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BACKGROUND: The financial and educational status of individuals living with sickle-cell anaemia contributes to their general well-being. It is widely known that education is closely linked with positive health-seeking behaviors i.e., the more educated a person is, the better the person is likely to seek medical attention when needed, and take care of themselves before the crisis. It is considered that a relatively well-educated person with a means of livelihood would purchase the required drugs for prophylactic use. In most African countries where poverty is acute, it becomes a problem when the resource for education and finance needed for the treatment is not available. This study assessed the socioeconomic parameters (financial and educational status) of individuals living with the disorder within the Ibadan metropolis, southwest Nigeria. METHODS: This study is a descriptive cross-sectional study using quantitative methods that assessed individuals' financial and educational status with sickle cell anaemia. Respondents were recruited from federal and state hospitals, non-governmental foundations, worship centers, and schools. The individuals' educational and financial statuses were accessed using standardized data collection and assessment tools, while the data were analyzed using SPSS (v22). Presentation of inferential statistics was done at a 5% level of significance. RESULTS: The study recruited 253 participants, of which more than half (58.1%) were females. Those between 12-28 years were 64.4%, and the mean age was approximately 27.7±10.3 years. Also, 67.2% had tertiary education, 74.7% were neither engaged nor married at the time of this study, 88.5% were Yoruba, 73.5% of the participants were from a monogamous family, and 73.1% were Christians. A significant directly proportional association was found between financial status, educational status, and general well-being. CONCLUSION: Sociodemographic, as well as educational factors, contributed to the general well-being of the individual participants. Thus, finance, level of exposure, and the environment were found to contribute significantly to well-being. More than half of the participants had tertiary education or are currently in school compared to those without tertiary education. There is an association between those with tertiary education and the number of hospital visits in the selected participants. While no association exists between those with buoyant financial status compared to those without a stable source of income.

CONTEXTE: La situation financière et le niveau d'instruction des personnes vivant avec la drépanocytose contribue à leur bien-être général. Il est largement connu que l'éducation est étroitement liée à des comportements positifs de recherche de santé, c'est-à-dire que plus une personne est éduquée, plus elle est susceptible de rechercher des soins médicaux en cas de besoin et de prendre soin d'elle-même avant la crise. On considère qu'une personne relativementinstruite et disposant de moyens de subsistance achèterait les médicaments nécessaires à des fins prophylactiques. Dans la plupart des pays africains où la pauvreté est aiguë, cela devient un problème lorsque les ressources pour l'éducation et les moyens financiers nécessaires au traitement ne sont pas disponibles. Cette étude a évalué les paramètres socio-économiques (situation financière et d'éducation) des personnes vivant avec la maladie dans la métropole d'Ibadan, au sud-ouest du Nigeria. MÉTHODES: Il s'agit d'une étude transversale descriptive utilisant des méthodes quantitatives qui ont permis d'évaluer la situation financière et éducative des personnes atteintes de drépanocytose. Les personnes interrogées ont été recrutés dans des hôpitaux fédéraux et d'État, des fondations non gouvernementales, des centres de culte et des écoles. La situation éducative et financière des individus a été vérifiée à l'aide d'une collecte de données qui est standardisée et des outils d'evaluation tandis que les données ont été analysées à l'aide de SPSS (v22). Les statistiques inférentielles ont été présentées à un niveau de signification de 5%. RÉSULTATS: L'étude a recruté 253 participants, dont plus de la moitié (58,1 %) étaient des femmes. Les participants âgés de 12 à 28 ans représentaient 64,4 % et l'âge moyen était d'environ 27,7±10,3 ans. En outre, 67,2 % des participants avaient fait des études supérieures, 74,7 % n'étaient ni fiancés ni mariés au moment de l'étude, 88,5 % étaient Yoruba, 73,5 % des participants étaient issus d'une famille monogame et 73,1 % étaient chrétiens. Une association significative directement proportionnelle a été trouvée entre la situation financière, le niveau d'éducation et le bien-être général. CONCLUSION: Les facteurs sociodémographiques et éducatifs, ont contribué au bien-être général des participants. Ainsi, les finances, le niveau d'exposition et l'environnement ont contribué de manière significative au bien-être. Plus de la moitié des participants ont fait des études supérieures ou sont actuellement scolarisés par rapport à ceux qui ne sont pas scolarisés. Il existe un lien entre les participants de l'enseignement supérieur et le nombre de visites à l'hôpital chez les participants sélectionnés. Bien qu'il n'y ait pas d'association entre les personnes ayant une financière par rapport à ceux qui n'ont pas de source de revenus stable. Mots-clés: Anémie drépanocytaire, Éducation, Situation financière, Visites à l'Hôpital, Bilans de santé, Bien-Être.

