A.U. Oronsaye

Adolescent induced abortion in Benin City, Nigeria

Induced adolescent abortion is a major cause of maternal and gynecologic death in the University of Benin Teaching Hospital, where 244 out of 349 such cases seen from January 1, 1974 to December 31, 1979 were reviewed. Ignorance and lack of contraceptive facilities were contributory factors. To deal with this problem that has been pervasive throughout Nigeria for the past decade, the authors advocate sex education, systematic dissemination of information for planned and conscientious parenthood as well as free availability of alternative methods of contraception. Interruption of early pregnancy should be an essential component of a national family planning program.

Emergency loan funds to improve access to obstetric care in Ekpoma, Nigeria

Preliminary studies: Focus group discussions in the community identified difficulties in paying for transport as a major barrier to seeking and reaching emergency care for obstetric complications. Interventions: After emergency obstetric services in local health facilities had been upgraded, the clans in Ekpoma were mobilized in 1995 to set up emergency loan funds for women with complications. Funds were managed entirely by the clans, with ongoing monitoring and supervision by project staff. Two percent simple interest was charged. Results: Of the 13 clans contacted, 12 successfully launched loan funds. Total donations amounted to US

Abortion-related morbidity and mortality in Benin City Nigeria: 1973-1985.

793, of which four‐fifths were contributed by the community. In the 1st year of the operation, 456 women/families requested loans (ranging from US

Attitudes toward abortion and contraception among Nigerian secondary school girls

7 to US

Pregnancy among schoolgirls in Nigeria

15), and 380 (83%) were granted. Three‐hundred and fifty‐four (93%) loans were repaid in full. In addition to being used for transport, loans were used to help pay for drugs, blood and hospital fees. Costs: The cost of establishing the loan fund was US

Improving obstetric care at the district hospital, Ekpoma, Nigeria

1360, including initial donations to the loan funds. The PMM project paid 55% of the total. Conclusions: With relatively little outside financial input, communities can set up and administer loan funds for emergency obstetric transport and care. However, sustaining the funds over the long term requires continuing effort and involvement with the communities.

The challenges of vaginal atresia and stenosis: Nigerian experience

In a 13‐year review of maternal deaths at the University of Benin Teaching Hospital, Benin City, abortion was one of the three major causes of death, accounting for 37 (22.4%) out of the 165 deaths. Induced abortion was responsible for 34 (91.9%) of these deaths. The usual victim is the teenage, inexperienced school girl who has no ready access to contraceptive practice. Death was mainly due to sepsis (including tetanus), hemorrhage and trauma to vital organs, complications directly attributable to faulty techniques by unskilled abortion providers, a by‐product of the present restrictive abortion laws. Total overhaul of maternal child health services and the family health education system, as well as integration of planned parenthood at primary health care level into the health care delivery system, are suggested. Contraceptive practice should be made available to all categories of women at risk, and the cost subsidised by governmental and institutional bodies. Where unwanted pregnancies occur, the authors advocate termination in appropriate health institutions where lethal and sometimes fatal complications are unlikely to occur. In effect, from the results of this study and a review of studies on abortion deaths in Nigeria and other developing countries, it is obvious that a revision of abortion laws as they operate, notably in the African continent, is overdue.

The outcome of pregnancies subsequent to induced and spontaneous abortion.

A study of the attitudes of school girls in Benin City, Nigeria, toward abortion and contraception was carried out in three of the citys postprimary schools, using a uniform multiple‐choice questionnaire. The findings show that although a significant proportion of the school girls had resorted to abortion to solve their problem of unwanted pregnancy, liberalized abortion law was only favored by a minority (approx. 30%). Also, although this indicated a high rate of sexual activity, their knowledge and practice of contraception and contraceptive methods is deficient and prejudiced. The latter findings may be responsible for the high rate of abortion among school girls in Nigeria.

Emergency loan funds to improve access to obstetric care in Ekpoma, Nigeria. The Benin PMM Team.

A study was made of 127 cases of schoolgirls with pregnancy‐related problems who were admitted into three of the major hospitals in Benin City, Nigeria, over a 10‐month period. The findings suggest that schoolgirl pregnancy in Benin City is found chiefly among teenage girls during the early years of secondary school. Lack of experience in family life and knowledge about contraceptive methods, coupled with poor parental control, are the major factors that put the young adolescent at risk of unwanted pregnancy. School drop‐out and complications of illegally induced abortion are the most frequent and worst consequences of schoolgirl pregnancies. The provision of formal education on family life and effective and easily accessible family planning methods for the adolescent population are suggested as a means to reduce the rate of schoolgirl pregnancy.

Maternal mortality at the University of Benin Teaching Hospital Benin City, Nigeria.

Preliminary studies: Facility reviews and focus group discussions revealed several factors at the district hospital contributing to maternal deaths in Ekpoma District, Nigeria. Interventions: In response, the necessary equipment for the operating theater, labor suite and laboratory were repaired or purchased. A blood bank and standby generator were repaired. Drugs and consumable material were purchased and a revolving fund established. Refresher courses were held for medical officers, nursing staff and laboratory technicians. At a later stage, community interventions focused on improving access and reducing delay in seeking care. Results: The number of cesarean sections performed increased from zero in 1990–1991 to between seven and 13/year in the period 1992–1995. The number of women with major obstetric complications seen at the hospital increased from seven in 1990 (5% of obstetric admissions) to a high of 29 (20% of obstetric admissions) in 1993. These gains were not sustained, however. In 1995, only 12 women with complications (9% of obstetric admissions) were seen. Costs: The cost of improvements was approximately US