Influence of Knowledge of Spousal Fertility Cycles on Male Reproductive Health Participation in Ibadan Metropolis, Nigeria.

In spite of the established roles and influence of men on women's uptake and utilization of reproductive health care interventions, the degree of involvement with intimate issues within the household which could help to understand male involvement and support remains an under-researched topic. The aim of this study was to investigate the degree of involvement at the family level of men within sub-urban communities of Ibadan in South-West Nigeria. A cross sectional survey design was conducted among 380 men selected from sub-urban communities in Ibadan, Oyo State using multi-stage sampling. Data was obtained using pre-tested, semi-structured, interviewer administered questionnaires. Data were analysed using descriptive statistics, bivariate analysis and logistic regression with level of significance set at 5%. Mean age of respondents was 41.1 ± 7.6 years. Men who were knowledgeable of spouse's menstrual cycles and ovulation dates were significantly more likely to have supported some form of public health intervention before (p <0.001). Age over 30, above secondary education, and men aware of menstrual dates of spouse were significant predictors of reproductive health interventions. Men who were aware of menstrual cycles of spouse were 96.6% more likely to be supportive or involved in reproductive health matters compared to those who were not (OR =0.034; 95% CI = 0.02 - 0.07; p <0.001). Involvement of men at family level as demonstrated in this study serves to influence and explain the level of involvement with reproductive health. Further research investigating other proximal factors that influence male participation is recommended.

Characteristics and outcomes of patients hospitalized with COVID-19 at a tertiary hospital in Nigeria.

Background: Data regarding the features and outcomes of hospitalized COVID-19 patients in Africa are increasingly available. Objectives: To describe socio-demographic, clinical and laboratory characteristics and outcomes of COVID-19 patients. Methods: A cross-sectional study of 86 adult patients hospitalized with COVID-19 between March and November 2020. Characteristics were described in survivors and non-survivors. Results: Mean age was 60.9±16.1 years, 53(61.6%) were male. Co-morbidities were found in 77(89.5%) patients. On severity, 6(7%) were mild, 23(26.7%) moderate, 51(59.3%) severe and 6(7%) critical. Oxygen saturation and respiratory rate were 71±22% and 38±11/minute in non-survivors and 90±7% and 31±7/minute in survivors respectively (p<0.001, p<0.001)). Overall mortality was 47.7% with no death among patients with mild disease and deaths in all patients with critical disease. Duration of hospitalization was 2.0(1.0-4.5) days in those who died and 12(7.0-15.0) days in those who survived (p<0.001). Of the 42 patients that received dexamethasone, 11(26.2%) died, while 31(73.8%) survived (p=<0.001). Conclusion: Most of the patients had co-morbidities and there was high mortality in patients with severe and critical COVID-19. Mean oxygen saturation was low and respiratory rate high overall. Factors associated with mortality included: Significantly greater hypoxia and tachypnea, less dexamethasone use and shorter hospitalization.

The microeconomic impact of out-of-pocket medical expenditure on the households of cardiovascular disease patients in general and specialized heart hospitals in Ibadan, Nigeria.

