Erhabor Sunday Idemudia

Barriers to antenatal care use in Nigeria: evidences from non-users and implications for maternal health programming

BackgroundIn Nigeria, over one third of pregnant women do not attend Antenatal Care (ANC) service during pregnancy. This study evaluated barriers to the use of ANC services in Nigeria from the perspective of non-users.MethodsRecords of the 2199 (34.9%) respondents who did not use ANC among the 6299 women of childbearing age who had at least one child within five years preceding the 2012 National HIV/AIDS and Reproductive Health Survey (NARHS Plus II), were used for this analysis. The barriers reported for not visiting any ANC provider were assessed vis-à-vis respondents’ social demographic characteristics, using multiple response data analysis techniques and Pearson chi-square test at 5% significance level.ResultsOf the mothers who did not use ANC during five years preceding the survey, rural dwellers were the majority (82.5%) and 57.3% had no formal education. Most non-users (96.5%) were employed while 93.0% were currently married. North East with 51.5% was the geographical zone with highest number of non-users compared with 14.3% from the South East. Some respondents with higher education (2.0%) and also in the wealthiest quintiles (4.2%) did not use ANC. The reasons for non-use of ANC varied significantly with respondents’ wealth status, educational attainment, residence, geographical locations, age and marital status. Over half (56.4%) of the non-users reported having a problem with getting money to use ANC services while 44.1% claimed they did not attend ANC due to unavailability of transport facilities. The three leading problems: “getting money to go”, “Farness of ANC service providers” and “unavailability of transport” constituted 44.3% of all barriers. Elimination of these three problems could increase ANC coverage in Nigeria by over 15%.ConclusionNon-use of ANC was commonest among the poor, rural, currently married, less educated respondents from Northern Nigeria especially the North East zone. Affordability, availability and accessibility of ANC providers are the hurdles to ANC utilization in Nigeria. Addressing financial and other barriers to ANC use, quality improvement of ANC services to increase women’s satisfaction and utilization and ensuring maximal contacts among women, society, and ANC providers are surest ways to increasing ANC coverage in Nigeria.

Migration challenges among Zimbabwean refugees before, during and post arrival in South Africa

Abstract: Background: Zimbabweans are immigrating to South Africa with a commonly cited reason being economic opportunities. Prospects of finding employment may be a significant reason to leave behind family, friends, and community, sources that buffer and offer social support against life’s challenges. Currently, there is a dearth of research examining the motivators for Zimbabweans immigrating and the experiences encountered along the way and after arrival in South Africa. Such research is essential as large numbers of Zimbabweans may be at risk for emotional and physical trauma during this process. Methods: Two gender specific focus group discussions, each lasting 90-minutes and consisting of homeless Zimbabwean refugees, were conducted in the Limpopo Province of South Africa. A semi-structured interview assessed for experiences in and reasons for leaving Zimbabwe, as well as experiences en-route and within South Africa. Discussions were audio-recorded, transcribed, and analyzed using consensual qualitative research and a constant comparison qualitative method. Results: Three temporal themes were identified and included challenges and trauma experienced in Zimbabwe (pre-migration), during the immigration journey (mid-migration), and upon arrival in South Africa (post-migration). While there were some experiential differences, Zimbabwean men and women shared numerous traumatic commonalities. In addition to the themes, three subthemes contributing to reasons for leaving Zimbabwe, two subthemes of negative and traumatic experiences incurred mid-migration, and two post-migration subthemes of challenges were identified. Conclusions: Despite the difficulties encountered in their homeland, newly arrived Zimbabweans in South Africa may be exchanging old struggles for a new array of foreign and traumatic challenges. Reasons to immigrate and the psychological and physical toll of migration exacted at the individual and community levels are discussed. Recommendations advocating for culturally congruent mental health research, the training of culturally competent researchers and clinicians, and the development of policies that could influence the quality of life of Zimbabwean refugees are provided.

The role of social support in the relationship between mental health and posttraumatic stress disorder amongst orthopaedic patients

BACKGROUND Some life-event experiences such as injuries in car accidents, gun shots and the like, can be life changing and traumatic. OBJECTIVES The article investigated the relationship between mental health and posttraumatic stress disorder (PTSD) symptoms after orthopaedic trauma, and attempted to understand whether social support moderates the relationship between mental health and PTSD. METHOD A cross-sectional research model was used. Two hundred participants were selected using simple randomisation within a hospital complex in Gauteng, South Africa. The sample consisted of 110 men and 90 women (x̄=37.8 years, s.d.=12.9 years). Data were collected using the Revised Civilian Mississippi Scale for PTSD, the Multidimensional Scale of Perceived Social Support (MSPSS), and the General Health Questionnaire version 28. RESULTS The findings of the study indicated that there is a statistically significant relationship between mental health and PTSD after orthopaedic trauma, and a positive correlation between poor mental health and PTSD (r=0.52, n=200, p<0.05). However, perceived social support did not moderate mental health or PTSD, indicating that perceived social support did not significantly influence mental health or PTSD, (MSPSS B=0.07, p=0.66). Those with high scores on social support had a lower regression coefficient (B=0.19) for mental health and PTSD than those who reported low social support (B=0.26). CONCLUSION There is a significant relationship between mental health and PTSD of orthopaedic patients, and social support did not moderate the relationship between mental health and PTSD.

