Kofoworola Odeyemi

Contraceptive prevalence among young women in Nigeria

Abstract In almost all societies in the world there is an increase in sexual activity among young persons (10 – 24 years). There is a need for contraceptive use among them to prevent high risk unintended pregnancies. This study was carried out to determine the contraceptive prevalence among young women in Nigeria. The study population was 832 young women between the ages of 15 and 24 years. Only 11.1% of the respondents had ever used contraceptives although 63.2% of them had had sexual intercourse. Contraceptive usage was significantly higher (p < 0.05) among the single sexually active women (38.5%) than among the married women (7.7%). Only 7.3% of respondents are currently using a contraceptive method. The main methods in use were condoms and pills. There is an unmet need for contraceptives among young women in Nigeria. It is necessary to improve these young womens abilities to protect themselves against unwanted pregnancies.

Sexual behavior and the influencing factors among out of school female adolescents in Mushin market, Lagos, Nigeria.

High rates of adolescent pregnancy, sexually transmitted infections, and unsafe abortions in Nigeria indicate the need for a greater understanding of factors that affect adolescent sexuality. The sexual health needs of adolescents remain poorly known and addressed particularly among vulnerable subpopulations like out-of-school adolescents. The objective of this study was to examine the sexual behavior of female out-of-school adolescents and to identify factors that influence their sexual behavior. This cross-sectional study was conducted among a representative sample of unmarried, out-of-school female adolescents (n = 332, mean age 17 y), selected using cluster sampling, who were working in a major market (Mushin) in Lagos, Nigeria. Data were collected using interviewer administered questionnaires. Many girls (43.7%) have had sexual intercourse. The mean age at initiation was 16 years. The main reason for initiation was curiosity. Risky sexual behavior and transactional sex was common. Nonconsensual sex was also reported. Sexual health knowledge was poor, and friends served as their main source of information on sexual health issues. Factors associated with the initiation of sexual activity were friends sexual behavior, the person adolescents reside with, parents marital status, availability of funds to meet basic needs, and watching pornography (p < .05). Out-of-school female adolescents engaging in risky sexual behavior are exposed to sexual abuse, lack skills to resist pressure, and have limited access to credible reproductive health information. Appropriate interventions including provision of sexuality education and a supportive environment must be instituted to address their needs.

Determinants of Smoking Initiation and Susceptibility to Future Smoking among School-Going Adolescents in Lagos State, Nigeria

BACKGROUND It is projected that low and middle-income countries will bear a major burden of tobacco related morbidity and mortality, yet, only limited information is available on the determinants of smoking initiation among youth in Africa. This study aimed to assess the determinants of smoking initiation and susceptibility to future smoking among a population of high school school students in Lagos, Nigeria. MATERIALS AND METHODS Baseline data from an intervention study designed to assess the effect of an anti-smoking awareness program on the knowledge, attitudes and practices of adolescents was analyzed. The survey was carried out in six randomly selected public and private secondary schools in local government areas in Lagos state, Nigeria. A total of 973 students completed self-administered questionnaires on smoking initiation, health related knowledge and attitudes towards smoking, susceptibility to future smoking and other factors associated with smoking. RESULTS Of the respondents, 9.7% had initiated smoking tobacco products with the predominant form being cigarettes (7.3%). Males (OR: 2.77, 95%CI: 1.65-4.66) and those with more pro-smoking attitudes (OR: 1.44, 95%CI: 1.34-1.54) were more likely to have initiated smoking. Those with parents and friends who are smokers were 3.47 (95%CI: 1.50-8.05) and 2.26 (95%CI: 1.27-4.01) times more likely to have initiated smoking. Non-smoking students, in privately owned schools (OR: 5.08), with friends who smoke (5.09), with lower knowledge (OR: 0.87) and more pro-smoking attitudes (OR 1.13) were more susceptible to future smoking. In addition, respondents who had been sent to purchase cigarettes by an older adult (OR: 3.68) were also more susceptible to future smoking. CONCLUSIONS Being male and having parents who smoke are predictors of smoking initiation among these students. Consistent with findings in other countries, peers not only influence smoking initiation but also influence smoking susceptibility among youth in this African setting. Prevention programs designed to reduce tobacco use among in-school youth should take these factors into consideration. In line with the recommendations of article 16 of the WHO FCTC, efforts to enforce the ban on the sales of cigarettes to minors should be also emphasised.

