Abstract:

The purpose of the study was to assess the quality of life from HIV counselling and social support among PLWHIV clinic attendees in specialist hospital Yola. A descriptive research was conducted. Data was collected using a structured questionnaire, where a total of 370 randomly selected PLWHA adult from the age of 18 years and above attending clinic at Specialist Hospital Yola participated in this study. Data was analysed using SPSS version 21.0. Descriptive statistics was used to analyse the demographic variables while tables and charts were used for the presentation of results. Pearson’s correlation was used between relevant variables while linear regression was used to predict outcomes. Statistical significance of this study was set at P≤ 0.05. The results indicate that most of the respondents were well informed (78.2%) about basic issues in HIV. This was like their levels of counselling and social support received (71.7%), perceived self-efficacy (63.8%), self-reported treatment adherence (80%) and self-reported quality of life (64.3%). This revealed that correct information, knowledge and awareness about basic issues in HIV and social support are very crucial to improving the behavioural skills and increase the level of confidence among PLWHA to perform adherent behaviours thereby significantly improve the quality of life of PLWHA clinic attendees.

Keywords: People living with HIV/AIDs, Quality of life, treatment adherence, information and social support.

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Abstract:

Human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV) [1, 2, 3].

HIV is spread primarily by unprotected sex (including anal and oral sex), contaminated blood transfusions, hypodermic needles, and from mother to child during pregnancy, delivery, or breastfeeding [4].

In 2015, about 37.3 million people were living with HIV and it resulted in 1.2 million deaths [5, 6]. Most of those infected live in sub-Saharan Africa [7]. Between its discovery and 2014 AIDS has caused an estimated 39 million deaths worldwide [8]. HIV/AIDS is considered a pandemic—a disease outbreak which is present over a large area and is actively spreading [9].HIV is believed to have originated in west-central Africa during the late 19th or early 20th century [10].AIDS was first recognized by the United States Centers for Disease Control and Prevention (CDC) in 1981 and its cause—HIV infection—was identified in the early part of the decade [11].

HIV was first confirmed in Ghana at the Noguchi Memorial Institute for Medical Research in 1986 [12, 13]. The infection has since spread to all parts of the country and is established within the whole society. The national prevalence as at 2015 was 1.37% with Greater Accra recording the highest prevalence by region [14]. At the Millennium Summit in September 2000 the largest gathering of world leaders in history adopted the UN Millennium Declaration, committing their nations to a new global partnership to reduce extreme poverty and setting out a series of time-bound targets, with a deadline of 2015, which have become known as the Millennium Development Goals. The Millennium Development Goals (MDGs) are the world's time-bound and quantified targets for addressing extreme poverty in its many dimensions-income poverty, hunger, disease, lack of adequate shelter, and exclusion-while promoting gender equality, education, and environmental sustainability [15].

Since the first case of HIV was diagnosed, enormous national and international efforts and resources have been expended through the National HIV and AIDS response to contain the epidemic [16, 17, 18].

Following the Declaration of commitment of the United Nations General Assembly Special Session on HIV/AIDS in 2001, the Government of Ghana earmarked 15% of its health budget for HIV/AIDS activities with support from multilateral partners including the World Bank [19].

MDG 6 specifically addresses HIV/AIDS with the following targets;

To halt by 2015 and have started to reverse the spread of HIV/AIDS

To achieve global access to treatment for HIV/AIDS for those who need it by 2010[20].

The goal of this study is to review Ghana’s progress on MDG 6 using the HIV Sentinel Survey (HSS) report.

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Abstract:

Background: The pre-MDGs prevalence of underweight among children under five years of age (MDGs goal 1, target 2, and indicator 4) for Nigeria was 35.1% by 1990. How successful was MDGs goal 1, target 2, indicator 4 in rural communities that benefited from MDGs activities in Nigeria? This is the cardinal research question that prompted this work. Objectives: To describe the post-MDGs underweight prevalence among children under-five years of age in the target population. To evaluate the progress made in reducing underweight among children under-five years of age with respect to achieving the MDGs goal 1, in the selected rural communities. Methods: This cross-sectional study used both primary and secondary data. The primary data was collected by direct weight measurement of the children under-five years of age from the selected communities, while secondary data were generated from the growth monitoring and delivery registers of the district PHC. Data were collated and analyzed using SPSS version 20.0. Result: The study recorded an underweight prevalence of 19.3% for children under-five years of age. Prevalence of underweight among the female subjects was 19.2%while their male counterpart was 19.5%. Conclusion: The under-five underweight prevalence for these communities was 19.3% slightly better than the National 2014 prevalence of 19.5%, however, still below the MDGs target of 17.75% at the end of 2015. More effort is therefore needed in the SDGs program to sustain the gain made via the MDGs activities and further improve the nutritional status of children under-five years of age in rural communities.

Keywords: Prevalence, underweight, under-five children, rural communities, SDGs, MDGs goal.

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Abstract:

The basis of outcomes assessment in epidemiology provides a framework for analyzing and understanding potential relationships between outcomes and medical interventions. Adherence clubs are a community and facility based intervention that is targeted at decongesting health facility, improving quality of care and retaining patients on ART and chronic medication. The study sought to model the relationship between health outcomes and the implementation of the adherence clubs. A literature review was conducted on the internal and external factors that generally influence health outcomes among adherence club patients. Due to the limited literature on adherence clubs patients, general patient related health outcome literature was used in the construction of the model. Common themes were grouped into broad categories to map out the model. The study shows that there are individual, economic, social, and environmental factors that generally influence health outcomes among patients. Furthermore, these are likely to be the leading elements to improved health outcomes among adherence club members.

Keywords: differentiated models of care, adherence clubs, health outcomes, chronic patients, antiretroviral therapy, HIV, health facility, decongestion

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[56].  Wouters, E., Heunis, C., van Rensburg, D., & Meulemans, H. (2009). Physical and emotional health outcomes after 12 months of public-sector antiretroviral treatment in the Free State Province of South Africa: a longitudinal study using structural equation modelling. BMC Public Health, 9, 103–111. doi:10.1186/1471-2458-9-103.

Abstract:

Background: While prior studies have identified a number of demographic factors related to general health practitioners’ decision to stay in public health practice, recruitment agencies have no validated methods to predict how long these health workers will commit to their placement. We aim to use machine learning methods to predict health professional’s length of practice in the rural public healthcare sector.

Methods: Recruitment and retention data from Africa Health Placements (n=13 698 with 1 838 completers) was used to development machine learning models to predict health workers’ length of practice. A cross-validation technique was used to validate the models, to evaluate which model performs better, based on their respective aggregated error rate of prediction. Length of stay was categorised into 4 groups (less than 1 year, less than 2 years, less than 3 years, and more than 3 years). Three machine learning models were trained and used 10-fold cross validation techniques to attain evaluative statistics.

Results: The three models attain almost identical results, with negligible difference in accuracy. The ‘best’-performing model (Multinomial logistic classifier) achieved a 47.34% [SD 1.63] while the decision tree model achieved an almost comparable 45.82% [SD 1.69]. The three models achieved the average AUC of approximately 0.66 suggesting sufficient predictive signal at the four categorical variables selected.

Conclusions: Machine learning models give us an effective tool to predict the recruited health workers’ length of practice. These models can be adapted beyond the scope of demographic information such as information about placement location and income. This modelling will also, allow strategic planning and optimization of public health care recruitment.

Key message

Human resource planning in healthcare can employ machine learning to effectively predict length of stay of recruited health workers who are stationed rural areas.

References:

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Abstract:

Globally, Malaria Is Noted To Be Among That Important Diseases Related To The Environment. However, Problem Related To Malarial Still Remains Very Enamours With Little Improvement. Much Is Interventions Are Needed To Be Done Particularly In Most Africa And Its Sub-Regions. Owing To A Widespread Resistance to Previously Known Anti-Malarial Chemotherapies, the Revision of Antimalarial Drug Policies by Most Sub-Saharan African Countries Is Essential

It Is Of This Concern That This Controlled Clinical Trial Study Was Conducted To Assess The Efficacy, Safety And Tolerability Of Single And Combination Antimalarial Homoeopathic Remedies For The Treatment Of Uncomplicated Malaria In The Sekeyer East District Of Ashanti Region, Ghana. 

The Study Documented The Following At The End Of The Trial. No Statistically Significance Difference Was Observed Between The Two Treatment Groups Of The Trial. A Percentage Efficacy Of 95.8% And 95% Was Observed For Treatment with Single Remedy and Combination Remedy Respectively. Again Participants On Control Group Showed No Improvement On Malaria Status At The End Of The Study. This Proved A Significant Efficacy of Homoeopathic Anti-Malaria Remedies.

With Reference To These Finding, The Study Recommend The Following As Well; Homoeopathy Remedies Be Advocated For Nationwide Usage As It Has About 90% To 95% Success Rate For The Treatment Of Uncomplicated Malaria With No Or Minimal Side Effect, The Research Should Be Reproduced In A Different Geographical Location Involving Large Samples Of Participants To Confirm The Validity Of The Present Findings And To Enhance Generalization.

Keywords: Un complication malaria, Homoeopathic remedies, Clinical trials, Sekeyere East District.

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Abstract:

Poor solid waste disposal is one of the major environmental and public health issues in Kano Metropolis, like in other cities in Nigeria and developing world at large. Poor solid wastes disposal pose threat to public health and environmental quality in the metropolis. The objective of this study was to examine the environmental and public health impact of poor solid waste disposal in Kano metropolis.

The study was cross sectional descriptive studies, simple random sampling technique was applied to sample the study population, and structured questionnaire were designed, pretested and re-distributed to participants. Secondary data sources were used. The result revealed that overall there were 554 households participated, with a response rate of 539 (98%). Demographic characteristics of respondents indicated 236 (44%) males, 303females (56%), marital status of the respondent indicated 198 (37%), were marriage, and other demographic characteristics. The result shows significant findings that relates to poor solid wastes disposal and the impact on environment and public health, 75% of household engaged in open mass dumping of solid wastes, other factors that contributes to poor solid waste disposal were observed and documents, distance to disposal sites, household storage of wastes, and poor separation of wastes. Over 77% households had perception about disease transmission from poor solid waste disposal. 53% had good knowledge about diseases related to solid waste disposal. Significant awareness as well as perception was good among the households but there is poor behavior in terms of effective management of solid waste, proper health education message dissemination must be enforced for better behavioral change by the relevant authorities.

Keywords: Environment, Health Solid waste Disposal, Dumpsite.

References:

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[7].     Banjo AA, Adebambo AAR, Dairo OS (2009). Inhabitants’ Perception on Domestic Waste Disposal in Ijebu Ode, Southwest Nigeria. Afr J. Basic Appl. Sci. 1(3-4): 62-66.

[8].     Beatrice A. (2013) Municipal solid waste Management Problems in Nigeria: Evolving Management Solution Int Jol. of Env. Chem. And Ecological and Geophysical Eng. Vol.7 No.6.

[9].     Boardi (2005) Environmental and Public Health Impact of Household Solid Waste Handling Disposal Practice a case study of Accre Ghana Journal of Env Hlth Vol 68 No 4 p34- 46.

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Abstract:

Background: Malaria is a major cause of morbidity and mortality in Nigeria, directly contributing to poverty, low productivity, and reduced school attendance. The mosquito-borne illness causes over 100 million clinical cases every year. It accounts for about 60% of all outpatient attendances and 30% of all hospital admissions and is responsible for the annual death of 300,000 children under 5 years as well as 11% of maternal mortality cases reported each year. In children, malaria is responsible for 25% of all infant-related mortality and 30% of child-related mortality. (National Malaria Control Strategic Plan FMOH 2009-2013)

 Integrated Supportive Supervision (ISS) is a harmonized supervisory system which uses a common tool and reporting format based on a collection of indicators from as many work processes/initiatives/programmes as possible. It is driven by a common supervisory team usually working as several sub-teams, thus ensuring that managers are in the field on a regular basis (monthly or quarterly) to check the performance of subordinates and help them to improve on their competencies and output. What is also key besides getting managers into the field on a regular basis and thus understanding the context and challenges within which health workers function, is the importance of both supervisors and supervisees agreeing on a plan of action to improve health care delivery. This plan of action must include activities/actions by both the supervisor and the supervisee. This is critically important and can be used to measure progress on subsequent visits.

This study aimed at evaluating the effect Malaria Integrated Supportive Supervision (MISS) on Malaria Service Delivery in MISS supported Primary Health Facilities and Non-Supported Primary Health Facilities across various LGAs in Nasarawa State.

Materials and Methods: This was a facility-based interventional study with MISS intervention and MISS non- intervention groups. The study subjects were Officers in charge of each Primary Health Facility, selected through a multistage sampling technique and data collection was done using semi structured self-administered questionnaire, all data were entered in an Excel sheet and analyzed using SPSS version 17.0. Paired t test was used in testing for significance between intervention and non-intervention group.

Results: On the Knowledge and Practice of malaria prevention and vector control, the mean score for the MISS and Non MISS groups are; 92.98 and 53.41respectively. The two-tailed P value equals 0.0395 which by conventional criteria, this difference is considered to be statistically significant.

Mean score on Diagnosis and Treatment knowledge and practice between the MISS intervention and Non-MISS intervention groups are; 81.49 and 66.53 respectively. The two-tailed P value equals 0.0642. By conventional criteria, this difference is considered not to be quite statistically significant. This could however be attributed partly to the fact that trainings on diagnosis and treatment was held jointly among the two groups.

Malaria in Pregnancy mean score between the MISS intervention and Non-MISS Intervention groups was 86.38 and 66.10 respectively. The two-tailed P value equals 0.0138 which by conventional criteria, this difference is considered to be statistically significant.

Conclusion: This study has demonstrated that integrated supportive supervision is an effective tool of improving knowledge and practice of malaria prevention and case management in Primary Health Facilities.

References:

[1]. Alphonse Laveran (1880) in Nye Edwin (2002) Discoverer of the malaria parasite and Nobel Laureate. Journal of medical biology.

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Abstract:

Postnatal period is a very critical stage for both the mothers and their babies. The importance of postnatal care services has been established in various studies globally. Yet postpartum care is the most neglected aspect of women’s health care, not only in developing countries but also in some developed countries. In Ghana 23% of postpartum mothers do not receive postnatal at all.

This study seeks to explore contributory factors associated with low postnatal service utilization in Ga East District of Greater Accra Region (GAR).

The study design was a cross sectional explorative and qualitative research using focus group discussions. The target population for the study were women in the reproductive age and living in the Municipality. The study used five focus group discussions to determine factors contributing to low postnatal coverage in Ga East Municipality.

A purposive sampling was employed to carry out to recruit the participants. The researcher moderated all discussions assisted by one trained assistants. The taped discussions were transcribed and the resulting texts analyzed by using thematic analysis.

The findings of the study will be communicated to both the School of Public Health and the Ghana Health Service.

Keywords: PNC; Postpartum; Postnatal; Coverage; Factors; Period.

References:

 Studies have found that the post-partum period also known as the pueperium begins with the delivery of the baby and the placenta. The end of the post-partum period is often considered as six to eight weeks after delivery because the effect of pregnancy on many systems may have resolved by this time and these systems would have largely returned to their pre pregnancy state. However, all organs do not return to their baseline within this period. The return to baseline is not necessarily linear overtime. In some studies, some women are considered post-partum for as long as 12months after delivery.

