Prevalence, pattern and predictors of intimate partner violence amongst female undergraduates in Abia State, Nigeria; public health implications.

BACKGROUND: Intimate Partner Violence (IPV) is the range of sexually, psychologically and physically coercive acts used against adult and adolescent women by a current or former male partner. It is a major public health problem globally. This study determined the prevalence, patterns and predictors of IPV amongst female undergraduates in Abia State. METHODS: A cross-sectional study was conducted from January - February 2022 amongst 306 female undergraduates in Abia State. A mixed method of an online structured questionnaire created on Google forms & onsite self-administered questionnaire were deployed for data collection. Descriptive, bivariate and multivariate analyses were done using IBM SPSS Version 26.0. The level of significance was set at 5%. RESULTS: A total of 306 respondents participated in the survey. The overall prevalence of IPV amongst female undergraduates was 51.2% (95% CI: 44.8-57.6%). Emotional abuse was the most common form of abuse 78.9%, followed by Physical abuse 42.0% and Sexual abuse 30.8%. Predictors of IPV reported include female earning/receiving more than their partner monthly (aOR = 2.30; 95% CI: 1.20-4.41); male (partner) alcohol consumption (aOR = 5.17; 95% CI: 2.46-10.88), being a smoker of cigarette/marijuana (aOR = 11.01; 95% CI: 1.26-96.25) and having witnessed domestic violence as a child (aOR = 3.55; 95% CI: I.56-8.07). Adverse effects such as unwanted pregnancies (12%), miscarriages (10%), eating/sleeping disorders (21%) and bruises (23%) amongst others were noted in some of the victims. CONCLUSION: Over half of all female undergraduates in Abia State have experienced IPV with emotional abuse being the commonest. Some Individual and relationship factors were identified as predictors of IPV. We recommend intensifying primary prevention campaigns against risk factors identified like smoking and alcohol consumption.

Unmet need for family planning and predictors among women in the extended postpartum period, southeastern Nigeria: a facility-based cross-sectional study.

Introduction: the ravaging COVID-19 pandemic has worsened the levels of unmet need (UMN) for family planning (FP). A pulse survey showed that FP services were interrupted during the lockdown in 68% of countries. There is a need to investigate the demand gap for FP among women in the postpartum period. This study aimed to determine the prevalence and predictors of UMN of FP among women in the extended postpartum period attending immunization clinics. Methods: this was a facility-based cross-sectional study among 485 women recruited from 5 health facilities using a random sampling technique and proportional to size allocation. Data was collected using an interviewer-structured questionnaire. Analysis was done using IBM SPSS version 26. Adjusted odds ratios with 95% confidence intervals were computed. The level of significance was 5%. Results: the total unmet need was 45.4% (95% CI: 40.2-50.7) with a higher need for child spacing (60.4%) compared to limiting pregnancies (39.6%). The mean age was 30.3 ± 6.1 years. The significant predictors included age [35-39 years (aOR=5.39, 95% CI: 1.61-18.06); ≥ 40 years (aOR= 32.48, 95% CI: 6.48-162.77)], lower education status (aOR= 5.21, 95% CI: 2.09-13.01), lower income (aOR =2.21, 95% CI: 1.10-4.46), rural residence (aOR= 4.27, 95% CI: 2.15-8.47), denomination [Pentecostal (aOR= 4.09, 95% CI: 1.77-9.43); Orthodox (aOR= 5.44, 95% CI: 2.03-14.58)] and poor knowledge of postpartum FP (PPFP) (aOR= 33.93, 95% CI: 13.21-87.12). The commonest reason for FP non-use was fear of side effects. Conclusion: close to half of the women in the extended postpartum period experienced UMN for PPFP. Policymakers should consider these factors when designing FP interventions.

Determinants of male involvement in family planning services in Abia State, Southeast Nigeria.

