Studies have linked the large percentage of maternal and neonatal mortality that occur in postnatal period to low uptake of postnatal care (PNC) services. Mobile health (mHealth) intervention through message reminders has resulted in significant increase in antenatal care utilisation in previous studies. However, its use in PNC services’ uptake has not been adequately investigated in Nigeria. This study aimed to evaluate the effect of a mobile health intervention on PNC attendance among mothers in selected primary healthcare facilities in Osun State, Nigeria. A quasi-experimental research design was utilised. Participants were allocated to Intervention Group and Control Group. One hundred and ninety pregnant mothers were recruited in each group. A mobile health intervention software was developed and used to send educational and reminder messages to mothers in the intervention group from the 35th week of pregnancy to six weeks after delivery. Uptake of PNC services was assessed at birth, 3 days, 10 days and 42 days after delivery. Data were analysed using descriptive statistics, chi-square and logistic regression models. About one-third (30.9%) of respondents in the intervention group had four postnatal care visits while only 3.7% in the control group had four visits (p < 0.001). After controlling for the effect of confounding variables, group membership remained a significant predictor of PNC uptake. (AOR: 10.869, 95% CI: 4.479–26.374). Mobile health intervention significantly improved utilisation of the recommended four postnatal care visits.

INTRODUCTION The period of pregnancy is associated with some level of physical, emotional and psychological stress which can be particularly heightened and have more deleterious impact when the expectant mother is a teenager who needs higher level of resilience to cope with the challenges linked with motherhood. This study aimed to assess the level of perceived pregnancy-related stress and its relationship with the level of resilience. METHODS An analytical cross-sectional study design was employed using a structured questionnaire and the study was conducted among 241 adolescents. Perceived stress and resilience were measured using Perceived Stress Scale, and Wagnild & Young Resilience Scale, respectively. Descriptive and inferential statistics were computed using percentages, means with standard deviations, Student's t-test, Pearson correlation, one-way analysis of variance (ANOVA) and multivariate logistic regression. RESULTS Majority of the respondents (194; 80.5%) were categorized as having moderate level of perceived pregnancy-related stress and 186 (77.2%) had low level of resilience. A significant inverse relationship was found between perceived pregnancy-related stress and resilience (r=-0.15, p=0.02). At multivariate level, three variables emerged as independent predictors of higher level of pregnancy-related stress: feeling of shame (OR=3.39; CI: 1.01-11.34), male partner's rejection of pregnancy (OR=3.43; CI: 1.45-8.12) and lack of parental involvement in care (OR= 3.56; CI: 1.65-7.71). CONCLUSIONS There is a significant inverse relationship between perceived pregnancyrelated stress and resilience among teenagers in Nigeria, with higher resilience among the older age groups and those who had support from significant others.

Purpose Adequate utilization of postnatal care (PNC) services is a major contributing factor to reducing maternal mortality among women. Hence, this study was designed to assess the level of utilization of PNC services and its predictors among postpartum women in Ekiti State, Nigeria. Design The study adopted a cross‐sectional descriptive design. Methods A total of 405 postpartum women from primary healthcare centers in five selected local government areas in Ekiti State participated in this study. A self‐structured questionnaire was used to collect data, which were analyzed using IBM SPSS Statistics version 20 (IBM Corp., Armonk, NY, USA). Data were presented using descriptive (means, frequencies, and percentages) and inferential (Pearson's chi square and binary logistic regression) statistics. Findings The mean age of the women was 27 ± 8 years. A preponderance of the respondents (98.8%) were aware of PNC services, of which only 22% utilized PNC services after their last delivery. Those who did not utilize PNC services identified some of the barriers to their utilization, which included poor attitude of the healthcare providers and insufficient financial resources. The rate of utilization was found to be significantly higher among those who were 25 to 34 years of age (p = .03), who had formal education (p = .04), who were employed (p = .01), who had made use of an antenatal care (ANC) clinic (p = .02), and who had a good level of knowledge about PNC (p = .02). Furthermore, a prior experience with PNC services reduced by almost 90% the odds of a mother's subsequent utilization after her last delivery (odds ratio 0.10; confidence interval 0.05–0.24). Conclusions The majority of respondents in this study were aware of PNC services, but this did not translate to utilization of the services. Also, the rate of utilization of PNC services was significantly associated with certain sociodemographic factors such as age, educational status, employment status, use of an ANC clinic, and level of knowledge about PNC. Clinical Relevance This study provides pertinent knowledge for healthcare providers, especially nurses, who provide PNC services.

The study concluded that menopausal symptoms had a negative influence on work ability of the respondents.

Background/Aims In Nigeria, women's partners are often excluded from taking part in maternal healthcare, as a result of sociocultural norms. However, the involvement of male partners in maternal healthcare services has the potential to improve maternal health outcomes. This study examined factors associated with male involvement in maternal healthcare services in Ife Central, Osun State, Nigeria. Methods A cross-sectional study was conducted, involving 265 men living in Ife Central who were married with at least one child, selected by multistage sampling. A structured questionnaire was used to assess men's knowledge of their expected roles in maternal healthcare, their perception of male involvement, and their current level of involvement in their spouse's healthcare. Descriptive and inferential statistical analyses were carried out to identify predictors of active male involvement in maternal healthcare, at a significance of P<0.05. Results Approximately half (55.6%) of the respondents had good knowledge of the expected role of men in maternal healthcare services and 76.6% had a positive perception of this role. Overall, less than half (47.6%) of the participants were actively involved in maternal healthcare services. The participants most frequently reported that men's involvement was influenced by their degree of knowledge (92.4%), job schedule (92.0%), and clinic waiting time (86.4%), among others. Age (odds ratio=2.33, P=0.038), educational status (odds ratio=2.42, P=0.004) religion (odds ratio=2.34, P=0.012), occupation (odds ratio=2.81, P<0.001) and level of knowledge (odds ratio=2.34, P=0.001) were found to be significantly associated with men's level of involvement in maternal healthcare services. However, only good level of knowledge (adjusted odds ratio=2.32, P=0.004) emerged as an independent predictor of men's level of involvement in maternal healthcare services. Conclusions The study concluded that men's involvement in maternal healthcare services was low, despite their positive perception towards it. Less than half of the participants had good knowledge regarding men's role in maternal healthcare, and this factor was identified as a significant predictor of level of involvement. Programmes and policies should aim to enhance men's knowledge of their role in maternal healthcare, and it may be necessary to restructure the healthcare delivery system to be more male friendly.

