Health Promotion & Education
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Item ` Knowledge and perceptions of marital rape among women in Oyo State, Nigeria.(Ibadan Biomedical Communications Group, 2020) Ogunwale, A. O.; Dipeolu, I. O.; Olaitan, O. L.Marital rape is a serious public health problem affecting many women worldwide. In Nigeria, there is dearth of evidence-based information on issues relating to knowledge and perceptions of marital rape among women. This study was therefore designed to assess the knowledge and perceptions about marital rape among married women in Oyo State, Nigeria. The cross-sectional survey was conducted among 1200 women aged 18-60 years who were ever-married. Participants were recruited using a multi-stage random sampling technique. A validated semi-structured questionnaire which contained a-8 point knowledge of health consequences of marital rape and a-20 point marital rape perception scales was used for data collection. Data were analyzed using descriptive statistics and Chi-square test. Respondents’ mean age was 36.6 ± 9.6 years, while their husbands’ mean age was 42.1 ± 10.3 years. Mean knowledge score was 3.9±2.2 and 23.4% had poor knowledge of marital rape. Respondents who had poor knowledge who were aged ≤24 years, 25–49 years and ≥50 years were 31.6%, 25.3% and 9.6%, respectively (P≤0.05). Mean perception score was 8.9 ± 3.6, and 69.8% had supportive perceptions relating to marital rape. A higher proportion of respondents with marriage duration of >20 years (84.6%) had marital rape supportive perception compared with those with marriage duration of 0-10 years (64.9%) (P≤0.05). Knowledge of marital rape remains inadequate, especially among younger women. Furthermore, many women had supportive perceptions for marital rape, a situation which can adversely hinder adopting appropriate preventive behaviours. Multiple community-based health educational interventions have potentials for addressing the phenomenon.Item Experience of dysmenorrhoea and self-care strategies among female students in a tertiary institution, Ibadan, Nigeria.(Academic Journals, 2019) Adeoye, T. E.; Arulogun, O. S.,; Dipeolu, I. O.,; Jidda, K. ABackground: The objective of the study was to investigate dysmenorrhoea experiences and self-care among female undergraduate students in two halls of residence at The Polytechnic, Ibadan, South West, Nigeria. Methodology: A descriptive cross-sectional survey was used, and 354 consenting female students aged 16-29 years who were residents in the halls participated in the study. A self-administered, semi-structured questionnaire was used for data collection. Knowledge was assessed on an 11-point scale, scores of 0-5 and 6-11 were categorised poor and good, respectively while perception was measured on a 13-point scale, scores of 0-6 and 7-13 were also categorised negative and positive, respectively. Data were word-processed using IBM SPSS software and analysed. Results presented in descriptive and inferential statistics at p<0.05. Results: Respondents’ age was 20.4 ± 2.4 years. Only 22.0% correctly stated the two types of dysmenorrhoea. Some (16.9%) correctly recognised family history, the age of menarche (8.5%), and excessive sugar intake (87.6%) as factors predisposing someone to dysmenorrhoea. Most respondents, 67.2%, believed dysmenorrhoea is normal. Nature of pain experienced by the respondents varied from mild (10.2%), moderate (44.4%) and severe (30.2%) with the majority (91.2%) experiencing pain in the lower abdomen. Most respondents (96.6%) had poor knowledge of dysmenorrhoea, the mean knowledge score was 1.5 ± 1.3. The reported effects of dysmenorrhea include a strained relationship with friends (50.3%), missing school (50.6%), mood swing (59.0%) and lack of concentration in class (61.6%). Use of medication (35.1%) and physical exercise (21.2%) was reported ways of preventing dysmenorrhoea. The majority, (87%) used drugs which are often associated with side effects. Conclusion: Majority of the respondents had poor knowledge about the types and major cause of dysmenorrhoea. Varied measures were taken in the management of the health condition. Health education interventions such awareness, sensitisation and use of appropriate behaviour change communication strategy aimed at addressing these gaps is of importItem Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000–17(Elsevier Ltd., 2020) Wiens, K. E.; Hay, S. I.; Reiner Jr, R. C.; Dipeolu, I. O . . . et alBackground Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000–17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2•5th and 97•5th percentiles of those 250 draws. Findings While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62•6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000–7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, withincountry geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910–68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers’ understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage.Item Outcome of reminder text messages intervention on completion of routine immunisation in rural areas, Nigeria.