IntroductionUtilization of antenatal care, institutional delivery and postnatal care services in Nigeria are poor even by african average.MethodsWe analysed the 2013 Nigeria DHS to determine factors associated with utilization of these health MCH indicators by employing both bivariate and multivariate logistic regressions.ResultsOverall, 54% of women had at least four ANC visits, 37% delivered in health facility and 29% of new born had postnatal care within two of births. Factors that consistently predict the utilization of the three MCH services are maternal and husband's level education, place of residence, wealth level and parity. Antenatal care strongly predicts both health facility delivery (OR = 2.16, 95%CI: 1.99-2.34) and postnatal care utilization (OR = 4.67, 95%CI: 3.95-5.54); while health facility delivery equally predicting postnatal care (OR = 2.84, 95%CI: 2.20-2.80).ConclusionImproving utilization of these three MCH indicators will require targeting women in the rural areas and those with low level of education as well as creating demand for health facility delivery. Improving ANC use by making it available and accessible will have a multiplier effect of improving facility delivery which will lead to improved postnatal care utilization.

BackgroundHIV/AIDS remain a major public health concern in Nigeria. People living with HIV/AIDS (PLWHA) face not only personal medical problems but also social problems associated with the disease such as stigma and discriminatory attitudes. This study provides an insight into HIV/AIDS related stigma and discrimination against PLWHA in Nigeria.MethodsThe data for this study was extracted from the 2013 Nigeria Demographic and Health Survey conducted by the National Population Commission. All men and women aged 15–49 years, permanent residents and visitors of the households were eligible for the interview. Several questionnaires were used in the survey, some covering questions on HIV/AIDS.ResultsA total of 56 307 men and women aged 15–49 years participated in this national survey. About half of the population in Nigeria have HIV stigma. Younger persons, men, those without formal education and those within poor wealth index are more likely to have stigma towards PLWHA. In addition, married people are more likely to have stigma on PLWHA and are more likely to blame PLWHA for bringing the disease to the community. Also about half of the population discriminates against PLWHA. However, those with higher levels of education and those from higher wealth index seem to be more compassionate towards PLWHA. About 70% in the population are willing to care for relative with AIDS, even more so among those with higher level of education.ConclusionThere is a high level of HIV stigma and discrimination against PLWHA in the Nigerian population. Education seems to play a major role in the society with respect to HIV stigma and discrimination against PLWHA. Educating the population with factual information on HIV/AIDS is needed to reduce stigma and discrimination towards PLWHA in the community.

BackgroundLow birth weight (LBW) continues to be the primary cause of infant morbidity and mortality.ObjectiveThis study was undertaken to identify the predictors of LBW in Nigeria.DesignThe data for this study was extracted from the 2013 Nigeria Demographic and Health Survey conducted by the National Population Commission. Several questionnaires were used in the survey, some covering questions on pregnancy characteristics. The inclusion criteria include mothers who gave birth to a child 5 years before the interview and aged 15–49 years who were either permanent residents or visitors present in the household on the night before the survey conducted. The birth weight of the infants was recorded from written records from the hospital cards or the mothers’ recall.ResultsThe prevalence of LBW in this study was 7.3%. Multiple logistic regression analysis showed an adjusted significant odds ratio for mothers from North West region (aOR 10.67; 95% CI [5.83–19.5]), twin pregnancy (aOR 5.11; 95% CI [3.11–8.39]), primiparous mother (aOR 2.08; 95% CI [1.15–3.77]), maternal weight of less than 70 kg (aOR 1.92; 95% CI [1.32–2.78]), and manual paternal employment (aOR 1.91; 95% CI [1.08–3.37]).ConclusionsThe risk factors for LBW identified in this study are modifiable. In order to reduce this menace in Nigeria, holistic approaches such as health education, maternal nutrition, improvement in socio-economic indices, and increasing the quality and quantity of the antenatal care services are of paramount importance.

IntroductionStroke has become a problem of public health importance worldwide. Knowledge and practices related to stroke prevention among hypertensive and diabetic patients are important in the control of the disease. In Nigeria, recent reports indicate an emerging epidemic of stroke. This study aimed to determine the knowledge and practices related to stroke prevention among hypertensive and diabetic patients in Sokoto, Nigeria.MethodsThis was a cross-sectional study among 248 patients attending hypertension and diabetes clinic of Specialist Hospital, Sokoto, Nigeria, selected by systematic sampling technique. A semi-structured questionnaire was used to collect data on the research variables. Data were analyzed using IBM SPSS version 20 statistical package.ResultsThe mean age of respondents was 48.21 ± 15.07 years and they were predominantly females (65.7%). The respondents had good knowledge of stroke (70.3%), organs or parts of body affected by stroke (89.1%), signs or symptoms of stroke (87.0%), stroke risk factors (86.6%) and stroke prevention (90.8%). Formal education was the sole predictor of good knowledge of signs or symptoms of stroke (aOR = 3.99, 95% CI = 1.58-10.13, p = 0.004), stroke risk factors (aOR = 4.24, 95% CI = 1.68-10.67, p = 0.002) and stroke prevention (aOR = 3.45, 95% CI = 1.09-10.93, p = 0.035). Stroke prevention practices were sub-optimal and significantly associated with formal education and being employed.ConclusionThese findings suggest the need for all stakeholders to focus on both patients' education and empowerment in halting the rising burden of stroke across the globe.