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Early initiation of breastfeeding (EIBF) is an essential first step in exclusive breastfeeding that is expected to commence within an hour after childbirth. This study examined the prevalence and the factors associated with EIBF among nursing mothers in Nigeria based on an analysis of the 2003, 2008, 2013, and 2018 Nigerian Demographic Health Survey (NDHS) data. The prevalence of early breastfeeding initiation by women's demographic, socio-economic and reproductive characteristics were computed for each of the survey rounds. The differences in the prevalence estimates for early breastfeeding initiation between the last two survey periods were calculated. A crude and adjusted model to examine association between explanatory variables and early breastfeeding initiation were fitted using Poisson regression model. The mean age of respondents was 29 years (SD=7.3). The prevalence of EIBF increased from 31.5% in 2003 (95% CI 28.4-34.5) to 43.8% in 2018 (95% CI 42.6-45.0), with a decline to 35.3% in 2013 (95% CI 34.0-36.7). The identified risk factors associated with EIBF were being 35-39 years, having at least a primary education, lower wealth quintiles, multiparity, and delivery in a public hospital. EIBF was lower among women that had skilled occupation, access to media, decided to delay pregnancy, history of previous caesarean section, small size baby at birth, and women who received antenatal care. The results indicate that the proportion of women with EIBF in Nigeria is low. Addressing the barriers identified in this paper will help promote EIBF practices in the country.

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Globally, malnutrition among under-five children remains a public health concern. There is increasing concern at research and policy levels about anthropometric failure and the double burden of child malnutrition across different groups of children. The objective of this study was to describe the magnitude and distribution of various forms of anthropometric failure (AF) among children under age five in Nigeria. We used the 2018 National Nutrition and Health Survey data collected among 19,471 under-five children in Nigeria. The most prevalent AF was stunting only (17.7%) followed by stunting and underweight (13.9%). Wasting, stunting and underweight was found among 3.5% of the sample. Wasting, stunting and underweight was most common in age 6-11 months (7.0%) and 12-23 months (6.9%). Overall, about 1 out of 5 under-five children has multiple anthropometric failure. The peak age group for multiple AFs was between six months and 35 months. Multiple AF was less likely among females compared to males (RR=0.74, CI: 0.69, 0.80). The risk of multiple AF was higher in both North East (RR=2.15, CI: 1.78, 2.59) and North West (RR=2.98, CI: 2.51, 3.55) relative to the North Central. In contrast, the risk was lesser in the South East (RR=0.75, CI: 0.59, 0.95) and other southern regions. The study showed that multiple anthropometric failure is a common problem among children in Nigeria. Programmes that will support prevention and early identification of different types of malnutrition among under-five children across States in Nigeria are recommended.

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Clinical competence of primary healthcare (PHC) workers is important in the delivery of maternal and child health care and services. In this cross-sectional study, we investigated the diagnostic accuracy and adherence to clinical guidelines for the management of some clinical conditions such as malaria, diarrhea, pneumonia, neonatal asphyxia and postpartum hemorrhage, as a proxy to measure the clinical competence of frontline health workers in PHCs in selected states in Nigeria. Ninety PHC facilities were randomly selected in each State and the FCT. Of the 3330 health workers, only 36.0% were able to correctly diagnose the five selected medical conditions. There was a significant difference in the diagnostic accuracy of the health workers with the doctors having highest diagnostic accuracy (65.5%) compared to other health workers (p <0.001). Adherence to the management guidelines was generally poor across all cadres of health workers and this pattern appear similar across the geopolitical regions in the country. The highest adherence to guidelines was observed among medical doctors (38.2%). The diagnostic accuracy and adherence to national guidelines for managing patients was poor among health workers, particularly, among other cadres except doctors. PHC workers in Nigeria need continuous training to enhance their clinical competence to improve quality of maternal and child health care.

