Public Health Facilities In Nigeria Research Articles

Addiction stigma and opioid use in chronic non-cancer pain management in Nigeria.

This study uses 26 in-depth interviews conducted with people who use drugs (PWUD) who had sought care for chronic non-cancer pain in public health facilities in Nigeria, to explore how drug consumption stigma constitutes patient legitimacy based on neoliberal ideals. It found drug consumption stigma to be salient and pervasive in PWUD health-care encounters, operating through interpersonal interactions and institutionalised policies and practices to shape access to care. Crucially, stigma emerged through disciplinary opioid prescribing and dispensing practices that defined, categorised and marginalised PWUD based on how their drug consumption disrupted normative values of rationality and responsibility. Accounts additionally revealed disengagement from biomedical care and reliance on alternative pain management approaches (e.g. herbal remedies and illegal drugs), which show how structural positions shape the exercise of choice and agency in socially marginalised populations. In conclusion, the study considers the need to improve the health-care experiences of PWUD as a strategy for enhancing health-care engagement and improving health outcomes. It called for interventions to address the structural factors and interactional dynamics that influence stigma in health-care settings as well as for a review of current guidelines and practices to improve access to opioids for chronic non-cancer pain management.

Evaluation of job satisfaction among pharmacists working in public health facilities

BackgroundThe decline in healthcare workforce is a global trend that is alarming in low and middle-income countries (LMIC) in LMIC and many countries worldwide, pharmacists plays critical role in healthcare, many of which are not limited to patient care, research and development, health promotion. However, growing dissatisfaction among pharmacists working in public health facilities has become increasingly common and can have severe public health consequence. Job dissatisfaction ranks among the most significant factors influencing healthcare employees to seek career changes, reduce productivity, and possibly migrate to more promising opportunities, thereby posing a public health threat in the region.' Furthermore, healthcare professionals are crucial to the functionality of a healthcare system, with human resources standing as a critical element ensuring organizational success vis-a-vis other dependent factors to optimize efficiency and effectiveness. ObjectivesTo examine the job satisfaction of pharmacists working in public health facilities in Nigeria. MethodA descriptive, cross-sectional study on pharmacists' job satisfaction was carried out between march and July 2023, to determine the job satisfaction of pharmacists working in primary, secondary, and tertiary healthcare facilities in Nigeria. Data were gathered using an anonymous online validated questionnaire adapted from the Minnesota questionnaire short form and the Job Description Index (JDI) (Measuring Job Satisfaction - Tools, Scales, and Methods). ResultsThe study identified an overall low job satisfaction level of 65%. Major influencers included facility conditions, co-worker relations, and remuneration. The demographic data revealed a dominance of female pharmacists in general hospital settings, with a significant proportion aged between 23 and 36 years. Remuneration emerged as a universal concern across different age groups, reflecting Nigeria's prevailing economic challenges. Interestingly, satisfaction with the working facility decreased with age, suggesting that enthusiasm and optimism wane over time. Relationship dynamics with co-workers showed positive progression with age, whereas satisfaction with pay remained universally low. ConclusionThe study underscores the need for a comprehensive strategic review in the health sector, focusing on remuneration, working conditions, and inter-personal relationships to boost job satisfaction and retention. Further research might delve deeper into specific allowances and the impact of home ownership on satisfaction.

Tackling corruption in the distribution of Covid-19 palliatives and public health facilities in Nigeria: legal insights and strategic blueprint for future emergencies

