Background and Objective: Antiretroviral therapy (ART) has transformed human immune deficiency virus (HIV) infection from a death sentence to a chronic syndrome, allowing infected individuals to lead near-normal lives, including achieving pregnancy and bearing children. Notwithstanding, concerns remain about the effects of ART in pregnancy. Previous studies suggested contradictory associations between ART and pregnancy. This study determined birth outcomes in pregnant women who accessed ART between 2004 and 2017 at a major tertiary hospital in North Central Nigeria. Methods: This was a retrospective study of 5,080 participants. Ethical clearance was obtained from the Institutional Review Board of the Harvard T. H. Chan School of Public Health Boston. A pro forma for data abstraction was designed and used to collect data. Abstracted data were sorted and managed using SPSS® version 22. The Chi-square test was used to calculate the proportions of pregnancy outcomes. One-way analysis of variance was used to test the effect of antiretroviral drug regimens on mean birth weight and gestational age at delivery. All levels of significance were set at p 0.05. Results: Pregnancy outcomes were recorded as live birth (99.8%), stillbirth (0.2%), preterm delivery (6.6%), and low birth weight (23%). There was a statistically significant association between ART in pregnancy and low birth weight {χ2[(5, n = 3439) = 11.99, p = 0.04]}. The highest mean birth weights were recorded in participants who received drug combinations with protease inhibitors or efavirenz, in contrast to participants who received Nevirapine, stavudine and Emtricitabine/Tenofovirbased regimens. However, there was no significant difference in the gestational age of babies at birth for the six ART regimens in the study. Conclusion and Global Health Implications: Findings support the benefits of ART in pregnancy, which is in line with the testing and treatment policies of the 90-90-90 targets for ending HIV by the year 2030. Copyright © 2021 Dapar et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.
Background: Community pharmacies are located close to the people, open long hours and weekends, making them ideal for provision of sexual and reproductive health (SRH) services, as a means of enhancing access and achieving universal coverage. However, structures (encompassing facilities and resources such as funds, private counselling space, number and qualification of staff) and processes (denoting actual activities undertaken such as: client screening, counselling, mechanisms for referral and collaboration with other healthcare professional) determine the suitability and capacity of community pharmacies to deliver quality SRH services. Objective: To assess the structures and processes of SRH services in community pharmacies in Jos, Nigeria. Methods: A cross-sectional questionnaire survey of staff in 63 community pharmacies of Jos metropolis, Plateau state, Nigeria. Three hundred and ten copies of the questionnaire were distributed to consenting participants. Statistical Package for Social Sciences (SPSS) ® version 21 was used to manage data. Results were presented as descriptive statistics for structures and processes of SRH in the study population. Results: A total of 296 completed questionnaires were retrieved. Eighty-two percent of respondents reported providing SRH services, which was mainly the sale of family planning (FP) products and counselling. Majority of these services 75%, were only offered on clients’ demand. SRH products sold were mainly oral contraceptive pills and the male condom. In terms of processes, about half (49.7%) of the respondents reported offering SRH services in collaboration with other health care providers, mainly in primary health care centres and private clinics. However, only a small proportion of the staff had any formal SRH specific training. Conclusion: The composition and qualification of mix of staff in community pharmacies presented some inherent weaknesses in their capacity to deliver quality and effective SRH services. This may impede the desired goal of promoting wider access and achieving universal coverage of SRH services.
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