Women''s perceptions of the complications of pregnancy and childbirth in two Esan communities, Edo State, Nigeria

The high prevalence of maternal mortality and its causes in the deveoping World have been well established. However, this information to a large extent is on institutional data. Establishment of the level and social context of maternal mortality through community-based studies are unavailable. Recent years have witnessed a new approach to providing an in-depth understanding of this problem through community-based studies involving a multi-disciplinary approach. Built into this approach is the use of classical anthropological methods including focus group discussions. Participants expressed their perceptions of maternal mortality in the focus groups. Issues such as alternative modes of treating complications in pregnancy or delivery are also discussed. This paper examines the complications and modes of treatment relating to pregnancy and delivery as perceived by Esan women. Focus group discussions generated data for analysis. The women identified miscarriage, separation of the placenta, haemorrhage, obstructed labour, and the retention of the placenta as complications experienced in pregnancy, labour or delivery. Of these complications, haemorrhage was the most severe and devastating because it kills easily owing to the amount of blood lost. However, two alternative modes of treatment, traditional and modern are in use, the most prevalent, cheapest, easier to obtain, and most trusted being the traditional mode of treatment. A reduction in maternal mortality requires a number of strategies. The most radical of these is the recommendation that both traditional and modern treatments need to complement one another in the same health institution to ensure the maximal effectiveness of both modes of treatment.     

Sexual and health behaviour of commercial sex workers in Benin City, Edo State, Nigeria

In this paper, examined are the sexual and health behaviours of commercial sex workers in Nigeria, a high-risk group in this era of the acquired immune deficiency syndrome (AIDS) and human immunodeficiency virus (HIV) epidemic. The aim is to provide in-depth knowledge of their sexual networking and the prevalence rate of sexually transmitted diseases (STDs). This analysis is intended to highlight their implications in the spread and control of AIDS and HIV infection. The results of the study show the extensive sexual networking of these commercial sex workers, the health implications, and the utilisation of nonorthodox health services in diagnosing STDs. The implications of these results are the likely drain on the limited health resources of the Nigerian government and the harmful effects on the women, fetuses, children, and other sexual partners of clients of these commercial sex workers.     

Factors related to induced abortion among young women in Edo State, Nigeria

Sub-Saharan Africa has the highest death rate from induced abortion in the world, and young women in southern Nigeria are particularly likely to terminate their pregnancies. This study assesses the prevalence of and factors associated with induced abortion among 602 young women aged 15-24 who were surveyed in Edo State, Nigeria, in 2002. We find that 41 percent of all pregnancies reported by the young women surveyed were terminated, and we estimate the age-specific abortion rate for 15-19-year-olds in Edo State at 49 abortions per 1,000 women, which is slightly higher than previous local estimates and nearly double the countrywide estimate for women aged 15-49. We construct explanatory multivariate models to predict the likelihood that a young woman has experienced sexual intercourse, has become pregnant, and has undergone an induced abortion, controlling for important demographic and risk-behavior factors. Young women unmarried at the time of the interview are found to be significantly more likely than married women to have had an abortion. Young women who have experienced transactional or forced sex are also significantly more likely to report ever having had an abortion, as are young women who have experienced more than one pregnancy. We conclude with suggestions for modifying the content and target populations of behavioral change messages and programs in the area.     

Knowledge of disease notification among doctors in government hospitals in Benin City,Edo State,Nigeria

