Factors Influencing the Choice of Child Delivery Location among Women Attending Antenatal Care Services and Immunization Clinic in Southeastern Nigeria.
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ABSTRACT:
SUBMITTER: Egharevba J
PROVIDER: S-EPMC5547229 | biostudies-other | 2017
REPOSITORIES: biostudies-other
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Project description:This study examined the determinants of specialty choice of preresidency medical graduates in southeastern Nigeria.We used a comparative cross-sectional survey of preresidency medical graduates who took the Basic Sciences Examination of the Postgraduate Medical College in Enugu, southeastern Nigeria, in March 2007. Data on participants' demographics and specialty selected, the timing of the decision, and factors in specialty selection were collected using a questionnaire. Data were examined using descriptive and analytical statistics. P < .05 was considered significant.The survey response rate was 90.8% (287 of 316). The sample included 219 men and 68 women, ranging in age from 24 to 53 years and with a mean age of 33.5 ± 1.1 (SD) years. Career choice was more frequently influenced by personal interest (66.6%), career prospects (9.1%), and appraisal of own skills/aptitudes (5.6%), and it was least affected by altruistic motives (1.7%) and influence of parents/relations (1.7%). The respondents selected specialties at different rates: obstetrics and gynecology (22.6%), surgery (19.6%), pediatrics (16.0%), anesthesiology (3.1%), psychiatry (0.3%), and dentistry (0.0%). Most (97.2%) participants had decided on specialty choice by the end of their fifth (of a total 16 years) postgraduate year. The participants significantly more frequently preferred surgery and pediatrics to other disciplines (P < .002, after Bonferroni correction for multiple comparisons).Preresidency medical graduates in southeastern Nigeria were influenced by personal interest, career prospects, and personal skills/aptitude in deciding which specialty training to pursue. The most frequently chosen specialties were surgery and pediatrics. These findings have implications for Nigeria's education and health care policy makers.
| S-EPMC3179211 | biostudies-other
Project description:BACKGROUND:Low utilization of health facilities for delivery by pregnant women poses a public health challenge in Nigeria. AIM:To determine the factors that influence the choice of birth place among antenatal clinic attendees. METHODOLOGY:This was a cross-sectional study of the eligible antenatal clinic attendees recruited at Mater Misericordiae Hospital, Afikpo and Saint Vincent Hospital, Ndubia in Ebonyi State from February 1, 2016 to June 30, 2016. Analysis was done using EPI Info 7.21 software (CDC Atlanta Georgia). RESULTS:A total of 397(99.3%) completely filled questionnaires were collated and analysed. Approximately 71% of the health facilities closest to the respondents had maternity services. It took at least 1 hour for 80.9% of the respondents to access health facilities with maternity services. Most (60.2%) of the respondents had at least one antenatal clinic attendance and majority of them did so at public hospitals. Approximately 43.8% of the respondents were delivered by the skilled birth attendants. The respondents' age and the couple's educational level, history of antenatal clinic attendance, distance of the health facility and availability of transport fare had a significant effect on delivery by skilled birth attendants. The common determinants of birth place were nearness of the health facilities, familiarity of healthcare providers, improved services, sudden labour onset and cost. Also 61.7% of the respondents chose to deliver in public health facilities due to favourable reasons but this could be hampered by the rudeness of some healthcare providers at such facilities. A significant proportion of private health facilities had unskilled manpower and shortage of drugs. CONCLUSION:A greater proportion of women will prefer to deliver in health facilities. However there are barriers to utilization of these facilities hence the need to address such barriers.
| S-EPMC6830769 | biostudies-literature
Project description:Background: Unintended pregnancy predisposes women of child-bearing age to risk factors like maternal deaths, poor child outcomes, mental illness because of stress, risky abortion, and vertical transmission of HIV. According to the Kenya Demographic Health Survey in 2014, 34% of the pregnancies were unintended and in the year 2020 it rose to 41.9% (Monitoring, 2020). Determinants of unintended pregnancy among women attending antenatal clinics in Kenya is diverse and is poorly understood due to no representative information. The objective of the study was to determine the factors associated with unintended pregnancy among women attending antenatal clinic particularly their individual factors, family planning practices and health facility-based factors. Method: A cross-sectional study design. Data was collected using a structured administered questionnaire from 227 participants. The proportion and determinants of unintended pregnancy was derived using bivariate analysis and multivariate logistic regressions. Results: In this study, a third (29.9%) of the pregnant women reported that their existing gravidity was unintended. Individual factors such as age less than 25 years [AOR 8.1 (95% CI 1.4-48.6)), p=0.001], use of contraceptive method [AOR 7.9 (95% CI 2.5-25.0), p<0.001] and the woman being the sole decision-maker on when to get pregnant [AOR 3.8 (95% CI 1.3-11.2), p=0.014] were significantly associated with unintended pregnancy. Conclusion: The study area had quite a significant proportion of unintended pregnancy underscoring the need for health facilities to enhance targeted contraceptive counselling during antenatal and postnatal clinics. Reinforcing effective utilization of family planning services in the pursuit to decrease unintended pregnancy not only in Nairobi but also in Kenya.
