Rural Local Government Areas Research Articles

439 Outcome of Reproductive Health Educational Intervention on Drop-Out Rate Due to Pregnancy among Rural High School Students In Sw Nigeria

Background and AimsIn Nigeria, many in- school adolescents engage in risky sexual behaviour, which predisposes them to social and health consequences, including unwanted pregnancy, school drop-out, STIs and HIV/AIDS. This...

Perception and utilization of traditional birth attendants by pregnant women attending primary health care clinics in a rural Local Government Area in Ogun State, Nigeria

BackgroundIn developing countries, most childbirth occurs at home and is not assisted by skilled attendants. This situation increases the risk of death for both mother and child and has severe maternal and neonatal health complications. The purpose of this study was to explore pregnant women’s perceptions and utilization of traditional birth attendant (TBA) services in a rural Local Government Area (LGA) in Ogun State, southwest Nigeria.MethodsA quantitative design was used to obtain information using a structured questionnaire from 250 pregnant women attending four randomly selected primary health care clinics in the LGA. Data were analyzed using Epi Info (v 3.5.1) statistical software.ResultsAlmost half (48.8%) of the respondents were in the age group 26–35 years, with a mean age of 29.4 ± 7.33 years. About two-thirds (65.6%) of the respondents had been pregnant 2–4 times before. TBA functions, as identified by respondents, were: “taking normal delivery” (56.7%), “providing antenatal services” (16.5%), “performing caesarean section” (13.0%), “providing family planning services” (8.2%), and “performing gynaecological surgeries” (5.6%). About 6/10 (61.0%) respondents believed that TBAs have adequate knowledge and skills to care for them, however, approximately 7/10 (69.7%) respondents acknowledged that complications could arise from TBA care. Services obtained from TBAs were: routine antenatal care (81.1%), normal delivery (36.1%), “special maternal bath to ward off evil spirits” (1.9%), “concoctions for mothers to drink to make baby strong” (15.1%), and family planning services (1.9%). Reasons for using TBA services were: “TBA services are cheaper” (50.9%), “TBA services are more culturally acceptable in my environment” (34.0%), “TBA services are closer to my house than hospital services” (13.2%), “TBAs provide more compassionate care than orthodox health workers” (43.4%), and “TBA service is the only maternity service that I know” (1.9%). Approximately 8/10 (79.2%) of the users (past or current) opined that TBA services are effective but could be improved with some form of training (78.3%). More than three-quarters (77.1%) opposed the banning of TBA services. Almost 7/10 (74.8%) users were satisfied with TBA services.ConclusionStudy findings revealed a positive perception and use of TBA services by the respondents. This underlines the necessity for TBAs’ knowledge and skills to be improved within permissible standards through sustained partnership between TBAs and health systems. It is hoped that such partnership will foster a healthy collaboration between providers of orthodox and traditional maternity services that will translate into improved maternal and neonatal health outcomes in relevant settings.

The System Dynamics Modeling of Geo-Synthetic Clay Landfill Liners

The effectiveness of geo-synthetic clay (GC) material as landfill liners using the system dynamics modeling approach is the focus of this paper. Study area is the Local Government Area (LGA) in Ogbomoso land of Oyo State, Nigeria. These five LGAs include the urban (Ogbomoso North and Ogbomoso South) and rural (Oriire, Ogo Oluwa and Suurulere). The properties of focus on the material were hydraulic conductivity, porosity, thickness and placement slope. A mathematical model was developed by applying the governing equations coded in Visual Basic Computer programming Language. This model was validated with field data collected on the study area. The interrelationship of the properties and the breakthrough times for GC liner was found through the STELLA 9.1.4 software application. It was discovered from this research that GC liners were more effective in urban than rural LGAs. The GC liner is therefore recommended for use as landfill liner in the urban LGAs of the study area.

Community based distribution agents’ approach to provision of family planning information and services in five Nigerian States: A mirage or a reality?

BackgroundReducing maternal mortality in Nigeria has received continuous attention both nationally and internationally.ObjectivesThis article highlights the outcome of an intervention which sought to address maternal mortality reduction through increasing contraceptive uptake in 10 rural local government areas (LGAs)in five Nigerian states.MethodThe community based distribution (CBD) approach was used in the implementation of a three year intervention that targeted 10 LGAs. Two hundred and fifty community members were trained as community based distribution agents (CBDA) to provide information on reproductive health, provide non-prescriptive family planning (FP) commodities, treat minor aliment and make referrals to primary health centres within the communities.ResultsFinal evaluation revealed an increase in the proportion of community members who had utilised FP commodities at all, from 28% at baseline to 49%, and an increase in the proportion of current contraceptive users from 16% at baseline to 37%. An average of 50% increase in clientele patronage was also observed in the 10 LGAs’ primary health care centres.Most (96%) of the interviewed CBDA agents reported that a drug-revolving system was in place to ensure that drugs and commodities were available. On-the-spot assessment of the service forms revealed that 86% of them had their activities regularly recorded in their worksheets. Some of the challenges faced by CBDA were discrimination and misconception of community members about family planning (38%), inadequate financial support (14%), and transportation problems (8%).ConclusionThis study has demonstrated that the CBD approach played a critical role in enhancing access to Reproductive Health and Family Planning information and services in the project communities.

