Objective To review what is known about COVID‐19 and highlight gaps in the context of Nigerian obstetric practice. Research data on COVID‐19 are understandably sparse in Africa. Nigeria, like most African countries, is battling a disease she is poorly equipped to fight. Methods The current available literature on COVID‐19 was reviewed in relation to obstetric practice in the Nigerian context, gaps were identified, and recommendations were made to improve the handling of the COVID‐19 pandemic in Nigerian obstetric practice. Results In and out of hospital, both the obstetrician and the obstetric patient are constantly being put at risk of exposure to the coronavirus because testing and preventive measures are either ineffective or non‐existent. Conclusion The pandemic has exposed the gross inadequacies in Nigeria’s healthcare system and is therefore a wake‐up call to the need for a complete overhaul of infrastructure and services. The government will do well to increase the budget allocation for health from the current paltry 4.14% to the recommended 15% of the total budget. The Nigerian obstetrician stands a high risk of exposure due to inadequate preventive measures, and testing and diagnostic challenges.

Background The COVID-19 pandemic has drastically impacted postgraduate training programmes worldwide. This study aims to evaluate the Nigerian situation with respect to surgical training, with a view to identifying gaps and proffering solutions. Methods A cross-sectional survey of surgical residents in Nigeria was conducted between 27 July 2020 and 14 August 2020. A structured questionnaire designed using the free software Google Forms ® was utilised for the study. The questionnaire was electronically distributed randomly to 250 surgical residents via emails and social media platforms including WhatsApp and Telegram. The data obtained was analysed by Google Forms ® . Ethical approval for the study was obtained from the ethics and research unit of the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria. Results At the end of the study period, 207 surgical residents completed and submitted the questionnaire, giving a response rate of 82.8%. The majority of respondents reported a reduction (164, 79.2%) or cancellation (11, 5.3%) of postgraduate programmes in their institutions. Of those who had academic programmes, meetings were done using virtual technology in all instances. The majority of respondents reported seeing fewer patients in the outpatient clinics (173, 83.6%), as well as a reduction in the number of emergency and elective operations (58.5% and 90.8%, respectively). About a third of the respondents (70, 33.8%) were contemplating emigrating from the country. Conclusion The COVID-19 pandemic has significantly affected the clinical, research and teaching components of surgical training in Nigeria. It has, however, led to increased adoption of digital technology which should be further explored in the face of current realities.

Background Unregulated work schedules have deleterious effects on trainees’ productivity and patients’ safety. For these reasons, duty hours have been capped in many developed countries. Such regulations, however, appear to be lacking in many parts of Africa, and the effects of unregulated work hours in this part of the world have only been scantily documented. This study evaluated the work schedule of Nigerian surgical trainees, and its impact on their wellbeing, as well as assessed the perception of trainees towards capped duty hours. Methods A cross‐sectional survey of 650 Nigerian Resident Doctors in surgical specialties was conducted in November 2020. Enquiries were made about their work schedules using a purpose‐designed questionnaire, developed using Google Forms®. The data were analysed using the IBM SPSS version 23. Results The mean weekly work hours of surgical residents was 122.72 ± 34.17 h. Majority (228, 40.4%) of the residents had cumulative call hours of ≥ 72 h per week. One‐half (283, 50.1%) of them worked continuously for up to 48–72 h during calls, with mean daily sleep hours of 3.53 ± 1.42 h during calls. The majority (558, 98.8%) of respondents had post‐call clinical responsibilities. Seventy‐five percent of the respondents reported hazards from prolonged work hours, and an overwhelming majority (530, 93.8%) desire official limits on work hours. Conclusion Prolonged, unregulated work schedules appear to be the norm among Nigerian surgical trainees. This trend calls for urgent measures, to avoid potentially catastrophic consequences on both physicians and patients.

No abstract

Background: Hysterosalpingography is the most commonly used investigative modality for the evaluation of tubal patency. It is cheap, readily available and reliable. However, its main drawback is associated pain. Objective: To determine the predictive factors for the severity of procedure-associated pain in infertile women undergoing hysterosalpingography. Materials and Methods: This prospective, descriptive, cross-sectional study was conducted at the infertility clinics and radiology departments of the Federal Medical Centre, Yenagoa and Niger Delta University Teaching Hospital, Okolobiri, both in Bayelsa State, Nigeria, between July, 2021 and February, 2022. Hysterosalpingography was done after written informed consent by the patient. The Visual Analogue Scale and Numerical Rating Scale were used to grade pain levels during and after the procedure, respectively. Data were analysed using Statistical Product and Service Solutions for Windows®, version 25. Results were presented in frequencies and percentages for categorical variables, and mean and standard deviation for continuous variables.                         Student’s t-test was used to compare sample means, and Chi-square, for testing                    associations. Results: The odds of experiencing pain increased with increasing age (Crude OR = 3.48 – 5.34; p = < 0.05). Women with tertiary level of education were three times more likely to report pain (Crude OR = 3.58; p = 0.029) than those with primary level of education.  Parity (ꭓ2 = 19.85; p – 0.001), type of infertility (ꭓ2 = 5.93; p = 0.015) and duration of infertility (ꭓ2 = 11.08; p = 0.004) had significant relationships with the severity of pain perception. Dysmenorrhoea (Crude OR = 1.99; p = 0.001) was also significantly associated with pain perception. Pain was two times more likely to be experienced by women with abnormal hysterosalpingography findings. Conclusion: Our study established that the predictors of pain perception in hysterosalpingography were age, level of education, duration of marriage, duration of infertility, parity, number of children, type of infertility, dysmenorrhoea and abnormal findings on hysterosalpingography.

No abstract

The COVID-19 pandemic has disrupted access to sexual and reproductive health services, including family planning, globally. This study sought to assess the effect of the COVID-19 pandemic on access to contraception amongst reproductive age women in Nigeria, and make recommendations that will improve access. A cross-sectional survey of sexually active, reproductive age women on modern methods of contraception was conducted in Nigeria. A structured questionnaire designed using the free software Google Forms ® was utilised for the study.

Surgical practice in the tropics very much reminds one of the famous quote attributed to Jean-Jacques Rousseau: ''Man is born free, but he is everywhere in chains''. The numerous and onerous challenges of tropical surgical practice are the metaphorical chains that bog down the tropical surgeon.Poor government funding of health care and very low health insurance coverage in the tropics make surgery materials rarely available in operating theatres, necessitating patients having to buy these materials out-of-pocket (OOP), even in emergencies. The majority of patients