Open Access Minireview Article

Alma Ata Declaration: Journey of Health Promotion on Respiratory Distress Syndrome among Pregnancy and Newborn in Nigeria

O. A. Akuirene, E. U. Nwose, J. E. Moyegbone, E. A. Agege, J. O. Odoko, J. O. Adjene, S. D. Nwajei

International Journal of Research and Reports in Gynaecology, Page 36-46

Purpose: In the discussion about landmark achievements of primary healthcare (PHC) in Nigeria, health promotion regarding respiratory distress syndrome (RDS) in maternal child health (MCH) is considered to be limited. The objective is to determine the landmark achievements in Nigeria with a view to identify health promotion needs.

Methods: This followed a critical narrative review approach. The critical literature search method was adopted as a systematic approach failed to yield any article that satisfies selection criteria, after applying all intended inclusion criteria. Search engines included Google and PubMed as well as government and organizational documents. Major evaluation was 10 years landmark achievement of Alma Ata on MCH program in Nigeria.

Results: There has been fluctuation and relatively slowed % rate of reduction in maternal mortality. Infant mortality has remained higher than national death rate, hence it is encouraging that Nigeria adopted in 2016 Every Newborn Tracking Tool of the Global Strategy progress monitoring. However, no study has focused on RDS in MCH with regards to impact of gas flaring in Delta State.

Conclusion: In the goal of achieving health for all emerged the Alma Ata Declaration on primary healthcare (PHC) being endorsed. Although, report is pending with regards to how much of the goals have been unachieved, major finding is dearth of data regarding MCH program in relation to gas flaring or the associated RDS. Studies have yet to focus on government policy regarding mitigation of RDS associated with gas flaring.

Open Access Original Research Article

A 6-Year Review of Gestational Trophoblastic Disease in the Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria

I. J. Abasi, I. D. Akanatei, I. A. Ibrahim

International Journal of Research and Reports in Gynaecology, Page 1-8

Background: Gestational Trophoblastic Disease (GTD) refers to a spectrum of diseases characterised by aberrant growth and development of the trophoblasts of the placenta that may continue even after the end of pregnancy.

Objective: To determine the prevalence, risk factors, clinical presentations and management of gestational trophoblastic disease in the Niger Delta University Teaching Hospital (NDUTH), Okolobiri, Bayelsa state, Nigeria .

Methodology: In this retrospective, descriptive, cross sectional study design, cases managed for gestational trophoblastic disease between January 2012 and December 2017 were audited using a self-developed proforma. Data collected include sociodemographic information, obstetric history, antenatal care in the index pregnancy, risk factors, management and outcome (morbidity and mortality) associated with gestational trophoblastic disease (GTD) in the Centre.

Results: There were 3172 deliveries that occurred during the 6year period under review in NDUTH with a total of 12 cases of GTDs. Hence, GTD is seen in 3.8 per 1,000 deliveries. The mean age of women with GTD was 31±6.3 years. Half of the women (50%) were in the low socio-economic class. The mean parity was 2 ± 1.6. The mean gestational age at presentation was 16.2 ± 5.4 weeks. All the women presented with amenorrhoea, Other presenting complaints include abnormal vaginal bleeding (83.0%) and uterine size greater than date (83.0%). Hydatidiform mole and choriocarcinoma accounted for 75.0% and 25.0% of cases, respectively. Seven (58%) of the patients had suction evacuation only for the management of hydatidiform mole, 1 patient (8.3%) had suction evacuation and chemotherapy for hydatidiform mole and subsequent persistent disease. Three (25%) of the patients had chemotherapy only for Choriocarcinoma. Ten (83.3%) of the patients were successfully treated. During the study period, 2 (17%) of the patients conceived after the treatment and had spontaneous vaginal delivery at term. Three (25%) of the patients made use of contraceptive pills during follow up. There were 2 maternal deaths due to GTD giving a case fatality rate of 6.7%.

Conclusion: GTDs though rare as shown in our study, they are however still associated with maternal mortality. This study underscores the need for histo-pathological examination of products of uterine evacuation. Urgent and intensified advocacy is needed in terms of good general education, poverty alleviation and improved health-seeking behaviour of our women to enhance early diagnosis, prompt and adequate treatment.

Open Access Original Research Article

Determining Factors Influencing Family Planning Practices among Adolescents in the Tema Central Sub-Metropolis, Greater Accra Region, Ghana

Douglas Adu-Fokuo, Albert Opoku, Patricia Akweongo

International Journal of Research and Reports in Gynaecology, Page 9-26

Introduction: The public health importance of family planning is well documented, some of which include averting the number of unintended pregnancies, reducing maternal and child mortality and number of abortion episodes among women. Adolescents are mostly vulnerable to peculiar health risks in relation to reproduction and sexuality. Despite interventions aimed at improving their family planning uptake, family planning practices among adolescents remain low in Ghana.

Objective: This study was carried out to determine factors influencing  the knowledge and  Family Planning  practices among adolescents at the Tema Central sub-metropolis of Ghana.

