A qualitative exploration of the contributions of Polio Eradication Initiative to the Nigerian health system: policy implications for polio transition planning.

BACKGROUND: The Nigerian health care system is weak due to lack of coordination, fragmentation of services by donor funding of vertical services, dearth and poor distribution of resources, and inadequate infrastructures. The Global Polio Eradication Initiative has supported the country's health system and provided strategies and skills which need to be documented for use by other health programs attempting disease control or eradication. This study, therefore, explored the contributions of the Polio Eradication Initiative (PEI) activities to the operations of other health programs within the Nigerian health system from the perspectives of frontline workers and managers. METHODS: This cross-sectional qualitative study used key informant interviews (KIIs) and inductive thematic analysis. Twenty-nine KIIs were conducted with individuals who have been involved continuously in PEI activities for at least 12 months since the program's inception. This research was part of a more extensive study, the Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE), conducted in 2018. The KII tool focused on four major themes: work experience in other health programs, similarities and differences between polio programs and other health programs, contributions of polio programs, and missed opportunities for implementing polio lessons. All interviews were transcribed verbatim and analyzed using a thematic framework. RESULTS: The implementation of the PEI has increased health promotion activities and coverage of maternal and child health interventions through the development of tangible and intangible resources, building the capacities of health workers and discovering innovations. The presence of a robust PEI program within a weakened health system of similar programs lacking such extensive support led to a shift in health workers' primary roles. This was perceived to reduce human resources efforts in rural areas with a limited workforce, and to affect other programs' service delivery. CONCLUSION: The PEI has made a notable impact on the Nigerian health system. There should be hastened efforts to transition these resources from the PEI into other programs where there are missed opportunities and future control programs. The primary health care managers should continue integration efforts to ensure that programs leverage opportunities within successful programs to improve the health of the community members.

Nigeria experience on the use of polio assets for the 2017/18 measles vaccination campaign follow-up.

BACKGROUND: The global polio eradication initiative has made giant stride by achieving a 99% reduction in Wild poliovirus (WPV) cases, with Nigeria on the verge of being declared polio-free following over 36 months without a WPV. The initiative has provided multiple resources, assets and lessons learnt that could be transitioned to other public health challenges, including improving the quality and vaccination coverage of measles campaigns in order to reduce the incidences of measles in Nigeria. We documented the polio legacy and assets used to support the national measles campaign in 2017/2018. METHODS: We documented the integration of the measles campaign coordination with the Polio Emergency Operation Centre (EOC) at national and state levels for planning and implementing the measles SIA. Specific polio strategies and assets, such as the EOC incident command framework and facilities, human resource surge capacity, polio GIS resource These strategies were adapted and adopted for the MVC implementation overcome challenges and improve vaccination coverage. We evaluated the performance through a set process and outcome indicators. RESULTS: All the 36 states and Federal Capital Territory used the structure and resources in Nigeria and provided counterpart financing for the MVC 2017/ 2018. The 11 polio high-risk states deployed the use of GIS for microplanning process, while daily call-in data were tracked in 99.7% of the LGAs and 70,846 reports were submitted real-time by supervisors using Open data kit (ODK). The national coverage achieved was 87.5% by the post-campaign survey with 65% of states reporting higher coverage in 2018 compared to 2015. CONCLUSION: Polio eradication assets and lessons learned can be applied to measles elimination efforts as the eradication and elimination efforts have similar strategies and programme implementation infrastructure needs. Leveraging these strategies and resources to support MVC planning and implementation resulted in more realistic planning, improved accountability and availability of human and fiscal resources. This approach may have resulted in better MVC outcomes and contributed to Nigeria's efforts in measles control and elimination.

THE ROLE OF EMPLOYERS IN FACILITATING SMOKING CESSATION AMONG STAFF: PERSPECTIVE OF DRIVERS IN A NIGERIAN UNIVERSITY.