BACKGROUND: Male involvement in family planning (FP) remains low in male-dominant communities. Family planning contributes to the regulation of fertility and population growth in Nigeria. Increasing male involvement in family planning services is crucial in reducing maternal morbidity and mortality in patriarchal societies such as Nigeria. This study identified the determinants of male involvement in family planning services in Abia State, Nigeria. METHODS: This was a cross-sectional study conducted in twelve communities of Abia State, Nigeria. A total of 588 married men who met the eligibility criteria were recruited using a multistage sampling technique. An interviewer-administered semi-structured questionnaire was used to collect data on the variables. Univariate, bivariate and multivariate analysis was done. The level of significance was set at 5%. RESULTS: The overall level of active male involvement in family planning services was 55.1% (95% CI:51.0-59.2%). The mean age of the respondents was 42.4 ± 8.0 years. Access to television (aOR = 1.58, 95% CI: 1.05-2.39), spouse employment status (aOR = 2.02, 95% CI: 1.33-2.06), joint decision-making (aOR = 1.66, 95% CI: 1.05-2.62), and accompanying spouse to the FP clinic (aOR = 3.15, 95% CI: 2.16-4.62) were determinants of active male involvement. CONCLUSION: At least, one out of every two men was actively involved in family planning services. This was determined by access to television, employment status of spouse, joint decision-making, and accompanying spouse to the FP clinic. There is a need to focus on the identified factors in order to further improve the active involvement of men in FP services.

Physical inactivity and perceived environmental factors: a cross-sectional study among civil servants in Abia State, Southeastern Nigeria.

Introduction: physical inactivity has been identified as the fourth leading risk factor for global mortality due to non-communicable diseases. Prevalence rates of 91.0% and 62.2%, have been documented among civil servants in the northern and southern parts of Nigeria, respectively. There is a paucity of data regarding the relationship between physical inactivity and environmental factors among civil servants in the State. This study assessed the prevalence and perceived environmental factors associated with physical inactivity among civil servants in Abia State Nigeria. Methods: we conducted a cross-sectional study in which we recruited 440 civil servants using a multistage sampling technique. We used an interviewer-administered structured questionnaire to collect data on sociodemographic, physical activity, and neighbourhood environmental attributes. Descriptive, bivariate and multivariate analysis were done. The level of significance was set at 5%. Results: the mean age of the respondents was 39.0±9.2 years, and 61% were females. The prevalence of physical inactivity was 48.4% (95%CI: 43.7%-53.2%). The putative environmental factors included perceptions of low residential density areas, perceived absence of neighbourhood sidewalks, perceived unavailability of bicycling facilities and the perception of an unsafe neighbourhood due to night crimes. The predictor of physical inactivity was the perceived absence of neighbourhood sidewalks (aOR=2.02, 95%CI: 1.10-3.73). Conclusion: in this study, physical inactivity is prevalent among civil servants in Abia State. The need for the stakeholders in collaboration with the Ministry of Environment to focus on the provision of sidewalk facilities, layout of residential areas and limit security risks in the State to enhance physical activity is highlighted.

Prevalence, pattern and predictors of self-medication for COVID-19 among residents in Umuahia, Abia State, Southeast Nigeria: policy and public health implications.

BACKGROUND: COVID-19 has led to restrictions on movements and lockdown measures, which have resulted to higher utilization of over-the-counter drugs compared to prescription-only drugs. This study determined the prevalence, pattern and predictors of self-medication for COVID-19 prevention and treatment. METHODS: A cross-sectional survey was conducted between October and November 2021 among the residents of Umuahia, Abia State. The respondents were selected using a snowball sampling technique, and a self-administered semi-structured questionnaire was used to collect data on the variables via Google forms. Descriptive, bivariate and multivariate analyses were done using IBM SPSS version 26. The level of significance was set at 5%. RESULTS: A total of 469 respondents participated in the survey. The overall prevalence of self-medication for COVID-19 prevention and treatment was 30.3% (95%CI: 26.7-34.1). The most commonly used medication was herbal products (43.7%). This was mainly self-prepared (41.5%). The major source of information for self-medication was from family members (39.4%). The majority of the respondents reported fear of isolation (76.3%), followed by fear of stigmatization (75.7%) as the triggers of self-medication. Older age (aOR = 1.87, 95% CI: 1.11-3.13), lower educational status [No formal education (aOR = 3.78, 95% CI: 1.28-11.19)], [Primary education (aOR = 2.15, 95% CI: 1.17-3.097)] and perception to cost (aOR = 2.29; 95CI: I.24-4.24) were the predictors of self-medication. CONCLUSION: Every one in three residents of Umuahia, Abia State, practiced self-medication for COVID-19 prevention and treatment. Some economic and socio-demographic factors were significantly associated with self-medication. We recommend intensifying public awareness campaigns on the risk of self-medication.

Magnitude and pattern of facility-based disrespect and abusive treatment of women during childbirth in Abia State, Nigeria.