STUDY OBJECTIVE: Notifiable diseases are conditions where regular, frequent and timely reporting of individual cases is considered necessary for the prevention and control of the disease. They can be classified into immediate, routine, international, and occupational notifiable diseases. Despite its importance, notification suffers some setbacks, as shown by worldwide studies. This study was carried out from August to November 1999 to assess the knowledge of disease notification among doctors at the University of Benin Teaching Hospital and Central Hospital, Benin City, Edo State, Nigeria. DESIGN: A cross-sectional study design was used, and a self-administered questionnaire, which was pretested, was used to collect data. SETTING: All doctors from the University of Benin Teaching Hospital and Central Hospital, Benin City, Edo State, Nigeria were included in the study. PARTICIPANTS: In total, 134 doctors participated in the study. MAIN RESULT: Only 11.9% of doctors had a good knowledge of disease notification. Thirty-one (23.1%) doctors knew where to obtain notification forms, and 32 (23.9%) knew how to complete these forms. CONCLUSION: Knowledge of disease notification among doctors in these major institutions is poor. It has therefore been recommended that quarterly seminars should be conducted to update doctors' knowledge and serve as reminders about disease notification.     

Blood lead, calcium, and phosphorus in women with preeclampsia in Edo State, Nigeria

The authors investigated the effect of blood lead (BPb) and its relationship with calcium and phosphorus in the development of preeclampsia in Nigeria. Blood samples were collected from 59 preclamptics, 150 normal pregnant, and 122 nonpregnant women. Blood lead and serum Ca and P were determined. Blood lead was significantly higher (p < .001), whereas serum Ca and P were significantly lower (p < .001) in preclamptics than in normal pregnant women (60.2 ± 12.8 vs 26.3 ± 8.0 μg/dL for Pb, 1.39 ± 0.33 vs 2.03 ± 0.22 mmol/L for Ca, and 0.76 ± 0.10 vs 0.99 ± 0.13 mmol/L for P, respectively). There was significant increase (p < .05) in BPb and decreases (p < .01) in serum Ca and P in pregnant women than in nonpregnant women (35.7 ± 18.0 vs 13.1 ± 6.4 μg/dL for Pb, 1.85 ± 0.33 vs 2.33 ± 0.20 mmol/L for Ca, and 0.93 ± 0.38 vs 1.24 ± 0.26 mmol/L for P). Also, BPb was negatively correlated with serum Ca and, P, and positively correlated with systolic and diastolic blood pressures in pregnancy (r = -.804 for Ca, r = -.728 for P, r = .908 for SBP, and r = .842 for DBP) and preeclampsia (p < .01). It appears that increase in blood lead, which parallels decreases in serum calcium and phosphorus, may be related to the development and progression of preeclampsia in this environment.     

Anorexia nervosa and bulimia: The socio-cultural context

The task of this paper is to examine the interplay between socio-cultural forces and personality, specifically psychopathology, as a way of explaining the increase in contemporary women suffering from eating disorders. Several questions are raised regarding the cultural preoccupation with thinness, the apparent increase in anorexia nervosa and related eating disorders, and whether the current theories of etiology of eating disorders are adequate in explaining the increase in this phenomena. Finally, an integrative psychosocial model is proposed.     

Inequalities in health care in Ondo State, Nigeria

The Third Development Plan (1975—80) for Nigeria focusedon the inequality in the distribution of medical facilitiesand health manpower in the country. The Plan, therefore, acceleratedhealth manpower production and aimed to reduce the imbalancein the distribution of facilities. The Fourth Plan (1980—85)categorically stated the necessity to ensure a more equitabledistribution of health facilities and manpower for every partof the Federation. The present paper assesses how the nationalobjectives have been met by reviewing health services in OndoState. Ondo became a separate state in February 1976 followingthe creation of the 19 state structure of Nigeria. The stateis divided into 17 administrative units or local governmentareas (LGAs). In 1979 when the civilian government took over,the number of health facilities was increased — hospitalsfrom 18 to 26, maternity centers 127 to 164 and dispensariesfrom 153 to 173. By 1985 there were also 30 comprehensive healthcenters as against two in 1979. However, the results of the location quotient analysis indicateincreasing disparities in the distribution of both hospitalsand the lower health facilities. Consequently, some LGAs havean excess share of the health facilities relative to their population.Spatial inequality in the distribution of health facilitiesis also reflected in the provision of hospital beds, nursesand doctors, despite the substantial increase in man power resourcesin the state during the study period. Despite the desire by the state government to ensure a moreequitable distribution of health resources, glaring disparitiesare still evident. The deterioration in government facilitieshas resulted in a mass exodus of health professionals due tolow salaries and poor working conditions. There has been, atthe same time, a marked growth in the private sector and a declinein government attempts to strengthen primary health care. Folasade Iyun, Phd, is a lecturer at the Department of Geography,University of Ibadan, Nigeria. Her research activities focuson the application of geographic methods and techniques in thestudy of health-related problems, Her main interests cente ondisease ecology and the location and utilization analysis ofhealth care delivery systems.     