BACKGROUND: Several interventions have been instituted to encourage smoking cessation among smokers. Many adults are currently working and spend several hours a day at work. Employers thus have a role to play in encouraging staff who smoke to quit. This study investigated the perception of drivers employed in the University of Ibadan, Nigeria on the role of their employers in facilitating smoking cessation among staff who smoke. METHOD: All 176 drivers employed by the University and who were available on the days of the interviews were interviewed. A semi-structured questionnaire was used to obtain information on drivers' opinion on the role of employers in facilitating smoking cessation among staff. RESULTS: All the drivers were male and had a mean age of 51.2 ± 5.8 years. Five (2.8%) drivers were current smokers. One hundred and thirty-six (77.3%) drivers were of the opinion that their employers had a role to play in encouraging smoking cessation among staff who smoke. They felt this could be done by organizing workshops to sensitize staff on the dangers of smoking 73 (53.7%), educating staff about the health effects of smoking 26 (19.1%) and arresting staff caught smoking during official hours 20 (14.7%). CONCLUSION: Many of the drivers felt that their employers had a role to play in encouraging smoking cessation among staff. The University authorities should build on this and take specific steps to institute a comprehensive workplace antitobacco policy which includes smoking cessation interventions to assist staff who smoke to quit.

Rural-urban disparity in knowledge and compliance with traffic signs among young commercial motorcyclists in selected local government areas in Oyo State, Nigeria.

This study compared knowledge and compliance with traffic signs among young commercial motorcyclists in rural and urban communities in Oyo state, Nigeria. Information on knowledge and compliance with 10 common traffic signs was obtained from 149 rural and 113 urban commercial motorcyclists aged 18-35 years. Aggregate knowledge scores were computed and categorized as good (≥5) and poor (<5) knowledge. Overall, 98.7% rural versus 61.1% urban motorcyclists had poor knowledge of traffic signs (p < 0.05). After controlling for age, level of education and years of commercial riding, motorcyclists in the rural areas were more likely to have poor knowledge of the traffic signs (OR = 58.15; 95% CI = 11.96-282.79). A higher proportion of rural than urban motorcyclists never obeyed any of the traffic signs. Young rural commercial motorcyclists' knowledge and compliance with the road signs was poorer than their urban counterparts. Interventions to improve the rural motorcyclists' knowledge and ultimately compliance with road signs are urgently required.

A review of the health problems of the internally displaced persons in Africa.

Globally, over 40 million people were displaced as a result of wars and violence due to religious and ethnic conflicts in 2015 while 19.2 million were displaced by natural disasters such as famine and floods. In Africa, 12 million people were displaced by armed conflict and violence and there were hundreds of thousands of people displaced by natural disasters. Despite these large numbers of internally displaced persons (IDPs) in Sub-Saharan African countries and the potentially negative impact of displacement on the health of these populations, there is limited information on the health problems of IDPs in the region. The previous studies have mainly focused on the health problems of refugees and single disease entities among IDPs. However, a more comprehensive picture is required to inform the provision of adequate healthcare services for this vulnerable population. The objective of this review was to fill this knowledge gap. Bibliographic databases were searched and screened, and nine studies were selected and reviewed. The major physical health problems and symptoms were fever/malaria (85% in children and 48% in adults), malnutrition in children (stunting 52% and wasting 6%), malnutrition in adult males (24%), diarrhoea (62% in children and 22% in adults) and acute respiratory infections (45%). The prevalent mental health problems were post-traumatic stress disorder (range: 42%-54%) and depression (31%-67%). Most of the studies reviewed focused on mental health problems. Limited evidence suggests that IDPs experience various health problems but more research is required to inform the provision of adequate and comprehensive healthcare services for this group of individuals.

Determinants of Utilization of Eye Care Services in a Rural Adult Population of a Developing Country.