Objectives: To ascertain the prevalence and pattern of reported facility-based disrespect and abuse of women during labour in Abia State, South-East, Nigeria. Design: A cross-sectional questionnaire-based study. Setting: One urban and one rural healthcare facility in Abia State- Federal Medical Centre, Umuahia and Nigerian Christian Hospital (NCH) Nlagu, respectively. Participants: A total of 312 women who were recently delivered of their babies in the two facilities in Abia State and attending postnatal clinics were sampled for the survey. Main Outcome Measure: Disrespect and abuse D&A) during labour among women who give birth in healthcare facilities in Abia State. Result: In all, over half (54.5%) of the women experienced disrespect and abuse in Abia State (50% urban and 63.5% in rural areas). The commonest form of disrespect and abuse was non-confidential care (22.9%). The commonest disrespectful and abusive care received was lack of privacy in the labour ward (18.3%). Conclusion: The study recorded a high prevalence of reported facility-based disrespect and abuse of women during delivery in Abia State. Training and re-training healthcare providers to promote respectful care, advocacy to policy makers and healthcare stakeholders on the development of respectful maternal care policies and further research in the area are needed. Funding: No funding was obtained for this study.

Urban-rural differences in health service-related factors associated with male involvement in family planning services in Abia State, Southeastern Nigeria.

Objective: To identify and compare the health service-related factors associated with male involvement in family planning services among the rural and urban areas in Abia State, Nigeria. Design: A community-based cross-sectional study. Setting: Twelve communities (six urban and six rural) in Abia State, Nigeria. Participants: Five hundred and eighty-eight (588) men aged 15-59 years and resident in the study area 6 months before the study were recruited. Main outcome measure: Male involvement in family planning services. Results: The mean ages of the respondents were 41.8±8.0 years and 43.1±8.0 years in the urban and rural areas, respectively. Active male involvement in family planning services was significantly higher in urban areas (62.6%, 95%CI: 56.8%-68.1%) compared to the rural areas (47.6%, 95%CI: 41.5%-53.2%. p<0.001). The predictors of male involvement included gender preference of healthcare workers (aOR=1.75, 95%CI:1.01-3.03) and attitude of the healthcare workers (aOR=2.07, 95%CI:1.17-3.67) among the urban participants, compared to occupational status of the respondents (aOR=2.50, 95% CI: 1.16-5.56) and the availability of male-friendly clinics (aOR=2.27, 95%CI:1.25-4.15) among the rural participants. Conclusion: Health service-related factors associated with male involvement varied between the urban and rural settings. Stakeholders should target addressing health service-related factors by types of settlement while designing family planning programs targeting men. Funding: No funding was obtained for this study.

Urban-rural differences in health service-related factors associated with male involvement in family planning services in Abia State, Southeastern Nigeria

Objective: To identify and compare the health service-related factors associated with male involvement in family planning services among the rural and urban areas in Abia State, Nigeria. Design: A community-based cross-sectional study. Setting: Twelve communities (six urban and six rural) in Abia State, Nigeria Participants: Five hundred and eighty-eight (588) men aged 15-59 years and resident in the study area 6 months before the study were recruited. Main outcome measure: Male involvement in family planning services Results: The mean ages of the respondents were 41.8±8.0 years and 43.1±8.0 years in the urban and rural areas, respectively. Active male involvement in family planning services was significantly higher in urban areas (62.6%, 95%CI: 56.8%-68.1%) compared to the rural areas (47.6%, 95%CI: 41.5%-53.2%. p<0.001). The predictors of male involvement included gender preference of healthcare workers (aOR=1.75, 95%CI:1.01-3.03) and attitude of the healthcare workers (aOR=2.07, 95%CI:1.17-3.67) among the urban participants, compared to occupational status of the respondents (aOR=2.50, 95% CI: 1.16-5.56) and the availability of male-friendly clinics (aOR=2.27, 95%CI:1.25-4.15) among the rural participants. Conclusion: Health service-related factors associated with male involvement varied between the urban and rural settings. Stakeholders should target addressing health service-related factors by types of settlement while designing family planning programs targeting men

COVID-19 vaccine hesitancy among healthcare workers and its socio-demographic determinants in Abia State, Southeastern Nigeria: a cross-sectional study.