The need for continuum of care as a core principle of programs for maternal, new born and child health and as means to reducing maternal, new born and child death has been emphasized by recent literature.(Kerber, de Graft-Johnson, Bhutta, Okong, Starrs, & Lawn,2007) Postnatal care services are the most neglected programme of the reproductive and child health programmes in the African region and yet a number of serious complications and majority of maternal deaths occur during the postnatal period especially in this part of the world (Ogwang., 2005,Warren Daly, Toure & Mongi., n.d). Many African mothers and their newborns, especially those who delivery at home do not receive postnatal care (PNC). From 23 demographic health surveys (DHS), out of the two thirds of the sub-Saharan African women who delivered at home, only 13% received postnatal visit within two days of birth. According to the DHS data in Mali 85% of women who delivered at home received no PNC and in Eritrea, 92% of women who delivered at home received PNC after six weeks of birth. (Warren et al, n.d).

Abstract:

Background: There has been wide agreement in some part of the world where there is generalized HIV/AIDS and high reproductive disease incidence that integration of sexual reproductive health (SRH) and HIV services is of great importance. Integration is assume to increase accessibility to and uptake of health services; it also ensures better use of resources as it improves efficiency at cheaper cost. But there are few studies on the significance of health care providers’ experiences to the system. This research study was carried out among frontline health personnel to investigate provider experiences on integration to establish their importance to the success of integrated health facilities.

Methods: Semi-structured questionnaires were administered with 32 frontline health care providers in some facilities providing integrated SRH and HIV services in Oyo State. The interviews were then transcribed and analyses by the researcher and research assistants.

Results: Respondents reported the benefits they are the clients received as a result of integration. Shortage of manpower to carter for increased workload was by far the most obvious challenge facing the health workers. Others included inadequate infrastructure, stock-out of materials, lack of motivation due to untimely payment of salary, gaps in training, language barrier, poverty and misconceptions:

Conclusions: The roles of health care providers is very critical to the successful implementation of integrated SRH and HIV services. Their performances can also be affected by some challenges identified in this study. However, this study has shown that integration can assist in ameliorating these identified problems and these valuable opportunities deserves further probing.

Keywords: Experiences; Health Care Providers; Integrated; SRH; HIV; Services; Oyo State.

References:

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Abstract:

Full Immunization (a child having received BCG, 3 doses of oral polio, three doses of pneumococcal conjugate, three doses of pentavalent and measles vaccine) against vaccine preventable diseases reduces deaths of under-fives in developing countries. Zimbabwe records show low full immunization coverage of 69.2% in 2015 and the causalities are poorly understood. We examine factors undermining full immunization coverage among children aged 12-23 months in Chadereka community, Centenary district. We adopted a cross sectional study design using modified cluster sampling method to select study participants. Fifteen systematically selected clusters of 8 children were utilized to determine full immunization coverage. Data collection was done using a pretested structured questionnaire and analysed using excel software. Mothers (n=120) with children (aged 12-23 months) were sampled and history of immunization was extracted from child’s baby card plus mother’s history. We found that 64.2% (95% CI: 53.9-74.5) of study participant had achieved full immunization. Specific vaccine coverage for BCG, three doses of polio, three doses of pneumococcal conjugate, three doses of pentavalent, and measles vaccine were 90.8%, 89.4%, 86.1%, 82.4% and 70% respectively. Source for immunization were health centre (53.5%), outreach services (37%) and hospital (9.5%). Mother’s awareness (p-value 0.0317) and wealth status (p value 0.01592) were the major predictors of full immunization coverage. Reasons given for failure to fully immunize children were obstacles (74.4%), lack of motivation (11.6 %), lack of information (9.3%) and community factors (4.7%). We conclude that improved awareness to mothers and empowering women potentially increase the national full immunization coverage.

Keywords: Full immunization, factors, coverage, vaccine preventable diseases.

References:

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Abstract:

Hypertension is one of the most important causes of the total disease burden in the world (Lloyd-Sherlock et al., 2014).

Non-communicable diseases, especially Coronary Artery Disease (CAD) including hypertension as a major risk factor accounts for almost 53% and 44% of deaths and disability adjusted life years (DALYs) (Mengistu, 2014).

Blood pressure is the single most useful test for identifying individuals with CAD (Barron et al., 2014).

CAD are nowadays increasingly seen in working people in age group of 35-64 years, in whom 35% of CAD deaths are observable (Adeloye et al., 2015; Angaw, Dadi and Alene, 2015).

Hypertension is an increasingly important medical and public health issue worldwide (Ma et al., 2013; Chen et al., 2014).

Currently, the prevalence of hypertension in many developing countries, particularly in urban societies is said to be as high as those observed in developed countries (Addo, Smeeth and Leon, 2007; Guwatudde et al., 2015).

The burden of hypertension in Nigeria is high and still growing (Adeloye et al., 2015) and we still cannot say with certainty the exact burden because of lack of usable data(Ujunwa et al., 2013).

References:

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Abstract:

Transgender is an umbrella term that refers to people with diverse gender identities and expressions that differ from stereotypical gender norms. Medical practitioners’ attitude towards Transgenders affects health care offered to such patients who experience health and health care disparities and have specific health care needs. There is sparse of literature that explores the knowledge and attitudes of health care providers towards Transgenders.

Objectives: This study was carried out with the following two objectives: 1) to assess the Indian Medical Practitioners’ knowledge about and attitude towards Transgenders. 2) To find out the current exposure and self-efficiency of Medical practitioners on treating transgender persons in their clinical set up and to identify the significant factors associated with them.

Methodology: This is a web based cross sectional study carried out among the Medical Practitioners of Allopathic medical system, all over India to assess their knowledge about and attitude towards Transgenders through an online survey questionnaire. The questionnaire collected the basic socio demographic details and clinical practice details of the participants. It also contained set of questions to assess their knowledge, attitude, current exposure of treating transgender individuals and their comfort level (self- efficiency) on treating them.

Results: There were 128 Medical practitioners who completed the online survey questionnaire within one month duration of the study period. Two third of the respondents are residing in urban area (81 -63.3%) and two third of them (68 - 67.2%) are working in tertiary care centre setups. Only 27 (21.1%) respondents know any transgender personally and only 22 (17.2%) respondents have treated any transgender so far. The average number of transgender individuals treated by these 22 respondents in the past year and past 1 month is only 4.18 and 0.91 respectively. While 95 (74.5%) participants correctly responded that the transgenderism due to biological causes, 64 (50.0%) participants correctly responded that the transgenderism is due to psychosocial causes. Years of experience is the only statistically significant factor affecting the participants’ general knowledge on transgenders and having provided treatment to any transgender individual.

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Abstract:

Honey is one of the foods that can be found abundantly in different provinces of Democratic Republic of the Congo (DRC). Harvesting in a traditional way, honey is being marketed in Kinshasa. It can easily be placed in the market without any microbiological control so far. However, honey is often used both as additive food and poison cure. This study concerns the microbiological control of seven samples of honey collected randomly in different markets of Kinshasa. Their physicochemical and microbiological parameters were analyzed and the results indicated that the samples of honey that came from DRC’s different areas had an average pH of 3 (5 ± 2.1), were contaminated by the fungal flora 69% and bacterial 31%. Molds (Aspergillus flavus and Penicillium sp.) account for 38%, yeasts (Candida sp.) for 31%, and bacteria (Staphylococcus aureus and Streptococcus sp.) for 31%. These results reflect a poor hygienic quality of honeys that is being sold in Kinshasa’s various markets. These results prove the possibility of arising an alarm bell on the risks that consuming this foodstuff can affect the population’s health.

Keywords: Microbiological control - Honey - Kinshasa market – DRC.

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[21].  Oussama, R.-M. (2010). Extraction de certains composés du miel naturel ayant effet antimicrobien. Université Kasdi Merbah Algérie.

[22].  Poorter, G. D. (2014). Techniques d'analyse en laboratoire. Agence Fédérale pour la Sécurité de la Chaîne Alimentaire. DIRECTION GENERALE DES LABORATOIRES. Formation Certifiée Niveau B/C.

[23].  Province de Kinshasa, Pauvreté et conditions de vie de la population. (2009, 3 1). Retrieved from http://www.cd.undp.org http://www.cd.undp.org/content/dam/dem_rep_congo/docs/povred/UNDP-CD-Profil-Ville-Kinshasa.pdf

[24].  Tshiesese, N. S. (2005). Le droit à l'alimentation dans les ménages de Kinshasa. Etude descriptive de quelques foyers de Lemba Terminus. Retrieved from http://www.memoireonline.com/11/13/7997/Le-droit--l-alimentation-dans-les-menages-de-Kinshasa-Etude-descriptive-de-quelques-foyers-de-Le.html

[25].  Villiers, B. (1987). L’apiculture en Afrique Tropicale. Paris: GRET.

Abstract:

Globally, one of the public health problems confronting the medical community is maternal mortality. This study seeks to investigate the relationship between maternal mortality, proteinuria and pregnancy induced hypertension among some pregnant mothers in Ghana. In this study, protein in the urine and blood pressure of some 450 pregnant women who visited the Hospital between Januarys to December, 2015were monitored. Retrospective data based on maternal death from January 2010 and December 2015 were also retrieved and analysed. This was augmented by interviewing150 respondents (75 each from antenatal and postnatal section of the hospital) based on maternal health history, knowledge on PIH etc. The results of the study with respect to proteinuria and the blood pressure (BP) monitoring showed that, 36% of these mothers had traces of protein in their urine whiles 32 mothers out of 450 had elevated systolic and diastolic BP. The study also revealed, when data on maternal mortality and PIH of pregnant mothers were retrieved that, a total of 75, 439 (N=75,439) mothers attended the antennal section of the Hospital. Out of this, 139 of them (0.18%) died due to PIH. Maternal child bearing behaviour, nulliparity when analysed showed that, greater proportions of antenal (AN) mothers (32.00%) were nulliparous compared to their PN counterpart (0%) (p<0.0001). Results of our study has shown that, maternal mortality due to PIH were high due to elevated systolic and diastolic blood pressure as well as high doses of trace amount of protein in pregnant mothers’ urine.

Keywords: Maternal, Mortality, Eclampsia, Clinical, Hypertension, Postnatal.

References:

[1]. (Anon 1) http://www.graphic.com.gh/news/general-news/35688-maternal-mortality-rate-increases-in-ghana-report.html.

[2]. Annon1. 2016 (www.ghanahealthservice.org/category.php?hid=2&cid=8) Date visited Feb. 2016.

[3]. Baha M. Sibai, MD (2005) Diagnosis, Prevention, and Management of Eclampsia, the American College of Obstetricians and Gynecologist, VOL. 105, NO. 2, FEBRUARY 2005 402 © 2005. doi:10.1097/01.AOG.0000152351.13671.99

[4]. Chames MC, Livingston JC, Invester TS, Barton JR, Sibai BM (2002). Late postpartum eclampsia: a preventable disease? Am J Obstet Gynecol 2002; 186:1174 –7.

[5]. Conde-Agudelo A, Belizán JM (2000) Maternal morbidity and mortality associated with interpregnancy interval: cross sectional study. BMJ. 2000 Nov 18; 321 (7271):1255-9. PMID: 11082085, PMCID: PMC27528, http://www.ncbi.nlm.nih.gov/pubmed/11082085

[6]. Fernanda B. C, Letícia G. P, Augusto K. M, Giovani G I C. Antonello, H D. Mistry, Carlos E. Poli-de-Figueiredo, Bartira E. Pinheiro da Costa (2014) is there any relationship between ABO/Rh blood groupand patients with pre-eclampsia? Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 4 (2014) 170–173, International Journal of cardiovascular Health, http://dx.doi.org/10.1016/j.preghy.2014.03.0032210-7789/www.elsevier.com/locate/preghy./

[7]. Kenny L C., Black M A., Poston L, Taylor R, Myers J E., Baker P N., McCowan L M., Simpson Nigel A.B., Dekker G A., Roberts C T., Rodems K, Noland B, Raymundo M, Walker J J., North R A ( 2014). Early Pregnancy Prediction of Preeclampsia in Nulliparous Women, Combining Clinical Risk and Biomarkers, Hypertension. 2014;64:644-652DOI:10.1161/HYPERTENSIONAHA.114.03578.

[8]. Magee L A., Pels A, Winnipeg H M, Rey E, Dadelszen P v .(2014) Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy: Executive Summary, J Obstet Gynaecol Can 2014;36(5):416–438, http://sogc.org/wp-content/uploads/2014/05/gui307CPG1405E1.pdf.

[9]. Mammaro A, Carrara S, Cavaliere A,  Ermito S,  Dinatale A, Pappalardo E M, Militello M, and Pedata R (2009). Hypertensive Disorders of Pregnancy, Prenat Med. 2009 Jan-Mar; 3(1): 1–5, PMCID: PMC3279097.

[10].  North R A, McCowan Lesley M E,Dekker Gustaaf A, Poston Lucilla, Chan Eliza H Y, Stewart Alistair W, Black Michael A, Taylor Rennae S, Walker James J, Baker Philip N, Kenny Louise C, (2011). Clinical risk prediction for pre-eclampsia in nulliparous women: development of model in international prospective cohort Research BMJ 2011; 342 doi: http://dx.doi.org/10.1136/bmj.d1875 (Published 07 April 2011) Cite this as: BMJ 2011; 342:d1875.

[11].  Pannu D, Das B, Hazari P, Maternal and perinatal outcome in eclampsia and factors affecting the outcome: a study in North Indian population. Int J Reprod Contracept Obstet Gynecol. 2014; 3(2): 347-351. doi:10.5455/2320-1770.ijrcog20140612.

[12].  Sibai BM. VOL. 105, NO. 2, FEBRUARY 2005 402 © 2005 by the American College of Obstetricians and Gynecologists. 0029-7844/05/$30.00 Published by Lippincott Williams & Wilkins. doi:10.1097/01.AOG.0000152351.13671.99.

[13].  Steven J. Wagner, Letitia A. Acquah, E. Paul Lindell, Iasmina M. Craici, Majken T. Wingo, Carl H. Rose, Wendy M. White, Phyllis August and Vesna D. Garovic (2011). Posterior Reversible Encephalopathy Syndrome and Eclampsia: Pressing the Case for More Aggressive Blood Pressure Control, Mayo Clin Proc. 2011 Sep; 86(9): 851–856. doi: 10.4065/mcp.2011.0090, PMCID: PMC3258001.

[14].  Sharma Amita, Pandey Kiran, Bhagoliwal Ajai (2013) Spot urine protein/creatinine ratio—A quick and accurate method for diagnosis of pre-eclampsia. Open Journal of Obstetrics and Gynecology, 2013, 3, 609-612 OJOG http://dx.doi.org/10.4236/ojog.2013.38109 Published Online October 2013 (http://www.scirp.org/journal/ojog/)

[15].  Thasneem Mohammed Arif , Jamila Hameed , S Haseena , Madhumitha Sekaran Ramya Ramadoss (2014) An interesting Case of Delayed Onset Postpartum Eclampsia, IJSS Case Reports & Reviews | December 2014 | Vol 1 | Issue 7, http://www.ijsscr.com/sites/default/files/articles/IJSS-CR_1(7)_CR05.pdf

[16].  Takahiro Yamada, Takashi Yamada, Mamoru Morikawa, Masamitsu Takeda, Ryutaro Nishida, Rina Akaishi, Hisanori Minakami (2011) Isolated proteinuria as an initial sign of severe preeclampsia. Open Journal of Obstetrics and Gynecology, 2011, 1, 13-16 doi:10.4236/ojog.2011.12003 Published Online June 2011 (http://www.SciRP.org/journal/ojog/OJOG). Published Online June 2011 in SciRes. http://www.scirp.org/journal/OJOG

[17].   Uzan Jennifer,  Carbonnel Marie, Piconne Olivier, Asmar Roland, and Jean-Marc Ayoubi (2011) Pre-eclampsia: pathophysiology, diagnosis, and management, Vasc Health Risk Manag. 2011; 7: 467–474.Published online 2011 doi: 10.2147/VHRM.S20181,PMCID: PMC3148420

[18].  WHO, 2005.,http://www.who.int/whosis/mme_2005.pdf

[19].  World Health Organization 2011, WHO recommendations for Prevention and treatment of pre-eclampsia and eclampsia, ISBN 978 92 4 154833 5 (NLM classification: WQ 215). http:// www.apps.who.int/iris/bitstream/10665/44703/1/9789241548335_eng.pdf.