BACKGROUND: Cardiovascular diseases (CVDs) present a huge threat to population health and in addition impose severe economic burden on individuals and their households. Despite this, there is no research evidence on the microeconomic impact of CVDs in Nigeria. Therefore, this study estimated the incidence and intensity of catastrophic health expenditures (CHE), poverty headcount due to out-of-pocket (OOP) medical spending and the associated factors among the households of a cohort of CVDs patients who accessed healthcare services in public and specialized heart hospitals in Ibadan, Nigeria. METHODS: This study adopts a descriptive cross-sectional study design. A standardized data collection questionnaire developed by the Initiative for Cardiovascular Health Research in Developing Countries was adapted to electronically collect data from all the 744 CVDs patients who accessed healthcare services in public and specialized heart hospitals in Ibadan between 4th November 2019 to the 31st January 2020. A sensitivity analysis, using rank-dependent thresholds of CHE which ranged from 5%-40% of household total expenditures was carried out. The international poverty line of $1.90/day recommended by the World Bank was utilized to ascertain poverty headcounts pre-and post OOP payments for healthcare services. Categorical variables like household socio-demographic and clinical characteristics, CHE and poverty headcounts, were presented using percentages and proportions. Unadjusted and adjusted logistic regression models were used to assess the factors associated with CHE and poverty. Data were analyzed using STATA version 15 and estimates were validated at 5% level of significance. RESULTS: Catastrophic OOP payment ranged between 3.9%-54.6% and catastrophic overshoot ranged from 1.8% to 12.6%. Health expenditures doubled poverty headcount among households, from 8.13% to 16.4%. Having tertiary education (AOR: 0.49, CI: 0.26-0.93, p = 0.03) and household size (AOR: 0.40, CI: 0.24-0.67, p = 0.001) were significantly associated with CHE. Being female (AOR: 0.41, CI: 0.18-0.92, p = 0.03), household economic status (AOR: 0.003, CI: 0.0003-0.25, p = <0.001) and having 3-4 household members (AOR: 0.30, CI: 0.15-0.61, p = 0.001) were significantly associated with household poverty status post payment for medical services. CONCLUSION: OOP medical spending due to CVDs imposed enormous strain on household resources and increased the poverty rates among households. Policies and interventions that supports universal health coverage are highly recommended.

Myths, misconceptions, and misunderstandings about epilepsy in a Nigerian rural community: implications for community health interventions.

Face-to-face interviews were conducted with 365 persons without epilepsy. Seventy-four (12%) attributed epilepsy to brain disorder, witchcraft (81.4%), destiny (49.8%), heredity (27.8%), and demonic possession (26.8%). Beliefs about modes of spread included saliva (28.8%), sharing utensils (19.5%), and making fun of a person with epilepsy (12.1%). Traditional medicine was the first preferred treatment option in 80.5% of participants; treatment approaches included herbal preparations (67.7%), spiritual exorcism (33.7%), special cultural diets (29.3%), charms (26.2%), and sacrificial offerings (24.1%). Reasons for preferring traditional treatment included the health facility being too far (86.1%), health personnel not being readily available (83%), and epileptic drugs not being readily available (79.6%). Incorrect local perceptions and cultural beliefs about epilepsy and inadequacies of the modern health care systems in developing countries might jointly contribute to the treatment gap. Local health staff, if appropriately strengthened, could take on additional tasks and bridge the treatment gap. Collaboration between modern and traditional health care systems may also improve treatment accessibility.

Clinical audit of antenatal service provision in Nigeria.

We audited records of 365 pregnant women whose mean age was 25.6 ± 5.6 years. Their mean gestational age at booking was 29.3 ± 2.7 weeks; their mean number of antenatal visits was 4.2 ± 2.3. Weight, blood pressure, and urine were checked on 97.3%, 95.1%, and 86.3% of the women respectively. Hemoglobin estimation was done on 19.2% of women; 34.8% received two doses of tetanus toxoid. Malaria prophylaxis and iron and folate supplements were provided to 263 (72.1%) and 293 (80.3%), respectively. Late booking was common, and antenatal service was inadequately equipped. Early booking and full implementation of preventive treatments are recommended. Support for detection of anaemia and immunization service is desirable.

Prevalence and determinants of low testosterone levels in men with type 2 diabetes mellitus; a case-control study in a district hospital in Ghana.

