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Midwifery and Midwives Service Scheme: A Panacea for Improvement of Some Maternal and Neonatal Indices in Nigeria—A Brief Review  [PDF]
Prosper Adogu
Open Journal of Obstetrics and Gynecology (OJOG) , 2014, DOI: 10.4236/ojog.2014.47051
Abstract:

Introduction: Midwifery is the art of caring for women during childbearing. It is practiced throughout the world according to the norms, traditions and cultural practices found in each country. Maternal mortality in Nigeria is high but there are wide variations between the geopolitical zones of the country. Government has established the midwives service scheme (MSS) as part of efforts towards reversing the country’s unacceptably high maternal mortality trends. To improve these indices, the MSS in Nigeria engaged newly graduated unemployed and retired midwives to work temporarily in rural areas. The midwives are posted for twelve months to selected primary care facilities linked through a cluster model in which four such facilities with the capacity to provide basic essential obstetric care are clustered around a secondary care facility with the capacity to provide comprehensive emergency obstetric care. This brief review is an attempt at exploring the impact of the midwives service scheme on maternal and neonatal indices in Nigeria. Main content: The outcome of the MSS four years has been an improvement though unevenly and marginally, in these indices in the various geopolitical zones of Nigeria. Improvements have been noticed in maternal indices such as antenatal care attendance, women receiving two doses of tetanus toxoid and number of deliveries by skilled personnel. Also reduction in maternal and neonatal mortality has been observed over the years following introduction of the scheme. Major challenges however, include lack of essential drugs, poor accommodation facilities for MSS staff, irregular payment of their remuneration and lack of water/power supply to some designated facilities for the scheme. Recommendations and conclusions: It is therefore recommended that 24 hours availability of essential drugs at primary healthcare centers be maintained. This should happen in conjunction with regular payment of full entitlements and benefits and provision of secured, habitable and good accommodation for MSS staff. Finally, aggressive community mobilization should continue in order to engender community involvement and participation for sustainable program development.

Pattern, Types and Predictors of Contraception among Female In-School and Out-of-School Adolescents in Onitsha, Anambra State, Nigeria  [PDF]
Prosper Adogu, Ifeoma Udigwe, Gerald Udigwe, Achunam Nwabueze, Chika Onwasigwe
Advances in Sexual Medicine (ASM) , 2014, DOI: 10.4236/asm.2014.43007
Abstract:

Introduction: The consequences of unsafe sex are suffered mostly by adolescent girls in Nigeria despite efforts to improve accessibility to the reproductive and sexual health of this group. This study elucidates the pattern of contraceptive use, the key socio-demographic factors, sexual beliefs and practices associated with its use amongst adolescent girls in Nnewi, Nigeria. Methods: It was a descriptive cross-sectional comparative study of in-school and out-of-school female adolescents. Data were collected using questionnaires and Focus Group Discussion (FGD), then analyzed by selecting socio-demographic and other variables to assess their interaction with contraceptive use and result compared between the two groups. Data were presented in tables and charts and multivariate and chi-square analyses were performed. Result: Higher proportion of sexually active out-of-school girls than their in-school counterparts had ever used contraception—used it in their first and last sexual exposures, while condom was the commonest contraceptive employed by both groups. Age (older adolescents; F = 0.041), belief in condom use (P = 0.05), willingness to get condom for partner (P = 0.001) and regular sexual practice (P = 0.003) were the most important predictors of contraceptive use among the sexually active adolescents. Generally, the out-of-school girls are more likely to use contraceptives than their in-school counterparts. Some misconceptions about pregnancy prevention and unscientific contraceptive methods were mentioned by the subjects during the FGD. Recommendation: Access to reproductive health services needs to be improved especially among the in-school female adolescents. There is need to incorporate the right contraceptive information in the school curriculum, and the out-of-school adolescents should receive periodic dissemination of appropriate Behavior Change Communication (BCC) on the relevance of contraception.

 

Review of Problems of Adolescent Sexual Behavior and the Role of Millennium Development Goals 4, 5 and 6 in Nigeria  [PDF]
Prosper Adogu, Ifeoma Udigwe, Gerald Udigwe, Chika Ubajaka
International Journal of Clinical Medicine (IJCM) , 2014, DOI: 10.4236/ijcm.2014.515126
Abstract:

