Choices and determinants of delivery location among mothers attending a primary health facility in Southern Nigeria.

BACKGROUND: The delivery locations of pregnant women contribute greatly to their birth outcome. The objectives of this study were to determine the choices and determinants of delivery locations among mothers attending a primary health centre (PHC) in southern Nigeria. RESEARCH METHODOLOGY: This was a descriptive cross-sectional study among mothers attending PHC, West Itam, Itu, Nigeria. Data were collected using interviewer-administered questionnaire and analysed with STATA version 12.0. Level of significance was set at 0.05. RESULTS: A total of 185 mothers participated in the study. The mean age of respondents was 27.6 ± 5.2 years. The delivery locations of last pregnancy were health facility (64.9%), traditional birth attendant's place (23.3%), respondent's residence (6.3%) and church (5.4%). The top five reasons that influenced the choice of delivery locations were distance (45.4%), cost (34.6%), skills of healthcare workers (30.3%), drug availability (27.6%) and attitude of healthcare workers (26.5%). Utilisation of healthcare facilities for delivery increased significantly with level of education and income of respondents and spouses (P < 0.05). CONCLUSION: Different non-institutionalised delivery locations were utilised by some of the respondents. Factors influencing women's choices of delivery locations included distance, cost and attitude of health workers. It is recommended that pregnant women be offered free or highly subsidised healthcare services to encourage their delivery at health facilities. Healthcare providers should endeavour to develop better relationship with clients who patronise their services. Female education should also be encouraged as this would empower them to make better choices about their health services options.

The influence of assistive technologies on experiences of risk among older adults with age-related vision loss (ARVL).

PURPOSE: Living with risk is a salient part of everyday living and although risk affects everyone, older adults are often regarded as a high-risk group, particularly older adults who are aging with a disability, such as vision loss. A prominent focus within low vision rehabilitation is the provision, and training, of older adults in the use of low vision assistive devices as a strategy to manage risks in both the home and community environment. This study aimed to unpack the influence of assistive technologies on experiences of risk among eleven older adults (aged 65+) with age-related vision loss. MATERIALS AND METHODS: This critical ethnographic study used home tours, the go-along method, and a semi-structured in-depth interview. RESULTS: The study identified five prevailing themes including: 1) Moving away from the individualization of risk; 2) The cost of assistive technologies as a risk contributor; 3) Practicing 'responsible living'; Technology as an adaptive strategy to risk taking; 4) Resisting the label of 'at risk'; The influence of technology on self-identity; and 5) Technology as a substitution versus supplement for social connectedness. CONCLUSIONS: The study findings highlight the importance of moving beyond a technico-scientific perspective of risk, in which risk is framed as an objective phenomenon located in older adults' bodies, and instead framing risk within a broader sociocultural perspective which moves our attention to those contextual or environmental factors that shape experiences of risk for older adults with vision loss.

Risk taking is an inevitable aspect of everyday living.An individualized approach to risk management is problematic.The cost of assistive technology is a contributing risk factor.Technology use may cause risks to social identity, embarrassment, and stigma.Technology use can help mitigate risk among older adults.

Social capital, social relationships and adults with acquired visual impairment: a Nigerian perspective.

PURPOSE: This study investigates the social capital implications of vision loss among working-age adults in Nigeria. The study explores the challenges of acquiring and maintaining social relationships post-vision loss, and investigates the extent to which visual rehabilitation services support social goals. METHOD: A qualitative study using a phenomenological approach was undertaken. Eight adults (18-59 years) were recruited from disability service organizations in Nigeria. Telephone interviews were recorded and transcribed, and thematic content analysis was used to analyze the data gathered in this study. RESULTS: Three broad themes were developed from participants' accounts of their experiences: (1) changes to relationships with friends and others; (2) finding strength in family relationships; and (3) rehabilitation and the confidence to interact. The findings indicate that the relationship between participants and their family members improved post vision impairment, enhancing bonding social capital. However, participants experienced reduced bridging and linking social capital due to diminished or broken relationships with managers, coworkers, friends, and others in the community. CONCLUSIONS: As social connectedness and relationships are highly valued in Nigeria's diverse society, we suggest that adults with visual impairment would significantly benefit from visual rehabilitation services placing greater emphasis on addressing the social goals of participants. Implications for Rehabilitation Visual impairment in working-age adults can strengthen family relationships (homogenous groups), creating bonding capital that is associated with access to important resources including emotional and moral support, and some financial and material resources. Visual impairment can negatively impact relationships with managers, coworkers, and others in the community (heterogeneous groups), resulting in diminished bridging and linking capital. Visual impairment can reduce access to resources such as an income, social status, and reduces participation in the wider community. Visual Rehabilitation Services could significantly benefit participants by placing greater emphasis on social goals, such as building and maintaining social networks, particularly with diverse (heterogeneous groups), which are valued in Nigeria's diverse cultural climate.

Evaluation of the in vivo antimalarial activity of ethanolic leaf and stembark extracts of Anthocleista djalonensis.

OBJECTIVE: To evaluate the in vivo antimalarial activities of ethanolic leaf and stembark extracts of Anthocleista djalonensis used traditionally as malarial remedy in Southern Nigeria in mice infected with Plasmodium berghei berghei. METHODS: The ethanolic extracts of the A. djalonensis leaf (1000 - 3000 mg/kg/day) and stembark (220 - 660 mg/kg/day) were screened for blood schizonticidal activity against chloroquine-sensitive P. berghei in mice. The schizonticidal effect during early and established infections was investigated. RESULTS: The A. djalonensis leaf extract (1000 - 3000 mg/kg/day) exhibited a significant antiplasmodial activity both in the 4-day early infection test and in the established infection with a considerable mean survival time, which was incomparable to that of the standard drug, chloroquine (5 mg/kg/day). The stembark extract (220 - 660 mg/kg/day) also demonstrated a promising blood schizontocidal activity in early and established infections. CONCLUSION: These plant extracts possess considerable antiplasmodial activities, which justify their use in ethnomedicine and can be exploited in malaria therapy.