Knowledge and Willingness to Accept Vasectomy as a Method of Family Planning among Married Male Workers in the University of Nigeria, Enugu Campus, Enugu State, Nigeria.

BACKGROUND: Vasectomy is a safe and effective contraceptive option available to men, yet the practice is very low. The study aimed to assess the knowledge and willingness to accept vasectomy as a method of family planning among male married workers in a university in Enugu, Nigeria. METHODS: This was a cross-sectional study conducted among 405 male married workers in a tertiary institution in Enugu, Nigeria. Samples were selected using multistage sampling technique. Data was collected using pretested structured questionnaire and analyzed using proportion, chi - square and logistic regression. Statistical significance was set at < 0.05. RESULTS: Very few of the respondents, 10.6% had good knowledge of vasectomy and about 20.7% showed willingness to accept vasectomy as a contraceptive option. Educational level (AOR = 2.441, C.I = 1.158 - 5.146), wife support (AOR = 0.201, C.I = 0.071 - 0.571) and completed family size (AOR = 0.063, P = 0.030 - 0.136) were found to be the predictors of willingness to use vasectomy as a contraceptive among male workers of University of Nigeria, Enugu. CONCLUSION: Knowledge of vasectomy and willingness to accept it as a contraceptive were found to be poor. Awareness campaign and health education on vasectomy and ensuring that family planning services are attended by couples with completed family size will improve knowledge and willingness to accept vasectomy.

CONTEXTE: La vasectomie est une option contraceptive sûre etCefficace offerte aux hommes, mais sa pratique est très faible. L'étude visait à évaluer les connaissances et la volonté d'accepter la vasectomie comme méthode de planification familiale chez les travailleurs mariés de sexe masculin dans une université d'Enugu, au Nigeria. MÉTHODES: Il s'agit d'une étude transversale menée auprès de 405 hommes mariés travaillant dans une institution tertiaire à Enugu, au Nigeria. Les échantillons ont été sélectionnés à l'aide d'une technique d'échantillonnage à plusieurs degrés. Les données ont été recueillies à l'aide d'un questionnaire structuré prétesté et analysées à l'aide de proportions, du chi carré et de la régression logistique. La signification statistique a été fixée à < 0,05. RÉSULTATS: Très peu de répondants, 10,6 %, avaient une bonne connaissance de la vasectomie et environ 20,7 % étaient prêts à accepter la vasectomie comme option contraceptive. Le niveau d'éducation (AOR = 2,441, C.I = 1,158 - 5,146), le soutien de l'épouse (AOR = 0,201, C.I = 0,071 ­ 0,571) et la taille de la famille (AOR = 0,063, P = 0,030 - 0,136) se sont avérés être les prédicteurs de la volonté d'utiliser la vasectomie comme moyen de contraception parmi les travailleurs masculins de l'Université du Nigeria, Enugu. CONCLUSION: La connaissance de la vasectomie et la volonté de l'accepter comme moyen de contraception sont faibles. Une campagne de sensibilisation et d'éducation sanitaire sur la vasectomie et l'assurance que les services de planification familiale sont fréquentés par des couples ayant une taille de famille complète amélioreront la connaissance et la volonté d'accepter la vasectomie. Mots clés: Connaissance, Volonté, Vasectomie, Planification familiale, Homme, Nigeria.

Prevalence and Factors Associated with HIV Sero-Discordance among In-Union HIV Patients Receiving Care in a Private Health Facility in Jos, North Central, Nigeria.

INTRODUCTION: The burden of HIV infection in households of people living with HIV (PLHIV) is usually high. The existence of HIV discordance and reasons for that is largely unknown. Moreover, how people in a discordant relationship can live happily together with negative partner not getting infected and/or safely have children are not well understood. This study is to determine the prevalence and factors associated with HIV sero-discordance among in-union HIV patients receiving care in a private health facility in Jos, north central Nigeria. METHODS: A descriptive cross sectional design was used for the study involving HIV clients. Their records were reviewed and a proforma used to extract needed information. Questionnaire was equally used. A total of 1505 patients were studied out of which 75 were sero-discordant. They were recruited consecutively. Data was analyzed using SPSS version 20 and presented using frequencies, percentages, and tables. RESULTS: Findings revealed that 75 (5.0%) were discordant giving a prevalence of 5%. Majority of the clients were females: [non-discordant 805(56.3%), discordant 45(60.0%)], attained secondary education [non-discordant 590(41.3%), discordant 60(80.0%)], have been in partnership for 1-10 years [non-discordant 525(36.7%). discordant 45(60.0%)], have sex with partner weekly [non-discordant 1385(96.9%), discordant 60(80.0%)], have no other sexual partner [non-discordant 1070(74.8%), discordant 75(100.0%)]. have viral load of <100 [non-discordant 1315(92.0%), discordant 75(100.0%)], have CD4 count of 200-499 [non-discordant 585(40.9%), discordant 30(40.0%)]. Most of participants knew that ART, consistent use of condom, abstinence and post exposure prophylaxis prevent HIV. There were statistical significant associations of characteristics of clients and their knowledge on HIV prevention with HIV status of partner. CONCLUSION: Prevalence of discordance is high. There was no identified predictor of HIV status of partner. For HIV prevalence and sero-discordant status to reduce, women should have a say or be at an equal platform as men in terms of control over their sexuality.

