Need For Advocacy Research Articles

The Occurence of Gastrointestinal Helminths in Slaughtered Cattle in Azare,North-East Nigeria

A Cross-sectional Study was carried out to determine the prevalence of gastrointestinal (G.I.) helminths parasites in slaughtered cattle at Azare abattoir, Katagum Local Government Area, Bauchi State, North-Eastern Nigeria. One hundred and twenty faecal samples were examined using the floatation and sedimentation method. Out of the total samples tested, G.I. helminths infections were detected in 62samples tested, giving an overall prevalence of 51.6%. Class nematodes are the most diverse class (56.5%) and then followed by trematodes (35.5%), while cestodes are the least prevalent (8.1%). There was a statistically significant difference in P-value >0.05. The sex revealed that males (52.6%) are more susceptible to G.I. helminths infection than females (50.0%) even though there is no statistical difference at P-value >0.05. However, the prevalence of G.I. helminths to age revealed a statistical difference at P-value >0.05, where the young have the highest prevalence of 59.5%. The Red Bororo breeds had the highest prevalence of 75%, while the least was recorded in White Fulani and Sokoto Gudali, 40% each. There was a statistically significant difference at P-value >0.05. This study revealed that Fasciola spp (15%) is the most prevalent G.I. helminths parasites detected, followed by Oesophagostomum spp (11.7%); Haemonchus spp (9.2%); Strongyloides spp (8.3%), Schistosoma spp (3.3%); and Moniezia spp (1.67%). Our findings from the present study revealed a high prevalence of G.I. helminths species affecting cattle in Azare and Nigeria as a whole. Therefore, there is a great need for proper advocacy on the need for appropriate management, regular deworming practices, and improved cattle hygiene to boost animal production. This will help in curbing great lost to Nigeria's economy and the world in general.

Isolated and On Guard: Preparing Neonatal Intensive Care Unit Families for Life with Hydrocephalus.

This study was aimed to characterize the parent experience of caring for a child with posthemorrhagic hydrocephalus and to describe parent preferences for counseling in the neonatal period and beyond. This was a qualitative interview study. Parents of infants born preterm with posthemorrhagic hydrocephalus completed semistructured interviews. Data were analyzed using a content analysis approach. Thematic saturation was reached on parent communication preferences after 10 interviews. Parent experiences of infant hydrocephalus broadly fell into two time periods, the neonatal intensive care unit (NICU) and after NICU discharge. The themes of uncertainty, isolation, hypervigilance, and the need for advocacy were common to each phase. Parents expressed interest in the development of tiered NICU counseling tools that would provide evidence-based and family-centric information to (1) initiate connections with community and peer resources and (2) combat the isolation and hypervigilance that characterized their family experience of living with hydrocephalus. · Infants with posthemorrhagic hydrocephalus are at risk for adverse neurodevelopmental outcomes.. · The parent experience of caring for a child with posthemorrhagic hydrocephalus is not well-described. In this interview study, parents described uncertainty, isolation, and hypervigilance.. · These findings call for structured NICU counseling and longitudinal family supports after discharge..

Where are the children in national hepatitis C policies? A global review of national strategic plans and guidelines