PurposeThe purpose of this study is to examine the corruption prevalent in the distribution of COVID-19 palliatives during the lockdown and movement restrictions in the country. This study seeks to analyse the current state of corruption in the distribution of COVID-19 palliatives and public health facilities in Nigeria while also providing a legal insight and strategic blueprint to combat corruption. To this end, this study will address the current legal framework for combating corruption and build upon this to formulate a working strategy for tackling corruption in the future.Design/methodology/approachUsing a doctrinal legal research methodology, this study draws upon existing literature, tertiary data sources and information from the Nigeria Centre for Disease Control. The collected data is analysed and compared with current literature to identify key findings. Rent-seeking and utilitarian theories of the law were examined to guide this study. This study offers useful insights into combating corruption. The use of this method is justified, as it enhances the credibility of the findings on the importance of strategies for future emergencies. This legal research approach is consistent with the law and can be easily verified. The empirical aspect of this study involved a survey of multidimensional health-care and economic data set of 36 states in Nigeria plus the Federal Capital Territory on COVID-19 in Nigeria. A survey linearised regression model was estimated to determine the influence of government revenue and public health-care facilities in the control of the virus spread in Nigeria.FindingsThis study reveals the need for emphasis on the imperative of combating corruption in the distribution of COVID-19 palliatives and establishing economic resilience through transparent and accountable practices, supported by legal frameworks.Research limitations/implicationsRent-seeking and utilitarian theories of law are evaluated because of their impacts on combating corruption. The limitation of this study is the intricacy of gathering data on COVID-19 palliatives corruption in Nigeria because of secrecy and the absence of reliable data on the subject.Practical implicationsEstimating the exact number of stolen palliatives and their fiscal impact on Nigeria's economy proves to be a formidable task because of the covert nature of corruption. This study equips policymakers in Nigeria with a better understanding of the legal challenges posed by corruption in the health care sector and provides an effective strategy to combat it.Social implicationsThe lack of reliable data on the extent of palliative theft hinders the ability of lawmakers to enact effective legislation and strategies for combating corruption in the distribution of COVID-19 palliatives and addressing future emergencies in Nigeria. The policy implications of this study can assist policymakers in Nigeria and other countries in formulating measures to combat corruption in the distribution of COVID-19 palliatives and other future emergencies. Furthermore, it recommends the overhaul of anti-corruption laws and mechanisms in Nigeria to ensure effective measures against corruption.Originality/valueIn conclusion, this study contributes to knowledge by proposing a legal model centred on people's participation to enhance transparency and accountability in future palliative distribution processes. This study recommends legal strategies that can effectively address corruption in future emergencies or shocks. This study proposes a strategic blueprint to tackle corruption in the future. This blueprint includes an analysis of existing laws and regulations, as well as potential policy changes and legislative reform. This study also includes recommendations for improved enforcement and oversight mechanisms and for improved public awareness and education. As part of this, this study considers the potential for public–private partnerships to increase transparency and accountability in public health and health-care services.

To what extent is antenatal care in public health facilities associated with delivery in public health facilities? Findings from a cross-section of women who had facility deliveries in Nigeria

BackgroundFacility delivery remains an important public health issue in Nigeria. Studies have confirmed that antenatal care may improve the uptake of facility delivery. However, information is rarely available in Nigeria on the extent to which antenatal care in public health facilities is associated with delivery in public health facilities. The objective of the study was thus to examine the extent of the association between antenatal care in public health facilities and delivery in public health facilities in Nigeria. The study was guided by the Andersen behavioral model of health services use.MethodsThe cross-sectional design was adopted. Data were extracted from the most recent Nigeria Demographic and Health Survey (NDHS). A sample of 9,015 women was analyzed. The outcome variable was the facility for delivery. The main explanatory variable was the antenatal care facility. The predisposing factors were maternal age, age at first birth, parity, exposure to mass media, and, religion. The enabling factors were household wealth, work status, partners’ education, women’s autonomy, health insurance, and, perception of distance to the health facility. The need factors were pregnancy wantedness, the number of antenatal care visits, and the timing of the first antenatal care. Statistical analyses were performed with the aid of Stata version 14. Two binary logistic regression models were fitted.ResultsFindings showed that 69.6% of the women received antenatal care in public health facilities, while 91.6% of them subsequently utilized public health facilities for deliveries. The significant predisposing factors were age at first birth, parity, maternal education, and religion, while household wealth, work status, women’s autonomy, and partners’ education were the significant enabling factors. The timing of the first antenatal contact, pregnancy wantedness, and the number of antenatal care visits were the important need factors.ConclusionTo a significant extent, antenatal care in public health facilities is associated with deliveries in public health facilities in Nigeria. It is imperative for governments in the country to take more steps to ensure the expanded availability of public health facilities in all parts of the country since their use for antenatal care is well-associated with their use for delivery care.