(Oxford University Press, 2020) Oladepo, O.; Dipeolu, I. O; Oladunni, O.Completion of routine immunization for infants has been a challenge in Nigeria, and existing strategies implemented to promote immunization coverage yielded limited success. The use of reminder short services message (SMS) in mobilizing mothers of infants, especially in rural areas with lower immunization coverage has been suggested. This study investigated the effect of reminder SMS sent to mothers in rural communities on full and timely completion of routine childhood immunization. A quasi-experimental design was adopted, 3500 mothers of infants were categorized into the Intervention and Control groups recruited at various Primary Healthcare Centres in 6 states and the FCT, Nigeria. Reminder SMS were sent to mothers in the intervention group for 10 months. We adopted mixed methods of data collection, significance level set at p¼0.05. Majority of respondents were married (Control 94.3%; Intervention 95.5%), have experienced multiple births (Control 79.0%; Intervention 74.9%). Adherence to routine immunization appointment dates and completion of all immunizations was higher in the Intervention group (76.0%) compared with the Control (73.3%). A significant association between adherence to appointment dates and completeness of routine immunization vaccine was found. The Intervention group had a significantly higher completion rate for measles and yellow fever vaccines (55.3%; 75.9%) compared with the Control group (26.8%; 23.9%). Qualitative findings revealed positive comments from mothers in the intervention group that the messages increase awareness of immunization dates, assisted in readjusting their time which influenced timely completion. Interventions using reminder SMS enhanced infant immunization delivery; we recommend scale-up and integration into the health system to increase national immunization coverage.Item Ethical issues in the COVID-19 pandemic control preparedness in a developing economy(AFENET, 2020) Jegede, A.; Ajayi, I.; Akintola, S.; Falade, C.; Dipeolu, I. O.; Cadmus, S.; Ajala, A.; Olaifa, A.; Olatoye, O.; Akinyemi, O.Adequate preparation for highly pathogenic infectious disease pandemic can reduce the incidence, prevalence and burden of diseases like COVID-19 pandemic. An antidote to the spread of the disease is adequate preparation for its control since there is no proven curative measure yet. Effective management of identified cases, social distancing, contact tracing and provision of basic infrastructure to facilitate compliance with preventive measures, testing are proven management strategies. Although these measures seem to be the best options presently, it is important to pay attention to ethical issues arising from the implementation process to ensure best practice. While disease epidemic is not alien to human societies, lessons from previous outbreaks are vital for addressing future outbreaks. For effective control of this pandemic, there should be a clear definition of social distancing in terms of distance and space in line with the WHO definition, adequate provision of basic amenities, screening and testing with specific criteria for selecting those to be screened. Also, there should be a free testing procedure, access to treatment opportunities for those who test positive, ethical free contact tracing practice, respect for the autonomy of those to be tested, and global best practice of open science, open data and data sharing practices. In conclusion, a framework/guideline for epidemic/pandemic ethics guidance should be developed while an ethical sensitive communication manual should be prepared for public engagement on epidemic and pandemic.Item Knowledge, perception and child care practices among adolescent mothers in Ibadan Metropolis, Nigeria.