STATISTICAL ANALYSIS OF INFANT AND CHILD MORTALITY RATE

CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

Infant mortality refers to the death of a child born alive before its first birthday and child mortality is the death of a child aged between one and five years. Demographers have for a long time been interested in the study of mortality which is one of the components of population change. Infant and child mortality are among the best indicators of socioeconomic development because a society life expectancy at birth is determined by the survival chance of infants and children.

Childhood mortality is an important indicator of all heath programs and policies; likewise it contributes to population projection. Childhood mortality measures also help identify specific population that are at increase in health risk. Several measures of childhood mortality are calculated using Demographic Health Survey (DHS) data. During the twentieth century almost all countries experienced decreases in child mortality rate. However, the timing and pace of the decline varied substantially. Sustained reductions in child mortality began in the nineteenth century in Europe, North America, and Japan and continued gradually throughout the twentieth century. Major declines in other parts of the world generally began only after World War II.

Mortality reductions in Asia, Latin America and Africa were usually much more rapid that they had been in countries that began mortality declines earlier. By 1999 there were great variations in child mortality among countries for example, although less than 0.5 percent of children died before the fifth birthday in Iceland, more than 33 percent died by age five in Niger. Since the 1960s the decline in child mortality sometimes has appeared to have stagnated as was the period from 1975– 1985, when many poor countries experienced severe crises and other problems such as economic recovery from the 0.1 crisis of 1973 – 1974. Recent evidence suggests that child mortality has continued to decline in most countries since 1980. However, during the 1990s the HIV/AIDS epidemic halted or reversed declines in child mortality in some eastern and southern African countries. For example, in Zimbabwe in the period 1990 – 1994 there were 50 deaths under age five per 1,000 live births.
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STATISTICAL ANALYSIS OF INFANT AND CHILD MORTALITY RATE

SOCIAL DETERMINANTS OF NUTRITIONAL PRACTICE IN PREGNANCY AMONG EXPECTANT MOTHERS ATTENDING ANTENATAL CLINIC IN KWALE DELTA STATE

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Pregnancy is the most vital time for having a proper nutrition plan. The high demand for nutrients is to deposit energy in to the new and developing tissues, the growth of maternal mother tissues including the breast and the uterus, and the increased energy necessities for tissue synthesis make pregnant women more susceptible to the dangers of malnutrition (Daba, 2011). In line with finding of Daba (2011), Pregnant women more at risk of malnutrition. In 2010, maternal and child malnutrition was accountable for 1.5 million deaths worldwide.

Maternal nutrition continues to gin populaity in many part of the world (Ojo, 2010). this may be attributed to the reality that pregnancy is associated with growth in physiological, metabolic and nutritional necessities imparted to the women by her growing infant (Arkkola, 2008). throughout pregnancy, the body’s energy requirements, protein and minerals increase by 13%, 54% and 50% respectively (Hoffmann, 2013). Therefore, the pregnancy period becomes a vital point to meet those needs for macro and micronutrients. Proper eating at some point in pregnancy assist prevent complications of pregnancy, facilitate postpartum recovery, assist breastfeeding, and additionally prevent the onset of disease in adulthood. However, if nutrients isn’t always maintained throughout pregnancy, malnutrition ensues.

It has being established by Saha (2007) that Socio economic and demographic status is one of the most critical factors related to pregnancy outcome and dietary desposition of expectant mothers. When Socio economic and demographic status is low, medical care will consequently be insufficient which can further lead to other unfavourable outcomes (kruger 2012). In pregnant women, low Socio economic and demographic status which is often described as financial hardship and low exposure to globalization, can increase the danger of detrimental pregnancy outcome. several studies have discovered that low Socio economic status is also associated with pregnancy complications such as abortion, preeclampsia, preterm delivery and eclampsia (kings, 2013; Obasi, 2015; Demin, 20016). women with low Socio economic don’t often have the means to acquire enough prenatal care and this may affect their dietary decision, leading to insufficient consumption of precise nutrients at some during pregnancy.
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SOCIAL DETERMINANTS OF NUTRITIONAL PRACTICE IN PREGNANCY AMONG EXPECTANT MOTHERS ATTENDING ANTENATAL CLINIC IN KWALE DELTA STATE

SEX EDUCATION AS A TOOL FOR REDUCING HIV/AIDS AMONG YOUTHS IN IVO LOCAL GOVERNMENT AREA OF EBONYI STATE

CHAPTER ONE

INTRODUCTION

Background to the Study

The issue of sex education as a tool for reducing HIV/Aids among secondary school students in Ivo Local Government Area of Ebonyi state has been of concern in the Local Government. Sex education is most appropriate for our time when the world at large and our society in particular has lost grip with the true knowledge and values for her sexuality.

Sex! This three-letter word connotes different things to different people. Sex and sexual symbols abound in our society. One can find sexually explicit information or images in the movies, book, television shows, on-line programmes, etc. Alters and Schiff, (1997). This all-important issue is no more treated with respect; it used to be accorded in the past. For instance, if one take a look at magazines or pictures, one will find attractive young men and women in advertisement for clothes, perfumes, soap, among others. This gives the impression that whether their product is a clothes, perfumes or soap. Advertisers and promoters know that “sex sells”.

The term sex refers to one’s gender, male or female as well as to sexual intercourse and certain intimate activities that involve the Alters and Schiff, (1997).
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SEX EDUCATION AS A TOOL FOR REDUCING HIV/AIDS AMONG YOUTHS IN IVO LOCAL GOVERNMENT AREA OF EBONYI STATE

MIDWIVES’ AND MOTHERS’ PERCEPTION OF MIDWIVES SERVICE SCHEME

CHAPTER ONE

INTRODUCTION

Background to the study

Pregnancy and childbirth are normal physiological processes that bring joyful experiences to individuals and families. However, in many parts of the world, pregnancy constitutes a perilous journey, a risky and potentially fatal experience for millions of women especially in developing countries. Over 289,000 women die annually from complications during pregnancy, childbirth, or postpartum period (World Fact book, 2014 and WHO, UNICEF, UNFPA &The World Bank 2014). About 70% of these deaths are largely treatable or at least preventable (UNICEF, 2010) and nearly all these deaths (over 90%) occur in developing countries where fertility rates are higher and a woman’s life time risk of dying during pregnancy and childbirth is over 400 times higher than in developed countries (Audu, Takai, &Bukar, 2010).

