Adherence to treatment instructions with antiretroviral therapy (ART) is very crucial for successful treatment outcome. However, sticking to treatment instructions pose-great challenges to HIV/AIDS patients. This cross-sectional study was on HIV infected adults attending ART clinic in Nigeria to explore nonadherence factors in relation to their socioeconomic characteristics. Validated structured questionnaire was administered to 221 participants. Results showed a high nonadherence rate of 85.1%. The commonest occurring factors of non-adherence were forgetfulness (53.8%), busy schedule (38.8%), side effects of drugs (31.9%), and stigma (31.9%). Males were more likely to complain from busy schedule, feeling healthy, fear of partner disclosure, long waiting period, and long term regimen. Patients with no formal education were more likely to attribute non-adherence to poor communication, side effects of drugs, and stigma. Employed patients seemed to miss their drugs more than the unemployed and artisans. The high non-adherence rate has serious implications for the control of HIV in infected individuals and management of HIV in general. Nurses should intensify efforts on patient education and counseling.

Breastfeeding is considered as the most complete nutritional source for infants because breast milk contains the essential carbohydrates, fats, proteins, and immunological factors needed for infants to thrive and resist infection in the formative first year of life. Knowledge of exclusive breastfeeding (EBF) among women is essential when promoting optimal breastfeeding practices. This cross-sectional descriptive survey assessed knowledge and intention to practice EBF and its associated factors during pregnancy among primiparous women in selected communities in Enugu State, Nigeria. A total population study that applied inclusion criteria was used to recruit 201 primiparous mothers attending their third trimester antenatal care from selected health facilities in rural and urban communities in Enugu State. A researcher-developed questionnaire was used to collect data on participants' knowledge and intention to practice EBF. Descriptive statistics of frequency, percentage, mean, and standard deviation were used to summarize categorical and continuous variables while Chi-square and Wald statistic tests predicted demographic data associated with knowledge status and intention to practice EBF of the participants. More than half (58.7%) of primiparous mothers had inadequate knowledge of EBF and only 62.7% had intention to exclusively breastfeed for 4–6 months. The Chi-square test result showed significant difference in the participants' place of residence (p = 0.024), EBF knowledge sources (p = 0.001), and EBF knowledge. The Wald statistic in Logistic regression model indicated the coefficient of age (p = 0.026), educational attainment (p = 0.046), EBF knowledge (p = 0.016), and sources of information about EBF (p = 0.027) to be significant predictors of good intention to practise EBF. Poor EBF knowledge and intention to practice in this population may be improved by combining facility-based and in-house methods of breastfeeding counseling, education, and support especially to intending and expectant mothers. Further studies are needed to be done using the multiparous women as well as assessing the effects of in-house EBF supportive-educative intervention to improve breastfeeding outcomes.

BackgroundThe combination of child care and domestic work demands on both housewives and the employed (hired) women may impact their health-related quality-of-life. There is paucity of studies to ascertain this. This study investigated the differences in health-related quality of life of employed and unemployed women with normal vaginal delivery and associated socio-demographic variables.MethodsThis longitudinal study was done from March, 2012 to June, 2013. Modified SF-36v2™ health-related quality of life questionnaire was administered to 234 newly delivered women drawn from six selected hospitals in Enugu, Southeast Nigeria at 6, 12 and 18 weeks postpartum. Respondents were reached for data collection through personal contacts initially at the hospitals of delivery, and subsequently by visits to their homes/workplaces or cell-phone calls. Women were asked to indicate how each of 36 items applied to them at each of the three times. Data collection lasted for six calendar months and 17 days (from September 3rd 2012 to 20th March, 2013).ResultsAll the women had their best HrQoL at 12 weeks postpartum. Employed women reported lower health-related quality-of-life than the unemployed at the three time-points, the lowest mean score being at 18 weeks postpartum (Mean = 73.9). Multiple comparison of scores of the two groups using Tukey HSD Repeated Mean showed significant variation on the eight subscales of the health-related quality-of-life. Physical functioning (p = 0.045), Physical role limitation (p = 0.000), bodily pain (p = 0.000), social functioning (p = 0.000) and general health (p = 0.000) were unequal guaranteeing type 1 error. Women with higher education and personal income reported higher health-related quality-of-life (p < 0.05). Employed women have more problems with physical health components and are more negatively affected by increasing age except those with higher education and personal income.ConclusionsIncreased responsibilities combined with increasing age and low socio-economic status reduce women’s health-related quality-of-life post-partum. The traditionally accepted paid 3 months maternity leave should be elongated by extra months to help women balance their daily work with baby care. Gender sensitive employment opportunities in favour of women are necessary to empower more women economically.Electronic supplementary materialThe online version of this article (10.1186/s12905-017-0481-0) contains supplementary material, which is available to authorized users.

