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Introduction: The use and influence of coping mechanisms vary across cultures and evaluation methods. Limited research exists on coping mechanisms for non-specific chronic low back pain (CLBP) in African societies. This secondary qualitative study explored adaptive and maladaptive coping strategies used by adults with CLBP in Nigerian and Zambian communities. Methods: Primary qualitative data from studies in rural Nigeria and peri-urban Zambia were used. Primary data were collected through in-depth face-to-face interviews with adults living with back pain to explore their experiences and coping strategies. Thematic analyses of interview transcripts from both studies were conducted using the framework approach, combining inductive and deductive analysis techniques. Findings: Participants used a mix of adaptive and maladaptive coping strategies for CLBP. Some strategies had both positive and negative aspects, with varying effects on individuals. A few participants focused on adaptive coping, staying positive, and actively managing their pain through stretching, exercise, pacing activities, spirituality, and belief in their strategies. They avoided seeking treatment for their back pain. Discussion: The nuances in coping with CLBP should be taken into consideration when developing coping assessment strategies and rehabilitation interventions for individuals with CLBP. [ABSTRACT FROM AUTHOR]

Introduction: single-dose of sublingual misoprostol 400mcg with the participant followed-up at the gynecology clinic one week after with an ultrasound scan for the completeness of the uterine evacuation. Objective: to compare the effectiveness of single-dose sublingual misoprostol to manual vacuum aspiration in the treatment of incomplete spontaneous abortion in Enugu, Nigeria. Methods: the primary outcome measure was the incidence of complete uterine evacuation (complete abortion) after one week of treatment while the secondary outcome measures included incidence, types, and tolerability of treatment side effects as well as participants' satisfaction with the treatment received. Results: two hundred and three participants who met the study criteria and completed the study were randomised into the intervention group (n=102) received single-dose sublingual misoprostol 400mcg and the control group (n= 101) received manual vacuum aspiration. Incidence of complete abortion was 86.3% for the misoprostol group and 100.0% for the control group, RR = 0.86, (CI 95%: 0.80 - 0.93), p <0.001. The most common side effect was abdominal pain with an incidence of 27.5% versus 48.55 for the misoprostol and control groups respectively (p = 0.002). Most participants in each group (81.1% versus 77.6% for the misoprostol and control groups respectively) considered the side effects as tolerable. The mean visual analogue scale score for maternal satisfaction was higher in the misoprostol group (86.7 ± 14.11) than the control group (81.36 ± 11.10), p < 0.001. Conclusion: the treatment of incomplete spontaneous abortion with single-dose sublingual misoprostol 400mcg produced a high rate of complete abortion among women in Enugu, Nigeria. Despite having a lower complete abortion rate, maternal satisfaction was higher when compared with women that had manual vacuum aspiration of the uterus. Trial registration: trial registration number - PACTR202009857889210, date of registration - September 23, 2020. Retrospectively registered. [ABSTRACT FROM AUTHOR]

Aim: To explore the prevalence of anemia in three cohorts of women, namely, married yet to be mothers, married and are mothers, and currently pregnant, to ascertain the patterns in anemia in women. Methods: We analyzed a sample of 130,965 married women from four Demographic Health Surveys: 2000, 2005, 2009 and 2015. The primary focus for the analysis was married women aged 15 to 49 years. In the absence of a longitudinal data that followed the same women over the periods, a synthetic cohort of the women of that age-group was constructed to get women aged 15 to 64 years over the four surveys. Women who were aged 15 to 19 years in 2000 were the same as those 30 to 34 years in 2015, while those aged 45 to 49 years in 2000 were the same as 60 to 64 years in 2015. Results: Logistic regression revealed that young mothers were significantly more infected (p <.001). Pregnancy affected anemia in the women (p <.001). Being younger and richer were associated with odds ratios of 0.599 (95% confidence interval, CI: [0.560, 0.640]) and 0.765 (95% CI: [0.726, 0.807]) for anemia, respectively. Being pregnant had odds ratio of 1.642 (95% CI: [1.439, 1.872]) for anemia. Conclusion: Public health strategies should target social deprivation at the household level while addressing maternal health issues. An analysis of data on unmarried women and their children is recommended. [ABSTRACT FROM AUTHOR]