The situation in Nigeria is especially grave as maternal mortality rateas high as630 per 100,000 live births is still recorded (World Health Organization, UNICEF & The World Bank, 2014), thus including Nigeria among the nations with the highest number of maternal deaths (WHO, 2010, National Primary Healthcare Development Agency (NPHCDA) 2009). Nigeria makes up only 1% of the total world population but accounts for about 10% of the global estimate for maternal mortality (FMOH & NPHCDA, 2010). The new-born and under-five mortality rates follow the same trend with an estimated infant mortality rate of 74/1,000 (Index Mundi, 2014).This ugly trend has been traced to deliveries being attended to by unskilled birth attendants (N&MCN Newsletter 2011 & NPHCDA, 2009). It is against this backdrop that the Midwives Service Scheme [MSS] was initiated in 2003 by the Nursing and Midwifery Council of Nigeria (N&MCN) though originally as a mandatory service for newly qualified basic midwives (NMCN Newsletter, 2011).
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MIDWIVES’ AND MOTHERS’ PERCEPTION OF MIDWIVES SERVICE SCHEME

MEASURES UTILIZED FOR PREVENTION OF NOSOCOMIAL INFECTION IN THE LABOUR WARD OF UNIVERSITY OF CALABAR TEACHING HOSPITAL (UCTH), CALABAR.

CHAPTER ONE

INTRODUCTION

Background to the Study

Nosocomial infection also known as Hospital Acquired Infections (HAI) is a localized or systemic infection acquired in a hospital or any other health care facility by a patient admitted for a reason other than the pathology present during admission. It may also include an infection acquired in a healthcare facility that may manifest 48 hours after the patient’s admission into the health care facility or discharge (Hildron, Edwards, Patel, Horan, Sievert, Pollock & Fridkin, 2008). Epidemiological studies report that nosocomial infections are caused by pervasive pathogens such as bacteria (Lepelletier, Perron, Bizouarn, Caillon, Drugeon, Michaud & Duveau, 2005), viruses (De-Oliveira, White, Leschinsky, Beecham, Vogt, Moolenaar, Perz & Safranek, 2005) and fungi present in air, surfaces or equipment. The pathogens are not present or incubating prior to the patient’s admission into healthcare facility and are most likely transmitted by direct person-to-person contact during invasive medical procedures (Anderson, Kaye, Chen, Schmader, Choi, Sloan & Sexton, 2009). Some of the pathogens are highly resistant to antimicrobial agents, andthis necessitates the prescription of more potent and costly antimicrobial agents (Mulvey & Simor,2009).

Nosocomial infections are prevalent nationally and internationally; and occur in patients of all age groups: neonates (Aly, Herson, Duncan, Herr, Bender, Patel & EI-Mohandes, 2005), immuno-compromised adults and the elderly (Lepelletier, Perron, Bizouarn, Caillon, Drugeon, Michaud& Duveau, 2005). The most frequent types of nosocomial infections are those associated with the urinary tract, surgical wounds, respiratory tract and blood stream (Lo, 2008). It is a serious global public health issue, causing the suffering of 1.4 million people across the world at any given time (WHO, 2007).
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MEASURES UTILIZED FOR PREVENTION OF NOSOCOMIAL INFECTION IN THE LABOUR WARD OF UNIVERSITY OF CALABAR TEACHING HOSPITAL (UCTH), CALABAR.

ENVIRONMENTAL SANITATION AND IMPLICATION ON THE HEALTH OF THE CHILDREN IN THE RURAL AREA IN EKITI

CHAPTER ONE

INTRODUCTION AND BACKGROUND TO THE STUDY

Introduction

Efforts to assuage poverty cannot be complete if access to good water and sanitation systems are not part. In the 2000, 189 nations adopted the United Nations Millennium Declaration, and from that, the Millennium Development Goals were made. Goal 4, which aims at reducing child mortality bytwo thirds for children under five, is the focus of this study. Clean water and sanitation considerably lessen water-related diseases which kill thousands of children every day (UN, 2006). According to the World Health Organisation (WHO), 1.1 billion people lacked access to an enhanced water supply in 2002, and 2.3 billion people got illfrom diseases caused by unhygienic water. Each year 1.8 million people die from diarrhoea diseases, and 90% of these deaths are of children under five years (WHO, 2004).

Ghana Water Company Limited had traditionally been the major stakeholder in the provision of safe water and sanitation facilities. Since the 1960’s the GWCL has focused its activity in the urban areas at the expense of rural areas (GWCL, 2007) and thus, rural communities in the Ekiti state are no exception. According to the Ghana 2003 Core Welfare Indicators Questionnaire (CWIQ II) Survey Report (GSS, 2005), roughly 97% in Accra, 86% in Kumasi and 94% in Sekondi-Takoradi owned pipe-borne water. Once more, the report show that a few households do not own any toilet facilities and depend on the bush for their toilet needs, that is 2.1%, 7.3%, and 5% for Accra, Kumasi, and Sekondi-Takoradi correspondingly. Access to safe sanitation, improved water and improved waste disposal systems are more of an urban than rural occurrencein Ghana. In the rural poor households, only 9.2% have safe sanitation, 21.1% use improved waste disposal method and 63.0% have access to improved

water. The major diseases prevalent in Ghana are malaria, yellow fever, schistosomiasis (bilharzias), typhoid and diarrhoea. Diarrhoea is of critical concern since it has been recognized as the second most universal disease treated at clinics and one of the major contributors to infant mortality (UNICEF, 2004). The infant mortality rate in Ghana stood at about 55 deaths per 1,000 live births (CIA, 2006).
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ENVIRONMENTAL SANITATION AND IMPLICATION ON THE HEALTH OF THE CHILDREN IN THE RURAL AREA IN EKITI