SummaryBackground & AimsIt is estimated that 3.26 million children and adolescents worldwide have chronic HCV infection. To date, the global response has focused on the adult population, but direct-acting antiviral (DAA) regimens are now approved for children aged ≥3 years. This global review describes the current status of policies on HCV testing and treatment in children, adolescents, and pregnant women in WHO Member States.MethodsWe identified national strategic plans and/or clinical practice guidelines (CPGs) for HCV infection from a World Health Organization (WHO) database of national policies from Member States as of August 2019. A standardised proforma was used to abstract data on polices or recommendations on testing and treatment in children, adolescents and pregnant women. Analysis was stratified according to the country–income status and results were validated through WHO regional focal points through August 2020.ResultsNational HCV policies were available for 122 of the 194 WHO Member States. Of these, the majority (n = 71/122, 58%) contained no policy recommendations for either testing or treatment in children or adolescents. Of the 51 countries with policies, 24 had specific policies for both testing and treatment, and were mainly from the European region; 18 countries for HCV testing only (12 from high- or upper-middle income); and 9 countries for treatment only (7 high- or upper-middle income). Twenty-one countries provided specific treatment recommendations: 13 recommended DAA-based regimens for adolescents ≥12 years and 6 still recommended interferon/ribavirin-based regimens.ConclusionsThere are significant gaps in policies for HCV-infected children and adolescents. Updated guidance on testing and treatment with newly approved DAA regimens for younger age groups is needed, especially in most affected countries.Lay summaryTo date, the predominant focus of the global response towards elimination of hepatitis C has been on the testing and treatment of adults. Much less attention has been paid to testing and treatment among children and adolescents, although in 2018 an estimated 3.26 million were infected with HCV. Our review shows that many countries have no national guidance on HCV testing and treatment in children and adolescents. It highlights the urgent need for advocacy and updated policies and guidelines specific for children and adolescents.

Nurses Who Assume the Role of Advocate for Older Hospitalized Patients: A Qualitative Study.

IntroductionPatient advocacy, acting on behalf of patients’ unmet needs, is fundamental to nursing, and the perception of the need for advocacy motivated this study. Nurses experience moral discomfort, which results from a divergent view regarding medical or caregivers’ decisions about patients’ clinical proceedings, in which patients’ involvement in making those decisions is either doubtful or absent.ObjectivesThe aim of this study is to assess the need for advocacy and explore the perspectives of nurses engaged in the care of older patients.MethodsThe methodological orientation is that of a qualitative design, by using a purposive and criterion sampling. The sample was of 14 nurses of a ward of general medicine. Focus group as collecting data tool was used, followed by a thematic analysis.ResultsNurses demonstrated a high level of moral sensitivity to ethical problems in clinical practice and on occasions, the courage to bring the problem to the physicians or patients’ family’s attention, or help patients develop self-determination. However, it is difficult to advocate because of insufficient communication between professionals, insufficient knowledge of ethics, and the emotional burden it places on nurses which results in emotional resignation in the face of interprofessional teams’ lack of consideration of nurses’ opinions.ConclusionThis research highlighted nurses’ need for advocacy to promote patients’ rights, wishes, and values. It is essential for nurses to be aware of their level of moral sensitivity and develop a strategy to regain courage to engage in advocacy. Therefore, ethics education and interprofessional ethical leadership is desired, which inspires healthcare professionals’ work and allows the foundations of an ethical decisionmaking process to be laid through patients and their families’ active involvement.

The Potential Role of Irrationality and Behavioural Nudges in Entrepreneurship Development Policies in India

Entrepreneurship Development Programs have received a lot of socio-political thrust in India especially of late. This is not unexpected for a country that is entering its maturity, in terms of economic stature; where entrepreneurship is one of the primary means of attaining nationwide financial and social growth for all sectors of society. The current article proposes to understand whether India as a nation has reached equilibrium or is still in a state of flux, when it comes to choosing a career between entrepreneurship and job-seeking. The study also looks into the underlying forces and policy implications for sustained progress in Indian Entrepreneurial scenario. The article first looks to validate the claim that there is a need for advocacy of entrepreneurship. Subsequently, it uses the notions of irrationality and behavioural economics to suggest more effective and sustainable policy framework, by explaining entrepreneurship as a process such as the Transtheoretical Model.