Anemia is a common nutritional problem, and it has a remarkably high prevalence rate in Southeast Asia. We analyzed a sample of 112,714 mothers aged 15 to 49 years and their children younger than 5 years from the 2005–2006 Indian National Fertility and Health Survey with available data on anemia to determine the anemia statuses and risk factors associated with maternal and childhood anemia. Logistic regression analyses were used to determine factors associated with anemia. The overall prevalence of maternal anemia was 52.0%, while the overall prevalence of childhood anemia was 66.7%. Predictors of maternal anemia are a young age (p <.001), maternal health practices (p <.001), and reproductive health-related infections (p <.001), among others. On the other hand, predictors of childhood anemia included iron deficiency (p =.007), vitamin deficiency (p =.003), and common infections (p =.008). Other predictors of childhood anemia included poor dietary intake (p <.01) and childcare practices (p <.001). Childcare practice has the strongest association with childhood anemia with an odds ratio of 1.67 (95% confidence interval [1.55, 1.79]). With respect to maternal anemia, the strongest risk factor was being infected with reproductive health infections with an odds ratio of 1.157 (95% confidence interval [1.11, 1.21]). Interventions designed to address prevalence of childhood and maternal anemia in India should take the risk factors in a holistic manner. A multifactorial framework should guide such interventions. [ABSTRACT FROM AUTHOR]

We explored the equity issues in access to maternal health services in Enugu State, Nigeria. We conducted a cross-sectional survey of 1,600 women who had babies within 6 months prior to the survey, drawn from four urban and rural local government areas in Enugu State of Nigeria, using structured questionnaire. Focus group discussions were held with grandmothers and fathers of the new babies. In-depth interviews were held with health workers. Results showed that inequities exist in access to quality health service when the mothers needed health care. The inequities in access to quality antenatal care (ANC) services were driven mainly by the type of localities of the mothers. Mothers who lived in the urban areas had better access (p = .013). Other factors that facilitated access to better ANC services included being educated (p = .049), being older (p = .009), and belonging to the richer wealth quintile (p < .001). With respect to access to health service when in need of health, differentials were seen with respect to living in urban residence (p < .001), distance to the health facilities (p < .001), and being rich (p < .001). Access to health services was associated with odds ratio of 3.6 (95% CI [2.9, 4.4]) and 1.54 (95% CI [1.3, 2.0]) for living in urban residence and existence of good ANC service points, respectively. Similarly, living in urban areas was associated with an odds ratio of 1.3 (95% CI [1.1, 1.6]) of having access to good ANC services. These inequities in access to health service were also captured in the qualitative data. Suboptimal access to quality health care by segments of the populations poses challenge to universal health coverage in Enugu State. Action is needed to promote coordinated delivery of health services to ensure no one is left behind, irrespective of where they live or the socioeconomic strata they are born into. [ABSTRACT FROM AUTHOR]

Introduction: Postoperative pain is one of the main postoperative adverse outcomes following caesarean section. Its management still remains a challenge especially in a low resource setting. Aim: To compare the efficacy of intramuscular pentazocine alone and combined intramuscular pentazocine with diclofenac for pain relief within 24 hours after caesarean section. Materials and Methods: This was a double blind randomized control study of post caesarean section pain management of 140 participants between April and December, 2015 at the Federal Teaching hospital, Abakaliki. Inclusion criteria involved consenting and low risk parturients who had caesarean section under spinal anaesthesia. The participants were randomly grouped into Pentazocine-Placebo (PP) group and Pentazocine-Diclofenac (PD) group. The PP group received pentazocine 30 mg every 4 hours for 24 hours and 3 milliliters of water for injection as placebo 12 hourly for 24 hours while the PD group received pentazocine 30 mg every 4 hours and diclofenac 75 mg every 12 hours for 24 hours. The level of pain control was assessed using the Visual Analog Scale (VAS). The data was analysed with IBM SPSS version 20.0. The level of significance was set at < 0.05. Results: The use of PD for 24 hour post caesarean section analgesia achieved better pain relief, faster onset of postoperative ambulation, bowel sound auscultation and oral feeding than the use of PP (p-value ⩽0.002). However, the use of PD is more expensive than PP (p-value =0.0001). There was no difference between the two groups of participants on the passage of flatus and duration of hospital stay (pvalue⩾0.05). The use of PP was associated with more maternal side effects (p-value=0.009). There was no difference on the level of satisfaction between the two groups of participants (p-value⩾0.05). Conclusion: The use of PD for post caesarean section analgesia is more effective in achieving a satisfactory pain relief and has less side effects. [ABSTRACT FROM AUTHOR]