AWARENESS OF THE DANGERS OF TEENAGE PREGNANCY AND MOTHERHOOD AMONG TEENAGE MOTHERS IN IKA SOUTH LOCAL GOVERNMENT

CHAPTER ONE

INTRODUCTION

1.1 Background of Study

The number of teenagers giving birth each year is staggering. In fact more than 10% of young mothers are teenagers. Nigerian birth rate for adolescent is one of the highest in the world and the prevalence among female adolescent in Nigeria of sexually transmitted infection including HIV is climbing rapidly. In an effect to reduce her high pregnancy rate by teenagers including other problems, Nigerians developed a national reproduction health policy in the year 2000 that focuses on preventing risk sexual behaviour during adolescent (national Population Commission) Nigeria demographic and health survey 2004, Abuja Nigeria Commission 2006. To become a parent, at any given age you have the capacity of generating a life–altering experience. Irrespective of race, education and socio-economic status motherhood and fatherhood both places high demands on one’s life that were not there before the birth of a child. Indeed, becoming a parent comes with several responsibilities, and when people of school ages (students) become parents, the new responsibilities can be very over-whelming and daunting. And for teenage parents that lack the support of their own parent, this experience can be more challenging and horrifying as they crave and seek support in adult–oriented systems in which even the older parents may find rather difficult to cope.

Teenage parents or students with children, as they are usually referred to in some literature, are parents that fall within the age bracket of thirteen (13) and nineteen (19). More often, these students drop out of school due mostly to pressures they experience, which include stigmatization that is limited with early parenting; isolation from their peers; and lack of the necessary support from their family, friends, schools, social service agencies and other organizations. These factors emerge because of the cultural and normative values that teenage pregnancy tends to breach.

According to the latest statistics, Nigeria has the highest teenage birth rate in Africa and the Niger Delta region seem to be the highest in the country (Channels Television, 15th July, 2013). To find research materials on this topic, we employed two basic methods which are Education are textbooks and Internet (using the Google search). A variety of terms were used either alone or in combination, and these include teenage parents, teenage pregnancy, student parents, school–age parents, adolescent parents, school-based child care, pregnancy, student achievement, drop-outs, and graduation.
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AWARENESS OF THE DANGERS OF TEENAGE PREGNANCY AND MOTHERHOOD AMONG TEENAGE MOTHERS IN IKA SOUTH LOCAL GOVERNMENT

CONTRACEPTION AND SEXUALITY AMONG STUDENTS OF COLLEGE OF EDUCATION

ABSTRACT

This research work centers on the contraception and sexuality among undergraduates in College of Education Ekiadolor in Ovia North East Local Government Area. From the findings, most undergraduates are involved in sexuality. They have knowledge of sex education, some use contraception like condoms and they do not believe in total abstinence before marriage. Recommendations made included special programmes to improve parent’s awareness of undergraduate’s sexual behaviour and reproductive health needs. Parents also need to discuss sex related issued with their children/wards.

CHAPTER ONE

INTRODUCTION

1.1 Background to Study

Sexuality and contraception among students can be seen to be a public health problem of immediate concern in developed and underdeveloped countries. While the knowledge of HIV/AIDS as an inevitable disease is high among Nigerians in general, HIV/AIDS transmission in reduction measures is inconsistently taken by sexually active individuals. The youths and adolescents are those that have high risk of being affected with STDS, if contraceptives are not used correctly or avoided, because the youths are vulnerable to indiscriminate sexual intercourse, with multiple sex partners.

Heterosexual transmission accounts for as high as 90% of HIV/AUIDS in Sub-Saharan African where about 14 million people were estimated to be infected with HIV. The federal ministry of Health and Human Services (FMH & HS 1992) in Nigeria suggested that about one million HIV infected people exist. This prevalence is increasing due to high risk of sexual behaviours. These STDS diseases are mostly common among individuals younger than 25 years world-wide. Several educators have shown that young people lack knowledge about prevention and the use of contraception and often have little or no idea about reproduction. Pregnancy and sexually transmitted disease among students is very rampant among undergraduate. Most of these pregnancies are unplanned and unwanted. They are often terminated illegally by quark doctors in the dark. About 600,000 clandestine abortions took place in Nigeria in the 1980s some of which had disasters consequences for the abortion seekers (African Journal of Reproductive Health, 2002). In most parts of Nigeria, sexual abstinence before marriage is expected from unmarried youths. However, studies show that premarital activity is high among adolescents. Parents, government and NGOS have expressed serious concerns about adolescents. Sexual activity based on the board information that adolescent who engaged in sexual activity whether orally or otherwise often fail to use contraceptives thus, exposing themselves to the risk of unwanted pregnancy and sexually transmitted infections and diseases.

The lower age limit for admission into most Nigeria higher institutions is 16-18 years. This means that majority of undergraduates are in their late teens and early twenties. Most of them live away from home, in school hostels and rented apartments close to their institutions. These arrangements weaken parental control and supervision of student’s activities. They are often exposed to influences from friends, which encourage casual sexual relationship and have to take personal important decisions about their social and reproductive lives. Unfortunately the use of contraceptives among Nigeria students is very low due to the fear of side effects and negative cultural attitudes of parents/guardians to contraceptive use.

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CONTRACEPTION AND SEXUALITY AMONG STUDENTS OF COLLEGE OF EDUCATION

AN INVESTIGATION INTO THE EFFECT, CAUSES AND PREVALENCE OF FEMALE PROSTITUTION IN NIGERIA TERTIARY INSTITUTION

ABSTRACT

The study investigated into the causes, prevalence and effect of female prostitution in Nigerian tertiary institutions: a case study of College of Education, Ekiadolor-Benin. In the course of the research and collection of data some research questions were postulated these include;How come about female prostitution? What are the effects of female prostitution?Do female prostitution cause by parents or government in our society?