Background: Nigerian parturients desire, but experience unsatisfactory pain relief as labour analgesia is underutilised and unpopular among skilled-birth attendants. Objectives: To assess pregnant women's knowledge and willingness to use non-pharmacological labour pain reliefs. Methods: Using a descriptive cross-sectional design, a pre-tested, structured questionnaire was interviewer administered to a convenient sample of 245 prenatal women at a specialist maternity hospital in Enugu. Results: Majority (68.6%) of the women knew, but 31.4% were unaware that non-pharmacological labour pain reliefs exist in the study facility. Only 34.7% were able to identify at least four such methods, 21.2% could elicit two (each) advantages and disadvantages, and 0% to 28.3% had perceived self-efficacy of how to use each method. The leading four methods identified were breathing exercises (51.8%), massage (36.7), position changes (32.2%), and relaxation techniques (26.5%). Majority (59.6%) of the women expressed willingness to use non-pharmacological pain strategies in future labour, which is associated with increased knowledge of the methods, and parity (p<0.001). Conclusion: Pregnant women had limited knowledge of, but majority expressed willingness to use in labour non-pharmacological pain reliefs. Nurses/midwives should give adequate childbirth information and preparation on labour pain reliefs to antenatal women to inform their choices and effective use during labour.

Background: Intimate Partner Violence (IPV) during pregnancy is a significant public health problem worldwide and its impact on newborn outcomes is largely documented. Although conditions resulting from the COVID-19 pandemic have provided a perfect environment for IPV to thrive, the magnitude of IPV among pregnant women remains unclear. This study aimed to determine the prevalence and determinants of IPV during the COVID-19 pandemic among pregnant women in south-western Uganda.  Methodology: This is a cross-sectional study of 345 pregnant women attending a large City Health Care facility consecutively enrolled. The validated WHO semi-structured women’s health and domestic violence questionnaire was used to identify women who had experienced IPV. Results:  Of the 345 pregnant women, 67.5% experienced some form of IPV. The categories of IPV experienced by pregnant women included: controlling behaviors 188(80.6%), psychological 127(54.5%), sexual 84(36.1%), economic 99(42.5%), and physical violence at 33(9.6%). The most important predictor of all types of IPV experience was marital conflicts experience. Specifically, the predictors of psychological IPV experience were marital conflicts experience and emotional support from relatives. The strongest predictor of controlling behaviors IPV experience was marital conflicts experience. The strongest predictors of sexual violence IPV experience were decision-making, marital conflicts experience, pregnant women aged ≥35, and communicating with the family of origin. The predictors of economic IPV experience were decision-making, marital conflicts experience, financial support from relatives, and marriage duration.  Conclusion: The IPV burden during the COVID-19 pandemic is widespread among pregnant women in south-western Uganda. Pregnant women reporting marital conflicts were more likely to experience IPV. These findings point to the need for integration of IPV screening in the routine ANC activities for every pregnant woman. Recommendations Health care providers need to identify and manage IPV as a health issue, not just as a societal matter if IPV is to be mitigated.