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      Analysis of the Effect of Health Education Activities on Selected Child Health Determinants in Two Communities of Ile Ife, Nigeria

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          Abstract

          Background

          Child survival in Nigeria is threatened not just by the direct causes of childhood mortality such as the common childhood diseases but also by the associated child health determinants. Health education activities as part of community integrated management of childhood illness have the potential to improve these child health determinants. The objective of this study was to assess the effect of community level health education activities on selected child health determinants in Ile Ife, Nigeria.

          Methods

          A cross-sectional comparative study was carried out among 722 caregivers in two LGAs of Osun State, Nigeria, using a multistage cluster sampling method. Data were collected from mothers of index children aged 0–59 months using an interviewer-administered questionnaire.

          Results

          Vitamin A supplementation before the study was received by 89.1% and 79.8% of the children aged 9 months old and above in implementing and non-implementing LGAs (p=0.002). Amongst children age 12–23 months in the implementing LGA, 93.4% received DPT3, (91.8%) received measles compared with non-implementing LGA in which 66.7% received DPT and (64%) measles. Children in the CIMCI implementing LGA were three times more likely to receive DPT Vaccine (Adjusted odds ratio (AOR) 3.02, 95% confidence interval (CI) 1.55–7.98), and five and half times more likely to receive measles vaccine (AOR 5.56, 95% CI 2.76–12.54).

          Conclusion

          The study concluded that community level health education activities have a positive effect on child health practices and determinants.

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          Most cited references7

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          The management of the faeces passed by under five children: an exploratory, cross-sectional research in an urban community in Southwest Nigeria

          Background Safe management of faeces (SMoF) and environmental contamination by faecal pathogens have been extensively researched although the SMoF in under-five children has been perennially neglected perhaps due to the misconception that it is harmless. This research, therefore, studied the situation, to determine the magnitude and dimensions of the problem aimed at making policy level stakeholders aware of child faeces management systems and so, inform evidence-based implementation of child and health-related programmes in Nigeria. Methods The study utilized an exploratory cross-sectional design and a multi-stage sampling technique to identify 300 respondents from 12 randomly selected streets from 4 wards in Ife central local government area. The study collected data with a pretested questionnaire which included direct observations of child defecation practices and existing toilet facilities. Cleaned data were analyzed by IBM-SPSS version 20 with child faeces management outcomes as the dependent variable. Results The mean age of respondents’ and monthly income (mode) were 30.8 ± 7.5 years and ₦10,000.00 ($28.60). Most respondents were mothers to the under five children (84.7%), had a secondary education (72.0%) and were semi-skilled (57.0%). The caregivers had access to improved water sources (93.7%), improved toilets (64.3%), with 64% and 53.7% having above average scores in knowledge and attitudes, respectively. In the study, 19.7% and 69.0% of caregivers practiced safe disposal of faeces passed by the under five child during the day and at night respectively, though most caregivers (94.3%) omitted steps in the safe management of child faeces chain. The under five diarrhoea prevalence rate was 13.7% and unsanitary passage of child faeces is associated with four folds likelihood of having diarrhoea (p = 0.001). The caregivers whose under five children practiced safe sanitation were rich (p = 0.009) and knowledge was significantly associated with ownership of household toilet (P = 0.037), night faeces management chain practice (P < 0.001) and disposal of anal cleaning materials (P = 0.002). Handwashing was significantly associated with household toilet (P < 0.001), wealth (P < 0.001), under five child defecation preferences during the day (P < 0.001) and at night (P = 0.008). Conclusion The high knowledge and positive attitudes exhibited by the caregivers were at variance with practice. Where under five children defecate during the day were influenced by the disposal of their anal cleaning materials, distance to the toilet and caregivers’ education. The findings highlight the dangers of unsanitary disposal of child faeces and the need to strengthen the related policies that can increase caregivers awareness and practice at all levels and in all livelihood domains. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4078-1) contains supplementary material, which is available to authorized users.
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            Impact of duration of structured observations on measurement of handwashing behavior at critical times