State violence and health in Nigeria

Discussions of health in Nigeria are often restricted to morbidity and mortality statistics, the political economic character and causes of which hardly enter the equation. Yet, morbidity and mortality indices exist within, and reflect, a specific political economic reality, including the State apparatus. It is contended here that beyond overseeing the political economy within which it exists, the State in Nigeria produces and promotes ill health and death through economic policies which invariably influence conditions of material existence and more overtly, through active violence. Specific instances of the latter are discussed.     

Prevalence of depression among adults in Oyo State, Nigeria: a comparative study of rural and urban communities

OBJECTIVE: This study was designed to assess the current prevalence of depression in Oyo State, Nigeria and the rural-urban variation in prevalence. SETTING: This is a two-phase community-based cross-sectional study. The urban areas selected for the study are the Ibadan North-West and Egbeda local government areas. The rural area selected was the Saki-East local government area. PARTICIPANTS: A total of 1105 participants were recruited into the study. Multistage sampling technique was used to obtain a representative sample of the participants from the communities in Oyo State. The study was conducted using an interviewer-administered structured questionnaire, and the general health questionnaire (GHQ 12) as a screening tool. The second phase of the interview was conducted only for those participants with a score of more than 3 using the GHQ 12. These participants were then clinically examined using the Structured Clinical Interview DSM IV for assessment of clinical depression. MAIN OUTCOME MEASURE: Prevalence of depression. RESULTS: A total of 721 (65.2%) were from urban communities, while 384 (34.8%) were from the rural community. The overall prevalence of depression was found to be 5.2%. Depression was more prevalent among women than men (5.7% vs 4.8%, chi(2) = 0.36 P = 0.55), and among adolescents (9.6%, P = 0.04). Furthermore, depression was more common in the rural areas than in the urban areas (7.3% vs 4.2%, chi(2) = 4.94 P = 0.02). CONCLUSION: Depression is more common in rural than urban areas in the Nigerian population. Mental health education for adolescents and secondary school students should be encouraged in rural communities.     

A question of balance: health behaviour and work context among male Glaswegians

Discussion of the persistence of social class inequalities in health has led to greater interest being paid to differences between the classes in lay health beliefs. Recent work on lay health beliefs, however, has mainly viewed social class as a proxy for wider aspects of lifestyle and paid less attention to its occupational component. Part of this can be explained by its predominant focus on the health beliefs of women. This paper remedies this imbalance by focusing on male Glaswegians' perceptions of the health effects of their occupations. It shows that not only were respondents very aware of the influence their jobs had on their health but that they also took action to redress the balance, either by compensating for such effects or controlling their work environment to minimise their influence. Respondents' degree of commitment to their work also had a direct bearing on their coping styles. Although traditional occupational class measures were found to obscure much of how occupation influences health, unskilled and semi-skilled workers did suffer the greatest limitations in coping with the health effects of work.     