PURPOSE: To describe the factors that determine the utilization of eye care services in a rural community in South-Western Nigeria. METHODS: A descriptive cross-sectional survey using a multistage sampling technique was conducted. The main outcome measure was self-reported previous consultation of an orthodox medical facility for eye care. RESULTS: The study sample included 643 participants. Only 122 (19%) respondents had previously visited orthodox facilities in search of eye care and 24% of those with presenting visual acuity <6/18 had sought eye care. Characteristics associated with previous utilization of eye care services were age of =70 years (odds ratio [OR] ≥ 1.7, P = 0.02); male gender (OR = 1.5, P = 0.04); literacy (OR = 1.7, P = 0.007); and residing close to an eye care facility (OR = 2.8, P < 0.001). Blind respondents were three times more likely to seek eye care (P < 0.001). Regression analysis revealed that factors associated with increased likelihood of utilization of eye care services included age ≥ 70 years; literacy; residence close to an eye facility; being diabetic or hypertensive; history of ocular symptoms, and blindness. CONCLUSIONS: These findings suggest that a significant proportion (75%) of adults in the study area are not utilizing eye care services and that blindness is an important determinant of utilization of eye care services. Health education and awareness campaigns about the importance and benefits of seeking eye care early, and the provision of community-based eye care programs are essential to boost the uptake of eye care services in this community as well as other rural areas of West Africa.

Young Age as a Predictor of Poor Road Safety Practices of Commercial Motorcyclists in Oyo State, Nigeria.

OBJECTIVE: This study examined the association between young age and poor road safety practices of commercial motorcyclists in Oyo state, Nigeria. METHODS: A cross-sectional study of 371 commercial motorcyclists selected via a multistage sampling technique was conducted. Information on sociodemographic characteristics and road safety practices (possession of a valid license, helmet use, number of passengers carried per trip, and compliance with 10 selected traffic signs) was obtained with the aid of an interviewer-administered questionnaire. Individual road safety practice items were scored and a total score was obtained giving minimum and maximum obtainable scores of 0 and 35. Respondents with scores ≤ 17.5 (i.e., less than or equal to half of the maximum obtainable score of 35) were categorized as having poor road safety practices. Descriptive statistics, chi-square, and multiple logistic regression tests were conducted. Selected sociodemographic and occupation-related factors were controlled for in the logistic regression analysis. RESULTS: All respondents were male, 80.1% had been riding for commercial purposes for less than 5 years, and 73.0% had other jobs in addition to commercial riding. Road safety practices were generally poor; that is, 84.4% of commercial riders were categorized as having poor road safety practices. Almost all (98.6%) respondents aged < 25 years compared to 84.3% of those aged 25 to <35 years and 76.8% of those ≥35 years had poor road safety practices. This difference was statistically significant. Following logistic regression, younger age (<25 years) remained predictive of poor road safety practices. Motorcyclists aged < 25 years had about 16 times higher odds of having poor road safety practices compared to those aged 35 years and more (odds ratio = 15.72, 95% confidence interval, 1.82-135.91). CONCLUSION: Most studies conduct only bivariate analysis to test the association between age and road practices of commercial motorcyclists; however, we investigated the influence of potential confounding variables using multivariate analysis. Our findings confirmed young age as a predictor of poor road safety practices among our sample of commercial motorcyclists and emphasizes the need for road safety programs to target this category of riders. The current minimum age for obtaining a rider's license in Nigeria is 18 years; our findings suggest that it might be beneficial to increase the age at which riders in our study area can obtain a commercial rider's license to above 25 years.

Prevalence and determinants of adherence to highly active antiretroviral therapy amongst people living with HIV/AIDS in a rural setting in south-south Nigeria.

Adherence to HAART is necessary to achieve the best virologic response and lower the risk of drug resistance amongst People living with HIV/AIDS (PLHIV). However, there is limited documentation of adherence amongst patients on HAART in the south-south region of Nigeria. This study aimed to determine the prevalence and determinants of adherence to HAART amongst PLHIV in a rural setting in Cross River State. A descriptive cross-sectional study was conducted among 393 patients on HAART attending the Heart to Heart centre Ugep using an interviewer-administered questionnaire. Adherence was measured via self report and patients were termed adherent if they took at least 95% of prescribed doses. The self reported adherence rate based on a one week recall was 50.4%. The main reason for skipping doses were being busy (50.6%), simply forgetting to take medications (43.8%) and religious constraints (16%). Perceived improved health status [OR 2.7; CI: 1.37-5.39], Non use of herbal remedies, [OR 1.8; 95% CI: 1.23- 2.64] and ARV regimens devoid of dietary instructions [OR 1.49; 95% CI: 1.07- 2.06] were significant predictors of adherence. The adherence rate reported in this study was low. Appropriate adherence enhancing intervention strategies targeted at use of simplified ARV regimens and discouraging herbal use is strongly recommended.

