Barriers to health in women of reproductive age living with or at risk of non-communicable diseases in Nigeria: a Photovoice study.

BACKGROUND: Nigeria has one of the highest maternal mortality ratios (MMR) globally with an MMR of 512 (per 100,000 live births) and the proportion of maternal deaths due to non-communicable diseases (NCDs) is increasing. While evidence shows that many of these deaths are preventable, limited attention is being paid to the unique vulnerabilities and experiences of women of reproductive age (WRA) with NCDs and their risk factors, as well as the barriers to the screening, diagnosis, and management of these diseases in Nigeria. METHODS: This study explored the lives of WRA in Lagos and Federal Capital Territory in Nigeria from May to June 2019 using a community-based participatory research (CBPR) methodology called Photovoice which is aligned with CBPR as it includes procedures such as the identification of important community issues, discussion of photo assignments and data analysis. Twenty-four women of reproductive age were provided with digital cameras and trained on how to capture photos that conveyed their current health, healthcare utilization and engagement, and experience journeys. Individual interviews with the women were held for an in-depth exploration of the photographs. The data was then analysed thematically. RESULTS: Six distinct themes were identified across the barriers highlighted by the women: food and nutrition, home and family, neighborhood-built environment, economic instability, religion and spirituality and low prioritization of self-care. These themes captured the challenge of reduced agency, limited contribution and participation, and a complex relationship between visible and invisible illness. CONCLUSION: The perspectives of WRA in Nigeria obtained through this qualitative research provided a strong substratum for understanding the environmental barriers that predispose WRA to NCDs in Nigeria. The results of the study are useful for the improvement of woman-centred services of prevention, diagnosis, and management of NCD risk factors across the maternal and reproductive health care continuum in Nigeria.

Disruptive consequences of monosodium glutamate on male reproductive function: A review.

Monosodium glutamate (MSG) is one of the most extensively used flavour enhancers worldwide. Although it is widely regarded as a safe food additive with no recommended daily dosage, its over-consumption has been associated with notably pathophysiological events in various tissues and organs of the body. Previous studies have reported of the neuro- cardio- and hepato- toxic effects of its excessive exposure. Moreover, the food additive instigates metabolic dysfunction. It has been established that MSG damages male reproductive accessory organs like prostate glands and epididymis. In addition, it impairs serum enzymatic activities and serum levels of testosterone, gonadotropin-releasing hormone, luteinizing hormone and cholesterol. Reduced sperm count, sperm motility, sperm morphology, and sperm viability, imbalances in male reproductive hormones, alongside alteration in the histoarchitecture of the testes and other male reproductive tissues have also been connected with excessive exposure to MSG. Literature reports affirm the link between the over-consumption of MSG and reproductive organ weight and male sexual behaviour. This review article addresses the multi-systemic effects of exposure to MSG and the possible mechanism of action of the compound with a focus on the negative implications of the food additive on male reproductive functions and the possible role of natural antioxidants in male reproductive functions. carefully selected keywords were used during the literature search to gather credible and up-to-date information about the subject matter.

Effect of emotion-based nutrition messages on consumption of calcium-rich foods among early adolescents in Ogbomoso, Nigeria.

Introduction: Calcium is a vital micronutrient for several physiological processes, yet it remains one of the significant shortfall nutrients among Nigerian adolescents. Objective: This study was designed to assess the effect of emotion-based nutrition messages on the consumption of calcium-rich foods among early adolescents in Ogbomoso, Nigeria. Methodology: The quasi-experimental study involved 220 adolescents (experimental: 110 and control: 110) selected using a three-stage sampling procedure. A semi-structured, interviewer-administered questionnaire was used to collect socio-demographic characteristics, dietary practice, calcium-rich foods consumption pattern, calcium intake, and anthropometric parameters. Second, calcium-rich foods consumption pattern was assessed using a food frequency questionnaire, and intake was evaluated using the multi-pass 24-hour dietary recall to define adequacy at intake level ≥1,300 mg per day. Third, the experimental group had five weeks of nutrition education using emotion-based nutrition messages. Data were analyzed using descriptive statistics and the Chi-square test at p < 0.05. Results: The age of respondents (years) in experimental (12.88±1.41) and control (13.4±1.03) groups was similar. Primary dietary calcium sources were meat, chicken, egg, white beans, cheese, soy milk, oranges, and locust beans at baseline. At post-intervention, intake of other calcium-rich foods such as milk, yogurt, ice cream, okra, sardine, and unripe plantain increased, however, calcium intake remains similar in both control (238.41±92.4 mg; 235.40±92.92 mg) and experimental groups (239.76±51 mg; 241.46±100.89 mg) at baseline and post-intervention, respectively. The overall calcium intake of the adolescents remains below the recommended intake level of 1,300 mg. Conclusion: Emotion-based nutritional messages did not significantly increase the total calcium intake among early adolescents.

Negotiating quality standards for effective delivery of labor and childbirth care in Nigeria and Uganda.

OBJECTIVE: "Negotiated standards" describe a level of quality of care that is acceptable and achievable within a specific health system, based on consensus between key stakeholders. This paper presents the development of negotiated standards for effective labor and childbirth care in selected hospitals and communities in Nigeria and Uganda. METHODS: A four-step development process involving different methodologies. The process included: (1) review and synthesis of internationally recognized intrapartum clinical principles and practices; (2) primary qualitative research to assess values and preferences of women and healthcare providers, and practices that align with these preferences; (3) draft contextualization of effective and ineffective behaviors to reflect values and preferences; and (4) WHO-mediated negotiations between relevant stakeholders, including community members, providers, and administrators. RESULTS: The primary outcomes of this process were a comprehensive set of effective behaviors and clinical practices covering the main domains of quality of care, which are practical and easy to communicate, implement, and audit across all levels of healthcare delivery. CONCLUSION: The process demonstrates that health facilities and providers can be motivated to adopt standards of care that uphold the values and preferences of both service users and providers, while adhering to international best practices.