Primary Public Hospitals Research Articles

A cross-sectional study of evidence-based practice and its determinants among healthcare professionals in Northwest Ethiopia.

Evidence-based practice (EBP) is the integration of current best evidence with clinical expertise by considering patient preferences and values. Evidence based practice has not been well studied in Ethiopia. Therefore, this study aimed to assess EBP and its determinants among health professionals working at primary public hospitals in the Central Gondar zone, Northwest Ethiopia. A facility-based cross-sectional study was conducted on 422 health professionals. A simple random sampling technique was used to select the study participants. The data were entered into EpiData version 4.6 and exported to SPSS version 25 for analysis. The descriptive, bivariable, and multivariable logistic regression analysis were conducted. Adjusted Odds Ratio (AOR) with 95% confidence intervals and p-value <0.05 were used to assess association of explanatory variables with EBP and declare statistical significance, respectively. About 44.1% (95%CI: 39, 50%) of healthcare professionals had good evidence-based practice. Educational status (AOR: 3.05, CI: 1.07-8.66), spare time (AOR: 1.90, CI: 1.09, 3.31), good knowledge (AOR: 7.95, CI: 4.83, 13.08), good skill (AOR: 2.39: CI: 1.27, 4.53), training (AOR: 2.13, CI: 1.26, 3.58), and internet access (AOR = 2.02: 95% CI: 1.25-3.27) were found to be significant predictors of evidence-based practice. This study revealed that EBP was low compared to national standards. Moreover, having good knowledge and skill about evidence-based practice, being trained, having spare time and internet access and upgrading educational status of health care professionals would enhance good evidence-based practice.

Women's satisfaction with comprehensive abortion care services and associated factors in central Gondar zone public primary hospitals, northwest Ethiopia, 2023.

Abortion complications are the leading causes of maternal death in low and middle-income countries, including Ethiopia. Providing quality and comprehensive abortion care services is crucial for improving the health of women and increased their satisfaction. Evaluating a client's satisfaction with abortion care is clinically relevant since women's satisfaction with health services is one of the key indicators of high-quality healthcare services. Therefore, this study aimed to assess women's satisfaction with comprehensive abortion care services and associated factors. An institution-based cross-sectional study was implemented among 333 women in Central Gondar Zone public primary hospitals from October 1, 2022, to April 30, 2023. Eligible participants were selected using a systematic random sampling technique. The data was collected using an interviewer-administered semi-structured, and pretested questionnaire. STATA version 17 and SPSS version 25 software were used for data entry and analysis respectively. Bivariable and multivariable logistic regression models were used to identify factors associated with clients' satisfaction with comprehensive abortion care services. A P-value of ≤0.05 with a 95% confidence interval was the cutoff point for determining statistical significance. This study revealed that the level of client satisfaction with comprehensive abortion care services was 60.4% (95% CI: 55.0%, 66.0%). The use of abortion medication (AOR = 4.41, 95% CI: 2.59, 7.48), women's age 20-24 years (AOR = 2.94, 95% CI: 1.02, 8.48), and being a student (AOR = 2.88, 95% CI: 1.10, 7.51) were significantly associated with women's satisfaction with comprehensive abortion care services. Women's satisfaction with comprehensive abortion care services was relatively low, and it was strongly correlated with the method of abortion, age, and occupation. To improve women's satisfaction requires a comprehensive understanding of women's values and perspectives, providing sexual and reproductive health education, and quality abortion care services are recommended.

Assessment of Job Satisfaction and Associated Factors Among Health Professionals Working at Public Hospitals in Arsi Zone, Oromia Regional State, Ethiopia/2021