P2-377 A rural-urban comparison of the prevalence and patterns of elder abuse in Oyo state, south western Nigeria

IntroductionGlobally, it has been documented that the population is ageing at an unprecedented rate. The issue of elder abuse has not been adequately addressed, especially in Nigeria because it has...

Clients' perception of quality of family planning services in urban and rural health facilities in Lagos State

Background: High quality of care of family planning services has been known to affect contraceptive uptake and continued usage of methods. The objective of this study was to compare clients perception of the quality of family planning services among women attending health facilities in Surulere (urban) and Ikorodu (rural) Local Government Areas in Lagos State. Methodology: A cross sectional descriptive study was carried out among women accessing family planning services from March to June 2005 in Surulere and Ikorodu Local Government Areas. Data collection was by exit interview of clients. Consecutive recruitment was done until the desired sample size (120) in each Local Government Areas was achieved. Results: The mean age of respondents was 34.3 years (Surulere) and 33.6 years (Ikorodu) while all 100% (Surulere) and 98% (Ikorodu) were currently married. Clients rating of the clinic visited includes; mean waiting time of 25.8 minutes (Surulere) and 32.4 minutes (Ikorodu) statistically significant differences observed were; sufficient privacy (100% and 92%) clean clinic area (98% and 85%) waiting time too long (4% and 18.4%) while for services providers; satisfaction with overall treatment (94% and 60%) comfortable to ask questions (99% and 80%) keeping of information shared (86% and 56%) (p<0.05) in Surulere and Ikorodu Local Government Areas respectively. Conclusion: Respondents that visited the urban health facilities were more satisfied. Retraining of providers in rural health facilities on interpersonal relationship counseling and communication skills is recommended.

Factors Associated with Use of Guideline in Home Management of Malaria among Children in Rural South West Nigeria.

The dosage regimen for artemether-lumefantrine which is the standard of care for malaria in most of Sub-Saharan countries requires use of treatment guidelines and instructions to enhance caregivers' performance in the treatment of malaria. As part of a larger study evaluating its effectiveness in a rural local government area in southwestern Nigeria, 552 caregivers whose children had fever two weeks preceeding the survey were recruited. Information was collected with interviewer administered questionnaire. A multilevel logistic regression model was fitted using the gllamm approach in Stata to determine the factors associated with use of guideline. Age and educational background of caregiver were significantly associated with guideline use. Caregivers aged 26–30 years were 4 times more likely to use guideline than those aged >40 years. Caregivers with primary education were 4 times more likely to use guideline compared with caregivers with no formal education. Between-village variance was 0.00092 ± 0.3084. Guideline use reduced with increasing age and lower education.

Knowledge of Malaria and Preventive Measures among Pregnant Women Attending Antenatal Clinics in a Rural Local Government Area in Southwestern Nigeria

This study determined the level of knowledge of malaria and preventive measures among pregnant women and its influence on the uptake of preventive measures. A cross-sectional survey was carried out among 209 participants selected from pregnant women attending antenatal clinics in primary healthcare centres in Irepodun/Ifelodun, a local government area in Ekiti state, Nigeria. Knowledge of malaria was found to be very good, average and poor among two (1.0%), 165 (78.9%) and 42 (20.1%) respondents, respectively. Of the 109 (52.2%) respondents who had heard about intermittent preventive treatment, eight (7.3%) scored "very good" on knowledge, while 53 (48.6%) and 48 (44.1%) scored "average" and "poor," respectively. Of the 144 (68.9%) respondents who had heard about insecticide-treated nets, 95 (66.0%) scored "good" on knowledge, while 49 (34.0%) scored "poor." Factors that significantly influenced knowledge about malaria were occupation, level of education, months at first appearance at antenatal clinic and transportation cost. Knowledge significantly influenced uptake of insecticide-treated nets and intermittent preventive treatment in pregnancy ( p < .05). There is a need to intensify efforts to provide health education on malaria and preventive measures as well as to encourage preventive practices among pregnant women.