Economic Impacts of Overweight and Obesity: Current and Future Estimates for Eight Countries

Background: Obesity continues to be a growing public health challenge worldwide with significant health and economic impacts. However, much of what is known about the economic impacts of obesity comes from high-income countries and is not readily comparable. Our objective is to estimate current and future economic impacts of obesity across heterogenous contexts globally. Methods: We estimated current and future economic impacts of overweight and obesity for eight countries encompassing a range of geographies and income levels. We employed a cost-of-illness approach including direct and indirect costs from a societal perspective. Country-specific data were sourced from published studies and international databases. Findings: In per capita terms, costs of obesity in 2019 ranged from US$20 in India to US$1,364 in Australia. The average GDP loss in 2019 due to obesity across the eight countries was 2·0%, ranging from 0·9% of GDP in India to 2·8% in Saudi Arabia. By 2060, the economic losses from obesity are projected to grow to 3·9% of GDP on average ranging from 2·8% of GDP in Spain to 5·1% of GDP in Brazil. Interpretation: Our findings demonstrate that the economic impacts of obesity are substantial across countries, irrespective of economic or geographic context, and will increase over time if current trends continue. The estimated GDP loss from obesity is on par with economic losses due to tobacco in many countries. These findings strongly point to the need for advocacy to increase awareness of the societal costs of obesity, and for policy actions to reduce the systemic roots of obesity. Funding Statement: Support for this work came from World Obesity Federation funds which include an unrestricted educational grant from Novo Nordisk. Declaration of Interests: None to declare.

More Attention to Policies! Improving the Distribution of FDI Benefits: The Need for Policy-Oriented Research, Advice and Advocacy

This article explores different ways in which governments can increase the benefits of FDI and manage the relationship between governments and international investors in a mutually beneficial manner. It focusses on three concrete policy fields in which discussions are afoot that bear on this issue, and where opportunities to exercise influence exist: encouraging more sustainable FDI; enhancing the distribution of benefits associated with FDI; and anchoring sustainable FDI, corporate social responsibility and responsible business conduct in the international investment law and policy regime and, specifically, in the context of the negotiations of an Investment Facilitation Framework for Development at the WTO. These are examples of policy areas that warrant attention, with a view toward scholars seeking to influence the way in which they are tackled, through applied multidisciplinary policy-oriented research, concrete recommendations and targeted advocacy.

Assessment of respectful maternity care during childbirth: Experiences among mothers in Manipur.

The relationship between the lack of quality care and adverse maternal outcomes is being highlighted globally. Respectful maternity care includes respect for women autonomy, dignity, feelings, privacy, choices and freedom from ill treatment, coercion, and consideration for personal preferences including option for companionship during the maternity care. This study planned to determine the prevalence and types of disrespect and abuse among mothers during childbirth and its associated factors. This was a cross-sectional study conducted among 231 women having children <2 years, who had undergone institutional deliveries and accessing immunization clinics during October to December 2018 using a semi-structured questionnaire adapted from the Person-Centered Maternity Care Scale, a validated instrument which gives a holistic measure of women's experiences during childbirth wherein the questions were grouped under seven domains. : The mean (standard deviation) age of the respondents was 28.9 ± 5.8 years. The prevalence of any form of abuse present was 96.5% with the highest found in "Facility and Environment" Domain (77.5%). Women delivering in public tertiary care facility were significantly more likely to face more abuse in the domains of "Dignity and Respect," "Support and Care," "Facility and Environment," "Predictability and Transparency," as compared to other types of health facilities (P < 0.05). : Nearly almost all of the respondents (96.5%) faced some form of abuse in one domain or the other. There is a need for greater action, dialog, research, and advocacy on this important public health issue for promoting dignified maternal health-care services.

Heavy Metals Analysis and Health Risk Assessment of Three Fish Species, Surface Water and Sediment Samples in Ogbaru Axis of River Niger, Anambra State, Nigeria