&amp;lt;i&amp;gt;Background&amp;lt;/i&amp;gt;: Job satisfaction encompasses the array of attitudes that employees hold towards their work. Various factors influence job satisfaction, including salaries, benefits, allowances, pension funds, working hours, and the level of respect received in the workplace. In Ethiopia, approximately 50% of nurses employed in public health facilities express dissatisfaction, citing reasons such as lack of motivation, inadequate salary, limited training opportunities, and insufficient human resources. &amp;lt;i&amp;gt;Objective&amp;lt;/i&amp;gt;: This study aimed to evaluate job satisfaction and its determinants among health professionals working in public primary hospitals in Arsi Zone, Oromia Regional State, Ethiopia in 2021. &amp;lt;i&amp;gt;Methods&amp;lt;/i&amp;gt;: An institutional-based cross-sectional study design was utilized, involving 207 health professionals selected systematically from public primary hospitals in Arsi Zone. Data were cleaned, coded, entered into EpiData 7, and analyzed using SPSS version 21. Multiple logistic regression analysis was conducted to identify statistically significant associations between dependent and independent variables and to predict factors influencing job satisfaction. &amp;lt;i&amp;gt;Results&amp;lt;/i&amp;gt;: The study revealed that 71 (35.3%) health professionals expressed agreement that they would choose the same career if given the chance again. While 60 (29.9%) respondents perceived personal growth in their work, 124 (61.7%) did not experience any personal development. A majority of participants (78.1%) reported having adequate opportunities for professional growth, with 125 (62.1%) indicating satisfaction in their profession. Multivariate analysis identified age, work experience, and income as significant factors influencing job satisfaction among health professionals. &amp;lt;i&amp;gt;Conclusions and Recommendations&amp;lt;/i&amp;gt;: The study found an overall low level of job satisfaction among health professionals. Age, work experience, and average monthly income emerged as key factors affecting job satisfaction in this group. The government should implement effective policies addressing all determinants of job satisfaction, improve payment structures, create conducive work environments, recognize achievements, and establish mechanisms for remote retention of staff. Hospital administrators should enhance work conditions, increase rewards, and prioritize the professional development of employees to boost staff job satisfaction.

An Empirical Study of PBL-CBL Combined Situational Simulation Teaching Method in Public Health Training in Primary Public Hospitals

Objective: to explore the effect of PBL-CBL combined with situational simulation teaching method in public health training in primary public hospitals. Methods: 20 assistant trainees who received public health training in our hospital from January 2022 to December 2022 were selected as the traditional group to receive the traditional teaching method; another 20 assistant trainees who were interned from January 2023 to December 2023 were selected as the observation group, and the PBL-CBL combined situational simulation teaching method was used. Compare the teaching effect of the two groups. Results: The level of practical skill mastery as well as teaching satisfaction of the observation group was higher than that of the traditional group (P&lt;0.05). Conclusion: The application of PBL-CBL combined with situational simulation teaching method in public health training in primary public hospitals has significant effect, which can effectively improve the level of mastery of practical skills and teaching satisfaction of assistant trainees, and it is recommended to widely popularize and apply this teaching method in public health training.

Surgical Capacity in Public and Private Health Facilities After a Five-Year Strategic Plan Implementation in Ethiopia: A Cross Sectional Study.

Surgical capacity is critical for ensuring optimum access to safe, affordable, and timely emergency and essential surgical care (EESC) in low- and middle-income countries (LMICs) like Ethiopia. A five-year strategic plan has been implemented during 2016-2020 in Ethiopia to improve surgical capacity. This study aims to evaluate the impact of the five-year strategy in surgical capacity in the country. A cross sectional survey was conducted in 172 health care facilities in Ethiopia from December 30, 2020, to June 10, 2021. Descriptive statistical analysis was done using STATA statistical software Version 15. A total of 2,312 surgical workforces were available and, the surgical workforce to population ratio ranged from 1.13:100,000 for public specialized hospitals to 10.8:100,000 for health centre operation room (OR) blocks. Surgical bed to population ratio was 0.03:1000 population, and the average numbers of OR tables per facility were 34. Nearly 25% and 10% of OR tables were not functional in public primary hospitals and private hospitals, respectively. The average surgical volume to population ratio was 189:100,000. Following the implementation of surgical care strategy, the surgical workforce density has increased. However, the study revealed that there is still a huge unmet gap in surgical capacity. The improvement in surgical volume is very low compared to the increment in the surgical workforce density. In addition to the investment being made to build surgical capacity, emphasis needs to be put on surgical system design and strengthening surgical system efficiency.

Exploring patients’ lived experience on the barriers to accessing low back pain health services