The research instrument used includes questionnaires and oral interview. The simple percentage data analysis was used for the collection. A total of ninety (183) respondents were used in conclusion, some recommendations were suggested to treat some of the identified problems.

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Prostitution has become rampant in our society today among growing teens and youths. These young people see selling of their bodies as the fastest way of getting income for their keeps. In the past those engaged in prostitution use to be women selling their bodies. However, today men have joined the trade of selling their bodies for different reasons including drugs, jobs or contracts and also good grades in exams. This is because sex consumers include politicians, bosses in offices, lecturers who find pleasure in exploiting the lower class by offering mouth-watering opportunities in exchange for sex (Alufohai, 2007). She further stated that some of the causes of prostitution are high level of poverty due to unemployment rate in the society, bribery and corruption. Family expectations and other problems are factors why men and women get involved in prostitution. Women most especially are pressured into the business to be able to cater for family and siblings education.

Prostitution leads to the spread of STDs (sexually transmitted diseases), AIDS (acquired immune deficiency syndrome), HPV (human papiloma virus), herpes amongst others. Some women suffer trauma and pelvic pains, in most cases these women are subjected to drinking and smoking to ease off the pain and this habit could cause cancer which puts their lives in more jeopardy and increases mortality rate of the country. (Alufohai, 2007)

A university don, Prof. Elizabeth Balogun, on Wednesday (2007) in Abeokuta, Ogun State, expressed her concern over the prevalence of prostitution among female undergraduates in the country. Balogun said the sex trade had become rampant on Nigerian campuses to such an extent that 80 percent of prostitutes that patronize night clubs, hotels and tourist centres in Ogun State are students of tertiary institutions. Prof. Balogun, a Biochemistry lecturer at the University of Ilorin, said this at a seminar organized by the National Association of Nigerian Students to mark its 31stanniversary where she delivered a lecture titled “Prostitution on our campuses: Effects and solutions.”

The guest speaker, who expressed regret said, “It is absurd to the level that young undergraduate lady would leave normal academic chores of attending lectures and visiting libraries for further studies during the day, only to metamorphose in the evening into a call-girl or pimp. “There is no doubt that prostitution in the long run corrupts the quality of the nation’s future leaders and affects their values. Understanding that young females constitute appreciable percentage of the nation’s population, little could be expected from them productively if they had been turned into cheap sexual machines, with warped self-esteem and self- actualization. “Inordinate desire for affluence and desperation by many

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AN INVESTIGATION INTO THE EFFECT, CAUSES AND PREVALENCE OF FEMALE PROSTITUTION IN NIGERIA TERTIARY INSTITUTION

AN ANALYSIS OF THE INCREASE IN MORTALITY RATE AS A RESULT OF ABORTION AMONG YOUNG WOMEN

CHAPTER ONE

INTRODUCTION

1.1 Background of Study

Unintended pregnancy is a pregnancy that is either mistimed or unwanted at the time of conception. It is a core concept in understanding the fertility of populations and the unmet need for contraception. Unintended pregnancy is associated with an increased risk of morbidity for women, and with health behaviours during pregnancy that are associated with adverse effects. For example, women with an unintended pregnancy may delay prenatal care, which may affect the health of the infant. Women of all ages may have unintended pregnancies, but some groups, such as teens, are at a higher risk.

The use of modern contraceptive methods has greatly reduced the incidence of unintended pregnancy, particularly in more developed countries and provision of family planning services and modern contraceptives to those who do not have access to them would prevent a large proportion of unintended pregnancies and abortions, as well as many maternal and infant deaths. It is reported that despite of the availability of different modern methods of contraceptives, ranging from short, long term to permanent methods, as well as natural methods of contraception, the problem of unwanted pregnancies is very big worldwide but still underreported in many communities due to its sensitive nature. This is so said due to the high incidence of pregnancy termination which contributes to high maternal mortality and morbidity. About 80 million of unintended pregnancies are estimated to occur worldwide annually. In developing countries more than one-third of all pregnancies are considered unintended and about 19% will end up in abortion, which are most often unsafe accounting for 13% of all maternal death globally (Guttmacher institute 2007, Marston 2004).

Unwanted pregnancies are affected by number of factors including personal beliefs, social services, religious and cultural values as well as the existing laws in the community. Most of the time unwanted pregnancies started as unplanned pregnancy, but occasionally the planned pregnancy may end up into being unwanted pregnancy (Baginsk, 2007).It is also shown that out of 210 million pregnancies occurring in the world annually, about 79 million are estimated to be unintended, of these more than 50% end up in abortion.(Bongarts & West off, 2000). The World Health Organisation estimates that at least 33% of all women seeking hospital care for complications related to abortions are less than 20 years of age. This may be explained by the fact that adolescents’ fertility rate is very high, this affects not only these young women but also their children’s health; because birth to women aged 15-19 years have the highest risks of infant and child mortality as well as high risk of maternal mortality (WHO). In Nigeria there are 139 reported births per 1000 women aged 15-19 years (WHO, Adolescent fertility statistics 2000). Even if all contraceptives users were too use their methods correctly at all time, still there will be nearly six million accidental pregnancies annually which may end up into unwanted pregnancy (WHO 2003). Countries were contraceptive use is very high, the rate of unwanted pregnancy as well as abortion has declined to a very great extent, that is contraceptive use is inversely proportional to the rate of abortion (Bongaarts and Westoff, 2000).

