Review of Problems of Adolescent Sexual Behavior and the Role of Millennium Development Goals 4, 5 and 6 in Nigeria

Introduction: The problems of adolescents’ sexual behavior are grave and far-reaching. Methods: Review of exiting literature via Google scholar, AJOL, Pubmed, HINARI and other relevant data bases on the common problems of adolescents’ inappropriate sexual behavior. Result: Adolescent sexual behavior could result in adolescent pregnancy which prevalence varies widely throughout Nigeria perhaps due to differences in culture and development. Abortion, the willful termination of pregnancy is another problem which is often undertaken for pregnancies resulting from incest and sexual abuse. Also common is trans-generational sex which occurs when an adolescent has non-marital sex in the last 12 months with a man who is at least 10 years older than her. Also related to this, is transactional sex found in both committed and casual relationships. It is not always done for survival because in some cultures, sex for favor is carried out for reasons other than subsistence. Furthermore, multiple sexual partners are the engagement in sex with more than one partner over a particular time frame. It may be sequential or concurrent. The high prevalence of these problems in Nigeria raises a question of the possibility of achieving the millennium development goals (MDGs) 4, 5 and 6 specifically targeted at reducing child mortality, improving maternal health and combating HIV/AIDS, malaria and other diseases respectively. Conclusion: Policies and strategies such as family life and HIV/AIDs education (FLHE) curriculum on adolescent reproductive health should be pursued with greater vigor in our secondary schools in addition to establishing HIV counseling centers and vocational training programs for out-of-school adolescents. WHO support and commitment to key action areas for countries and member states will build and strengthen their capacity to improve reproductive and sexual health.

Midwifery and Midwives Service Scheme: A Panacea for Improvement of Some Maternal and Neonatal Indices in Nigeria—A Brief Review

Introduction: Midwifery is the art of caring for women during childbearing. It is practiced throughout the world according to the norms, traditions and cultural practices found in each country. Maternal mortality in Nigeria is high but there are wide variations between the geopolitical zones of the country. Government has established the midwives service scheme (MSS) as part of efforts towards reversing the country’s unacceptably high maternal mortality trends. To improve these indices, the MSS in Nigeria engaged newly graduated unemployed and retired midwives to work temporarily in rural areas. The midwives are posted for twelve months to selected primary care facilities linked through a cluster model in which four such facilities with the capacity to provide basic essential obstetric care are clustered around a secondary care facility with the capacity to provide comprehensive emergency obstetric care. This brief review is an attempt at exploring the impact of the midwives service scheme on maternal and neonatal indices in Nigeria. Main content: The outcome of the MSS four years has been an improvement though unevenly and marginally, in these indices in the various geopolitical zones of Nigeria. Improvements have been noticed in maternal indices such as antenatal care attendance, women receiving two doses of tetanus toxoid and number of deliveries by skilled personnel. Also reduction in maternal and neonatal mortality has been observed over the years following introduction of the scheme. Major challenges however, include lack of essential drugs, poor accommodation facilities for MSS staff, irregular payment of their remuneration and lack of water/power supply to some designated facilities for the scheme. Recommendations and conclusions: It is therefore recommended that 24 hours availability of essential drugs at primary healthcare centers be maintained. This should happen in conjunction with regular payment of full entitlements and benefits and provision of secured, habitable and good accommodation for MSS staff. Finally, aggressive community mobilization should continue in order to engender community involvement and participation for sustainable program development.

Pattern, Types and Predictors of Contraception among Female In-School and Out-of-School Adolescents in Onitsha, Anambra State, Nigeria

Introduction: The consequences of unsafe sex are suffered mostly by adolescent girls in Nigeria despite efforts to improve accessibility to the reproductive and sexual health of this group. This study elucidates the pattern of contraceptive use, the key socio-demographic factors, sexual beliefs and practices associated with its use amongst adolescent girls in Nnewi, Nigeria. Methods: It was a descriptive cross-sectional comparative study of in-school and out-of-school female adolescents. Data were collected using questionnaires and Focus Group Discussion (FGD), then analyzed by selecting socio-demographic and other variables to assess their interaction with contraceptive use and result compared between the two groups. Data were presented in tables and charts and multivariate and chi-square analyses were performed. Result: Higher proportion of sexually active out-of-school girls than their in-school counterparts had ever used contraception—used it in their first and last sexual exposures, while condom was the commonest contraceptive employed by both groups. Age (older adolescents;F = 0.041), belief in condom use (P = 0.05), willingness to get condom for partner (P = 0.001) and regular sexual practice (P = 0.003) were the most important predictors of contraceptive use among the sexually active adolescents. Generally, the out-of-school girls are more likely to use contraceptives than their in-school counterparts. Some misconceptions about pregnancy prevention and unscientific contraceptive methods were mentioned by the subjects during the FGD. Recommendation: Access to reproductive health services needs to be improved especially among the in-school female adolescents. There is need to incorporate the right contraceptive information in the school curriculum, and the out-of-school adolescents should receive periodic dissemination of appropriate Behavior Change Communication (BCC) on the relevance of contraception.