Diabetes mellitus, an endocrine disorder, has been implicated in many including hypogonadism in men. Given the fact that diabetes mellitus is becoming a fast-growing epidemic and the morbidity associated with it is more disabling than the disease itself. This study sought to assess the prevalence of low testosterone levels and predictors in type 2 diabetes mellitus patients and non-diabetic men in a district hospital in Ghana. This hospital-based case-control study comprised 150 type 2 diabetics and 150 healthy men. A pre-structured questionnaire and patient case notes were used to document relevant demographic and clinical information. Venous blood sample of about 6 ml was taken to measure FBS, HbA1c, FSH, LH, and testosterone levels. All data were analyzed using STATA version 12 (STATA Corporation, Texas, USA). The overall hypogonadism in the study population was 48% (144/300). The prevalence of hypogonadism in type 2 diabetic subjects was almost three times more than in healthy men (70.7% vs 25.3%). The odds of having hypogonadism was lower in the men with normal weight and overweight with their underweight counterparts (AOR = 0.33, 95% CI; 0.12-0.96, p = 0.042) and (AOR = 0.29, 95% CI; 0.10-0.84, p = 0.023) respectively. Also, the odds of suffering from hypogonadism was lower in non-smokers compared with smokers (AOR: 0.16, 95% CI; 0.05-0.58, p = 0.005). Participants who were engaged in light (AOR: 0.29, 95% CI; 0.14-0.61, p = 0.001), moderate (AOR: 0.26, 95% CI; 0.13-0.54, p<0.001) and heavy (AOR: 0.25, 95% CI; 0.10-0.67, p = 0.006) leisure time activities had lower odds hypogonadal compared to those engaged in sedentary living. Type 2 diabetic men have high incidence of hypogonadism, irrespective of their baseline clinical, lifestyle or demographic characteristics. Smoking and sedentary lifestyle and BMI were associated with hypogonadism in the study population. Routine testosterone assessment and replacement therapy for high risk patients is recommended to prevent the detrimental effect of hypogonadism in diabetic men.

Cost-effectiveness of screening methods for urinary schistosomiasis in a school-based control programme in Ibadan, Nigeria.

OBJECTIVE: To carry out a comparative cost-effectiveness analysis of screening methods for urinary schistosomiasis; terminal haematuria, unqualified haematuria, dysuria, visual urine examination and chemical reagent strip technique, in a school-based control programme. DESIGN: Estimation of costs and determination of cost-effect ratios of the screening methods applied in a school-based screening and treatment programme, from the perspective of a programme manager. SETTING: A junior secondary school in Ibadan, Nigeria. MAIN OUTCOME MEASURES: Cost per number of cases correctly diagnosed. RESULTS: Unqualified haematuria was found to be the most cost-effective method costing N51.06 (US$ 2.16) to diagnose a case correctly, followed by terminal haematuria N58.91 (US$ 2.50) and dysuria N84.24 (US$ 3.57). Despite the relatively high input costs of chemical reagent strip technique over visual urine examination (N22.12 (US$ 0.94) per student vs. N6.44 (US$ 0.27) per student), it was found to be more cost effective costing N304.56 (US$ 12.91) to diagnose a case correctly than visual examination of urine cost of N317.58 (US$ 13.46) per correct case diagnosed. CONCLUSION: From the viewpoint of a programme manager, interview method of screening by asking for blood in the urine remains the most efficient means of screening for urinary schistosomiasis in school-based control programmes in our environment.

Compliance of commercial motorcyclists with road safety measures in a Nigerian metropolitan city.

Objectives: Motorcycle crashes are the second most common cause of road traffic injuries in Nigeria, which can be prevented through compliance with road safety measures. Compliance is defined as a state of being in accordance with established guidelines or legislations. There is a dearth of information on compliance with these measures by motorcyclists in Ibadan. Commercial motorcyclists often ignore safety measures, making them prone to accidents with other road users. This study therefore assessed the knowledge and reported compliance of commercial motorcyclists in Ibadan North Local Government Area with road safety measures as well as the factors influencing compliance.Data and methods: A cross-sectional study was carried out among motorcyclists in all 5 motorcycle parks in the city of Ibadan. Participants were selected through a simple random sampling technique after a proportional allocation to the size of the motorcyclists in the parks was concluded. A total of 439 motorcyclists were interviewed. A pretested, semistructured, interviewer-administered questionnaire was used to collect information on sociodemographic characteristics, knowledge, reported compliance, and attitudes toward road safety measures (Nigeria Highway Code). A total of 34 items on traffic rules and regulations were used to assess compliance. Chi-square test and logistic regression were used for analysis at a 5% level of significance.Result: Respondents were aged 34.4 ± 7.8 years. All respondents were male and 15.2% had a tertiary education in a university or institution of higher learning. About 20.0% had no proper formal or informal training as motorcyclists. Ninety-four respondents (21.6%) self-reported ever being involved in a motorcycle crash, of which 32 (34.0%) occurred 6 months preceding the study. About half of respondents (51.9%) had good knowledge of road safety measures. About 50.6% of the respondents were compliant with road safety measures. Only 54.4% of respondents who had ever been involved in a motorcycle crash were wearing a crash helmet at the time of the crash. However, 71.8% of respondents had a crash helmet with them during the study. About 73.6% owned the motorcycles they rode. About two thirds (60.4%) of motorcycle owners were significantly more compliant compared to 23.3% of those who were not owners. Respondents who were motorcycle owners were almost 4 times more likely to be compliant with road safety measures than those who were not owners (odds ratio [OR] = 4.0; confidence interval [CI], 2.0-7).Conclusion: Commercial motorcycle ownership and training contributed to knowledge and compliance with road safety measures and consequently low reporting of motorcycle crash. There is therefore the need to encourage ownership, conduct training, and create stringent laws to guide road safety.