Human activities on environmental resources have negatively affected floras and faunas in maintaining fair balance. In this research study, selected heavy metals (Al, As, Cd, Cr, Cu, Fe, Hg, Pb, Ni, Zn) concentration in three fish species (Clarias gariepinus, Heterotis niloticus and Anguilla labiate), surface water and sediment samples in Ogbaru axis of River Niger, Anambra State, Nigeria. We evaluated the samples using atomic absorption spectrophotometer (AAS). The result of heavy metal analysis in fish samples showed that in decreasing order in Clarias garipinus in increasing order of Cu &gt;Fe &gt; Ni &gt; Hg &gt; Pb &gt; Zn &gt; As &gt; Cd &gt; Al &gt; Cr, while Heterotis niloticus followed the order Cu &gt; Zn &gt; Fe &gt; Ni &gt; Pb &gt; Cd &gt; Al &gt; As &gt; Hg &gt; Cr, and Anguilla labiate followed the pattern of Cu &gt; Fe &gt; Zn &gt; Ni &gt; Pb &gt; Cd &gt; Cr &gt; As &gt; Hg &gt; Al. For surface water, As, Cd, Cr, Cu, Fe, Hg and Pb showed high concentration for the raining season compared to dry season, as Al, Ni and Zn were dominant during dry season, while sediment samples of Cr, Cu, Ni and Pb concentration in raining season were higher than dry season and vice versa for other As, Cd, Fe, Hg, Zn. Correlation matrices showed positive value showing that heavy metals were from a similar source with migration route and vice versa for negative correlation. Health and exposure risk assessment was conducted for carcinogenic and non-carcinogenic exposure in adults and children, where the cumulative cancer risk was within USEPA regulatory standard and cumulative hazard index were above 1 for adults (2.02) and children (4.93), implying that children are at risk of having adverse health issues compared to adults. Therefore, there is a need for regulatory advocacy and special care to mitigate anthropogenic release and safeguard the environment.

Beyond housing: Understanding community integration among homeless-experienced veteran families in the United States.

Community integration is important to address among homeless-experienced individuals. Little is known about helping veteran families (families with a parent who is a veteran) integrate into the community after homelessness. We sought to understand the experiences of community integration among homeless-experienced veteran families. We used a two-stage, community-partnered approach. First, we analysed 16 interviews with homeless-experienced veteran parents (parents who served in the military; n=9) living in permanent housing and providers of homeless services (n=7), conducted from February to September 2016, for themes of community integration. Second, we developed a workgroup of nine homeless-experienced veteran parents living in a permanent housing facility, who met four times from December 2016 to July 2017 to further understand community integration. We audio-recorded, transcribed and analysed the interviews and workgroups for community integration themes. For the analysis, we developed community integration categories based on interactions outside of the household and built a codebook describing each topic. We used the codebook to code the individual interviews and parent workgroup sessions after concluding that the workgroup and interview topics were consistent. Findings were shared with the workgroup. We describe our findings across three stages of community integration: (a) first housed, (b) adjusting to housing and the community, and (c) housing maintenance and community integration. We found that parents tended to isolate after transitioning into permanent housing. After this, families encountered new challenges and were guarded about losing housing. One facilitator to community integration was connecting through children to other parents and community institutions (e.g. schools). Although parents felt safe around other veterans, many felt judged by non-veterans. Parents and providers reported a need for resources and advocacy after obtaining housing. We share implications for improving community integration among homeless-experienced veteran families, including providing resources after obtaining housing, involving schools in facilitating social connections, and combating stigma.

Outpatient and Inpatient Service Use by Chinese Adults Living in Rural Low-Income Households

Background: This study applied the Andersen Model of Health Care Utilization to explore the variables associated with health service use among Chinese adults living in rural low-income households. Method: A survey of 2,429 adults living in 787 low-income households in Jiangsu, China was conducted. Respondents were asked the presence of outpatient service in the past one month and the amount of hospitalization in the past one year. Mixed effect logistic and negative binomial models were used to examine the relationship of individual-level and household-level characteristics with health service use. Results: Health condition was the predominant determinant of both outpatient and inpatient service use (Odds Ratio [OR] >1, p<0.001). Individuals living in a poor household were less likely to use outpatient service (OR=0.05, 95% confidence interval CI: 0.00, 0.71), and the longer in poverty status the less likely to use outpatient service (OR=0.92, CI: 0.86, 0.99). Age was associated with lower likelihood to use outpatient service (OR=0.93, CI: 0.93, 1.00), and this relationship was stronger for larger households (OR=1.01, CI: 1.00, 1.01). For inpatient service use, most household-level measures were insignificant. Conclusion: Rural Chinese health service use was influenced primarily by needs variables. Outpatient service use was constrained by household enabling variables. Older adults were at a disadvantage for using outpatient service when the family prioritized younger members in allocating resources. These results suggest the need for policy advocacy to expand insurance reimbursement and improve benefits for poor older adults.