(Publishing Office of the University of Rzeszów , Poland, 2020) Oyewole, O. E.; Todowede, C. M.; Dipeolu, I. O.Introduction. There is little information regarding childcare practices among adolescent mothers in the study areas. Aim. This study was aimed at investigating knowledge, perception and childcare practices among adolescent mothers. Material and methods. A descriptive cross-sectional survey was conducted on randomly select 382 adolescent mothers. A validated semi-structured questionnaire was used to collect data, which were analysed using, descriptive and multivariate analyses with p-value set at 0.05. Age of respondents was 18.5±0.7 years. Results. Majority (80.6%) had poor knowledge of when to start ante-natal care. Also, 70.0% of the respondents could not perceive growth monitoring as a necessary strategy for child survival and 86.4% perceived diarrhoea as normal for children during the teething period. Many (58.4%) did not practise exclusive breastfeeding. Respondents with secondary education were less likely to have poor knowledge than those with primary education (OR: 0.2, CI: 0.6-0.9, 95%). Respondents, who received supervision from older women during childcare, were less likely to have poor childcare practice than those who did not (OR: 0.2, CI: 0.4-0.7, 95%). Conclusion. Respondents had poor knowledge of childcare practices when childcare survival strategies were used as the yardstick for evaluation. Involvement of older women is suggested to assist adolescent mothers improve their knowledge and practices of childcare.Item Assessment of design and challenges in the implementation of state supported health insurance scheme in a South West State, Nigeria.(College of Medicine, University of Ibadan, 2019) Adewole, D. A.; Dipeolu, I. O.Background: Poor health indices in most low and middle-income countries are due to inadequate access to available health care. In Nigeria, the National Health Insurance Scheme (NHIS) devolved to State Supported Health Insurance Programme (SSHIP), a new approach aimed at improving access to health care and achieving Universal Health Coverage (UHC). Currently, not much is known about the design of SSHIP, anticipated challenges associated with its implementation, and plans to mitigate and appropriately address them. To elicit useful information about these (anticipated) challenges, the study was carried out among stakeholders who were directly involved in the design of the scheme in Oyo State, Nigeria. Findings will help to identify likely gaps needed to be addressed at the early stage of the scheme. This will contribute to efforts in implementing a sustainable health insurance scheme in the state. Methods: This is a descriptive cross-sectional study. To allow the researchers achieve the study objectives, a purposive sampling technique was employed in selecting all the 12-man Steering Committee members in the State Health Insurance Scheme for interviews. A validated In-Depth Interview (IDI) guide was used to collect qualitative data from the target population. Transcripts from the data were analysed using the thematic approach with the aid of ATLAS Ti software package version 7. Ethical approval was obtained from the Oyo State Ministry of Health Research Ethics Committee, Ibadan Nigeria. Consent was also sought and obtained from individual study participants. Results: The concept and design of the SSHIP are fundamentally the same as any other social health insurance scheme like the NHIS, however, certain differences exist. In Oyo State, the SSHIP is made compulsory, it is supported by the organised trade unions, and policies (and benefits packages) are stratified based on the financial ability of individuals to subscribe to different premium platforms. Certain features of the scheme such as enrolment, premium determination and collection methods, and the absence of government funding support are likely areas of challenges that may militate against its sustainability. Stakeholders need to address these appropriately. Likewise, awareness and understanding the basic design of the scheme among potential beneficiaries will go a long way in the efforts to implement and sustain a successful scheme. Conclusions: Findings in this study are suggestive that the State SSHIP enjoys good support from stakeholders in Oyo State. However, identified likely areas in the design of the scheme that could become. a challenge to the scheme need to be appropriately addressed to ensure its successful implementation and sustainability. We accept as a limitation to more robust information the inability to interview certain key stakeholders such as the State Chairman of the Nigerian Labour Congress and some of the potential beneficiaries of the scheme.Item Nigerian rural mothers’ knowledge of routine childhood immunisations and attitudes about use of reminder text messages for promoting timely completion.