Culture, Beliefs, Attitude and Peer Group Influence on Female Genital Mutilation in Southeast Nigeria

Background: Female Genital Mutilation is still practiced in Ebonyi State in Southeast Nigeria, despite the complications that follows it and government legislation against the practice. Aim: To determine the impact of Culture, Beliefs, attitude and Peer Group Influence on the persistence Female Genital Mutilation practice in the State especially in the rural areas. Materials and Methods: Qualitative study that used Focused Group Discussion and In-depth interviews for data collection. Those willing and given consent were recruited into the group discussion according to age, marital status, educational level and their location in the state. In-depth interviews were used with the Stake Holders, Opinion Leaders, Traditional Rulers and the Clergy. Result: A total of 454 participants were recruited from the 13 local government areas of Ebonyi State but only 420 (92.5%) participated. The age ranges of participants were 25 to 35 years for single males and females while the married participants male and female were aged 35 to 70 years. One hundred single females (23.8%) and 94 single males (21.4%) participated while 97 (23.1%) married women and 95 (22.6%) married men participated. Out of the 26 health workers recruited only 22 (5.2%) participated. Four traditional rulers, 4 women leaders, 4 youth leaders and 2 clergy 12 (2.9%) in number had in-depth interviews. All the participants had knowledge of FGM and its practice. Rural health workers are getting more involved. ‘Female Genital Crushing’ is replacing actual cutting. The participants all agreed there is no benefit and the practice should stop. Conclusion: Female Genital Mutilation is secretly practiced and is getting replaced by “Female Genital Crushing” perpetrated by rural health workers as well as mothers, fathers, traditional birth attendants and the peer group playing a major role with low knowledge of the Law against Female genital mutilation.

Cervical Ripening for Induction of Labor: A Randomized Comparison between Vaginal Misoprostol versus Foley’s Catheter Placement in a Nigeria Tertiary Hospital

Background: Cervical ripening is prerequisite of successful induction of labor. Vaginal misoprostol and Foley’s catheter placement have been widely used for this purpose but the data are not always sufficient. We attempted to determine which (misoprostol versus Foley’s catheter) is more effective/safer in Nigerian setting. Methods: A randomized controlled trial was performed at Federal Teaching Hospital Abakaliki, Nigeria, involving 135 term pregnant women requiring cervical ripening and labor induction. Participants were randomly allocated to misoprostol versus catheter group. The following were recorded/measured/analyzed: Bishop’s score, age, parity, body mass index, gestational age, labor duration, indication, oxytocin use, mode of delivery, and Apgar score. Chi square test and t test were used where appropriate. Results: At 24 hours, all of misoprostol group were either in labor, had ripe cervix, or had delivered, whereas 35.4% of catheter group had still unripe cervix (x2 = 29.856, P = 0.0001). Misoprostol group was less likely to require oxytocin infusion (x2 = 52.600, P = 0.0001) and less likely to require cesarean delivery (cesarean: misoprostol versus catheter: 11% versus 34% (x2 = 9.800, P = 0.001)). Total medical cost for misoprostol was less than that of catheter (x2 = 14.703, P = 0.0001). Conclusion: 50 μg vaginal misoprostol, compared with catheter placement, was more effective, cheaper, and safe as a procedure of cervical ripening before induction of labor.

Breastfeeding Awareness and Practices in Abakaliki, Southeast, Nigeria

Background: The Federal Teaching Hospital is the only tertiary hospital in Ebonyi State Nigeria. It receives referrals from the general and private hospitals, primary health centers in the state as well as the surrounding state. Breast feeding is a social norm among the indigenes of the state hence practiced commonly. Aim: The study was aimed at determining the knowledge and practice of exclusive breast feeding among the women presenting in the hospital. Methods: This was a cross-sectional study in the maternity unit of the hospital over three months’ period from March to May 2015. A structured data sheet was administered to each mother presenting in the maternity unit of the hospital and willing to participate which were consecutively recruited into the study. Results: A total of 500 mothers participated in the study. About 98.4% were aware of exclusive breast feeding while 90.2% practiced it for different reasons and duration. Only 76.4% practiced it for a period of 4 - 6 months. Majority of the mothers (90.0%) got the information about exclusive breast feeding from the hospital. Times of initiation of breast feeding after delivery were 38.2% within 30 minutes and 33.2% an hour respectively. Seventy six percent of the mothers’ breastfed on demand. About 91.6% were willing to practice exclusive breast feeding for subsequent babies. Surprisingly 10.2% of the mothers discarded their colostrums. Practice of exclusive breast feeding was significantly related to educational status and occupation. Conclusion: Greater awareness and practice of exclusive breastfeeding has been achieved but more still needed to be done especially about the time of initiation, giving of colostrums and the duration of exclusive breast feeding since up to 10.4% of the participants still discarded their colostrums particularly those that delivered outside the hospital.