Background
Methods
Description of study sites
Nigeria characteristics | |
---|---|
Population | 159,288,426 |
Size (Km2) | 923, 768 |
Number of states | 36 |
Number of geopolitical zones | 6 |
Predominant language | Yoruba, Igbo, and Hausa |
Predominant religions | Christianity and Islam |
Ogun State characteristics | |
Population | 4,000,000 |
Size (Km2) | 16,409 |
Number of local government areas | 20 |
Predominant language | Yoruba |
Predominant religion | Christianity |
Local Government Area characteristics | |
Cumulative population | 469,271 |
Cumulative size (Km2) | 1657 |
Number of study areas | 4/40 |
Data collection
Data analysis
Results
# |
N participants | Region | Age (yr) median [range] | Religion |
N children median [range] | % Married |
---|---|---|---|---|---|---|
1 Islam | ||||||
2 Christian | ||||||
3 Traditional religion | ||||||
Community leaders | ||||||
1 | 12 | Yewa South | 52 [27, 70] | 1 = (N = 6) | 5 [0, 6] | 100 % |
2 = (N = 6) | ||||||
2 | 10 | Remo North | 44 [43, 77] | 1 = (N = 3) |
Not known
| 100 % |
2 = (N = 5) | ||||||
3 = (N = 2) | ||||||
3 | 12 | Remo North | 58 [30, 85] |
Not known
|
Not known
| 100 % |
4 | 10 | Ogijo | 50 [26, 71] | 1 = (N = 5) | 6 [1, 9] | 100 % |
2 = (N = 5) | ||||||
5 | 12 | Ogijo | 57 [45, 72] | 1 = (N = 3) | 8 [4, 10] | 100 % |
2 = (N = 6) | ||||||
3 = (N = 3) | ||||||
6 | 12 | Imeko-Afon | 45 [20, 55] | 1 = (N = 6) | 3 [0,10] | 100 % |
2 = (N = 6) | ||||||
Male decision-makers | ||||||
1 | 12 | Yewa South | 38 [27, 49] | 1 = (N = 2) | 3 [1, 5] | 100 % |
2 = (N = 10) | ||||||
2 | 11 | Remo North | 40 [35, 62] | 1 = (N = 4) | 3 [0, 9] | 100 % |
2 = (N = 6) | ||||||
3 = (N = 1) | ||||||
3 | 12 | Imeko-Afon | 51 [40, 60] | 1 = (N = 11) | 6 [4, 10] | 100 % |
2 = (N = 1) | ||||||
New mothers | ||||||
1 | 12 | Yewa South | 27 [20, 42] | 1 = (N = 6) | 3 [1, 5] | 100 % |
2 = (N = 6) | ||||||
2 | 12 | Yewa South | 31 [20, 42] | 1 = (N = 4) | 2 [1, 3] | 100 % |
2 = (N = 8) | ||||||
3 | 12 | Remo North | 29 [21, 39] | 1 = (N = 3) | 4 [1, 6] | 100 % |
2 = (N = 9) | ||||||
4 | 12 | Remo North | 28 [21, 34] | 1 = (N = 5) | 2 [1, 4] | 100 % |
2 = (N = 7) | ||||||
5 | 12 | Ogijo | 31 [26, 43] | 1 = (N = 4) | 3 [1, 4] | 92 % |
2 = (N = 8) | ||||||
6 | 12 | Ogijo | 29 [22, 38] | 1 = (N = 1) | 2 [1, 5] | 100 % |
2 = (N = 11) | ||||||
7 | 12 | Imeko-Afon | 30 [16, 36] | 1 = (N = 5) | 3 [1, 5] | 100 % |
2 = (N = 7) | ||||||
8 | 11 | Imeko-Afon | 30 [18, 36] | 1 = (N = 6) | 3 [1, 6] | 100 % |
2 = (N = 5) | ||||||
Pregnant women | ||||||
1 | 12 | Yewa South | 26 [20, 33] | 1 = (N = 3) | 1 [0, 4] | 100 % |
2 = (N = 9) | ||||||
2 | 12 | Yewa South | 26 [20, 39] | 1 = (N = 4) | 3 [1, 3] | 100 % |
2 = (N = 8) | ||||||
3 | 12 | Remo North | 30 [20, 36] | 1 = (N = 1) | 1 [1, 3] | 100 % |
2 = (N = 11) | ||||||
4 | 12 | Remo North | 32 [23, 40] | 1 = (N = 5) | 3 [1, 5] | 100 % |
2 = (N = 7) | ||||||
5 | 9 | Ogijo | 27 [19, 34] | 1 = (N = 6) | 1 [0, 2] | 100 % |
2 = (N = 3) | ||||||
6 | 10 | Imeko-Afon | 22 [19, 26] | 1 = (N = 7) | 1 [0, 4] | 100 % |
2 = (N = 3) | ||||||
7 | 12 | Imeko-Afon | 25 [20, 30] | 1 = (N = 2) | 2 [0, 4] | 100 % |
2 = (N = 10) | ||||||
Traditional birth attendants | ||||||
1 | 12 | Yewa South | 44 [32, 65] | 1 = (N = 7) | 3 [1, 4] | 100 % |
1 = (N = 5) | ||||||
2 | 12 | Remo North | 50 [41, 77] | 1 = (N = 1) | 5 [3, 5] | 100 % |
2 = (N = 8) | ||||||
3 = (N = 2) | ||||||
3 | 12 | Ogijo | 40 [25, 50] | 1 = (N = 5) | 4 [0, 5] | 83 % |
2 = (N = 6) |
# | Stakeholder group | Cluster |
---|---|---|
1 | Head of traditional birth attendants | Sagamu |
2 | Head of traditional birth attendants | Yewa South |
3 | Head of traditional birth attendants | Imeko-Afon |
4 | Head of traditional birth attendants | Remo North |
5 | Community leader | Imeko-Afon |
6 | Male community leaders | Imeko-Afon |
7 | Women community leaders | Sagamu |
8 | Women community leaders | Imeko-Afon |
9 | Women community leaders | Remo North |
Local terms for pre-eclampsia and eclampsia
Local terms for pre-eclampsia | ||
Ìfúnpá gígâ | Èjè rírû (stormy blood) | |
Local terms for eclampsia | ||
Gìrì âlábôyún (pregnancy-related seizure) | Gìrì (Seizure) | Gìrì àgbàlâgbà (Seizure in adults) |
Gìrì ipa (stubborn seizure) | Gìrì înú ôyún (pregnancy-related seizure) | Òyì ôrí (dizziness in the head) |