[20].  World Health Organization, 2015, Trends in Maternal Mortality: 1990 to 2015 - World Health Organization www.apps.who.int/iris/bitstream/10665/194254/1/978924 1565141_eng.pdf

[21].  (www.elsevier.com/locate/preghy).

Abstract:

Complications from miscarriages and unsafe abortion often lead to short and long term morbidities. About 40% of maternal deaths in Nigeria are attributable to complications from miscarriage and unsafe abortion. Seasonal variations in the incidence and prevalence of spontaneous miscarriage have been reported in other climes but there is no literature describing this phenomenon in Nigeria.

This analysis aimed to determine if there was a seasonal variation in the prevalence of post abortion complications cases managed in Kano State, Nigeria.

This analysis was based on a retrospective review of records of all women who presented for treatment of post abortion complications in 30 hospitals over a 36 months period. Stata SE version 14 was used for analysis.

Aggregated monthly number of cases over the three year period revealed a cyclical pattern with two dips in December and June and a peak around the months of February and March. This pattern remained consistent when the data was disaggregated into the different years. No statistically significant difference was observed in the number of PAC cases treated during the rainy season compared to those treated in the dry season. However, there was a statistically significant difference in the number of PAC cases treated in the first year compared to the second and third year.

Findings from this study indicates that there was no difference in the number of PAC cases treated in Kano state during the rainy season compared to those treated during the dry season. The number of cases treated however, appeared to differ across years.

Keywords: Miscarriage, Complication, Post-abortion care, Post-abortion contraception, seasonal, Trimester.

References:

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[4].     Chodick G, Flash S, Deoitch Y, Shalev V. (2009). Seasonality in birth weight: review of global patterns and potential causes. Hum Biol. 81:463–477.

[5].     Cohen A.J. (2000). Outdoor air pollution and lung cancer. Environ Health Perspect, 108 Suppl; 4:743-750.

[6].     Corbett MR, Turner KL. (2003). Essential Elements of Postabortion Care: Origins, Evolution and Future Directions. Int Fam Plan Perspect. 29(3):106-111.

[7].     Czeizel A, Bognar Z, Rockenbauer M. (1984). Some epidemiological data on spontaneous abortion in Hungary, 1971-1980. J Epidemiol Community Health. 38:143-148.

[8].     Deschenes O, Greenstone M, Guryan J. (2009). Climate Change and Birth Weight. American Economic Review. 99(2):211–17.

[9].     Elter K, AY E, Uyar E, Kavak ZN. (2004). Exposure to low outdoor temperature in the midtrimester is associated with low birth weight. Aust New Zeal J Obstet Gynaecol. 44:553–557.

[10].  Enkhmaa D, Warburton N, Javzandulam B, Uyanga J, Khishigsuren Y, Lodoysamba S, et al. (2014). Seasonal ambient air pollution correlates strongly with spontaneous abortion in Mongolia. BMC Pregnancy and Childbirth. 14:146 available from http://www.biomedcentral.com/1471-2393/14/146

[11].  Flouris AD, Spiropoulos Y, Sakellariou GJ, Koutedakis Y. (2009). Effect of seasonal programming on fetal development and longevity: Links with environmental temperature. Am J Hum Biol. 21:214–216.

[12].  George L, Granath F, Johansson AL, Annerén G, Cnattingius S. (2006). Environmental tobacco smoke and risk of spontaneous abortion. Epidemiology. 17:500–505.

[13].  Griebel CP, Halvorsen J, Golemon TB, Day AA. (2005). Management of Spontaneous Abortion. Am Fam Physician. 72(7):1243-1250.

[14].  Ipas. (1991). Strategy for the Next Decade: Women’s Health Initiatives. Ipas, Publication, Carrboro, NC, USA.

[15].  Lee SJ, Steer PJ, Filippi V. (2006). Seasonal patterns and preterm birth: a systematic review of the literature and an analysis in a London-based cohort. BJOG. 113:1280–1288.

[16].  McDonald AD. (1971). Seasonal Distribution of Abortions. Brit. J. prev. soc. Med. 25:222-224.

[17].  McGrath JJ, Barnett AG, Eyles DW. (2005). The association between birth weight, season of birth and latitude. Ann Hum Biol. 32:547–559.

[18].  Murray LJ, O’Reilly DP, Betts N, Patterson CC, Davey SG, Evans AE. (2000). Season and outdoor ambient temperature: effects on birth weight. Obstet Gynecol. 96:689–695.

[19].  National Population Commission (NPC) [Nigeria] and ICF International. 2014. Nigeria Demographic and Health Survey 2013. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF International.

[20].  Omo-Aghoja L, Aisien O, Akuse J, Bergstrom S, Okonofua F. (2010). Maternal mortality and emergency obstetric care in Benin City, south-south Nigeria. J Clin Med Res.2:55-60.

[21].  Oye-Adeniran BA, Umoh AV, Nnatu SN. (2002). Complications of unsafe abortion: A case study and the need for abortion law reform in Nigeria. Reprod Health Matters. 10(19):18-21.

[22].  Pope CA, Ezzati M, Dockery DW. (2009). Fine-Particulate Air Pollution and Life Expectancy in the United States. N Engl J Med. 360:376-386.

[23].  Postabortion Care Consortium Community Task Force, Essential Elements of Postabortion Care: an expanded and updated model, PAC in Action, 2002, No. 2, Special Supplement.

[24].  Sedgh G, Bankole A, Oye-Adeniran B, Adewole IF, Singh S, Hussain R. (2006). Unwanted pregnancy and associated factors among Nigerian women. Int Fam Plan Perspect 32(4):175-184.

[25].  Strand LB, Barnett AG, Tong S. (2011). The influence of season and ambient temperature on birth outcomes: a review of the epidemiological literature. Environ Res. 111:451–462.

[26].  Subramanjam V. (2007). Seasonal variation in the incidence of preeclampsia and eclampsia in tropical climatic conditions. BMC Womens Health. 7:18. Available from http://www.biomedcentral.com/1472-6874/7/18

[27].  Tustin K, Gross J, Hayne H. (2004). Maternal exposure to first-trimester sunshine is associated with increased birth weight in human infants. Dev Psychobiol.45:221–230.

[28].  Vineis P, Forastiere F, Hoek G, Lipsett M. (2004). Outdoor air pollution and lung cancer: recent epidemiologic evidence. Int J Cancer. 111:647-652.

[29].  Weinberg CR, Moledor E, Baird DD, Wilcox AJ. (1994). Is There a Seasonal Pattern in Risk of Early Pregnancy Loss? Epidemiology. 5(5): 484-489.

[30].  WHO (2012). Safe abortion: technical and policy guidance for health systems-2^nd ed.World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.

[31].  Yackerson N, Piura B, Sheiner E. (2008). The influence of meteorological factors on the emergence of preterm delivery and preterm premature rupture of membrane. J Perinatol. 28:707–711.

Abstract:

The new born weight is one of the major indicator providing information of the nine months’ intrauterine life and may predict the survival rate of new born. In fact, birthweight is one of the most accessible and most misunderstood variables in epidemiology. A baby’s weight at birth is strongly associated with mortality risk during the first year and, to a lesser degree, with developmental problems in childhood and the risk of various diseases in adulthood. Epidemiological analyses often regard birthweight as on the causal pathway to these health outcomes. Under this assumption of causality, birthweight is used to explain variations in infant mortality and later morbidity, and is also used as an intermediate health endpoint in itself.

References:

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[2].     Graham S, Pulver LRJ, Wang YA, Kelly PM, Laws PJ, Grayson N, et al. The urban-remote divide for Indigenous perinatal outcomes. Med J Aust. 2007; 186 (10):509–12.

[3].     Hemming K, Hutton JL, Glinianaia S V, Jarvis SN, Platt MJ. Differences between European birthweight standards: impact on classification of “small for gestational age”. Dev Med Child Neurol. 2006; 48(11):906–12.

[4].     ISSN 2347-954X (Print) © Scholars Academic and Scientific Publisher (An International Publisher for Academic and Scientific Resources) Maternal Obstetric and Morbidity Factors in Re ... 2016; (May).

[5].     J Pharm et al. Maternal Socio-demographic factors and anthropometric characteristics related to infant birth weight. 2013; 29(13):788–97.

[6].     Lie KK, Grøholt E-K, Eskild A. Association of cerebral palsy with Apgar score in low and normal birthweight infants: population based cohort study. BMJ. 2010; 341(oct06_6):c4990.

[7].     Levine EM, Ghai V, Barton JJ, Strom CM. Mode of delivery and risk od respiratory diseases in newborns. Obstet Gynecol. 2001; 97(6):1025–6.

[8].     Malin G, Morris R, Ahmad S, Riley R, Khan K. PP.03 Does the Apgar Score Matter? Investigating the Relationship Between a Low Score and Adverse Outcomes from Birth to Childhood. Arch Dis Child - Fetal Neonatal Ed. 2013; 98(Suppl 1):A83–A83.

[9].     Michalczuk M, Urban B, Chrzanowska-Grenda B, Ozi?? b?? o-Kupczyk M, Bakunowiczazarczyk A. An influence of birth weight, gestational age, and apgar score on pattern visual evoked potentials in children with history of prematurity. Neural Plast. 2015; 2015.

[10].  Montgomery KS. Apgar Scores: Examining the Long-term Significance. J Perinat Educ an ASPO/Lamaze Publ. 2000; 9(3):5–9.

[11].  Mori R, Shiraishi J, Negishi H, Fujimura M. Predictive value of Apgar score in infants with very low birth weight. Acta Paediatr Int J Paediatr. 2008; 97(6):720–3.

[12].  Negrini R, Assef LC, F DSC, E AJ. Delivery modes and the neonatal outcomes of low birth-weight neonates in a Brazilian reference health center Neonatální výsledky u novorozenců nízké porodní hmotnosti v brazilském referenčním centru polikliniky. 2016; 366–71.

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[15].  Straube S, Voigt M, Jorch G, Hallier E, Briese V, Borchardt U. Investigation of the association of Apgar score with maternal socio-economic and biological factors: An analysis of German perinatal statistics. Arch Gynecol Obstet. 2010; 282(2):135–41.

[16].  The INTERGROWTH-21 st Project. WwwThelancetCom. 2014; 384:857–68.

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[19].  Wilcox AJ. On the importance--and the unimportance--of birthweight. Int J Epidemiol. 2001; 30(6):1233–41.

Abstract:

Background: Malaria remains a major public health problem in Sierra Leone. One contributory factor to the high malaria burden is the unavailability of Insecticide Treated Nets (ITN). This study assessed ownership and use of ITN by pregnant women.

Methodology: Cross sectional study design and multi-stage cluster sampling were employed to collect data from 333 eligible and consenting pregnant women. An Interviewer-administered, semi-structured questionnaire was used for data collection. Analyses was done using SPSS version 21. Mean, median and standard deviation were used to summarize quantitative variables and frequencies and proportions for qualitative variables. Association between demographic and pregnancy variables and ITN use was statistically tested. Level of significance for all tests was at 5%.

Result: The mean age of the surveyed pregnant women was 28.49 years. While only 30.3% of pregnant women owned ITN, 97.2% slept under bed net the night before the survey and, 79.2% slept under bed nets always in the 3 months preceding the survey. The ITN ownership by household was 35.4%. The sources of ITN include street traders (38%), mass campaign (25%), health facilities (18%) and shops (15%). The reasons for not sleeping under ITNs are unavailability (79.7%), heat (25.8%), odour (19%), use of other malaria preventive measures (12.1%), and cost, inconveniences and itching (13.8%). ITN use by pregnant women is statistically associated with their educational status, age and ownership of at least one ITN

Conclusion: Pregnant women should have access to ITN at all times as this may increase ITN use during pregnancy.

Keywords: Insecticide Treated Nets, Pregnant, Women, and Malaria.

References:

[1].     Adebayo et al. (2015), Knowledge of malaria prevention among pregnant women and female caregivers of under-five children in rural southwest Nigeria. Peer J 3:e792; DOI 10.7717/peerj.792

[2].     Akaba GO, Otubu J, Agida ET, Onafowokan O. Knowledge and utilization of malaria preventive measures among pregnant women at a tertiary hospital in Nigeria's federal capital territory. Niger J Clin Pract 2013; 16:201-6

[3].     Ajibola Idowu, Gbenga Omotade Popoola, Babatunde Akintunde, Samuel Aaanu Olowookere, and Samson Ayo Deji, “Ownership and Use of Insecticide Treated Nets in Selected Rural Communities of Oyo State, Nigeria: Implication for Policy Action.” American Journal of Public Health Research, vol. 4, no. 6 (2016): 222-229. doi: 10.12691/ajphr-4-6-5

[4].     Belay M, Deressa W. Use of insecticide treated nets by pregnant women and associated factors in a pre-dominantly rural population in northern Ethiopia Trop Med Int Health. 2008 Oct; 13(10):1303-13. doi: 10.1111/j.1365-3156.2008.02159.

[5].     Chukwurah J. N,Idowu E. T, Adeneye A. K, Aina O.O, Agomo P.U, Otubanjo A.O: Knowledge, attitude and practice on malaria prevention and sulfadoxine pyrimethamine utilization among pregnant women in Badagry, Lagos State, Nigeria: MWJ 2016 7:3

[6].     Editor: Lawrence Kazembe, Chancellor College, University of Malawi, Malawi. Received March 29, 2012; Accepted May 25, 2012; Published June 22, 2012

[7].     Humphrey W, Adoke Y, Ruth K, Denis R, Sussann N, Asadu S, Moses K, Scott F, Grant D , Laura S. Long-lasting insecticide-treated bed net ownership and use among children under five years of age following a targeted distribution in central Uganda Wanzira et al. Malaria Journal 2014, 13:185 http://www.malariajournal.com/content/13/1/185

[8].     Lelisa D.S, Wakgari A. D, Ahmed A.A. Predictors of long-lasting insecticide-treated bed net ownership and utilization: evidence from community-based cross-sectional comparative study, Southwest Ethiopia. Sena et al. Malaria Journal 2013, 12:406 http://www.malariajournal.com/content/12/1/406

[9].     Onoriode E, Samson B. A, Omokhudu I, Elijah A. B, Ernest N-Determinants of use of insecticide-treated nets among pregnant women in Nigeria- International Journal of Women’s Health 2015:7 655–661-8

[10].  Sierra Leone Malaria Control Strategic Plan 2016 to 2020, MOHS, GoSL. Chapter 3.2.4, Page 43-Dynamics of Malaria Transmission and level of endemicity in Sierra Leone

[11].  Sierra Leone Demographic Health Survey, 2008 and ICF Macro, 2009: Chapter 12. Page 170-https://dhsprogram.com/pubs/pdf/FR225/FR225

[12].  Sierra Leone service availability and readiness assessment (pdf 4.9Mb). GoSL, MOHs, 2011

[13].  Sierra Leone LLIN universal access campaign post campaign ownership and use survey. GoSL, MOHS

[14].  Sierra Leone Maria Indicator Survey 2016. Chapter 3.2-Pages 30/31

[15].  Sangaré LR, Weiss NS, Brentlinger PE, Richardson BA, Staedke SG, et al. (2012) Determinants of Use of Insecticide Treated Nets for the Prevention of Malaria in Pregnancy: Jinja, Uganda. PLoS ONE 7(6): e39712. doi:10.1371/journal.pone.0039712

[16].  Statistics Sierra Leone 2015 Population Census.