Introduction: The problems of adolescents’ sexual behavior are grave and far-reaching. Methods: Review of exiting literature via Google scholar, AJOL, Pubmed, HINARI and other relevant data bases on the common problems of adolescents’ inappropriate sexual behavior. Result: Adolescent sexual behavior could result in adolescent pregnancy which prevalence varies widely throughout Nigeria perhaps due to differences in culture and development. Abortion, the willful termination of pregnancy is another problem which is often undertaken for pregnancies resulting from incest and sexual abuse. Also common is trans-generational sex which occurs when an adolescent has non-marital sex in the last 12 months with a man who is at least 10 years older than her. Also related to this, is transactional sex found in both committed and casual relationships. It is not always done for survival because in some cultures, sex for favor is carried out for reasons other than subsistence. Furthermore, multiple sexual partners are the engagement in sex with more than one partner over a particular time frame. It may be sequential or concurrent. The high prevalence of these problems in Nigeria raises a question of the possibility of achieving the millennium development goals (MDGs) 4, 5 and 6 specifically targeted at reducing child mortality, improving maternal health and combating HIV/AIDS, malaria and other diseases respectively. Conclusion: Policies and strategies such as family life and HIV/AIDs education (FLHE) curriculum on adolescent reproductive health should be pursued with greater vigor in our secondary schools in addition to establishing HIV counseling centers and vocational training programs for out-of-school adolescents. WHO support and commitment to key action areas for countries and member states will build and strengthen their capacity to improve reproductive and sexual health.

Perception of Abortion and Abortion Laws by Lawyers in Anambra State Nigeria  [PDF]
Chika F. Ubajaka, Prosper O. U. Adogu, Chitoo Ilika, Amobi L. Ilika
International Journal of Clinical Medicine (IJCM) , 2014, DOI: 10.4236/ijcm.2014.512095
Abstract:

Abortion is the knowing destruction of the life of an unborn child in the womb other than for the principal purpose of producing a life birth or removal of a dead tissue. The Nigeria law stipulates that abortion is allowed only where there is risk to the life of the woman and or to her physical or mental health. This study is aimed at determining the perception of abortion and the relevant laws by lawyers in Anambra State, Nigeria. It is a descriptive cross sectional study carried out between May-June 2010 using pre-tested self administered questionnaires to collect data from consenting 200 lawyers in the 3 major towns of Anambra State. All the respondents knew about abortion, recognized health hazards associated with it and mentioned infertility as the major complication of abortion (53%) followed by death (52.5%) and bleeding (42.5%). About 80% of respondents said abortion should be allowed in cases of danger to woman’s life, rape or incest. Eighty-five percent of the lawyers were aware of the existing abortion law in Nigeria and 76.5% of this knew abortion was legal only to save the life of the woman. Only 26% were in support of legalization of abortion. The Lawyers recommended health education and family planning, among others as means of preventing abortion and its complications. Stigma associated with abortion should be removed to improve free reporting of abortion cases for legal actions. Further research should involve other stakeholders on abortion to make for a holistic approach to the problem.

Perception, Prevalence and Predictors of Rape among Female Students in a Tertiary Institution South East Nigeria  [PDF]
Prosper O. U. Adogu, Echendu D. Adinma, Victor I. Onyiaorah, Chika F. Ubajaka
International Journal of Clinical Medicine (IJCM) , 2014, DOI: 10.4236/ijcm.2014.514110
Abstract:

The essential elements of the rape crime are sexual penetration, force, and the lack of consent. The prevalence of rape worldwide has been reported to be a staggering 20%. In Nigeria, most victims of rape will elect to remain silent about the experience, because of stigmatization leading to under reporting of the crime. This study was aimed at elucidating the perception of rape and determining its prevalence and predictors among female undergraduates in a tertiary institution in South Eastern Nigeria. This was a descriptive cross sectional study in which self administered questionnaires were used to collect relevant data from 280 female undergraduates of UNIZIK Okofia Nnewi Campus, Nigeria, selected by cluster sampling technique. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 19. Bivariate and multivariate analyses were used to determine associations and identify independent predictors of rape respectively. The level of significance was set at p < 0.05. Result showed that the female students had a good knowledge and the perception of rape and that some had fallen victims (16.4%). Acquaintance rape was markedly common (p < 0.02). The single (p < 0.032), and off campus (p < 0.031) female students, often the party going (p < 0.02) types who enjoyed night (p < 0.029) activities were significantly more likely to become victims of rape than those married, on campus and non-party-going counterparts. Also, students who attended single gender schools (p < 0.03) were more predisposed to rape than those counterparts who attended co-educational colleges. Awareness campaigns through peer education, introduction of sexuality education in the school curriculum and establishment of school health programmes are highly recommended.

