Hadiza S. Galadanci

Maternal health in Northern Nigeria- : a far cry from ideal

Objective  To determine the level of maternal care in Northern Nigeria.

Cervical cancer risk perception and predictors of human papilloma virus vaccine acceptance among female university students in northern Nigeria

Cancer of the cervix is the most common cancer and the leading cause of cancer mortality among women in sub-Saharan Africa. Although a vaccine against human papilloma virus (HPV) is now available, its acceptance among vulnerable women in developing countries islargely unexplored. We studied cervical cancer awareness and HPV vaccine acceptance among 375 female university students in northern Nigeria. A total of 133 participants knew of HPV (35.5%), 202 (53.9%) had heard of cervical carcinoma and 277 (74.0%) were willing to accept HPV vaccination. After adjusting for potential confounders, age (adjusted odds ratio (AOR) = 2.3, 95% confidence interval (CI), 1.47–6.53); medical education (AOR = 3.4, 95% CI, 1.74–6.93); HPV knowledge (AOR = 1.8, 95% CI, 1.38–5.41) and awareness of cervical cancer (AOR = 2.3, 95% CI, 1.52–5.06) were significant predictors of readiness to accept HPV vaccine. Public health education and appropriate communication strategies should be implemented in advance of large scale vaccine introduction to increase awareness and prevent misconceptions about the HPV vaccine.

Obstetric quality assurance to reduce maternal and fetal mortality in Kano and Kaduna State hospitals in Nigeria.

To achieve Millennium Development Goals 4 and 5 in Nigeria, a quality assurance project in obstetrics in 10 hospitals in northern Nigeria was established to improve maternal and fetal outcome.

Sexual and Reproductive Health Communication Between Mothers and Their Adolescent Daughters in Northern Nigeria

We employed structured interviews and focus groups to investigate reproductive health (RH) communication practices among 184 mother–daughter pairs in Ungogo, northern Nigeria. Transcripts were analyzed using the grounded theory approach. A total of 136 mothers reported discussing RH issues with their daughters. The majority of daughters acquired RH education from their mothers. Parents were more likely to discuss marriage, menstruation, courtship, premarital sex, and sexually transmitted infections (STIs) than other sex education topics. Mothers in northern Nigeria need to be empowered with knowledge and skills to improve the scope and quality of home-based RH education.

Prevalence and Risk Factors for Domestic Violence Among Pregnant Women in Northern Nigeria

Many women experience domestic violence during pregnancy. The magnitude and risk factors for domestic violence during pregnancy are not well documented in many countries, including Nigeria. Using interviewer- administered questionnaires the authors investigated predictors of domestic violence during current pregnancy among women presenting for antenatal care at a tertiary care facility in northern Nigeria (n = 400). A total of 29 of 392 respondents (7.4%) experienced domestic violence during the current pregnancy. Of those who experienced violence, the majority (58.6%) reported being physically assaulted. Sexual violence was reported by only 4 respondents (13.8%). Financial and domestic issues were the major triggers of domestic violence. After adjusting for potential confounders, it was found that victims’ educational attainment and occupation remained significant predictors of domestic violence. Higher educational attainment of women and their engagement in economic activity outside the home were associated with a decreased risk for domestic violence. There is a need for preventive, protective, and redress mechanisms to guard against domestic violence in Nigeria.

Postpartum beliefs and practices in Danbare village, Northern Nigeria

Summary Postpartum cultural beliefs and practices are widely prevalent in northern Nigeria. Using a cross-sectional survey, we set out to examine contemporary postpartum beliefs and practices among a cohort of 300 mothers in Danbare village, northern Nigeria. Common postpartum practices included sexual abstinence (100%), physical confinement (88%), hot ritual baths (86%), nursing in heated rooms (84%) and ingestion of gruel enriched with local salt (83%). The majority of mothers (93%) believed that these practices made them stronger and helped them regain their physiologic state. Most respondents believed that non-observance could lead to body swelling, foul-smelling lochia and perineal pain. Mothers with formal education were significantly more likely to believe that these practices were non-beneficial compared with those mothers without formal education (odds ratio (OR) = 9.9, 95% confidence interval (CI) = 3.6 – 28.8). Almost half of the respondents (49%) said they would continue with these practices. In conclusion, women are still holding on to postpartum cultural beliefs and practices in northern Nigeria. However, educated women could act as useful agents of change towards the elimination of practices harmful to the health of mothers and their children.

Pregnancy outcomes in women with sickle-cell disease in low and high income countries: a systematic review and meta-analysis

Pregnancy in women with sickle‐cell disease (SCD) is associated with increased adverse outcomes. Findings on the association between SCD and adverse pregnancy outcomes are conflicting, and the results do not address whether these associations are similar in both low‐ and high‐income countries.

Phenotypes of intimate partner violence among women experiencing infertility in Kano, Northwest Nigeria.

To determine the prevalence of and risk factors for intimate partner violence (IPV) among women attending a large urban fertility clinic in Kano, Nigeria.

Adherence to intermittent preventive treatment for malaria in pregnancy in urban Kano, northern Nigeria

Abstract Malaria in pregnancy is associated with substantial risk of maternal and fetal morbidity and mortality. The uptake of preventive antimalarials is low in malaria endemic countries, including Nigeria. Using a cross-sectional study design, we assessed factors associated with uptake and adherence to intermittent preventive treatment for malaria in pregnancy (IPTp) among antenatal attendees in primary health centers in Kano, northern Nigeria (n = 239). A total of 137 respondents (57·3%) reported receiving preventive antimalarials, but only 88 respondents (36·8%) [95% confidence interval (CI): 30·7–43·3%] reported ingesting pills in the clinic under supervision. Factors associated with adherence to IPTp after adjustment for potential confounding included: advanced maternal age [adjusted odds ratio (AOR) (95%CI) = 2·1 (1·3–6·37)], higher educational attainment [AOR (95%CI) = 3·2 (1·32–6·72)], higher parity [AOR (95%CI) = 1·6 (1·07–3·94)], lower gestational age at booking [AOR (95% CI) = 1·72 (1·24–3·91)], and use of insecticide-treated nets [AOR (95%CI) = 2·03 (1·13–3·26)]. There is a need for strengthening health systems and addressing cultural factors that impede efforts at expanding coverage of malaria prevention strategies in Nigeria.

Menstrual Patterns and Gynecologic Morbidity among University Students in Kano, Nigeria

OBJECTIVE To examine menstrual patterns and effects of menstrual disorders on social and academic lives of undergraduate students in Kano, Nigeria. PARTICIPANTS Students attending Bayero University Kano, Nigeria (n = 383). INTERVENTION Self-administered questionnaires. MAIN OUTCOME MEASURES Sociodemographic characteristics, menstrual patterns, and associated symptoms were elicited. Treatment-seeking behavior and effects of symptoms on academic and social activities were ascertained. RESULTS The mean age at menarche was 13.7 ± 1.68 years. Menstrual bleeding lasted an average of 5.2 ± 1.6 days. Cycle length was 21-35 days in 92% of cases (n = 353). Approximately 72% of respondents reported dysmenorrhea. After adjusting for confounding, age at menarche, menstrual cycle length, duration of menstrual bleeding and use of contraceptive pills remained significant predictors of dysmenorrhea. Menstrual disorders interfered with social and academic life of 91% and 84% of respondents respectively. CONCLUSIONS Gynecologic morbidity related to menstruation is common among adolescent Nigerians and is associated with detrimental effects on academic and social activities. Student health services should prioritize measures to mitigate the social and physical impact of menstrual disorders in young women.