E. O. Orji

Prevalence and determinants of contraceptive practice in a defined Nigerian population

This study investigates the prevalence and determinants of contraceptive practice in Ile-Ife, Nigeria. A prospective study of 500 rural women in the reproductive age group was conducted between April to June 1999 in the Igboya health district of Ife central local government area of Osun State. A comprehensive contraceptive promotion and distribution had been carried out in this area by the University Teaching Hospital, the State Ministry of Health and many non-governmental organisations in the past 10 years. It is therefore expected that the contraceptive awareness and use in this environment would be high. Unfortunately, although all the respondents (100%) were aware of contraception and 78% were sexually active, only 18·8% used contraception. A majority of the non-users gave no reasons for failure to use contraception. Among reasons given by others include fear of side effects, no need for contraception, not married, religion, need for more children and student status. The most common contraceptive method among users was intrauterine contraceptive device followed by pills, condoms and injectable contraceptives. Factors which were significantly associated with utilisation of contraception were availability of family planning services, parity, knowledge of contraception and child spacing ( P < 0·05). Religion, literacy level, attitudes of family planning providers and distance to family planning services were not found to be significant ( P > 0·05). Recommendations that will improve wide contraceptive usage are preferred.

Occupational health hazards among health care workers in an obstetrics and gynaecology unit of a Nigerian teaching hospital

The occupational health hazards among health-care workers in an obstetrics and gynaecology unit were investigated. A total of 78 pretested questionnaires were administered to the doctors, nurses and ward orderlies in the unit of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. The common occupational health hazards were work-related stress (83·3%), needle-stick injuries (75·6%), bloodstains on skin (73·1%), sleep disturbance (42·3%), skin reactions (37·2%) assault from patients (24·3%) and hepatitis (8·9%). Nearly half of the staff used diazepam, lexotan or alcohol to cope with the stress of work. A greater percentage of doctors compared to nurses and ward orderlies used safety precautions such as gloves, facemasks and aprons. All the staff employed regular handwashing after various procedures. However no category of staff adopted regularly proper disposal of needles and sharps into separate puncture-resistant containers. About 59% of the staff recap used needles. The implications of the findings were discussed and recommendations made appropriately.

Sexual behaviour and contraceptive use among secondary school students in Ilesha South West Nigeria

Data from several parts of Nigeria point to increasing sexual activity among single adolescents of both sexes with progressive decreasing age at initiation and poor contraceptive use. This paper investigates the sexual behaviour and contraceptive use among teenage secondary school students in Ilesha, southwest Nigeria. This is a cross-sectional population survey of 300 male and female secondary school students within the age group of 13 – 19 years. The setting is secondary school coaching classes in Ilesha, southwest Nigeria. The outcome measures include prevalence of sexual activity, age at first sexual debut, circumstances leading to first sexual debut, number of sexual partners and family planning use. The result shows that out of the 300 studied, 50% were sexually active, the predominant age at first coitus was 15 – 19 years, and circumstances leading to sexual debut included mutual agreement, coercion and curiosity. Predominant proportion of sexually active teenagers (86.7%) did not use contraception at the time of first coitus and most of them had more than one sexual partner. The conclusion from this study is that 50% of teenage secondary school girls in this part of Nigeria are sexually active; 68.7% whom, have multiple sexual partners, and 86.7% of them did not use contraception at sexual debut. This unsafe sexual behaviour therefore put them at a great risk of acquiring STDs including HIV infection, and unwanted pregnancy. This study therefore recommends sex education/family life education for young people to encourage them to delay sexual activity as much as possible and practice safe sex when it eventually commences. There is also the need to sensitise the young people, parents, teachers, the community and all stake holders on the magnitude of the problem and to open up dialogue that will break the social, cultural and other mysteries hindering adolescents and youth reproductive health education and services in Nigeria.

Female genital mutilation: an analysis of 522 cases in South-Western Nigeria

This study was conducted at three teaching hospitals in South-Western Nigeria. Paturients were examined to find out if they had had female genital mutilation. Those who did were given a self-administered questionnaire. Results show that all the patients had either Type I (69%) or Type II (31%) mutilation (using WHO classification). The average age at which the procedure was performed was 6.9 ± 2.9 years, with 4% of women having the procedure performed in pregnancy. The majority of the procedures were performed by medically untrained personnel (89%). Up to 67% of the women reported complications following the procedure. Severe pain and bleeding were the most common (69%) of the complications reported. The most common reason given for the procedure is cultural/traditional (63%). About a fifth of the women want their female child to undergo female genital mutilation. This study highlights the need for further interventions aimed at discouraging the practice of female genital mutilation.