[17].  Tesfaye G, Yemane B, Alemayehu W-Low long-lasting insecticide nets (LLINs) use among household members for protection against mosquito bite in kersa, Eastern Ethiopia-BMC Public health 2012, 12-914-10

[18].  Ugwu E.O, Ezechukwu P.C, Obi S.N, Ugwu A.O, Okeke T.C; Utilization of insecticide treated nets among pregnant women in Enugu, South Eastern Nigeria-Nigerian Journal of Clinical Practice Vol. 15 June-September 2013. Vol 16 IP 154.66-37-156-9

[19].  World Malaria Report 2016 Fact sheet- Published 13^th December, 2016

[20].  World Health Organization, April 2016 Report on Malaria in pregnancy available at www.who.int/malaria/areas/high_risk_groups/pregnancy

[21].  Yassin I.M, Rosnah S, Osman M: Factors Influencing the Usage of Insecticide Treated Mosquito Nets among Pregnant Women, Omdurman, Sudan- International Journal of Health Research, September 2010; 3(3): 139-144

Abstract:

Malnutrition among children is very common in developing countries. Malnutrition is a physical state in which physical function of an individual is impaired to the point at which he or she can no longer maintain adequate bodily performance processes (growth, pregnancy, lactation, physical work, and resisting or recovering from diseases.) (1).

Malnutrition presents a double burden in the world currently.

1.  Severe acute wasting Malnutrition also called thinness (2) which is fast or rapid wasting of body weight [weight for height ratio below < -3 standard deviation (SD)] or bilateral nutritional edema.

2.  Severe overweight also called Obesity (3) which is defined as excess body fat deposited in the body contributing to comorbidity. Body Mass Index (BMI) is the measurement of obesity [when BMI is > 30 or when waist circumference is > 88cm (Female) and > 102cm (Male), there is obesity].

Severe acute wasting Malnutrition and obesity are all conditions that have an impact on a Public Health Point of view.

Indeed, according to the data published by UNICEF, WHO and World Bank Group in 2015 (4):

·     Stunting also called shortness (meaning chronic malnutrition based on height per age ratio) are dropping but 159 million children around the world are still affected.

·     There are 41 million overweight children in the world, about 10 million more than there were 2 decades ago.

·     Wasting still threatens the lives of 50 million children across the globe.

·     The majority of children under 5 suffering from wasting live in Asia. In 2015 , 34,3 million wasted children under 5 were from Asia which represent 68% of the globally number of wasted children under 5(Southern Asia being the house to more than half of all wasted children under 5 globally) (4). Africa is the second worst continent with the second higher number of wasted children under 5 which is around 13, 9 million (28% of the global number) (4).

57% of world stunted children are from Asia while 37% of world stunted are from Africa mostly in Eastern Africa, Middle Africa and Western Africa. (4).

Low income and lower middle income countries are the majority of countries that experience more of wasting and stunting among children under 5(4).

References:

[1].     African Economic Outlook , AFDB/OECD 2008

http://www.oecd.org/dev/emea/40578314pdf

[2].     Global Nutrition Policy Review: What does it take to scale up nutrition action?, World health Organization (WHO), 2013.

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Abstract:

Poor retention in HIV care is a known main challenge for antiretroviral treatment programs resulting to poor performance and increased morbi-mortality. Many studies related to retention are focused on adults including pregnant women, leaving out children, especially in sub Saharan Africa. The objective of this study is to assess 12 months retention and determine factors associated with retention among children on ART. A cross-sectional study was carried out in a pediatric reference in Yaounde, Cameroon. Registers of children enrolled on antiretroviral therapy from Oct 2015 to Oct 2016 were reviewed for retention. Factors associated with retention in children were determined for future improvement.

A total of 416 children were enrolled and after 12 months follow up, 398 (90.9%) were found to be alive and still on treatment. Young age (age less than 1 year) of start on ART and CD4% were the factors associated with poor retention & attrition at 12 months after initiation.

Twelve months retention in care for children living with HIV is near optimal (90.0%) with a high chance of long term survival. Age less than 1 year and CD4% were baseline risk factors for poor retention. Given that children rely on their caregivers for optimal retention, there is need for robust prevention of mother to child transmission programs and pediatric case finding & linkage to care strategies. Quality data will help improve strategies and procedures to boost long term retention required for viral suppression needed end the HIV pandemic.

Keywords: HIV, Assessment, Retention, 12 months, Children, Cameroon.

References:

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Abstract:

Background: Paediatric HIV infection and malnutrition remain two major health issues in Nigeria. Malnutrition is one of the clinical presentation of HIV in children who survive infancy undiagnosed, diagnoses usually occurs on presentation to health care services. We investigated the effectiveness of integrating provider-initiated testing and counselling (PITC) with nutrition services for children less under 5 years attending primary care clinics.

Methods: After an evaluation of HTC services for malnourished children aged 6-59 months in 2 primary health care facilities offering community management of acute malnutrition (CMAM) sites in Adamawa State, Nigeria, PITC was integrated into nutrition services. The change in the proportion of eligible children offered and receiving HIV tests and yield of HIV-positive diagnosis were compared for periods of 6 months before the integration of PITC and 6 months after the integration of PITC into CMAM OTP.

Results: There were 440 and 278 malnourished children eligible for HIV testing before and after the integration of PITC within nutrition services. The proportion of eligible malnourished children offered testing increased from 59% to 100% and test uptake improved from 50% to 98% in PITC integration period compared with before PITC integration period. The yield of HIV diagnosis increased from 0 to 1.5%, and a malnourished child attending the clinic post intervention had 0.03 increased adjusted risk (95% CI: 0.01 to 0.08) of receiving an HIV test in PITC integration period compared with pre-intervention period.

Conclusion: PITC integration into CMAM intensified paediatric HIV case finding.

Keywords: Nigeria, HIV, Malnourished Children, PITC.

References:

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Abstract:

Abstract

Background: Nigeria ranks 5^th among the 22 countries that contributed 80% of the global Tuberculosis (TB) burden. The risk of developing TB is between 20 and 37 times greater in people living with HIV (PLWHIV) than among those who do not have HIV infection. The purpose of this study was to assess the level of Isoniazid Preventive Therapy (IPT) implementation among PLWHIV.

Methods: Retrospective cohort study conducted to examine the IPT implementation among the PLWHIV in Specialist Hospital Yola, Nigeria. Information’s were extracted from the IPT enrolment register and client’s folders, analyzed with excel and compared with the data in the District Health Information System (DHIS). Chi-square test was used to measure the strength of associations between the various variables and probability of statistical significant level set < 0.05 at 95% Confidence interval

Results: Eight hundred and seventy-three (873) clients were enrolled in to HIV care and treatment from January-December 2015 and were all screened for TB. 777 (89%) clients had no presumptive TB, only 273 (35%) clients were initiated on IPT out of those without presumptive TB. 143 (93%) clients on ART completed their IPT as against the 97 (80%) Pre-ART clients that completed IPT.

Conclusion: The IPT utilization in the prevention of TB among the PLWHIV in this health facility was very low, however consistent availability of Isoniazid and effective adherence counselling to eligible PLWHIV before commencement of IPT would help in increasing uptake and reducing the rate of defaulters on IPT.

References:

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Abstract:

Since a number of years, many changes and a great
evolution have occurred in the process of care and treatment as well as program
management of HIV/AIDS control, worldwide. Many terms
and paradigms have in fact emerged in the field of HIV/AIDS. New terms and paradigms
such as the 90-90-90 target by 2020, the “test and treat”, the linkage or the yield.
As a matter of fact and according to the UNAIDS [11], “Ending the AIDS epidemic
is more than a historic obligation to the 39 million people who have died of the
disease. It also represents a momentous opportunity to lay the foundation for a
healthier, more just and equitable world for future generations.” This will
undoubtedly be an enormous achievement for mankind as a whole, for what has been
one of the greatest fears of the last 30 years. Thus, one of
the biggest demands to date to achieve the elimination of the HIV epidemic is certainly
the need to make the treatment universal, through the availability of ARVs.it should
ensured that all those who have been initiated into antiretroviral treatment remain
be admitted that, not only must treatment be made available, but it must also be
faithful to it throughout their lives; hence the notions of linkage to treatment
antiretroviral treatment not only reduces the viral load in the individual undergoing
and retention to treatment. It should be remembered that a good follow-up of the
treatment, resulting in a better quality of life and a longer life but also reduces the capacity
of the infected person to transmit the HIV infection to others. Therefore, advantages
obviously exist for both the infected individual and the entire community. In this respect, a powerful
momentum initiated by the UNAIDS [11], is now building towards
a new narrative on HIV treatment and a new, final, ambitious, but achievable target.

References:

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Abstract:

Introduction: The scourge of HIV/AID has negative impact on human existence. Global trends in HIV prevalence are alarming despite the use of potent antiretroviral medications for many decades. The impact on individual in a society and communities at large is a public health concern and all hands should be on deck to curb this social menace. The big question is what more can we do to help get to Zero? The objective of this study was to reflect on the trends in HIV care in a tertiary health facility in South West Nigeria and compare with what is obtainable globally and elucidate what more can be done now, to safeguard the future of the next generation.

Methods: In this study, secondary data was used. Monthly records of seropositive patient enrolled in ART care for 10 consecutive years were retrieved. Including routine clinic visits, and wards admissions. A review of monthly records of seropositive clients’ (adult, paediatric and antenatal clinics) enrolled in ART programs of Federal Medical Centre Owo Ondo Nigeria was conducted. Data analysis was done using SPSS version 22.0.

Result: Total number of seropositive clients enrolled between the years 2006 to 2015 in the adult ART clinic is 3844 with a monthly average of 344.4 clients. Total number of male that attended ART clinic was 1782 (46.5%) while total number of female was 2058 (53.5%). Prevention of Mother to Child Transmission (PMTCT) the total of pregnant women tested from year 2008 to 2015 is 19,641 but only 3530 (17.97%) were seropositive. Highest enrollment occurred in year 2008 which was 857(22%), with lowest enrollment occurring in 2006 which was 251(6.5%). Therefore, showing decrease in enrolment over the years. A total of 225 clients were transferred out, 19.5% were lost to follow up. However, total pregnant women tested from year 2008 to 2015 is 19,641 out of which 3530 (18%) were seropositive. There is an appreciable decline in the incidence of HIV/AIDS among pregnant women from 2008 till 2015, from 884 (25%) to 173 (4.9%). The prevalence of seropositive pregnant women have reduced from 7.95% in 2008 to 0.9% in 2015.

Conclusion: Early enrolment in ART programme will ensure access to drugs and help safeguard the future. Adequate counseling will help form good habits and thereby reduce the spread of HIV. The use of antiretroviral therapy is significant in reducing morbidity and mortality in HIV positive clients especially in developing countries.

Keywords: Trends, Client, Seropositive, Antiretroviral.

References:

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[8].     Mattew fox, Factors influencing Enrollment in Treatment for HIV/AIDS in Zambia, Donor/Finder CDC, 2007-2009.bu.edu/cghd/our.work/project.

[9].     Nigeria 2013 HIV Survey. Last viewed on 01/12/15

[10].  Nigeria HIV Fact Sheet – US Department of State.

[11].  Nigeria National Agency for the Control of AIDS (2014) ‘Countries Progress Report 2014’

[12].  Ondo State Ministry of Health HIV AIDS Control programme: www.ondostatemoh.gov.ng/hiv-aids.php. Last viewed on 21/12/15

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[19].  UNAIDS and The Henry J. Kaiser Family foundation 2014 ‘financing the Response to HIV in low and Middle-Income Countries: International Assistance from Donor Governments in 2013’.

[20].  UNAIDS (2014) ‘The Gap Report’.

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Abstract:

Background: Millennium Village Project (MVP) is designed to harness the progress of the time-bound Millennium Development Goals (MDGs).

Objective: This study aimed to assess the perception of the Ikaram Millennium Village Project by the residents of Akoko North–West Local Government Area of Ondo State.

Method: A descriptive cross-sectional study of 496 residents of five out of the seven communities that make up the Ikaram MVP was done. The perceptions of the respondents were rated poor or good by scoring response to eight validated questions. Chi square test was used to assess significant association.

Result: The mean age of the respondents was 42.20±17.1 years, 250 (50.4%) were females, married were 311 (62.7%). Only 15(3%) were from other tribes aside Yoruba, 430(86.7%) have ever accessed the MVP health services. Poor perception was reported among 353 (82.1%) respondents. Among the Yorubas 79(17.1%) had good perception compared to 7(46.7%) from other tribes, p= 0.003. The location of the health facility contributed to the poor perception about the Ikaram MVP.

Conclusion: For community orientated health projects to be successful community participation is important.

Keywords: Millennium Village project, rural communities, perception, health facilities, community participation.

References:

[1].     Andrew S. Kanter, Joel Negin, Bernard Olayo et al. Millennium Global Village-Net: Bringing together Millennium Villages throughout sub-Saharan Africa. International journal of medical informatics, 78, 802–807.

[2].     Gertler, P., J., Sebastian M., Patrick P., Laura B., R., Christel M., J., V., (2011). Impact Evaluation in Practice. The World Bank.

[3].     Kish, Leslie (1965): survey sampling. New York: John Wiley and Sons, INc. p. 78-94

[4].     Millennium Villages. www.millenniumvillages.org.

[5].     Millennium Villages Project, (2009b). Study Protocol, Integrating the delivery of health and development interventions: Assessing the impact on child survival in sub-Saharan Africa. https://ciesin.columbia.edu/.../MVPMashego TA, Peltzer K. Curationis. Community perception of quality of (primary) health care services in a rural area of Limpopo Province, South Africa: a qualitative study. 2005; 28(2):13-21.Omotara BA, Yahya SJ, Shehu U, Bello HS, Bassi AP. Communities’ awareness, perception and participation in the Community-Based Medical Education of the University of Maiduguri. Educ Health (Abingdon). 2006; 19(2):147-54.

[6].     Ousséni Kinda. The Monitoring and Evaluation System of the Millennium Villages Project-Potou/Senegal: Close Look at the Mid-term Evaluation Report. Consilience: The Journal of Sustainable Development Vol. 9, Iss. 1 (2012), Pp. 33 – 46

[7].     The Millennium Villages Project: The next five years: 2011-2015. www.millenniumvillages.org/reports/the-millenium-villages-project-the-next-five-years-2011-2015.

[8].     The Millennium Villages Project: An Overview, The Earth Institute, Millennium Promise & UNDP, February 2007, p1.

[9].     The MDG Centre West and Central Africa, Earth institute/Columbia University http://www.mdgwca.org/en/clutter.php?mv=Ikaram%20(Nigeria)&PHPSESSID=fb2d40065601c63e9dd80eeaf861572

[10].  The Millennium Villages Project: Progress Report November 2006. www.undp.org.sn/new/mv/Newsletter

[11].  UNDP, (2009). Handbook on planning, monitoring and evaluating for development results.

[12].  Xu K, Evans DB, Carrin G, Aguilar‐Rivera AM, Musgrove P, Evans T. Protecting households from Catastrophic health expenditures. Health Affairs. 2007; 6:972‐83.

Abstract:

Background: Under Nutrition Is One of World’s Most Serious but Least Addressed Health Problems. Malnutrition Is Widespread In Cameroon Especially In The Northern Regions Of Cameroon. There Are Currently Very Little Or No Data On Factors Associated With Stunting In Cameroon. This Paper Presents Some Factors Associated With Stunting In Adamaoua, East, Far North And North Regions Of Cameroon.