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Despite the availability of healthcare centres for the provision of antenatal care (ANC) services in Nigeria, the services are still underutilized by pregnant women. ANC services not only reduce maternal mortality and birth defects, but also have a strong link to many causes of maternal deaths. This study explored the individual and ecological relationships between antenatal care, skilled birth assistance during delivery, and family planning use across states in Nigeria. This study was a secondary analysis of data from the 2018 National Nutrition and Health Survey (NNHS) carried out among 24,985 women aged 15-49 years in the 36 states and the Federal Capital Territory (FCT) in Nigeria. Analysis was carried out at the level of individual women and at the ecological level. Only 68.3% visited a health professional (doctors, nurses, midwives, community health extension workers, and community health officers) for ANC in the most recent pregnancy before the survey. At delivery, 44.9% were assisted by delivery attendants with about half (50.1%) assisted by non-professional (traditional birth attendants, relatives and friends) during delivery. There was a significant variation in use of modern family planning (FP) across types of ANC provider. There was a strong positive correlation between ANC utilisation and skilled birth attendance (SBA) (r=0.706, p <0.001), and between SBA and FP (r=0.730, p <0.001). These results have implications for the design of appropriate interventions for strengthening the role of healthcare providers to enhance ANC patronage, utilization of safe delivery services and sustained use of reproductive health services.

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Coronavirus Disease (COVID-19) is the largest outbreak of severe acute respiratory syndrome (SARS). It was declared a pandemic by the World Health Organization (WHO) on 11 March 2019, and it has since disrupted many health systems and a threat to the fragile, unprepared health care services in LMICs. Many patients avoided the health facilities despite battling with chronic non-communicable diseases which needed medical attention. Hence, the healthcare providers had to devise means of ensuring the running of essential medical services amidst the pandemic. Scheduled patients' appointments and medical consultations through telemedicine were adopted. A scrutiny of the adjustment in the routine medical consultations in a limited resource country like Nigeria will help to identify the strength and limitations in sustaining safe consultations even after COVID-19 pandemic.

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OBJECTIVE: Complementary and alternative medicine (CAM) is commonly used, but many physicians have limited knowledge of CAM despite its widespread use. Therefore, this study sought to assess the knowledge, attitude, and practice of medical students on complementary and alternative medicine in the management of COVID-19. METHODOLOGY: A descriptive cross-sectional study was conducted among 150 medical students from three Federal Universities in South West, Nigeria. A self-administered semi-structured online Google Forms questionnaire was used to collect information. Chi-squared and Fisher's exact test was used to analyze the bivariate relationship between KAP status and sociodemographic characteristics. Spearman's correlation coefficient matrix was computed to determine the association between knowledge, attitude, CAM, age, and religiosity practice. RESULTS: The median age was 22 years (interquartile range: [IQR]: 21-23 years). Median self-rated score for religion was 4.00 (IQR: 3.00-4.25). Median knowledge score was 4.00 (IQR: 3.75-5.00), median attitude score 2.75 (IQR: 2.38-3.00) and median practice score 2.00 (IQR: 1.00-2.00). Thirty-seven respondents (24.7%) were considered to have poor knowledge about CAM use in COVID-19 while the rest (75.3%) had good knowledge. Thirty-eight (25.3%) had a poor attitude towards using CAM in COVID-19 and 112 (74.7%) had a good attitude. CONCLUSION: Medical students have good knowledge and a positive attitude towards CAM modalities as adjunct management for COVID-19. However, their practices do not reflect wide acceptability. There is a need for clinical trials on the efficacy of CAM as an adjunct treatment for COVID-19 to further inform its use.

