Missed opportunity for self-injectable contraception awareness and adoption: Insights from client exit interviews in Uganda and Nigeria.

Objectives: To assess the extent to which self-injection contraceptive information and services are provided to women in Uganda and Nigeria. Study design: We conducted a descriptive information cascade analysis using data from a cross-sectional exit interviews with 492 family planning clients in Uganda and 720 in Nigeria. Results: More than a third of respondents in Uganda (31.2%) and Nigeria (40.5%) reported not receiving any information about the self-injection contraceptive during service provision. Only 45.6% clients who adopted self-injected DMPA-SC in Uganda and 1.7% in Nigeria were issued with additional doses to take home. Conclusion: The findings suggest that there are missed opportunities to provide women with information and services on DMPA-SC self-injection. Implication: A contraceptive counseling and services cascade can be a useful tool for identifying gaps in the quality and person-centeredness of family planning services, and ultimately improving the experience of clients.

Cervical Cancer Screening Positivity Among Women Living With HIV in CDC-PEPFAR Programs 2018-2022.

BACKGROUND: The US President's Emergency Plan for AIDS Relief aims to address the higher risk of cervical cancer among women living with HIV by offering high-quality screening services in the highest burden regions of the world. METHODS: We analyzed the US President's Emergency Plan for AIDS Relief Monitoring, Evaluation, and Reporting data from Centers for Disease Control and Prevention-supported sites in 13 countries in sub-Saharan Africa for women living with HIV aged older than 15 years who accessed cervical cancer screening services (mostly visual inspection, with ablative or excisional treatment offered for precancerous lesions), April 2018-March 2022. We calculated the positivity by age, country, and clinical visit type (first lifetime screen or routine rescreening). We fitted negative binomial random coefficient models of log-linear trends in time to estimate the probabilities of testing positive and any temporal trends in positivity. RESULTS: Among the 2.8 million completed cancer screens, 5.4% identified precancerous lesions, and 0.8% were positive for suspected invasive cervical cancers (6.1% overall). The positivity rates declined over the study period among those women screening for cervical cancer for the first time and among those women presenting to antiretroviral therapy clinics for routine rescreening. CONCLUSIONS: These positivity rates are lower than expectations set by the published literature. Further research is needed to determine whether these lower rates are attributable to the high level of consistent antiretroviral therapy use among these populations, and systematic program monitoring and quality assurance activities are essential to ensure women living with HIV have access to the highest possible quality prevention services.

Knowledge and practice of vaccination logistics management among primary health care workers in Nigeria.

Vaccines are highly thermo-sensitive materials whose potency requires a functional cold chain system which is dependent on the ability of health care workers to effectively manage the system toward eliminating vaccine-preventable diseases.This study assessed knowledge and practice of vaccination logistic management systems among primary health care workers in Osun state Nigeria.It was a descriptive cross-sectional study among 180 randomly selected health care workers who took part in a larger study on the design and pretesting of vaccine cold chain (VACOC) coolers. Research instruments were self-administered semi-structured pretested questionnaire that was analyzed using the SPSS version 23.0.The mean age was 36.7 ± 8.9 years, 87 (48.3%) could correctly explain the vaccination logistic management system, 132 (73.3%) had been trained on the system, 129 (71.7%) could assemble the ice packs used in the vaccine career box, 135 (75.0%) could assemble the vaccines, while 145 (80.6%) could assemble the diluents and thermometer. One hundred and fifty-one (83.9%) and 146 (81.1%) were found to have good knowledge and attitude to the management systems, respectively. Spending more than 5 years in profession, being a male, being a Community Health Officer were significant predictors of having a good practice of immunization logistic management system.Some gaps in knowledge, attitude, and practice of vaccination cold chain logistic system still exist among studied respondents, and these should be addressed by stakeholders in immunization programs.

Birth preparedness and complication readiness among pregnant women in Osogbo Metropolis, Southwest Nigeria.