Exposure to electric power generator noise among small scale business operators in selected communities in Ibadan, Nigeria.

Inadequate and erratic power supplies mean small businesses use electric generators for alternative power. The authors' goal in the study described here was to assess noise from electric generators and impacts in the commercial areas of Agbowo and Ajibode in Ibadan, Nigeria. Noise levels (A-weighted decibels [dBA]) were measured over 12 weeks, three times a day, during the 2010 dry season using a sound level meter. A questionnaire was administered (515 respondents; 304 in Agbowo, 211 in Ajibode) and audiometric measurements were conducted on 40% of respondents. Mean noise levels varied by source (104 ± 7.7 dBA [diesel], 94.0 ± 6.3 dBA [petrol]) and were highest midday (90.6 ± 5.3 dBA [Agbowo], 70.9 ± 6.2 dBA [Ajibode]). Mean noise levels in Agbowo (78.5 ± 3.9 dBA) and Ajibode (65.7 ± 4.4 dBA) exceeded World Health Organization guidelines (65 dBA) for outdoor commercial environments. Working and living in Agbowo was significantly associated with current evidence of hearing impairment (odds ratio: 6.8, 95% confidence interval: 3.4-13.7). Reducing exposure to noise from electric power generators serving urban small businesses and homes is warranted.

Prevalence and determinants of adherence to HAART amongst PLHIV in a tertiary health facility in south-south Nigeria.

BACKGROUND: Adherence to Highly active antiretroviral therapy (HAART) is a major predictor of the success of HIV/AIDS treatment. Good adherence to HAART is necessary to achieve the best virologic response, lower the risk of drug resistance and reduce morbidity and mortality. This study therefore aimed to determine the prevalence and determinants of adherence to HAART amongst PLHIV accessing treatment in a tertiary location in Cross River State, Nigeria. METHODS: A cross-sectional study was conducted among patients on HAART attending the Presidential Emergency plan for AIDS relief (PEPFAR) clinic of the University of Calabar Teaching Hospital between October-December 2011. A total of 411 PLHIV visiting the study site during the study period were interviewed. PLHIV who met the inclusion criteria were consecutively recruited into the study till the desired sample size was attained. Information was obtained from participants using a semi-structured, pretested, interviewer administered questionnaire. Adherence was measured via patients self report and were termed adherent if they took at least 95% of prescribed medication in the previous week prior to the study. Data were summarized using proportions, and χ2 test was used to explore associations between categorical variables. Predictors of adherence to HAART were determined by binary logistic regression. Level of significance was set at p < 0.05. RESULTS: The mean age of PLHIV who accessed treatment was 35.7 ± 9.32 years. Females constituted 68.6% of all participants. The self reported adherence rate based on a one week recall prior to the study was 59.9%. The major reasons cited by respondents for skipping doses were operating a busy schedule, simply forgot medications, felt depressed, and travelling out of town. On logistic regression analysis, perceived improved health status [OR 3.11; CI: 1.58-6.11], reduced pill load [OR 1.25; 95% CI: 0.46-2.72] and non-use of herbal remedies [OR 1.83; 95% CI: 1.22-2.72] were the major predictors for adherence to HAART. However, payment for ART services significantly decreased the likelihood of adherence to HAART. [OR 0.46; 95% CI: 0.25-0.87.]. CONCLUSIONS: The adherence rate reported in this study was quite low. Appropriate adherence enhancing intervention strategies targeted at reducing pill load and ensuring an uninterrupted access to free services regimen is strongly recommended.

Health problems and associated risk factors in selected urban and rural elderly population groups of South-West Nigeria.

