Challenges and Coping Strategies of Student Nursing Mothers in University of Ibadan,Oyo State,Nigeria

Abstract

The rigor of combining motherhood with education poses great challenge to student nursing mothers (SNMs). This study identified the challenges experienced by the SNMs and determined the factors associated with the challenges experienced in University of Ibadan, Ibadan Oyo State, Nigeria. This study utilized a nonprobability sampling technique of snowballing. Responses were elicited from 250 consenting SNMs using the pretested semistructured questionnaire. The SNM challenges were measured on 15-point scale. Challenges scores were classified as moderate (≤9) and severe (≥10). The mean age of the SNMs was 29.5 ± 2.8 years. Majority of the respondents (70.0%) reported facing severe challenges which included economic, childcare, and academic challenges (43.2%, 37.2%, and 24.8%, respectively). χ² test showed significant associations between ages, course of study, and level of study of the SNMs (χ² = 10.520, p = .005; χ² = 14.934, p = .002; and χ² = 9.523, p = .002, respectively) and the overall challenges experienced. Research findings reveal that childhood health problems occurred mostly among SNMs having problems breastfeeding their babies.

Keywords

student nursing mothers challenges Nigeria

Introduction

Formal education is one of the most empowering tools for human development because the amount of education a woman obtains would influence the future aspects of her life.¹ It has been argued that education of women and girls is an important topic that helps identify some challenges women faced, which is in alignment with the Sustainable Development Goal 5 of achieving gender equality.² It provides them with an understanding of basic health, nutrition, and family planning, given them choices and the power to decide over their own lives and bodies.³ It has also been noted that educated women were better able to contribute to national development and participate more effectively in the economic and political life of societies,⁴ but societal norms, traditions, as well as economic and social circumstances make it difficult for girls to attain desired higher levels of education.⁵ Despite this difficulty, however, the education of girls and women in Africa has greatly improved owing to high priorities placed on girls’ education in national and international education policies.⁶ Nevertheless, the reproductive characteristics of females such as having the right to have children impede the quest by some to achieve their full potential in their academic life. This is because the reproductive rights are not considered equally as important as their education rights. Pursing higher education while nursing children becomes a challenge, putting the women under constant demands from school and family, causing women to abandon one role for the sake of the other.⁷

The role of 21st-century woman often requires her to be a wife, mother, nurse, teacher, and cobreadwinner all at the same time, and the changing role of women in the society has made it necessary for nursing mothers to combine childcare, home care, career, and studies. In recent times, the number of female students’ enrollment in higher institutions is increasing, which mostly consists of mothers resuming school or enrolling into university late, also is the increasing numbers of student mothers (SMs) who gave birth either in secondary school or during their higher education pursuit.⁸

Performing the roles of a student and mother by SMs is characterized by several challenges such as academic, childcare, and economic or financial.⁹ Maternal-related illness, fatigue, lateness to lectures, inability to meet assignment deadlines, nonparticipation in examinations, uncompromising attitudes of lecturers, stigma (or unfavorable comments), lack of or inadequate access to spouse, family, friends, lecturers, church members, and leisure, economic challenges such as inadequate funds for academic fees (including purchase of books, handouts, etc.), accommodation fees, feeding, purchase of other logistics including drugs are some of the listed challenges faced by SMs.^4,10–12 It has been reported that some students voluntarily withdraw from the program only to rejoin after weaning their babies,⁴ while many had to interrupt their studies because the college would not accommodate them in the hostels.¹³ These challenges impact negatively on such learners, consequently affecting their academic work and results and eventually stalling progress toward the achievement of their set goals.⁴

SMs face many challenges during the course of their education, feeling weak, drowsy, and lack of consideration in classes leading to failure. Lidgard¹⁴ asserts that significant challenge for SMs is inadequate time to spend with their children, significant other, families and friends, and to study as well as complete assignments. Unfortunately, as SMs are dedicated to both their children and their education, in the end, the time crunch can have devastating effects on the relationship with their children.¹⁵