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AN ANALYSIS OF THE INCREASE IN MORTALITY RATE AS A RESULT OF ABORTION AMONG YOUNG WOMEN

THE STRATEGIES FOR IMPROVING THE FUNCTIONALITIES OF IN-SERVICE TRAINING OF SECRETARIES IN MODERN BUSINESS ORGANIZATIONS IN ENUGU STATE

CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

In introduction topic a survey of the strategies for improving the functionalities of ins service training of secretaries in a modern business organization in Enugu state, we must first understand when in-service training is all about.There are many definition of in service training but I will highlight on just a few in order to see ways of improving its functionalities for a modern secretary.

Otto and Sender (1964) stated that in service training is a continued education of person while they are in service.Hass (1964) stated that in service training include all activities engaged by professional personnel during service and designed to contribute to professional improvement.

Dillon Peterson (1981) defines in service training and professional growth for individuals within a respectful, supportive, positive organizational climate having as its ultimate aim to better learning. Having seen the definitions of in service training, let us consider the strategies f improving its functionalities.

The aim of in service training for the secretaries being to help them overcome many challenges posed to them by the modern technologies such as computers, fax machines, word processors etc. to now improve the functionalities of this training for secretaries it becomes imperative to train them in the use of these equipment to enhance their productivity and efficiency. To also improve on the functionalities of in service training for secretaries in a modern business organization, such must be well articulated and well-designed toward personal and organizational goals.

According to WynReilay (1979) he said that there are two schools of thought as to the extent the design and running of their services. We are more interested in the second school of thought which agrees that trainees should participate in determining what should constitute an in service training for them. For it helps to develop a sense of responsibilities.

Granting study leave instead of on the job training will improve the functionalities of in service training of secretaries in no small measures, in that they will have enough time to consulate on the training and also remove stress which will not help in the training.

Attachment of incentives like promotion, monetary reward etc, can as well enhance the functionalities of in service training of secretaries. The type of personnel assigned to conduct the training will equally in no small measure improve the functionalities of this training, seeing that in service training si a two way course that really involves a trainee and a tutor. How the tutor handles the course will go a long way to arouse the interest and dedication of the trainees. Using qualified personnel will in turn bring in new motivation, fresh insights, whose teaching techniques is based on many years if experience will impact and improve the functionalities of in service training of secretaries in a modern business organization in Enugu sate.

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THE STRATEGIES FOR IMPROVING THE FUNCTIONALITIES OF IN-SERVICE TRAINING OF SECRETARIES IN MODERN BUSINESS ORGANIZATIONS IN ENUGU STATE

THE IMPACT OF TRADITIONAL BIRTH ATTENDANT PRACTICE IN THE PRIMARY HEALTH CARE SYSTEM

ABSTRACT

The study is designed to examine the impact of traditional birth attendant practices (TBAs) in primary health care and on women. Randomly-selected women (n=100) were interviewed to gain a more thorough understanding of the impact of traditional birth attendant practices (TBAs) in primary health care. Research question 1: what made women start receiving care from traditional birth attendant? Shows that 12% visits TBAs because of the cost of services in the hospital, 32% visits TBAs because of family member’s opinion while 36% visits TBAs because of accessibility. Research question 2: Have they ever encountered any complications from birth complication from birth attendant’s shows that 68% of the respondents have encountered complications while 32% of while respondents have not. Research question 3: What forms of complications do pregnant women encounter from traditional birth attendant? Shows that 31.3% of the respondent had excessive bleeding, 26.9% had retention of placenta, 11.9% had fresh stillbirth, 10.4% of the respondent lost their babies and 6.0% had in one way or the other lost a relative. Research question 4: How were the complications resolved? Shows that 22% of the respondents were referred to the hospital, 23.7% was solved using herbal preparation, 10.2% was solved by encouraging maternal efforts, 1.7% was by manipulating the womb manually, 1.7% of the respondents were given bed rest and 22% was solved by encouraging maternal efforts and bed rest. All this result makes it possible for the researcher to conclude that the effect of traditional birth attendant on women is negative. Continuing efforts to examine the effect of TBAs on pregnant women may benefit in the reduction of maternal and neonatal mortality and morbidity

CHAPTER ONE

INTRODUCTION

1.1 Background of Study

Since the adoption of the Primary Health Care (PHC) approach in Nigeria in 1979, government has recognized the need for integrating traditional birth attendants (TBAs) into the PHC system and had consequently initiated TBAs training programmes. In spite of the high patronage of traditional birth attendants, many of their practices during childbirth have been found to adversely affect the health of mothers.

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THE IMPACT OF TRADITIONAL BIRTH ATTENDANT PRACTICE IN THE PRIMARY HEALTH CARE SYSTEM

THE IMPACT OF HEALTH EDUCATION TOWARDS COMPLIANCE OF IMMUNIZATION AMONG CHILDREN 0-5 YEARS IN AHOADA GENERAL HOSPITAL, RIVERS STATE

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Immunization is one of the safest and most effective interventions to prevent disease and early child death. Although, about three quarters of the world‘s child population is reached with the required vaccines, only half of the children in Sub-Saharan Africa get access to basic immunization. In recent years, many countries have employed a growing range of strategies to increase both the provision and utilization of immunization services. These experiences are in consonant with the Global Immunization Vision and Strategy (GIVS) of ―using a combination of approaches to reach everyone targeted for immunization.

A substantial number of children worldwide do not complete immunization schedules because neither health services nor conventional communication mechanisms regularly reach their communities. In some communities, low immunization rates are associated with families living a long distance from health services, having little access or exposure to large-scale or local media, and low doctor- and nurse-patient ratios (e.g. slum-dwellers in the Philippines and South Africa, nomadic populations in Sub-Saharan Africa, and internal migrants in Brazil, Cameroon, and Mozambique). Underserved communities have consistently shown low immunization coverage. Innovative outreach strategies are needed to particularly target children who are excluded or beyond the reach of immunization services.