Factors Associated with Intimate Partner Violence among Wives of Military and Civilian Men in Abuja Nigeria  [PDF]
Prosper Obunikem Uchechukwu Adogu, Uzoamaka Carol Chimah, Amobi Linus Ilika, Chika Florence Ubajaka
Sociology Mind (SM) , 2015, DOI: 10.4236/sm.2015.52007
Abstract: Intimate partner violence (IPV) constitutes transgression of gender norms especially in patriarchal societies such as Nigeria where women are expected to be seen and not heard. The purpose of this study was to determine the factors associated with IPV among women in civilian and military settings. A comparative cross sectional study of 260 eligible women married to military and civilian partners (130 on either side), was selected using a multi-stage sampling technique. Data were collected on personal variables and types of IPV experienced. Relationship between the different forms of IPV and the respondents’ personal and partner characteristics in the two populations were compared using Chi square and significant p-value set at <0.05. Multiple logistic regression analysis was used to predict the outcome of the independent variables. Partner alcohol consumption (p = 0.004, OR = 2.8), partner physical fight with another man (p = 0.009, OR = 3.1) and quarrels in intimate relationship (p = 0.002; OR = 29.7) were all significant predictors of emotional violence. Also belonging to Yoruba ethnic group (p = 0.043, OR = 4.31) and being married for >2 years but <10 years (p = 0.001, OR = 4.02) significantly predict physical violence. Moslem women were at a higher risk (p = 0.000, OR = 5.23) of experiencing sexual violence compared to respondents of other religions. Unskilled respondents were over five times at higher risk of experiencing sexual violence than their skilled counterparts; (p = 0.024, OR = 5.52). Similarly, alcohol consumption by respondent’s partner was a significant predictor of sexual violence among the respondents, (p = 0.012). Family value re-orientation to address traditional norms of negative unbalanced patriarchy should be pursued with renewed vigor. Alcohol and hard drugs use should be discouraged among men who must be informed to understand that the abuser of today is a father of the abused tomorrow.
The Prevalence and Presentation Pattern of Diabetes Mellitus in Patients at Imo State University Teaching Hospital (IMSUTH) Orlu and Imo State Specialist Hospital (IMSSH) Umuguma Owerri (A 10-Year Retrospective Study: 1st November 2004 to 31st October 2013)  [PDF]
Prosper Obunikem Uchechukwu Adogu, Henry Nnaemeka Chineke, Morris Uzoma Ewuzie, Okezie Oguamanam Enwere, Nonye Bibiana Egenti
Journal of Diabetes Mellitus (JDM) , 2015, DOI: 10.4236/jdm.2015.52006
Abstract: Background: The rising prevalence of diabetes mellitus imposes great burden on health worldwide. The burden is enormous in terms of pressure on existing human and material health resources. Diabetes is insidious in onset and has many patterns of presentation which often militates against early detection and diagnosis. Thus most patients present late with the exacerbation of symptoms and complications. Objective: To determine the prevalence and pattern of presentation of diabetes mellitus among patients attending Imo State University Teaching Hospital (IMSUTH) Orlu and Imo State Specialist Hospital (IMSSH) Umuguma Owerri, both in Imo State, Nigeria. Methodology: A retrospective study of the prevalence and pattern of presentation of diabetes mellitus. A total of 2028 patients had diabetes mellitus. Using data collection proforma, information relating to their pattern of presentation such as symptoms and complications, as well as their sociodemography was collected from the case folders. Data were analyzed using SPSS version 17 and results presented in frequency tables and pie charts. Result: A total of 18,912 patients attended the designated hospitals within the period under review, out of which 2028 were diabetic giving a prevalence of 107.2 per 1000 patients (10.7%). Out of these 2028 diabetic patients studied, 75% (1521) had onset of the diseases at the age of 40 years and above, while the remaining 25% (507) had the onset of the diseases before the age of 40 years. The most affected group was in the age range of 51 - 60 years, 585 (28.7%), while the least affected age group was 1 - 10 years, 6 (0.31%). The commonest symptom at presentation was polyuria 2028 (100%), followed closely by polydypsia 1939 (95.6%), while the least presenting symptoms were vaginal discharge and erectile dysfunction 27 (1.35%) respectively. Overall, the symptoms at presentation were polyuria, polydysia, weight loss, fever, blurred vision, paraesthesia, vaginal discharge, erectile dysfunction etc. Conclusion: Diabetes mellitus is a chronic illness with many patterns of presentation ranging from the classical symptoms of polyuria, polydysia, polyphagia and weight loss to the less common ones. The study highlights the need for early detection of the condition through appropriate health information dissemination and institution of prompt and adequate treatment.
Awareness, Knowledge, Perception and Attitude towards Prescription Medicines Abuse among Medicines Prescribers and Dispensers in Nnewi Nigeria  [PDF]