“The university culture tends to assume that students have time to attend classes without other responsibilities, and can treat their education as their primary responsibility, as if their higher education is the centre of their life.”¹⁶ Therefore, taking on motherhood and childcare alongside educational pursuit is not considered normal in several universities. SMs experience unpleasant emotional pressures and receive negative feedback from the academic setting, implying that education is the first priority. As it is implied that bringing a child shows that the SM does not have the obligatory interest and enthusiasm toward her education.⁹

Unfortunately, empirical evidence is lacking on the challenges faced by SMs in Nigeria.¹⁷ A few studies outside Nigeria have suggested that extended family members and universities could provide support to student nursing mothers (SNMs) in respect of taking care of their children¹⁸ providing breastfeeding rooms (to ease the challenges faced by SNMs in breastfeeding¹⁹ and counseling services to enable them manage better the challenges resulting from their productive, reproductive, and community service roles, respectively).²⁰ However, the extent to which these occur remains largely unknown. Therefore, this article seeks to investigate the challenges faced by SMs in their academic pursuit. The objective of this study is to identify and assess the challenges experienced by SMs in University of Ibadan and the factors associated with the challenges experienced by the participants.

Methods

This study was a cross-sectional descriptive study employing the quantitative method of data collection. A total of 250 SMs in University of Ibadan, Oyo State participated in the study. Female students with babies in University of Ibadan were eligible for this study, while nonconsenting female students with babies were excluded.

Procedure

The participants were selected by using nonprobability sampling technique of snowballing; this method was used as the SMs are not an organized group. An SM, however, can provide the research team with contact or location of similar individuals eligible for this study; this was continued until the minimum sample size was acquired.

Measures

Pretested semistructured questionnaire which elicited information on respondents’ sociodemographic characteristics and challenges faced by the selected SMs was administered interviewer style for better comprehension and clarification of question items that are not clear. The SMs challenges were measured on a 15-point scale. Challenges scores were classified as moderate (≤9) and severe (≥10); this classification was based on the proportion of SNMs who responded yes to all the questions on challenges in each section.

Reliability and Validity of the Instruments

Validity of the instrument was ensured through the development of a draft instrument by consulting relevant literature, adopting questions from relevant questionnaires of researches related to the study, and subjecting the draft instrument to independent, academic peer, and expert reviews, particularly experts in public health. In addition, the instrument was pretested among female students with babies in Obafemi Awolowo University sharing same characteristics with the study participants. Results obtained from the pretest were used to make necessary corrections for the main study to ensure relevance, appropriateness, and adequacy of the items in the instrument.

The Cronbach’s α correlation coefficient of the Statistical Package for Social Sciences (SPSS) was used to analyze the pretest data and to determine the reliability. An acceptable reliability coefficient of .82 was obtained.

Data Analysis

Administered questionnaire was coded and cleaned for incompleteness. Cleaned questionnaires were entered into SPSS version 21, and the data were analyzed using descriptive and inferential statistics (χ²). Information obtained was summarized and presented in tables and figures.

Results

Respondents’ Demographic Characteristics

Respondents’ mean age was 29.5 ± 2.80 years; 246 (98.4%) were married, while 129 (51.6%) were undergraduates. In addition, 210 (84.0%) were from Yoruba ethnic group and 220 (87.2%) were Christian. Also, 132 (52%) were unemployed and with no income, but 155 (62%) had husbands with professional jobs (see Table 1).

Table 1.

Socioeconomic and Demographic Characteristics of Student Mothers.

Variables	Frequency (n = 250)	Percentage
Age-group
≤25	15	6.0
25–29	169	67.6
≥31	66	26.4
Marital status
Married	246	98.4
Others (single and separated)	4	1.6
Number of children
<3	202	80.8
≥3	48	19.2
Ethnicity
Yoruba	210	84.0
Others (Igbo, Hausa, and Edo)	40	16.0
Religion
Christianity	220	88.0
Others (Islam and traditional)	30	12.0
Course of study by faculty
Arts	82	32.8
Social sciences	13	5.2
Science	106	42.4
Education	49	19.6
Level of study
Undergraduate	129	51.6
Postgraduate	121	48.8
Employment status
Unemployed	132	52.8
Employed	52	20.8
Self-employed	66	26.4
Income per month
5,000–49,000	52	20.8
50,000–99,000	30	12.0
≥100,000	13	5.2
No income	132	52.8
No response	23	9.2
Occupation of spouse
Professional	155	62.0
Others (skilled and unskilled)	95	38.0
Educational sponsorship
Husbands	132	52.8
Husband and myself	73	29.2
Myself	33	13.2
Work	6	2.4
Government scholarship	4	1.6
Husband and my immediate family	2	0.8

Challenges Faced

Three challenges reportedly faced by the SMs are economic (43.2%), followed by childcare (37.2%) and academic (24.8%).

