FACULTY OF CLINICAL SCIENCES

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    Reproductive health challenges among women in internally displaced camps in Benue State: a protocol for a community-based health education interventional study.
    (Women's Health and Action Research Centre (WHARC), 2023-10) Ngwibete, A.; Ogunbode, O.O.; Oluwasola, T. A. O.; Omigbodun, A. O.
    Sexual and reproductive health (SRH) services are a necessity for marginalized persons such as the displaced. The protocol describes an intervention that can contribute to overcoming challenges associated with SRH service delivery of three selected reproductive health (RH) services: HIV/AIDS, contraception, and cervical cancer screening. A pre-and post-intervention approach will be used to evaluate the effect of an intervention with trained Community-Based Reproductive Health Personnel (CBRHP) and/or mHealth technology within the selected IDP camps. Three (3) months of health education through the CBRHP and/or via mHealth technology will be provided. Using a questionnaire, interviews, and Focus Group Discussion (FGD) guide, the researcher will assess the suitability of this intervention to attain the objectives. Data analysis will be done with SPSS version 26. Univariate analysis will include mean and standard deviation, bivariate analysis will include a chi-square test of goodness for the association of variables, and McNemer’s test to evaluate the effect of the intervention by comparing consistency in response across the variables under study. Multivariate analysis will be used to assess if sociodemographic, knowledge and health service impacts access and use of RH services. For qualitative analysis, findings will be grouped into themes. The outcomes of each theme will be used to complement the findings of the quantitative analysis. The primary outcome measures will include the level of knowledge of SRH, the number of people who want to access RH services and which RH services are most sought by the respondents. If the use of CBRHP is successful, there will be an increase in knowledge and use of HIV/AIDS, contraception and cervical cancer services. Challenges associated with access and uptake of RH services will also be assessed. (Afr J Reprod Health 2023; 27 [10]: 133-144).
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    Guidelines and standard of care manual for managing gynaecological cancers.
    (Ibadan University Press, 2014) Odukogbe, A. A.; Awolude, O. A.; Oluwasola, T. A. O.; Adewole, I. F.; Omigbodun, A. O.
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    Anaemia and its associated risk factors among pregnant women in the Gambia.
    (2024) Oluwasola, T. A. O.; Amadi, A. O
    Background: Anaemia is a global health problem affecting about a third of the world’s population. In pregnancy, it is a public health concern with consequences for mothers and infants, including maternal death and infant mortality. In low-income countries, 25% indirect maternal mortality and 30% neonatal deaths are due to anaemia in pregnancy. This study aimed to determine the prevalence of anaemia among pregnant women in The Gambia and identify common risk or predisposing factors associated with anaemia in pregnancy among them. Methods: This was a cross-sectional study of 180 consenting pregnant women, who attended two secondary-care level hospital for antenatal care between March and May 2023. They were selected by using a simple random sampling technique. Data were collected using a validated structured questionnaire and participants’ current antenatal cards while SPSS software version 26.0 was used for analyzing data. Results: The findings of this study shows that 21.7% and 8.3% of the pregnant women were anaemic at booking using 11.0g/dl and 10.0g/dl as cut off respectively with the mean haemoglobin concentration of 11.76+-1.36g/dl. The study revealed that anaemia during pregnancy is associated with factors such as educational level (p=0.048) and the average income per month (p=0.039). Majority of the women, (166, 92.2%), have taken malaria prophylaxis but only 95 (52.8%) admitted to sleeping under insecticide-treated mosquito nets which shows the low prevalence of Malaria among the participants (5.6%) Conclusion: The prevalence of anaemia among pregnant women in the Gambia is 21.7% which implies that anaemia is still a public health problem. Therefore, it is important for actions like early booking and improvement on health and nutritional education to be taken in order to reduce anaemia among pregnant women.
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    Birth preparednenss and complications readiness among pregnant women in the Gambia.
