ASSESSMENT OF UMBILICAL CORD CARE GIVEN BY TRADITIONAL BIRTH ATTENDANTS IN OGHARA ETHIOPE WEST LGA NORTH LOCAL GOVERNMENT AREA

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CHAPTER ONE—————————————————————————1

INTRODUCTION—————————————————————————–1

Background of study———————————————————————-1

Aim/Purpose of study——————————————————————–2

Statement of problem———————————————————————3

Broad objective of the study————————————————————-3

Specific objective————————————————————————3

Significance of study——————————————————————–3

Scope of study / delimitation ———————————————————-3

Operational definition of terms——————————————————–4

CHAPTER TWO

Literature review—————————————————————————5

Conceptual framework——————————————————————-22

Hypothesis ———————————————————————————24

CHAPTER THREE

MATERIALS AND METHODS

Research design————————————————————————–26

Research site and setting—————————————————————-26

Research population ——————————————————————–26

Sample and sampling techniques——————————————————27

Instrument for data collection———————————————————-27

Validity/reliability ———————————————————————–27

Method of data collection—————————————————————28

Procedure for data analysis————————————————————-28

Ethical consideration——————————————————————–28

CHAPTER FOUR

RESULT———————————————————————————–29

Data analysis and interpretation———————————————————30

Testing of hypothesis———————————————————————-41

CHAPTER FIVE

DISCUSSION OF FINDINGS————————————————————44

Discussion of findings———————————————————————44

Nursing implication————————————————————————46

Summary ———————————————————————————–47

Conclusion———————————————————————————-47

Recommendation—————————————————————————47

References ———————————————————————————49

Appendix ———————————————————————————-52

                                                      ABSTRACT

Proper care of the umbilical cord is very important to avoid sepsis in the life of the neonates. This study was on Assessment of Umbilical Cord Care given by Traditional Birth Attendants in OgharaEthiope West LGA. 92 open and closed ended structured questionnaires were administered and 82 were retrieved successfully which wereanalyzed to all the TBAs in Oghara community. The findings revealed that 57 (69.51%) of the respondents do not know about cord care while 25 (30.49%) knows of cord care. This Shows that majority of the TBA are not informed on appropriate care of the umbilical area of a new born.. The hypothetical statements was tested using chi-square.  A theoretical value of 3.3which was found higher than the computed value which showed that there is significant relationship between the knowledge of TBAs on cord and their practice on cord care. The data analyzed were compared with the empirical works for similarities and dissimilarities; Reasons for Identified dissimilarities were discussed. Based on the findings,  itwas recommended that the government should empower the TBAs by providing funds to support them to organize seminars and workshops on relevant  issues that concern their  maternal and child health care.

 CHAPTER ONE

INTRODUCTION

Background of the Study

Umbilical cord is the lifeline of the fetus and of the neonate in the first few minutes immediately after birth. Care of the cord and stump during neonatal period varies according to the social, cultural, economic and geographical factors. Measures take to ensure sterility in cutting and tying the umbilical cord may prevent cord infection (Mullay, 2005). Clean umbilical cord care is accomplished by the maintenance of aseptic technique so that the umbilical cord is uncontaminated by pathogens.At birth, hands should be washed with clean water and soap before tying and cutting the cord. The newborn should be laid on a clean surface and the cord should be cut with a sterile instrument. In the postnatal period, routine cord care includes washing hands with clean water and soap before and after care and keeping the cord dry and exposed to air or loosely covered with clean clothes. The napkin should be folded below the umbilicus. Touching the cord, applying unclean substances to it and covering it with bandages should be avoided. Every year globally, an estimated 4 million infants die and approximately two-third of all these deaths occur in the neonatal period (NNHS, 2004). A substantial proportion of neonatal deaths from infection are due to cord infections (WHO, 2004). Nepal has one of the highest neonatal mortality ratesin the world which is 34 per 1,000 live births. Neonatal Mortality Rates currently accounts two thirds of all infant mortality (MoHP, New ERA and Measure DHS, 2006).