Economic Challenges

In respect to economic challenges, some of the respondents are not receiving full economic support as just a little above half, 52.8% received educational sponsorship from their husband, 68% of the husbands pay their house rents, and 21.2% could not pay their baby sitters.

In addition, 52.8% could not afford to have a baby sitter, while 6.0% were unable to meet the financial cost of coming to the schools with baby sitters (Table 2).

Table 2.

Economic Challenges Faced by Student Mothers.

Variables	Frequency	Percentage
Cost of hiring a baby sitter
Able to hire a baby sitter	118	47.2
Unable to hire a baby sitter	132	52.8
Payment of baby sitter^a
Husband	30	12.0
Myself	10	4.0
Husband and myself	20	8.0
No payment	53	21.2

^aMultiple responses.

Childcare Challenges

In respect of childcare challenges, inability to breastfeed children exclusively topped the list (41.6%), followed by child illness (38.8%), inadequate time for breastfeeding (36.4%), nonavailability of comfortable room for breastfeeding the child (33.6%), and inadequate time to care for the child (30.0%). Others are shown in Table 3. Not surprisingly, respondents’ children suffered from a variety of communicable diseases, mostly skin infections (45.8%) and cough (31%; see Figure 1).

Table 3.

Childcare Challenges Faced by Student Mothers.

Variables	Frequency (n = 250)	Percentage
Breastfeeding
Inability to breastfeed child exclusively	104	41.6
Nonavailability of comfortable room for breastfeeding	84	33.6
Pain in the breast	8	3.2
Trauma of expressing breast milk	5	2.0
Health care of the child
Sickness of child	97	38.8
Unable to take the child to clinic	28	11.2
Weaning practice
Weaning baby too early	10	4.0
Attention for the child
Inadequate time for breastfeeding	162	36.4
Inadequate time to care for the child	75	30.0
Inability to employ a baby sitter	44	9.9

^aThe variables/results/value were of multiple choices. It can also be removed or deleted if need arise.

Figure 1.

Childhood problems reported by student mothers since enrollment in school.

The results showed most (81.1%) of the SNMs who reported having problems breastfeeding their babies had children with childhood health problems, while children of 18.2% of these SNMs had no childhood health problem (see Table 4).

Table 4.

Comparison of Breastfeeding Challenges and Childhood Health Problems.

	Breastfeeding challenges
Childhood health problems	Yes (%)	No (%)	Total (%)
Yes	99 (81.1)	22 (18.2)	121 (100.0)
No	75 (58.1)	54 (41.9)	129 (100.0)
Childhood illnesses
Diarrhea	19	9	28
Cough	38	10	48
Body infection	59	12	71
Ear infection	4	2	6
Obesity	2	0	2
Coryza	1	0	1
Catarrh	1	0	1

Academic Challenges

Major academic challenges faced include challenges during examination, learning, and lectures. Topmost on the challenges during examinations was respondents’ inability to prepare adequately for examination (50.4%), combining childcare and learning at night (47.1%), and getting late to lecture rooms (46.0%; see Table 5).

Table 5.

Academic Challenges Faced by Student Mothers.

Variables	Frequency	Percentage
Challenges faced during examination (n = 226)
Inability to prepare adequately toward exams	126	50.4
Difficulty in getting a place to keep child during exams	31	12.4
Inability to concentrate when reading for exam	43	17.2
Feeding the child when exam is going on	26	10.4
Challenges faced in learning^a
Combining child care and learning at night	145	47.1
Lack of concentration	97	31.5
Understanding topics taught in my absence	35	11.4
Inability to learn in the libraries	31	10.1
Challenges faced during lectures (n = 177)
Not getting to lecture room on time	115	46.0
Lack of concentration	35	14.0
Sleeping during lectures	25	10.0
Leaving the class during lectures	2	0.8

^aMultiple responses.