Prosper Obunikem Uchechukwu Adogu, Ifeoma A. Njelita, Nonye Bibiana Egenti, Chika Florence Ubajaka, Ifeoma A. Modebe
Pharmacology & Pharmacy (PP) , 2015, DOI: 10.4236/pp.2015.65028
Abstract: Background: Abuse of medicines is becoming a serious problem in many parts of the world, with negative consequences ranging from addiction, psychosis, cardiovascular complications, and premature deaths from unintentional overdose. Objectives: The objective of this study is to assess awareness, knowledge, perception and attitudes toward the abuse of prescription medicines (PM) among medicines prescribers and dispensers in Nigeria. Design and Participants: A descriptive cross-sectional study was carried out among pharmacists, other pharmacy staff in retail pharmacies, licensed patent medicines vendors (chemical sellers), and medical doctors in Nnewi, Nigeria. Data were collected through self-completed questionnaire supervised by trained research assistants, between December 2013 and April 2014. Three hundred and seventy-five participants were recruited for this study. Data Analysis: The Statistical Package for the Social Sciences (SPSS) version 17 for windows was used for data analysis. Bivariate and multivariate analyses were carried out to evaluate differences and associations based on selected variables. Results: The perception was high 294 (78.4%) among respondents that PM abuse was a problem in the community. Knowledge of health problems associated with PM abuse was also high at 226 (60.3%). However the attitude of the respondents towards early detection of PM abuse among their patients/clients was discouraging. Education, educational status, work status and gender significantly predict good knowledge and positive attitude about PM abuse. Conclusion: Findings from this study will assist health authorities to formulate appropriate health promotion interventions to control and prevent abuse of prescription medicines. Actions directed at early intervention, capacity building, education, public health initiatives and law enforcements will hopefully curb the menace of PM abuse in Nnewi, Nigeria.
Attitude and Perception of Intimate Partner Violence among Women in Military and Civilian Communities in Abuja Nigeria  [PDF]
Uzoamaka Carol Chimah, Prosper Obunikem Uchechukwu Adogu, Chika Florence Ubajaka, Amobi Linus Ilika, Nonye Bibiana Egenti
Advances in Applied Sociology (AASoci) , 2015, DOI: 10.4236/aasoci.2015.56019
Abstract: This was a descriptive comparative study of attitude towards intimate partner violence (IPV) involving 260 female intimate partners of military and civilian men in Abuja, Nigeria. More civilian respondents than the military believed in total submission of a wife to her husband’s views (p = 0.000), frowned at wife beating (p = 0.000), supported sexual assertiveness by women (p = 0.006) and believed that a wife should satisfy her partner sexually, (p = 0.000). More military respondents than civilians preferred family matters to be kept confidential (p = 0.000). Addressing IPV requires immediate and long term commitment and strategies to the attitude of both the women and their husbands.
Factors Influencing Sexual Behavior among Female Adolescents in Onitsha, Nigeria  [PDF]
Ifeoma Bridget Udigwe, Prosper Obunikem Adogu, Achunam Simeon Nwabueze, Echendu Dolly Adinma, Chika Florence Ubajaka, Chika Onwasigwe
Open Journal of Obstetrics and Gynecology (OJOG) , 2014, DOI: 10.4236/ojog.2014.416139
Abstract: Background: The sexual health indices of the adolescents are very poor. This study ascertained the factors influencing the sexual behaviour among female adolescents in Onitsha, Anambra state, Nigeria. Method: This was a cross sectional design in which a total of 800 female adolescents were selected from secondary schools in the area using multistage sampling method; and also selected from a major market (for those who were not at school) in the same geographical area using cluster sampling technique. Data were collected from the respondents about socio-demographic profile, reproductive and sexual health knowledge, attitude, behavior, sources of sexual health information. Result: The highest proportion of students who had ever had sex was found among the 16 - 17 years age group while the modal age group was 18 - 19 years for non students. Also “not living with both parents” and poor family background, were markedly associated with increased likelihood to engage in sexual activity. Poverty level was particularly high among the non-student adolescents. Furthermore, wrong knowledge of fertile period, low risk perception of HIV and premarital, and use of condoms among the respondents were all significantly associated with increased chance to engage in sex. The student adolescents got sexuality information mainly from the teachers; as opposed to their non-student counterparts who had youth organization and friends as main sources. Conclusion: Family values, poverty alleviation, change of attitude through appropriate health and sexuality education especially targeting the non-student adolescents are highly recommended. Sexual negotiation skill, accessible formal education for all should be encouraged to create the right sexual behavior among the adolescent girls.
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