Management of postpartum hemorrhage by midwives in selected healthcare facilities in Ekiti State: An exploratory qualitative study.

OBJECTIVES: Maternal mortality continues to pose a critical challenge in obstetric practice, with postpartum haemorrhage as one of the major causes. This study aimed to explore the lived experiences of midwives regarding the management of postpartum haemorrhage (PPH). METHODS: The study employed a qualitative phenomenological approach. Participants were selected using purposive sampling technique, and 15 participants were recruited for the study. Data collection was done using a semi-structured interview guide for in-depth interviews. The interviews were audio-recorded, and data analysis was done using thematic analysis. RESULTS: Two themes emerged from the analysis, including 1) management practices adopted against PPH and 2) hospital protocol for the management of PPH. The major management practices adopted by the midwives were using uterotonics, especially oxytocin, and other management practices such as anti-shock garments, stimulation of contractions by rubbing the uterus, and assessment of the cause of bleeding and suturing of lacerations. It was also deduced that different healthcare facilities had policies for managing postpartum haemorrhage. Barriers affecting the effective management of PPH were understaffing, unavailability of suitable facilities and equipment, restrictions on nurses/midwives in managing PPH, unfavourable hospital policy and lack of communication among the healthcare team. CONCLUSION: The participants' experiences suggest they are somewhat satisfied with PPH management in their facilities. However, barriers such as understaffing, unavailability of equipment, poor communication among healthcare teams and restrictions on nurses in PPH management should be addressed to improve midwives' experiences in PPH management.

Assessment of Self-Medication Practices and Its Associated Factors among Undergraduates of a Private University in Nigeria.

Background: Self-medication is the use of drugs to treat self-diagnosed disorders or symptoms or the intermittent or continued use of prescribed drug for chronic or recurrent disease or symptoms, and it is mostly common in developing countries. This study therefore assessed the practice of self-medication among undergraduate students of a private university in Nigeria. Methods: The study employed a descriptive cross-sectional design. A pretested questionnaire was self-administered to 384 undergraduate students of the university. Data were analysed and summarised using descriptive and inferential statistics such as chi-squared and Fisher's exact tests. Results: Overall, 297 (81.8%) undergraduate students practiced self-medication. About 71% of the students had used analgesic, antibiotics (10.5%), and antimalarial drugs (33%) without prescription within one month prior to the survey. The most commonly used drug for self-medication was paracetamol (75.1%). Furthermore, self-medication was found to be significantly associated with age (p=0.021), gender (p < 0.001), college (p=0.025), and year of study (p=0.004). Some of the reasons why undergraduate students practiced self-medication were because of the unfriendly attitude of health care workers (27.7%), lack of time to go to school clinic (26.7%), school clinic is too far from hostel (15.3%), and drugs prescribed in the school clinic do not improve health condition (15.3%). Conclusion: Majority of the students attributed the practice of self-medication to unfriendly attitude of health care workers in the university clinic.