Access to penile prostheses differ across provinces in Canada: A survey of Canadian urologists

Surgical implantation of a penile prosthesis is the gold standard treatment for refractory erectile dysfunction. The purpose of this study was to investigate the use of and access to these procedures in Canada. Canadian urologists known to perform penile prostheses procedures were surveyed on areas such as surgical volume, type of device used, and the direct cost to patients for both malleable and inflatable devices. Of the 50 urologists invited to participate in the study, 34 (68%) completed the online survey. Participants represented nine Canadian provinces and included a mix of academic (65%) and community (35%) urologists. Most participants (79%) performed less than 10 procedures per year. Roughly three-quarters of participants (74%) used inflatable devices in over 90% of cases, while half implanted inflatable devices exclusively. The most common devices implanted were American Medical Systems (AMS). Participants from Alberta, Manitoba, New Brunswick, and Newfoundland reported full coverage for both malleable and inflatable devices. Saskatchewan was the only province where no coverage was reported. The remaining provinces were found to have variable degrees of coverage. Across all centers without full coverage, the median reported cost to patients for a malleable and inflatable device was $5000 and $6000, respectively. The urologists surveyed most commonly perform inflatable penile prostheses procedures. Significant geographical differences exist with respect to reported coverage for these procedures. This study highlights the need for continued advocacy on behalf of the urological community towards the goal of equity in coverage for penile prostheses across Canada.

Tauopathies: Need for education and advocacy — Que Tau? A pilot study

AbstractIntroductionWhen we ask a medical student or a medical resident about tauopathies our perception of the level of knowledge is in average low. It reinforces the need for education and advocacy of tauopathies involving health care professionals and general population in our country, and probably worldwide.ObjectiveTo disseminate information about tauopathies using social media campaign.MethodsWe planned an educational program for medical students and medical residents named Que Tau? (in Portuguese Que Tal, means: What about?). We will use social media, sending information by messaging app (WhatsApp and/or Telegram) using images (jpg), short videos, texts or articles (PDF). A pilot study will involve a sample of 60 undergraduate and 60 postgraduate students of a medical school in Brazil, and the same number of controls. Both groups will be asked about tauopathies key concepts three months later the messages.ResultsThis strategy to use smartphones to disseminate information about tauopathies can result in a good initiative to take attention of medical residents and medical students for tauopathies and to stimulate future actions to fight these diseases.ConclusionWe expect that he level of knowledge about tauopathies can increase between medical students and residents according to dissemination of information using social media campaign.

Dementia families: Relinquishing home care to aged care services: Guilt, traumatic loss and growth.

Few studies explore both negative and positive perspectives of family members who relinquish home care of a family member with dementia for systemic aged care. This phenomenological study sought the 'lived' experience of relinquishing the role of home carer for a family member with mild to severe dementia to others within care home settings, by seeking to understand the impact of aged care on family members' psychological well-being. Using semi-structured interviews, positive and negative subjective interpretations from 17 families (27 individuals) provided data for analysis, following the protocols of interpretative phenomenological analysis. One superordinate theme, mistrust/integrity, overarched oscillation between mistrust of the aged care system and a struggle for personal integrity in caring for these participants. Two sub-themes emerged: intrinsic trauma and extrinsic trauma. Intrinsic trauma explained feelings of helplessness and guilt, and internally directed responses that triggered a retreat into submission ultimately reducing the participant's role in advocacy. Extrinsic trauma represented externally directed responses such as anger and frustration, where family members became more engaged and watchful and recognised a need for vigilance and advocacy. Paradoxically oscillating between these personal struggles, participants exhibited growth, a third theme that defined assertive/advocacy utilised to nurture hope, gratitude, courage and change. Family members experienced complex distress as they relinquished home care to others within systemic aged care for a member with dementia. By developing adaptive responses as appropriate, for example, advocating for their family member or accepting compliance with treatment, collaborative care between family and staff created better outcomes for the family member with dementia.

