| 1 |
Author(s):
Mrs. Bindhya Das P.M., Mrs. Linda Varghese.
Page No : 1-10
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Effectiveness of Breast Crawl on Initiation of Breastfeeding among Newborn and Mother’s Self Satisfaction in a Tertiary Care Hospital, Kochi
Abstract
Introduction: Breast milk is a divine gift for a baby and breast feeding is the nature’s best way to nurture the newborn. Immediately after the delivery breast feeding encourages the bonding of the mother to her baby. The International Organizations like WHO, UNICEF and WABA recommend that breast feeding should be initiated in the first hour of birth. One of the methods for early initiation of breast feeding was breast crawl. Breast crawl is the natural instinctive behaviour of the newborn and everything in breast crawl is perfectly designed by nature. The present study intends to evaluate the effectiveness of breast crawl technique on initiation of breast feeding among newborns and mothers self-satisfaction in a tertiary care hospital, Kochi. Objectives: The study was performed to evaluate the effectiveness of breast crawl on initiation of breast feeding among newborns, compare the time of initiation of breast feeding among newborns in two groups and assess the self-satisfaction of mothers in experimental group. Materials and Methods: A quasi experimental study, with Post-Test only Control group design and quantitative approach conducted in labour room of AIMS, Kochi among 60 full term newborns and born through normal vaginal delivery and selected by using non-probability purposive sampling technique. Among the 60 newborns, 30 were allocated to both experimental and control group. The breast crawl technique proposed by UNICEF IN 2018 was performed to experimental group and assessed the initiation of breast feeding by LATCH breast feeding assessment tool. Routine hospital care and health education regarding importance of breast feeding was given to the control group. Results: The mean LATCH breast feeding score was 8.87±0.681 in experimental group and 6.50±0.861 in control group which was found to be significant at p˂0.001. About the time duration for initiation of breastfeeding among the two groups, the mean score was 34.57±5.5 in experimental group and 75.23±4.6 minutes in control group which was found to be significant with p˂0.001. Among the mothers in the experimental group, 57% were highly satisfied, 43% were moderately satisfied and none of the mothers had less satisfaction. Conclusion: Breast crawl technique was found to be effective in breast feeding initiation among the newborn and increased maternal satisfaction among experimental group and expressed that breast crawl was totally a new experience and will suggest it to others. Clinical Significance: Based on the study findings, breast crawl technique can be implemented and practiced in clinical settings for initiation of breast feeding among newborns.
| 2 |
Author(s):
Ibrahim Sahr Momoh, Mimi K. K. Rogers.
Page No : 11-22
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Professional Development Training Programme for Registered Healthcare Workers Especially Nurses and Midwives in Sierra Leone
Abstract
In developed countries like Australia, Canada, UK and USA, continuous professional development (CPD) is statutory or mandatory training for all regulated healthcare staff such as doctors, midwives, nurses, pharmacists and physiotherapists. All patients facing healthcare professionals are expected to attend stipulated programs of learning some with annual recall. These trainings are compulsory to attend. Staff employers would be in breach of statutory laws or regulatory requirements if they employ or allow staff to work with expired CPD competencies. In a low- or middle-income country (LMIC) like Sierra Leone, CPD is currently selective, and voluntary and registration licences are not revalidated. This can invariably put patients at risk as clinical skills/knowledge are not regularly verified. This paper discusses the rationale for the Government of Sierra Leone (GoSL) to consider introducing mandatory CPD training programmes, especially for nurses and midwives employed in healthcare settings in the country.
| 3 |
Author(s):
Remilekun Oluwaseun Omole.
