The role of universal health coverage in the eradication of obstetric fistula in Nigeria-A commentary.

Obstetric fistula is a serious public health problem affecting women in low- and middle-income countries. It is characterized by continuous leakage of urine and/or feces from the vagina as a result of injuries sustained from childbirth. It has continued to exist in Nigeria because the publicly funded health-care system has failed to provide quality, equitable, accessible, and affordable maternal health care. It is largely a problem of poor, young, uneducated, and rural women who lack access to quality maternity care. Universal health coverage implies a system which provides quality health-care and financial protection to all citizens of a country. This is attained when all citizens have the needed health services without being subjected to out-of-pocket expenditure. Universal health coverage is currently not obtainable in Nigeria. When implemented, it will eliminate the existing inequality in access to health care, thereby allowing the poor and vulnerable citizens access to quality maternity care and safe delivery. A comprehensive health insurance cover for all pregnant women regardless of socioeconomic status, priority setting in resource allocation, and public-private partnership are advocated for eradication of obstetric fistula in Nigeria.

Cervical Cancer Screening: Assessment of Perception and Utilization of Services among Health Workers in Low Resource Setting.

BACKGROUND: Cervical cancer is a preventable disease and the most common cancer among women in Nigeria. OBJECTIVES: To appraise the perception and utilization of cervical cancer screening services among female nurses in Federal Teaching hospital, Abakaliki. MATERIALS AND METHODS: A cross-sectional study was done using semi-structured questionnaires on 408 consenting female nurses. Data was represented using simple percentages, charts, and Chi-square. RESULTS: Of the 408 questionnaires shared, 388 were correctly and completely filled and analyzed. The respondents in this study showed good knowledge of cervical cancer as all (388) were aware that cervical cancer is a preventable disease of public health concern. Majority of them, 179 (46.1%) were between 21 and 30 years of age. The most common symptom of cervical cancer identified was postcoital bleeding (57%). Nursing training was the most common (73.5%) source of cervical cancer information. Utilization of cervical cancer screening was poor in this study as only 20.6% of the respondents had ever undergone screening. The most common reason for nonscreening was that they have not thought of it (28.4%). CONCLUSION: Despite the high level of awareness of cervical cancer screening, utilization remains low. There is, therefore, the need for cervical cancer education for the nurses to help improve utilization.

Impacts of elevated prenatal blood lead on trace element status and pregnancy outcomes in occupationally non-exposed women.

BACKGROUND: Lead toxicity has been reported to affect hematopoietic, nervous, reproductive, cardiovascular and urinary tract systems. Many investigators have so far studied the effects of high blood lead levels on pregnancy outcomes. OBJECTIVE: To investigate the effects of elevated maternal blood lead during pregnancy on some trace elements and pregnancy outcomes. METHODS: Blood lead and plasma copper, iron and zinc were measured in 349 pregnant women with a mean ± SD age of 27.0 ± 4.8 years, and gestational age of 21.8 ± 3.1 weeks, at recruitment using atomic absorption spectrophotometer. Maternal and fetal outcomes were recorded during follow-up and at delivery, respectively. A blood lead level of ≥ 10 µg/dL was considered high. RESULTS: Women with elevated blood lead had significantly higher plasma copper and iron and lower plasma zinc than women with low blood lead level (<10 µg/dL). Blood lead level correlated with maternal hemoglobin concentration (r = -0.1054, p = 0.051) and total white blood cell count (r = 0.1045, p = 0.053). Hypertension, malaria and low birth weight were significantly higher (p<0.05) in women with elevated blood lead than in those with low blood lead level. CONCLUSION: Complications of pregnancy may be induced by a high blood lead level possibly through the alterations in trace element metabolism.

Uterine fibroids in a tertiary health centre South East Nigeria.

BACKGROUND: Uterine fibroids are common benign tumours of the female reproductive tract. This study evaluated the clinical presentations and the treatment of fibroids at Ebonyi State University Teaching Hospital over the 5-year period (2001-2005). METHODS: A retrospective analysis of all cases of uterine fibroids admitted into the gynaecological ward of the Ebonyi State University Teaching Hospital (EBSUTH) over the five-year period (2001-2005). RESULTS: Uterine fibroids accounted for 13.6% of all gynaecological admissions during the period. It was found predominantly during the third and fourth decades of life in nulliparas and women of the higher socio economic class. Primary infertility (22.9%), lower abdominal mass (21. 6%), menstrual abnormalities (15.9%), lower abdominal pain (15.9%) and anaemia (11.8%) were the common clinical presentations while abdominal myomectomy was the commonest modality of treatment employed (90%). CONCLUSION: Uterine fibroid is common among gynaecological admissions in Igbo women of Southeastern Nigeria. Infertility is a common presentation necessitating abdominal myomectomy in majority of the cases.