Rural-urban differences in utilization of antenatal and delivery services in Ebonyi State, Nigeria

Background

The high maternal death burden in developing countries when compared to the developed could be attributed to differences in use of antenatal and skilled delivery care.

Aim

To assess the differences in utilization of antenatal and delivery services in urban and rural communities of Ebonyi state, Nigeria.

Methods

A cross-sectional comparative study design was used. Two stage (cluster) sampling technique was used to select 660 women in 4 of 13 local government areas in the state. The respondents were women who were permanent residents of communities and have delivered in last one year. Outcome measure was good utilization of antenatal and delivery services and was assessed by proportion of respondents who obtained antenatal and delivery from a skilled provider and also made at least four antenatal visits.

Results

The mean age of respondents was urban, 29.6 ± 6.2 and rural, 28.6 ± 5.1 years. Majority in urban, 51.8% utilized tertiary health facility for antenatal care while in rural, 77.9% used primary health centers (P < 0.001). Comparable proportions in urban, (77.3%) and rural, (79.1%) had good use of antenatal and delivery services (P = 0.572). Predictors of good use of antenatal and delivery services in urban included having one child (AOR = 4.8; 95%C1: 1.4--17.0), having attained tertiary education, (AOR = 2.6; 95%C1: 1.2--5.5), being in low socioeconomic class, (AOR = 0.4; 95%C1: 0.2--0.7), and having good knowledge of danger signs, (AOR = 2.6; 95%C1: 1.3--5.4). In rural, predictors included having one child, (AOR = 2.8; 95%C1:1.1--7.1), being unmarried, (AOR = 0.3; 95%C1: 0.1--0.9), and having good knowledge of danger signs (AOR = 3.7; 95%C1: 1.8--7.5).

Conclusion

Utilization of antenatal and delivery services in health facilities in study area was high but there is room for improvement. There is need to plan specific interventions aimed at improving utilization of maternal health services by some groups like urban poor and unmarried mothers, especially teenagers. Emphasis should also be placed on improving community understanding of danger signs of pregnancy.

The prevalence of osteoporosis among antenatal clinic attendees in a rural mission hospital in South-East Nigeria

INTRODUCTION

Osteoporosis is a global public health problem characterized by reduction of bone mineral density (BMD). This study aimed to assess the prevalence of osteoporosis among antenatal clinic attendees in a rural Southeastern hospital.

MATERIAL AND METHODS

This was a cross-sectional study of booking Antenatal Clinic Attendees at Mile 4 Catholic Hospital, Abakaliki, between October 2014 and February 2015. The study participants were selected through systematic random sampling. The BMD of the right calcaneal bone of the participants was measured using the OsteoPro, a Quantitative ultrasound scan.

RESULTS

A total of 327 eligible women participated in the study. The average age of the participants was 29 ± 4.5 years. The average parity was 2 ± 1.6 childbirths. The mean T-score was -1.19 ± 4.9. Osteoporosis and osteopenia were recorded in 119 women (36.4%) and 56 women (17.1%), respectively, whereas 152 (46.5%) were within normal range. History of regular exercise by the respondents is statistically significant on the reduction of osteopenia and osteoporosis (P ≤ 0.05). The history of ever use of calcium supplementation by the study participants in the index pregnancy did not have any significant effect on the reduction of osteoporosis.

CONCLUSION

There is a high prevalence of osteoporosis among pregnant women in Southeast Nigeria. This may be due to the predominant poor adherence and low dose of calcium supplementation among pregnant women in this environment. Therefore, there is an urgent need for sensitization on this public health problem.

Pulmonary problems among quarry workers of stone crushing industrial site at Umuoghara, Ebonyi State, Nigeria

BACKGROUND

Respiratory problem is one of the major health hazards in dust-exposed workers; it is a major cause of morbidity and mortality all over the world.

OBJECTIVE

To determine the prevalence of respiratory problems and lung function impairment among quarry workers in Ebonyi State, Nigeria.

METHODS

Respiratory problems and lung function were studied in 403 quarry workers aged 10-60 years. Respiratory problems were investigated with a questionnaire based on international models adapted for the study population. Lung function was assessed by spirometry and chest roentgenography.

RESULTS

The respiratory problems found were chest pain (47.6%), occasional cough (40.7%), occasional shortness of breath (6.5%) and wheezing (5.2%). The mean±SD FEV1 and FVC values were significantly decreased with length of exposure-respectively, 3.52±0.77 and 3.91±0.72 L for <5 years; 2.79±0.68 and 3.09±0.87 L for 5-10 years; and 2.03±0.92 and 2.86±0.83 L for >10 years of exposure. Moreover, the mean±SD FEV1 and FVC values of smoker (3.37±0.81 and 3.56±1.02 L, respectively) were significantly (p<0.05) lower than that of non-smokers (3.68±1.02 and 3.89±0.99 L, respectively) working in the quarry site.

CONCLUSION

Chronic exposure to dust due to stone quarrying may increase the risk of respiratory problems and impaired lung function-cigarette smokers are at higher risk.

The perception of health professions on causes of interprofessional conflict in a tertiary health institution in Abakaliki, southeast Nigeria

BACKGROUND

Interprofessional conflict in university teaching hospitals in Nigeria is on the increase. This study was aimed at assessing the health professions' perception of factors responsible forconflict.

METHODOLOGY

A cross-sectional descriptive survey among six health professions.

RESULTS

The perceived causes of conflict include differential salary between doctors and others, physician intimidation and discrimination of other professions, "inordinate ambition" of the other professions to lead the health team, and envy of the doctor by the other professions. Doctors differed significantly from the other professions on the role of each of these in causing conflict. Mutual respect for each other's competence, proper remuneration and clear delineation of duties for all, and other groups appreciating the salary differential between them and doctors were perceived as means of resolving the conflict. While all accepted mutual respect and proper remuneration as effective, other health workers differed significantly from doctors on the effectiveness of appreciating salary differential between them and doctors in resolving the conflict.

CONCLUSION

Differential salary between the doctor and the other health workers is the main factor perceived to cause interprofessional conflict. The government and all health professions should accept, and maintain the relativity in salary differential between doctors and other health professions.

Concurrent use of multiple antenatal care providers by women utilising free antenatal care at Ebonyi State University Teaching Hospital, Abakaliki

Observation has revealed that women who book at Ebonyi State University Teaching Hospital, Abakaliki, concurrently use multiple antenatal care givers (formal and non-formal). This study was therefore conducted to identify the other sources of antenatal care for the women and to examine them in relation to their socio-demographic characteristics. A total of 200 antenatal women chosen from two randomly selected booking clinics were interviewed using a structured questionnaire. The results show that 25% and 30.5% respectively from the two clinics were concurrently using formal and unorthodox ANC givers. Age and education were significantly related to the practice (p < 0.0002 and p < 0.02 respectively). These findings suggest that free services alone may not be enough to make women attend ANC in the hospital. A larger study, especially investigating patient's perspective of the quality of care, is recommended.