    (2025) Oluwasola, T. A. O.; Olaitan, O. G
    Background: The goal of birth preparedness and complication readiness (BPCR) is to minimize delays in seeking care, facilitate the attendance of skilled professionals during birth, and promote facility deliveries. This study aimed to evaluate the knowledge of BPCR among women in the postpartum ward of the Edwards Francis Small Teaching Hospital (EFSTH) in The Gambia. Methods: This was a cross-sectional study conducted at the EFSTH, the only teaching hospital and tertiary care centre in the Gambia. Data was collected using an interviewer-administered questionnaire from 267 consenting parturients. Data was analyzed using the SPSS version 29. Results: The mean age of the participants was 28.6±6.7 years. Of the 220(82.4%) participants who were aware of birth preparedness, 181(67.8%) had a good understanding while one-third, 97(36.3%), demonstrated good knowledge of danger signs in pregnancy. For antenatal care, 117(43.8%), registered during the first trimester, and 219(82%) attended at least four antenatal visits while 168(62.9%) said they had eventful pregnancies. About three-fifths of the participants, 160(59.9%), were adequately prepared for birth and possible challenges although 119(44.6%) made arrangements for the baby's essentials and 201(75.3%) made adequate arrangements for transportation. Statistical analysis revealed significant associations between education level (p=0.01) as well as income (p=0.007) and BPCR. Additionally, gestational age at booking and attendance of skilled personnel during antenatal care (ANC) were significantly associated with knowledge of danger signs in pregnancy (p=0.017 and p=0.015, respectively). Conclusion: Despite meeting the BPCR indicators to some extent based on WHO standards, this study demonstrated existence of gaps in the knowledge and practice of BPCR among pregnant women. Furthermore, socio-economic factors, maternal knowledge, and health services were found to influence BPCR practices. It is therefore important to enhance awareness campaigns, improve pregnant women's understanding of benefits of BPCR, and encourage their partners to adopt shared decision-making options for obstetric services
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    The need for integration of cervical cancer screening into family planning services among women in Ibadan, Nigeria: A cross sectional study.
    (2024) Ndikom, C. M.; Saka, A. O.; Oluwasola, T. A. O.; Oluwatosin, O. A.; Young, A. M.; Barton-Burke, M.; Adedimeji, A.
    Cervical cancer screening (CCS) access has remained a major challenge in developing countries. Integration of CCS into family planning services (FPS) is one strategy that could increase access and uptake of CCS services (CCSS). There are limited data on the integration of CCS into FPS, in Ibadan; hence, this study assessed the need for integration of CCS into FPS in Ibadan, Nigeria. This cross-sectional study was conducted among 202 female family planning clinic attendees selected using purposive sampling technique. A structured interviewer-administered questionnaire was used for data collection. Quantitative data were analyzed using descriptive and inferential statistics at 0.05 level of statistical significance. Mean age of the women was 32.7±6.5 years, 74.3% had poor knowledge of cervical cancer 80.2% had positive perception of the integration of CCS into FPS, 7.4% had utilized CCS, 76.2% were willing to uptake CCSS. There was also a significant association between educational level and knowledge on CCS (p= 0.000); also with the perception of inclusion of CCS into FPS and willingness to utilize CCSS (p= 0.000). The need for integration was evident as the respondents had positive perception of integration of CCS into family planning services.
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    Knowledge and skills of basic emergency obstetrics care among healthcare providers in selected primary health care centres in Ibadan, Southwest Nigeria
    (2024) Famutimi, E. O.; Oluwasola, T. A. O.; Okanlawon, F. A.
    Introduction: Healthcare providers (HCPs) need to be adequately informed and experienced in Basic Emergency Obstetric Care (BEmOC) techniques to effectively manage obstetric and neonatal emergencies. This study evaluated the knowledge and skills of HCPs in selected Primary Health Centres (PHCs) in Ibadan Metropolis, Nigeria. Method: This was a cross-sectional study comprising 319 HCPs working in 6 Local Government Areas within the Ibadan metropolis. A structured, self-administered questionnaire was used to collect data on their knowledge and skills regarding BEmOC. Both self-reported as well as demon-strated knowledge and skills were considered while comparisons were made among various HCPs. The knowledge scores were categorized as good (≥85.0%) and poor (<85.0%), and Skills as good (≥ 75th percentile) and poor (<75th percentile). Statistical analysis was done using Statistical Package for Social Sciences (25.0) with a p-value set at <5%. Results: The mean age of participants was 47.0±6.5 years with more than four-fifths, 261(81.8%), being Community Health Workers. Of all the partici-pants, 228(71.5%), have been practicing for over 10 years while only about one-quarter, 83(26.1%), had ever been trained on BEmOC. Among those ever trained, 45(54.2%) had the training within the last five years. Overall, only 1.3% and 1.8% of the participants demonstrated good knowledge and skills of BEmOC respectively. Both self-reported and standard scores were statistically similar regarding knowledge (p=0.54) and skills (p=0.08). There was no statistically significant difference between the level of education and knowledge of BEmOC, (aOR=0.52; 95% CI 0.26-1.05), but those in practice for more than 10 years were less likely to have good knowledge (aOR=0.54; 95% CI 0.45- 0.65). Conclusion: There is an urgent need for periodic training and re-training of HCPs especially at PHCs to improve their knowledge and skills of BEmOC to make a positive impact on improving maternal and neonatal outcomes.
