Background: A gamut of factors including culture-related beliefs and knowledge seem to have constrained effective implementation and uptake of WHO/UNICEF's Baby-Friendly Hospital Initiative (BFHI) in most developing countries. Aim: To assess mothers' breast-feeding initiation and use of colostrum and prelacteal feeds. Subjects and Methods: The design was a cross-sectional descriptive survey. A sample of 285 mothers with children under two years was drawn from an estimated population of 32,571 women of child-bearing age. Data were collected using validated researcher-developed interviewer-administered structured questionnaire. Data were analyzed using frequency tables, odds ratio and ANOVA at a significance level of p < 0.05. Results: About 61.1% (174) of mothers initiated breast-feeding early; 12.3% (35) expressed and discarded the colostrum, and 39.6% (113) gave prelacteals. Women who delivered in hospital initiated breast-feeding earlier than those delivered at home/TBA or health center. Mode of delivery influenced their time of breast-feeding initiation (p = 0.035) and prelacteal feeding (p = 0.023). Mothers are more likely to feed colostrum to their baby (odds ratio 10.872, 95% CI: 7.1-16.6). Conclusion: Findings showed that the BFHI is yielding good result in newborn nutrition. However, objectives of the initiative are not yet completely achieved because of the predominant practice of using prelateals and discarding colostrum among nursing mothers. Skilled care providers need to step up efforts to encourage women to deliver at health facilities; increase heath education, supervise and monitor mothers to increase compliance with BFHI principles.

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Background: The standard case management for acute respiratory infections (ARI) initiated by the World Health Organization (WHO) seeks to reduce pneumonia mortality by encouraging appropriate maternal home-care practices and early treatment from a health-care provider. Objective: To determine the practices and treatment-seeking behaviour of mothers for symptoms and signs of childhood acute respiratory infections. Methods: A health facility-based, prospective cross-sectional study of 400 mothers with interviewer-administered structured questionnaires was conducted. Data were analyzed with descriptive statistics on SPSS (version 17.0), and results were expressed in means ± standard deviations, frequencies and proportions (percentages). Pearson's chi-square test was used to determine the effect of maternal socio-economic class on treatment-seeking behaviour for ARI symptoms. P value less than 0.05 was adopted as the level of statistical significance. Results: For cough, 124/400 (31.0%) mentioned allopathic treatment and self-advised drugs while 274/400 (68.5%) would prefer to seek immediate medical consult. For catarrh, 230/400 (57.5%) would administer home remedies as first line of treatment while 156/400 (38.5%) preferred to seek medical consult from the outset. A substantial majority would immediately consult a health personnel for ear-ache/ear discharge (380/400; 95.0%) and sore-throat (372/400; 85%). For signs of pneumonia, majority would prefer immediate medical consult for fast breathing (394/400; 98.5%), difficult breathing (376/400; 94.0%) and chest in-drawing (390/400; 97.0%). There was no statistically significant difference between the socio-economic classes of mothers would seek immediate medical consult for cough and cold and ear-ache/discharge and those who would not (p > 0.05), but a statistically significant difference was noted between the socio-economic classes of mothers who would seek and those who would not seek immediate medical consult for sore-throat (p <0.05) and pneumonia signs (p <0.001). Conclusions: Mothers would prefer self-advised home remedies for upper respiratory tract infections, but would generally seek immediate medical consult for symptoms of pneumonia. The latter treatment-seeking behaviour appears to be influenced by their socio-economic class. The practice of early self-referral for pneumonia signs may contribute to the successful implementation of the ARI control programme.