Since the adoption of the primary health care approach in Nigeria in 1979, the three tiers of government (federal, state and local government levels) have accepted the idea of the need to integrate Traditional Birth Attendants into PHC. TBAs presently deliver majority of women in Nigeria as in other developing countries. It is estimated that between 60 and 80% of all deliveries in the developing countries occur outside modern health care facilities, with a significant proportion of this attended to by TBAs (WHO, 2004). Traditionally African births, including prenatal and postnatal care, take place at home, supervised by at least one older, trusted female member of the family or community.. The influence and acceptability of these females, known as Traditional Birth Attendants (TBAs) continue to exist amongst people in remote rural areas and even when formal health services are available. Thus the evaluation of the care of cord stump by TBA is essential in primary health care (Davies, Yin Nu, Oum and Waisi, 2012)

TBAs cannot, however, be automatically incorporated with western health care. Some authors have observed flaws in the practice of TBAs such as poor hygienic practices and infection control, for example, lack of hand washing, unsafe cutting of the cord threatening the safety of the baby, interference with labour, and harmful traditional practices such as taking oxytocic agents (http://www.mariestopes.org.uk/ case studvl.html; Sahachowdhury, 2009).

Immediately after the baby is born, the cord is cut with an instrument by a Traditional birth attendant using the following; bark of a bamboo or a hard and sharp stalk of a plant, razor blade, two sharp stones between the cord is crushed, scissor, etc. hygienic precautionary measures are not always observed. Traditionally, one of the following materials may be applied to the stump of the umbilical cord, also scraping from a coconut shell, cow dung, ashes from the heart of the stones.etc

Poor care and assessment of umbilical cord by traditional birth attendant have been the major factors causing child mortality after birth, thus the researcher was prompted to carry out a research to determine the assessment of umbilical cord care among traditional birth attendants in OgharaEthiope West L.G.A Delta State

A STUDY ON THE KNOWLEDGE AND ACCEPTANCE ON MEN TOWARDS VASECTOMY AS A METHOD OF CONTRACEPTIVE AMONG MALE STAFF AT CENTRAL HOSPITAL, AGBOR

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CHAPTER ONE—————————————————————————1