INTRODUCTION: healthcare workers are at higher risk of COVID-19 infection with ease of infection transmissibility to coworkers and patients. Vaccine hesitancy rates of 56% and up to 25% have been reported among healthcare workers in US and China respectively. Vaccination is known as the most effective strategy to combat infectious diseases. Acceptance of the COVID-19 vaccine plays a major role in combating the pandemic. This study assessed the sociodemographic factors associated with COVID-19 vaccine hesitancy among healthcare workers in Abia State. METHODS: a cross-sectional study among 422 healthcare workers was conducted in Abia State with an online-based questionnaire. The questionnaire extracted information on socio-demographics and willingness to take vaccine uptake. Descriptive statistics was used to calculate frequencies and proportions. Bivariate analysis was used to test the association between the socio-demographic factors and the outcome variable (vaccine hesitancy). Logistic regression was conducted to identify the predictors of COVID-19 vaccine hesitancy. The level of significance was 5%. RESULTS: mean age of the respondents was 40.6 ± 9.5 years and 67.1% were females The COVID-19 vaccine hesitancy rate was 50.5% (95%CI: 45.6%-55.3%). Socio-demographic factors included age, marital status, location of practice, profession, and income. Vaccine Hesitancy was predicted significantly by younger age (aOR=9.34, 95%CI:2.01-43.39), marital status (single) (aOR=4.97, 95%CI:1.46-16.97), lower income (aOR=2.84, 95%CI:1.32-6.08), and profession - Doctor (aOR=0.28, 95%CI:0.11-0.70), Nurse (aOR=0.31, 95%CI:0.15-0.64) and other allied health professionals (aOR=0.22, 95%CI:0.10-0.44). CONCLUSION: COVID-19 vaccine hesitancy was high among healthcare workers. Significant sociodemographic predictors influence the uptake of the COVID-19 vaccine. We recommend that the Federal and State Ministries of Health conduct awareness campaigns targeting the younger age group, singles, lower income class, and non-clinical staff.

Patient-Doctor relationship in underserved environment: A cross-sectional study of attitudinal orientation, practice inclination, barriers and benefits among medical practitioners in Abia State, Nigeria.

BACKGROUND: Healthcare has become complex requiring balance of ever-increasing demands on physicians against humanness of medicine. As the impetus for the delivery of patient-centred care grows, there is need to study the attitude and practice orientations of medical practitioners to patient-doctor relationship (PDR). The study was aimed at describing the attitude, practice, barriers and benefits of PDR among medical practitioners in Abia State. PARTICIPANTS AND METHODS: A descriptive cross-sectional study was carried out on 210 medical practitioners in Abia State who were consecutively recruited for the study. Data were collected using self-administered questionnaire that elicited information on attitude, practice, barriers and benefits of PDR. Attitude was assessed with the 18-item Patient-Practitioner Orientation Scale (PPOS) with subscales of caring and sharing. RESULTS: The age of the participants ranged from 26 to 77 years with the mean of 36 ± 8.4 years. There were 173 (82.4%) male. The caring attitude score (mean = 3.57 ± 0.80) was higher than sharing (mean = 3.42 ± 0.65) (P = 0.036). Practice was predominantly doctor-centred (86.7%) than patient-centred (64.3%, P < 0.0001). The most common barrier to PDR was patient-doctor communication, while the most common benefit of PDR was improvement in patient satisfaction. Medical practitioners with duration of practice <10 years had significantly higher mean scores in attitudinal subscale of caring when compared with those with duration of practice ≥10 years (P < 0.0001). The study participants with duration of practice ≥10 years had significantly higher adequate practice (75.0%) of patient-centred care when compared with their counterparts with duration of practice <10 years (47.6%) (P = 0.00005). CONCLUSION: The attitude to caring did not translate to comparative disposition to sharing. The practice was more doctor-centred than patient-centred. The most common barrier and benefit of PDR were communication drawbacks and improvement in patient satisfaction, respectively. Duration of practice was associated with caring attitude and practice of patient-centred care, respectively.

Abia State HIV epidemic and response: challenges and prospects.

Since the first seroprevalence survey in 1999, the HIV prevalence in Abia State has increased from 1.8% to 7.3% in 2010. The state is currently experiencing a generalized epidemic, with most transmission occurring through heterosexual low-risk sex. Drivers of the epidemic include low knowledge of HIV prevention, low risk perception, predominantly male factor-driven risky sexual behavior, and low condom use. This study reviewed the state HIV epidemic trend in relation to response, sought to identify the gaps between the epidemic and response, and recommended measures to strengthen the state response.