Method: This Study Analysed Dataset Of The Firth Round Of Cameroon Multiple Indicator Cluster Survey (MICS5) To Establish Risk Factors Associated With Stunting In Four Regions Of Cameroon

Results: 3085 Cases were Analysed, with stunting Prevalence Rates Of 31.7% At National Level, 37.8%, 35.8% , 41.9% And 33.8% Respectively In Adamaoua, East, Far North And North Regions. The Highest Risk of Stunting Was Among Children Age 36-45 Months (10.2%, 8.8%, 11.9%, And 10.4% Respectively In the Adamaoua, East, Far North and North Regions). Rural Children across All Four Regions Were More Affected By Stunting (22%, 27%, 31.9%, And 27.4% Respectively In Adamaoua, East, Far North and North Regions than Their Urban Counterparts (13, 9%, 8%, 8%, And 6.5% Respectively).

Conclusion: The Study Recorded High Prevalence Of Stunting, Underweight And Wasting Among Children Age 6-59 Months. Malnutrition was noted as a Burden in Children Age 6-59 Months in Cameroon, Particularly the Four Regions of the Study. Age And Place Of Residence Of Child, Were Found To Be Significantly Associated With Stunting And That Child Age Was Significantly Associated With Minimum Acceptable Diet.

Keywords: Cameroon, Under-Nutrition, Stunting, Determinants, Association.

References:

[1]. Abuya BA1, Ciera J, Kimani-Murage E (2012). Effect of mother's education on child's nutritional status in the slums of Nairobi. BMC Pediatr 12: 80.

[2]. Addis Continental Institute of Public Health December 04, 2009.

[3]. Ahmed E, Mofida Y, Elkhalifa, Maria H, ElnasikH (2011). Nutritional status of the children under age of five in a desertified area of Sudan; alrawakeeb valley, Khartoum, Sudan. International Journal of Current Research 2: 103-108.

[4]. Ahmed S, Ferdous F, Das J, Farzana FD, Chisti M.J (2015). Shigellosis among Breastfed Children: A Facility Based Observational Study in Rural Bangladesh. J Gastrointest Dig Syst 5:327. doi:10.4172/2161-069X.1000327.

[5]. Babasaheb A. (2011). An Investigation into Factors Affecting Child Undernutrition in Madhya Pradesh Sibabrata Das and Harihar Sahoo. Ravenshaw University, Cuttack 753 003, Odisha, India harashtra. 2011: 6-7.

[6]. Beka T, Wambui K, Zewditu G, Girum T (2009). Magnitude and determinants of stunting in children underfive years of age in food surplus region of Ethiopia: The case of West Gojam Zone. Ethiop. J. Health Development 23: 98-106.

[7]. Bryce, J. (2008). Maternal and child under utrition.

[8]. Gobotswang K. (2008). Factors associated with nutritional status of the under five children Amita Pradhana. Asian journal of medical sciences. 2008.

[9]. Kandala NB1, Madungu TP, Emina JB, Nzita KP, Cappuccio FP (2011). Malnutrition among children under the age of five in the Democratic Republic of Congo (DRC): does geographic location matter? BMC Public Health 11: 261.

[10].  Laure NJ, Christelle MM, Bilkha L, Desire MH, Julius O (2014). Nutritional Status and Risk Factors of Malnutrition among 0-24 Months Old Children Living in Mezam Division, North West Region, Cameroon. J Nutr Disorders Ther 4:150. doi:10.4172/2161-0509.1000150.

[11].  Mostafa KS (2011). Socio-economic determinants of severe and moderate stunting among under-five children of rural Bangladesh. Malays J Nutr 17: 105-118

[12].  Nagahori C (1), Tchuani JP, Yamauchi T (2015). Factors associated with nutritional status in children aged 5-24 months in the Republic of Cameroon: Laure NJ, Christelle MM, Bilkha L, Desire MH, Julius O (2014) Nutritional Status and Risk Factors of Malnutrition among 0-24 Months Old Children Living in Mezam Division, North West Region, Cameroon. J Nutr Disorders Ther 4:150. doi:10.4172/2161-0509.1000150.

[13].  Nakamori M, Ninh N.X, Khan N.C, Huong C.T, Tuan N.A, Mai L.B. (2010). Nutritional status, feeding practice and incidence of infectious diseases among children aged 6 to 18 months in northern mountainous Vietnam.

[14].  Ngambouk Vitalis Pemunta and Mathias Alubafi Fubah (2014). Socio-cultural determinants of infant malnutrition in cameroon. Journal of Biosocial Science, Available on CJO 2014 doi: 10.1017/S0021932014000145.

[15].  Nguyen NH, Nguyen NH2 (2009). Nutritional Status and Determinants of Malnutrition in Children Under Three Years of Age in Nghean, Vietnam. Pakistan Journal of Nutrition. 8: 958-964.

[16].  Paramita S, Nina P, Benjamin A. I. (2010). Epidemiological correlates of under-nutrition in under-5 years children in an urban slum of Ludhiana, india Health and Population: Perspectives and Issues 33: 1-9.

[17].  Report of a webcast colloquium on the operational issues around setting and implementing national stunting reduction agendas Childhood Stunting: Challenges and Opportunities 14 October 2013 – WHO Geneva.

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[19].  Sumit M (2010). Assessing Vulnerability to Chronic Undernutrition among Under-Five Children in Egypt. Academic Editor: Abbas Bhuiya10-12.

[20].  Tibilla M.A (2007). The nutritional impact of the world food programme-supported supplementary feeding programme on children less than five years in rural tamale, Ghana 17-18.

[21].  The Lancet 2008.

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[24].  Yalew BM, Amsalu F, Bikes D (2014). Prevalence and Factors Associated with Stunting, Underweight and Wasting: A Community Based Cross Sectional Study among Children Age 6-59 Months at Lalibela Town, Northern Ethiopia. J Nutr Disorders Ther 4:147. doi:10.4172/2161-0509.1000147.

[25].  Zhang XS, Pebody RG, McCauley JW (2016). Seasonal Influenza Vaccination: Its Expected and Unexpected Effects. J Vaccines Vaccin 7:314. doi:10.4172/2157-7560.1000314.

Abstract:

Introduction: This study aims to determine the unmatched Public Health Humanitarian Emergencies Context with recurrently outdated methods of response -South Sudan is used as a case study. With specific objective: to increases the support for vital, approach in Public health activities in humanitarian emergencies and ascertain new ways of delivering Public health activities in humanitarian emergencies system.

Methodology: The study, was secondary research to track down useful existing published information and a review of the secondary literature on Public health activities in humanitarian emergencies, the principle investigator summaries the articles from South Sudan NGOs forum, BioMed central , Web of Science (2005- 2017) and PubMed (2005- 2017).

Results: South Sudan reported the highest Humanitarian access incidence in the region, most frequent report in 2017, (101) in August 2017 laterally, and most implicate violence against humanitarian workers and properties. Evidence indicate South Sudan is not receiving enough support and appropriate global focused, due jeopardy, that lead to losing more humanitarian support. Yet, it’s not the humanitarian agencies that’s going to solve the Public health humanitarian emergencies in South Sudan, than the political will and support.

Conclusion: South Sudan situation cannot be put in to one box, because it has many vigorous, therefore need different approaches and interventions. The study recommends that improved data are imperative towards supporting inter-sectorial work in addressing Public health care needs of the persons of concern to Humanitarian agencies.

Keywords: Complex emergency, humanitarian, Health Information System (HIS) – Public health -0 persons of concern to Humanitarian agencies.

References:

[1].     Ann M. Simmons, 2016, Cash for crises: Who gives, who gets and why it's not enough, http://www.latimes.com/world/global-development/la-fg-global-humanitarian-funding-snap-story.html.

[2].     Humanitarian Practice Network, 2017, the crisis in South Sudan number 68, January 2017 http://odihpn.org/wp-content/uploads/2017/01/HE-68-web.pdf.

[3].     (HPN) Humanitarian Practice Network, 2017, Humanitarian Exchange, Special feature the crisis in South Sudan.

[4].     Interagency Health and Nutrition Evaluations in Humanitarian Crises (IHE) Initiative, 2007, Guidelines for Interagency Health and Nutrition Evaluations in Humanitarian Crises.

[5].     James MacKinnon and Barbara MacLaren, 2012, Human Resources for Health Challenges in Fragile States: Evidence from Sierra Leone, South Sudan and Zimbabwe.

[6].     John Mitchell, Coordinator, ALNAP Secretariat WHO, 2003, Health in Humanitarian Emergency. http://www.who.int/hac/about/9545.pdf.

[7].     Lawry et al. Reproductive Health (2017), A mixed methods assessment of barriers to maternal, newborn and child health in Gogrial West, South Sudan 14:12 DOI 10.1186/s12978-016-0269-y.

[8].     Special Feature: Comprehensive CME Program on Disaster Medicine Part 1 Conferences and Lectures, International Standards for Public Health Activities JMAJ 56(1): 15–18, 2013 https://www.med.or.jp/english/journal/pdf/2013_01/015_018.pdf.

[9].     UNHCR, 2016, Community Based Health, Nutrition and Hygiene Promotion Program in Refugees Setting, Maban, South Sudan.

[10].  UNHCR, 2017 Guidelines for Interagency Health and Nutrition Evaluations in Humanitarian Crises, 2007, Interagency Health and Nutrition Evaluations in Humanitarian Crises (IHE) Initiative, p 1.

[11].  UNHCR, 2017, As South Sudan crisis deepens, more funds needed for refugees http://www.unhcr.org/news/latest/2017/5/5919a18f4/south-sudan-crisis-deepens-funds-needed-refugees.html.

[12].  UNHCR, 2017, SOUTH SUDAN SITUATION 2017 http://www.unhcr.org/partners/donors/593e9e9b7/unhcr-south-sudan-revised-supplementary-appeal-january-december-2017.html?query=South%20Sudan%20Crises.

[13].  WHO, 1998, Health Interventions in Complex Emergencies a Case Study of Liberia http://www.who.int/hac/techguidance/training/analysing_health_systems/liberia_health_interventions_complex_emergencies.pdf.

[14].  WHO. Health Action in Crisis - definitions. Available from: http://www.who.int/hac/about/definitions/en/.

[15].         Zachary A. Lomo, the Struggle for Protection of the Rights of Refugees and IDPs in Africa: Making the Existing International Legal Regime Work, 18 Berkeley J. Int'l Law. 268 (2000). Available at: http://scholarship.law.berkeley.edu/bjil/vol18/iss2/8.

Abstract:

Contraception has proven to be an effective way of controlling fertility and spacing births. Studies have shown that contraception can avert high risk pregnancies and consequently reduce maternal deaths. Uptake of modern contraception is promoted as a mechanism to address the reproductive health needs of men and women, as well as the crucial challenge of rapid population increase. Therefore, this study was conducted to assess the factors affecting the uptake of modern contraception services among women of reproductive age in Oyo state, Nigeria.

A cross sectional descriptive study using a two stage systematic sampling technique was used to select 530 women of reproductive age in five wards using sample size based on proportion to size in 20,000 households. Respondents were interviewed using a semi structured questionnaire which included questions on socio-demographic characteristics, awareness, knowledge, factors affecting the usage of modern contraceptives and perception of contraceptive use. Knowledge was assessed on a 5 point scale in which score of ≤ 2 were rated poor while perception was scored on a 36 point-scale in which scores ≤ 18 rated low. Data were analysed using descriptive statistics, Chi-square test and logistic regression at p=0.05.

Age of respondents was 30.3 ±7.8 years and 73.0% were married. Sixty percent were muslims and 34.5% had secondary education. Seventy two percent of the respondents were self-employed. About 90% had good knowledge of contraception while 60.8% had ever used contraceptives. The commonest source of information about contraception was mass media (72.8%). Twenty six percent obtained husbands’ approval before using contraceptives while 20.0% had used modern contraceptives before first birth. Fifty percent of the respondents agreed that contraception helps in improving standard of living and 64.7% had good perception about contraception. Factors that hindered effective uptake of contraceptive services included poor service providers’ attitude (33.3%) and congestion at the service centers (4.5%). Respondents with non-use of contraceptive before first birth were less likely to subsequently use contraceptives (OR= 0.324, 95%CI= 0.1-0.5). Husband’s approval of contraceptives use was the major determinant of women’s contraceptive use (OR = 3.4, 95%CI = 1.3-8.7). About 42.0% of the respondents had family planning centers not more than 5 kilometers walking distance to their residence. Twenty-one percent of those who had to take transportation to the service venues did not use contraception services.

Majority of the women in Ibadan North West were knowledgeable and aware of contraception services but husband’s approval on the use of modern contraceptives remains poor. Programmes that enhance husbands’ approval of modern contraception are thus recommended.

Keywords: Contraception uptake, Husband’s approval, Service provider’s attitude.

References:

[1].     Allen K, Larissa J, Alice R, Gorette N, James N, and Lynn A. (2014). Barriers to male involvement in contraceptive uptake and reproductive health services: a qualitative study of men and women’s perceptions in two rural districts in Uganda. Available from: http://www.reproductive-health-journal.com/content/ [Accessed February 20, 2015].

[2].     Anyadike, N, and Emeh EJ (2012). Universal Journal of Education and General Studies Vol. 1(4); 088-102.

[3].     Best, Kim, (2002). Medical Barriers Often Unnecessary. Family Planning and Reproductive Health Behaviours in Nigeria Network 21(3): 4-15.

[4].     Campbell MM, Sahin-Hodoglugil NN, Potts M (2006). Barriers to fertility regulation: a Review of the literature. Studies in family planning; 37: 87-98.

[5].     Centre for Reproductive Rights and the Women Advocates Research and Documentation Centre (2008). Broken Promises: Human Rights, Accountability and Maternal Death in Nigeria. New York and Lagos. Journal of Adolescent Health, 12: 15-37.

[6].     Centre for Reproductive Rights and the Women Advocates Research and Documentation Centre. From http://www2.ohchr.org/english/bodies/cedaw/docs/ngos/CRR_Nigeria41.pdf [Retrieved December 1, 2012].

[7].     Federal Ministry of Health, (2004) Nigeria The health system in Nigeria and health status of Nigerians is in a deplorable state” (Health Sector Reform Programme, 2004–2007).

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[10].  Finkle, C, Jacqueline ED, Susheela S (2011). Data analysis based on private communications The Allan Guttmacher Institute.

[11].  Frost JJ, Singh B, Finer LB (2007). Factors Associated with Contraceptive Use and Non -use, United States. Perspectives on Sexual and Reproductive Health, 39(2): 90-99.

[12].  Gaetano M, Lutuf A, Zaake D, Annika J. Predictors of Contraceptive use Among Female Adolescents in Ghana. African Journal Reproductive Health March. 2014; 18(1): 102. PubMed.

[13].  Garenne M, Tollman S, Kahn K (2000). Premarital fertility in rural South Africa: a challenge to existing population policy. Studies in Family Planning, 31:47–54.

[14].  Gebremariam A, Addissie A. Intention to use long acting and permanent contraceptive methods and factors affecting it among married women in Adigrat town, Tigray, Northern Ethiopia. Reprod Health. 2014 Mar 16; 11(1):24. PubMed.

[15].  Ghana Demographic and Health Survey (GDHS Ghana Trend Report. (2005). Trends in demographic, family planning and health indicators in Ghana, 1960-2003. Calverton, MD: ORC Macro.

[16].  Guttmacher Institute and International Planned Parenthood Federation. (2010). Facts on Satisfying the Need for Contraception in Developing Countries. In Brief. www.guttmacher.org/pubs/FB-Unmet need-Intl.pdf.