BACKGROUND: The increasing number of the elderly persons and their attendant health problems has implications on public health programs in developing countries. However, there is limited information on the elderly residing outside major cities in Nigeria. Therefore, this study was conducted to determine and compare prevalent health problems and associated risk factors in the elderly of urban and rural communities in Oyo State, Nigeria. MATERIALS AND METHODS: A comparative cross-sectional survey of consenting adults aged 60 years and above in Iseyin (urban) and Ilua (rural) communities of Oyo State in south-west, Nigeria. Using cluster sampling technique, a total of 630 respondents; 316 in the urban and 314 in the rural participated. Information was sought on the respondents' socio-demographic characteristics, life style, self-reported health problems. Anthropometric measurements and clinical examination including blood pressure measurements and visual acuity were conducted. RESULTS: The mean age of urban respondents was 72.2 ± 9.5 years compared with 70.8 ± 8.1 years in the rural. There were more females (61.1%) than males (38.9%) in both the locations. Self-reported health problems in both locations were similar and included reduced sexual fulfillment, musculoskeletal problems such as muscular and low back pain. On clinical examination, the main health problems were visual impairment 58.7% in the urban versus 41.7% in the rural ( P < 0.001). Prevalence of hypertension among urban and rural respondents was 38.3% and 34.7%, respectively ( P = 0.35). Osteoarthritis was significantly higher 8.5% in urban than 3.2% obtained in rural ( P = 0.004v). On multivariate analysis, female gender, increasing body mass index, and low monthly income were significant predictors of hypertension in both locations. CONCLUSIONS: Cardiovascular, musculoskeletal, and visual noncommunicable diseases were prevalent in both elderly populations. Social conditions and gender play important role in the health status of the elderly.

The use of non-standard motorcycle helmets in low- and middle-income countries: a multicentre study.

BACKGROUND: The use of non-standard motorcycle helmets has the potential to undermine multinational efforts aimed at reducing the burden of road traffic injuries associated with motorcycle crashes. However, little is known about the prevalence or factors associated with their use. METHODS: Collaborating institutions in nine low- and middle-income countries undertook cross-sectional surveys, markets surveys, and reviewed legislation and enforcement practices around non-standard helmets. FINDINGS: 5563 helmet-wearing motorcyclists were observed; 54% of the helmets did not appear to have a marker/sticker indicating that the helmet met required standards and interviewers judged that 49% of the helmets were likely to be non-standard helmets. 5088 (91%) of the motorcyclists agreed to be interviewed; those who had spent less than US$10 on their helmet were found to be at the greatest risk of wearing a non-standard helmet. Data were collected across 126 different retail outlets; across all countries, regardless of outlet type, standard helmets were generally 2-3 times more expensive than non-standard helmets. While seven of the nine countries had legislation prohibiting the use of non-standard helmets, only four had legislation prohibiting their manufacture or sale and only three had legislation prohibiting their import. Enforcement of any legislation appeared to be minimal. INTERPRETATION: Our findings suggest that the widespread use of non-standard helmets in low- and middle-income countries may limit the potential gains of helmet use programmes. Strategies aimed at reducing the costs of standard helmets, combined with both legislation and enforcement, will be required to maximise the effects of existing campaigns.

Intimate partner violence in southwestern Nigeria: are there rural-urban differences?

The researchers in this study assessed the prevalence of different types and experience of intimate partner violence among 600 women aged 15 to 49 years in selected rural and urban communities in southwestern Nigeria between October and December, 2007. Lifetime prevalence of intimate partner violence was 64% in the rural and 70% in the urban areas. Controlling behavior was the most frequently reported type of intimate partner violence experienced by both groups of women, and sexual violence was reported least. More urban women reported sexual violence and controlling behaviors than rural women (16.4% versus 11.6% and 57.7% versus 42.0%, respectively). More rural women had experienced physical violence (28% versus 14%). More urban women experienced controlling behaviors, while more rural women experienced physical violence. In both locations, history of partners' involvement in physical fights was significantly associated with reporting sexual violence (rural: odds ratio [OR] = 3.9; 95% confidence interval [CI] 1.2-12.3; urban: OR = 8.4; 95% CI 1.4-51.8). History of alcohol consumption by partners was significantly associated with reporting physical violence (rural: OR = 2.3; 95% CI 1.2-4.4; urban: OR = 3.2; 95% CI 1.4-7.2). However, among rural respondents, younger partners were more likely to perpetuate controlling behavior (OR = 5.1; 95% CI 1.7-15.6) and being in a relationship for ≥10 years was related to psychological and physical violence. Among urban respondents, history of partners' involvement in physical fights was associated with controlling behavior (OR = 8.2; 95% CI 1.1-65.4) and physical violence (OR = 4.5; 95% CI 1.2-17.3). These results suggest that intimate partner violence is a frequent experience in women in both communities, although the types of intimate partner violence experienced differed, and multidisciplinary strategies are required to reduce intimate partner violence.