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OBJECTIVE: Adequate nutrition is needed to enhance the immune system, especially at the time of COVID-19 pandemic for disease prevention and treatment. OBJECTIVE: The study aimed to assess physicians' knowledge to nutrition-related issues of COVID-19 infection and explore their attitudes to offering nutritional counselling to patients. METHODOLOGY: This was a cross-sectional online study conducted among doctors in private and public institutions across the six (6) geo-political zones in Nigeria using the social media online platforms of the Nigerian Medical Association (NMA) from August 17 to September 26, 2020. A categorisation of the knowledge score into sufficient and insufficient was done using the mean (sd) knowledge score. The attitude score was categorised into positive and negative using the median (IQR) attitude score, and bivariate analysis was used to test for associations. RESULTS: Responses were gotten from a total of 176 doctors over six weeks of data collection. Majority 97(55.1%) were females, and 84 (47.7%) had practised between 11 and 20 years. Majority 95(54.0%) had insufficient knowledge, while 128(72.7%) of the respondents had a negative attitude to nutrition counselling of patients regarding COVID-19. Females had significantly better knowledge about nutrition-related issues of COVID-19 (p=0.004). However, there was no significant difference in the respondents' attitude based on professional cadre, gender, place of practice, and years of practice. CONCLUSION: Respondents were deficient in the knowledge of common food items containing relevant nutrients essential for boosting immunity. Hence, there is a need to encourage physicians training in nutrition and nutritional counselling.

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BACKGROUND: One of the strategies adopted to improve interest in family medicine (FM) by many regions was the introduction of undergraduate family medicine training into the Medical School Curriculum. However, medical students' interest in FM has been reportedly low ranging from 3 - 29%. OBJECTIVES: This study described the pattern of medical students' specialty choices and assessed factors associated with interest in FM specialization among them. METHODS: Using a cross-sectional study design, total sampling of fourth to sixth-year medical students undergoing family medicine rotation as of November 2017 (N= 412) was done. The response rate was 75% (N=309). A pre-validated semi-structured, self-administered questionnaire was utilized to assess factors associated with respondents' interest in 12 medical specialties including FM. RESULTS: The respondents were predominantly male (67.3%), with a mean age of 23 (± 7.9) years. Most (83.4%) of them had at least one parent with tertiary school education. Fifteen (4.9%) of the respondents indicated a current interest in specializing in FM while 112 (36.2%) would consider FM in the future. A higher proportion of those with family members with FM specialization (28.6%) expressed current interest in FM while the female gender was associated with future consideration of FM. CONCLUSION: There is a low interest in FM specialization among medical students and this may be attributable to the fact that FM undergraduate training is relatively new in Nigeria. Further research on the role of mentorship and preceptorship on specialty choices of medical students needs to be carried out.

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BACKGROUND: Patients with knee osteoarthritis experience pain and functional impairment, which impacts upon activities of daily living ultimately leading to a loss of functional independence and low quality- of-life. This study therefore aimed at evaluating the functional health status of patients with knee osteoarthritis in the Family Medicine clinic, University College Hospital, Ibadan, Nigeria. METHODS: A cross-sectional study was conducted on 270 eligible respondents between January and March 2011. The Ibadan Knee/Hip Osteoarthritis Measure (IKHOAM) was administered after screening with the knee pain screening tool (KNEST). Respondents'Socio- demographic characteristics and knee pain intensity ratings were also recorded. RESULTS: The age range of respondents in the study was from 28 years to 85 years with a female: male ratio 5:1. Out of the 270 respondents studied, 146 (54.1%) reported restriction in performing duties at work. One hundred and twenty seven respondents (47.0%) needed some assistance in walking outside the house for 15 to 20 minutes, whilst 195 (72.2%) required some assistance in climbing stairs. Thirty four (12.6%) of Muslims and 77 (28.5%) of Christians could not kneel to pray. Males are twice more likely to have a better functional health than females (OR= 2.1, 95% CI= 1.0- 4.6, p=0.046). CONCLUSION: Knee osteoarthritis significantly impairs activities of daily living, especially some socio-cultural and religious practices of respondents. Therefore in addition to treating the knee symptoms, removing environmental barriers may reduce immobility within and outside the home thereby improving functionality.

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