Similarly, anti-vaccination information and/or refusal to get children immunized is not new in the world. Historically, populations have rejected immunization due to concerns about vaccine safety as well as political, cultural, and religious reasons. Today, trust and acceptance of immunization faces two new formidable challenges. Firstly, a global, fast-paced communication environment makes it possible for negative publicity and anti-immunization positions to be disseminated quickly worldwide. Localized opposition (e.g., polio campaigns in India and Nigeria), negative publicity surrounding vaccine safety (e.g., MMR vaccination in the UK), and suspected or real adverse events following immunization are more likely to attract wide media coverage, and spread through the Internet. Secondly, increased democratization promotes debates about individual and community rights and choice. Today, democratization offers an environment more conducive to the emergence of challenges to government-mandated programs such as immunization. In a growing ―rights environment in both the developed and developing world, national programs like immunization are more vulnerable to being questioned.

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THE IMPACT OF HEALTH EDUCATION TOWARDS COMPLIANCE OF IMMUNIZATION AMONG CHILDREN 0-5 YEARS IN AHOADA GENERAL HOSPITAL, RIVERS STATE

PERCEPTION AND ACCEPTANCE OF CAESAREAN SECTION AMONG PREGNANT WOMEN IN IUTH OKADA, EDO STATE

CHAPTER ONE

INTRODUCTION

BACKGROUND OF STUDY

Maternal mortality represents the leading cause of death among the pregnant women in most developing countries including Nigeria (Mekonnen and Mekonnen, 2003; WHO, 2007). Furthermore, it is estimated that one third of all maternal deaths globally occur in just two countries, namely India and Nigeria (Mboho et al 2013). According to UNFPA (2012), in 2010, India was accountable for about 20% of global maternal deaths (56,000) and Nigeria, 14% (40,000). Meanwhile, disease, deformity and death are terms usually employed to describe the experiences of a vast majority of sub-Saharan African women during pregnancy and birthing (Harrison, 2001; Brookman-Amissah and Moyo, 2004; WHO, 2004a). Similarly, the majority of African women are often viewed as being at high risk of infections, injury and death during pregnancy and the periods surrounding it (Izugbara and Ukwayi, 2007). In recent time women in Nigeria have expressed worries about choices of childbirth especially the issues surrounding vaginal birth. The joy of every woman is to deliver her baby normally. Some decades ago the most available or preferred option for most women was vaginal birth. Some of the women had their babies at home with traditional birth attendants but quite often with difficult labour resulting from obstruction and the women died before any meaningful interventions. Today, however, many babies have been delivered successfully through caesarean section. This success story in not without criticism. Among women in the developing countries, caesarean section is still being perceived as a ‘curse’ of an unfaithful woman (Adeoye and Kalu 2011). The authors further assert that caesarean section is seen among weak women. In addition, caesarean section is surrounded with suspicion, aversion, misconception, fear, guilt, misery and anger among the women of South Western Nigeria (Adeoye and Kalu 2011). Furthermore, in most sub-Saharan African countries including Nigeria, caesarean section is being accepted reluctantly even in the face of obvious clinical indication (Adeoye and Kalu 2011).

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PERCEPTION AND ACCEPTANCE OF CAESAREAN SECTION AMONG PREGNANT WOMEN IN IUTH OKADA, EDO STATE

PATIENT PERCEPTION AND SATISFACTION WITH HEALTHCARE PROFESSIONALS AT PRIMARY CARE FACILITIES

CHAPTER ONE

INTRODUCTION

1.1 Background of Study

Primary Health Care forms the bedrock of the health-care services of a country. It is the quality of health care available to the majority of the population that determines the health status of the country and is the best indicator for the level of social development of the country. The important conditions of Primary Health-Care Services are that they should be: Efficient with regard to cost, techniques and organization; readily accessible to those concerned; Acceptable to the community served; at a reasonable cost. Health-care services should be available in a manner and language that is suitable to the community and population it serves and accommodating of local traditions and customs, and at a price which the population can afford. Patient satisfaction has been linked to increased patient compliance, continuity of care, better clinical outcomes, and greater service utilization and risk management. Patient satisfaction is thus a key marker for the quality of health-care delivery and an important indicator for evaluation and improvement of health-care services. Studies of Patient Satisfaction in health care originated in the USA during the 1950s,the earliest studies attempted to identify patient characteristics such as age, gender, and race to predict patient satisfaction levels (Apostle and Oder 1967;Bertakis et al. 1991). Another group of studies analysed health-care attributes such as nursing care, physician care, etc. to identify attributes that influence overall patient satisfaction (Ware et al. 1975; Ross et al. 1993; Dansky and Brannon 1996; Oswald et al. 1998). DrVeera Prasad in his comparative study of patient satisfaction said that there are five determinants of patient satisfaction. Reliability: The ability to perform the promised service dependably and accurately. Responsiveness: The willingness to help the patients and provide prompt service. Assurance: The knowledge and courtesy of employees and their ability to convey trust and confidence. Empathy: The provision of caring and individualized attention to patients. Tangibles: The appearance of physical facilities, equipment, personal, and communication materials. A study was carried out to identify which attributes of a primary health-care experience access, staff care and physician care, and which aspects of each attribute are most significant in patients’ response to the services they receive.