Prevalence and correlates of elder abuse among older women in rural and urban communities in South Western Nigeria.

Elderly women face the same health, economic, and social issues that all elderly people face, but often encounter more challenges compared with men and are more prone to abuse. Elder abuse has hitherto been uncharacterized among women in South Western Nigeria. A cross-sectional survey was conducted to describe the prevalence, patterns, and factors associated with elder abuse among elderly women in Nigeria. The abuse of elderly women is quite prevalent in the two communities studied, especially physical abuse. Positive predictors of elder abuse were urban dwelling, financial dependency, and a high level of educational attainment. Appropriate interventions should be targeted toward reducing the occurrence.

Prevalence and correlates of erectile dysfunction among primary care clinic attendees in Nigeria.

INTRODUCTION: Erectile dysfunction (ED) has become a public health issue in Nigeria because of its increasing magnitude, association with chronic medical conditions and negative impact on sexual life. MATERIALS AND METHODS: Cross-sectional study of 450 male patients aged 18-70 years who presented with non-ED related complaints. Main outcome measurements were prevalence and severity of ED which was assessed with International Index of Erectile Function (IIEF-5) and single-item sexual function questionnaire. Also assessed were socio-demographic characteristics, physical activities, sexual satisfaction and morbidities. RESULTS: The prevalence of ED was 55.1% (mild, moderate and severe were 32.6%, 17.8% and 4.7% respectively). Prevalence of ED was significantly associated with age (p < 0.0001), marital status (p = 0.032), income (p = 0.001), social class (p = 0.004), physical activities (p = 0.006) and BMI (p = 0.012). Prevalence of ED was significantly high among men with diabetes mellitus (72.7%), hypertension (70.7%), peptic ulcer disease (70.4%) and previous prostate surgery (76.2%). Logistic regression showed dissatisfaction with sexual life (OR = 0.689, CI = 1.233-5.866; p = 0.013) and having sexual activities less than desired (OR = 3.331, CI = 1.416-7.839; p = 0.006) to be the most significant factors associated with ED. There was a strong positive correlation between the IIEF-5 and single-item sexual function questionnaire (r = 0.747, p < 0.0001). CONCLUSION: The prevalence of ED is high among males attending a primary care clinic in Nigeria with non-ED related complaints. ED was more prevalent in men with chronic medical illnesses and sedentary lifestyle. Family physicians should inquire about this condition in these men and refer them early for specialist consultation.

Comparative study of mental health and quality of life in long-term refugees and host populations in Oru-Ijebu, Southwest Nigeria.

BACKGROUND: Refugees as "People Living in Highly Stressful Situation" are particularly vulnerable to mental ill-health as a result of the trauma experienced pre- and post-migration. The lack of information on the mental health disparities of refugees and non-refugees in West Africa is what this study aimed to bridge. A cross-sectional study design was employed using a cluster sampling technique. Interviewer-administered structured questionnaires consisting of the Mini-International Neuropsychiatric Interview (MINI), WHO quality of life (WHOQOL-BREF) and the Community Quality of Life (CQoL) were used for data collection. Data were analyzed with SPSS version 17. Logistic regression analysis was used to determine the predictors of mental health status and QoL. RESULTS: Respondents consisted of 444(45.7%) refugees and 527(54.3%) non-refugees. Two-thirds 292 (66%) of the refugees were Liberians. Mean age: refugees--34.8 ± 12.8 years versus non-refugees--33.3 ± 8.1 years (p < 0.05). While the majority 376(84.7%) of the refugees were married, most 468(88.8%) of the native population were not (p < 0.001). Significantly higher proportion of refugees had polygamous marriages, lived in poorer type of accommodation and had no formal education compared to the non-refugees (p < 0.05). The overall QoL and CQoL scores were both significantly lower for the refugees (p < 0.001). Refugees were three times more likely than non-refugees to have poor mental health [OR: 3.43; 95% CI: 1.83-6.40]. Overall, being currently ill tripled the odds of mental ill health [OR: 2.73; 95% CI: 1.98-3.77]. Unskilled workers [OR: 2.78; 95% CI: 1.68-4.60], skilled workers [OR: 2.98; 95% CI: 2.03-4.38] and the unemployed [OR: 1.94; 95% CI: 1.29-2.92] had two or more times the odds of poor mental health compared to professionals. CONCLUSIONS: QoL and occupational status were the major threats to the mental health of the refugees. Results of this study point to the need for continued attention to not only the healthcare needs but the welfare, housing, employment and overall QoL to support the long-term mental health of refugees and non-refugee populations alike.