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[24].  Johns Hopkins Bloomberg School of Public Health and Advance Family Planning. 2011. Taking Injectable Contraceptives to Villages: An Advocacy Case Study in Uganda [casestudy].www.advancefamilyplanning.org/system/files/Uganda%20CBD%20Case%20 Study%2010%2018%202011%20FINAL.pdf.

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[46].  Raphael A 2008. Maternal death rate puts Nigeria in spotlight. From (Retrieved November 7, 2012).

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[48].  Ross J., and W. Winfrey. 2002a. “Contraceptive Use, Intention to Use and Unmet Need during the Extended Postpartum Period.” International Family Planning Perspectives 27 (1): 20–27.

[49].  Rimal RN, Ratzan SC, Arntson P, Freitmuth YS 2002. Reconceptualising the Patient: Health Care Promotion as Increasing Citizens’ Decision-Making Competencies. Communication, 9(1): 61-74.

[50].  Singh, S., J. E. Darroch, M. Vlassoff, and J. Nadeau. 2004. Adding it Up: The Benefits of Investing in Sexual and Reproductive Health Care. Washington, DC, and New York: The Alan Guttmacher Institute and the United Nations Population Fund.

[51].  Susheela Singh et al., Adding It Up: The Benefits of Investing in Sexual and Reproductive Health Care (New York: Guttmacher Institute and UNFPA, 2003).

[52].  Ugoji FN, 2008. Attitude of Undergraduates towards Contraceptive Use. Pakistan Journal of Social Sciences, 5(1): 111-115.

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[57].  World Health Organization. 2007. Report of a WHO Technical Consultation on Birth Spacing Geneva: 1(2). 67-69.

[58].  World Health Organization. 2009. Unsafe Abortion: Global and regional estimates of incidence and associated mortality. 4th ed. Geneva WHO, 2004.

Abstract:

Introduction: Accidental Exposure to Blood and body fluids (AEB) is one of the most important risks among Healthcare workers (HCW), and is less reported in some settings. They are exposed to many blood borne pathogens including HIV, Hepatitis C virus, and Hepatitis B virus. The objective of this study was to assess the quality of the case reporting, the post-exposure management and to address some suggestions for the HCW protection in the Biyem-assi District Hospital (BDH).

Method: We obtained an administrative authorization, we conducted a cross sectional hospital-based study from 6^th September to 20^th October 2016. We used the register of all the reported Accidental injuries, a convenience sampling in the different HCW groups in contact with patients, and addressed a questionnaire to assess their knowledge, their immunization status against HBV. We performed a descriptive analysis of data using Epi info version 7.1.1.14.

Results: There is a good knowledge of the definition of the AEB. Only injuries with the HIV positive patients were reported, no hepatitis test and Anti-Hbs titer were performed on the victims. Less information is known about the outcome after the post-exposure prophylaxis, 48.84% of the HCW have not received a vaccination against Hepatitis B. 83.72% of the participants do not have any Health insurance.

Conclusion: AEB is less reported in the BDH. 48.84% of HCW are not vaccinated against the HBV. There is a need for Sensitization for a complete case -reporting, follow-up after injuries; Strong regulations for a mandatory immunization among HCW.

Keywords: Accidental- Exposure, Healthcare -workers, HIV, HBV, HCV.

References:

[1]. Bekele, T., Gebremariam, A., Kaso, M., & Ahmed, K. (2015). Attitude, reporting behavour and management practice of occupational needle stick and sharps injuries among hospital healthcare workers in Bale zone, Southeast Ethiopia: a cross-sectional study. Journal of Occupational Medicine and Toxicology (London, England), 10, 42. https://doi.org/10.1186/s12995-015-0085-2

[2]. Eloumou B., S., Noah N, D., & Ngaba, G. P. (2014). Vaccinal status against Hepatitis B and carying the AgHBS among Medical and pharmacy students in the University of Douala.

[3]. Etounou Akono, T., & al. (2009). Connaissancs Attitudes et Pratiques du personnel de santé aux acccidents d’exposition au sang à la maternité de l’hopital central de Yaoundé. Université de Yaouné I, Yaoundé.

[4]. Gupta, E., & Gupta, A. (2016). Blood-borne viruses and health care workers: A neglected entity! Indian Journal of Medical Microbiology, 34(2), 137–138. https://doi.org/10.4103/0255-0857.176854

[5]. Jain, M., Sabharwal, E. R., & Srivastava, D. (2016). Practices of Health Care Personnel Regarding Occupational Exposure. Journal of Clinical and Diagnostic Research: JCDR, 10(11), DC14-DC17. https://doi.org/10.7860/JCDR/2016/20934.8893

[6]. Mbah, C. C. (2014). Reporting of accidental occupational exposure to Blood and Body Fluids by Doctors and Nurses in the Public Primary Health Care setting of sub district F of Johannesburg Metropolitan district. University of Wiwatersrand, Johannersburg.

[7]. Mbanya, D., Ateudjieu, J., Tagny, C. T., Moudourou, S., Lobe, M. M., & Kaptue, L. (2010). Risk Factors for Transmission of HIV in a Hospital Environment of Yaoundé, Cameroon. International Journal of Environmental Research and Public Health, 7(5), 2085–2100. https://doi.org/10.3390/ijerph7052085

[8]. Mueller, A., Stoetter, L., Kalluvya, S., Stich, A., Majinge, C., Weissbrich, B., & Kasang, C. (2015). Prevalence of hepatitis B virus infection among health care workers in a tertiary hospital in Tanzania. BMC Infectious Diseases, 15, 386. https://doi.org/10.1186/s12879-015-1129-z

[9]. Nilsson, J., Pembe, A. B., Urasa, M., & Darj, E. (2013). Safe injections and waste management among healthcare workers at a regional hospital in northern Tanzania. Tanzania Journal of Health Research, 15(1), 64–70.

[10].  Noubiap, J. J. N., Nansseu, J. R. N., Kengne, K. K., Tchokfe Ndoula, S., & Agyingi, L. A. (2013). Occupational exposure to blood, hepatitis B vaccine knowledge and uptake among medical students in Cameroon. BMC Medical Education, 13, 148. https://doi.org/10.1186/1472-6920-13-148

[11].  Nouetchognou, J. S., Ateudjieu, J., Jemea, B., & Mbanya, D. (2016). Accidental exposures to blood and body fluids among health care workers in a Referral Hospital of Cameroon. BMC Research Notes, 9. https://doi.org/10.1186/s13104-016-1923-8

[12].  Puro, V., De Carli, G., Cicalini, S., Soldani, F., Balslev, U., Begovac, J., … European Occupational Post-Exposure Prophylaxis Study Group. (2005). European recommendations for the management of healthcare workers occupationally exposed to hepatitis B virus and hepatitis C virus. Euro Surveillance: Bulletin Européen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin, 10(10), 260–264.

[13].  Rajkumari, N., Thanbuana, B. T., John, N. V., Gunjiyal, J., Mathur, P., & Misra, M. C. (2014). A prospective look at the burden of sharps injuries and splashes among trauma health care workers in developing countries: true picture or tip of iceberg. Injury, 45(9), 1470–1478. https://doi.org/10.1016/j.injury.2014.03.001

[14].  Streefland, P. H. (2001). Public doubts about vaccination safety and resistance against vaccination. Health Policy (Amsterdam, Netherlands), 55(3), 159–172.

[15].  World Health Organization. (2012). International travel and health.

Abstract:

Hypertension contributes largely to morbidity and mortality experienced from cardiovascular diseases worldwide. Studies have been conducted on hypertension among various populations in Nigeria, but only a few have provided data on hypertension-related preventive Health-Seeking Behaviour (HSB) among workers in the hospital environment. This study was conducted to determine the preventive HSB relating to hypertension among non-teaching staff of the College of Medicine, University of Ibadan (CoMUI).

A total of 315 non-teaching staff University College Hospital was involved in the study. Data were collected using a pre-tested a semi-structured questionnaire. Respondents’ preventive HSB were assessed through preventive practices. Respondents’ attitudes towards preventive behaviour were measured on 20-point scale. Using SPSS, Data were analysed via descriptive statistics, Chi-square and logistic regression.

Preventive behaviour by respondents included non-consumption of alcohol (65.1%), regular BP check-up (46.3%), regular exercise (41.9%) and low salt intake 47.3%. Few respondents (39.3%) had positive attitude towards preventive HSB. Non-alcohol consumption was 4 times more likely to be observed (OR: 4.2; 95% CI 2.6-6.9) while exercise was twice less likely (OR: 2.1; 95% CI 0.3-0.7) by the respondents. Respondents’ educational qualifications and administrative rank were significantly associated with preventive HSB (p<0.05). Less than half (43.8%) of the respondents had low knowledge of hypertension prevention (screening/early detection; 14.9%).

Although more than half of the respondents do not consume alcohol, other aspects of preventive behaviours practices were relatively low which therefore calls for effective work-place health promotion and education programme for behavioural change towards prevention of hypertension.

Keywords: Hypertension, Hypertension prevention, Hypertension risk factors, Preventive Health- seeking behaviour, University Non-teaching staff, Hospital environment.

References:

[1].     Adeloye D, Basquill C, Aderemi AV, Thompson JY, Obi FA (2015). An estimate of the prevalence of hypertension in Nigeria: a systematic review and meta-analysis. J Hypertens 2015; 33: 230–242. doi: 10.1097/HJH.0000000000000413 [PubMed].

[2].     Amaghionyeodiwe LA (2008). Determinants of the choice of health care provider in Nigeria. Health. Health Care Management Science; 11 (3): 215-227.

[3].     Danaei G., Finucane M. M., JLin. K. et al. (2011), “National, regional, and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 5·4 million participants. Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Blood Pressure),” The Lancet, vol. 377, no. 9765, pp. 568–577, 2011. View at Publisher · View at Google Scholar · View at Scopus.

[4].     Godfrey, B.S. Iyalomhe and Sarah I. Iyalomhe (2010). Hypertension-related knowledge, attitudes and life-style practices among hypertensive patients in a sub-urban Nigerian community Journal of Public Health and Epidemiology Vol. 2(4), pp.71-77.

[5].     John Joseph Tesha (2006) Knowledge of stroke among hypertensive patients in selected hospitals in the Tanga Region, Tanzania Retrieved on June 2010, available online http://www3.who.int/icf/onlinebrowser/icf.cfm.

[6].     Kasl, S. V., and Cobb, S. (1966). "Health Behavior, Illness Behavior, and Sick Role Behavior." Archives of Environmental Health 12:246–266,531–541.

[7].     Kayima J, Wanyenze RK, Katamba A, Leontsini E, Nuwaha F. (2013). Hypertension awareness, treatment and control in Africa: a systematic review. BMC Cardiovasc Disord 2013; 13:54 doi: 10.1186/1471-2261-13-54 [PMC free article] [PubMed].

[8].     Khor, GL (2001) cardiovascular epidemiology in the Asia-Pacific region. Asia Pac J Clin Nutr; 10:76–80.

[9].     Lawes C. M., Hoorn S. V., and Rodgers A., (2008) “Global burden of blood-pressure-related disease, 2001,” The Lancet, vol. 371, no. 9623, pp. 1513–1518, 2008. View at Publisher · View at Google Scholar · View at Scopus.

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[11].  Mlunde Linda (2007) Knowledge, Attitude and Practices Towards Risk Factors for Hypertension in Kinondoni Municipality, Dar es Salaam DMSJ Vol. 14 No.2.

[12].  Oluranti B. Familoni, S. Abayomi Ogun and A. Olutoyin Aina (2004). Knowledge and Awareness of Hypertension among Patients with Systemic Hypertension. Journal of the National Medical Association Vol. 96, No. 5.

[13].  Sule SS, Ijadunola KT, Onayade AA, Fatusi AO, Soetan RO and Connell FA (2008). A study on the utilization of primary health care facilities in a rural community, Nigerian journal of medicine; vol 17 (1): 98-106.

[14].  Westberg, J., and Jason, H. (1996). "Influencing Health Behavior." In Health Promotion and Disease Prevention in Clinical Practice, eds. S. H. Woolfe, S. Jonas, and R. Lawrence. Baltimore, MD: Williams and Wilkins.

[15].  World Health Organization, (2002). Reducing risks, promoting healthy life. The world health report Geneva.

[16].  World Health Organization, (2013) “Global brief on hypertension,” 2013, http://apps.who.int/iris/bitstream/10665/79059/1/WHO_DCO_WHD_2013.2_eng.pdf?ua=1.

Abstract:

Background: A report of suspected human anthrax in Kwekwe District was received by Midlands Provincial Medical Director. Anthrax is a notifiable disease. We investigated factors associated with contracting anthrax in Kwekwe.

Methods: An unmatched 1:2 case control study was conducted. A case was an Ntabeni resident and satisfied the standard case definition of anthrax. Controls were residents who did not develop anthrax. Unmatched analysis was used to establish risk factors.

Results: Twenty-one cases, median age 33 (Q₁=16; Q₃=49) and 43 controls, median age 33 (Q₁=27; Q₃=44) were interviewed. Twelve cases were males. All cases had contact with dead cattle or their products. Knowledge on anthrax was low. Risk factors were skinning OR = 8.9 (95% CI 2.32-33.8) and cutting meat OR = 3.2 (95% CI 1.07-9.58). Not handling anthrax infected carcasses was protective OR = 0.06 (95% CI 0.01-0.3), having no cuts OR = 0.04 (95% CI 0.003-0.28) and having no cattle deaths in the household OR = 0.12 (95% CI 0.03-0.45). Epidemic preparedness and response was below the national standards. No communication system was in place. Cost of the outbreak control activities was US$19950.

Conclusion: Outbreak resulted from contact with and consumption of anthrax infected carcasses. Skinning and cutting were risk factors for contracting anthrax. Quality of outbreak response was poor. We recommend that the district prioritize Ntabeni clinic for radio provision, hold zoonotic committee meetings and conduct an awareness campaign.

Keywords: notifiable, zoonotic committee, epidemic preparedness.

References:

[1]. Anthrax General Information: Issued by PHLS–CDSC. Version: M1, issue date: 10 December 2002

[2]. Hugh-Jones M. 1996–97 Global Anthrax Report. Journal of Applied Microbiology 1999; 87:189–191,

[3]. Guidelines for the Surveillance and Control of Anthrax in Humans and Animals, 3^rd Edition, PCB Turnbull. World Health Organization, 1998.

Dragon DC, Rennie RP. The ecology of anthrax spores: tough but not invincible. Canadian Veterinary Journal 1995; 36:295–301,

Gates CC, Elkin BT, Dragon DC. Investigation, control and epizootiology of anthrax in a geographically isolated, free-roaming bison population in Northern Canada.

[4]. Canadian Journal of Veterinary Research 1995; 59:256–264).

[5]. A major epidemic of anthrax in Zimbabwe, Part 1. Davies JCA. Central African Journal of Medicine 1982; 28:291-298.

[6]. Zimbabwe Public Health Act, CAP 15:09, Revised Edition 1996: Government Printers, Harare

[7]. Factors associated with human anthrax outbreak in the Chikupo and Ngandu villages of Murewa District, Mashonaland East; Mwenye KS, Siziya S, Peterson D: Central African Medical Journal Nov 1996 42(11): 312-5

[8]. Risk factors for human anthrax among contacts of anthrax-infected livestock in Kazakhstan. Woods CW, Ospanov K, Myrzabekov A, Favorov M, Plikaytis B, Ashford DA: American Journal Tropical Medicine Hygiene. 2004 Jul; 71(1):48-52.

[9]. An epidemic of human anthrax--a study. Lakshmi N, Kumar AG: Indian Journal Pathology and Microbiology. 1992 Jan; 35(1):1-4.