Page No : 23-39
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Assessment of Factors Affecting Mothers’ Perception of Caesarean Delivery in State Hospital Ijebu-Ode
Abstract
This study is aimed at assessing the perceptions and attitudes towards caesarean section (CS) among women attending maternity care at the State Hospital, Ijebu-ode Community. This is a descriptive study which involved all pregnant mothers using State Hospital, Ijebu-Ode. They were interviewed with a structured questionnaire containing socio-demographic characteristics, previous pregnancy and delivery history as well as knowledge, perceptions and attitudes towards CS. The results were analyzed with statistical package for social science (SPSS) software and presented as frequency and percentages. This was further analyzed using chi-square and t-test. The women had good knowledge of CS; however, only 39% had a fair perception of CS as a method of delivery, while 60% of Christian mothers would accept CS if needed to save their lives and that of their babies. Up to 13.3% of women from the Islamic religion would not accept CS under any circumstance. The positive perception of CS among mothers can be closely related to the study area (university community) where everybody has a pre-knowledge of CS. Logistic regression showed that women's low level of education, and past successful vaginal and instrumental deliveries, were most likely to be associated with women's non-acceptance of indicated CS. Further analysis showed that this was mainly due to inaccurate cultural and religious perceptions of labour and CS in the cohort of women. There is a need for programs to increase women's and community’s perceptions of CS as a method of delivery in Nigeria.
| 4 |
Author(s):
Awosika Esther Olayinka, Agbapuonwu Noreen Ebelechukwu (PhD).
Page No : 40-49
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Determinants of Substance Abuse Among High Abusers of Drugs in Ondo State Universities
Abstract
This study examined determinants of substance abuse among high abusers of drugs in Ondo State universities. This study adopted descriptive research design of the case study type. The population of the study includes 51 undergraduate students identified to be high abusers of drugs. The identified students were purposively selected as samples for this study. An inventory on use of drugs was randomly distributed to undergraduate students. The study obtained data through the use of semi-structured questionnaires. The instrument was divided into four (4) sections. In order to ascertain the validity of the instrument, the instrument was presented to two research experts in the field of mental health for face and content validity. To ensure the reliability of this instrument, a test-retest form of reliability was used. Data was coded and analyzed using both descriptive and inferential statistics. Chi-square test established that family background and personal factors influence substance abuse while school management has no influence. The study concluded that the increase in substance abuse among university students in Ondo State is as a result of the orientation of the students from their respective homes and the kind of friends or people the students associate with. It was recommended among others that most of the campaigns against substance abuse should be focused on peer group and family background influence.
| 5 |
Author(s):
Igboka Anthonia Ngozi, Prof. Elkhanah Chubike Ndie (PhD), Agbapuonwu Noreen E. (PhD).
Page No : 50-61
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Prevalence of Substance Abuse Among Secondary School Adolescents in Owerri Municipal Council of Imo State
Abstract
Substance abuse can be described as any chemical abuse, implying the use of one or more substances in a manner that its user excessively and progressively consumes the substance in large quantities or in a manner detrimental to themselves or to those around them. The study examined the prevalence of substance abuse among secondary school adolescents in Owerri Municipal Council of Imo State. The study adopted the descriptive survey design. Two research questions and hypotheses guided the study. The population of the study comprised all 4,435 Senior Secondary School II students in the ten public secondary schools in Owerri Municipal Council of Imo State. A sample of 420 students was drawn for the study using the simple random sampling technique (balloting) and proportionate sampling technique. A self-structured questionnaire titled “prevalence of substance abuse among adolescents in secondary schools” (POSAASS) and interview question on students’ substance abuse for teachers, principals and counsellors were used to obtain data. The questionnaire was designed on a four-point Likert scale. The face and content validity of the questionnaire was ensured. The test-retest method and Cronbach alpha method was used to establish the internal consistency and a reliability coefficient of 0.85 was obtained. Responses to the research questions were answered with mean and standard deviation, while the hypothesis was tested with independent t-test statistics. The findings of the study revealed that there is a high prevalence of substance abuse among the adolescents in secondary schools in Owerri Municipal council of Imo state, with alcohol rating as the most used and abused substance (100%) and stimulants the least used and abused substances (20.71%). Other substances that are used and abused among adolescents’ in secondary schools in Owerri Municipal council of Imo state include cigarettes (89.76%), and menthol sweet melted in carbonated drinks (98.1). Based on the findings of the study, it was recommended among others that there should be constant regulation and monitoring by parents of the kind of company their children keep, counselling and health education of the adolescents in schools by the school health nurse and counsellors.
| 6 |
Author(s):
Auwalu Muhammed (PhD), Khuan Lee (PhD), Salmiah Md Said, Sazlina Shariff-Ghazali (PhD), Abdullahi Haruna Ibrahim.