When the above challenges were measured on a 15-point scale and classified as moderate (≤9) and severe (≥10), result shows that 70% of the respondents were in the severe challenges category and 30% in the moderate category.

Factors Associated With Challenges Experienced

There were significant associations between age, course of study, and level of study of the SNMs and the overall challenges experienced. The proportion (93.3%) of respondents <25 years facing severe challenges was significantly higher than those aged older than 30 years (p = .005). In addition, the proportion of those facing severe challenges in the social sciences (84.6%) was significantly higher than those in the sciences (56.6%; p = .002). Similarly, the proportion (78.3%) of undergraduate respondents facing severe challenges was significantly higher than those in the postgraduate (60.3%, p = .002; see Table 6).

Table 6.

Association Between Overall Challenges With Demographic and Socioeconomic Characteristics of the Respondents.

Variables	Overall challenges		Total n = 250 (%)	Test statistics χ²	p
Variables	Moderate n = 76 (%)	Severe n = 174 (%)	Total n = 250 (%)	Test statistics χ²	p
Age-group
≤25	1 (6.7)	14 (93.3)	15 (100)	10.520	.005
26–30	46 (27.2)	123 (72.8)	169 (100)
≥31	29 (43.9)	37 (56.1)	66 (100)
Number of children
<3	63 (31.2)	139 (68.8)	202 (100)	0.309	.578
≥3	13 (27.1)	35 (72.9)	48 (100)
Course of study by faculty
Arts	17 (20.7)	65 (79.3)	82 (100)
Social sciences	2 (15.4)	11 (84.6)	13 (100)	14.934	.002
Science	46 (43.4)	60 (56.6)	106 (100)
Education	11 (22.4)	38 (77.6)	49 (100)
Level of study
Undergraduate	28 (21.7)	101 (78.3)	129 (100)	9.523	.002
Postgraduate	48 (39.7)	73 (60.3)	121 (100)
Employment status
Unemployed	42 (31.8)	90 (68.2)	132 (100)	4.356	.113
Employed	20 (38.5)	32 (61.5)	52 (100)
Self-employed	14 (21.2)	52 (78.8)	66 (100)
Occupations of spouse
Professional	51 (32.9)	104 (67.1)	155 (100)	1.208	.272
Others (skilled and unskilled)	25 (26.3)	70 (73.7)	95 (100)

Note. The bold face is indicating that the p-value is less than 0.005.

Discussion

The study reported that majority of the SMs faced severe challenges and a good number faced economic or financial, childcare, and academic challenges. These findings are in line with those reported by Adofo⁹ in which majority of the SNMs faced academic challenges, most faced childcare challenges, and almost all had financial challenges. One important childcare challenge is the respondents’ poor practice of exclusive breastfeeding and other poor breastfeeding practices. Such poor practices have been shown to have devastating impact on the healthy growth of a child most especially cognitive, emotional, and physical development.²¹ The occurrence of childhood illnesses such as skin infections and diarrhea among children of respondents in this study further buttresses the effect of poor breastfeeding practices and inadequate care of the children by their SMs as the study found that most of the SNMs who reported having problems breastfeeding their babies had children with childhood health problems. The World Health Organization (2003)²² recommends that wherever possible, infants should be fed exclusively on breast milk alone until 6 months of age, owing to the fact that breastfeeding protects infants against numerous infectious diseases including otitis media, respiratory infections, and diarrhea, as well as lowering children’s risk of chronic conditions such as diabetes, asthma, and cardiovascular risk factors.²³

The study found that majority of the SNMs combined childcare with learning at night and also get to lecture halls late probably as a result of tiredness from night hangovers. These academic challenges could have great implication on the academic performance of SNMs because poor concentration and lack of adequate preparation toward examination could lead to failure in examination which could result in loss of motivation and possibly dropping out of school.²⁴

Another key finding in this study is that respondent’s dependency on husbands for offsetting cost baby sitter which constitute major economic constraints of the SNMs. When financial resources are in sufficient to sustain students, they could temporarily abscond from some educational activities such as lectures to source for funds and other essential materials. Even when the SMs do not abscond from lectures and continued as if all was well, worry and anxiety could torment them so much that their presence in the lecture room may not yield the intended academic benefits.⁴ In this study, age, course, and level of study factors were associated with the challenges faced by the SNMs. This was in agreement with²⁵ findings which reported a significant association between age and respondents’ academic challenges but not with marital status.

