Utilization of health care services by pregnant mothers during delivery: a community based study in Nigeria.

OBJECTIVE: Poor utilization of health facilities during delivery by pregnant mothers is still a major cause of maternal and childhood morbidity and mortality in Nigeria. The aim of this study was to determine the level of utilization of health care services by pregnant women during delivery in Gokana Local Government Area of River State, Nigeria. MATERIALS AND METHODS: This was a cross-sectional, questionnaire; based study involving 112 mothers aged 15 years to 49 years from Gokana Local Government Area of Rivers State, Nigeria. The local Government Area has 12 health centres and 6 health centres were selected by multistage sampling. 112 were then selected by simple random sampling. RESULTS: Of the 112 mothers interviewed 91 (81.3%) were married, 13 (11.6%) were single, 5 (4.5%) were widows, 2 (1.8%) divorced and 1 (0.9%) separated. Ninety seven (86.6%) of these mothers (n = 112) had formal education while 15 (13.4%) had no formal education. Most 42 (37.5%) of the mothers were between 25-29 years. Sixty four (57.1%) of the 112 mothers in their recent delivery used a health facility while 48 (42.9%) did not. Factors responsible for non utilization of health facility for delivery include: Long distance to health facility 33 (68.7%), onset of labour at night 40 (83.3%), unavailability of means of transportation 37 (77.1%), Lack of money for transportation 26 (54.2%), unsatisfactory services at health facility 26 (54.2%), unfriendly attitude of staff of the health facility 34 (70.8%), unavailability of staff at health facility 32 (64.0%), lack of urgency at health facility 36 (75.0%), previous uneventful delivery at the health facility 32 (66.7%). CONCLUSION: Utilization of health care services during delivery in Nigeria is still poor. Concerted efforts should be made both at community and Government levels to improve utilization of health facility during delivery. This will go a long way in reducing maternal and child mortality.

Insecticide - treated bednet ownership and utilization in Rivers State, Nigeria before a state-wide net distribution campaign.

BACKGROUND & OBJECTIVES: Malaria presents a huge health and economic burden to families living in malaria endemic areas. The use of insecticide-treated nets (ITNs) is one of the global strategies in decreasing the malaria burden on vulnerable populations. The use of ITNs reduces clinical malaria by over 50% and all cause mortality in children by 15-30% when the overall population coverage is >70%. This study was aimed at establishing the level of household insecticide -treated bednet ownership and utilization in Rivers State, Nigeria before a statewide scale -up distribution campaign. STUDY DESIGN: A descriptive, cross - sectional study was carried out in the Rivers State in November 2008 among household heads or their proxies to serve as a pre -intervention baseline for the scale -up distribution of insecticide treated bednets in the state. The households were selected by a multi -staged sampling technique: first stage being the selection of Local Government Areas (LGAs) from Senatorial districts, second stage the selection of communities from LGAs and final stage the selection of households. Data were collected using a questionnaire adapted from the WHO/FMoH and analyzed using the Epi -Info version 6.04d statistical software package. Hypothesis tests were conducted to compare summary statistics at 95% significance level. RESULTS: A total of 811 household heads or their proxies were interviewed. Their age ranged between 20 and 70 yr, with a mean of 47.96 ± 4.39 yr. The study showed that although 552 (68.1%) of the households owned bednets, only 245 (30.2%, 95% CI=27.1-33.5) of them owned long -lasting insecticidal nets (LLINs). Similarly, only 37.2% of those who owned ITNs slept under them the night preceding the survey. CONCLUSION: Household ITN ownership and utilization were low in the state. Incorporating behavour change communication package as part of the ITN distribution intervention is advocated to increase ITNs utilization in the state.

Identifying barriers and sustainable solution to childhood immunization in Khana local government area of Rivers State, Nigeria.

The aim of this study was to uncover barriers to childhood immunization in order to make recommendations that will address the problem in Rivers State and Nigeria. A descriptive, cross-sectional study was carried out in September 2008, among mothers and caregivers of children aged 0-5 years, to examine the various barriers to childhood immunization in the Khana Local Government Area of the State. Data was analyzed using Epi Info version 6.4d software. A total of 1560 mothers and caregivers were interviewed. Their knowledge about immunization was low. Only 15.2% was able to define immunization and mention six vaccine preventable diseases. Most children (46.8%) did not complete their immunization schedule because of frequent shortage of vaccines in the health facilities. Long-term and advance commitment by the government to vaccine manufacturers to purchase vaccines and engaging communities in dialogue over benefits of immunization is advocated to improve immunization in the State.