| S-EPMC9606630 | biostudies-literature
Project description:Vaccine hesitancy (VH) is an issue of global concern. The quality of communication between healthcare providers and parents can influence parental immunization acceptance. We aimed to describe immunization uptake following specialist immunization clinic (SIC) consultation for Australian children of VH parents as a cohort, and according to pre-clinic parental position on immunization. At a single tertiary pediatric SIC (RCH, Melbourne) a retrospective descriptive study classified VH families according to 3 proposed parental positions on immunization at initial clinic attendance. Immunization status at follow up was ascertained via the Australian Children's Immunization Register and National HPV Program Register and compared between groups. Of the VH cohort, 13/38 (34%) families were classified as hesitant, 21 (55%) as late/selective vaccinators and 4 (11%) as vaccine refusers. Mean follow up post-SIC attendance was 14.5 months. For the overall VH cohort, the majority chose selective immunization (42%) following SIC consultation. When analyzed by pre-clinic parental position on immunization, there was a trend for hesitant families to proceed with full immunization, selective families to continue selective immunization and refusing families to remain unimmunised (p < 0.0001). The most commonly omitted vaccines were hepatitis B (66%) and Haemophilus influenzae type B (55%), followed by the meningococcal C conjugate vaccine (53%) and measles, mumps and rubella vaccine (53%). Immunization outcome appears to correlate with pre-clinic parental position on immunization for the majority of families attending a SIC in Australia, with selective immunization the most common outcome. Tailored communication approaches based on parental position on immunization may optimise clinic resources and engagement of families, but require prospective research evaluation.
| S-EPMC5054782 | biostudies-literature
Project description:Hearing loss is the third leading cause of years lived with disability. Approximately 1.4 billion people have hearing loss, of which 80% reside in low- and middle-income countries with limited audiology and otolaryngology care available to them. The objective of this study was to estimate period prevalence of hearing loss and audiogram patterns of patients attending an otolaryngology clinic in North Central Nigeria. A 10-year retrospective cohort study was carried out analyzing 1507 patient records of pure tone audiograms of patients at the otolaryngology clinic at Jos University Teaching Hospital, Plateau State, Nigeria. Prevalence of hearing loss of moderate or higher grade increased significantly and steadily after age 60. Compared to other studies, there was a higher prevalence of overall sensorineural hearing loss (24–28% in our study compared to 1.7–8.4% globally) and higher proportions of the flat audiogram configuration among the younger age patients (40% in younger patients compared to 20% in patients older than 60 years). The higher prevalence of the flat audiogram configuration compared to other parts of the world may be suggestive of an etiology specific to this region, such as the endemic Lassa Fever and Lassa virus infection in addition to cytomegalovirus or other viral infections associated with hearing loss.