Page No : 62-76
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Planned Home Birth as a Safe Alternative to Hospital Birth for Low-Risk Women: A Systematic Review
Abstract
Home birth is a widely practised norm among women in most developing countries. Studies continue to evaluate the safety of planned home birth (PHB) for low-risk women in high-income countries. However, such studies are scarce in Africa and other developing countries. The study examined PHB as a safe alternative to planned hospital birth for low-risk women. An electronic search was carried out on databases such as Medline database, Cochrane, Google Scholar, PubMed, and CINAHL to identify studies published in English from January 2007 to December 2017. A Meta-analytic study, systematic reviews, and observational (prospective and retrospective) studies were included in the literature reviews. The studies were analyzed using descriptive and narrative synthesis. The strength and or limitations of each study were assessed. Sixteen eligible articles were finally reviewed. PHB is equally safe in terms of complication (especially postpartum haemorrhage) compared to planned hospital birth. PHB would have a similar outcome in reducing maternal death for low-risk women if compared with planned hospital birth. Although neonatal asphyxia is mixed across studies, PHB is associated with a similarly low rate of neonatal intensive care unit admission. It was also indicated that there was no increase in neonatal mortality for PHB, especially for parous women. PHB compared to the hospital is associated with a similar low risk of maternal complications, maternal deaths, newborn complications, and newborn deaths, especially for parous women. Therefore, PHB is a safe alternative to hospital birth for low-risk women. While studies that are more recent are required to evaluate its feasibility and safety in developing countries, PHB (if properly attended) may reduce maternal and newborn complications and death associated with unplanned home births.
| 7 |
Author(s):
Abaribe Chidinma E., Odufowokan Moyinoluwa, Dike Chinwenmeri, Komolafe Folashade, Ogungbesan Joshua , Opatunji Florence .
Page No : 77-87
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Uptake of Intermittent Preventive Treatment of Malaria Among Pregnant Women Attending Selected Primary Healthcare Centers in Ogun State, Nigeria
Abstract
Background: Malaria in pregnancy is a major public health concern and one of the leading causes of maternal morbidity and mortality which poses intrauterine and maternal complications during pregnancy. This study assessed the uptake of intermittent preventive treatment of malaria among pregnant women attending primary health care centers in Ikenne Local Government Area. Methods: A quantitative descriptive survey design was employed for this study; researcher-structured questionnaires were used for data collection and a multi-stage sampling technique was used to select one hundred and fifty-one mothers from the primary health centers. Result: It showed that the majority (62.5%) of the participants had average knowledge of malaria in pregnancy, and 54.6% of the participants utilized IPTP. The study found no significant relationship between respondents’ knowledge of malaria in pregnancy and the uptake of IPTP (p-value = 0.888>0.05). Moreso, findings revealed no significant relationship between the time of antenatal initiation and the uptake of intermittent preventive treatment of malaria in pregnancy p-value = 0.281>0.05 (1, X2 = 1.163). In the same vein, no significant relationship was further revealed between the level of education and the uptake of intermittent preventive treatment of malaria in pregnancy p-value = 0.842>0.05 (1, X2 = 0.040). Conclusion: Generally, in Nigeria, the uptake of intermittent preventive treatment for malaria is still low irrespective of the level of the mother's knowledge. Therefore, an increase in awareness and education of women on IPTp with direct observation under uptake was hereby recommended.
| 8 |
Author(s):
Emmanuel Sahr Nyuma, Daphne Cummings-Wray, Lawrence Sao Babawo.