Appraisal of primary health care services in Federal Capital Territory, Abuja, Nigeria: how committed are the health workers?

INTRODUCTION: The primary health care model was declared as the appropriate strategy for ensuring health-for-all. However up till date, very few studies have assessed the services provided by primary health centres in terms of its basic components. This study aimed to appraise health services provided and to estimate the commitment of the health workers in selected primary health care centres within Abuja Nigeria. METHODS: A cross sectional study was utilized to obtain information from 642 health workers across 6 area councils of the Federal Capital Territory, Nigeria. Data collection was performed using pre-tested, structured, interviewer-administered questionnaires and data were analyzed at 95% level of significance using SPSS version 17.0. RESULTS: Our study participants were largely females (58.6%), Christians (63.2%) and aged 30-39 years (40.0%). Health services offered in centres were adequate in all components of PHC except for mental health (23.7%) and care of the elderly (43.0%). Conduct of home visits was least practiced by health workers (83.8%) compared to the use of patient appointments (96.4%) and conducting staff outreach activities (94.9%). Commitment was three times more likely when service was related to health promotion and education (OR = 2.52; CI = 1.23-5.18); nutrition education (OR = 3.13; CI = 1.13-8.68). CONCLUSION: Health workers in primary health centres of the federal capital territory still provide sub-optimal services with respect to mental health and care of elderly. Concerted efforts and unrelenting political will to strengthen mental and geriatric health components are recommended.

A cost analysis of road traffic injuries in a tertiary hospital in south-west Nigeria.

This study examines the burden of road traffic injuries (RTIs) among road crash victims in a tertiary hospital in Ibadan, Nigeria. The study adopted a purposive sampling method to obtain primary data. Interview was done with 266 RTI victims who were admitted to the University College Hospital, Ibadan and discharged between March and May, 2015, using a structured questionnaire. From the data obtained, the study carried out descriptive statistical analyses. The results showed that the average cost per patient for RTI treatment was ₦ 42,946 ($215.9); on average, the amount expended on surgery was the highest followed by wound dressing and drugs; and the prevalence of catastrophic out-of-pocket (OOP) expenditure was over 86%. It is recommended that given the high burden of OOP hospital expenditure associated with RTI, there is need to implement more effective financial protection mechanisms against the high OOP expenditure faced by crash victims.

Expanding health insurance scheme in the informal sector in Nigeria: awareness as a potential demand-side tool.

INTRODUCTION: The implementation and expansion of a health insurance scheme in the informal sector, particularly in developing countries, is a challenge. With the aid of an innovative Information-Education and Communication model, titled 'Understanding the concept of health insurance: An innovative social marketing tool', an assessment of the awareness and perception of the scheme among market women was carried out. METHODS: This is a cross-sectional descriptive survey, carried out among market women in Ibadan, Nigeria. In a multi-stage sampling technique, a total of 351 women were interviewed using an interviewer-administered, semi-structured questionnaire. The data was analysed using SPSS version 16. Chi-square test was used to test associations between selected variables of interest. Logistic regression model was used to determine predictors of awareness of the National Health Insurance Scheme (NHIS). A model controlling for participants' enrolment status was built and Adjusted Odds Ratio (AOR) reported. Level of statistical significance was set at p < 0.05. RESULTS: A total of 344 market women aged 18 years and above participated in the study, a response rate of 98.0%. Respondents' educational status was the only predictor significantly associated with awareness of the NHIS. Respondents with post-primary education had 10 times the odds of being aware of the NHIS than respondents with no education or only primary education (Adjusted Odds Ratio = 10.3; 95% CI = 4.1-26.0). CONCLUSION: Innovative models to enable potential beneficiaries, especially among the informal sector, to better comprehend and accept the concept of prepayment methods of financing healthcare costs is important in efforts to implement and expand a social health insurance scheme.