The use of the sisterhood method for estimating maternal mortality ratio in Lagos state, Nigeria

Summary Estimates of maternal mortality are crucial to inform the planning of reproductive health programmes and guide advocacy. The aim of this study was to obtain a population-based estimate of maternal mortality in Lagos State, Nigeria. The sisterhood method was used in 2008 to carry out the survey using a questionnaire in which respondents were asked about their sisters who died during pregnancy, childbirth or within 6 weeks after childbirth. The survey involved 4,315 respondents who provided information on 9,910 ever married sisters. The life-time likelihood (risk) of maternal death for women aged 15–49 years was found to be 0.0239 or 1 in 42. The estimated maternal mortality ratio was 450 per 100,000 live births with a 95% CI of 360 and 530. Out of 111 reported deaths, 35 (31.5%) occurred during pregnancy, 49 (44.1%) occurred during delivery and 27 (24.3%) within 6 weeks of delivery.

Causes of maternal mortality in Lagos State, Nigeria

Background: Maternal mortality remains a major problem in many parts of the world including Nigeria.Understanding the causes of maternal mortality is crucial in confronting the challenge of unyielding high rates. The aim of this study was to determine the direct and indirect causes of maternal mortality in Lagos State, Nigeria. Materials and Methods: The study is a descriptive cross-sectional survey. The study population consisted of adults residing in Lagos State, Nigeria. The sample size used for this study was 29,988. The respondents were selected by multistage sampling from all the local government areas in the state. Data were collected using a structured interviewer-administered questionnaire. Data entry, cleaning, validation and analysis were done using Statistical Package for Social Sciences version 15.0. Results: Among the 29,988 respondents, 306 (1.0%) gave a history of married sisters who died during pregnancy, childbirth or during the postpartum period. Of the 306, 138 (45.1%) died during pregnancy; 107 (34.9%) died during childbirth, and 61 (19.9%) died during the postpartum period. Abortion, ectopic pregnancies and hypertension were the most commonly mentioned cause of death during pregnancy, while anemia, prolonged labor and obstructed labor were the common causes during childbirth. Human immunodeficiency virus/acquired immunodeficiency syndrome , infection and malaria were the common causes of maternal death during the 6 weeks after end of pregnancy/childbirth. Conclusions and Recommendation: Over half of the maternal deaths in Lagos State occurred during labor and immediately postpartum. Community education on the importance of having skilled attendants at delivery must be provided. Emergency obstetric care should be available, accessible and affordable at health facilities, and efforts must be made to prevent unwanted pregnancies and unsafe abortions by increasing contraceptive use. The malaria control efforts should be intensified.

Comparative analysis of prevalence of intimate partner violence against women in military and civilian communities in Abuja, Nigeria.

