Substance Use: Prevalence, Pattern and Risk Factors among Undergraduate Students in a Tertiary Institution in Southwest Nigeria

Background: Substance use is a global public health problem with increasing burden among university students. This study assessed the prevalence, pattern and risk factors of substance use among undergraduate students of Afe Babalola University, Ado-Ekiti, Nigeria.Methods: This was a cross-sectional study of undergraduate students of Afe Babalola University, Ado-Ekiti. A multi-stage sampling technique was used to select respondents. Data collection tool was a structured self-administered questionnaire. Data analysis was done using Statistical Package for the Social Sciences (SPSS) version 23. Statistical significance was set at p value <0.05Results: The respondents’ mean age was 19.5 ± 2.0 years and all 416 (100.0%) were aware of substance abuse. The prevalence of substance use was 299 (71.9%). Alcohol 133 (32.0%) and over-the-counter drugs (29.9%) were the two most commonly used substance. Being male (p=0.017) and in 400 level (p=0.047) were associated with substance use while curiosity 112 (37.5%), peer pressure 95 (31.8%) and school stress 85 (28.4%) were reasons given. Predictors of substance use were being a female (aOR: 2.54; 95% CI=1.89-3.66; p=0.011), civil servant mother (aOR: 5.75; 95% CI=1.90-17.4; p=0.002) and mother with secondary education (aOR: 5.27; 95% CI= 2.20- 12.65; p<0.001).Conclusion: There was high prevalence of substance use with curiosity, peer pressure and school stress being influencers of substance use among the study population. Predictors of substance use were being a female, civil servant mother and mother with secondary education. The University authority should institute measures to prevent access to alcohol and other substances by the students.

Exploring the views of Heads of Schools on School Health Services in Public Primary Schools in Enugu Metropolis, Nigeria: A Qualitative Study

Background: School health services offer a great opportunity for many children to access primary health care, especially in developing countries. This study assessed the status of health services in public primary schools in Enugu Metropolis, Enugu State, Nigeria from the perspectives of the school heads.Methods: This was a qualitative study conducted among 24 public primary school head masters/mistresses in the three Local Government Areas making up Enugu metropolis. They were purposively selected from the 117 public primary schools in the metropolis. Data were collected through the use of Key Informant Interview (KII) guide, and analyzed using thematic approach.Results: Only one of the participants knew about the school health policy, while others expressed surprise at its existence. All the schools had a first aid box, but most of the boxes were not sufficiently stocked. None of the schools had a trained first aider. De-worming was carried out once in a while in all the schools. Majority of the schools did not document health services provided. The schools rarely referred pupils to health facilities as needed, but rather informed parents if their children became ill while in school.Conclusion: The implementation of health services in public primary schools in Enugu Metropolis leaves much to be desired. Health services, including health appraisal were generally poor. Basic resources necessary for school health services were lacking in the schools. There is need for stakeholders to take urgent steps in order to redress the situation.

Perception and Determinants of Uptake of Preventive Health Services among the Staff of Obafemi Awolowo University, Ile-Ife, Osun State

Background: The rising burden of chronic non-communicable diseases in Nigeria makes the need for preventive health services (PHS) imperative. Thus, this study assessed the perception and determinants of uptake of preventive health services among the staff of Obafemi Awolowo University, Ile-Ife, Osun State.Methods: A cross-sectional analytical study was employed. Two hundred and ninety academic and non-academic staff of the university were enrolled in the study, using a stratified random sampling technique. The sample size was proportionally allocated to various subunits in the institution. Data were collected using a self-administered questionnaire. Determinants of uptake of PHS were assessed using binary logistic regression. A p-value of < 0.05 was considered to be statistically significant.Results: The majority of the respondents, 280 (96.6%) had good perceptions of PHS, and 176 (60.7%) reported barriers in access to PHS. Although a majority of the respondents, 268 (92.4%) had positive attitudes towards PHS, most of the respondents 196 (67.6%) had poor uptake. Common barriers to uptake of PHS were availability and affordability of the services, time constraints, and interference with other activities. Being an academic staff (p = 0.001) and presence of chronic illness (p = 0.043) were significant determinants of PHS uptake.Conclusion: Uptake of PHS was poor among majority of the respondents despite their good perception of the services. This may be linked to the perceived barriers to access. Thus, there is a need for policy formulation and provision of an enabling environment by the University’s authority for ease of access to PHS.

