Health Care Delivery In Nigeria Research Articles

Factors Influencincing Discharge against Medical Advice among Paediatric Patients in Abakaliki, Southeastern Nigeria

Discharge against medical advice (DAMA) has become a major problem in health care delivery in Nigeria. Children are the victims because most of the times they are not the one taking the decision, and may not understand or contribute to it. This retrospective study was undertaken to identify the factors that influence DAMA among paediatric patients in Ebonyi State University Teaching Hospital, Abakaliki in southeastern Nigeria, with a view at curbing it. There were 97 cases of DAMA out of a total admission of 6505 giving a prevalence rate of 1.5%. Infants constituted 52.2% of them, of which 37.8% were neonates. Majority (96.7%) were from lower social classes residing in rural villages (61.1%).Neonatal conditions (36.7%) were the most common condition for which DAMA was sought, followed by severe malaria (22.2%) and road traffic accident with fractures (12.2%). The common reasons given for DAMA were financial constraint (33.3%), resort to native treatment (25%) and hopelessness of the disease condition (15%). DAMA at the study site is closely asssociated with parental poverty and ignorance. Neonates and older children with surgical conditions are the most vulnerable group. Policies should be targeted at protecting these groups.

The role of optometry in primary health care delivery in Nigeria: A case study of Abia State University, Uturu, Nigeria

Optometry as a profession has a very important place in the Primary Health Care Programme for us to achieve health for all by 2010. Optometry is the art and science of vision care. An optometrist as defined by the Optometrists and Dispensing Opticians Registration Board of Nigeria is a health-care professional specializing in the art and science of vision care and whose scope of practice include: eye examinations to determine refractive errors and other departures from the optimally healthy and visually efficient eye; corrections of refractive errors of binocularity by means of vision training (orthoptics); diagnosis and management of minor ocular infections which do not pose a threat to the integrity of the ocular or visual system; and ocular first aid. The Optometrist by training is in the position to move vision and eye care delivery as close as possible to where people live and work. The global initiative, “Vision 2020. The right to Sight” established by the World Health Organization (WHO) and the International Agency for the Prevention of Blindness, has created valuable and effective collaboration with organizations involved in a wide range of eye care and community healthcare activities aimed at the elimination of avoidable blindness and impaired vision. The Vision 2020's major priorities are the tackling of cataract, trachoma, onchocerciasis; childhood blindness, refractive error, low vision and so on. These have been selected not only because of the burden of blindness that they represent but, also because of the feasibility and affordability of interventions to prevent and treat these conditions.Global Journal of Mathematical Sciences Vol. 6 (1) 2007: pp.25-28

Health Care Providers's Perception on Tele-Medicine/Tele-Health Usage in the Health Care Delivery System in South-West Nigeria

Concern has been expressed for the past few years now, about the impact of globalization and telecommunication on the economic growth of any nation especially in the developing worlds with limited or no resources available for its implementation. However, tele-medicine and tele-health are newer emerging concepts in the healthcare delivery system in this part of the world. Hence, we aim to determine the perception of the professional health care providers at all levels of health care institutions towards tele health/ telemedicine in Lagos, South-west Nigeria. A prospective postal survey of a cross section of professional health care providers in Lagos, Nigeria was conducted using a modified highly structured questionnaires administered to health workers (doctors, nurses, medical laboratory scientists, health records) in the secondary and teaching hospital (LASUTH/ LASUCOM), and community heath workers, medical doctors and nurses at the local government areas. The result showed that 74% of the health workers agreed that telemedicine was beneficial in the health care delivery in Nigeria. While, some concern of its ethical consideration was expressed by 58.7% of health workers. However, 40.5% of respondents had never heard of telemedicine/tele-health as a means of improving health care delivery. Moreover, the main sources of information on this subject came from media (12%) and 13.5% got awareness through internet and professional partner. 74.3% of the health workers indicated their willingness to adopt Tele medicine in health care delivery if available and when giving appropriate training on its usage. In addition, twenty-two (22%) of respondents stated that Tele medicine should be adopted in our healthcare system for reasons of affordable and accessible health care, while 15% had agreed to its adoption for improving quality healthcare services offered to all patients in Nigeria. Moreover, telephone uses appear to be a major significant telemedicine tool available. Thus, it is highly desirable to give tele medicine a chance in the healthcare delivery system in order to breach for the present deficiency in the system.

Questionnaire survey of working relationships between nurses and doctors in University Teaching Hospitals in Southern Nigeria

BackgroundSmooth working relationships between nurses and doctors are necessary for efficient health care delivery. However, previous studies have shown that this is often absent with negative impact on the quality of health care delivery. In 2002, we studied factors that affect nurse-doctor working relationships in University Teaching Hospitals (UTH) in Southern Nigeria in order to characterize it and identify managerial and training needs that might be used to improve it.MethodQuestionnaire survey of doctors and nurses working in four UTH in Southern Nigeria was done in 2002. The setting and subjects were selected by random sampling procedures. Information on factors in domains of work, union activities, personnel and hospital management were studied using closed and open-ended questionnaires.ResultsNurse-doctor working relationships were statistically significantly affected by poor after-work social interaction, staff shortages, activist unionism, disregard for one's profession, and hospital management and government policies. In general, nurses had better opinion of doctors' work than doctors had about nurses' work.ConclusionWorking relationships between doctors and nurses need to be improved through improved training and better working conditions, creation of better working environment, use of alternative methods of conflict resolution and balanced hospital management and government policies. This will improve the retention of staff, job satisfaction and efficiency of health care delivery in Nigeria.