| S-EPMC10128921 | biostudies-literature
Project description:BackgroundThe Erbil psychiatric hospital is the major governmental psychiatric facility in the governorate of Erbil, the capital of the Kurdistan region in Iraq, providing services for the diagnosis, treatment and follow-up of patients from the city and its surrounding areas. The child and adolescent outpatient clinic in the hospital is for patients younger than 18 years. The objectives of this study were to explore the sociodemographic, pregnancy and birth characteristics, as well as the clinical profiles, of patients who presented to the child and adolescent psychiatric outpatient clinic to statistically estimate the frequency of various psychiatric disorders among the attendees and to test hypotheses of the association of these psychiatric disorders with sociodemographic and birth and pregnancy characteristics as reported by many previous studies but with inconsistent results.MethodsA descriptive consecutive cross-sectional study was conducted from October 2017 to February 2018 in the Child and Adolescent Psychiatric Outpatient Clinic in Erbil province of Iraq's Kurdistan region. The diagnostic criteria of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) were implemented. Chi-square tests were used to test the hypothesized associations.ResultsOf a total of 207 patients, 142 were males and 65 were females, and most lived in low socioeconomic status. Most of the patients' fathers were school educated, and most mothers were illiterate. Consanguinity was found in 41% of the parents, 26.6% of the patients were born by caesarean section(C/S), 62.8% were nurtured exclusively by breastfeeding in their first six months after birth, 42.5% of them visited faith healers before consulting a psychiatrist, 43% had neurodevelopmental disorders, 26.6% had intellectual disabilities with behavioral and emotional comorbidities and 30.4% had other mental/behavioral disorders.ConclusionThis study revealed that the child and adolescent psychiatric disorders in Erbil city are versatile and that many factors are significantly associated with them. Cultural concepts are still influential in the region in a way that can interfere with children's well-being, a situation that calls for more concern and attention.
| S-EPMC6395034 | biostudies-literature
Project description:BackgroundChildhood immunisation coverage is very low in Nigeria (31%) with Zamfara State being amongst the states with the poorest coverage (<10%). Lack of maternal knowledge, attitude, outcome expectations, self-efficacy, cultural beliefs and assumptions of religious regulations of antenatal mothers towards childhood immunisation are the contributory factors to poor childhood immunisation uptake. This study aims is to develop, implement and evaluate the effects of an immunisation health educational intervention with application of Social Cognitive Theory on pregnant women to improve knowledge, attitude, outcome expectations, self-efficacy, cultural beliefs and assumptions on religious regulations regarding childhood immunization uptake in Federal Medical Centre Gusau, Zamfara State, Nigeria.MethodologyThe study will be a single-blind parallel-group randomised controlled trial, where baseline data will be collected from 392 estimated antenatal mothers, after that they will be evenly randomised using randomly generated permuted block sizes (each containing two intervention and two control assignments). The study participants will be antenatal mothers of ages 18 years and above who are in third trimesters and attending Federal Medical Centre Gusau, Zamfara State, Nigeria; during the study period and fulfilled all the inclusion and exclusion criteria. The intervention group will undergo five-health education sessions on immunisation, which will be strictly guided by Social Cognitive Theory-based intervention module: while the control group will receive usual care (standard care). Follow-up data will be collected using the same questionnaire at 6-weeks post-delivery, 10-weeks post-delivery and 14-weeks post-delivery. The generalized linear mixed model will be carried-out to determine the overall effect of the intervention after controlling for 14 potential confounding variables. An intention to treat analysis will also be carried-out. Childhood immunisation uptake is the primary outcome while the secondary outcomes are: improved knowledge scores, attitude scores, outcomes expectation, self-efficacy scores, cultural beliefs scores and assumptions on religious regulations scores.DiscussionThe study will be a randomised controlled trial, that focuses on the effects of an immunisation health educational intervention with application of Social Cognitive Theory on pregnant women to improve knowledge, attitude, outcome expectations, self-efficacy, cultural beliefs and assumptions on religious regulations regarding childhood immunisation uptake in Federal Medical Centre Gusau, Zamfara State, Nigeria.Trial registrationPan African Clinical Trial Registry PACTR202006722055635. Protocol registered on 09 June 2020.
| S-EPMC9731461 | biostudies-literature
Project description:Timely entries to antenatal care have various benefits for pregnant women and birth outcomes. The aim of antenatal care is to assure that every pregnancy culminates in the delivery of a healthy baby without negative effects on the health of pregnant women through health promotion and disease prevention, early detection, and treatment of complications and existing diseases. Hence, this study assessed the late initiation of antenatal care and associated factors among pregnant women attending antenatal clinics at public health centers of Ilu Ababor Zone, southwest Ethiopia. An Institution-based cross-sectional study was carried out among 389 pregnant women who were attending antenatal care service at twelve randomly selected health centers. A systematic sampling technique was employed to recruit pregnant women. Pretested and structured questionnaires were used to collect data. Data were entered into Epidata and exported to SPSS for analysis. Those women who started antenatal care follow up after 12 weeks of gestational age were categorized as booked lately. Bivariable and multivariable logistic regression was employed to identify an association between the independent predictors and the outcome variable. In this study, 277 (71.2%) of the participants were booked their first antenatal care visit lately. Having family size of ≥ 4 (AOR: 2.25; 95% CI: 1.07-4.74), maternal age ≥ 25 years (AOR: 2.30; 95%CI: 1.02-5.18) and perceived the right time of booking > 12 weeks of gestation (AOR: 2.39; 95% CI: 1.13-5.04) had higher odds of late antenatal care initiation. Similarly, not being a member of women's health developmental army (AOR: 2.35; 95%CI: 1.09-5.07) and ANC not attended previously (AOR: 3.32; 95% CI: 1.17-9.42) had also a more likelihood of booking antenatal care lately. In this study, the majority of women started antenatal care lately. Thus, the provision of health education on the importance of attending first antenatal care early is recommended.