'Mobile men with money': the socio-cultural and politico-economic context of 'high-risk' behaviour among wealthy businessmen and government officials in urban China

China's transition from an injection drug-driven HIV epidemic to one primarily transmitted through sexual contact has triggered concern over the potential for HIV to move into the non-drug-injecting population. Much discussion has focused on the migrant men of China's vast 'floating population' who are considered a high-risk group. As a result, many men who frequently engage in high-risk behaviour but are not included in this especially vulnerable group are evading HIV prevention messages. This paper highlights the socio-cultural and politico-economic factors that motivate many of China's wealthy businessmen and government officials, sometimes referred to as 'mobile men with money', to engage in such behaviour. Examination of the activities related to the work of these men reveals a situation where the confluence of a market-oriented economy operating within a socialist-style political system under the influence of traditional networking practices has engendered a unique mode of patron-clientelism that brings them together over shared social rituals including feasting, drinking and female-centered entertainment that is often coupled with sexual services. As a result, consideration of the socio-cultural factors influencing these men's sexual practices is important for responding to the newly emerging stage of China's HIV epidemic.     

The influence of socio-cultural factors on breast cancer screening behaviors in Lagos,Nigeria

Culture has been shown to influence health beliefs and health-related behaviors by influencing the type of health information to which women have been exposed and shapes health and illness perceptions and practices. To increase screening rates, cultural influences should be considered as important correlates of screening behaviors for breast cancer. This study used semi-structured interviews of women attending a cancer screening facility in Lagos, Nigeria guided by the PEN-3 model to describe culturally relevant factors that shape attitudes toward breast cancer and breast cancer screening. Religion was the most prominent theme and was shown to have positive, negative and existential effect on breast cancer perceptions. Other major themes observed were related to family and traditional beliefs. The results from this study could be used to develop and implement culturally relevant cancer prevention interventions, strategies, and recommendations to overcome screening barriers in an effort to increase breast cancer participation and awareness among Nigerian women.     

Hospital workers' opinions on the predisposing factors to blood-related work accidents in Central Hospital,Benin City,Edo State,Nigeria

INTRODUCTION: Hospital workers are prone to accidental injuries during their day-to-day activities at work. These accidental injuries are of importance because many of these predispose the workers to blood-borne infections. METHODS: A total of 242 hospital workers at Central Hospital, Benin City, Edo State participated in a cross-sectional study carried out between June and August 1999 aimed at finding out the predisposing factors to blood-related work accidents. The study group consisted of 53 doctors, 34 laboratory workers and 155 nurses. All doctors and laboratory workers at Central Hospital were involved in the study, while 50% of the nursing population were involved in the study. The nurses were selected using a stratified random sampling method. The respondents completed a pretested self-administered questionnaire. RESULTS: The results showed that the four main factors responsible for accidents among the hospital workers were: non-availability of protective measures; desire to hasten the procedure; type of procedure; and use of inadequate/inappropriate equipment. The major factor responsible for accidents at work among hospital workers was non-availability of protective measures.RECOMMENDATIONS: It is therefore recommended that adequate materials and equipment should be provided. This study could be further validated using a qualitative study design (focus group discussions).     

Knowledge attitude to modern family planning methods in Abraka communities, Delta State, Nigeria

OBJECTIVE: To assess the level of regard and misconceptions of modern family planning methods in Abraka communities. METHODS: The interviewer's administered questionnaire method was used to gather the required information from 657 respondents randomly chosen from PO, Ajalomi, Erho, Oria, Otorho, Umeghe, Urhuoka and Uruagbesa communities in Abraka kingdom. RESULTS: Results show that 75.3% of those interviewed were aware of modern family planning but only 42.9% were using it to plan their families. Those using condom, safe periods and withdrawal constitute 32.6% of the 42.9% figure. Thus, data indicate a fairly high degree of awareness but little regard for family planning. CONCLUSION: Campaigns should be organized in order to educate Abraka communities on the benefits and need for family planning. Government should provide quality, comprehensive and subsidized family planning services. In addition, research efforts should be intensified on how to take advantage of the traditional methods of family planning to systematically introduce the modern method, so as to gradually eliminate the associated bias and misconceptions associated with modern methods of family planning.