Conclusion

This study has heighted certain issues in this regard; overall challenges have statistical significant associations with age, course of study, and level of study of the SNMs. The study has provided useful insight into the challenges faced by SNMs and ways in which some of them are ameliorated within an institution. Because husbands and family members provided some support to cushion the effect of the challenges experienced by the SNMs, spousal social support education for couples and intended couples should be promoted at community, religious institutions, and among male local organizations. These findings are useful for the university administrators, community associations, and nongovernmental organizations to develop some appropriate policies and programs to support this vulnerable group.

It is therefore recommended that counseling units are established in Nigerian Universities aimed at providing mental and psychological help to SMs and foster capacity building on establishing coping mechanism. Also, there is need for provision of motherhood indicator on annual registration form in universities, which will assist the institutions to better cater for the social, academic, and psychological needs of SMs, guiding the development of policies for improving the welfare of SMs. A support group is also encouraged in Nigerian institutions for SMs, as social support has been proven to be highly instrumental in establishing coping mechanisms; additionally, having an organized community of SMs will encourage efficacious interventions toward an improved quality of life.

Study Limitation

The study was carried out among female students with babies in higher institutions of learning; hence, generalization of outcomes to all other categories of female students in higher institution of learning has to be done with caution. Also, this research was only based on quantitative approach and not on both qualitative and quantitative research approaches because the SNMs were difficult to reach and engage due to their busy schedule. Finally, the study was carried out in one of the Universities in Nigeria, a wider study including other higher institutions of learning in Nigeria and a larger sample size will be representative.

Implications and Contribution

The findings from this study could inform intervention programs targeted at reducing the challenges faced by SMs and poor child health or care among SNMs which could result from little or no support from institutions of higher learning and husbands in the study area and Nigeria at large. Through counseling and education programs, SNMs would be able to manage better the challenges resulting from their productive, reproductive, and community service roles. Targeted populations for counseling and education should include the SNMs, relatives, university administrators and staffs, community and religious leaders, and the National University Commission and state government educational board. Appropriate strategies to improve childcare or health include putting in place policies that will enhance learning condition of SNMs such as special accommodation, lactating rooms, and transportation support as well as spousal social support education. Programs should be tailored to suit the age, course of study, and other characteristics of the SMs as well as the cultural context considering the peculiarities of the study population.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author Biographies

Ifeoluwa Anibijuwon has her degrees in Nutrition and Dietetics (BSc) and Health Promotion and Education (MPH) from Obafemi Awolowo University Ile Ife. She has been a researcher for 5 years and has participated in both international and local projects. Ifeoluwa has experience in both basic and applied research, with cognate experience in qualitative and quantitative study. Currently, she works(volunteers) with African Regional Health Education Centre, University of Ibadan, Nigeria.

Peju Esimai is a professor, physician and consultant of Public Health. She has her degrees in Early Childhood Development (Graduate Diploma), Environmental, Control & Management and Bioethics (MSc), FMCHP, FWACP. She lectures in Department of Community health, research and services, faculty of Clinical Sciences, Obafemi Awolowo University, Ile Ife, Nigeria with a keen interest in epidemiology, reproductive health, environmental health and bioethics. She is a reviewer to local and international journals and she has authored and co-authored numerous publications in peer reviewed journals. She has served as the Head of Department, member of the appointment and promotion committee, member of postgraduate board, member of Scientific and Ethic research committee in the OAUTHC and focal person of the OAU CARTA. She has also served as survey coordinator at the national survey on catastrophic cost of Tuberculosis, served as a lead consultant to World Health Organization Polio eradication and TY foundation. She is presently a consultant to Obafemi Awolowo University Teaching Hospital.

ORCID iD

Ifeoluwa Anibijuwon

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