Cc Ezechukwu

Breast-feeding, return of menses, sexual activity and contraceptive practices among mothers in the first six months of lactation in Onitsha, South Eastern Nigeria.

Summary The objective of this study was to determine the exclusive breast-feeding practices, return of menstruation, sexual activity and contraceptive practices among breast-feeding mothers in the first six months of lactation. The study was based in Onitsha, South Eastern Nigeria. A structured questionnaire was used to obtain data from breast-feeding mothers on their age, educational attainment, breast-feeding practices, return of menstruation, sexual activity and contraceptive practices within the first six months of lactation at intervals of 6 weeks, 10 weeks 14 weeks and 6 months post delivery. Analysis of the information obtained showed that out of the 178 mothers who participated in the study 81% of the mothers were within the ages of 20 – 34 years. While all the mothers had formal education, the majority (59%) had secondary education. Seventy-three percent initiated breast-feeding within one hour of delivery. On discharge from hospital, all of them had already established breast-feeding which continued up to six weeks and dropped to 97.8% at six months. Exclusive breast-feeding which was practised by 100% on discharge dropped to 3.9% at six months. The feeding regimen was on demand as practised by 98.9% of the mothers. Menstrual flow had returned in 33.8% of the mothers by 6 weeks of lactation, and had risen to 70.2% at six months. There was more prolonged lactational amenorrheoa in exclusively breast-feeding mothers than in those who were not. By 6 weeks post delivery 31.6% of the mothers had resumed sexual activity and this rose to 93.6% at six months. With the resumption of sexual activity only 5% of the mothers resorted to contraceptive practices other than lactational amenorrhea and this increased to 54% at six months. There was no pregnancy in any of these women during the six months period. While appreciating the role of lactational amenorrhea in child spacing and considering the early return of sexual activity among the mothers the practice of introducing contraceptive practices needs to be encouraged especially in women whose menstruation has returned.

Evaluation of the capacity of Pediatricians in Nigeria to conduct of research: A nationwide Survey.

Background Quality health care service delivery to children and adolescents is enhanced by continuous research into the health challenges of this subpopulation led by paediatricians with tremendous capacity to investigate and proffer solutions to the myriads of childhood illnesses. Understanding the health issues therefore is the foundation for implementation of viable interventions that assure optimum service delivery. In view of this background, the Paediatric Association of Nigeria (PAN) directed that research into children’s health challenges in Nigeria should be brought to the front burner in the country. Pursuant to this laudable goal this study was conceived to evaluate the research capacity and capability of paediatricians in Nigeria and the institutions they represent. In view of above needs, this study aimed at evaluating the research capacities and challenges among paediatricians. Methods The survey used a cross-sectional nationwide design to enroll paediatricians into the study. The study was a combination of both online and face-to-face survey using questionnaire developed from Research Capacity Assessment Framework. Information on previous research work, challenges encountered, existing capacity and utilization of research outcome were obtained. The SPSS version 20 was used for data entry and analysis. For qualitative variables, similar responses were grouped under thematic heading. Results The response rates for online (via email survey, group-administered in a conference and individual face-to-face (at workshops) were 32 (3.2%), 75 (13.6%) and 15 (60%) respectively. The majority, 87(85.5%) of the participants had conducted prevalence studies, compared to 9 (8.8%) that had done experimental studies. Those who have ever received grant funding for their studies were 21 (19.4%), while the proportion whose research outcome had informed policy update and practice were policy 20 (18.2%). More than 55% of the participants had challenges on some of the seven aspects of research: research topic, proposal, funding, fieldwork, analysis, utilizing findings and collaboration. Less than 40% of the participants had received training on some of the tested 14 research capacity areas except for the area of ethics where 78 (70.9%) reported having received training. For 51 (46.4%) this ethics training included the Good Clinical Practice Guidelines. Conclusion Nigerian Academic Paediatricians need to be stimulated to develop interest in research by building their presently low research capacity if future paediatric practice is to be driven significantly by evidence.