Local Government and Health Care Delivery in Nigeria: A Case Study

This paper seeks to highlight the recent activities of local government in health care delivery. The literature review reveals the interconnectedness between local government and the sustenance of primary health care in Nigeria. The study traced the historical antecedent of health service delivery from the colonial era to the present day. It identifies the major contradictions in the management of primary health care implementation, using a local government as case study. They include shortage of qualified personnel and finance, inadequate transportation, inaccessibility to communities, lack of maintenance culture, political instability, high degree of leadership turn-over. For the sustainability of health care service delivery at the grassroots, the study recommends increase financial allocation, community mobilization, improved health education, policy consistency and provision of qualified health workers.

The Obstetrician/Gynaecologist and The National Health Insurance Scheme

The Decree establishing the National Health Insurance Scheme was promulgated in 1999; however, actual implementation commenced in 2002 and has remained at a rudimentary stage. This is despite the very laudable reasons for establishing the NHIS, to provide a financial lifeline to health care delivery in Nigeria. As stakeholders in the NHIS, obstetricians/gynaecologists have a very important role to play to ensure its successful implementation and sustenance. This is especially so in view of the unfavorable reproductive health indices in Nigeria, to which poverty is an important contributory factor. In this article, some background information on health insurance and the NHIS deemed relevant to the obstetrician/gynaecologist is given. Subsequently, the role expected of, and the benefits to be derived by the obstetrician/gynaecologist are presented. [Trop J Obstet Gynaecol, 2004; 21:172-176]

Disease Notification Among Physicians in a Nigerian Tertiary Health Institution

The objective of this study was to assess the physicians' knowledge, attitudes, and practice as related to disease notification. A random sample of 125 physicians was initially recruited for the study but only 120 returned the questionnaires completed, giving a response rate of 96%. Knowledge about disease notification was generally low (14.2%) and among physicians with good knowledge, those in public health specialty had the highest percentage (52.3%) while those in pathology specialty had no knowledge at all (0%). A positive attitude was reported by a large majority (94.2%), who believed that disease notification is beneficial to Nigeria's health care delivery system because it aids-prevention and control of disease outbreak. This attitude was significantly more common in those with few years of professional activity. Even though most of the diseases for routine and immediate notification were diagnosed and treated almost on daily basis by the physicians, yet only 5.8% of them had reported these diseases to the appropriate health authority in the last six months. This study showed that there is a great need for efforts to improve physicians' knowledge on disease notification. Nigerian Medical Practitioner Vol. 45 No 6, 2004 (111-115)

Planning priorities and health care delivery in Nigeria

Economic development had grave as well as beneficial effects on the health of a nation. While it might enhance health standards through better prevention, diagnosis and treatment of diseases, it could endanger health via new eating habits and a tempo of life not conducive to healthy living. These effects of development necessitate rational health planning, the main ingredients of which are manpower planning, physical planning to ensure an even and equitable distribution of medical facilities between urban and rural localities, measures to integrate traditional and orthodox medical practices and financial planning to ensure an adequate allocation of funds to the health sector. In spite of official declarations of intentions to effect a comprehensive health coverage for Nigeria, financial allocation and planning priorities have failed to reflect this. Planned capital expenditure for the health sector has consistently hovered around the 2% mark, only attaining 4.6% in the second development plan, 1970–1974. This low priority accorded the health sector manifests itself in inadequate medical manpower, facilities and coverage of the population by modern medical services. Meeting the health needs of the Nigerian population requires a substantial financial allocation, the integration of modern and traditional medical practices and the reorganisastion and improved management of medical facilities.

Traditional medicine and its practitioners among the yoruba of Nigeria: A classification

Nigeria, like many other developing countries, suffers from severe shortage of Western-trained health personnel. The only means of health care available to most of the 80% of her population who live in the rural areas are the traditional healers. Previous classification of Traditional healers among the Yoruba were critically reviewed. From information accruing from interviews of over fifty herbalists supplemented by the scanty information in the literature, a new and more comprehensive classification of Yoruba traditional healers was proposed. The criteria on which the classification was based were clearly stated. Seven categories of Yoruba Traditional healers were identified. These are the Babalawo; Onisegun (or Adahunse ); Alasotele (soothsayer); Olorisa (or Abore ); Awon 'leku-leja (traditional pharmacists); specialists comprising of traditional bone-setters, traditional psychiatrists, traditional birth attendants or midwives and the “Olola”; and a miscellaneous group consisting of Afaa (Mallams) and Aladura (spiritual healers). The functions of each category of traditional healers identified were clearly defined. The result of the study was discussed, with particular reference to the types of traditional healers found in other countries of the World where the role of traditional healers have been studied. The relevance of the present classification to the possible role of traditional healers in health-care delivery in Nigeria is highlighted.