[10].  Frequently Asked Questions about Anthrax: Centres for Disease Control, updated 30/10/01 www.cdc.gov: Accessed 21/09/16

[11].  Control of Communicable Diseases Manual: Chin J. American Public Health Association; 17^th Edition (20)

Factors associated with contracting anthrax in Chirozva area, Buhera District; Mabaera B, Tshimanga M., Mudyiradima R., Siziya S. Emerging and Re-emerging Infections Part II: Abstract 2.9.

[12].  Human anthrax in India: urgent need for effective prevention. Kumar A, Kanungo R, Bhattacharya S, Badrinath S, Dutta TK, Swaminathan RP: Journal of Communicable Diseases. 2000 Dec; 32(4):240-6

Human behavioural factors implicated in outbreaks of human anthrax in the Tamale municipality of northern Ghana. Opare C, Nsiire A, Awumbilla B, Akanmori BD. Acta Tropica. 2000 Jul 21; 76(1):49-52.

Abstract:

There is no agreed construction of an acceptable inclusive definition of term international education. The term therefore is ambiguous as it appears to refer to contrasting usages in educational studies. The terminology most often discussed in the context of the fields that are related to comparative education, but a different sense of the term has also developed in the context of the theory and practice of education in international schools and other institutions (Cambridge* et al., 2004). This write up will therefore explore the different perspectives of the terminology. International education will also be discussed with with respect to globalization, modernization, and multiculturalism. A comparative analysis of education in USA and Japan with respect to the constitutional provision, administration, finance and educational structure will also be discussed.

References:

[1]. Altbach, P. G. and Knight, J. (2007) ‘Journal of Studies in International Education the Internationalization of Higher Education : Motivations and Realities’, Journal of Studies in International Education, 11(290). doi: 10.1177/1028315307303542.

[2]. Azeutziu, (2014). Modernization vs Globalization, tulaneict4d.wordpress.com/2014/02/07/modernization-globalization access: 01-10-2017, 16:24.

[3]. Cambridge, J., Thompson, J., Cambridge, J. and Thompson, J. (2010) ‘Compare : A Journal of Comparative Internationalism and globalization as contexts for international education Internationalism and globalization as contexts for international education’, Journal of Comparative and International Education, 13(37), pp. 37–41. doi: 10.1080/0305792042000213994.

[4]. Mccabe, L. T. (2001) ‘Internationalization : The Impact on Education Abroad Programs’, 5(2), pp. 138–145.

[5]. Phillips, D., Schweisfurth, M. (2014). Comparative and International Education: An Introduction to Theory, Method.

[6]. Vandana Aggarwal, V., and Sachar, G (2016). An insight into the role of education for social change and modernization. International Education and Research Journal Vol 2, No 9 (2016).

Abstract:

The purpose of this study was to identify and highlight the hazards that are most commonly found at construction sites in Botswana. Respondents from Estate Construction Company located in Gaborone was selected for this study. Questionnaire survey was conducted on the construction site to establish the health and safety hazards prevailing and control measures therein. A physical observation was also conducted on the construction sites in order to relate questionnaire responses to what actually obtains on the construction site.

In Botswana, the construction industry is booming as economic development takes its course. However, much as construction has come with its benefits, records of the factories inspectorate of the department of labour reveal that between 2000 and 2003, five fatalities were recorded in Botswana’s construction industry. Even though the number of these accidents is not alarming, the benefits paid to the accidents victims are high. These accidents represent a considerable economic and social burden to employers, employees and to the society as a whole. This therefore calls for urgency in mitigating this problem. This study will help come up with comprehensive measures to rectify this problem such; identifying the hazard, assessing the risk and controlling the risk to ensure a safe and conducive working condition for the workers. Implementation of control measures requires different approaches due to changing working environment at the construction sites.

Keywords: Construction, Hazards, Safety, Workers, Booming, Industry.

References:

[1]. Al Sari, M. I; Al Khatib, I. A. Eastern Mediterranean Health Journal; Alexandria 18.10 (2012): 1028-33

[2]. Coble, R.J. and Haupt, T.C. (1999), "Construction safety in developing countries", in Singh, A., Hinze, J.H. and Coble, R.J. (Eds), Implementation of Safety and Health on Construction Sites, A.A. Balkema, Rotterdam.

[3]. Gould, F.E. and Joyce, N.E. (2002), Construction Management - Professional Edition, Prentice-Hall, London.

[4]. Health and safety (H&S) awareness and implementation in Botswana's construction industry. Musonda, Innocent; Smallwood, John. Journal of Engineering, Design and Technology; Bingley6.1 (2008): 81-90. Kathryn M. Borman and Margaret D. Lecompte.

[5]. UK Government: Addressing major causes of fatalities remains HSE Construction Division's priority in 2003/04, M2 Presswire; Coventry [Coventry] 24 Apr 2003: 1.

[6]. https://www.britsafe.org/media/1570/the-causes-incidence-occupational-accidents-ill-health-across-globe-report.pdf

[7]. http://www.researchsystem.siam.edu/images/independent/Consumer_acceptance_of_air_purifier_products_in_China/CHAPTER_3.pdf

Abstract:

Zimbabwe is implementing a Result Based Financing program since 2011, which was designed to improve utilization of maternal and child health services offered by public health facilities. Four years after the program inception, reports of low vitamin A coverage and, high home deliveries are common. The study sought to understand why there is still low uptake of maternal and child health services. Using cases of Mazowe district health facility catchments, community dialogues were employed to explore underlying causalities to low maternal and childhood health services uptake. Qualitative data analysis methods of transcribing, organizing, categorizing, and coding were used to sift themes and emerging issues. Out of 135 community leaders who participated in this study, we found poor accessibility of health facilities (high transport cost, poor road network, long walking distance and unavailability of outreach services), limited health service promotion, and socio-cultural beliefs (clients linked early attendance for antenatal care with abortion from bewitchment) as major barriers to health service utilization in the study community. We also found dialoguing a good method to inform, educate and stimulate collective responsibility towards improving health services uptake in our study communities. We suggest that health programs in Zimbabwe should consider improving accessibility of health facilities, promotion of health services and increase dialoguing with communities on cultural barriers in order to increase the impact of Results Based Health Financing Programs.

Keywords: Barriers, Utilization, Maternal and Childhood Services, Community dialogue, Results Based Financing.

References:

[1].     Andersen, R.M. and Newman, J.F. (1973), “Social and individual determinants of medical care utilization in the United States”, Milbank Memorial Quarterly, Vol. 51, pp. 95-124.

[2].     Financing in Health”, Centre for Global development, accessed from http://www.researchgate.net/publication/267399930.

[3].     Loewenson, R., Kadungure, A., Shamu, S. and Laver, S. (2012), “Assessment of facilitators and barriers to maternal and child health services in four rural and urban districts of Zimbabwe”, Training and Multiple Indicator Monitoring Survey, UNICEF, 2009.

[4].     Minkler, M. and Wallerstein, N. (2005), “Improving Health through Community Organization and Community Building: A Health Perspective. Community organizing and Community Building for Health”, Second edition, The State University of New Jersey. pp. 26-50.

[5].     Research Support Centre (TARSC) Report with UNICEF Collaborating Centre for Operational Research and Evaluation (CCORE) Report.

[6].     Result Based Management Mazowe District Work plan. (2015), unpublished quarterly work plan report.

[7].     Save doff, W.D. (2010), “Results-Based Financing for Health Basic Economics of Results-Based United Nations Zimbabwe (2013), “Maternal Mortality in Zimbabwe: Evidence, Costs, Implications”, Issue Paper Series, United Nations Zimbabwe Publication Paper 1.

[8].     Valente, T.W., & Fosados, R. (2006), “Diffusion of innovations and network segmentation: The part played by people in the promotion of health”, Journal of Sexually Transmitted Disease, 33, S23-S31.

[9].     (The) World Bank (2013), News, Harare, Press Release.

Abstract:

Abstract

Integration of sexual reproductive health (SRH) and Human Immunodeficiency Virus (HIV) services is very poor in Nigeria, but it is very important because of its benefit to both the clients and the health care providers. However, successful implementation of integration of SRH and HIV services depends a great deal on adequate awareness, knowledge, positive attitude and best practices of all personnel involved in the system. Respondents from 65 health facilities were selected from 20 Local Government Areas in the three Senatorial Districts in the state. Their knowledge, attitude and practice towards the integration of SRH and HIV services programme were assessed. Findings showed that health care providers are adequately aware and also have average knowledge of the integration system. But there is capacity gap identified among the respondents in the area of training and documenting program activities. Also they generally exhibit positive attitude towards the programme but perform most of their service delivery with poor motivation under fairly comfortable working environment. It is recommended amongst others for the system to be very effective, there should be training and retraining programs for the personnel in the health facilities. This will hopefully enhance their skills thus enabling them perform all core integrated services successfully to clients.

Keywords: Assessing; Knowledge; Attitude; Practice; Integration; SRH; HIV; Health Care Providers; Oyo State; Nigeria.

References:

[1].     Adebimpe W. O, Akindele R. A, Asekun-Olarinmoye E. O and Olugbenga-Bello, A. I. (2013). Attitude and motivation factors towards volunteering for HIV/AIDS care work in Southern Nigeria. Int. J. Med. Sci. Public Health, 2(4):824-828.

[2].     Bharat, S, Vaishali, A & Mahendrab, S. (2007). Meeting the Sexual and Reproductive Health Needs of People Living with HIV: Challenges for Health Care Providers Reprod. Health Matters 15(29):93-112.

[3].     Chama, C. M., Yahaya, J.Y., and Ajayi, B. B. (2007). The Knowledge, Attitudes and Practices of Health Workers in Maiduguri with regards to HIV/AIDS and the Prevention of Mother to Child Transmission (PMTCT) of HIV. Kanem Journal of Medical Sciences; 1(1):5-9.

[4].     Chinomnso, C. N., Chika, N.O., Prosper, O.U., and Ugochukwu, U. O. (2012). Awareness and Knowledge of Disease Surveillance and Notification by health-care workers and Availability of facility Records in Anambra State, Nigeria. Nigerian medical Journal, Vol. 53.

[5].     Lu Ann Aday, PhD. Sample Design: How many will be in the sample. Descriptive Studies? The University of Texas of Texas School of Public Health. Available from: higheredbcs.wiley.com/legacy/college/aday/0787975605/.../lecture15.pp (Accessed 17^th July 2017).

[6].     National Population Commission (NPC). (2009). Nigeria Demographic and Health Survey 2008. Abuja: National Population Commission (NPC) and ICF Macro.

[7].     Nichter, M. (2008): Global Health: Why cultural perceptions, social representations, and biopolitics matter. University of Arizona Press; Tuscon.

[8].     Nihgov. (2013). Nihgov. Retrieved 5 July, 2017, from http://www.nichd.nih.gov/womenshealth/STDHIV.cfm.

[9].     Oyostategovng. (2017). Oyostategovng. Retrieved 20 September, 2017, from https://oyostate.gov.ng/about-oyo-state/.

[10].  Ratcliffe, J. W. (1976): Analyst biases in KAP surveys: A cross-cultural comparison. Studies in Family Planning Vol.7 (11).

[11].  Schopper, D., S. Doussantousse and Orav, J. (1993): Sexual behaviors relevant to HIV transmission in a rural African population: How much can a KAP survey tell us? Social Science & Medicine; Vol. 37(3). 27. Smith, H. L. (1993): On the limited.

[12].  Stover, J. (2006).

Http://wwwpolicyprojectcom/abstractcfm/2741%20in%20post%202015_27%20May_Final%2019H30pdf. Retrieved 6 July, 2017, from

http://www.policyproject.com/abstract.cfm/2741%20in%20post%202015_27%20May_Final%2019H30.pdf

[13].  Tomori, O. M. (2016). Assessing knowledge and practice of prevention of mother to child transmission of HIV documentation among health workers in Oyo State. Texila International Journal of Public Health, 4:4.

[14].  UNFPA (2004). “The New York call to commitment: Linking HIV/AIDS and sexual reproductive health”. UNFPA NEWYORK. Accessed from http://www.unfpa.org/icpd/10/docs/hiv-aids-rh-call-commitment.doc.

[15].  World Health Organization (WHO.) (2004). scaling up HIV/AIDS care: Service delivery and human resources perspectives. World Health Organization, Geneva. Available at: http://www.who.int/hrh/documents/en/HRH_ART_paper.pdf Accessed 18th July 2017.

Abstract:

A retrospective research through review of Tuberculosis (TB) registers was conducted in Mabutsane sub district from July to September 2016. This study was intended to assess the TB program achievements from the period of 2013 to 2015 in order to improve TB case management for better district Tuberculosis performance.

To this end, the cure and success rates, the proportion of TB patients with completed treatment, the defaults, as well as the HIV testing rates have been determined.

The results were as follows: the cure rates 29.57% (2013), 19% (2014), 11.10% (2015), the treatment completion 80 %( 2013), 79.4 %( 2014), 68.5 %( 2015), and the default rate was below 5% for the whole study period. The success rates were 78.6% (2013), 78% (2014) and 67.1% (2015).

The overall cure rate was low, and very low among patients seen in 2015. There have been a marked completion treatment and success rate over the first two years of a study with decline in 2015 due to poor documentation or poor program.

HIV testing rate was more than 90% among Tuberculosis patients throughout the all years, with TB/HIV co infection rate between 40% and 60%.

Mabutsane sub district Tuberculosis program is a weak program as shown by a low cure rates, and sputum follow up.

Keywords: Tuberculosis cure and success rates, HIV testing rate, default rate, treatment completion.

References:

[1].     Botswana National TB register, 2008 89. TB and Malaria in SADC Countries. Thuthula Balfour SADC Health Sector Coordinating Unit, Pretoria.

[2].     Botswana Tuberculosis and Leprosy Programme, Annual Report 201223.

[3].     Botswana National Tuberculosis Programme Manual, Seventh Edition 2011.

[4].     Caholo J. S. Regional Integration in the Context of HIV and AIDS, TB and Malaria: The case of SADC, Presentation at the XIX International AIDS Conference, Washington DC, 2012.

[5].     Global tuberculosis report, 2015.

[6].     Global tuberculosis report, 2016 http://www.tbfacts.org/tbstatistics/#sthash.Rn1Of6xY.dpuf

[7].     Gebretsadik Berhe et al. (2012). Treatment outcome of smear-positive pulmonary tuberculosis patients in Tigray Region, Northern Ethiopia. Group Division of Tuberculosis Elimination National Center for HIV, STD, and TB, 2006.

[8].     https://en.wikipedia.org/wiki/Southern_District_%28Botswana%29

[9].     Harmonized Minimum Standards for the Prevention, Treatment and Management of Tuberculosis in the SADC Region, 2010.

[10].  LIZ King and Shama ahuja. TB and HIV co infection: current trends and treatment updates, 2006.

[11].  Margaret E. Kruk et al. Timing of default from tuberculosis treatment: a systematic review, 2008. Monitoring and evaluation frameworks and the performance and governance of international funds, 2001.

[12].  Norgbe, G.K. et al. Factors influencing default rates of tuberculosis patients in Ghana, 2011.

[13].  Reid A. et al. (2006). Towards universal access to HIV prevention, treatment and support. http://www.aho.afro.who.int/profiles_information/index.php/Botswana:Tuberculosis Botswana Census, 2011.

[14].  Rebecca Gross, M.A. and Christina Blumel, Literature Review of Tuberculosis (TB) Intervention Studies, 2008

[15].  Tom Hiatt et al. (2013) Epidemiology and control of tuberculosis in the Western Pacific Region, WHO Regional Office for the Western Pacific, Manila, Philippines.