(Palgrave Macmillan, 2019) Oladepo, O.; Dipeolu, I. O.; Oladunni, O.Mothers’ poor knowledge and attitudes about routine immunization impede childhood immunization completion. This study assessed mothers’ knowledge in rural communities about routine immunization and acceptability of mobile phone reminder text messages as an intervention for improving uptake and timely completion of routine immunization. The study adopted a descriptive cross-sectional design among 3440 consenting mothers of infants in six randomly selected Nigerian states and in the Federal Capital Territory (FCT). We used a Focus Group Discussion guide and validated questionnaire to collect data; we analysed data using a thematic approach and descriptive statistics. Respondents’ ages were 26.7 ± 5.5 years. Knowledge of routine immunization was poor; attitudinal disposition was positive. Most (90.5%) indicated willingness to accept reminder text messages for routine immunization and 91.5% opined that mobile phones can be effective in providing such information. Mothers’ willingness to accept the use of SMS reminder text messages for promoting routine immunization completion requires well-designed and culture sensitive persuasive messages.Item Involvement of pastors’ wives in educating nursing mothers on childcare practices in Ibadan North Local Government Area, Nigeria.(College of Medicine, University of Ibadan, 2019) Oyewole, O. E.; Akpamu, U.; Dipeolu, I. O.Poor childcare practices among nursing mothers have been implicated as one of the factors influencing high child morbidity and mortality in many developing countries including Nigeria. Many health promotion and education approaches have been used in previous studies to improve childcare practices but very few have considered the inherent potentials of using faith-based strategy as one of the acceptable means of health promotion in many developing countries. This descriptive cross-sectional study was aimed at investigating the involvement of Pastors’ wives as change agents in educating nursing mothers on childcare practices in Ibadan North Local Government Area. Multi-stage sampling technique was used to select pastors’ wives from all the registered churches in the Local Government Area. A pre-tested interviewer-administered questionnaire was used for data collection. Data were analysed using descriptive and inferential statistics. One hundred and twenty-eight (N=128) pastors’ wives with age of 46.1±9.3 years were interviewed. Overall, 9.4% had never taught or preached on childcare practices or other health-related matters to mothers/women in the church before. Analysis showed that 42.2%, 26.6% and 31.3% of Pastor’s wives had good, fair and poor level of basic communication techniques, respectively. Age and educational status of Pastors’ wives significantly affect the level of communication between Pastors’ wives and mothers in the church (p<0.05). Involvement of Pastors’ wives with the mothers on childcare practices was through counselling (90.6%), teaching (53.1%), preaching (29.7%) and phone calls (18.8%). Counselling was the most preferred method (68.0%) of communication. This study establishes the fact that Pastors’ wives and nursing mothers have been communicating health matters through counselling, which can be used as an opportunity for improving child care through faith-based setting.Item Attitude and Willingness of Infertile Persons Towards the uptake of Assisted Reproductive Technology in Ibadan, Nigeria.(Annals of Ibadan Postgraduate Medicine, 2019) Akande, S. O.; Dipeolu, I. O.; Ajuwon, A. JIntroduction: In most developing countries the joy of every married man and woman is to procreate and raise children of their own. However, this desire does not always find fulfilment among some couples because of primary or secondary infertility. The majority who experience this condition live in developing countries where fertility services including Assisted Reproductive Technologies (ARTs) are not always available. This study, therefore, investigated the attitude and willingness of infertile persons to uptake ARTs. Methods: The study was a descriptive cross-sectional survey; a three-stage multi-stage sampling technique was adopted to select 202 married persons receiving fertility services at a gynaecological clinic in Ibadan, Nigeria. A validated interviewer-administered semi-structured questionnaire was used for data collection. Data were analysed using SPSS with descriptive and inferential statistics with the level of the significant set at <0.05. Results: Respondents’ age was 34.3 years (SD ± 6.5); 88.6% were female; 55.5% had tertiary education; 54.5% reported a history of primary infertility. The negative attitude towards ARTs was observed among many of the respondents; however, some were willing to use ART services. In vitro fertilization (IVF) was the most preferred method; only 15.0% were optimistic of non-complications. The cost was the most mentioned barrier to use of ART. Positive association existed between attitude and willingness to use ART. Females are three times more likely than males to have a positive attitude toward the uptake of ART. Conclusion: Public enlightenment and advocacy are recommended to influence negative attitude towards ARTs.