The burden of chronic low back pain (CLBP) is a major concern to public health. However, the treatment of CLBP in primary care has shown to be ineffective in South Africa. Understanding the barriers encountered by patients in accessing CLBP healthcare services is paramount in the development of context-specific intervention strategies. To explore the patients' lived experiences on the barriers to accessing diagnostic, referral and treatment services for CLBP. A health facility-based study conducted at five primary public hospitals in KwaZulu-Natal, South Africa. A phenomenological study by means of in-depth interviews using the general interview guide approach. Interviews were conducted by a research assistant with relevant experience and qualifications in qualitative methods. A total of 15 participants were recruited to participate in this study. All interviews were audio-recorded and transcribed. Data were analysed iteratively until saturation was reached, where no new themes were emerging. All the transcripts were exported to NVivo 12 Pro for analysis. The results of this study identified the following barriers: travel, long waiting periods, shortage of personnel, poor infrastructural development, inadequate healthcare personnel, communication barrier, social influence, beliefs around cause and effect, misdiagnosis and inappropriate and/or ineffective treatment approaches. This study concluded that barriers to patients' accessing diagnostic, referral and treatment services exist. Efforts should be made towards developing health systems in underserved communities.Contribution: This is the first study to be conducted in South Africa that explored the barriers associated with accessing healthcare services for chronic low back pain. Based on the results of this study, in order to improve health outcomes for low back pain there need to be a change of emphasis in primary health care by ensuring sufficient allocation of resources towards musculoskeletal disorders.

Depression, anxiety and associated factors among people with epilepsy and attending outpatient treatment at primary public hospitals in northwest Ethiopia: A multicenter cross-sectional study.

ObjectiveTo assess the magnitude and factors associated with depression and anxiety among people with epilepsy and attending out-patient treatment at central Gondar zone primary public hospitals, northwest, Ethiopia.MethodAn institutional based cross-sectional study was conducted from May—June, 2020 at central Gondar zone primary public hospitals. A total of 589 participants were chosen by systematic sampling technique. Data was collected by utilizing Amharic version interviewer-administered structured and semi-structured questioners. Depression and anxiety were assessed by using hospital anxiety and depression scale. Bivariate and multivariate logistic regression analysis was done to recognize variables related to both depression and anxiety. Association was described by using “adjusted odds ratio” (AOR) along with 95% full Confidence interval (CI). Finally, P-values < 0.05 in adjusted analysis were taken as a cut off for significant association.ResultOut of 556 participants included in the study, 30.9%, 33.1% had depression and anxiety respectively. Being divorced/widowed (AOR = 2.43, 95% CI, 1.18–4.99), using two and above number of antiepileptic medications (AOR = 1.77,95% CI,1.02–3.09), very frequent seizure frequency (AOR = 2.68, 95% CI,1.30–5.51), current substance use (AOR = 1.82, 95% CI, 1.03–3.22), perceived stigma (AOR = 5.67,95% CI,3.14–8.18), and hazardous alcohol use (AOR = 2.84, 95% CI,1.32–6.09) were statistically associated with depression. While, being a single (AOR = 1.65, 95% CI, 1.04–2.63), using two and above number of antiepileptic medications (AOR = 2.27, 95% CI, 1.42–3.62), duration of illness ≥16 years (AOR = 2.82, 95% CI, 1.26–6.31), and perceived stigma (AOR = 2.49, 95% CI, 1.63–3.82) were statistically associated with anxiety at a p-value < 0.05.ConclusionThis study showed that the magnitude of depression and anxiety were relatively high among people with epilepsy. Using two and above number of antiepileptic medications and perceived stigma were statistically associated with both depression and anxiety. Screening, early identification and providing appropriate intervention of depression and anxiety among people with epilepsy should be great concern for the health care providers.

Magnitude and associated factors of suicidal ideation and attempt among people with epilepsy attending outpatient treatment at primary public hospitals in northwest Ethiopia: a multicentre cross-sectional study

ObjectiveThis study aimed to assess magnitude and associated factors of suicidal ideation and attempt among people with epilepsy attending outpatient treatment at primary public hospitals, northwest Ethiopia using suicide module...

Neonatal Sepsis and Its Associated Factors Among Neonates Admitted to Neonatal Intensive Care Units in Primary Hospitals in Central Gondar Zone, Northwest Ethiopia, 2019.