Determinants of Willingness to Pay for COVID-19 Vaccines among Residents of Osun State, South-West Nigeria

Background: COVID-19 pandemic has affected virtually all spheres of society. As countries await the COVID-19 vaccine, it is imperative to plan for its financing to ensure high vaccine coverage. This study aimed to determine the willingness to pay for COVID-19 vaccine among adult residents of Osun State.Methods: A cross-sectional analytical study design was employed. Seven hundred and forty-four respondents were enrolled from three selected Local Government Areas using multistage sampling method. An interviewer-administered questionnaire in electronic format (Kobo Collect) was used for data collection while the data was analysed using SPSS version 25. Determinants of willingness to pay for COVID-19 vaccine were assessed using binary logistic regression. A p-value of < 0.05 was considered statistically significant.Results: About one-quarter, 181 (24.3%) were willing to pay for COVID-19 vaccine. The median amount respondents were willing to pay was ₦650 (IQR= ₦1563) [$1.71 (IQR = $3.96)]. Being a healthcare worker (Odds ratio = 2.0, 95% CI =1.085–3.712, p=0.026), perception of susceptibility (Odds ratio = 1.9, 95%CI = 1.232-2.973, p=0.029) and self-efficacy (Odds ratio = 2.5, 95% CI = 1.571 – 4.071, p<0.001) were significant positive determinants of willingness to pay for COVID-19 vaccine. Misconceptions or perceived barriers were not significant determinants of willingness to pay for the vaccine.Conclusion: These findings indicate that there is a need for health promotion interventions to correct misconceptions about COVID-19. Government and private donor interventions may be required to subsidize the vaccine to ensure high vaccine coverage.

Assessment of Household Management Practices of Drinking Water in Two Selected Rural Communities of Plateau State

Background: Understanding how drinking water is managed in rural households that lack access to improved water sources is necessary for designing effective strategies that can meet their drinking water requirements. This study aimed to assess the drinking water management practices of rural households in two selected communities of Plateau State.Methods: A descriptive cross-sectional study was carried out in Plateau State among 202 female caregivers of under-five children residing in households of two rural communities who were selected using a multistage sampling technique. An interviewer-administered questionnaire and an observational checklist were used to obtain information on water sources, collection, storage and treatment practices. Data were analyzed using SPSS 23.0. Bivariate analysis was done to identify factors associated with household water treatment practice followed by logistic regression to determine predictors. Level of significance was set at p<0.05.Results: Mean age of respondents was 32.5±12.3 years. Nearly half (48%) of the households obtained drinking water from unimproved sources and 18.3% treated water at home which were mainly inappropriate methods. About 75% always stored drinking water separately from other uses while 64% stored water for over 3days. Only 51% were observed to store water in clean containers. Independent predictors of household water treatment were perception of drinking water safety (AOR=4.6; 95%CI: 2.1–10.3) and encouragement to treat water within the community (AOR=16.7; 95%CI: 2.1 – 28.5).Conclusion: There is a need to educate and encourage the rural populace on appropriate water management methods while efforts are being made to increase access to improved sources.

Knowledge, Attitude and Willingness to Screen Younger Infants for Sickle Cell Disease among Mothers attending Immunization Clinic in an Urban Community in Lagos, Nigeria

Background: Over 300,000 babies are born worldwide with sickle cell disease, mostly in low- and middle-income countries with the majority of these births in Africa. Nigeria has the largest population of people with sickle cell disease with about 150,000 children born with the disease every year. This study assessed the knowledge, attitude and willingness to screen younger infants for sickle cell disease among mothers attending immunization clinic in an urban community in Lagos, Nigeria.Methods: A cross-sectional descriptive study was carried out at primary health care centres in Somolu Local Government Area in Lagos, Nigeria. Two hundred and ninety-one mother-infant pairs were consecutively recruited from August 2019 to January 2020. Data were collected with a pre-tested, interviewer-administered questionnaire. The analysis was done using SPSS version 22 software. Univariate and bivariate analysis were conducted with the level of significance set at p<0.05.Results: The mean age of respondents was 29.9 ± 5.4 years. Most 212 (72.9%) were aware of sickle cell disease. One hundred and fifty-one (71.2%) of those who were aware of sickle cell disease had good knowledge while 148 (69.8%) had a positive attitude towards SCD prevention. Majority of the respondents 180 (84.9%) were willing to screen their infants for sickle cell disease. A statistically significant association was found between good knowledge and positive attitude towards SCD (p<0.001).Conclusion: There is the need for increased education of mothers of younger infants attending routine immunization clinic about SCD for better knowledge, attitude and willingness for early infants screening of SCD.

Assessment of Infection Prevention and Control Implementation in Primary and Secondary Health Care Facilities in Rivers State

Background: Controlling infections in healthcare facilities is necessary for reducing infection transmission. There is limited data on the status of Infection Prevention and Control (IPC) programme in healthcare facilities in Rivers State. An assessment of IPC implementation in health facilities in Rivers State was therefore conducted.Methods: In this cross-sectional study, stratified sampling technique was applied to select 99 healthcare facilities. Health personnel in-charge of selected facilities were interviewed using the validated Infection Prevention and Control Assessment Framework (IPCAF) tool. It was modified to focus on four out of eight core components areas and graded using the World Health Organization IPCAF guidelines.Results: Twenty (20.2%) facilities had IPC programmes with clearly defined objectives and activity plans. A copy of the IPC guidelines was available in 56 (56.6%) facilities, however, only 13 (13.1%) monitored implementation of the guidelines. Forty (40.4%) facilities had healthcare workers that were trained based on updated IPC guidelines. Supply of personal protective equipment was adequate in 29 (29.3%) facilities and a mixed method of healthcare waste disposal was practiced in 46 (46.4%) facilities. Overall, 56 (56.6%) of the facilities had scores within the basic IPC level of practice while 43 (43.4%) had scores within the intermediate level of IPC practice.Conclusion: Findings from this study indicate that IPC committees should be set up in all healthcare facilities with the obligation of updating IPC guidelines, training healthcare personnel, and implementing IPC activities in respective healthcare facilities.