Self-referral patterns among federal civil servants in oyo state, South-Western Nigeria.

INTRODUCTION: Primary health care is widely accepted as the first point of care; yet, individuals requiring healthcare engage in self-referrals to higher levels of care thereby by-passing primary care. Little is known of the extent to which self-referrals are carried out when care is needed. This study thus sought to determine the prevalence of self-referral, its patterns and factors influencing self-referrals amongst federal civil servants in Southwestern Nigeria. METHODS: A cross-sectional study was carried out among 300 federal civil servants who were interviewed using validated and pre-tested interviewer-administered semi structured questionnaires. Data was analyzed using univariate and Chi-square test at level of significance set at P <0.05. RESULTS: Mean age of the respondents was 39.96 ± 9.1 years with majority being married (80.7%); 90.7% completed tertiary education (and 76.7 % were middle grade (7-12) level officers. Most (60.0%) of the respondents had ever engaged in self-referral. Malaria was the commonest health problem (39.7%) for self-referral to secondary or tertiary facilities. Desire for quality service (35.7%) and competent staff (35.2%) were the commonest reasons for self-referral to a higher level of health care. More female respondents (76.0%) compared to male respondents (64.0%) significantly engaged in self-referral (p = 0.02, X2 = 5.14). Respondents having good knowledge of referral practices engaged less in self-referral compared to those with poor knowledge. (p = 0.02, X2 = 5.43). CONCLUSION: Having good knowledge of referral practices and being male are positively associated with referral practices. Creating awareness and improving knowledge on referral practices with special emphasis on women population are desirable strategies for encouraging the use of primary health care as first of point of contact with health systems.

Stigmatising Attitudes Towards Co-workers with HIV in the Workplace of a Metropolitan State, Southwestern Nigeria.

BACKGROUND: Despite demonstrating global concerns about infection in the workplace, very little research has explored how co-workers react to those living with HIV in the workplace in sub-Saharan Africa. This study aimed to assess the level of stigmatising attitude towards co-workers living with HIV in the workplace. METHODS: The study was a descriptive cross-sectional survey involving 403 respondents. They were recruited from selected companies through a multistage sampling technique. Survey was carried out using pre-tested semi-structured questionnaires. Data were analyzed using the Statistical Package for the Social Sciences to generate frequencies, cross tabulations of variables at 5% level of significance. Logistic regression model was used to determine the predictors at 95% confidence intervals. RESULTS: Mean age of respondents was 32.9 ± 9.4 years with 86.1% being females. Overall, slightly below two-third (63.0%) had good knowledge on transmission of HIV/AIDS while 218 (54.1%) respondents had a high stigmatising attitude towards co-workers with HIV in the workplace. More female respondents (69.6%) demonstrated high stigmatising attitudes towards co-workers with HIV in the workplace (p = 0.012). Female workers were twice more likely to have high stigmatising attitudes towards co-worker with HIV [OR 2.1 (95% CI: 1.13 - 3.83)]. CONCLUSION: Stigma towards people living with HIV/AIDs is still very persistent in different settings. Good knowledge amongst our participants about HIV/AIDs did not translate to low stigmatising attitudes among workers. Concerted efforts and trainings on the transmission of HIV/AIDs are essential to reduce stigma that is still very prevalent in workplace settings.

What factors influence the average length of stay among stroke patients in a Nigerian tertiary hospital?