INTRODUCTION: High maternal mortality is a major problem in Nigeria. Birth Preparedness and Complication Readiness will ensure that women can have professional delivery thus reducing obstetric complications. This study assessed the birth preparedness and complication readiness among pregnant women in Osogbo metropolis, a south western community in Nigeria. METHODS: A community based descriptive cross sectional survey was used. A total of 180 women were selected using multistage sampling technique. Pretested semi-structured interviewer administered questionnaires were used to elicit information about previous obstetric history, knowledge of the danger signs of pregnancy and level of birth preparedness. Composite score and mean were computed. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 17. P-value was set at < 0.05. RESULTS: The mean age was 26.11 ± 3.63 years. A total of 51.1% were carrying their 2nd or 3rdpregnancies. A total of 70.8% were aware of danger signs in pregnancy and the commonest danger sign mentioned was bleeding per vagina. In all, 82.1% were well prepared for birth. Being in the younger age group (p = 0.026), being more educated (p < 0.0001) and being aware of danger signs in pregnancy (p < 0.0001) was more significantly associated with being well prepared. CONCLUSION: The respondents were well prepared for birth with the younger women, educated ones and those knowledgeable of danger signs being better prepared. Continuous education about the Birth Preparedness and Complication Readiness should be sustained in order to maintain and improve women's preparedness.

Contraceptive prevalence and determinants among women of reproductive age group in Ogbomoso, Oyo State, Nigeria.

BACKGROUND: The fertility rate in Nigeria is 5.7 children per woman. The contraceptive prevalence rate has been found to be low at 15% in 2013, compared to other countries such as the US and Pakistan. OBJECTIVE: The study aimed to assess the contraceptive prevalence among women of reproductive age in Ogbomoso town, and determinants of use, with a view to make appropriate recommendations that will enhance the uptake of family planning services. MATERIALS AND METHODS: This is a descriptive cross-sectional study conducted with 560 respondents, using a multistage sampling technique. Data were retrieved using a semi-structured, pretested questionnaire. RESULTS: All the respondents were aware of contraception; however, only 49.7% (271) had ever used any method, while 25.4% (69) of the number who had ever used contraception were currently using a method. The methods being used were the traditional type (four [5.9%]), natural type (two [3.0%]), and modern type (63 [91.1%]). The predictors of contraception use included the age group of 40-49 years (odds ratio [OR] 14.1; confidence interval [CI] 3.06-73.24; P=0.0001); the married women were approximately four times more likely to use contraception than the single women (OR 4.5; CI 3.03-6.72; P<0.0001). The women with tertiary level of education were three times more likely to use contraception than those without formal education (OR 3.1; CI 1.13-9.95; P=0.0268), and the odds ratio of respondents with a positive attitude to using contraception more than those with negative attitude was 2 (OR 2; CI 1.41-2.91; P<0.0001). CONCLUSION: In light of the advantages associated with contraception use, there needs to be a conscious effort, especially among health care workers, to educate women about contraception and encourage its use.

Pubertal Timing and Demographic Predictors of Adolescents in Southwest Nigeria.

BACKGROUND: Changes in the timing of puberty have been an area of research interest in developed countries because of its associated health and psychosocial problems. Adolescents in Africa are no exception as they are reaching adulthood today much earlier than before. This changing trend may have a major influence on adolescents' sexual behaviour. AIM: This study determined the timing of puberty and demographic predictors among the adolescents in southwest Nigeria. MATERIALS AND METHODS: The study was a cross-sectional study. Using Modified Sexual Maturity Scale (MSMS) of pubertal assessment, data were collected from 1000 respondents from rural and urban areas of Osun state, Nigeria. Data were collected using pre-tested Assisted Self Completion Questionnaires (ASCQ). The rate of pubertal development was based on age group and current pubertal stage. Data were analysed using SPSS version 16. Chi-square and logistic regression analyses were done to identify significant demographic predictors. Statistical significance was at 5% level. RESULTS: The overall mean age of the respondents was 14.22±2.47 years. The mean age for males was 14.19±2.38 years and 14.25±2.57 years for females. A total of 52.9% of the respondents were males and 47.1% were females. Higher proportions of the females, 41.6% were already in late puberty stages compared to their male counterparts where 21.9% were at this stage. With regards to this rate of pubertal development, more males, 14.2% significantly had late rate of pubertal development than the females 5.1%. The significant demographic predictors was socio-economic class in females only. CONCLUSION: From this study, the timing of puberty was early for females and socio-economic class is an important demographic predictor for pubertal development. This study was however limited because intrinsic factors such as genetic makeup and nutritional status which could affect the finding were not be excluded.