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    Maternal and pregnancy outcomes following PMTCT cohort registration in a displaced setting - A retrospective study.
    (2024) Ngwibete, A.; Oluwasola, T. A. O.; Popoola, V. O.
    BACKGROUND/AIM: This study assessed maternal and pregnancy outcomes following the Prevention of Mother-to-Child Transmission (PMTCT) cohort registration in a displaced setting. RESULTS: Of the 223 HIV-positive pregnant women, 201 were enrolled in the program. However, only 186 maternal records met the inclusion criteria. Registration for the PMTCT program occurred primarily during the prenatal period, between the ages of 26 and 30, with a mean gestational age of 15.2 weeks. Only 5.95 reported facility delivery, and up to 70% had over 4 PMTCT follow-up visits before delivery (χ2 = 6.825, P = 0.03). The retention rate among the cohort was 98.4%, with 62 % of the women being active throughout the program and over 86% having a live birth. Most miscarriages occurred during the first trimester. Bivariate analysis suggested that aside from maternal age, similar factors affected maternal and pregnancy outcomes. These factors include maternal prior PMTCT experience, total number of visits, and the place of delivery. CONCLUSIONS: Active follow-up and documentation constitute an effective strategy to improve PMTCT maternal retention in care and improve patient outcomes. Ensuring that women are active in PMTCT care by engaging community health workers in service delivery will create positive outcomes in the program.
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    Use of amniotic fluid lactate concentration in prediction of dysfunctional labour at the University College Hospital, Ibadan.
    (2023) Tsele, T. A.; Oluwasola, T. A. O.; Bello, F. A.; Yusuf, B. O.; Odukogbe, A. A.
    Introduction: Dysfunctional labour is a common indication for instrumental vaginal delivery or cesarean section. Raised myometrial lactate level following prolonged uterine activities has been shown to cause inhibition of contractions (poor or uncoordinated) and lack of progress or dysfunctional labour. Therefore, determining the amniotic fluid lactate concentration (AFLC) in labour may be a potential biochemical marker for labour dystocia and a good predictor of labour outcome. Methodology: We recruited booked, consenting parturients in active phase of labour into a cross-sectional study between September 2014 and March 2015. Amniotic fluid samples were taken twice – at initial vaginal examination or during artificial rupture of membranes and at delivery while the AFLC was determined using a primed lactate meter. Results: The main outcome measure was the mean AFLC. Of the 113 parturients with mean age of 30.49 ± 4.37 years, the overall mean AFLC was 18.94 ± 4.84 mmol/L while 10 (8.8%) had dysfunctional labour. Mean AFLC for parturients who had vaginal delivery was 18.76 ± 4.90mmol/L and 17.42 ± 5.26 mmol/L at first and second samplings while for those who had cesarean deliveries, mean AFLCs were 20.80 ± 2.75 and 18.24 ± 3.59 at the two samplings respectively. The cut–off for AFLC that best discriminated between normal and dysfunctional labour was 19.80 mmol/L. Conclusion: High levels of AFLC may play a role in predicting dysfunctional labour among pregnant women in labour.
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    Assessment of antenatal care satisfaction amongst postpartum women at the University College Hospital, Ibadan, Nigeria.
    (2023) Adedeji, O. A.; Oluwasola, T. A. O.; Adedeji, F. M.