INTRODUCTION————————————————————————–1

Background of study———————————————————————-1

Aim/purpose of study———————————————————————2

Statement of problem———————————————————————2

Research question————————————————————————–3

Broad objective of the study————————————————————–3

Specific objective————————————————————————–3

Scope of study / delimitation ————————————————————-3

Significance of study———————————————————————-4

Operational definition of terms———————————————————4

CHAPTER TWO

Literature review—————————————————————————5

Conceptual framework——————————————————————-11

Hypothesis ——————————————————————————–16

CHAPTER THREE

MATERIALS AND METHODS

Research design————————————————————————-17

Research site and setting—————————————————————-17

Target population ———————————————————————–18

Sample and sampling techniques——————————————————18

Instrument for data collection———————————————————-18

Validity/reliability of instrument——————————————————18

Method of data collection————————————————————–19

Procedure for data analysis————————————————————-19

Ethical consideration——————————————————————–19

Limitation of study———————————————————————-19

CHAPTER FOUR

RESULT———————————————————————————–21

Data analysis and interpretation———————————————————21

Testing of hypothesis———————————————————————-31

CHAPTER FIVE

DISCUSSION OF FINDINGS———————————————————-34

Discussion of findings———————————————————————34

Nursing implication————————————————————————35

Summary————————————————————————————35

Conclusion ———————————————————————————36

Recommendation—————————————————————————36

References ———————————————————————————37

Appendix ———————————————————————————-42

                                                      ABSTRACT

This study was on the knowledge and acceptance on men towards vasectomy as a method of contraceptive among male staff at central hospital, Agbor150 questionnaires were administered and 120 were retrieved successfully and analysed. Closed ended structured questionnaires were used to collect information from the researcher to knowledge and acceptance on men towards vasectomy as a method of contraceptive. The data analysed were incorporated in frequency tables with their percentages after which the tables were elucidated on. 70 (58.33%) said they have heard of vasectomy while 50 (41.67%) has never heard of vasectomy before, 15 (12.5%) said they have thought of choosing vasectomy as a method of contraceptive while 105 (87.5%) did not accept it, 105 (87.5%) said their religious believe was not in support of it while 15 (12.50%) did not see anything wrong with vasectomy. The hypothetical statements was tested using chi-square and a level of significance of 0.05 with a theoretical value of 55.07 which was  higher than the computed value which made the null hypothesis to be accepted . The data analyzed were compared with the empirical works for similarities and dissimilarities and reasons for dissimilarities were discussed. It was recommended that the hospital administration should organize seminar and workshop on vasectomy to enhance the knowledge of men on the acceptance of vasectomy as a method of contraceptive also the government should create more awareness on vasectomy via Mass media (Radio, Television, Newspaper).

CHAPTER ONE

Introduction

Background of study

Vasectomy is unique among the array of modern methods of contraception as it enables the male partner to take primary responsibility for fertility control, (Kincaid, 2006). Its availability broadens the choice of methods for family planning users and contributes to promoting male involvement in family planning, (NCPD, 2004). Furthermore, vasectomy is highly effective in preventing pregnancy independent of subsequent behavior modification by the vasectomized man and the non scalpel vasectomy procedure is convenient and safe for the client and simple to perform, (FHI, 2002). While sterilization is the most widely used family planning method worldwide, in most settings the number of women sterilized for contraceptive purposes far exceeds the number of men, (NCPD, 2004).The lowest rates of sterilization in the world are found in Africa where fewer than three percent of married women of reproductive age rely on sterilization to avoid pregnancy and male sterilization is negligible, (Ross and Frankenberg, 2003). Male attitudes are often blamed for the underutilization of vasectomy method, (Wilkinson , 2006).Frequently cited examples of attitudes which discourage the use of vasectomy include men’s lack of interest in or responsibility for avoiding pregnancy, the association of vasectomy with castration, and fear of the procedure, (FHI,2012). However, some advocates of vasectomy believe more than negative attitudes among potential male adopters underlie the low levels of use, (Liskin, Benoit, and Blackburn, 2012).

The use of vasectomy in the world varies significantly by region and country. Almost three-fourths of the 37 million couples who use vasectomy† live in Asia, with China and India alone accounting for more than two-thirds of this total, (NCPD, 2004). Four and one-half million men in the developing world outside of these two countries use vasectomy. Vasectomy use in Latin America has increased four-fold in the past 10 years.

Prevalence remains less than 1% in most of the region, with the exception of Brazil, 14 Colombia, 19 Guatemala, 7 and Mexico, 12 where programs benefited from donor support in the 1980s and early 1990s, (FHI, 2012). Vasectomy rates in almost all of Africa are 0.1% or less, although vasectomy services have been introduced within a number of Sub-Saharan African countries, such as Kenya, Ghana, Malawi, and Tanzania, (NCPD, 2004). Still, vasectomy has been adopted by at least some men in every country where it has been introduced. Vasectomy, which can be provided in a variety of primary care settings, has a potentially important role to play in helping individuals and programs meet the ever-growing family planning and reproductive health needs outlined above, especially as donor support declines and national family planning programs increasingly need to focus on cost-effective services and methods, (Ross and Frankenberg, 2003).Vasectomies, or male sterilization, are a highly underutilized method of family planning, although they are safer, simpler, less expensive and equally as effective as female sterilization. Throughout the world, vasectomies are one of the least used and least known methods of contraception.  In Asia, it is 8 times more common, while in Latin America and the Caribbean it is 15 times more common. The rates of male sterilization in sub-Saharan Africa are too low for an accurate comparison. Worldwide, approximately 43 million couples rely on vasectomy, while approximately 210 million couples rely on female sterilization as their method of family planning.