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PATIENT PERCEPTION AND SATISFACTION WITH HEALTHCARE PROFESSIONALS AT PRIMARY CARE FACILITIES

KNOWLEDGE AND PRACTICE OF HAND WASHING AS A MEASURE OF DISEASE CONTROL AMONG STUDENTS IN AFE BABALOLA UNIVERSITY

TABLE OF CONTENTS

CHAPTER ONE

BACKGROUND OF STUDY 2

STATEMENT OF THE PROBLEM 3

RESEARCH OBJECTIVES 5

RESEARCH QUESTIONS 5

SIGNIFICANCE OF STUDY 6

SCOPE OF STUDY 6

LIMITATIONS TO STUDY 7

OPERATIONAL DEFINITION OF TERMS 7

CHAPTER TWO

INTRODUCTION 9

CONCEPT OF HAND WASHING AND DISEASE CONTROL 9

THE LINK BETWEEN HAND HYGIENE AND INFECTION 13

EMPIRICAL FRAMEWORK 17

THEORETICAL FRAMEWORK 21

CHAPTER THREE

SOURCES OF DATA 23

POPULATION OF THE STUDY 23

DETERMINATION OF SAMPLE SIZE 24

STUDY AREA 25

DESCRIPTION OF THE RESEARCH INSTRUMENT 26

RESEARCH DESIGN 27

VALIDITY OF THE INSTRUMENT 27

RELIABILITY OF THE INSTRUMENT 28

METHOD OF DATA ANALYSIS 28

CHAPTER FOUR

INTRODUCTION 29

DATA ANALYSIS 32

DISCUSSION OF FINDINGS 42

CHAPTER FIVE

SUMMARY OF FINDINGS 53

CONCLUSION 56

RECOMMENDATIONS 60

REFERENCES 62

APPENDIX

QUESTIONNAIRE 69

ABSTRACT

The purpose of the thesis was to study the knowledge and practice of hand washing as a measure of disease control among students in AfeBabalola University. The goal was to know how well the knowledge of hand hygiene is known to the students and their attitudes towards maintaining good hand hygiene and to find possible ways for better adherence. The quantitative research method was used. Questionnaire was divided in 4 sections and distributed to students who were used for the study as respondents. Results from the findings indicated that majority of the students maintained good hygiene prior and after eating. The students also maintain good hand hygiene after using the restroom. The results revealed that although majority of the students wash hands during these cases most of them do not fully know or understand the right procedures and techniques of proper and effective hand hygiene and the right use of alcohol hand rub in the prevention of illness. In the conclusion it came to attention that there is the need for further education for the students on the various procedures of proper hand and personal hygiene to effectively prevent the spread of infection and diseases. It was recommended to hold hand hygiene educational events interesting enough to attract students from all the various fields of study to participate.

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KNOWLEDGE AND PRACTICE OF HAND WASHING AS A MEASURE OF DISEASE CONTROL AMONG STUDENTS IN AFE BABALOLA UNIVERSITY

KNOWLEDGE AND PERCEPTION OF HYPERTENSION AND ITS MANAGEMENT AMONG CLIENTS/PATIENTS

ABSTRACT

Hypertension is an important public health challenge at Auchi Nigeria. The purpose of this qualitative phenomenological survey was to determine hypertensive patients’ knowledge, perceptions, attitudes and life-style practices so as to optimize their health and treatment needs. We examined a cohort of 108 randomly selected hypertensive by means of a self-structured questionnaire and a detailed interview. Analysis was by statistical package for social sciences (SPSS) and chi- square was used for significance tests at 0.05 level. More males 60 (55.6%) than females 48 (44.4%) were assessed. Their age range was 35 – 80 years (mean = 59.05 ± 9.06 years), the modal age group was 56 – 60 years (24.1%). Sixty-six respondents (61%) knew hypertension to be high blood pressure (BP), 22 (20%) thought it meant excessive thinking and worrying while 57 (53%) claimed it was hereditary. Forty-three (40%) felt it was caused by malevolent spirits, 32 (30%) believed it was caused by bad food or poisoning. A few (18%) knew some risk factors. Symptoms attributed to hypertensionwere headache, restlessness, palpitation, excessive pulsation of the superficial temporal artery and “internal heat”, but 80 (74%) attested to its correct diagnosis by BP measurement. Although 98 (90.7%) felt the disease indicated serious morbidity, only 36 (33.3%) were adherent with treatment and fewer practiced life-style modification. Thirty-two (30%) knew at least one antihypertensive drug they use. Psychosocial factors like depression and anxiety fear of addiction and intolerable drug adverse effects impacted negatively on patients’ attitude to treatment. We conclude that patients’ knowledge of hypertensionin Auchi is low and their attitudes to treatment negative. Patient education, motivation and public enlightenment are imperative.

CHAPTER ONE

INTRODUCTION

1.1 Background of Study

Hypertension remains a major global public health challenge that has been identified as the leading risk factor for cardiovascular morbidity and mortality (Kearney, Whelton, Reynolds, Muntner, Whelton& He, 2004). It increases hardening of the arteries, thus predisposing individuals to heart diseases, peripheral vascular diseases, stroke, heart failure and kidney failure. Hypertension is the commonest non-communicable disease in the world and all races are affected with variable prevalence. Castelli (2004) explained that its prevalence is on the increase in developing countries where adoption of western lifestyle and stress of urbanization, both of which are expected to increase morbidity associated with unhealthy lifestyle are not on the decline.

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KNOWLEDGE AND PERCEPTION OF HYPERTENSION AND ITS MANAGEMENT AMONG CLIENTS/PATIENTS

HEALTH SEEKING BEHAVIOR TOWARDS HEALTH PROMOTION AMONG FAMILIES WITH ELDERLY IN ISIALA MBANO LGA IMO STATE

ABSTRACT

The purpose of this study was to find out the health seeking behavior towards health promotion among families with elderly in Isiala Mbano LGA Imo State. To achieve this purpose the ex- post facto research design was used to assess 399 respondents drawn from three clans of Isiala Mbano LGA through stratified sampling technique. A closed ended questionnaire was used to obtain responses from the respondents, 400 copies of questionnaire were distributed to the respondents while 399 copies were received. Data collected for this study were analyzed using descriptive statistics of frequency counts, percentage mean and standard deviations and inferential statistics of ANOVA, Scheffe post hoc test and independent t- test. 0.05 level of significance was used for all test of significance. The findings show that age has significant effect in health care seeking behavior among the aged group in Isiala Mbano LGA Imo State and poor health care seeking behavior is present among age 80 years and above compared to 60 – 64 and 70 – 74 years respectively. It was concluded that age is a significant factor in decreasing healthcare seeking behavior among the aged in Isiala Mbano LGA. It was recommended that the government should embark on massive enlightenment programes for the aged in other to educate them and encourage them on health services available to them and also seek them when needed. Cost reduction and disease management should also be considered.