    Background: Maternal mortality is unacceptably high especially in developing countries. About 287,000 women died during and following pregnancy and childbirth in 2020. The vast majority of these deaths (95 %) occurred in low and lower middle countries in 2020 and most could have been prevented. Every day in 2020, approxi-mately 800 women died from preventable causes related to pregnancy and childbirth. Utilization of antenatal visit has been shown to improve birth outcome as well as the maternal outcome during pregnancy-related events, giving a positive impact when the visit frequency and care are adequate while satisfaction has equally been an important outcome measures of quality of care. In order to improve feto-maternal outcome and turn the tide against maternal deaths, it is expedient to assess the satisfaction of women who had experienced antenatal care with the aim of identifying areas requiring additional attention. Objective: This study aimed to assess the level of antenatal care satisfaction of postpartum women and factors associated with satisfaction at the University College Hospital (UCH), Ibadan and their future intention for subsequent utilization of antenatal care. Methods: A descriptive cross-sectional study of 261 women in the postnatal ward using simple random sampling technique was conducted with an interviewer-administered structured questionnaire. Items in the questionnaire included sociodemographic and obstetric variables, assessment of quality of amenities, waiting time and level of satisfaction. Data was entered, cleaned and analyzed by computer using the Statistical Package for Social Sci-ences Version 23.0 (SPSS, IBM). The variables were summarized using frequencies, proportions, means and standard deviation. Chi Square was used for test of significance with the p-value set at P <0.05. Results: Of the 261 participants 176 (67.5 % percent) were aged 25–34 years; majority (244,93.5 %) had tertiary education while (189, 72.4 %) were skilled workers or professionals. Most of the women (243, 93.2 %) were Para 1–3 and the pregnancy was planned (80.8 %) while financing was mostly out of pocket (60.9 %). Only one-third of the participants has at least eight (8) antenatal contacts. In overall rating, most women (90.0 %) were satisfied with the antenatal care services received. The highest rating of satisfaction was with the competence of the service providers (90.4 %) especially with the care given to them and their unborn babies (90.4 %). The parity, distance of their home from antenatal clinic, number of antenatal contacts, number of health education sessions attended, total time spent, attitude of health workers, cost of services and desire to register again at the facility were statistically associated with patient’s satisfaction. Also, the number of antenatal visits was statistically associated with the fetal outcome. Conclusion: There is a high overall level of satisfaction with antenatal services among postpartum women in UCH. It is important to encourage women to register early to ensure they have adequate number of antenatal contacts and also participate in the health education sessions.
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    Exploration of the need for integration of cervical cancer Information into postnatal services at primary health care centers in Ibadan Nigeria.
    (2023) Ndikom, C. M.; Oluwatosin, O. A.; Salami, K. K.; Owolabi, G. O.; Oluwasola, T. A. O.; John-Akinola, Y. O.; Akpa, M. O.; Barton-Burke, M.; Ayegboyin, M.; Adedimeji, A.; Adebisi, T.; Young, A. M.
    Background: Cervical cancer (CC) is a preventable disease yet it is one of the leading causes of death, especially in low-income countries. In Nigeria, information on CC is yet to be part of routine health talk at Postnatal Clinics (PNC) at the Primary Health Care (PHC) level. The PNC would however have been a good avenue to reach women at risk of CC. This study explored health care workers (HCWs)’ willingness to integrate CCS services (CCSS), and women’s readiness to uptake the services at PHCs in Ibadan, Nigeria. Method: A qualitative study design was employed in this study. Data were collected through four sessions of Focus Group Discussions (FGDs) among the women attending PNC, and 20 Key Informant Interviews (KIIs) for health workers in PHC facilities. The Atlas.ti software, version 8 was used for the analysis. Thematic contents from the study were presented as quotes and streams of thoughts. Results: Information on CCS is currently excluded from the list of PNC activities such that most women have never heard of the need for CCS. They were interested in receiving CCS information and services. Women pleaded for the integration of CCS information in PHC clinic activities but preferably in a free or subsidized format in order to encourage utilization of the services. Challenges identified were mainly a shortage of manpower and a lack of training on CCS. Conclusion: Health workers were willing to integrate CCS services in PHC activities, however, recommended recruitment of more hands to ensure effective service delivery in line with National health policy on PHC in Nigeria.