes in the developing World have been well established. However, this information to a large extent is on institutional data. Establishment of the level and social context of maternal mortality through community-based studies are unavailable. Recent years have witnessed a new approach to providing an in-depth understanding of this problem through community-based studies involving a multi-disciplinary approach. Built into this approach is the use of classical anthropological methods including focus group discussions. Participants expressed their perceptions of maternal mortality in the focus groups. Issues such as alternative modes of treating complications in pregnancy or delivery are also discussed. This paper examines the complications and modes of treatment relating to pregnancy and delivery as perceived by Esan women. Focus group discussions generated data for analysis. The women identified miscarriage, separation of the placenta, haemorrhage, obstructed labour, and the retention of the placenta as complications experienced in pregnancy, labour or delivery. Of these complications, haemorrhage was the most severe and devastating because it kills easily owing to the amount of blood lost. However, two alternative modes of treatment, traditional and modern are in use, the most prevalent, cheapest, easier to obtain, and most trusted being the traditional mode of treatment. A reduction in maternal mortality requires a number of strategies. The most radical of these is the recommendation that both traditional and modern treatments need to complement one another in the same health institution to ensure the maximal effectiveness of both modes of treatment.

Child sexual abuse in Benin City, Edo State, Nigeria: a sociological analysis.

A study is presented of the reported cases of child rape in Benin City, the capital of Edo State in Nigeria. The conditions that make children, particularly females, more vulnerable to sexual abuse are explored. The organization of family life places children in a dependency cycle that makes rape both inevitable and invisible. Change that is responsive to family needs is more likely to have a positive effect in preventing child rape.

Sexual networking of market women in Benin City, Edo State, Nigeria.

The manifestation of acquired immune deficiency syndrome (AIDS) all over the world has increased the need for information on the nature and pattern of sexual networking in Africa, where there is a dearth of such information. In the present study, information on the sexual networking of market women in Benin City, Nigeria, was obtained using a questionnaire instrument. The questionnaire covered the sexual, reproductive, and health behaviors of these women. The data revealed that the levels of both premarital and extramarital sexual networking are high. Such a high degree of sexual networking has exposed a number of these women to sexually transmitted diseases. The manifestation of AIDS in this society will be widespread and devastating to the people and the society because these women are in a polygamous relationship in a society that frowns on the use of contraceptives by couples. In addition, controversies surround the correlation between socioeconomic status (SES) and AIDS, geographical areas of prevalence, and the role of prostitutes in the spread of the disease. For example, studies in Africa show that whereas there is no correlation between SES and AIDS in Kinshasa, the attack rate was higher in educated people in Rwanda and Zambia. Moreover, there are predominantly urban outbreaks in other countries, such as Uganda (Piot & Carael, 1988).

The socio-cultural context of health behaviour among Esan communities, Edo State, Nigeria.

This paper reports on health beliefs and their influence on treatment decisions and behaviour among the Esan people of mid-west Nigeria. The sources for the study are my own experience of growing up in Esan society, anthropological field work, and focus groups. The research revealed a transitional society where both traditional and modern medicine are employed and where the choice between them is determined by belief systems which are themselves in the process of change, as well as by distance and costs. The traditional health-belief system was one which placed most responsibility and blame upon women, and a system of social control over the adult female population. Changing health beliefs are less the result of the introduction of a new health philosophy than of the retreat, under the impact of Christianity, of traditional religion which embodied the older health philosophy.

PIP: An anthropological examination is made of the Esan population living in Ekpoma, Egoro-Haoko, OkhuEsan, and Ubiaja in Edo State, Nigeria, during 1988-89. The focus is on the Esan perception of illness, the Esan health behavior, and the treatment of illness. The sample areas are not densely populated due to migration to urban areas. Traditional or Christian religions are practiced. Piped water, good roads, and electricity are inadequate. Polygyny is widely practiced. The Esan people believe illness is caused by people or natural or supernatural forces. The most common illnesses among children are measles, convulsions, and headache, which are attributed to supernatural factors. Diarrhea, vomiting, malaria, smallpox, chicken pox, pneumonia, and tetanus are thought to be due to natural factors. Child mortality due to witchcraft is reduced through the taking of oaths at shrines. Christianity has helped to protect people from the power of witches and wizards. In traditional times, natural illnesses were attributed to poor sanitation, poor nutrition, and lack of good water. Presently, women believe that natural illnesses occur from environmental factors such as overgrown weeds or poor water drainage. Many health programs have improved the situation for prevention and treatment. Adult male illnesses are reported as back and waist pains, sugar disease, hemorrhoids, blindness, and sudden swelling of the body, legs, and knees. Blindness occurs due to supernatural forces caused by a lack of maintaining traditional customs, such as adultery of a wife. When a husband dies of a supernatural illness, the wife is frequently held accountable. Adult females report illnesses from pregnancy, childbirth, and postpartum. Miscarriage, hemorrhage, retention of the placenta, and obstructed labor are considered to be due to supernatural factors subsequent to such behaviors as having sex in the afternoon or in the fields. Traditional treatment is dispensed according to the type of illness and is mainly used by adults. Children are treated more quickly than adults. Cost and distance from health services affects use of modern medicine. Mixes of modern and traditional practices are common.

Circumcision: its nature and practice among some ethnic groups in southern Nigeria.

A questionnaire survey carried out in five rural communities in mid-southern Nigeria documents the degree and range of male and female circumcision practices among Bini, Esan, Etsako, Ijaw and Ukwuani ethnic groups. Two hundred and eighty adults (154 males and 126 females) reported on themselves and their 1417 children (757 sons and 660 daughters). Circumcision of both sexes remains widely practised, though the timing of the event and extent of surgery show wide variations among, and sometimes, within ethnic groups. The commonest reason for the practice is a strong desire to continue ethnic traditions. Altered sexual urge for women, increased sexual performance for men, protection of baby's health, as well as general reproductive and aesthetic consideration are also important reasons. Traditional surgeons usually perform the operation and few complications were reported to be associated with the procedure in either sex. Female circumcision in this area is not as destructive or mutilating as in some Arabic and East African cultures. Because of the relatively low rate of complications a major campaign against circumcision in these areas does not at present seem warranted.