INTRODUCTION: Increased emphasis is being laid on ensuring that health resources are efficiently utilized, especially in resource-constrained settings such as in Nigeria. One of the main indices of how efficiently a health institution is being run is Length of Stay (LOS), which is likely to be higher in chronic diseases such as stroke and diabetes. Stroke is a chronic disease that is currently on the rise in Low and Middle income countries (LMICs) who are also characterized by constraint of health resources. This study seeks to determine the LOS of stroke patients as well as factors that affect it. METHODS: A retrospective analysis of health records of stroke victims admitted into the medical wards of the University College Hospital, Ibadan between January 2012 and December 2014 was conducted. Data on sociodemographic information, comorbidities and risk factors were extracted while LOS was calculated by counting the number of days the patient was admitted. Analysis was carried to using SPSS. RESULTS: A total of 143 records were used in the final analysis with 53.1% of them being males and having a mean age of 61.5 ± 14.2 years. More than half (53.8%) of the cases were ischemic strokes. The average length of stay was 13.7 ± 8.9 days while bivariate analysis showed that a greater proportion of cases who consumed alcohol, had diabetes and hypertension had LOS of over 7 days than those who did not. However, these differences in proportions were not statistically significant (0.310

Awareness and knowledge of National School Health Policy and School Health Programme among public secondary school teachers in Ibadan metropolis.

BACKGROUND: The awareness, knowledge, and involvement of teachers in the implementation of School Health Programme (SHP) in secondary schools are essential in ensuring the effectiveness and overall success of the School Health Policy. This study assessed the awareness and knowledge of teachers on SHP in Ibadan metropolis. METHODS: A descriptive cross-sectional study was carried out using a two-stage sampling technique to select 426 secondary school teachers across all the five Urban Local Government Areas (LGAs) in Ibadan metropolis by balloting. Pretested semi-structured questionnaires were used to collect data from 426 teachers. Quantitative data were analyzed using descriptive statistics, Chi-square, and logistics regression tests at 5% level of significance. RESULTS: About one-third of the respondents had heard of National School Health Policy (NSHP); however, few had seen the document. About half of the respondents were aware of the SHP in their schools. Many of the respondents had a good knowledge of SHP. Age and level of education of participants significantly influenced the knowledge of SHP. Above 50 years of age and postgraduate qualification were the significant predictors for the good knowledge of SHP. CONCLUSIONS: Awareness of the NSHP was low despite the good knowledge of SHP. This could be due to the tertiary education that most of the respondents had. Concerted efforts of stakeholders are required to intensify the health education awareness campaign to improve teachers' knowledge based on NSHP.

Interventions for violence prevention among young female hawkers in motor parks in south-western Nigeria: a review of effectiveness.

An intervention study was carried out among hawkers, drivers, instructors, police and judicial officers to reduce the incidence of violence against young female hawkers in three states of south-western Nigeria. Knowledge and experience of violence among the hawkers before and after the interventions were then compared. Findings show that they had greater knowledge of the different types of violence (p < 0.05), were more aware of their vulnerability to violence (99.4% after compared to 82.7% before intervention) and sought help or redress (76.3% after compared to 45.8% before intervention) following violent acts. Sexual violence was the commonest type experienced (30.4% and 15.7% at base line and end line respectively). The rate of violence also decreased. We conclude that multidisciplinary interventions that empower women economically and educationally and involve all stakeholders are effective in preventing violence against women.

Maternal complication prevention: evidence from a case-control study in southwest Nigeria.