Lack of adequate equipment for healthcare – The agony of patients and nurses: A review

The health sector is crucial to the growth and development of a nation. Despite sound policies and interventions to develop the Nigerian health sector, there are challenges that continue to reduce the progress and achievement of universal access to healthcare. The major factors that affect the overall performance of the health system include inadequate health facilities/structure, poor human resources and management, poor remuneration and motivation, lack of fair and sustainable healthcare financing, unequal economic and political relations. Other factors inlucde neo-liberal economic policies of the Nigerian state, corruption, illiteracy, very low government spending on health, high out-of-pocket expenditure in health, and the absence of an integrated system for disease prevention, surveillance and treatment, inadequate mechanisms for families to access healthcare, and the most persistent problem, the shortage of basic and essential equipment in most public health facilities in Nigeria. The agony which patients and nurses are passing through due to the non-availability of equipment needed to render the required services causes inefficient service delivery and increases job stress. This review paper describes the enormity of the problems and recommends options vital to addressing the problem to attain equilibrium in demand, quality and efficiency in healthcare delivery.

Cost of illness of non-communicable diseases in private and public health facilities in Nigeria: a qualitative and quantitative approach

the cost of illness (COI) of non-communicable diseases (NCDs) has detrimental effects on healthcare outcomes in addition to the serious economic impact on patients and their families. This study estimated and compared the COI of NCDs and its predictors in private and public health facilities (HF) in Ado-Ekiti, Nigeria. the study was carried out in selected HF (39 private; 11 public) using a comparative cross-sectional design with a mixed method of data collection. Quantitative data were collected from 348 hypertensive and/or diabetic patients (173 private; 175 public) using a semi-structured, interviewer-administered questionnaire while qualitative data were from 5 key informant interviews (KII) conducted with HF heads or their representatives. the average monthly COI of NCDs was higher among patients in private (₦15,750.38±14,286.47 [US$43.75±39.68]) than in public HF (₦13,283.37±16,432.68 [US$ 36.90±45.65]) (P<0.001), however, the indirect cost was higher in public HF (private, ₦1,561.07 [US$4.34]; public, ₦3,739.26 [US$10.39]) (p<0.001). Predictors of COI of NCDs identified were income and admission in both groups. Additionally, age, payment method, type of NCDs, having two or more complications, and exercise were identified in private while socioeconomic status, length of diagnosis, and alcohol were identified in public HF. The KII revealed a long waiting time for the public HF patients which accounted for the huge indirect cost. the study found a huge indirect cost in the public HF that could be minimized by developing policies that would reduce the waiting time of patients. Government and private interventions targeting identified predictors should be applied to reduce the financial burden of NCD.

Challenges and Enhancement of Medical Social Workers in Public Health Facilities in Nigeria

ABSTRACT The study sought to explore the challenges and enhancement of medical social workers in public health facilities in Nigeria, with particular reference to Delta State, Nigeria. A phenomenological and exploratory research design was adopted for the study. An unstructured in-depth interview (IDI) guide was used for data collection. Lack of legal backing, inadequate facilities, unfavorable organizational structure, lack of graduate medical social workers, inadequate recognition of the role of medical social workers, domineering attitude of medical professionals, inadequate remuneration, lack of means of transportation, and inadequate motivation, were the challenges facing social workers in the public health care facilities. This study, to enhance medical social workers recommends, amongst others, that social work education and practice should be legalized and given the needed professional status in Nigeria. All health professionals, including medical social workers, should imbibe the values/ethics of interprofessional teamwork in public health facilities. Professional medical social workers should be engaged in all Nigerian public health facilities.