BackgroundNeonatal sepsis contributes substantially to neonatal morbidity and mortality and is an ongoing major global public health challenge particularly in developing countries. Studies conducted on the proportion and risk factors of neonatal sepsis in Ethiopia are from referral hospitals, which may not be generalized to primary health care units where a significant proportion of mothers give birth in these health facilities. This study sought to determine the proportion of clinical neonatal sepsis and associated factors in the study areas.MethodsInstitutional-based cross-sectional study was conducted from March to April 2019, in Amhara regional state, central Gondar zone public primary hospitals in Ethiopia. A total of 352 subjects (mother-neonate pairs) were selected using a systematic random sampling technique and pre-tested and structured questionnaires were used to collect data. Multivariable logistic regression analysis was fitted to identify factors associated with neonatal sepsis. Adjusted odds ratio (AOR) with the corresponding 95% confidence interval (CI) was used to show the strength of associations and variables with p-values of <0.05 were considered as statistically significant.ResultsThe overall proportion of neonatal sepsis was 64.8% (95% CI (59.2, 69.2)). Being male neonate (AOR=3.7; 95% CI (1.76, 7.89)), history of urinary tract infections during the index pregnancy (AOR =6, 26; 95% CI (1.16, 33.62)), frequency of per-vaginal examination greater than three during labor and delivery (AOR=6.06; 95% CI (2.45, 14.99)), neonatal resuscitation at birth (AOR=6.1; 95% CI (1.71, 21.84)), place of delivery at the health center (AOR=3.05; 95% CI (1.19, 7.79)), lack of training of health workers on neonatal resuscitation and infection prevention practices (AOR=2.14; 95% CI (1.04, 4.44)), late age of neonate at onset of illness (AOR=0.05; 95% CI (0.01, 0.21)) and maternal age of 30–34 years (AOR=0.19; 95% CI (0.047, 0.81)) were significantly associated with neonatal sepsis.ConclusionThe proportion of neonatal sepsis is high. Maternal, neonatal, and health service related factors were identified for neonatal sepsis. Therefore, training of health workers, provision of health care services as per standards, and monitoring and evaluation of obstetrical/neonatal care during labor and delivery are mandatory.

Hand hygiene compliance and associated factors among health care providers in Central Gondar zone public primary hospitals, Northwest Ethiopia

BackgroundPoor hand hygiene compliance is one in all the leading contributory factors to healthcare-associated infections. This is an important source of complications across the continuum of care and poses a serious threat to people admitted to hospitals. However, the magnitude and associated factors of hand hygiene compliance in public primary hospitals were not well investigated in Ethiopia. Therefore, this study was conducted to assess hand hygiene compliance and associated factors among health care providers in Central Gondar Zone public primary hospitals, Northwest Ethiopia.MethodsAn Institutional based cross-sectional study was conducted from March to April 2019 among health care providers. The data were collected using self-administered questionnaires and observational checklists. Using Epi Info 3.1, data was entered and analyzed using SPSS version 23. The data were analyzed using descriptive statistics and logistic regression models. A p-value less than 0.05 with 95% confidence interval was used to declare statistical significance.ResultsOf 335 study participants, 50 (14.9%), had good hand hygiene compliance. Training on hand hygiene (AOR = 8.07, 95%CI: 2.91, 22.39), availability of adequate soap and water for hand hygiene (AOR = 5.10, 95%CI: 1.93, 13.52), availability of alcohol-based hand rub (AOR = 3.23, 95%CI: 1.32, 7.92), knowledge about hand hygiene (AOR = 6.74, 95%CI: 2.96, 15.34) and attitude towards hand hygiene (AOR = 2.15, 95%CI: 1.04, 4.46) were factors associated with hand hygiene compliance.ConclusionThe overall level of hand hygiene compliance among health care providers was poor. Training, availability of adequate soap and water, availability of alcohol-based hand rub, knowledge on hand hygiene, and attitude of health care providers were significantly associated with hand hygiene compliance.

Prices, availability, and affordability of national essential medicines in public primary hospitals: A cross-sectional survey in poverty-stricken rural areas in China.

This study aimed to determine the prices, availability, and affordability of national essential medicines in public primary hospitals in poverty-stricken areas of Anhui province, China. A cross-sectional study was conducted in 143 public primary hospitals in Anhui province, eastern China. Data on access to 44 essential medicines was evaluated using the standardized methodology available in the World Health Organization and Health Action International manual. Median price rates show that 46.51% (21 of 44) of the lowest price generics and 100% of the originator brands were more expensive than the international reference price. The median availability of the 44 medicines was 31.47%, and 65.91% (29 of 44) of the medicines had less than 50% availability. The majority of the medicines were affordable as they would cost less than a day's income in sample areas. Suppliers could respond to 88.27% of the procuring orders raised by the 143 hospitals in the study, but this ranged from 43.96% to 99.86%. There is poor availability and non-ideal response rate of medicine delivery in public primary hospitals in poverty-stricken areas in eastern China. Further implementation of national essential medicine policy needs to focus on improving both availability and distribution efficiency in these areas.