Evaluation of health workers' training in use of the partogram

To assess the impact of training on use of the partogram for labor monitoring among various categories of primary health care workers.

The role of men in family planning decision-making in rural and urban Nigeria

Objectives To determine the role of men in family planning decision-making in both rural and urban areas of Nigeria. Methods A total number of 370 married men (244 rural and 126 urban) were interviewed using a pre-tested, semi-structured interviewer based questionnaire. The study was conducted in the Iwaro community in Atakumosa West Local Government area (rural men) and the Oranfe Community in Ife East Local government area (urban men), both in Osun State, South West Nigeria. Results The results showed a high level of awareness of family planning among both study groups (98.3% rural and 98.4% urban). Most men in both groups believe that a decision about family planning should be made jointly by the spouses instead of being the prerogative of either. This contrasts with the generally held belief that men are opposed to family planning and a take predominant role in contraceptive decision-making. The condom was the most commonly known and used method with a preponderance among urban (81.1%) over rural men (69.4%). Many men would use family planning if their wives demanded it. However, most respondents in both study groups believed that men should not accompany their wives to the family planning centre to obtain contraceptive supplies and advice. Conclusion Deciding about contraception should be done jointly by men and women in South West Nigeria.

Infant feeding intentions and practices of HIV-positive mothers in southwestern Nigeria.

It has been shown that infant feeding pattern affects mother-to-child transmission of HIV. This study reports the infant feeding practices of HIV-positive mothers in southwestern Nigeria. J Hum Lact. 24(3):303-310. Este estudio investigó factores que determinan las intenciones de alimentación infantil y las prácticas verdaderas de 104 mujeres embarazadas infectadas con el VIH en el suroeste de Nigeria desde Enero del 2004 a Junio del 2006. Ellas recibieron conserjería como se recomienda en las directrices de alimentación infantil de la OMS y seguimiento mensual durante 6 meses postparto. Entre ellas, 71 (68.3%) y 33 (31.7%) planeaban lactancia materna exclusiva (LME) y alimentación de reemplazo exclusiva (ARE) respectivamente. Las madres con compañeros que sabían que eran VIH positivos, que habían revelado su estado de VIH a sus familiares/ amigos, y que tenían historia de un hijo muerto planearon ARE. De 84 parejas madre-hijo que completaron el estudio, 9 (15.5%) y 13(50%) de aquellas que tenían la intención de LME y ARE respectivamente practicaron alimentación mixta (p = 0.001). Se concluyó que la mayoría de madres infectadas con VIH que recibieron conserjería basada en las recomendaciones de la OMS prefirieron LME. Las madres que habían revelado su estado de VIH, con historia de hijo muerto y con esposo que sabia que era VIH positivo practicaron mas la ARE.

Analysis of perinatal mortality in a Nigerian teaching hospital.

A 5-year retrospective analysis of perinatal mortality was carried out at Wesley Guild Hospital, Ilesa Nigeria between January 1996 and December 2000. The perinatal mortality rate during the study period was 77.03 per 1000 total births. There was a steady increase in rate over the study period. The most common cause of perinatal death was asphyxia (55.2%), immaturity (23.1%), and macerated stillbirth (18.3%). The high incidence of unbooked patients, multiple pregnancies and low birth weight babies are the main reasons for the high perinatal mortality rates in our environment. Education of the public on danger signs of prolonged labour and regular retraining of health personnel on intrapartum care in addition to upgrading neonatal facilities are important measures necessary to reduce the currently high perinatal mortality rate in Nigeria.

A prospective randomized clinical trial of urethral catheter removal following elective cesarean delivery

To compare immediate and 24‐hour postoperative removal of urethral catheters for elective cesarean delivery.

Brought-in maternal deaths in south-west Nigeria

Not all pregnant women who decide to seek care at a medical facility in Nigeria arrive in time to be treated. Some die while trying to get there. Data on such deaths are, however, scarce. In this study, conducted over a 5-year period (1995-99), when any pregnant woman was brought in dead into the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria, the relatives were interviewed immediately to discover the immediate and remote causes. Reasons given for late presentation include: inability to obtain transportation in time (41·7%), inability of the health-care staff to detect an obstetric emergency early enough and refer to an appropriate centre (33·3%), inability of the referring hospital to perform an emergency caesarean section (33·3%), fear of caesarean section (25%), unwillingness of drivers to travel by night (25%) and no money to pay for hospital costs (16·7%). Causes of death include eclampsia, ruptured uterus, severe postpartum haemorrhage, severe antepartum haemorrhage, sickle ...