Barriers and facilitators of access to maternal, newborn and child health services during the first wave of COVID-19 pandemic in Nigeria: findings from a qualitative study.

BackgroundCOVID-19 pandemic may have affected the utilization of maternal and newborn child health services in Nigeria but the extent, directions, contextual factors at all the levels of healthcare service delivery in Nigeria is yet to be fully explored.The objective of the study was to explore the barriers and facilitators of access to MNCH services during the first wave of COVID-19 pandemic in Nigeria.MethodsA qualitative study was conducted among different stakeholder groups in 18 public health facilities in Nigeria between May and July,2020. In-depth interviews were conducted among 54 study participants (service users, service providers and policymakers) selected from across the three tiers of public health service delivery system in Nigeria (primary health centers, secondary health centers and tertiary health centers). Coding of the qualitative data and identification of themes from the transcripts were carried out and thematic approach was used for data analyses.ResultsBarriers to accessing MNCH services during the first wave of COVID-19-pandemic in Nigeria include fear of contracting COVID-19 infection at health facilities, transportation difficulties, stigmatization of sick persons, lack of personal protective equipment (PPE) /medical commodities, long waiting times at hospitals, shortage of manpower, lack of preparedness by health workers, and prioritization of essential services.Enablers to access include the COVID-19 non-pharmacological measures instituted at the health facilities, community sensitization on healthcare access during the pandemic, and alternative strategies for administering immunization service at the clinics.ConclusionAccess to MNCH services were negatively affected by lockdown during the first wave of COVID-19 pandemic in Nigeria particularly due to challenges resulting from restrictions in movements which affected patients/healthcare providers ability to reach the hospitals as well as patients’ ability to pay for health care services. Additionally, there was fear of contracting COVID-19 infection at health facilities and the health systems inability to provide enabling conditions for sustained utilization of MNCH services. There is need for government to institute alternative measures to halt the spread of diseases instead of lockdowns so as to ensure unhindered access to MNCH services during future pandemics. This may include immediate sensitization of the general public on modes of transmission of any emergent infectious disease as well as training of health workers on emergency preparedness and alternative service delivery models.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12913-022-07996-2.

A comparative assessment of the level of stockouts of modern family planning services in private and public health facilities in Nigeria

Background: The use of family planning (FP) methods and stockouts of contraceptives are major challenges to the FP program in Sub-Saharan Africa. This study assessed the level of stockouts of contraceptives in Nigerian health facilities. This survey was carried out in 767 health facilities offering FP services across all six geopolitical zones of Nigeria. Materials and Methods: This was a cross-sectional study involving a quantitative technique. Data were collected from 116 private and 651 public health facilities in Nigeria. A structured questionnaire was used to collect data from the facilities, and a physical inventory was taken. Data were analyzed using IBM-SPSS, version 25.0. Results: The stockout rate in the last 3 months was 63.8% in private and 47.5% in public health facilities (P = 0.001), whereas stockouts on the visit day were 63.8% in private and 51.0% in public facilities (P = 0.011). On the day of the visit, the stockout rate in private health facilities ranged from 9.3% to 26.5%, whereas it ranged from 5.3% to 24.2% in public health facilities. The main causes of stockouts of some contraceptives are low/no demand and a lack of supply. Conclusions: This study found a high level of stockouts of FP services in private and public health facilities, but higher in private facilities. Both the poor supply and low demand for FP services in Nigeria require the attention of policymakers and health officials.