Male Involvement in Family Planning: A Qualitative Survey of the Barriers and Facilitators amongst Married Men in Sokoto metropolis

Background: Although large families are desired in Nigeria, women tend to want fewer children than men but are often unable to limit or space childbirth due to gender dynamics within relationships. Studies have identified men as a significant barrier to the use of contraceptives by their wives. The study explored married men’s knowledge and perception on family planning (FP), involvement in FP, barriers and facilitators of male involvement (MI) in FP in Sokoto Metropolis.Methods: A qualitative study was done among married men in Sokoto Metropolis in November 2017. Four focus group discussions were conducted among thirty-two men grouped based on educational status and age. Data was transcribed verbatim and a content analysis on emerging themes was done.Results: All the participants were aware of FP and most of them said that it is beneficial to everyone in the community. Most of the participants perceived that FP is an issue for both men and women. All the participants said that men should be involved in FP. The barriers to MI in FP mentioned were lack of knowledge on FP and poverty while increasing awareness on FP, religious leaders and traditional rulers championing FP, and making FP free were the facilitators suggested.Conclusion: The participants said that FP is beneficial to everyone in the community and men should be involved in FP. Traditional and religious leaders should be made the champions of FP in their various communities to improve acceptance and utilisation.

Knowledge and Attitude of Men towards Factors influencing Childhood Mortality in a Semi-Urban Community in Northwestern Nigeria

Background: In spite of concerted global efforts to reduce childhood mortality, countries in Sub-Saharan Africa are still being plagued with incomparably high mortality rates; thereby contributing majorly to the global burden. These deaths occur from causes which are preventable. Men play a pivotal role in sustained efforts to reduce childhood mortality, however, they are usually overlooked in favour of the mothers. The study aimed to assess the knowledge and attitude of men towards factors influencing childhood mortality in a semi-urban community, North-Western Nigeria.Methods: A descriptive cross-sectional study was conducted using structured interviewer-administered questionnaire. A total of 174 married men were sampled using a multistage sampling technique. Data collected were analysed using the IBM SPSS version 21. Results were presented in tables and bar charts. The level of statistical significance was set at p<0.05.Results: The mean age (±SD) of the respondents was 38 (±11.2) years. One hundred and ten (64.7%) of the respondents had lost a child under the age of five years. Majority 142 (83.5%) of the respondents had poor knowledge of risk factors influencing childhood mortality and 141 (82.9%) of the respondents had a positive attitude towards prevention of childhood mortality.Conclusion: The study has highlighted the need for increased male involvement in child health issues. Interventions such as health education and community mobilization that aims to educate men on risk factors and danger signs associated with poor childhood health outcomes should be carried out in this area.

Knowledge of Malaria and Utilization of Insecticide-Treated Nets amongst Mothers of Under-five Children in selected Rural Communities of Nigeria’s Federal Capital Territory

Background: Malaria is a life-threatening parasitic disease caused by the plasmodium parasite and women and under-five children are more prone to its adverse consequences. The use of insecticide-treated nets (ITNs) is recommended to reduce malaria burden in endemic communities. The study aimed to determine knowledge of malaria and utilization of insecticide-treated nets (ITNs) amongst mothers of under-five children in rural communities of Nigeria’s Federal Capital Territory, and the predictors.Methods: A community-based cross-sectional design was used. Multi-stage sampling method was used to select 160 mothers of under-five children in two rural communities. A structured questionnaire was used for data collection. Data analysis was done using SPSS statistical software version 22.0 and level of statistical significance was determined by a p value of < 0.05.Results: Mean age of respondents was 29.0±5.4 years, and majority 144 (90%) of the women were married. Lower proportion of respondents had good knowledge of malaria 33 (20.6%). Ninety-four (58.8%) of respondents owned ITNs, but less than half 45 (47.9%) utilized the nets. Predictors of good knowledge of malaria were having attained tertiary education [Adjusted Odds Ratio (AOR); 2.7, 95% Confidence Interval (CI):1.1–8.1], p=0.042, and being self-employed, (AOR; 3.4, 95% CI: 1.1-13.1), p=0.043). Predictor of utilization of ITNs was being aged 30 years and above (AOR; 2.5, 95% CI: 1.1-6.1, p=0.031).Conclusion: Lower proportions of respondents had good knowledge of malaria and utilization of ITNs. Health education of mothers on malaria and benefits of ITNs use should be intensified in the study area.