Obesity indices as predictors of pattern of self-reported arthritis among elderly women in Southwestern Nigeria.

OBJECTIVES: This study assessed obesity indices and pattern of arthritis among elderly women in Osun State, Southwestern Nigeria. METHODS: The cross-sectional descriptive study was carried out among 350 elderly women selected by multistage sampling technique. Research instruments used in data collection were semi-structured, interviewer-administered pre-tested questionnaires that were analyzed using the Statistical Package for Social Sciences software version 17.0. RESULTS: The mean age of the participants was 69.1 (±1.4) years. A total of 232 (66.3%) of them had complaints of joint pains (Awoka as expressed in the local language). Pattern of arthritis showed that 172 (74.0%) had recurrent joint pains, while 35 (15.1%) had joint swelling; the knee joint was mostly affected. A total of 97 (28.0%) were overweight while 84 (24.0%) were obese. Obese women were twice more likely to have arthritis when compared to the nonobese (odds ratio: 2.4, 95% confidence interval: 1.8-9.4, p = 0.001). CONCLUSION: There is a need to give high priority to weight reduction strategies targeted at the elderly and the entire population.

Evaluation of the Effectiveness of Peer Education in Improving HIV Knowledge, Attitude, and Sexual Behaviours among In-School Adolescents in Osun State, Nigeria.

Introduction. Young people are at the centre of the global HIV/AIDS epidemic. This study therefore aimed to evaluate the effectiveness of peer education in improving HIV knowledge, attitude, and preventive practices among in-school adolescents in Osun State, Nigeria. Methods. This was an intervention study that was carried out among in-school adolescents attending mixed secondary schools in Osun State, Nigeria. The study was in three stages: before intervention, intervention, and after intervention. The impact of peer education was evaluated twelve weeks after intervention. Data were collected using pretested semistructured questionnaires and data analysis was done with SPSS version 16. Results. At the preintervention stage, the study and control groups were similar in their sociodemographic characteristics, HIV knowledge, attitude, and preventive practices, including high risk behaviours for HIV/AIDS transmission. After the peer education intervention, those with good knowledge and positive attitudes towards HIV/AIDS increased significantly from 50.0% to 86.7% and from 49.0% to 85.6%, respectively (P < 0.05). Conclusion. The study showed that peer education is effective in improving knowledge, attitude, and some preventive practices towards HIV/AIDS among in-school adolescents. Educational programmes about HIV/AIDS should therefore be designed to target this age group putting into consideration their unique characteristics.

Public perception of climate change and its impact on health and environment in rural southwestern Nigeria.

BACKGROUND: Climate change (CC) has received extensive media attention recently, and it is currently on the international public health agenda. A study of knowledge and attitudes to climate change, most especially from rural Nigerian communities, is important for developing adaptation strategies. This is a study of public perceptions of CC and its impact on health and environment in rural southwestern Nigeria. METHODS: This was a community-based descriptive cross-sectional study of 1,019 rural respondents using a multistage sampling method. The research instrument used was a pretested, structured, interviewer-administered questionnaire. Data were analyzed using SPSS software. χ2, Cramér's V, and Kendall's τ-c statistics were employed in addition to fitting the data to a logistic regression model to explore associations found significant on bivariate analysis. RESULTS: Mean age of respondents was 36.9 (±12.4) years. About 911 (89.4%) of respondents opined that there has been a change in climate in the last 10 years. Supernatural reasons were prominent among respondent-reported causes of CC. Identified risky behavior contributing to CC included smoking (10.7%), bush burning (33.4%), and tree felling (41.0%). Poor knowledge of causes but good knowledge of effects of CC were found in this study. About two-thirds of respondents had a positive attitude to causes of CC, while half had a positive attitude to the effects of CC. A significant association was found between educational status (P˂0.001, Kendall's τ-c=-0.042), occupational status (P˂0.01, Kendall's τ-c=0.088), and attitude to causes of CC. Further analysis using logistic regression showed that occupational status was significantly associated with likelihood of having a positive attitude, but educational status and marital status were not. CONCLUSION: Rural areas of Nigeria are vulnerable to the adverse effects of CC. Respondents' poor knowledge but positive attitude to CC calls for dissemination of adequate information on CC in sustained health-promotion programs.