Roles of Technology Enhanced Learning in Tackling Antimicrobial Resistance among Laboratory Professionals in Public Health Facilities in Nigeria

Technology has been found effective in almost all aspects of life. This includes its effectiveness in the field of education through technology enhanced learning. This paper aimed to look at roles of technology enhanced learning in tackling antimicrobial resistance among laboratory professionals in public health facilities in Nigeria. Qualitative research design was adopted for the study. Population of the study included all 75300 laboratory professionals in the North-west Nigeria. Convenience sampling technique was used to select 382 participants as sample for the study. This was guided by Research Advisors Model for selection of sample size. The instrument (open ended questionnaire) was used to gather data for the study. It was validated by experts, pilot study was conducted, and reliability index of 0.88 was obtained. It was found from the study that most of the health care professionals lamented not only they lack modern laboratory equipment but also lack technical knows how to operate the modern laboratory equipment/tools/apparatuses. It also was gathered that vast majority of them use handheld devices (smart phones) with few of them using laptops and in extreme cases desktops computers for learning and other day-to-day activities. Based on the findings from the study, it was concluded that in the 21st Century, collaborations through technology has become imminent. Thus, technology enhanced professional learning will not only help share information about global challenges but also help in providing lasting solutions to it. The study recommended that workshops and regular trainings should be organized to teach health care professionals on how to effectively collaborate, generate and share information through social media platforms.

Patients Satisfaction with Waiting Time and Attitude of Health Workers in the General Outpatient Department of a State Teaching Hospital, Enugu State, Nigeria

Background/Aim: Overall patients’ satisfaction with services provided in a hospital is an objective of care, and also a desired outcome. Dissatisfied patients are more likely not to comply with prescriptions, follow-up appointments, or further use the health facility. Services provided in public health facilities in Nigeria have been perceived by both patients and health care providers as being poor. Teaching hospitals in Nigeria are the apex referral centers, with the General Outpatient Department (GOPD) being the first unit that patients mostly go to first. Waiting time and attitude of health workers are key contributors to overall patients’ satisfaction. The objective of this study is to assess patients’ satisfaction with waiting time, and attitude of health workers in the GOPD of a Teaching hospital in Nigeria.&#x0D; Materials and Methods: Cross-sectional study, conducted over three months in 2017 at the GOPD of Enugu State University Teaching Hospital, Nigeria. Structured, interviewer-administered questionnaire was used. Exit interview was conducted on randomly selected 13 patients as they were leaving the GOPD Pharmacy unit on Tuesdays and Thursdays of every week, until 313 respondents were interviewed.&#x0D; Results: A total of 313 patients were interviewed, 131 (41.9%) males and 182 (58.1%) females. Analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0, and the results were expressed as percentages. Patients’ satisfaction score for the various items studied were found to be 53.7% for waiting time, 74.4% for attitude of Records staff, 78.3% for nurses, 71.9% for doctors, 70.6% for time spent with doctor, 72.5% with doctor's explanation and 40.6% with privacy.&#x0D; Conclusions: Overall satisfaction with services rendered at the GOPD was 60.4%. Identifying and implementing interventions that will enhance patients satisfaction, shall improve health facility utilization.

The role of the family physician in the fight against Coronavirus disease 2019 in Nigeria.

The Coronavirus disease 2019 (COVID-19) pandemic has been ravaging Nigeria and the world with increasing morbidity and mortality. Despite efforts by the Nigerian government implemented through the Nigerian Centre for Disease Control (NCDC) to reduce the scourge of the disease through public enlightenment and regular updates, the number of new cases and mortalities from COVID-19 are still increasing. Family physicians (FPs) who are the first contact of care for most patients accessing private and public health facilities in Nigeria have been working tirelessly to reduce the scourge of the pandemic in Nigeria. They continuously update themselves through regular webinars and online resources and guidelines provided by the Society of Family Physicians of Nigeria (SOFPON). Measures adopted by FPs across the country in the fight against the scourge include triaging patients as they present to the family medicine clinics; health education and enlightenment of the populace; and ensuring social distancing, regular handwashing and compulsory use of face mask by both physicians and patients during clinical consultations. Other measures include incorporating family-focused behavioural interventions in their practice, home-based care to reduce the number of persons visiting the hospital, telemedicine and Hospice and palliative care services to the elderly and terminally ill. In conclusion, FPs in Nigeria are helping to reduce the scourge of COVID-19 through patient education and innovative healthcare delivery that does not put patients at increased risk of the disease whilst promptly recognising potential COVID-19 patients and referring them for early diagnosis and treatment.