TABLE OF CONTENTS

ABSTRACT 1

CHAPTER ONE: INTRODUCTION

Background to the Study 5

Statement of the Problem 6

Research Objectives 7

Research Questions 8

Significance of the Study 8

Scope and Limitation of the Study 9

Operational Definition of Terms 10

CHAPTER TWO: REVIEW OF RELATED LITERATURE

Introduction 11

Concept of Aging 11

Concept of Health Care 12

Health Care Seeking Behavior Among the Aged 15

Awareness of Health Care Service Among the Aged Persons 17

Practice of The Aged Persons towards Health Care 18

Health Problems Associated with Ageing 20

Theoretical Framework on Health Care Seeking Behavior among the Aged 23

Empirical Studies on Health Care Seeking Behavior 31

CHAPTER THREE: METHODOLOGY

Introduction 34

Research Design 34

Population of the Study 35

Sample and Sampling Techniques 35

Instrumentation 36

Validation of the Instrument 36

Procedure for Data Collection 36

Procedure for Data Analysis 37

CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS

Introduction 39

Results 39

Test of hypotheses 46

Discussion of Findings 53

CHAPTER FIVE: SUMMARY, CONCLUSION AND RECOMMENDATION

Summary 57

Conclusions 58

Recommendations 59

REFERENCES 60

APPENDIX 73

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HEALTH SEEKING BEHAVIOR TOWARDS HEALTH PROMOTION AMONG FAMILIES WITH ELDERLY IN ISIALA MBANO LGA IMO STATE

FACTORS INFLUENCING APPLICATION OF CLINICAL INSTRUCTIONS IN NURSING PRACTICE AMONG NURSING STUDENTS IN MADONNA UNIVERSITY

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Learning is a change in behaviour over time that is brought about by experience during training in educational encounter (Akubuiro and Joshua, 2003). Training as part of education, is the acquisition of knowledge, skills and competence as a result of the teaching of practical skills and knowledge that relate to specific useful competences (Angel, 2007). Training helps the learner to acquire certain useful skills and develop critical mind for the learner’s self development. Therefore, the knowledge that comes from training is more of knowledge of how to do or perform specific tasks. Thus, the modification in behaviour as the product of training can occur following newly acquired skills, knowledge, perception, facts, principles and new information at hand (Adeyanju, 2004). Nursing education is a term used to describe the overall body of knowledge that applies to nursing profession. It encompasses a variety of knowledge, skills, concepts, and practices which revolve around the unique concepts of nursing, health, the person and the environment (Melone, 2010). Nursing education consists of acquisition of a body of knowledge that is partly delivered in a classroom setting which forms the theoretical bases of nursing knowledge and an organized and supervised clinical training experiences that take place in the clinical settings where the nurse- patient relationship is experienced directly or indirectly (Shariff and Masoumi, 2005). Sonwuttanayut (2003) noted that the training process in nursing education should aim at enabling the students to gain skills and experiences up to their highest potentiality. This shall focus on the learners as being the most important in the process. In addition, basic knowledge, attitude, skills and the ability to apply knowledge into the actual practice of nursing should be developed and inculcated into the student nurses in these processes. Training can be reinforced with learning aids and equipment of different varieties simply because they stimulate, motivate as well as arrest learners’ attention for a while during the instructional process.

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FACTORS INFLUENCING APPLICATION OF CLINICAL INSTRUCTIONS IN NURSING PRACTICE AMONG NURSING STUDENTS IN MADONNA UNIVERSITY

EFFECTIVENESS OF EXCLUSIVE BREASTFEEDING IN THE DEVELOPMENT OF UNDER-5 CHILDREN

ABSTRACT

The purpose of this study was to examine the effectiveness of exclusive breastfeeding in the development of children under-five in Benue State, Nigeria. To achieve this purpose, 10 hospitals were randomly selected using multi-stage sampling technique (simple random, stratified, and purposive sampling techniques). The data was collected using close-ended questionnaire. 500 questionnaires were distributed to nursing mothers who visited antenatal clinics in the randomly selected hospitals, from which 455 were duly completed and returned. Frequencies of percentages and cross tabulation statistics were used to answer research questions. Associations between demographic determinants and breastfeeding practices were analysed using Chi-square statistics at alpha level of 0.05 to test the formulated hypotheses. The findings of the study, indicated high (99.8%) prevalence of breastfeeding among nursing mothers, out of which 83.5% exclusively breastfed for up to 4-6 months. Only 16.5% however supplemented breastfeeding. The findings of the study revealed that; mother’s age significantly influenced the practice of exclusive and non-exclusive breastfeeding of babies, indicating high exclusive breastfeeding among mothers of 25years and above, and low exclusive breastfeeding among younger mothers of 19 years and below. The results further showed that, mother’s level of education significantly influenced the practice of exclusive and non-exclusive breastfeeding of babies, indicating high exclusive breastfeeding practice among literate mothers with at least secondary education. Those with low educational attainment had poor or low practice of exclusive breastfeeding. Based on the results of this study, the following conclusions are drawn: Mother’s age influence the practice of exclusive and non-exclusive breastfeeding of babies in Benue State. Mother’s level of education influenced the practice of exclusive and non-exclusive breastfeeding of babies in Benue State. Based on the conclusions, the following recommendations are made: Special interventions should be made for young mothers with poor breastfeeding practices usually (15-19years) by health care workers to encourage them endure the herculean task of breastfeeding, through education, and nursing support to enable them breastfeed exclusively. Since education remains the most viable means of reaching mothers on the benefits of exclusive breastfeeding, health care workers should intensify education to provide mothers with complete and current information on the methods of exclusive breastfeeding in order to increase mother’s knowledge of benefits of child development derived from exclusive breastfeeding.