Introduction Intimate partner violence (IPV) occurs across the world, in various cultures, and affects people across societies irrespective of economic status or gender. Most data on IPV before World Health Organization multicountry study (WHOMCS) usually came from sources other than the military. Result of this study will contribute to the existing body of knowledge and may serve as a baseline for future studies in military populations. This study compares the prevalence of the different types of IPV against women in military and civilian communities in Abuja, Nigeria. Methods Using a multistage sampling technique, 260 women who had intimate male partners were selected from military and civilian communities of Abuja. Collected data on personal characteristics and different types of IPV experienced were analyzed to demonstrate comparison of the association between the different forms of IPV and the respondents’ sociodemographic and partner characteristics in the two study populations using percentages and χ-square statistics, and P-value was assumed to be significant at ≤0.05. Results The prevalence of the four major types of IPV was higher among the military respondents than among civilians: controlling behavior, 37.1% versus 29.1%; emotional/psychological abuse, 42.4% versus 13.4%; physical abuse, 19.7% versus 5.9%, and sexual abuse, 9.2% versus 8.8%. Significantly more respondents from the military population (59 [45.4%]) compared to civilians (21 [19.4%]) were prevented by their partners from seeing their friends (P=0.000). The situation is reversed with regard to permission to seek health care for self, with civilians reporting a significantly higher prevalence (35 [32.4%]) than did military respondents (20 [15.4%]) (P=0.002). The military respondents were clearly at a higher risk of experiencing all the variants of emotional violence than the civilians (P=0.00). The commonest form of physical violence against women was “being slapped or having something thrown at them, that could hurt”, which was markedly higher in the military (43 [33.1%]) than in the civilian population (10 [9.3%]), (P<0.05). Conclusion IPV is a significant public health problem in Abuja, and the military population is clearly at a higher risk of experiencing all forms of IPV compared to the civilian population. The military should encourage and finance research on effect of military operations and posttraumatic stress disorders on family relationships with a view of developing evidence-based treatment models for military personnel.

Psychosocial burden of caregivers of children attending Sickle Cell Clinic, Lagos, Nigeria, 2014

Introduction : sickle Cell Disease (SCD) is the most common genetic disorder amongst the black people and one of the major chronic non-communicable diseases affecting children. Nigeria accounts for more than 100,000 new births annually. The impact on the family is worse in developing countries because of inadequate social welfare and poor access to health care services. Our objectives were to determine the knowledge and attitude of caregivers of children with SCD towards the disease and the associated psychosocial burden.

Sexual Violence Among Out-of-School Female Adolescents in Lagos, Nigeria

Sexual violence against females is a public health problem. This descriptive cross-sectional study sought to determine the prevalence of sexual violence among out-of-school female adolescents in Lagos, Nigeria and examine the context in which it occurs. Three hundred and fifty adolescents, between the ages of 10 and 19 years, working in Sandgrouse market, Lagos, were selected using cluster sampling. Data were collected using an interviewer-administered questionnaire. Almost half (42.9%) of the respondents have had sexual intercourse, and median age at initiation was 17 years. Forced initiation was reported by 15.8%, and 36.3% reported that first intercourse was due to coercion. Among the sexually active, only 12.3% stated that “it is what they desire.” Majority of respondents (64.1%) believe that rape is common in their community, and 18% of the sexually active have experienced rape. Out-of-school adolescents in this community are at risk of sexual violence. The factors that make them vulnerable need to be addressed.

Factors Determining Correct Case Management of Acute Respiratory Infections in Children by Primary Health care in Ibadan

Background: Inappropriate case management of Acute Respiratory Infections (ARIs) is one of the factors responsible for the high ARI mortality in developing countries. Identification of factors which influence ARI case management by health workers is key for interventions to improve Quality of case management. Objective: To identify factors which determine correct case management of Acute Respiratory Infections (ARIs) in children by primary health care workers in Ibadan. Design: A descriptive cross sectional study was carried out from June to December 1999 in Ibadan South East LGA and Lagelu LGA. Study materials included observation checklists, validation checklist, and health worker interview questionnaires. Results: Twenty-five health workers and 20 health workers were observed managing 390 children and 386 children in Ibadan South East and Lagelu LGA respectively. More than half of Pneumonia cases were correctly treated in the two LGAs (62.3% and 66.1% respectively). Sex and category of health workers was significantly associated with correct treatment of mild ARI with female workers and Nursing staff doing better (Odds ratio 4.57, 95% CI 2.15, 9.95 and 4.61, 95% CI 2.57, 8.31 respectively). Health workers who had been trained performed better in the management of Pneumonia though it was not statistically significant. Conclusions: There is a need for targeted research to identify the relative contribution of the myriad of factors influencing health worker performance in specific localities in order to improve the quality of care in child health programmes. Keywords : Factors, Case Management, ARI, Health workers. NQJHM Vol. 16 (1) 2005: pp. 14-19