ATTITUDE OF MEN TOWARDS FAMILY PLANNING AND IMPLICATION FOR THEIR INVOLVEMENT IN OGHARA-EFE COMMUNITY

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                                                  ABSTRACT

Family planning is a very important matter because it has a role to play the in family and the development of the country at large. Failure to target men in health intervention has weakened the impact of the reproduction health programme. This prompted the research to undertake a study on the attitude of men towards family planning and the implication for their involvement. The rationale for this study is based on the fact that men hardly face to plan their family, putting the health of their wives at risk. In carrying out the research 10% of the target population of 208.4 was used, using stratified random sampling technique. Questionnaire was distributed and findings were analyzed using simple percentage, tables, pie chat. It was found out that the attitude of men in Oghara – efe community towards family planning is fair, also the result of the data implies that family planning would be more effective if men are actively involved.

Conclusively it is recommended that adequate health education as regards to issue bordering on family planning should be provided by nurse, especially to men and ensures that they are also actively involved.

Also extension research should be carried out to provide varieties of contraceptives for males.

Word count:        200  

CHAPTER ONE

Background of the Study         –         –         –         –         –         –         –    1

Statement of the Problem        –         –         –         –         –         –         –    4

Objective of the Study    –         –         –         –         –         –         –         –    5

Significance of the Study          –         –         –         –         –         –         –    5

Research Questions        –         –         –         –         –         –         –         –    6

Research Hypothesis      –         –         –         –         –         –         –         –      7

Delimitation / Scope of the Study     –         –         –         –         –         7

Limitation of the Study  –         –         –         –         –         –         –         7

Operational Definition of terms         –         –         –         –         –         8

CHAPTER TWO

Literature Review –         –        –         –         –         –         –         –         10

Definition    –         –         –         –         –         –         –         –         –         12

Aims and Objectives of Family Planning      –         –         –         –         12

Principles of family Planning    –         –         –         –         –         –         13

Classification and Types of Family Planning Methods     –         –         13

Highlight of some of the most commonly used methods           –         17

Family Planning Method –         –         –         –         –         –         –         19

Advantages –         –         –         –         –         –         –         –         –         19

Some Side Effects Contraceptives have on Human Body-        –         20

Some of the Misconceptions of Family Planning    –         –         –         21

Reasons for not Accepting Family Planning –         –         –         –         22

Reasons for utilizing Contraceptives –         –         –         –         –         22

Economic Reason  –         –         –         –         –         –         –         –         23

Pleasure Reason   –         –         –         –         –         –         –         –         23

Mankind Dominion Reason      –         –         –         –         –         –         23

Eugenic Reasons  –         –         –         –         –         –         –         –         23

Health Reasons     –         –         –         –         –         –         –         –         24

Demographic Motives (Reasons)         –         –         –         –         –         25

Method of Family Planning For Males          –         –         –         –         26

Factors Responsible for the Negative Attitude of Males

towards Family Planning          –         –         –         –         –         29

Ways of Improving Fathers Altitudes Towards Family Planning         32

Conceptual/ Theoretical Framework –         –         –         –         –         36

Implications for the Involvement of Men in Family Planning    –         38

Empirical Researches     –         –         –         –         –         –         –         40

CHAPTER THREE

Research Design   –         –         –         –         –         –         –         –         43

Study Setting        –         –         –         –         –         –         –         –         43

Target Population –         –         –         –         –         –         –         –         44

Study Population –         –         –         –         –         –         –         –         44

Samples and Sampling Techniques   –         –         –         –         –         45

Instruments for Date Collection        –         –         –         –         –         46