| S-EPMC7845970 | biostudies-literature
Project description:ObjectivesHypertensive disorders of pregnancy contribute significantly to maternal and neonatal morbidity and mortality globally. Health-seeking behaviour is influenced by adequate knowledge of the condition. However, current data on pregnant women's knowledge of the condition and health-seeking behaviour are relatively scant in Ghana and has not been previously studied in the Central Region where hypertensive disorders of pregnancy was the leading cause of maternal mortality from 2016 to 2018. The study sought to generate data to fill this knowledge gap.MethodsA cross-sectional study was conducted among 404 pregnant women attending antenatal clinic at the Cape Coast Teaching Hospital from 1 April to 30 September 2020. Data on sociodemographic characteristics, including age, level of education and parity, and knowledge of hypertensive disorders of pregnancy, including its risk factors, clinical presentations and complications, were collected using structured questionnaires. The outcome variable, knowledge of hypertensive disorders of pregnancy, was a composite variable categorized as adequate and inadequate knowledge. Descriptive statistics were generated and association between independent and outcome variables were explored using chi-square and Fisher's exact tests and logistic regression methods.ResultsSixty-two participants (15.4%) showed adequate knowledge of hypertensive disorders of pregnancy. About 62% (251/404) of respondents had heard about hypertensive disorders of pregnancy. Of those who had heard of hypertensive disorders of pregnancy, 29.4% (72/245) correctly indicated the condition was underlined by hypertension in pregnancy ⩾ 20 weeks gestation. Women with tertiary education were six times more likely to have adequate hypertensive disorders of pregnancy knowledge than those with basic education. Women with parity 1-4 were 52% less likely to have adequate knowledge compared to nulliparous women.ConclusionThe remarkably low proportion of pregnant women with adequate knowledge of hypertensive disorders of pregnancy in the study is worrisome because of its potential adverse implication for the health of mothers and their babies. Re-packaging the antenatal health education programme and its delivery is needed for greater impact as far as hypertensive disorders of pregnancy morbidity/mortality is concerned.
| S-EPMC8943573 | biostudies-literature
Project description:BACKGROUND:Hepatitis B virus disease is a potentially life-threatening liver infection and a major global health problem. It causes chronic infection and puts people at high risk of death from cirrhosis and liver cancer. WHO estimated 257 million people are living with hepatitis B virus (HBV) infection and in 2015 alone HBV resulted in to 887,000 deaths globally. We determined the prevalence and associated factors of hepatitis B virus infection among Antenatal Care (ANC) attendees in Gamawa Local Government Area, Bauchi State. METHODS:We conducted a descriptive cross-sectional, health facility-based study between March and April 2018. We used systematic random sampling technique to recruit 210 pregnant women aged 15-49?years. With a structured questionnaire, we interviewed the respondents and collected blood sample to test for hepatitis B surface antigen. We calculated frequencies, means, proportions, and tested for associations using Epi Info 7.2 and Microsoft Excel. RESULTS:The mean age of respondents was 24.5?±?6.0?years; 112 (53%) of whom were younger than 25?years. All were married, 183 (87%) had no formal education and up to 190 (90%) were employed. Overall, 14 (6.7%) tested positive for HBsAg; women aged ?35?years had the highest prevalence (10%). None with tertiary education tested positive and women married before 18?years had 13 (6.2%) prevalence. CONCLUSIONS:The prevalence of HBsAg among pregnant women in Gamawa LGA was 6.7% which is quite lower than the national prevalence reported. We recommended improved surveillance of HBV infection and screening of women attending ANC.
| S-EPMC7059287 | biostudies-literature