Telehealth, friend and foe for health care social work

The author describes her experience as a health care social worker with the proliferation of telehealth as the standard medium of intervention with patients since the onset of the COVID-19 pandemic. As a practicing health care social worker for more than twenty years, she describes the advent of telehealth, her introduction to it, and current experience in her outpatient practice setting. She delineates the surprising benefits it has provided to patients during the pandemic. She also outlines the threats it poses in the increasingly corporatized US health care environment to social work values and the well-being of social work's focal populations, the vulnerable, oppressed, and those living in poverty. She emphasizes the need for vigilance and advocacy by social workers as the pandemic progresses and recedes.

Forest depletion in Ghana: the empirical evidence and associated driver intensities

PurposeThis study seeks to provide a robust piece of evidence of forest depletion in Ghana and its associated driver intensities to inform national policy decisions towards achieving Sustainable Development Goal (SDG) 15 and beyond.Design/methodology/approachUsing a representative sample size of 733 households, which was obtained with the aid of a structured questionnaire, a descriptive analysis is used to show the evidence of forest depletion. For robustness purposes, the geographic information system (GIS) is used to provide a piece of remote sensing evidence to substantiate the claim. In addition, an ordered probit regression model is estimated given the ranked nature of the responses to determine the drivers of forest depletion.FindingsThe results provide evidence that the urban forests in the Greater Accra Region (GAR) of Ghana have been depleted. Overall, 44% argued that the depletion of the forests is high, 30% indicated that the depletion is moderate, while 26% indicated that the depletion is low. Consistent with the literature, the ordered probit regression results show that human behaviour, climate change and institutional failure are the driver intensities of forest depletion in the Region. Besides, the authors find an increasing order effect for all three drivers. Using a descriptive analysis, majority of the respondents posited that human behaviour is the main driver intensity, followed by climate change and then institutional failure. This study recommends the need for education and advocacy, community participation, law enforcement, resource mobilization, modern adaptation strategies and internalization of externalities as a way of controlling the drivers of forest depletion.Originality/valueThe study uses remote sensing techniques to provide empirical evidence of protected forest depletion in the GAR, Ghana. In addition, an ordered probit regression is used to identify the driver intensities that explain the depleted protected forests in the region.

Determinants of Implementation of a Clinical Practice Guideline for Homeless Health.

Clinical practice guidelines can improve the clinical and social care for marginalized populations, thereby improving health equity. The aim of this study is to identify determinants of guideline implementation from the perspective of patients and practitioner stakeholders for a homeless health guideline. We completed a mixed-method study to identify determinants of equitable implementation of homeless health guidelines, focusing on the Grading of Recommendations Assessment, Development and Evaluation Feasibility, Acceptability, Cost, and Equity Survey (GRADE-FACE) health equity implementation outcomes. The study included a survey and framework analysis. Eighty-eight stakeholders, including practitioners and 16 persons with lived experience of homelessness, participated in the study. Most participants favourably rated the drafted recommendations’ priority status, feasibility, acceptability, cost, equity impact, and intent-to-implement. Qualitative analysis uncovered stakeholder concerns and perceptions regarding “fragmented services”. Practitioners were reluctant to care for persons with lived experience of homelessness, suggesting that associated social stigma serves as a barrier for this population to access healthcare. Participants called for improved “training of practitioners” to increase knowledge of patient needs and preferences. We identified several knowledge translation strategies that may improve implementation of guidelines for marginalized populations. Such strategies should be considered by other guideline development groups who aim to improve health outcomes in the context of limited and fragmented resources, stigma, and need for advocacy.

