ABSTRACT
Environmental sanitation and waste management are critical components of public health, environmental sustainability, and urban development. In Calabar, Nigeria, rapid urbanization and infrastructural challenges have exacerbated issues related to poor environmental sanitation, improper waste disposal, pollution, and disease outbreaks. The aim of the present study was to assess the knowledge, attitude and perception (KAP) of community members in Calabar regarding environmental sanitation and waste management. Three research questions, three objectives and one hypothesis were formulated to guide the study. Literature was review based on major research variables. Health belief model and unitary human being model were used. The study employed a descriptive cross-sectional design. A multistage stage sampling technique was used to select a total of 301 residents from 2 randomly selected council wards in Calabar municipal. The streets from where data was collected were further selected via a convenience purposive method. Data were collected using 54-item Adopted questionnaires validated for content and reliability. Data collected was coded using SPSS version 25.0 and analysed using descriptive statistics and multivariate regression at p value 0.05, significance level. Findings revealed a high level of knowledge (mean = 2.96), positive attitude (mean = 2.92), and favourable perception (mean = 2.89) of environmental sanitation and waste management. Moreover, hypothesis test indicates F-value of 9.762 for the relationship between variables, because the p-value 0.000 is less than 0.05 level of significance at 3 and 298 degrees of freedom, there was significant relationship between the variables. This indicates that increased knowledge, positive attitude and perceptions are associated with responsible waste management behaviours. The study emphasized the need for continuous community education, infrastructural development, and policy enforcement to sustain positive environmenta

ABSTRACT
Background: Maternal mortality remains a major public health challenge globally, particularly in Sub-Saharan Africa and Zambia, despite the availability of interventions aimed at reducing preventable deaths. In Mazabuka District, maternal deaths continue to occur, reflecting gaps in access to timely and quality maternal healthcare services. Achieving the Sustainable Development Goal target of reducing maternal mortality to fewer than 70 deaths per 100,000 live births by 2030 remains a significant challenge. Objective: This study aimed to determine the prevalence and identify the determinants of maternal mortality in Mazabuka District, Zambia. Materials and Methods: A retrospective analytical cross-sectional study design using a quantitative approach was employed. Data were extracted from 13,519 maternal records at Mazabuka General Hospital covering the period January 2018 to December 2022. Purposive sampling was used to select maternal death cases, while systematic random sampling was used for non-mortality cases. Data were analysed using descriptive statistics, Chi-square tests, and Pearson’s correlation analysis at a 95% confidence level. Results: The prevalence of maternal mortality during the study period was 0.274% (37/13,519). Maternal mortality was significantly associated with maternal age (p<0.01), referral status (p<0.001), duration of referral (p<0.001), and mode of delivery (p<0.001). Patient-related factors including cause of death, pregnancy interval (p=0.002), parity (p=0.001), period of death (p<0.001), and complications during pregnancy (p=0.003) were also significantly associated with maternal mortality. Postpartum haemorrhage was identified as the leading cause of death. Socio-demographic factors such as education, marital status, occupation, and residence were not significantly associated with maternal mortality. Conclusion: Maternal mortality in Mazabuka District is primarily driven by delays in referral, obstetric complications, and high-risk c

ABSTRACT
Background: Despite free maternal health services and increasing antenatal care attendance, home deliveries remain common in rural Zambia. This study explores the determinants of home deliveries among post-natal mothers in Kazungula District. Methods: A cross-sectional survey was conducted with 44 post-natal mothers who delivered at home in 2022 within Kazungula District Hospital’s catchment area. Structured interviews were used to collect data on socio-economic factors, cultural beliefs, attitudes toward facility delivery, and maternal knowledge. Descriptive statistics were analyzed using SPSS v24. Results: Key contributors to home deliveries included distance to health facility (45.5%), lack of transport funds (22.7%), short labor intervals (34.1%), and preference for traditional birth attendants (25%). Additionally, 62.5% of mothers lacked awareness of birth complications, and 65.9% expressed negative attitudes toward facility delivery. While 81.8% stated they would prefer facility births, structural, economic, and cultural barriers impacted actual behavior. Conclusion: Persistent home deliveries in Kazungula District are primarily driven by socio-economic barriers, cultural beliefs, and maternal knowledge gaps. Addressing these factors through targeted health education, community sensitization, and transportation support is essential.

ABSTRACT
Illness during pregnancy poses a significant challenge for expectant mothers, as it can lead to high levels of uncertainty, which, if not properly managed, can affect their physical, emotional, and social well-being. In this context, the ability to understand the condition, interpret symptoms, and access clear information becomes a key factor in making informed decisions and coping healthily with the pregnancy. The literature indicates that uncertainty, when not accompanied by cognitive strategies and structural support, increases biopsychosocial vulnerability and limits women’s autonomy in their care process. To analyse these dynamics, a correlational study was conducted involving 91 pregnant women attending two health centres. The majority belonged to middle socioeconomic strata and had a university education. More than half were experiencing a high-risk pregnancy, and 45.1% presented a high biopsychosocial risk, mainly associated with high blood pressure and infectious conditions. The findings showed that uncertainty is related to a lack of clarity about the condition and to symptom variability. Furthermore, significant associations were identified between cognitive ability, biopsychosocial risk, sources of structural support, and overall uncertainty. These findings suggest that biopsychosocial risk is closely linked to higher levels of uncertainty during pregnancy. Consequently, there is a need to strengthen the processes of informational, cognitive, and structural support aimed at pregnant women, particularly those who are hospitalised or have high-risk conditions. Promoting educational interventions, effective communication strategies, and comprehensive support helps reduce perceived uncertainty and encourages healthier coping in clinical settings.

ABSTRACT
Background: Patient-Reported Experience Measures (PREMs) have emerged as essential tools for evaluating the quality of healthcare delivery from the patient’s perspective. In nursing practice, PREMs provide a structured mechanism for capturing patient voices, aligning care delivery with professional nursing values such as compassion, dignity, respect, and patient-centredness. Despite growing global interest, the systematic use of PREMs within hospital nursing services in Saudi Arabia remains limited. Objective: This study aimed to assess patient experiences of nursing care using PREMs at Aster Sanad Hospital, Riyadh, and to examine associations between patient sociodemographic characteristics and reported care experiences. Methodology: A quantitative cross-sectional design was employed. Adult inpatients admitted to medical and surgical wards were recruited using systematic sampling. Data were collected using a validated PREM questionnaire covering communication, responsiveness, emotional support, respect, and involvement in care. Descriptive and inferential analyses were conducted using SPSS version 26. Results: A total of 320 patients participated. Overall PREM scores indicated high experiences of nursing communication and respect, while lower scores were reported for shared decision-making and emotional support. Significant associations were identified between PREM scores and age, education level, and ethnicity (p < 0.05). Female patients reported slightly higher overall experience scores compared to males. Conclusion: PREMs provide valuable insights into how nursing values are perceived and experienced by patients. Integrating PREMs into routine nursing evaluation can strengthen patient-centred care, guide quality improvement initiatives, and enhance nursing accountability within hospital settings.