BACKGROUND: The importance of strengthening maternal health services as a preventive intervention for morbidities and complications during pregnancy and delivery in developing countries cannot be over-emphasised, since use of prenatal health services improves maternal health outcomes. AIM: This study investigated differences in risk factors for maternal complications in booked and unbooked pregnant women in Nigeria, and provided evidence for their prevention. SETTING: The study was carried out in a postnatal ward in a secondary health facility. METHODS: This was a case-control study involving booked and unbooked pregnant women who had delivered. Consecutive enrolment of all unbooked pregnant women (cases) was done, and one booked pregnant woman (control) was enrolled and matched for age with each of these. Both groups were interviewed using a questionnaire, whilst records of delivery were extracted from the hospital files. Findings were subjected to logistical regression at a significance level of p < 0.05. RESULTS: Booked women had a lower median length of labour (10 hours) compared to unbooked women (13 hours). More women in the booked control group (139; 35.1%) than in the unbooked case group (96; 23.6%) reported at least one type of morbidity during the index pregnancy (p = 0.0004). Booking status was associated with a likelihood of spontaneous vaginal delivery. Young maternal age, low education, rural residence and low socio-economic status were associated with less likelihood of using prenatal services. Young maternal age, low education and intervention in the delivery were associated with a likelihood of experiencing a complication of delivery. CONCLUSION: Strengthening antenatal and secondary healthcare services as short- and medium term measures might be cost-effective as a preventive strategy in complications of pregnancy,whilst socio-economic dimensions of health are accorded priority in the long term.

Are very poor women more vulnerable to violence against women? Comparison of experiences of female beggars with homemakers in an urban slum settlement in Ibadan, Nigeria.

This study compared the prevalence and nature of violence against women (VAW) experienced by 104 female beggars with those of 219 homemakers in Sabo, an urban migrant slum settlement in Ibadan, Nigeria. The lifetime experience of VAW was 66.3% (95%CI: 62.5-70.1) among the beggars and 54.8% (95%CI: 52.2-57.6) among the homemakers (p=.05), while six months preceding the survey was: 56.7% (95%CI: 55.2-58.2) and 21.9% (95%CI: 20.8.2-23.0) respectively p=.0001). Psychological violence was experienced by 34.7% and 20.8% (p=.05); physical violence by 31.9% and 16.7% (p=.02) and sexual by 20.3% and 0.8% (p=.0001) of the beggars and homemakers respectively. Beggars with higher knowledge levels (aOR 0.23; 95%CI 0.07-0.80) and with more egalitarian attitudes (aOR 0.38; 95%CI 0.12-0.91) were less likely to experience violence. Suggestions to end VAW included female education (27.8%) and economic empowerment (59.2%). There is need to protect beggars by increasing access to health information, schooling, vocational training and income generating activities.

Prevention of congenital transmission of malaria in sub-saharan african countries: challenges and implications for health system strengthening.

Objectives. Review of burden of congenital transmission of malaria, challenges of preventive measures, and implications for health system strengthening in sub-Saharan Africa. Methods. Literature from Pubmed (MEDLINE), Biomed central, Google Scholar, and Cochrane Database were reviewed. Results. The prevalence of congenital malaria in sub-Saharan Africa ranges from 0 to 23%. Diagnosis and existing preventive measures are constantly hindered by weak health systems and sociocultural issues. WHO strategic framework for prevention: intermittent preventive therapy (IPT), insecticide-treated nets (ITNs), and case management of malaria illness and anaemia remain highly promising; though, specific interventions are required to strengthen the health systems in order to improve the effectiveness of these measures. Conclusion. Congenital malaria remains a public health burden in sub-Saharan Africa. Overcoming the challenges of the preventive measures hinges on the ability of national governments and development partners in responding to the weak health systems.

Preventive treatments of iron deficiency anaemia in pregnancy: a review of their effectiveness and implications for health system strengthening.

OBJECTIVES: We conducted a review of effectiveness of preventive treatments of iron deficiency anaemia in pregnancy in developing countries and highlighted their constraints as well as interventions required to strengthen the health services. Methods. Literature from Pubmed (MEDLINE), AJOL, Google Scholar, and Cochrane database was reviewed. RESULTS: Evidence-based preventive treatment options for iron deficiency anaemia in pregnancy include prophylaxis iron supplements and food fortification with iron. Evidence abounds on their effectiveness in reducing the prevalence of iron deficiency anaemia in pregnancy. However, these prospects are threatened by side effects of iron supplements, low utilization of maternal health service in developing countries, partial implementation of preventive treatments, and weak infrastructure and political commitment to implement mass fortification of local staple foods by national governments. CONCLUSION: Sustainability of effectiveness of preventive treatments of iron deficiency anaemia in pregnancy could be achieved if the identified threats are adequately addressed.