[16].  Treatment of Tuberculosis, Guidelines, fourth edition. WHO, 2010.

[17].  TB Program Evaluation Handbook: Introduction to Program Evaluation Tuberculosis Evaluation Work 

Abstract:

Objectives: This research work aimed at assessing prevalence and pattern of drug use for enhancement of daily and sexual activities among commercial drivers in Ile-Ife, Osun State.

Methodology: a descriptive cross-sectional study designed was utilized. A semi-structured interviewer administered questionnaire was used to obtain data from 240 commercial drivers. Data obtained include socio-demographic variables, drug use for daily activity enhancement, the pattern of perceived sexual challenges, usage of the drug for sexual performance enhancement and willingness accept counselling. Data were analysed using Statistical Program for the Social Sciences (SPSS) version 20 and a p-value of <0.05 was considered to be statistically significant.

Result: Though 67.9% believe their activities can be enhanced only 57.1% do take any psychoactive substance. Prevalence of alcohol consumption was 55.8% and it is the most commonly abused substance to enhance their daily activity performance. Most common means of sexual performance enhancement was the use of herbal mixture (20.3%). Worry about sexual performance, daily activity enhancement, smoking, and alcoholism are predictors of sexual performance enhancing drug usage. A number of sexual partners, age and religion were not significant factors in the use of sexual performance enhancement drugs.

Conclusion: commercial drivers are one of the groups at risk of substance abuse in our society. There is a need for behavioural change communication for this group and create a more suitable environment for counselling on the sex related matters in the health facilities. The existing law prohibiting sales of a psychoactive substance in the motor parks should be enforced.

References:

[1].     Adamson, T. A., Ogunlesi, A. O., Morakinyo, O., & Akinhanmi, A. O. (2015). Descriptive National Survey of Substance use in Nigeria. Journal of Addiction Research and Therapy.

[2].     Anyanwu, M. O., Akinyode, F., & Adewole, A. (2016). Outbreak of methanol poisoning in a semi urban community, Ondo state, southern Nigeria, April-May 2015: A descriptive analysis. International Journal of Infectious Diseases, 45, 216. doi: 10.1016/j.ijid.2016.02.492.

[3].     Ayodele, R. B. (2017). BAN ON ALCOHOLIC DRINK SALES IN MOTOR PARKS: FACTS AGAINST ITS WORKABILITY IN ROAD ACCIDENT PREVENTION IN NIGERIA. [ban, alcohol drinks, accident, drivers]. 2017.

[4].     Berdjis, N. (2015). Nigeria Mystery Outbreak Solved. The Disease Daily, from www.healthmap.org/site/diseasedaily/article/nigeria-mystery-outbreak-solved-24915.

[5].     Kehinde, O. S., & Olusegun, F. F. (2012). Taking alcohol by deception II: Paraga (alcoholic herbal mixture) use among commercial motor drivers in a south-western Nigerian city. [journal article]. BMC Research Notes, 5(1), 301. doi: 10.1186/1756-0500-5-301.

[6].     Laebikan, V. O., & Ayinde, O. (2012). Rapid situation assessments of alcohol and substance use among commercial vehicle drivers in Nigeria East African Medical Journal, 89(11).

[7].     Makanjuola, A. B., Aina, O. F., & Onigbogi, L. (2014). Alcohol and other psychoactive substance use among tanker drivers in Lagos, Nigeria. European Scientific Journal, 10(15).

[8].     Muazu, M., & Aliyu, A. (2008). Prevalence of psychoactive substances use among commercial Motorcyclistsand its health and social consequences in Zaria, Nigeria. Annal of African Medicine, 7(2).

[9].     Ndikom, C. M., Ndikom, O. B., & Uvere, E. (2014). Substance Use and Perceived Consequences on Health and Safety among Commercial Motorcyclists in Ibadan North Local Government, Ibadan, Nigeria. NDLEA. (2015). National Drug Control Master Plan (NDCMP) 2015-2019, from www.ndlea.gov.ng.

[10].  Okafor, O. (2015). FRSC bans the sale of alcohol in motor parks in Rivers State, PM News. Retrieved from www.pmnewsnigeria.com/2015/11/30/frsc-bans-sale-of-alcohol-in-motor-parks-in-rivers.

[11].  Okpataku, C. (2015). Pattern and reasons for substance use among long-distance commercial drivers in a Nigerian city. [Original Article]. Indian Journal of Public Health, 59(4), 259-263. doi: 10.4103/0019-557x.169649

[12].  Williams, Y. (2015). FRSC to ban alcoholic beverages' sale at motor parks, from www.happenings.com.ng/frsc-to-ban-alcoholic-beverages-sale-at-motor-parks/.

Abstract:

Background: Transfusion usually is a life-saving therapeutic intervention, however many preventable errors may make it hazardous for donors or recipients. Ensuring supply of safe blood is a key intervention in reducing mortality and morbidity attributable to blood transfusion. We conducted a descriptive, coss-sectional study among blood donors to assess blood donor safety in Minna, north-Central Nigeria.

Methods: We recruited consecutively, all consenting, HIV, hepatitis B and C and anaemia screened blood donors between September, 2013 and January, 2014. We screened all subjects for haematological indices using a haematological analyzer (Abacus analyzer 2.75, Diatron^® U.S.A) respectively. We administered structured questionnaires to obtain socio-demographic and socio-economic characteristics and practices. Data was subjected to descriptive statistical analyses using Epi Info version 3.5.4. Significant associations were presumed if p<0.05.

Results: A total of 345 subjects were recruited, 336 (97.4%) males. Mean age ± SD was 32.4± 8.5 years. Monthly earnings ranged from $109 to $212 136(40.6%). The majority of the blood donors 195 (55.9%) were anaemic (PCV<36, Hb<12g/dl), 158 (81.0%) of which were for purpose of family replacement. Strata of the blood donors were family replacement 274 (79.4), voluntary 60 (17.4), commercial interest 11 (3.2%).

Conclusions: The blood donor safety is low in Minna. Majority of the blood donors were anaemic. The quality of routine donor screening for anaemia should be improved.

Keywords: Anaemia, Transfusion, Blood donors, Safety, Nigeria.

References:

[1].     Abdel Messih AY, Ismail MA, Saad AA AM. The degree of safety of family replacement donors versus voluntary non-remunerated donors in an Egyptian population: a comparative study. Blood Transfus. 2014;12(2):159–66.

[2].     Adediran IA, Fesogun RB, Oyekunle AA. Haematological parameters in prospective Nigerian blood donors rejected on account of anaemia and/or microfilaria infestation. Nigerian Journal of Medicine 2005; 14: 45-50

[3].     Alao OO, Joseph DE, Mamman A, Banwat EB. The Seroprevalence of cytomegalovirus antibodies among prospective blood donors in Jos. Nigerian Journal of Medicine, National Association of Resident Doctors of Nigeria 2009; 17(2):200-202.

[4].     Ahmad MM, Terri K, Faustine EN, Kenra F. Maternal mortality: A consideration for developing countries and emergency preparedness blood safety plan. Afr Sang 2008; 11(2):5.

[5].     Ahmed SG, Ibrahim UA, Hassan AW. Adequacy and pattern of blood donations in northeast Nigeria: the implications for blood safety. Annals of Tropical Medicine and Parasitology 2007; 101: 725-731.

[6].     Barret CL, Pretorius L, Jata AD. New opportunity for transfusion training for African nurses: Development of a distance based blood transfusion short learning program. Afri Sang 2011; 14:1.

[7].     Egbewale EE, Ogunro PS, Muhibi MA. Knowledge, attitude and practice of blood donation in south west Nigeria. Nigerian Hospital Practice 2008; 2: 132-136.

[8].     Federal Ministry of Health. The Nigerian National Blood Policy. Nigeria, Abuja, 2006.

[9].     Hamdan HZ, Abdelbagi IE, Nasser NM AI. Seroprevalence of cytomegalovirus and rubella among pregnant women in western Sudan. Virol J. 2011;11(8):217.

[10].  Jeremiah ZA, Umoh RE, Adias TC (2011).Subclinical leukopenia in a cross section of Nigerian blood donors. J Blood Med. 2011; 2:79-85.

[11].  JM H. Child bearing practices in northern Nigeria. Ibadan Univ Press. 1972;1:5–11.

[12].  Madauci IH, Isah Y DB. Hausa customs. North Niger Publ Co. 1992;1:12.

[13].  National Population Commission (NPC) FR of N. National Demographic and Health Survey (NDHS). CCF Macro Calvert. 2008;33.

[14].  Seferi I, Xhumari P BG. Prevalence of cytomegalovirus in paid and unpaid blood donor population in Tirana. Int J Heal Sci. 2009;2(4):261.

[15].  Taglietti F, Drapeau CM, Grilli E, Capone A, Noto P TS et al. Hemolytic anemia due to acute cytomegalovirus infection in an immunocompetent adult: a case report and review of the literature. J Med Case Rep. 2010;4:334.

[16].  World Health Organization. Resolutions, Recommendations and Decisions. League of Red Cross and Red Crescent Societies. Geneva, 1984.

[17].  Xu L-H, Fang J-P, Weng W-J, Huang K, Guo H-X, Liu Y et al. Pure red cell aplasia associated with cytomegalovirus and Epstein-Barr virus infection in seven cases of Chinese children. Hematology. 2013;18(1):56–9.

Abstract:

Youths with Sickle Cell Disease (SCD) are sexually active and at higher risk of uncertain reproductive health outcomes because of their health status. This study was a theory-grounded quasi-experimental design to evaluate the effects of two Reproductive Health-Information (RHI) Education intervention programmes with counseling among youths with SCD in South-west Nigeria.

Seventy five participants were purposively assigned to control (CG) and two intervention groups that were randomly selected. All groups completed pretest of Behavioural-Intentions (BI) measures by questionnaire, however, only intervention group one (IG-1) received Reproductive Health-Information (RHI) Education while intervention group two (IG-2) received both (RHI) Education with counseling. At 13^th week follow-up, post-test BI was measured for all groups. Data were analyzed using descriptive statistics and ANOVA to compare pre- and post-test measures for all groups at p=0.05.

There was no significant difference in measures among the three groups at baseline in respect of RHI (19.16±6.61; 16.40±9.35; 16.68±6.31), Motivation (15.08±4.13; 11.88 ±5.26; 12.80±3.81), Behavioural Skills/Self-Efficacy (14.88±4.79; 15.20±7.80; 16.40±7.16) and Behavioural Intentions (18.04±7.96; 16.68±9.04; 16.32±8.04) respectively. However, at 13^th week follow-up, Intervention group 2 demonstrated significantly higher scores in respect of RHI (17.20±4.38; 16.68±6.33; 32.32±18.87), Motivation (14.80±3.37; 14.96±4.39; 17.40±2.84), Behavioural Skills/Self-Efficacy (19.24±5.83; 16.28±4.74; 21.04±4.95) and BI (18.88±6.68; 23.40 ±5.61; 26.68±7.42) than Intervention group 1 and Control respectively.

Intervention 2 combining RHI -Education with counseling had the most significant impact on youth reproductive health behavioural-Intentions. It is therefore recommended that reproductive health information for the SC youths should strategically be accompanied with counseling to achieve behavioural change.

Keywords: Reproductive Health, Information, Motivation, Behaviour, Behavioural Intentions, Sickle Cell youths.

References:

[1].     Abajobir, A. A., &Seme, A. (2014). Reproductive health knowledge and services utilization among rural adolescents in east Gojjam zone, Ethiopia: a community-based cross-sectional study. BMC Health Services Research, 14, 138. http://doi.org/10.1186/1472-6963-14-138

[2].     Abiodun O, Abiodun OO, Ani F, Sotunsa O (2016) Sexual and Reproductive Health Knowledge and Service Utilization among In-school Rural Adolescents in Nigeria. J AIDS Clin Res 7:576. doi:10.4172/2155-6113.1000576

[3].     Aninanya GA, Debpuur CY, Awine T, Williams JE, Hodgson A, Howard N (2015) Effects of an Adolescent Sexual and Reproductive Health Intervention on Health Service Usage by Young People in Northern Ghana: A Community-Randomised Trial. PLoS ONE 10(4): e0125267. https://doi.org/10.1371/journal.pone.0125267

[4].     Bodenheimer T, Review helping patients improve their health-related behaviors: what system changes do we need? Dis Manag. 2005; 8(5):319-30.

[5].     Cai Y, Wang Y, Zheng Z, Wang J, Yao W, et al. (2013) Predictors of Reducing Sexual and Reproductive Risk Behaviors Based on the Information Motivation-Behavioral Skills (IMB) Model among Unmarried Rural-To-Urban Female Migrants in Shanghai, China. PLoS ONE 8(4): e62787.doi:10.1371/journal.pone.0062787

[6].     Chang, S. J., Choi, S., Kim, S. A. & Song, M. (2014) Intervention Strategies Based on Information-Motivation-Behavioral Skills Model for Health Behaviour Change: A Systematic Review. Asian Nursing Research 8 (3): pp.172-181.

[7].     CIA world fact book, 2017

[8].     Cohen, J. (1988), Statistical Power Analysis for the Behavioral Sciences, 2nd Edition. Hillsdale, N.J.: Lawrence Erlbaum.

[9].     Envuladu, Esther Awazzi, AnkeVan de Kwaak, Zwanikken Prisca, Zoakah Ayuba Ibrahim, (2017). Sexual and Reproductive Health Challenges of Adolescent Males and Females in some Communities of Plateau State Nigeria, International Journal of Psychology and Behavioral Sciences, Vol. 7 No. 2, 2017, pp. 55-60. doi: 10.5923/j.ijpbs.20170702.02.

[10].  Fisher, C.M., (2012). Adapting the Information − Motivation − Behavioral Skills Model: Predicting HIV-Related Sexual Risk among Sexual Minority Youth. Health Educ Behav 2012 39: 290 DOI: 10.1177/1090198111406537

[11].  Fisher, W. A., Fisher, J. D, & Harman, J. (2003). The Information-Motivation – Behavioral skills model as a general model of health behaviour change: Theoretical approaches to individual – level change .In suls, J. and wallston, k. (Eds.) Social psychological foundations of health (pp. 127 – 153). London: Blackwell publishers.

[12].  Gallo, A. M., Wilkie, D., Suarez, M., Labotka, R., Molokie, R., Thompson, A., Johnson, B. (2010).Reproductive decisions in people with sickle cell disease or sickle cell trait. Western Journal of Nursing Research, 32(8), 1073–1090.

[13].  Grunbaum, J.A., Kann, L., Kinchen, S., Ross, J., Hawkins, J., Lowry, R., Harris, W.A., McManus, T., Chyen, D., Collins, J. (2004) Youth risk behavior surveillance--United States, 2003. Morbidity and Mortality Weekly Report. Surveillance Summaries, 53(2), 1-96.

[14].  Housten Ashley, Abel Regina A, Dadekian Joyce, & King Allison Ann (2015); Youth with Sickle Cell Disease: Genetic and Sexual Health Education Needs; American journal of health behaviour 39(6):856-865. DOI: 10.5993/AJHB.39.6.13

[15].  Jaworski Beth C, Carey Michael P, ( 2001); Effects of a brief, theory-based STD-prevention program for female college students Journal of Adolescent Health; Volume 29, Issue 6, December 2001, Pages 417–425. http://dx.doi.org/10.1016/S1054-139X(01)00271-3

[16].  Jungling Gao, Jingli Wang, Yaocheng Zhu and Jinming Yu, (2013): Validation of an Information-Motivation-Behavioural skills model of self-care among Chinese adults with type 2diabetes. Biomed Central Public Health 13:100