Cervical Spine Trauma Management

The incidence of spine injury following accidents are still very high in developing countries. Many problems occur after the accident including primary intervention on the scene, transportation to the public primary hospital, the referral system, and finally, the management at the central hospital.Cervical spinal cord injuries represent 20-33% of total spinal injuries with the prevalence of the subaxial levels. In patients with a preoperative neurological deficit due to spine trauma, in case of spinal cord compression or instability, surgery is often the treatment of choice to grant a chance of neurological recovery, early mobilization, and faster return to usual daily activities compared to the conservative treatment. In the past, many authors suggested a delayed surgical treatment to reduce postoperative complications rate, but recent studies have shown that an early decompression (&lt;72 h) may facilitate a postoperative neurological improvement probably due to the prevention of the secondary mechanisms of damage in acute SCI.In the context of the advanced management of spinal injuries, the main points of the focused assessment, the important waypoints of a full classification of the skeletal and spinal cord injury, the principles of early prioritization and decision making, the outline of the surgical strategy including indications, timing, approaches, technique and post-operative care, and the outline principles of rehabilitation. The authors in this paper try to summarize and create a guideline of management, based on experience in a regional centre.

Cervical Spine Trauma Management

The incidence of spine injury following accidents are still very high in developing countries. Many problems occur after the accident including primary intervention on the scene, transportation to the public primary hospital, the referral system, and finally, the management at the central hospital.Cervical spinal cord injuries represent 20-33% of total spinal injuries with the prevalence of the subaxial levels. In patients with a preoperative neurological deficit due to spine trauma, in case of spinal cord compression or instability, surgery is often the treatment of choice to grant a chance of neurological recovery, early mobilization, and faster return to usual daily activities compared to the conservative treatment. In the past, many authors suggested a delayed surgical treatment to reduce postoperative complications rate, but recent studies have shown that an early decompression (&lt;72 h) may facilitate a postoperative neurological improvement probably due to the prevention of the secondary mechanisms of damage in acute SCI.In the context of the advanced management of spinal injuries, the main points of the focused assessment, the important waypoints of a full classification of the skeletal and spinal cord injury, the principles of early prioritization and decision making, the outline of the surgical strategy including indications, timing, approaches, technique and post-operative care, and the outline principles of rehabilitation. The authors in this paper try to summarize and create a guideline of management, based on experience in a regional centre.

National Breast Cancer Chemotherapy Program in Haiti

Abstract 19 Background: Project Medishare launched a breast cancer program in Port-au-Prince in 2013 at the request of local partners. In 2015, the program was expanded as part of a national breast cancer treatment program with Equal Health International. With the mission of strengthening Haiti’s Ministry of Health (MSPP) cancer care infrastructure, the program seeks to decentralize cancer care for women living up to eight hours driving distance from Port-au-Prince by building hospital capacity for cancer screening, diagnosis, chemotherapy and hormone therapy provision at outlying hospitals. Methods: In 2013, two physicians and three nurses were trained to handle, mix and administer chemotherapy by American nurses and doctors. To expand the national program in January 2015, 20 additional physicians and 32 nurses from all ten geographic regions underwent a three-day training in Port-au-Prince on treatment algorithms and practical training for breast cancer. As patients came in for treatment at the local institutions, Project Medishare nurses were on site to supervise mixing and administration of chemotherapy. Physicians continued their practical training via telemedicine to confirm treatment plans and dosage calculations. Results: By September 2015, onsite practical training and chemotherapy had occurred at the primary public hospitals in Gonaives, Jacmel, and Les Cayes. One physician and three nurses were fully trained at each site and seven patients with breast cancer have been treated thus far at the new sites. Future efforts will focus on quality improvement and continuing onsite training at the other hospitals as well as encouraging more doctors and patients to utilize regional programs instead of coming to the capital for treatment. Conclusion: To our knowledge, this is the first regularly-operating multi-site chemotherapy program in a low-income country. Our experiences may inform others to expand already established protocol-based cancer programs in low-resource settings. Next steps include working with MSPP to expand chemotherapy access to Cap-Haitien and to launch breast reconstruction programs through similar trainings in Port-au-Prince. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.