Knowledge and utilization of intermittent preventive treatment for malaria among pregnant women attending antenatal clinics in primary health care centers in rural southwest, Nigeria: a cross-sectional study

BackgroundIntermittent preventive treatment for prevention of malaria in pregnancy (IPTp) is a key component of malaria control strategy in Nigeria and sulfadoxine-pyrimethamine (SP) is the drug of choice. Despite the evidence of the effectiveness of IPTp strategy using SP in reducing the adverse effects of malaria during pregnancy the uptake and coverage in Nigeria is low. This study set out to assess the use of IPTp among pregnant women attending primary health centres in the rural area and determine factors that influence the uptake.MethodsA cross-sectional study was carried out between July and August 2007 among 209 pregnant women selected by systematic random sampling from antenatal care attendees at primary health care in a rural Local Government Area of Ekiti State, Nigeria. Information on knowledge of IPT, delivery, adherence and acceptability was obtained using an interviewer administered questionnaire. Descriptive statistics such as means, range, proportions were used. Chi-square test was used to examine association between categorical variables. All analyses were performed at 5% level of significance.ResultsOne hundred and nine of 209 (52.2%) respondents have heard about IPTp but only 26 (23.9%) were able to define it. Fifty seven (27.3%) reported to have received at least one dose of IPTp during the index pregnancy and all were among those who have heard of IPTp (52.3%). Twenty one of the 57 (36.8%) took the SP in the clinic. Only three of the twenty-one (14.3%) were supervised by a health worker. Twenty two of the 36 women (61.1%) who did not take their drugs in the clinic would have liked to do so if allowed to bring their own drinking cups. Almost half (43.9%) of those who had used IPTp during the index pregnancy expressed concern about possible adverse effect of SP on their pregnancies. Periodic shortages of SP in the clinics were also reported.ConclusionIn this study, IPTp use among pregnant women was very low and there was poor adherence to the Directly Observed Therapy (DOT) scheme. Concerted effort should be made to increase awareness of IPTp among the public especially women of child bearing age. Health workers should also be trained and monitored to ensure adherence.

Socio-Psychological Factors Influencing the Educational Aspiration of Married Women in Rivers State, Nigeria

This research work investigated the influence of socio-psychological factors on the educational aspiration of married women in Rivers State. A stratified random sample of 680 married women selected purposively from 8 out of 23 local government areas of Rivers State was used for the study. The sample covered both the urban and rural residential areas (4 urban local government areas and 4 rural local government areas). An 80-item questionnaire consisting of 60 positive and 20 negative questions aimed at examining the influence of socio-psychological factors such as attitude to education, self concept, and job Interest, on the educational aspiration of married women, was constructed to enable the researcher collect adequate information for the study. For the purpose of analyses of data, mean, standard deviation and t-test were used. Findings revealed that the married women in Rivers State generally have high educational aspiration and chances are there that given a boost, their educational aspiration may even be higher. The findings also revealed that there was no significant difference in the educational aspiration of married women, with high and low level of education, and married women with high and low level of income. There was however significant difference; between the educational aspiration of married women in the urban and rural locations, between the educational aspiration of married women and their attitude to education, between the education aspiration of married women and their job interest. Out of the 6 null hypotheses formulated, 2 were accepted while 4 were rejected. Some recommendations were made and suggestions offered. Keywords : educational aspirations, socio-psychological factors, location, level of education, level of income, self-concept, job interest Nigerian Journal of Guidance and Counselling Vol. 13 (1) 2008: pp. 92-108

Use of geographic information system in the assessment of bacteriological quality and sanitary risk factors of household drinking water sources in Ibadan, Nigeria

This study used a combination of Geographic Information System (GIS), bacteriological analysis and sanitary inspections to assess the risk of contamination of drinking water sources in 62 randomly selected households in Ibadan, Nigeria. Findings revealed that the majority of the households used groundwater sources of poor quality. The raw bacteriological data was classified into five water quality Grades A to E (from no risk to very high risk). Majority (82.3%) of the households were grouped as D and E, implying that a large proportion of the households was exposed to high bacterial load in their water supplies thus exposing these households to the risk of water-borne diseases. Results of sanitary inspection also showed that most (62.9%) households have intermediate/high risks associated with physical defects in the water supply facilities which could lead to quality deterioration. A weak positive correlation (Spearman's r =0.379, p =0.02) was observed between the E. coli and sanitary risk score grades. The study proposed urgent remedial action by all stakeholders and an extension of the study to cover the rural and urban local government areas in Ibadan.

