Preparedness of primary health care facilities on implementation of essential non-communicable disease interventions in osun state south-west Nigeria: a rural-urban comparative study.

BACKGROUND: Global response to the growing burden of non-communicable diseases (NCDs) in developing countries includes the development of WHO Package of Essential Non-communicable Disease Interventions (WHO PEN) for Primary Health Care (PHC). The study assessed the level of preparedness of PHC facilities on implementation of essential NCD interventions in rural and urban Local Government Areas (LGAs) of Osun State, Nigeria. METHODS: The study was a comparative cross-sectional survey. Information was collected from heads of 33 rural and 33 urban PHC facilities and through direct observation on the domains of staff training, basic equipment, diagnostics and essential medicines for cardiovascular diseases, diabetes and chronic respiratory diseases (CRDs) using a semi-structured interviewer administered questionnaire. RESULTS: Manual sphygmomanometer was found in similar proportions (84.8%) of PHC facilities in rural and urban LGAs. Glucometer was available in 45.5% of the PHC facilities in urban and 33.3% of the PHC facilities in the rural LGAs, the difference was not statistically significant (χ2 = 1.015; p = 0.314). Basic equipment for CRDs were not available in majority of PHC facilities in both locations. Moduretic tablets were the most reported essential NCD medicines, available in 15% of PHC facilities in rural LGAs and none in urban LGAs. The anti-diabetic medicines were not available in any of the PHC facilities in both locations. More than 90% (≥ 30) of the PHC facilities in both locations were not prepared to implement essential interventions for each NCD across domains of staff training and essential medicines. Overall, 97.0% of the PHC facilities in the rural LGAs and all the PHC facilities in urban LGAs were not prepared on implementation of essential interventions for the three NCDs. CONCLUSION: The level of preparedness of the PHC facilities on implementation of essential NCD interventions in the rural and urban LGAs of Osun State is very low. Government needs to strengthen the PHC system by providing needed essential medicines, basic diagnostics, equipment, and training of clinical health care workers for implementation of essential NCD interventions in the state.

Nutritional status of under-five children born to teenage mothers in an urban setting, south-western Nigeria.

OBJECTIVE: There have been many studies on the nutritional status of under-fives and factors responsible but very few looks at this special group of women. This study assessed the breastfeeding practices of teenage mothers and determined its association with the nutritional indices of their under-five children. The study was a descriptive cross-sectional survey. A total of 300 mother-child pair was selected using a multi-stage sampling technique from Primary Health Care centres in Ondo West Local Government Area, Ondo State, Nigeria. Bivariate and multivariate logistic regression were done to identify predictors' of poor nutritional status at p < 0.05. RESULTS: About 87% initiated breastfeeding less than 1 h after birth while 31.9% breastfed their children exclusively for 6 months. Prevalence of stunting, wasting and underweight among the under-fives were 18.6%, 25.3%, and 29.5% respectively. Initiation of breastfeeding more than 1 h after birth increased the odds of stunting (OR = 9.551, CI = 1.279-16.310) and underweight (OR = 6.674, CI = 3.159-14.097) by about 10 and 7 times respectively. Whereas odds of wasting (OR = 2.346, CI = 1.228-4.480) was 2 times higher with breastfeeding duration less than 6 months. Therefore, education of teenage mothers on breastfeeding initiation and duration is vital in reducing malnutrition among under-fives.

Pattern and determinants of gestational weight gain an important predictor of infant birth weight in a developing country.

The study aimed to determine correlates of gestational weight gain and infant birth weight of pregnant women attending antenatal clinics in public primary health care facilities in lfe Central and East Local Government Areas of Osun State, Nigeria. Over 1000 women were recruited during booking and antenatal clinic and followed up till delivery. Chi square was used in the bivariate analysis of association between gestational weight gain, pre pregnancy BMI and demographic characteristics. The correlates of gestational weight gain and infant birth weight were determined by linear regression analysis. Eight percent are underweight, 10.3% are overweight or obese, 78% had a weight gain less than 7kg and 0.5% had a weight gain above 11.5kg. Ninety seven percent gained less than recommended weight, only 3% of the women gained the recommended weight for their pre pregnant BMI mostly the obese women. Twenty eight percent of the women had infant weight within normal (2.5kg and above) .The infant weight increases with the gestational age, maternal age and parity but decreases with gestational weight gain though not significant. Maternal age and parity were significant predictors of gestational weight gain and. pre pregnancy BMI was a significant predictor of infant birth weight. The gestational weight gain and infant weight reduces as the pre pregnant BMI increases. Most of the women had low birth weight babies. There is a need to educate mothers on good weight before conception in order to improve birth outcome in view of other factors not looked into in the present study.