Women at risk of physical intimate partner violence: a cross-sectional analysis of a low-income community in southwest Nigeria.

Intimate Partner Violence (IPV) is prevalent in Nigeria but a culture of silence exists, making it difficult to identify women at risk. A descriptive cross-sectional survey was employed to determine the prevalence and predictors of physical IPV in a low income, high density community in south west Nigeria. Among 924 interviews of ever-partnered women aged 15-49 years, prevalence of lifetime experience of physical IPV was 28.2%. The significant predictors for physical IPV were previous experience of psychological abuse (adjusted OR: 4.71; 95% CI: 3.23-6.85); sexual abuse (aOR: 5.18; 3.21-8.36); having attitudes supportive of IPV (aOR: 1.75; 1.2-2.4); partner's daily alcohol consumption (aOR: 2.85; 1.50-5.41); and previous engagement in a physical fight (aOR: 3.49; 1.87-6.50). Community based IPV prevention programmes targeted at breaking the cycle of abuse, transforming gender norms which support IPV and reducing alcohol consumption should be developed.

Experiences of Discrimination Among Youth with HIV/AIDS in Ibadan, Nigeria.

Nigerian youth currently bear a disproportionate burden of the HIV epidemic. This paper presents findings on the occurrence of HIV-related discrimination among youth with HIV accessing care in Ibadan, Nigeria. A cross-sectional study was conducted and information on history of discrimination experienced by 170 youth with HIV was obtained. About 80% of respondents had disclosed their HIV status. The majority had informed their spouses (66.3%), mothers (47.1%), fathers (39.1%) and siblings (37.7%). Sixteen (11.5%) respondents [15 (93.8%) females and one (6.2%) male] had suffered discrimination since disclosure of their status. Of these, 25.0% respondents were sent out of their matrimonial homes by their husbands, 25.0% were abandoned by their spouses and 12.5% indicated their fiancé broke up their relationship. A higher proportion of females (12.9%) than males (4.3%) had suffered discrimination. In addition, a significant proportion of respondents who were separated/divorced (73.3%) had been victims of discrimination compared with those who were widowed (10.5%) or single (5.9%) (P<0.05). The study confirmed that young people living with HIV/AIDS, especially women experience extreme forms of discrimination. More efforts aimed at addressing HIV/AIDS-related discrimination are required especially as it is a known barrier to HIV prevention and treatment efforts.

Building capacity of drivers in Nigeria to provide first aid for road crash victims.

This paper presents the effect of first aid training on the first aid knowledge and skills of university drivers. The intervention group (n=98) received training on first aid and controls (n=78) received training on HIV/AIDS. First aid knowledge and skills were measured at baseline, immediately after the training and 4 months post-intervention. Changes in knowledge and skills were assessed using repeated measures analysis of variance. Knowledge scores were 51.2±14.8%, 59.6±12.8% and 57.6±12.8% (p>0.05) for intervention drivers versus 51.6±11.6%, 53.2±12.0% and 56.4±12.4% (p>0.05) in controls. The skill scores for intervention drivers were 49.2±14.2%, 78.3±12.9% and 77.5±11.7% (p<0.05) versus 37.7±12.4%, 40.4±16.3% and 41.7±12.1% (p>0.05) for controls. Four months after intervention, >75% of the 13 intervention drivers who came across a crash had used the skills acquired. The intervention improved the first aid skills of intervention drivers. In view of the reduction in scores by the fourth month post-intervention, periodic refresher training is recommended to sustain the skills acquired.