Parents' Perception on Use of Insecticide-Treated Bed Net in Port Harcourt

Background: Insecticide treated bed nets (ITN) are protective against malaria; but they are poorly utilized. The utilization of the nets; especially by the under fives; will depend on their caregivers' awareness of the net and their perception of its usefulness. The study therefore aims to evaluate awareness and utilization of ITN . Methods: This was a descriptive hospital-based study. It involved the distribution of 15-itemed questionnaires to 212 parents (with at least one under five aged child); who brought their children to the Paediatrics outpatient clinic of University of Port Harcourt Teaching Hospital. Questions asked covered: the awareness of ITN; the number of ITN owned by each participant and the number of under fives who slept under ITN the night preceding the interview. Results: A total of 212 parents participated in this study. Male to female ratio was 1:4. One hundred and eighty nine (89.2) participants had heard of ITN. The two most common advantages opined by the participants were that it prevents malaria (42.0) and mosquito bite (38.2). The commonest identified side effects was that it causes heat (45.8) and 113(53.3) participants owned at least one ITN. Only 45 (21.2) participants said their under fives slept under ITN on the night preceding the interview. Conclusion: There is a fair awareness of the use of ITNs for malaria control; however there is poor utilization of the nets by the under five aged children in Port Harcourt

Evaluation of Health Knowledge of Teachers in Public Primary Schools in Bonny Local Government Area of Rivers State

Background: The noncompulsory nature of health education as a subject in some teacher training colleges and the generalists' position of teachers in primary schools raise concern over the teachers' health knowledge and the accuracy of health information that pupils are given. Aim: The study was undertaken to evaluate the health knowledge of primary school teachers and to assess the effect of short term training on their health knowledge. Methods: This was a school-based intervention study carried out in June 2006. Health knowledge of all teachers from the 20 public primary schools in Bonny Local Government Area of Rivers State was assessed before and after a workshop on school health using a health knowledge assessment test. Scores of 50and more were regarded as pass. Data was analyzed using SPSS version 11 software. Test for statistical significance was done using Chi-square test and student t-test. P value less than 0.05 was regarded as statistically significant. Results: Twenty nine of the 100 participants (29) passed the pre-test. These were holders of University degrees [13 (56.5)]; National Certificate of Education [13 (28.3)] and Teachers' Grade II Certificate (TCII) [3(10)]. Post workshop; health knowledge improved across board as all the teachers passed (p=0.000). Conclusion: The health knowledge of school teachers from public primary schools in Bonny local government area is low. This was worse among those with lower academic qualifications (TCII and below). However this improved following a short term training workshop

Mortality pattern in children: a hospital based study in Nigeria.

BACKGROUND: Hospital based data on mortality pattern is a reflection of what is obtainable in a community at large. Therefore, data obtained from such review is usually beneficial in re-evaluating existing services and in improving facilities and patient care. The aim of this study was to evaluate the mortality pattern of children admitted into the children medical wards of the University of Port-Harcourt Teaching Hospital from Jan 2007 to December 2008. MATERIALS AND METHODS: This was a retrospective study. The case files of all patients aged one month to 16 years, admitted into the paediatric wards of University of Port-Harcourt Teaching Hospital, Port-Harcourt, Nigeria over a 2 year period were reviewed. Neonatal and surgical cases were excluded. RESULTS: There were 2,174 admissions during the study period. Sixty one of the total number of admissions died in the children medical wards giving a mortality rate of 2.8%. The youngest child was 2 months and the oldest 10 years. Fifty two (80.3%) were under 5 years. There was male preponderance. Most of the deaths occurred between April and September. The commonest causes of death were HIV/AIDS and bronchopneumonia in the under five age group; while in those above 5 years of age malignancies and HIV/AIDS were the predominant causes. CONCLUSION: Effective HIV/AIDS control measures will significantly reduce child mortality in our community. Also there is need to have a closer look at the potential risk for malignancies. Health intervention programmes such as integrated management of childhood illnesses and primary health care, which have been shown to reduce childhood deaths significantly, need to be intensified in order to achieve the MDG 4 by 2015.