Background: In Uganda, 12% of previously treated TB cases and 1.6% of new cases have MDR-TB and require specialized treatment and care. Adherence is crucial for improving MDR-TB treatment outcomes. There is paucity of information on the extent to which these patients adhere to treatment and what the drivers of non-adherence are. Methods: We conducted a cohort study using retrospectively collected routine program data for patients treated for MDR- TB between January 2012 – May 2016 at Mulago Hospital. We extracted anonymized data on non-adherence (missing 10% or more of DOT), socio-economic, demographic, and treatment characteristics of the patients. All participants were sen- sitive to MDR-TB drugs after second line Drug Susceptible Testing (DST) at entry into the study. Factors associated with non-adherence to MDR-TB treatment were determined using generalized linear models for the binomial family with log link and robust standard errors. We considered a p- value less than 0.05 as statistically significant. Results: The records of 227 MDR- TB patients met the inclusion criteria, 39.4% of whom were female, 32.6% aged be- tween 25 – 34 years, and 54.6% living with HIV/AIDS. About 11.9% of the patients were non-adherent. The main driver for non-adherence was history of previous DR-TB treatment; previously treated DR-TB patients were 3.46 (Adjusted prev- alence ratio: 3.46, 95 % CI: 1.68 - 7.14) times more likely to be non-adherent. Conclusion: One in 10 MDR-TB patients treated at Mulago hospital is non-adherent to treatment. History of previous DR- TB treatment was significantly associated with non-adherence in this study. MDR-TB program should strengthen adherence counselling, strengthen DST surveillance, and close monitoring for previously treated DR-TB patients. Keywords: Non-adherence; multi-drug resistant tuberculosis; treatment.

Background The postnatal period implies a crucial and delicate time for both the mother and the newborn. There is a growing body of evidence that is increasingly pointing to mHealth interventions as a potential tool for improved utilisation of maternal and child health services, including postnatal care. This can promote the health of mother and baby during this delicate period. However, the success of the interventions must be explored to validate their usefulness and reliability. Hence, this study explored the experiences of postpartum women on the usefulness of the mHealth intervention (postnatal care assistant) they received. Methods Twenty women, who were involved in mHealth intervention were interviewed using a semi-structured interview guide. They were recruited from the intervention group of a quasi-experimental study that evaluated the effect of a mHealth intervention on the uptake of postnatal care services. Thematic analysis of data was done using NVivo software version 10. Results Five major themes emerged from data shared by the participants. They are general feelings about the messages, benefits derived from the messages about pregnancy and hospital delivery, increased knowledge about baby care, facilitation of PNC utilisation and involvement of significant others in decision making. They affirmed that the information and reminder messages gave them the impetus to utilise postnatal care services. Conclusion Mothers reported that mHealth intervention provided immense support and assistance during pregnancy and the reminder messages encouraged them to utilise postnatal care services. This study suggests that improved education and reminder messages via mobile phones are needed during pregnancy and after childbirth to promote mother and child health through the utilization of postnatal care services, and efforts to put this approach to action should be pursued.

Background: A high rate of unintended pregnancy is said to be driving population growth, particularly in Sub-Saharan Africa, where approximately half of all pregnancies are unintended, coming too soon or even unwanted. Most of these unintended pregnancies could have been prevented with effective family planning services. There, however, remains an unmet gap between the women’s reproductive intention and their contraceptive behaviour. Objectives: This study determined the prevalence of unmet needs for family planning and examined its determinants among women of reproductive age group at a tertiary health facility in Southwest Nigeria. Design: This was a hospital-based cross-sectional study. Methods: Two hundred eighty-five sexually active women were recruited using a pre-tested, semi-structured, validated, interviewer-administered questionnaire. The questionnaire assessed the respondent’s socio-demographic characteristics, obstetrics and gynaecological history, and contraceptive history. Relevant clinical parameters were measured and recorded. Data were analysed using SPSS version 21. Multivariable logistic regression analysis was done using a 5% significance level to identify the determinants of unmet needs for family planning. Results: The prevalence of unmet family planning needs for prevention, spacing and limiting were 28.8%, 33.1% and 38.1%, respectively, with 58.2% overall prevalence of unmet needs. The commonest reason for the non-uptake of contraceptives among those with unmet need was the fear of side effects (66.3%). The odds of having unmet needs for family planning were higher for respondents with four or fewer children (adjusted odds ratio (AOR): 7.731; 95% confidence interval (CI): 28.504–2.907, p = 0.002) and those with one partner (AOR: 2.008; 95% CI: 3.669–1.090, p = 0.025). Conclusion: A high rate of unmet family planning needs was found in the study. This requires specific interventions and policies towards increasing contraceptive uptake, such as intensified health education aimed at allaying fears related to the side effects.