Knowledge of the national health act among physicians in two tertiary hospitals in Southern Nigeria

Objective: Knowledge of provisions of the National Health Act among physicians and stakeholders is pivotal to its successful implementation. This study aimed to assess the knowledge of the National Health Act (NHA) among Physicians in two tertiary hospitals in Nigeria. Methods: This was a cross-sectional study conducted in two tertiary hospitals in Southern Nigeria. The consecutively recruited eligible respondents were assessed for knowledge of NHA using a 24-item self administered close-ended structured questionnaire. The total obtainable score was 26. Those with <13 points had poor knowledge, 13-21 points had good knowledge and >21 points had excellent knowledge. Data were analyzed using SPSS version 21 software. P-value of < 0.05 was taken as significant. Results: One hundred and ninety-five doctors with a male: female ratio of 1.9:1 participated in the study. The majority (91.8%) were ≤40 years and 129(66.2%) of the participants were ≤ 10 years post qualification. The frequency of correctly answered questions ranged between 7.7% - 89.2%. According to overall knowledge scores; 64.6% had poor knowledge; 35.4% had good knowledge and none had excellent scores. There was no statistically significant association between knowledge of NHA and gender, age, and number of years post qualification (p > 0.05). Conclusion: This study showed that only about a third of the participants had good knowledge of key provisions of the NHA. We strongly recommend that relevant sections of the Act should be incorporated into the medical curriculum both at the undergraduate and postgraduate levels.

Cardiovascular risk factors and renal impairment among young adults in a tertiary institution in Southwest Nigeria

Background: Specific research is sparse on renal dysfunction among homogenous group of young adults. This study estimated the prevalence of renal dysfunction among apparently healthy young adults and determine association (if any) between renal dysfunction and some cardiovascular risk factors. Methodology:Undergraduates (18-37 years) of a tertiary institution were studied on 2017 World Kidney Day. Their biodata, blood pressure, anthropometry, total cholesterol and estimated glomerular filtration rate were determined. Data was analyzed using SPSS version 20.0. Results:A total of 640 students were studied (M:F=1:3.8). Their mean age was 23.1±2.8 years. Thirty-three(5.2%) participants had renal dysfunction (eGFR < 60ml/min/1.73m2). The mean age of subjects with renaldysfunction (eGFR < 60ml/min/1.73m2) was significantly higher with an inverse association to renal function (p = 0.005). Two hundred and fifty-seven(40.2%) and 58 (9.1%) participants were pre-hypertensive and hypertensive respectively; overweight, abdominal obesity and hypercholesterolaemia were found among 12.2%, 14.2% and 8.1% of subjects respectively. The mean body mass index (p = 0.009) and serum total cholesterol (p = 0.003) were significantly higher among females. There was a higher prevalence of renal dysfunction among females even though this was not to the significant level (5.9 v 2.2%, p = 0.12). Conclusions:The prevalence of renal dysfunction among young adults is lower than current global estimates. The prevalence of cardiovascular risk factors for CKD were lower than that of older adults with no significant association to renal dysfunction. Increasing age was found to be significantly associated with reduced renal function.