Utilization of dental services among secondary school students in Lagos, Nigeria

Objective: This study was carried out to determine the prevalence of dental visits among secondary school students in Lagos State and to identify factors influencing the use of these services. Materials and Method: The study was a cross- sectional one comprising of secondary school students aged 10-19 years in Lagos State. They were selected by a multistage sampling method from 4 secondary schools in 2 (1 Urban and 1 Rural) Local Government Areas of the state. After obtaining an informed consent, a pre-tested self-administered questionnaire was filled after by each student. Data were collected on their demographic characteristics, visit(s) to the dentist in the previous 12 months, reasons for these dental visits, factors preventing subsequent dental visit and barriers to visiting the dentist for those who made no previous visit. The data collected were analyzed with an SPSS version 11.5 using Chi square statistics to test for association and differences. Results: Five hundred and two students aged 10-19 years (mean 14.1 ± 0.22) participated in the study. The students had a dental visit prevalence of 14.9% in the previous 12 months, with 69.3% of the visits prompted by pain. The dental visit prevalence varied significantly with age (p = 0.019), being higher (18.1%) in the younger age group (10-14 years) than 10.5% in the older age group (15-19 years). Reasons for no previous visits ranged from “No dental problem” to “fear of the dentist. Eighteen out of the 75 who made previous dental visits were dissatisfied with the treatment received hence refused to visit again. Conclusion: The level of utilization of dental services was very low and the standard measure of one visit per year to the dentist was not met. There is need for a “School oral health program” which will promote oral health awareness and encourage routine dental checkups among these students. Keywords: Dental services, utilization, students, NigeriaNigerian Dental Journal Vol. 15 (2) 2007: pp. 87-91

An Assessment of the Quality of Family Planning Services in a Rural Local Government Area in Lagos, Nigeria

An Assessment of the Quality of Family Planning Services in a Rural Local Government Area in Lagos, Nigeria

Where do tuberculosis patients go for treatment before reporting to DOTS clinics in southern Nigeria

Health-seeking patterns of persons with tuberculosis (TB) before reporting at the Directly Observed Treatment Short-course (DOTS) clinic for diagnosis and treatment were analysed. A total of 221 persons registered in the DOTS programme in 12 randomly selected rural and urban Local Government Areas in southern Nigeria were interviewed using a semi-structured questionnaire. Perceived causes of TB influenced first choice of treatment. Patients re-evaluated initial choices and shop for alternatives in persistent TB. Chemists were the first port of call for most patients. Those with unscientific causative theories of tuberculosis such as witchcraft engaged more in multiple health-seeking than those who indicated bacterial infection (P < 0.0001). The respondents had a median diagnostic-delay of 90 days. Delay in commencement of DOTS treatment was attributable to ignorance among patients and poor attitude of health workers. In conclusion, delay exists between recognition of symptoms and initiation of treatment in DOTS clinics partly because of ignorance among patients. Health workers' attitude to patients reporting at health clinics also discouraged the use of DOTS facilities. Consequently, it is recommended to address such delay through social mobilization of communities and through engaging Chemists in TB service delivery in this area.

Factors responsible for non acceptance of modern family planning methods by married men in two rural local government areas in Nigeria

Factors responsible for non acceptance of modern family planning methods by married men in two rural local government areas in Nigeria

Residential Environment and Mortality in the Lagos State of Nigeria

This study examines the operational factors of the indoor and outdoor residential environments in the Lagos State of Nigeria for their impact on the mortality of residents. Using a sixteen point index of outdoor and a twenty-eight point index of indoor residential environmental pressure, the deceased were scored one point depending on the existence of the index within the proximity of the residence. It was discovered that about 71.3% of the deceased were subjected to high or very high outdoor residential environmental pressure during their lifetime whereas about 91 % of them were subjected to high or very high indoor environmental pressure. Results show that the extent of outdoor residential environmental pressure depends on the locality of the deceased (i.e. whether such individual lived in a rural or urban local government area) and that there is no significant difference between indoor residential environmental pressure and the locality (urban or rural) of the deceased. Keywords : Outdoor, Indoor, Residential, Environment, Cardiovascular Ghana Journal of Development Studies Vol. 3 (2) 2006: pp. 83-98