            Background Structured observation is frequently used to measure handwashing at critical events, such as after fecal contact and before eating, but it is time-consuming. We aimed to assess the impact of reducing the duration of structured observation on the number and type of critical events observed. Methods The study recruited 100 randomly selected households, 50 for short 90-minute observations and 50 for long 5-hour observations, in six rural Bangladeshi villages. Based on the first 90 minutes in the long observation households, we estimated the number of critical events for handwashing expected, and compared the expected number to the number of events actually observed in the short observation households. In long observation households, we compared soap use at critical events observed during the first 90 minutes to soap use at events observed during the latter 210 minutes of the 5-hour duration. Results In short 90-minute observation households, the mean number of events observed was lower than the number of events expected: before eating (observed 0.25, expected 0.45, p < 0.05) and after defecation (observed 0.0, expected 0.03, p = 0.06). However, the mean number observed was higher than the expected for food preparation, food serving, and child feeding events. In long 5-hour observation households, soap was used more frequently at critical events observed in the first 90 minutes than in the remaining 210 minutes, but this difference was not significant (p = 0.29). Conclusions Decreasing the duration of handwashing significantly reduced the observation of critical events of interest to evaluators of handwashing programs. Researchers seeking to measure observed handwashing behavior should continue with prolonged duration of structured observation. Future research should develop and evaluate novel models to reduce reactivity to observation and improve the measurement of handwashing behavior.
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              Effect of community integrated management of childhood illness on mothers' healthcare-seeking behaviour and home management of childhood illness in Ile-Ife, South-West Nigeria: A household survey

              BACKGROUND: Care-seeking interventions, as part of community integrated management of childhood illness (CIMCI), have the potential to substantially reduce child mortality in countries where common childhood illnesses are a major problem. Prompt and appropriate care-seeking practices are important to avoid many deaths attributed to delays in or not seeking care, particularly in developing countries such as Nigeria. OBJECTIVE: To assess the effect of community-level intervention on mothers' care-seeking behaviour for common childhood illnesses and related influencing factors. METHODS: The study had a comparative cross-sectional design and was conducted in two local government areas (LGAs) of Osun State, South-West Nigeria. A total of 722 mothers of index children aged <5 years were selected through a multistage cluster sampling technique. Data were collected and analysed using SPSS version 16.0. Descriptive, bivariate and multivariate analyses were performed. RESULTS: Care-seeking for children who reported illness was higher in the CIMCI-implementing LGA (90.2%) compared with 74.8% in the non-implementing LGA (p=0.002). Care was sought within the first 48 hours of perceived onset of illness for 83.2% and 57.9% of sick children in the CIMCI-implementing and non-implementing LGAs, respectively. Residing in a CIMCI-implementing area (odds ratio (OR) 2.54, 95% confidence interval (CI) 1.24 - 5.45) and maternal education level (OR 1.50, 95% CI 1.06 - 3.03) were identified as predictors of healthcare-seeking practices among mothers. CONCLUSION: The study concluded that a high level of care-seeking behaviour exists where community-level intervention was operating. Therefore the CIMCI programme should be strengthened further and also scaled up to include non-implementing communities.
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                Author and article information

                Journal
                Ethiop J Health Sci
                Ethiop J Health Sci
                Ethiopian Journal of Health Sciences
                Research and Publications Office of Jimma University (Jimma, Ethiopia )
                1029-1857
                2413-7170
                March 2018
                : 28
                : 2
                : 217-226
                Affiliations
                [1 ]Department of Community Medicine and Primary Care, State Specialist Hospital, Ondo City, Ondo State, Nigeria
                [2 ]Department of Paediatrics and Child Health, State Specialist Hospital, Ondo City, Ondo State, Nigeria
                Author notes

                Funding: Nil

                Competing Interests: The authors declare that this manuscript was approved by all authors in its form and that no competing interest exists.

                Article
                jEJHS.v28.i2.pg217
                10.4314/ejhs.v28i2.13
                6016336
                c7d9bd6b-45ee-4977-952d-c46ca6bcc029
                © 2018 Birkneh Taddese., et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 1 November 2017
                : 3 November 2017
                Categories
                Original Article

                Medicine
                community,immunisation,cimci child health,health education,mothers,determinants
                Medicine
                community, immunisation, cimci child health, health education, mothers, determinants

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