Adherence with lipid screening guidelines in standard- and high-risk children and adolescents

Retrospective cohort study using MarketScan® commercial and Medicaid insurance claims databases, a geographically representative sample of U.S. children. Subjects who passed through the 9- to 11-year window and had continuous insurance coverage between 1/1/2013 and 12/31/2016 were studied. Multivariable models were calculated, evaluating the association between other patient factors and the likelihood of screening. The primary hypothesis was that screening rates would be low, but that high-risk conditions would be associated with a higher likelihood of screening. In total, 572,522 children (51% male, 33% black, 11% Hispanic, 51% Medicaid) were studied. The prevalence of high-risk conditions was 2.2%. In unadjusted and adjusted analyses, these subjects were more likely to be screened than standard-risk subjects (47% vs. 20%, OR: 3.7, 95% CI 3.5-3.8, P < .001). Within this group, the diagnosis-specific likelihood of screening varied (26-69%). Endocrinopathies (OR 5.4, 95% CI 5.2-5.7), solid organ transplants (OR 5.0, 95% CI 3.8-6.6), and metabolic disease (OR 3.9, 95% CI 3.1-5.0, all P < .001) were associated with the highest likelihood of undergoing screening. Despite national recommendations, lipid screening was performed in a minority of children. Though subjects with high-risk conditions had a higher likelihood of screening, rates remained low. This study highlights the need for research and advocacy regarding obstacles to lipid screening of children in the United States.

Infectious Diseases and Advocacy: This Is our Lane.

The disparate effects of severe acute respiratory syndrome coronavirus 2 virus on communities of color, paired with disjointed federal and local responses to the pandemic and the ongoing examples of structural racism’s effects on health, highlight the need for physician advocacy on behalf of patients. The job of infectious disease physicians has always involved caring for the “whole patient,” but the need for advocacy around issues related to racism, housing, food insecurity, substance use disorders, and mental health has increased. Advocacy at all levels—local, regional, and national—can make a difference and be a profoundly rewarding part of the career of an infectious disease/HIV physician.

Pathways to Care for Children with Mental Disorders and Epilepsy Attending Specialist Clinics in Nigeria

Aims: This study set out to identify and compare the pathways to care for children and adolescents presenting at child psychiatry and paediatric neurology clinics in South West Nigeria.&#x0D; Study Design: This was a comparative cross sectional study.&#x0D; Place and Duration of Study: Departments of Child and Adolescent Psychiatry and Paediatrics, University College Hospital Ibadan, Nigeria between February and May 2017.&#x0D; Methodology: A sociodemographic questionnaire and the World Health Organization’s (WHO) pathway encounter form were used to assess 114 participants (57 in each group) recruited sequentially into the study. Kaplan meier survival analysis was used to compare time to seeking orthodox and specialist care between the two groups, and Atlas Ti software was used to analyse qualitative responses about barriers to accessing care. &#x0D; Results: There were slightly more males than females in both groups, and the mean age of participants was 9.87 years (SD =5.52). Participants in the paediatric neurology group were significantly more likely to access orthodox care at their first level of contact than their child psychiatry counterparts {41 (71.93%) vs. 18 (31.58%); P.&lt;0.001}. There were significant differences in the median survival time to accessing orthodox medical care between the two groups: {paediatric neurology 8 weeks (IQR =23.79) vs. child psychiatry 192 weeks (IQR =80; P &lt; 0.001}. There was however no siginificant difference in median survival time to specialist care between the two groups. Lack of finances, frequently having to take time off work, and long distances to the hospital were the major barriers to accessing orthodox medical care in both groups.&#x0D; Conclusions: Our findings suggest a need for continous advocacy to promote better access to orthodox healthcare for youths with psychiatric and neurological disorders in the developing world context.