INTRODUCTION: Le fardeau de l'infection par le VIH dans les ménages de personnes vivant avec le VIH (PVVIH) est habituellement élevé. L'existence de la discordance du VIH et les raisons de cette discordance sont largement inconnues. En outré la façon dont les personnes dans une relation discordante peuvent vivre heureuses avec un partenaire négatif qui n'est pas infecté et / ou avoir des enfants en toute sécurité n'est pas bien comprise. Cette étude vise à déterminer la prévalence et les facteurs associés à la sérodiscination du VIH chez les patients syndiqués du VIH recevant des soins dans un établissement de santé privé à Jos, dans le centre-nord du Nigéria. MÉTHODES: Un plan transversal descriptif a été utilisé pour l'étude portant sur des clients séropositifs. Leurs dossiers ont été examinés et un formulaire a été utilisé pour extraire les informations nécessaires. Le questionnaire était également utilisé. Au total, 1505 patients ont été étudiés, dont 75 étaient séro-discordants. Ils ont été recrutés consécutivement. Les données ont été analysées à l'aide de la version 20 du SPSS et présentées à l'aide de fréquences,et tableaux. RÉSULTATS: Les résultats ont révélé que 75 (5.0%) étaient discordants, ce qui donne une prévalence de 5%. La majorité des clients étaient des femmes : [805 (56.3 %), 45 (60.0 %) discordants], ont fait des études secondaires [590 non discordants (41.3 %), discordants 60 (80.0 %)], sont en partenariat depuis 1 à 10 ans [non discordants 525 (36.7 %). discordants 45 (60.0 %)], ont des relations sexuelles avec un partenaire hebdomadaire [non discordant 1385 (96.9 %), discordant 60 (80.0 %)], n'ont pas d'autre partenaire sexuel [non discordant 1070 (74.8 %), discordant 75 (100.0 %)]. ont une charge virale de <100 [non discordant 1315 (92.0%), discordant 75 (100.0%)], ont un compte de CD4 de 200- 499 [non discordant 585 (40.9%), discordant30(40.0%)]. La plupart des participants savaient que le TAR, l'utilisation régulière du condom, l'abstinence et la prophylaxie post-exposition préviennent le VIH. Il y avait des associations statistiquement significatives de caractéristiques deles clients et leurs connaissances sur la prévention du VIH avec le statut VIH de partenaire. CONCLUSION: La prévalence de la discordance est élevée. Il n'y avait pas de prédicteur identifié du statut VIH du partenaire. Pour que la prévalence du VIH et le statut de sérodispondant diminuent, les femmes devraient avoir leur mot à dire ou être sur un pied d'égalité avec les hommes en termes de contrôle sur leur sexualité. Mot-clé: Séro-discordance, Immunodéficience humaine, Cohabitation Couple.

Determinants of patterns of maternal and child health service utilization in a rural community in south eastern Nigeria.

BACKGROUND: Women and children constitute a large proportion of any population. They are the most vulnerable to morbidity and mortality especially in developing countries. In many situations the problem of poor maternal and child health stems from the poor use of available services even when they are not of optimum quality. This study seeks to describe the patterns of utilization of Maternal and Child health (MCH) services in a rural area of Enugu State, and identify factors that are associated with and responsible for determining them. METHODS: The study used a cross sectional analytic design. Pretested semi structured questionnaires were administered by interviewers to 602 women from a rural community in Enugu state, South east Nigeria. Two focus group discussions (FGDs) involving 8-10 men/ women each were conducted to identify factors affecting service utilization. Chi square analysis was done to identify factors associated with Maternal and Child Health services utilization. Logistic regression was used to identify determinants of utilization patterns. N vivo software was used to analyze findings of the FGDs. RESULTS: The study revealed that increasing age, educational level, monthly income, number of children and occupation of both women and their husbands were associated with increased MCH service utilization. Average monthly income (OR: 1.317, p = 0.048, CI: 0.073-0.986) and number of children (OR: 1.196, p < 0.01,CI: 1.563-7.000) were determinants of increased use of child care services while educational level (OR: 0.495, p < 0.001, CI: 1.244-2.164) and age (OR: 0.115, p < 0.001, CI: 0.838-0.948) determined better use of delivery and family planning services respectively. CONCLUSIONS: Improved use of MCH services is related to socio economic challenges women face such as illiteracy and low income. Furthermore, the way health facilities and their staff are perceived by rural women affect how they use some of these services and should be considered in programs which seek to reduce maternal and child mortality. Behavioral change programs with high local content need to be implemented within rural areas especially among younger, illiterate women .

Rural retention of human resources for heath.

BACKGROUND: Health workers are the heart of the health system in any country and are made up of health service providers and the health support workers. The global health workforce is over 59 million and 67% of them are the service providers. AIM: The goal of this paper is to review the most relevant papers on the retention of health workers in the underserved areas and also on how to attract and retain health workers in the rural areas. METHODOLOGY: A systematic search of literature was conducted. Grey literature (conference papers, technical reports), journal articles, abstracts, relevant books and internet articles were reviewed. RESULTS: Shortage of health workers are among the constraints in achieving the three health related Millenium Development Goals and this is more pronounced in the resource poor countries. These same resource poor countries are faced with international migration of health workers to the developed countries. CONCLUSION: The numbers of health workers across the globe are few relative to need and this is more pronounced in the rural areas of the world who unfortunately bear the greater burden of disease and there is need for policies and actions that will help to attract and retain rural health workers.