Child-birth is a risk producing event that requires timely and adequate medical intervention for women who experience obstetric complications. The provision of a health worker with midwifery skills at every birth, plus access to emergency hospital obstetric care, is the option to mitigate this risk. However, in sub Saharan Africa, most births take place outside health facilities and without skilled attendants. This study aimed to determine and compare the factors which influence the choice of place of delivery among women in an urban and a rural community in Sokoto. It was a cross-sectional comparative study of 600 randomly selected women of reproductive age, in Sokoto South and Gwadabawa Local Government Areas of Sokoto State, Nigeria using semi-structured interviewer administered questionnaires. The proportion of women who delivered in health facilities was 65.0 and 4.7% in the urban and rural groups, respectively; whereas the proportion that had skilled attendants at delivery was 70 and 4.3% in the urban and rural groups, respectively. Lack of consent from husband, no privacy in health facilities, distance to the health facility and non-availability of delivery wards were the reasons for home deliveries in the rural study group, while the emergency nature of labour was the reason in the urban group. Women residing in rural areas need health promotion interventions in order to meet the International Conference on Population and Development + target of achieving 90% births attended by skilled attendants by 2015.

Hepatitis B virus (HBV) infection threatens the health of populations across the globe. It is an important occupational risk for health care workers (HCWs); they are known to be at high risk of the infection following needle stick injuries and accidental exposure to infected blood and other body fluids. This study was conducted to assess the knowledge, risk perception and hepatitis B vaccination status of HCWs in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria. A descriptive cross-sectional study among 124 HCWs selected by multistage sampling technique was conducted in the months of February to April 2013. Informed consent was taken and information was collected by a pre-designed questionnaire, data analysis was done using computer software, SPSS version 20. Majority of respondents (86.3%) demonstrated good knowledge of HBV infection. Most of the respondents (92.7%) perceived themselves to be more at risk of HBV infection as compared to the general population by virtue of their profession. Only 50 (40.3%) of the 124 respondents have been vaccinated against HBV infection. In addition, only 28 (56.0%) of the 50 respondents that have been vaccinated against HBV infection had the recommended three doses of the vaccine. This study demonstrated poor uptake of hepatitis B vaccination among HCWs in UDUTH, Sokoto, Nigeria, despite good knowledge and high risk perception. Periodic education of staff on prevention of transmission of blood and other body fluids borne pathogens in the hospital setting, and promotion of accessibility to vaccines against relevant vaccine preventable diseases in the healthcare facilities are hereby suggested.

Background:The amount of time a patient waits to be seen is one factor which affects utilization of healthcare services. Patients perceive long waiting times as barrier to actually obtaining services and keeping patients waiting unnecessarily can be a cause of stress for both patient and doctor.Aim:This study was aimed at assessing the determinants of patients’ waiting time in the general outpatient department (GOPD) of a tertiary health institution in northern Nigeria.Subjects and Methods:This descriptive cross-sectional study was carried out among new patients attending the GOPD of the Usmanu Danfodiyo University Teaching Hospital, Sokoto, North Western Nigeria. A structured questionnaire was used to elicit information from 100 patients who were recruited into the study using a convenience sampling method. Data collected were entered and analyzed using Statistical Package for Social Sciences version 17; Chi-square test was used to compare differences between proportions with the level of statistical significance set at 5% (P < 0.05).Results:Sixty-one percent (59/96) of the respondents waited for 90-180 min in the clinic, whereas 36.1% (35/96) of the patients spent less than 5 min with the doctor in the consulting room. The commonest reason for the long waiting time in the GOPD was the large number of patients with few healthcare workers.Conclusion:There is an urgent need to increase the number of health workers in the GOPDs which serves as the gate way to the hospital if the aims of the Millennium Development Goals are to be realized.

BackgroundExclusive Breastfeeding (EBF) refers to the practice of feeding breast milk only, (including expressed breast milk) to infants; and excluding water, other liquids, breast milk substitutes, and solid foods. Inadequately breastfed infants are likely to be undernourished and have childhood infections. EBF knowledge and infant feeding practices have not been studied sufficiently in Sokoto State, Nigeria. We describe the results of a randomized community trial to promote Exclusive Breastfeeding (EBF) in two local government areas Kware and Bodinga selected as intervention and control groups respectively.MethodsDuring advocacy meetings with community leaders, a Committee was formed. Members of the Committee were consulted for informed consent and selection of ten female volunteers who would educate mothers about breastfeeding during home visits. Participants comprised mothers of infants who were breastfeeding at the time of the study. A total of 179 mothers were recruited through systematic random sampling from each community. Volunteers conducted in-person interviews using a structured questionnaire and counseled mothers in the intervention group only.ResultsAt baseline, intervention and control groups differed significantly regarding maternal occupation (P=0.07), and age of the index child (P=0.07). 42% of infants in the intervention group were up to 6 months old and about 30% of them were exclusively breastfed. Intention to EBF was significantly associated with maternal age (P=0.01), education (P=0.00) and women who were exclusively breastfeeding (P=0.00). After counseling, all infants up to 6 months of age were exclusively breastfed. The proportion of mothers with intention to EBF increased significantly with maternal age (P=0.00), occupation (P=0.00) and women who were exclusively breastfeeding (P=0.01). Post-intervention surveys showed that source of information and late initiation of breastfeeding was not significantly associated with intention to EBF. Mothers who reported practicing EBF for 6 months, were older (P=0.00) multi-parous (P=0.05) and more educated (P=0.00) compared to those who did not practice EBF. Among them, significantly increased proportion of women agreed that EBF should be continued during the night (P=0.03), infant should be fed on demand (P=0.05), sick child could be given medication (P=0.02), EBF offered protection against childhood diarrhea (P=0.01), and helped mothers with birth spacing (P=0.00).ConclusionThis study shows that there is a need for reaching women with reliable information about infant nutrition in Sokoto State. The results show decreased EBF practice among working mothers, young women, mothers with poor education and fewer than five children. Counseling is a useful strategy for promoting the duration of EBF for six months and for developing support systems for nursing mothers. Working mothers may need additional resources in this setting to enable them to practice EBF.