The role of stigmas in mental health: A comparative study

BACKGROUND HIV (Human immunodeficiency Virus), AIDS and cancer are feared terminal diseases. HIV sufferers are known to be stigmatized. The stigma surrounding cancer, unfortunately, is hardly the focus of psychological investigations, and hence this provoked the need to compare the stigma suffered by both groups, and how these have impacted on the psychological functioning of the disease sufferer. OBJECTIVES The study had two main objectives, firstly, to explore whether HIV patients suffer more stigma than cancer patients or not, and secondly, to understand the most common type of stigma and if stigma is associated with psychopathology. Psychopathology is measured with GHQ-28 which evaluates somatic complaints, anxiety, depression and social dysfunction. METHOD The study was a survey, and descriptive in nature, and anchored on two hypotheses: Firstly, that HIV patients will experience more stigmas than cancer patients and consequently report more psychological dysfunctions. Secondly that there will be a significant difference between types of stigma and the symptoms reported about them. Data were collected from a conveniently sampled group of 50 HIV positive patients and another 50 patients diagnosed with cancer, in two clinics and a hospital around the Gauteng Province. The majority of the participants were females, numbering 62 (62, 0%), whilst 38 (38.0%) were males. The age of the respondents ranged from 20-73 years with a mean age of 44.4 years (s.d. = 11.6). RESULTS Results revealed a significant main effect for enacted stigma F = (1.98), = 17.629, p < .001 and anxiety F = (1.98) = 5.750, p < .001. A post hoc Bonferroni also showed that HIV patients had a higher mean score of enacted stigma (X-bar = 4.22) than cancer patients (X-bar = 1.28) and also HIV patients reported more anxiety (X-bar = 8.81) than cancer patients (X-bar = 6.42). Enacted stigma significantly influenced the GHQ Total (F = (98) = 1.700, p < .05); anxiety (F = (97) = 2.578, p < .004); and depression (F = (97) = 3.390 p < .001). The perceived community stigma had one main effect for depression (F = (1.98) = 1.452, p < .05). There were no significant main effects for internally felt stigma and psychological dysfunctions. Both hypotheses were partially supported. CONCLUSION Recommendations included tailoring interventions to meet the cultural needs of patients. Other recommendations were made in accordance with the findings of the study.

Wealth and antenatal care utilization in Nigeria: Policy implications

ABSTRACT Antenatal care (ANC) utilization is lower in Nigeria than the African average. We investigated the relationship between wealth and utilization of ANC and also assessed other determinants associated with ANC utilization in Nigeria. Using data of the most recent births within 5 years prior to a 2012 nationally representative survey, we modeled predictors of ANC utilization. Respondents in the wealthiest quintile were over five times (aOR = 5.5 (95% CI: 4.2–7.2) more likely to adequately use ANC. The odds of ANC use were generally lower among the poor and the least educated women living in rural areas who need ANC the most.

Gender Differences in Trauma and Posttraumatic Stress Symptoms among Displaced Zimbabweans in South Africa

BACKGROUND Over the years, more than 3.4 million Zimbabweans (a quarter of the countrys population) have fled the country to other countries with South Africa as the main popular destination. In South Africa, they become a vulnerable group with the plausibility of suffering trauma and PTSS or PTSD due to xenophobic attacks and resentment. How males and females are impacted is undocumented in psychological literature, particularly with regards to Africa. In addition, global research on gender differences, trauma and PTSS/PTSD are inconclusive. This paper explores gender differences in PTSS among displaced Zimbabweans in South Africa. A poor mental health status, pre and post-migration traumas of men and women were hypothesized to have a relationship with PTSS for women, but not to the same extent for men. METHOD Through a guided purposive convenient sampling, in-depth interviews using questionnaires, data were obtained from a sample of 125 displaced and homeless Zimbabwean refugees in Polokwane, Limpopo Province, South Africa. Participants were assessed on demographic variables, pre- and post-migration difficulties checklists, mental health using the General Health Questionnaire (GHQ-28) and the PTSD Checklist (Civilian Version (PCL). RESULT The hypothesis of a gender difference in the predictability of PTSD was tested in structural equation models. For men none of the three paths (pre-migration stress, post-migration stress, and poor mental health) on PTSD is significant, whereas for women both the path from poor mental health onto PTSD (ß=.36, p=.013) are significant, but the size of the gender differences was modest. However, effect sizes are always larger for women than they are for men. CONCLUSION The findings help closing the gap in PTSS/PTSD research for Africans and suggest that indeed likely gender differences in the prediction of PTSS, suggested in the literature, needs further attention.