Îpá ná (Hot seizure) | Îlè tútù (cold ground) | Òyì ôjú (dizziness in the eyes) |
Perceived causes of pre-eclampsia and eclampsia
“If the pregnant woman is having depressive thoughts, if she encounters something that is beyond her, and she begins to worry about the issue, a thing like that could cause high blood pressure.” [Pregnant Woman]
“It is caused by their husband’s bad behaviour, because a lot of men want their wives and not her pregnancy. Some husbands would stop taking care of their wives when they become pregnant.” [Community Leader]
“There is a belief that if a pregnant woman frequently sleeps on a cold floor, it could cause convulsion, or if the body is exposed to too much breeze […] and also if there are excessive depressive thoughts…it can lead to convulsion.” [Pregnant Woman]
“Something that I have noticed about ‘gìrì’ is that some things are hereditary. There are some things that people would say similar thing happened to the father or mother at a time. So things like this would have become hereditary and if this is not treated early it will run from two to three generations and it would become a family problem.” [Community Leader]
“If she’s under too much stress, she might not sleep and it gets to the point that she finds it difficult to sleep and the health care workers begin to monitor her blood pressure, a thing like this could cause convulsion for an adult and it’s the same predicament for a pregnant woman” [Male Decision-Maker]
Perceived causes of pre-eclampsia | |
Depressive thoughts | |
Hereditary | |
Stress | |
Perceived causes of eclampsia | |
Prolonged exposure to cold | |
Hypertension | |
Anaemia | |
Malaria | |
Urinary tract infections | |
Diabetes | |
Oedema | |
Lack or loss of blood | |
Pre-existing hypertension | |
Taking cold food or drinks | |
Sleeping on a cold floor |
“What causes convulsion is like the other participant explained earlier, if a pregnant woman should have high blood pressure there would be a substance in her urine, there’s a way they detect the substance, also if her legs are swollen…blood shortage could cause swollen legs for the pregnant woman, lack of blood in her system could make her legs to swell. If a woman should stress herself too much during pregnancy a thing like this could make her develop high blood pressure, all these factors together would cause convulsion for the pregnant woman and the condition would be out of control. [Community Leader]
Prevention strategies for pre-eclampsia and eclampsia
“If a pregnant woman has a history of convulsion and her husband is aware of her condition her husband could find a person that would be assisting his wife, he would tell the person that “in case my wife convulses, please you would help me assist her” and when they see that the pregnant woman is heavy and she’s about to deliver they shouldn’t let her be alone, they shouldn’t allow her to be alone.because it could affect her pregnancy.” [New Mother]
Outcomes of pre-eclampsia and eclampsia
“High blood pressure is like a trap, once it affects a woman, it may be difficult to cure. Sometime it may be hereditary and once a woman has it, she can also transfer it to her unborn baby since they both share the same blood, high blood pressure can lead to the death of women.” [Male Decision-Maker]
Traditional treatment of pre-eclampsia and eclampsia
“If it (convulsion) happens, the woman would be given a local concoction “oògùn ilè tútù” or would be taken to the hospital. But she would usually be given the local concoction until the convulsion subsides.” [Pregnant Woman]
“They should turn her to her right side and raise her up…that is what I know and that is what I’ve witnessed, if they pour water on her head and raise her up and put her down gently. Nobody should say a word around her at that moment. If it’s just a normal convulsion, she would be revived.” [New Mother]
“I use original tobacco leaves… use it with boiling water and soak it with lemon juice, if pregnant woman is convulsing give her one teaspoon, rub it on her eyes and body… it will usually calm her down.” [Traditional Birth Attendant]
“They treat it in the traditional way, using [herbs], black soap, burnt leaves or make incisions. You would see some pregnant women with many incisions on their heads.” [Community Leader]