EFFECT OF ELECTRONIC HEALTH INFORMATION SYSTEM ON MEDICAL RECORDS MANAGEMENT IN PUBLIC HEALTHCARE INSTITUTIONS

The worrisome state of Nigerian hospitals in the last decades owing to continued to adopt the global trend on information systems to move away from healthcare delivery characterised by inefficiencies, poor management practices evidenced by continuous use of the traditional paper record system in most public health facilities in Nigeria, which often time causes delay and long patient waiting time, resulting in cases of infant and maternal mortality. Hence, this study investigated how an electronic health information system can improve medical records management in Nigeria’s public healthcare institutions. The study employed the numerical and qualitative research philosophy, adopted the survey and case study research strategies, the cross-sectional and qualitative research designs. The study sample covered 332 respondents spread across four selected Federal Medical Centres in Makurdi, Keffi, Lokoja and Abuja FCT, all located in the North Central Region of Nigeria. In the collection of primary data, the researcher took cognisance of ethnic consideration regarding the confidentiality of data and protection of respondents’ trust. The study used the simple frequency percentage table to analyse collected data. The finding revealed that, though there is still heavy reliance on traditional paper-based records system, however, adoption of eHIS will reduce risk of treatment errors, decrease patient waiting time, enhance timely communication among practitioners, protects patient information from unauthorised personnel and enhance healthcare service delivery. The study, therefore, recommended that the government and hospital management should prioritise the provision of necessary infrastructure in the health capital budget to support adoption and implementation of the electronic health information system and electronic medical records management to reduce high mortality rates from delayed treatments and preventable medical errors.

Implementation of Isoniazid Preventive Therapy among People Living with HIV in Northwestern Nigeria: Completion Rate and Predictive Factors.

Background:Despite proven benefits of isoniazid preventive therapy (IPT) for people living with HIV (PLHIV), its implementation remains limited in low-resource settings. There are also programmatic concerns of the completion rate of IPT particularly when full integration with other HIV services has not been achieved.Aim:The aim of this study was to determine the completion rate of IPT and predictive factors among PLHIV attending six government hospitals in Kebbi state, Northern Nigeria.Methods:This was a retrospective cohort study of program data spanning a 5-year period (December 2010–June 2016). Data were collected between January 2017 and June 2017.Results:A total of 1,134 IPT patients were enrolled of whom 740 (65.3%) were female. The mean age was 40.3 ± 3.7 years. Four hundred and fifty-four (40%) of those who initiated IPT completed the 6-month course. Of the 680 (60%) IPT noncompleters, 117 (17.2%) were lost to follow-up by month 1, 305 (44.9%) by month 2, 156 (22.9%) by month 3, 48 (7.1%) by month 4, and 54 (7.9%) by month 5. Being initiated on IPT by a pharmacist (adjusted odds ratio [aOR]: 23.7, 95% confidence interval [CI]: 16.5–33.9) and receiving ≤2 tuberculosis screening evaluation during IPT period (aOR: 0.58, 95% CI: 0.43–0.78) were associated with a higher and lower risk of completing IPT, respectively, whereas age, sex, and anti-retroviral therapy (ART) status were not significantly associated.Conclusion:IPT completion rate among PLHIV is relatively low, highlighting the need to strengthen IPT rollout in public health facilities in Nigeria. Pharmacy-led IPT adherence education and regular clinical evaluation may improve IPT completion rates, along with synchronizing and prepackaging IPT and ART resupplies for PLHIV.