Value Orientations, Acculturative Stress and Mental Health Among African German Immigrants

This study describes the relationship between value orientations, acculturative stress, and wellbeing of African migrants in Germany. Concepts from culture learning theory are applied in the context of intercultural interaction. Data were collected from 85 African migrants (males=73.4, females=26.5%; age range =18–46 years recruited from several German metropolitan areas. The participants completed the MMPI-2, a stress checklist developed by the author and Schwartz Value Survey. Data were analyzed using hierarchical regression analysis and tested with structural equation modelling. Results showed that value preferences significantly influenced mental health: African migrants who cherish self-enhancement values (power and achievement values) experience a poorer mental health than their fellow migrants who place a lower value on the same attributes. Self-transcendence values related to good mental health. Openness values predicted higher perceived racism scores.

Burnout among paramilitary personnel in Nigeria: a perspective from Conservation of Resources Theory

The job demands–resources model attributed burnout to incompatibility between job demands and job resources, and underplayed the role of personal resources in employees’ adaptation. Based on the Conservation of Resources Theory, this study proposes the inclusion of personal resources as predictors of burnout. A cross-sectional survey design was employed to gather data from 256 paramilitary personnel in Nigeria. Participants’ ages ranged from 19 to 65 years (M = 35.03 years, standard deviation [SD] = 8.55 years). Data were collected using measures of emotional intelligence, self-efficacy, organization-based self-esteem, optimism, and burnout. Results confirmed the joint influence of psychological resources on burnout. Emotional intelligence, self-efficacy, organization-based self-esteem, optimism, and tenure were found to have a significant influence on burnout. The findings suggest that organizations should be able to minimize burnout among their employees by increasing their adaptive capacities through appropriate training and development workshops.

Examining the Influence Personality Factors on Knowledge Sharing Intention among Employees of Two Selected Banks

Abstract This study examined the influence of personality factors (that is, need for achievement, need for affiliation, and need for power) on knowledge sharing intention. A cross-sectional survey design was adopted while a total of 207 employees selected from two commercial banks in Nigeria using accidental sampling technique participated in the study. The participants were made of 113 (54.6%) males and 94 (45.4%) females. Their ages ranged between 26 and 47 years with a mean of 33.35 and standard deviation of 3.87. A structured questionnaire with three sections was used for data collection. Three hypotheses were tested using t-test of independent mean. The results showed that need for achievement [t (205) = 2.07, p < 0.05] and need for power [t (205) = 16.79, p < .001] significantly influenced knowledge sharing intention, while need for affiliation did not [t (205) = 1.05, p > 0.05]. These findings suggested the need for human resource personnel of various banks in Nigeria to design recruitment and selection strategies that can help them identify employees with high need for achievement and need for power; since they are more motivated to share their knowledge.

Cumulative Adversities and Mental Health of Employees in Workplace Settings in Gauteng Province, South Africa

Abstract The authors examined the relationship between cumulative adversities, exposure to violence and mental health of employees in workplace settings in Gauteng Province, South Africa. Five hundred participants were randomly selected from three hospitals. Age of participants ranged between 18-65 years. Males were 251 (50.2%) and females were 249 (49.8%). Mean age of employees was 33.8 years (SD= 11.03). Results of a multiple regression model showed that cumulative adversities (Family, childhood, personal) and exposure to violence (direct and indirect witnessing of violence in childhood) jointly and significantly predicted poor mental health of workers, R2 = 0.35, F (5, 440) = 47.49, p<.0001. The variables (CA FAM, CAPerAdv, CA ChildAdv, indirect exposure (CEDV1) and direct exposure (CEDV 2) explained 59% of the total variance on poor mental health. Of the variables, the main significant predictors of mental health were: CA PerAdv (b= .35, t(445) = 7.56, p < .01), CEDV1 (b = -.123, t (445) = -2.18, p< .05) and CEDV2 (b= .37, t (445= 6.25, p< .01). In addition, the Durbin- Watson result (1.58) is less than 2 and therefore shows that the assumption of independent error is met for this model. There were no significant results for Cumulative Childhood adversity (CA.ChildAdv), indirect exposure (CEDV1) and the four subscales of mental health-somatic complaints, anxiety, social dysfunctions and depression. Since ‘prevention is better than cure’, it is recommended among others that workplace programmes whi ch promote positive health should be implemented, the establishment of on-site wellness programmes.