Pain experience, health service utilization and psychological coping in adult patients with sickle cell disease were compared cross-culturally between the UK and Nigeria. Patients in the UK experienced a significantly greater number of pain episodes and of longer duration, with more frequent visits to accident and emergency departments compared with those in Nigeria. The Nigerian patients, on the other hand, applied more psychologically active coping strategies such as distraction to deal with their sickle cell pain in the community. These significant differences are explained in relation to external health locus of control factors including beliefs, and the cost of healthcare in relation to the use of health services. Clinical implications of these findings are also considered.

BackgroundInfant mortality in rural areas of Nigeria can be minimized if childhood febrile conditions are treated by trained health personnel, deployed to primary healthcare centres (PHCs) rather than the observed preference of mothers for patent medicine dealers (PMDs). However, health service utilization/patronage is driven by consumer satisfaction and perception of services/product value. The objective of this study was to determine ‘mothers’ perception of recovery’ and ‘mothers’ satisfaction’ after PMD treatment of childhood febrile conditions, as likely drivers of mothers’ health-seeking behaviour, which must be targeted to reverse the trend.MethodsUgwuogo-Nike, in Enugu, Nigeria, has many PMDs/PHCs, and was selected based on high prevalence of childhood febrile conditions. In total, 385 consenting mothers (aged 15–45 years) were consecutively recruited at PMD shops, after purchasing drugs for childhood febrile conditions, in a cross-sectional observational study using a pre-tested instrument; 33 of them (aged 21–47 years) participated in focus group discussions (FGDs). Qualitative data were thematically analysed while a quantitative study was analysed with Z score and Chi square statistics, at p < 0.05.ResultsMost participants in FGDs perceived that their child had delayed recovery, but were satisfied with PMDs’ treatment of childhood febrile conditions, for reasons that included politeness, caring attitude, drug availability, easy accessibility, flexibility in pricing, shorter waiting time, their God-fearing nature, and disposition as good listeners. Mothers’ satisfaction with PMDs’ treatment is significantly (p < 0.05) associated with mothers’ perception of recovery of their child (χ2 = 192.94, df = 4; p < 0.0001; Cramer’s V = 0.7079). However, predicting mothers’ satisfaction with PMDs’ treatment from a knowledge of mothers’ perception of recovery shows a high accord (lambda[A from B] = 0.8727), unlike when predicting mothers’ perception of recovery based on knowledge of mothers’ satisfaction with PMDs’ treatment (lambda[A from B] = 0.4727).ConclusionsMothers’ satisfaction could be the key ‘driver’ of mothers’ health-seeking behaviour and is less likely to be influenced by mothers’ perception of recovery of their child. Therefore, mothers’ negative perception of their child’s recovery may not induce proportionate decline in mothers’ health-seeking behaviour (patronage of PMDs), which might be influenced mainly by mothers’ satisfaction with the positive attributes of PMDs’ personality/practice and sets an important agenda for PHC reforms.

Background: Infant feeding is an integral part of the reproductive process with important implications for the health of mothers and their babies. However, various practices exist in different communities. It is therefore pertinent to know the infant feeding practices among rural dwellers, as well as the factors that influence them.Methods: This study was a cross sectional survey. A total of 372 volunteering parturient women were recruited using a multi-stage stratified sampling technique. Ethical approval and respondents’ informed consent was obtained. A self-developed and validated questionnaire was used to collect data. Descriptive and inferential statistics was used to analyse data.Results: Findings revealed that majority (84.4%) of the respondents were aware of exclusive breastfeeding (EBF), but only about half (50.5%) ever practiced exclusive breastfeeding. Also, a significant percentage of the respondents introduced complimentary feeding to the baby immediately after birth while 29.3% of participants reported drinking palm wine which is mainly alcoholic to stimulate breast milk secretion. Occupation of parturient women was associated with the practice of EBF (p=0.002).Conclusions: Almost half of our studied parturient women do not engage in EBF. There is need for health care workers to strategically educate parturient women and their significant others on the numerous benefits of exclusive breast feeding.

No abstract

Background: Despite the progress made in recent decades to reduce the number of child deaths globally, many new-borns continue to die preventable deaths from conditions such as neonatal infections, especially in developing countries such as Nigeria. The umbilical cord remnants provide a good site for proliferation of infectious organisms which can lead to the death of newborn babies in their first month of life. Hence this study explored the newborn cord care practices of parturient women and the factors that contribute to such practices. Method: This study was a descriptive, cross-sectional survey of parturient women, who gave birth in the past one year. A Multi-stage sampling technique, was used to recruit respondents across selected communities. Ethical clearance was obtained, while informed consent was obtained from the study participants. A total of 400 volunteering respondents were consecutively recruited while a self-developed and validated questionnaire was used to collect data Result:The major findings of the study were that a significant percentage (12.2%) of the respondents did not deliver their babies in any health facility. There were evidences of potentially harmful newborn cord care practices among the respondents such as application of herbs and toothpastes to new-born's umbilical cord (12% and 5.2% respectively) and 8% applied hot balms to hasten cord separation. Fifteen percent of the respondents indicated that they noticed signs of infection on the baby's cord while place of delivery influenced their new born cord care practices.