Methods: A descriptive cross-sectional study design was used to investigate the objective of this study. A total of 381 adolescents from adolescent service friendly units in the Tema Central sub-metropolis were sampled using cluster sampling technique for the study. Knowledge of adolescents on FP services was analysed descriptively using frequencies, percentages. The Chi-Square statistic was used to estimate differences in FP knowledge and demographic data of respondents. Statistical significance was considered based on p-value <0.05.

Findings: There was a high level of awareness of family planning among the adolescents (96.1%). Knowledge on family planning was good among the adolescents (98.4%). Age (P<0.05) and level of education (P<0.05) had significant influence on knowledge on family planning among the adolescents. However, out of the 381 adolescents, only twelve (3.1%) had ever used a FP method in the past and only six were using a FP method at the time of the study. Adolescent general perception of youth friendly services provided for the adolescents was positive.

Conclusion: Despite the high level of awareness and good knowledge of family planning among the adolescents, their family planning practices were poor. There is the need to repackage and advertise adolescent family planning services and make the services attractive to adolescents through collaborative effort between the Ghana Health Service, the media and all stakeholders.

Open Access Original Research Article

A 5-Year Review of Uterine Rupture in the Federal Medical Centre, Yenagoa, South-South Nigeria

D. O. Allagoa, P. C. Oriji, T. J. Wagio, D. C. Briggs, O. I. Oguche, T. R. Mbooh, G. Atemie, B. Eneni

International Journal of Research and Reports in Gynaecology, Page 27-35

Background: Rupture of the pregnant uterus refers to complete disruption of all uterine layers, including the serosa. It is a life-threatening obstetric emergency and a major cause of maternal and perinatal morbidity and mortality.

Objectives: To determine the incidence of uterine rupture and the maternal and perinatal outcomes associated with it at the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria over a 5-year period.

Materials and Methods: This retrospective survey was carried out between 1st January, 2016 and 31st December, 2020. Data were retrieved, entered into a pre-designed proforma, and analysed using IBM SPSS version 23.0. Results were presented in frequencies and percentages for categorical variables and mean and standard deviation for continuous variables.

Results: Thirty-four women presented with uterine rupture out of the 4,571 obstetric patients that were managed in the Centre with an incidence rate of 7.4 per 1,000 pregnancies. Majority (79.4%) of the women were multiparous, and referred (94.1%) from traditional birth attendant (TBA) homes. All the pregnancies were term, unbooked for antenatal care and none of the women had tertiary level of education. There were 3 cases of maternal mortality (case fatality rate of 8.8%) and 28 (82.4%) cases of perinatal mortality.

Conclusion: Uterine rupture is still a major public health problem in the developing countries, that has a high potential for causing perinatal and maternal morbidity and mortality. Behavioural change strategies should be employed in educating women and their spouse through peer education, group engagement and culturally sensitive and acceptable strategies on the need to attend antenatal clinics, and have their deliveries in hospitals equipped with trained and skilled personnel to supervise pregnancy, labour and delivery.

Open Access Original Research Article

Are Primary and Secondary Healthcare Workers in Rural Parts of Ebonyi State of Nigeria Aware of Obstetric Fistula?

Johnson Akuma Obuna, Ugochukwu Chinyem Madubueze, Adebayo Babafemi Charles Daniyan, Henry Chukwuemeka Uro-Chukwu

International Journal of Research and Reports in Gynaecology, Page 47-52

Background: Obstetric fistula remains a public health concern in Nigeria. New cases continue to occur despite massive campaigns to end it, so one begins to wonder if the workers in Primary Health Centers in rural parts of the state are aware of this menace. This study aimed to survey the level of awareness of PHC workers in the rural part of Ebonyi State.

Methods: This was a cross-sectional descriptive study. Ethical approval was obtained from Ebonyi State Research and Ethic Committee. An interviewer-administered, semi-structured questionnaire was used to collect data from the Officers-in-Chargeof the facilities. Frequencies and proportions were calculated for categorical variables while means and standard deviations were calculated for numerical variables. Data was analyzed using the Statistical Software for Social Sciences version 21. Tests of significance were done. A p-value < 0.05 was considered to be statistically significant.

Results: A total of 60 health care workers were studied, 44(73.3%) in primary and 16(26.7%) in secondary facilities. Twenty (33.3%) of them were between age group 40-48 years with mean age 39.6±9.8 while 52(86.7%) were females. Majority (86.7%) had tertiary education and 70% of them were qualified Community Health Extension Workers. Almost all (57; 95%) were aware of obstetric fistula. The major source of information was conferences (52.6%) and electronic media (52.6%). Health workers with more years of experience were more aware of obstetric fistula (93.3%) compared with those with less experience. This was statistically significant, (P= 0.05).

Conclusion: Awareness of obstetric fistula is very high among health workers, main sources being conferences/workshops and electronic media. Longer years of work experience improved awareness. Policies for continuous awareness creation, capacity building and retention of health workers in the rural areas are recommended to sustain this awareness level and eradicate obstetric fistula in the state.