Page No : 88-102
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Factors Associated with Late Antenatal Care Initiation for Pregnant Women Aged 15-49 Years in Sierra Leone Using the 2019 Demographic Health Survey
Abstract
Background: Antenatal care (ANC) is acknowledged as a critical maternal service in improving a wide variety of health outcomes for women and children as a result of better awareness of the importance of women being braced physically, mentally, and even logistically for delivery. Therefore, the timely initiation of ANC is critical to women. Objective: This study seeks to identify the factors affecting the timely initiation of ANC among women aged 15-49 in Sierra Leone. Methodology: This study adopted an analytical cross-sectional study using secondary data from the Sierra Leone Demographic and Health Survey. Frequencies and percentages were used to describe the explanatory variables. A multivariate logistic regression was conducted to identify the factors influencing the timely initiation of ANC in Sierra Leone. Results: The prevalence of timely initiation of antenatal care was 55.42%. Women residing in the northern (aOR=1.51, 95%CI 1.09-2.09), northwestern (aOR=1.87, 95%CI 1.33-2.61), southern (aOR=1.64, 95%CI 1.22-2.20) and western regions (aOR=2.00, 95%CI 1.38-2.89) had a high likelihood of starting antenatal late compared to those residing in the eastern region. Furthermore, women from the Limba (aOR=3.10, 95%CI 1.25-7.69), Sherbo (aOR=2.80, 95%CI 1.02-7.69) and Korankoh (aOR=2.79, 95%CI 1.13-6.85) ethnic groups had a higher likelihood of starting antenatal late compared to women from the creole ethnic group. Women who had no problem seeking for permission from their husbands for healthcare (aOR=0.71, 95%CI 0.55-0.89) and women who took healthcare decisions together with their husbands (aOR=0.83, 95%CI 0.70-1.00) had a lower likelihood of late initiation of antenatal care compared to those who had a big problem seeking for permission from their husbands for healthcare and respondents who took healthcare decisions alone. Conclusion: Findings from this study reveal that the timely initiation of antenatal care among women aged 15-49 years in Sierra Leone is low. Also, region of residence, ethnicity, husband’s authorization for seeking healthcare and decision making on healthcare are the factors influencing the timely initiation of antenatal care in Sierra Leone among women aged 15-49. It is recommended that women empowerment programs be organized regularly to educate women on the need to make their personal healthcare decisions. Government must also build more health facilities in the other regions of the country, with more skilled maternal healthcare training in the country to ensure equal distribution of health workers.
| 9 |
Author(s):
Fennie Mantula, Timothy L. Luzane, Yevonnie Chauraya.
Page No : 103-118
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Service Accessibility as a Determinant of Cervical Cancer Screening in Gwanda District, Zimbabwe
Abstract
Zimbabwe has one of the highest prevalence of cervical cancers in the world. The country has a low screening coverage despite the availability of cost-effective and evidence-based interventions for the prevention of the disease that include screening. This study therefore assessed service accessibility as a determinant of screening in Gwanda District, Zimbabwe. An explanatory sequential mixed-method design was employed firstly using a quantitative survey of 609 screening-eligible women selected through multi-stage random sampling. Subsequently, 36 women purposely selected from the quantitative phase were engaged in focus group discussions, and 25 health-care workers as key informants. About 74.4% of rural participants had never been screened compared to 62.1% of urban participants. Qualitative findings revealed that the district has two screening sites, both in urban locations. Rural based women access the service through outreach clinics which are inconsistent with no provision for treatment. Furthermore, treatment facilities are centralised to the provincial hospital at a fee. Financial constraints associated with travel expenses and treatment costs emerged as the key factor that hinders participation in screening. Improved access to services could greatly increase screening rates to match the high demand in the district. Decentralising screening to primary health facilities could ensure ready access of the service and enhance screening. Supplemental to that, outreach services to hard to reach areas need to be increased and sustained.