World Suicide Prevention Day: “Think Globally, Plan Nationally, Act Locally”

EditorialWorld Suicide Prevention Day: “Think Globally, Plan Nationally, Act Locally”Annette L. Beautrais and Brian L. MisharaAnnette L. Beautrais University of Otago, Christchurch, New Zealand Search for more papers by this author and Brian L. Mishara University of Quebec at Montreal, Canada Search for more papers by this authorPublished Online:June 16, 2008https://doi.org/10.1027/0227-5910.29.2.59PDFView Full Text ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInReddit SectionsMoreReferences Gajalakshmi, V. , Peto, R. (2007). Suicide rates in rural Tamil Nadu, South India: Verbal autopsy of 39,000 deaths in 1997–98. International Journal of Epidemiology, 36, 203–207. First citation in articleCrossref Medline, Google Scholar Hegerl, U. , Wittman, M. , Arensman, E. , Van Audenhove, C. , Bouleau, J. , van der Feltz-Cornelis, C. , et al. (2008). The European Alliance Against Depression (EAAD): A multifaceted, community-based action program against depression and suicidality. World Journal of Biological Psychiatry, 9, 51–59. First citation in articleCrossref Medline, Google Scholar Knox, K.L. , Litts, D.A. , Talcott, G.W. , Catalano-Feig, J. , Caine, E.D. (2003). Risk of suicide and related adverse outcomes after exposure to a suicide prevention programme in the US Air Force: Cohort study. British Medical Journal, 327, 1–5. First citation in articleCrossref Medline, Google Scholar Nock, N. , Guimaraes Borges, G. , Bromet, E. , Alonso, J. , Angermeyer, M. , Beautrais, A. et al. . (2008). Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. British Journal of Psychiatry, 192, 98–105. First citation in articleCrossref Medline, Google Scholar Ohberg, A. , & Lonnqvist, J. (1997). Suicide trends in Finland 1980–1995. Psychiatrica Fennica, 28, 11–23. First citation in articleGoogle Scholar United Nations. (1996). Prevention of suicide: Guidelines for the formulation and implementation of national strategies. New York: Author. First citation in articleGoogle Scholar World Health Organization.. (1993). Guidelines for the primary prevention of mental, neurological, and psychosocial disorders: 4. Suicide. Geneva: Author. First citation in articleGoogle ScholarFiguresReferencesRelatedDetailsCited byMagnitude and associated factors of suicidal ideation and attempt among people with epilepsy attending outpatient treatment at primary public hospitals in northwest Ethiopia: a multicentre cross-sectional study4 January 2021 | BMJ Open, Vol. 11, No. 1A study on suicidal ideation and associated factors in prisoners of addis ababa correctional centerAnnals of Indian Psychiatry, Vol. 2, No. 1A Survey of the Suicidal Attempt Risk Factors in Adolescents in Southern Iran6 November 2017 | International Journal of School Health, Vol. In Press, No. In PressHigh school students’ knowledge and experience with a peer who committed or attempted suicide: a focus group study18 October 2014 | BMC Public Health, Vol. 14, No. 1Risk factors for suicidal ideation, plans and attempts in Malaysia — Results of an epidemiological surveyComprehensive Psychiatry, Vol. 55Suicide and related health risk behaviours among school learners in South Africa: results from the 2002 and 2008 national youth risk behaviour surveys4 October 2013 | BMC Public Health, Vol. 13, No. 1Depressive symptoms and interpersonal needs as mediators of forgiveness and suicidal behavior among rural primary care patientsJournal of Affective Disorders, Vol. 149, No. 1-3Correlates of Suicide Ideation and Attempt among Youth Living in the Slums of Kampala16 February 2012 | International Journal of Environmental Research and Public Health, Vol. 9, No. 2Suicide Attempts Among Depressed Inpatients with Depressive Disorder in a Malaysian Sample Psychosocial and Clinical Risk FactorsL. F. Chan, T. Maniam, and A. S. Shamsul1 January 2011 | Crisis, Vol. 32, No. 5Doing Qualitative Research on Suicide in a Developing Country Practical and Ethical ChallengesJames Mugisha, Birthe Loa Knizek, Eugene Kinyanda, and Heidi Hjelmeland1 January 2011 | Crisis, Vol. 32, No. 1A Pirandellian Perspective on Suicide2 April 2009 | International Quarterly of Community Health Education, Vol. 29, No. 1 Volume 29Issue 2March 2008ISSN: 0227-5910eISSN: 2151-2396 InformationCrisis (2008), 29, pp. 59-63 https://doi.org/10.1027/0227-5910.29.2.59.© 2008Hogrefe & Huber PublishersPDF download

Prioritizing drug procurement expenditure in selected primary public hospitals in Lagos State

Prioritizing drug procurement expenditure in selected primary public hospitals in Lagos State