Healthcare providers\u2019 perspectives of disrespect and abuse in maternity care facilities in Nigeria: a qualitative study

ObjectivesTo explore healthcare providers’ perspectives of disrespect and abuse in maternity care and the impact on women’s health and well-being.MethodsQualitative interpretive approach using in-depth semi-structured interviews with sixteen healthcare providers in two public health facilities in Nigeria. Interviews were audio-recorded, transcribed, and analysed thematically.ResultsHealthcare providers’ accounts revealed awareness of what respectful maternity care encompassed in accordance with the existing guidelines. They considered disrespectful and abusive practices perpetrated or witnessed as violation of human rights, while highlighting women’s expectations of care as the basis for subjectivity of experiences. They perceived some practices as well-intended to ensure safety of mother and baby. Views reflected underlying gender-related notions and societal perceptions of women being considered weaker than men. There was recognition about adverse effects of disrespect and abuse including its impact on women, babies, and providers’ job satisfaction.ConclusionsHealthcare providers need training on how to incorporate elements of respectful maternity care into practice including skills for rapport building and counselling. Women and family members should be educated about right to respectful care empowering them to report disrespectful practices.

Motivation for donation among hospital blood donors and their attitude towards voluntary blood donation in State Government Hospitals, Kaduna, Nigeria

BackgroundVoluntary blood donation (VBD) is critical to adequate blood supply. Public health facilities in Nigeria rely mostly on replacement blood donation. Motivation for blood donation among hospital donors was assessed, and factors that influence VBD were determined in Kaduna, Nigeria.MethodsThis is a cross‐sectional study on 361 blood donors in three selected hospitals. A structured questionnaire was used to collect information from respondents. Logistic regression was used to identify predictors of VBD at P &lt; 0·05.ResultsThe major motivator (86·9%) for respondents was when relatives or friends required blood transfusion. About 86% (310) of the respondents had good attitude towards VBD. Having primary or no formal education [adjusted odds ratio {AOR} (95% CI): 0·35(0·12–0·98)] and those who were not in marital relationships [AOR (95% CI)]: 0·45 (0·21, 0·97) were less likely to have good attitude to VBD. Additional factors that hinder VBD were concerns that donated blood might be sold [AOR (95% CI)]: 0·11 (0·05, 0·24) and poor phlebotomy technique by personnel [AOR (95% CI)]: 0·10 (0·03, 0·41). However, repeat blood donors were more likely to have good attitude to VBD [AOR (95% CI)]: 4·22 (1·79, 9·94).ConclusionThe main motivator for respondents is when a family member or a friend needs blood transfusion. Low educational attainment, not been in a marital relationship, concerns that donated blood might be sold and fear of phlebotomy technique were deterrents to VBD. Appropriate blood donor education and providing conducive setting with skilled personnel could convert eligible replacement donors to voluntary donors.

Women and Continuous Labour Support in Public Health Facilities in Nigeria

Childbirth is a multifaceted process that is influenced by several factors resulting in an unsatisfactory or satisfactory childbirth experience. Continuous labour support (CLS) has been identified as a positive contributor to a satisfactory birthing experience, and consequently positive maternal health outcomes. The World Health Organization recommended the right of a pregnant woman to have a companion of her choice during labour, but CLS practice remains a mirage in Nigerian hospitals. This descriptive cross-sectional study explores the perceptions, attitudes and preferences of 368 randomly selected women regarding CLS in public hospitals in South West Nigeria. Data were collected using a pretested questionnaire developed from the literature review and analysed with descriptive and inferential statistics using SPSS Version 20. The findings revealed that the participants perceived support from midwives during labour as inadequate but that they were satisfied with professional care at birth. The participants perceived the inclusion of a familiar person for support as beneficial and expressed positive disposition to the introduction of persons from their social network for labour support in public health facilities. The preference for husbands and mothers as labour support persons was higher among the study participants.

