Public Health

Background Improving adolescent sexual and reproductive health continues to be a global public health need. Effective parent–adolescent communication on sexual health issues has been cited as a factor that could influence adolescents towards adopting safer sexual behaviour. The current review synthesises qualitative literature to understand the nature and relevance of parent–adolescent sexual and reproductive health communication and the barriers to effective communication in sub-Saharan Africa. Methods We systematically searched and synthesised qualitative literature published between 1st January 1990 to December 2019 and searched from CINAHL, PsycINFO, MEDLINE, Global Health, EMBASE, PubMed, and Google Scholar. We assessed the methodological quality of included studies using the Critical Appraisal Skills Programme (CASP) checklist. We thematically analysed qualitative data from the included primary studies. Results Fifteen studies were included. Social and physiological events act...

BACKGROUND
After decades of clinical practice and research, much is now known about labour. Hitherto, active phase labour has been defined from 4cm of cervical os dilatation. Recently, this 4cm landmark has been criticized, with suggestion that active phase labour should be diagnosed from 6cm instead.
AIM
To determine whether or not 6 cm is a better cervical dilatation threshold for the onset of active phase labour compared to 4 cm in a low risk nulliparous population of parturients in spontaneous labour at term.
METHODS
In this randomized controlled study, 88 nulliparous parturients with low risk pregnancy in spontaneous labour at term with 4 cm of cervical dilatation were randomized into two groups. Those in the control group (A) had active management of labour (AML) instituted at admission according to departmental protocol while those in the study group (B) were considered to be in latent phase labour and had 1-2 hourly vaginal examination until 6cm of cervical dilatation was achieved at which point active phase labour was diagnosed and AML instituted. All data were entered into a Proforma and analysis was done using the IBM SPSS for Windows version 20.
RESULTS: Four of the 88 women recruited for the study were later stepped down from the study. The mean age of parturents and the mean gestational age were 27.77±4.689 years and 38.98±0.931 weeks respectively. 97.5% of women in the study group and 75% of those in the control group had spontaneous vaginal delivery (RR=6.50; 95% CI=0.983-42.962; p=0.003). Twenty-five percent of the controls had caesarean delivery. There was no Caesarean delivery in the study group (p=0.001).  The mean cervical dilatation rate for the study group was 1.06±0.232 cm/hour compared to 0.80±0.457 cm/hour for the control group (p=0.002). 65% of the study group had an average cervical dilatation rate of ≥1 cm/hour compared to 29.5% in the control group (p=0.001). 70.5% of controls had their labour augmented compared to 29.5% of the study group, and all the Caesarean sections were done in women who had labour augmentation (p=0.001). Ninety-five percent of the study group had babies with good APGAR scores compared to 72.7% of controls (p=0.006). Four (9%) of the controls had primary postpartum haemorrhage. There was none in the study group.
CONCLUSION: This study has established the whole idea of redefining active phase labour, vis a vis changing the cervical dilatation threshold for onset of active phase labour from 4cm to 6cm, as plausible. However, a larger number of low risk nulliparous women in spontaneous labour should be studied possibly in a multicentre randomized controlled trial to come to a more robust conclusion about the whole issue of a redefinition of active phase labour in terms of threshold cervical dilatation.

BACKGROUND After decades of clinical practice and research, much is now known about labour. Hitherto, active phase labour has been defined from 4cm of cervical os dilatation. Recently, this 4cm landmark has been criticized, with suggestion that active phase labour should be diagnosed from 6cm instead. AIM To determine whether or not 6 cm is a better cervical dilatation threshold for the onset of active phase labour compared to 4 cm in a low risk nulliparous population of parturients in spontaneous labour at term. METHODS In this randomized controlled study, 88 nulliparous parturients with low risk pregnancy in spontaneous labour at term with 4 cm of cervical dilatation were randomized into two groups. Those in the control group (A) had active management of labour (AML) instituted at admission according to departmental protocol while those in the study group (B) were considered to be in latent phase labour and had 1-2 hourly vaginal examination until 6cm of cervical dilatation was ac...

Introduction: Maternal and Neonatal Tetanus (MNT) are important causes of maternal and neonatal deaths, and this led the World Health Assembly in 1999 to launch the maternal and neonatal tetanus elimination strategy with a target of 2020 after earlier targets of 2005, 2015 were missed. Tetanus claims tens of thousands of deaths annually with majority of the deaths occurring in Sub-Saharan Africa and Asia. Safe delivery practice is one of the strategies for elimination of MNT and it can be achieved if delivery is handled by a skilled health worker that have adequate knowledge on the care of the umbilical cord. Methods: This study which is a descriptive study that covered 62 high risk Local Government Areas (LGAs) is aimed at determining the delivery practices and cord care practice of Women of Child bearing Age. (WCBA) in sixty–two Local Government Areasin the six States of Ondo, Osun, Ekiti, Imo, Enugu and Ebonyi in Nigeria that were involved in the three rounds of tetanus toxoid va...

Strategizing to respond to any Cholera outbreak requires a proper understanding of the factors leading to a Cholera incidence. Cholera incidence in Maiduguri has been widely under-reported and ignored for decades by the Nigerian Government. Eulogizing the strengths of the existing response plan and highlighting the aspects of weakness of the response strategy is the main aim of this work.
International, national, state and local measures should be adopted in every decision making platform in designing a sustainable Cholera prevention and preparedness plan.