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Background: Despite the availability of highly effective emergency contraceptives, the risk of unintended pregnancy remains a major challenge to the reproductive wellbeing of young women. Aims: To evaluate and compare the knowledge, usage and practice of emergency contraception (EC) among medical and non-medical undergraduates and the risk of unintended pregnancy between the two groups. Method: A cross sectional comparative study of female medical and non-medical students was conducted among female undergraduates at a University in Abakaliki, Nigeria. Four hundred and twenty four (424) female undergraduates were interviewed with pre-tested self administered semistructured and confidential questionnaires. Data was analyzed with SPSS package version 20. The level of statistical significance was set at p-value < 0.05. Results: There were 424 respondents; made up of 214 medical and 210 non-medical undergraduates. The response rate was 85.6%. Over two-thirdof medical students (153/214; 71.5%) and more than half of non-medical students (115/210; 54.8%) were aware of emergency contraception [OR= 0.52: 95% CI =0.33-0.82; p=0.002]. The commonest sources of information were lectures (20.0%; 43/214), and books (9.4%; 20/214) for medical students, and peers (27.1%; 57/210) for non-medical students. More medical students (92.1%; 197/214) had accurate knowledge of conventional EC than non-medical students (60.3%; 129/210), [OR=1.31; CI (0.75-4.08), p=0.01]. Over one-quarter (27.8%; 118/424) of respondents used Levonorgestrel as EC. The risk of unintended pregnancy was higher among nonmedical students 46(62.2%) than medical students 28(37.8%): [OR= 1.04, CI (0.37-2.96), p=0.03]. Unsafe abortion was also higher among non-medical students (41%) than their medical peers (11%): [OR=1.71; CI (1.03-2.83), p=0.02]. Conclusion: Medical undergraduates were found to have greater knowledge and usage of emergency contraception, with less risk of unintended pregnancy and unsafe abortion than their non-medical counterpart. Creation of widespread awareness of effective EC is recommended to ensure proper utilization.

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Background:Malaria remains one of the leading causes of morbidity and mortality worldwide especially in Africa and Nigeria in particular. Aim: The study investigated level of ownership and utilization of ITNs, with focus on the availability of ITNs, level of awareness about ITNs, ownership, utilization of ITNs and factors influencing ownership and utilization of ITNs in Igbo Eze South Local Government Area of Enugu state. Subject and Methods: Cross sectional descriptive survey was adopted. Data were elicited from pregnant women and nursing mothers in three public health facilities located in urban, semi-urban and rural area within the local government. The quantitative data were analyzed to determine frequencies and percentage of ownership, utilization, factors influencing ownership and utilization. Also Chi-square was generated to determine association of age and education with ownership and utilization of ITNs. Results: The study revealed that ownership and utilization were both high (81%). However, factors influencing ownership and utilization of ITNs were discontinuity of distribution of free nets (78.4%), fear of chemical impregnated with ITNs (72.5%) and poor attitude towards the use of ITNs (97.3%) have the most influence. In addition, poor knowledge (66.0%) and cultural beliefs (63.3%) affected ownership and utilization of ITNs. The study revealed that the utilization of ITNs differed by level of age and education. Conclusion: Concerted efforts need to be made to resolve the various factors that constrain the ownership and use of ITNs. Also, efforts should be sustained to scale up the distribution and ownership of ITNs in the study area.

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Background: Managerial competencies and organizational skills remain important tools to successful and prudent hospital management. Things that influence the acquisition of these skills by the management cadre are explored because they enable excellence in all indices of hospital operations. Aim: To assess the contributors to hospital managers' competencies and organizational skills and using the results in policy directives to encourage such acquisition. Subjects and Methods: Data for this study came from a cross-sectional survey using self-administered questionnaire distributed among management staff in twenty five (25) hospitals in the Federal Capital Territory (FCT) Abuja. One hundred and twenty (125) questionnaires were distributed, out of which one hundred and four (104) were answered and returned giving a response rate of 83.2%. Results: The result indicates that more than 50% of the respondents reported having good skill on measurement of organizational performance, excellent skill assessing the quality of hospital care, good skill on evaluating health services, while less than half of the respondents had good skill on financial performance evaluation. The result also showed that female respondents had more selfreported excellent skill on assessing patient's satisfaction (8.014, p=0.018), better skill on good nursing quality care (7.925, p=0.048) and better skill on providing feedback to patients (4.478, p=0.034). The respondents in public hospitals reported being better skilled on the measurement of organizational performance (11.267, p=0.010) and were better skilled yet on assessment of quality of care (13.037, p=0.005). Conclusion: Hospital managers' competencies and contributors to their organizational skills remain very important in today's health facility management as all hospitals---public and private will remain inept at accomplishing service delivery innovations without them.

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