Nurse reported patient safety in low-resource settings: a cross-sectional study of MNCH nurses in Nigeria

PurposeRepeated international studies demonstrate the critical role of nursing and the associations between patient safety and nurse staffing and the nurse practice environment in high resource countries, yet nurse reported patient safety studies are sparse in Sub-Saharan Africa. This study explored nurse reported patient safety in Nigeria and examined the extent that patient safety is associated with nurse staffing levels and the nurse practice environment. MethodsA cross-sectional study of 27 public health facilities in Nigeria used anonymous nurse surveys (N=222) to examine associations between nurse staffing, the nurse practice environment and nurse reported safety. Descriptive statistics and generalized linear mixed models (GLMM) were used to account for clustering of nurses within facilities. ResultsOf the 222 nurse participants, 26% reported patient safety as poor/fair. Nurses who cared for greater than 20 patients had higher percentages of poor/fair patient safety. With the GLMM models adjusted for type of facility and nurse staffing, the nurse practice environments had the strongest association with patient safety. As the nurse practice environment score increased, nurses were nearly three times more likely to rank patient safety as excellent/good OR=2.9 (1.5, 5.7). ConclusionsThe taxonomy used globally with nurse safety research was comparable in Nigeria. Enhancing the nurse practice environment could offer opportunities to improve nurse reported patient safety in public health facilities in Nigeria. Further research is needed to better understand nurse reports of worse patient safety in secondary level health facilities and facilities with worse nurse staffing.

Adherence to treatment guidelines for uncomplicated malaria at two public health facilities in Nigeria; Implications for the 'test and treat' policy of malaria case management.

ObjectivesAdherence to treatment guidelines for uncomplicated malaria is critical to the success of malaria case management. Poor adherence has implications for increased malaria burden, in view of the risk of widespread parasite resistance and treatment failures. This study analyzed the diagnostic and prescription pattern for uncomplicated malaria at two public health facilities, south east Nigeria, to assess the current state of compliance to policy guidelines on the use of artemisinin-based combination therapy (ACT).MethodsRetrospective audit of patients’ records, treated for uncomplicated malaria, between the months of January and March 2013, was undertaken at two public health facilities. Demographics, diagnostic information, medication and cost data were extracted. Questionnaires were distributed to providers to assess their malaria treatment intent. Data from the facilities were analyzed and compared for similarities and systematic differences, and conformity to malaria treatment policy, in terms of laboratory diagnosis, use of ACT, co-medication and cost of medication.ResultsA total of 2,171 records of patients who had been treated for uncomplicated malaria were analyzed. Of these, 1066 (49%) were sent for laboratory confirmation of malaria using mostly microscopy, out of which 480 (45%) tested positive. 51% (1105) of the prescriptions was on the basis of presumptive treatment. 58% of slide negative results received antimalarial drugs. 93% of patients received ACT, with artemether-lumefantrin, AL (50.5%) as the most prescribed antimalarial drug. Monotherapy accounted for 7% of prescriptions, comprising mostly sulphadoxine + pyrimethamine, SP (46.5%) and monotherapy artemisinin, AS (29.2%). 97% of the prescriptions received at least one co-medication. Antibiotics were prescribed to 50% of patients. Overall, median cost of medication was N1160.00 (US$7.48 (US$0.19 - 267.87) per case, higher in tertiary than the secondary facility. There were significant variations in treatment practices between the two facilities.ConclusionEvidence suggests good compliance to policy on the use of ACT as first line treatment for uncomplicated malaria. However, there exists significant scope for improved diagnosis and rational drug use, to enhance accuracy of treatment, reduced wastages and risks of adverse drug reactions, in line with the goals of ‘test and treat’ policy of malaria case management.

PIN107 - Prescription Practices for Uncomplicated Malaria at two Public Health Facilities in Nigeria; A Descriptive, Comparative Study

PIN107 - Prescription Practices for Uncomplicated Malaria at two Public Health Facilities in Nigeria; A Descriptive, Comparative Study