Validity/ Reliability of Instrument     –         –         –         –         –         47

Method of Data Collection        –         –         –         –         –         –         47

Method of Date Analysis –         –         –         –         –         –         –         48

Ethical Considerations   –         –         –         –         –         –         –         48

CHAPTER FOUR

Results        –         –         –         –         –         –         –         –         –         49

Presentation of results   –         –         –         –         –         –         –         49

Testing of Hypothesis     –         –         –         –         –         –         –         67

CHAPTER FIVE

Discussion of Findings    –         –         –         –         –         –         –         72

Discussion of findings and demographic data       –         –         –         72

Relationship to other research study –         –         –         –         –         74

Implication of Nursing    –         –         –         –         –         –         –         75

Summary and conclusion        –         –         –         –         –         –         77

Recommendation/ suggestion for further study   –         –         –         78

References –         –         –         –         –         –         –         –         –         80

Appendix     –         –         –         –         –         –         –         –         –         83

CHAPTER ONE

BACKGROUND OF THE STUDY

The issue of family planning all over the world has attracted attention due to it important in decision making about population growth and development issues. Uncontrolled birth is a major contributing factor of an increase in the world’s population, particularly in Nigeria. Statistics shows that the population of the world was about one billion in 1859 in 1930, the population had doubled (two billion) in 1976, the total population was said to be four billion. Today, it is more than six billion, with Nigeria having a population of over 162 million, thus being the largest country in Africa and the 7^th in the world map (United States Census Buxau, 2010). Life is a precious gift that every individual hunger for and in an attempt to grab this gift, our health must be maintained.

There are so many problems that have been found to result from poor family planning method. Some of these problems include: Over population, criminal abortion, child dumping, increased child morbidity and mortality, as well as increases material morbidity and mortality rates. Over population as one of the consequences of poor family planning has succeeded in causing a lot of harm to individuals, families, society and the nation at large.

Maternal mortality and child mortality have been found to occur due to poor family planning practice, according to the statement of the WHO (World Health Organization) and United Nation Education, Scientific Children’s Organization (UNESCO) in 1991) that over three million children and two hundred thousand women die each year and also women’s health and action research (2004) had showed rates of child and maternal mortality and morbidity  rate in the world due to poor altitude towards Ante-natal care in which family planning is one of the objectives. The President of Nigeria, his Excellency, Goodluck Ebele Jonathan was quoted in Vanguard newspaper on June 28, 2012saying “Nigeria families should have only the children they can afford. To ensure this order was followed , a new planned Parenthood Federation of Nigeria (PPFN) was created. He said it may be time for birth control legislation.

Family planning, until recently, a very sensitive subject in Africa, is now very increasingly accepted as a necessary ingredient of socio-economic development. It is now thought to be an important health measure that contributes to the health of parents, children and the entire nation. Because of the great effect over population has on socio-economic status, education and health in general, a full understanding of this phenomenon and the  major factors governing it are essential, thus the need to adopt family as a means of checking the escalating  birthrate cannot be over emphasized. Unfortunately, this idea is not adequately emphasized on, especially in the rural areas, where it was observed that they g=have a high regard for large families and children are seen as a blessing from God. They believed that the more children a man has, the more hands to help with work especially on the farm. It is also believed that children give status to a women and security in old age. In Oghara-efe Community in Delta State, it was observed that husband often make sexual demands with little or no consideration for material health and the children’s survival. They compound their wives potential mortality rate by either not allowing her to seek family planning, advice or will not seek it as a collection responsibility. This present mentality in Oghara-efe community and its consequent socio-economic, educational and health effect on the villagers makes it important for this study to be carried out.

Statement of the Problem

Most fathers shy away from sharing the responsibility of family planning with their wives therefore, leaving the burden on her alone to bear. Although in Urban town, most father have started having good perception of family planning, but in rural areas like Oghara-efe community, the fathers still have a wrong perception towards family planning.