Avoidable mortality in Victoria between 1979 and 2001

To describe trends in avoidable mortality (AM) in Victoria by sex, degree of socio-economic disadvantage and remoteness. The analysis is based on mortality and population data for 1979-2001 supplied by the Australian Bureau of Statistics (ABS) for Victoria. Total and disease-specific AM rates were age standardised using the direct method. For the period between 1997 and 2001, comparisons of total AM rates by sex were made between metropolitan and rural local government areas (LGAs), and between LGAs grouped into quintiles based on socio-economic disadvantage and categories of remoteness. Total AM rates declined significantly (p < 0.05) in both males and females between 1979 and 2001, but were significantly higher in males compared with females. Total AM rates were significantly higher in rural compared with metropolitan LGAs, from 1997 to 2001 in males and in 1998 in females. Total AM rates in the least disadvantaged quintile were significantly lower than those in the most disadvantaged quintile over the entire five-year period in males and in three years in females. Total AM rates were highest in remote LGAs and lowest in highly accessible LGAs. There were significant declines in ischaemic heart disease, stroke and road traffic accident AM rates among males. In females, IHD, stroke, breast and colon cancer AM rates declined significantly. Despite large declines in AM in Victoria, there are significant differences in rates between the sexes and in the population based on socio-economic status or remoteness. These results provide opportunities for policy makers to prioritise public health and health services interventions, targeting population groups and specific disease conditions to reduce health inequalities.

The contribution of privately owned hospitals in the provision of essential obstetric care in Nigeria.

To highlight the private sector contribution in the provision of essential obstetric care in Abia State, Southeastern Nigeria. Following two workshops a structured questionnaire was used to seek information on the type of facility, ownership, type of services, number of staff, instruments and medical consumables, deliveries and data on clients attended to in the previous twelve months. On the basis of the response the facilities were classified into not essential obstetric care, basic essential obstetric care and comprehensive essential obstetric care. Of 638 facilities visited only 378 offered antenatal and postnatal services. The 13 government hospitals and 173 primary health centers conducted 5601 deliveries. The 146 private hospitals/clinics and 46 maternity homes conducted 21,128 deliveries. Only 121 offered essential obstetric services: 42 basic with 2488 deliveries and 79 comprehensive with 14,489 deliveries. Of the basic essential obstetric facilities that were private, 84.6% were concentrated in the 6 urban local government areas (LGA) leaving 15.4% in the 11 rural LGA. Similarly 85.6% of the comprehensive essential obstetric facilities that were private are concentrated in the 6 urban LGA leaving 14.4% scattered in the 11 rural LGA CONCLUSION: The private sector, with its greater essential obstetric facilities, is concentrated mainly in the 6 urban LGA. This resulted in 14,970 deliveries as against 2007 deliveries in the government facilities. Although there is an apparent neglect of the other 11 LGA, the deliveries in the private facilities constituted over 79% within the study period. This greater contribution should be noted and considered when planning maternal and infant mortality and morbidity reforms in Nigeria.

A qualitative study exploring barriers to a model of shared care for pre-school children's oral health

To explore the oral health beliefs and practices of primary health care professionals which may act as barriers to the development of a model of shared care for the oral health of pre-school children. Qualitative focus group discussions and semi-structured interviews. Four rural local government areas in Victoria, Australia, 2003. maternal and child health nurses, general medical practitioners, dental professionals and paediatricians working in the four local government areas. discipline specific focus groups and semi-structured interviews. transcription, coding, clustering and thematic analysis. Several strong themes emerged from the data. All participants agreed that dental caries is a significant health issue for young children and their families. Beliefs about the aetiology of dental caries and its prevention were variable and often simplistic focusing predominantly on diet. Dental professionals did not believe that they had a primary role in the oral health of pre-school aged children but that others particularly maternal and child health nurses did. However other health care professionals were not confident in assuming this role. This study has identified important barriers and possible strategies for the development of an integrated and shared approach to preventing dental caries in pre-school aged children. Clear and consistent oral health information and agreed roles and responsibilities need to be developed.

Barriers to shared care for pre-school oral health

Objective To explore the oral health beliefs and practices of primary health care professionals which may act as barriers to the development of a model of shared care for the oral health of pre-school children. Design Qualitative focus group discussions and semi-structured interviews. Setting Four rural local government areas in Victoria, Australia, 2003. Subjects and methods Subjects: maternal and child health nurses, general medical practitioners, dental professionals and paediatricians working in the four local government areas. Data collection: discipline specific focus groups and semi-structured interviews. Data analysis: transcription, coding, clustering and thematic analysis. Results Several strong themes emerged from the data. All participants agreed that dental caries is a significant health issue for young children and their families. Beliefs about the aetiology of dental caries and its prevention were variable and often simplistic, focusing predominantly on diet. Dental professionals did not believe that they had a primary role in the oral health of pre-school aged children but that others particularly maternal and child health nurses did. However other health care professionals were not confident in assuming this role. Conclusions This study has identified important barriers and possible strategies for the development of an integrated and shared approach to preventing dental caries in pre-school aged children. Clear and consistent oral health information and agreed roles and responsibilities need to be developed.