Survey of Medical Specialists on their Attitudes to and Resources for Health Research in Nigeria

Aim: To study the views of medical specialists on their attitude to and the resources for health research in Nigeria and draw appropriate policy implications. Materials and Methods: Structured questionnaires were distributed to consenting 90 randomly selected medical specialists practising in six Nigerian tertiary health institutions. Participants' background information; importance attached to research; motivations for conducting research; funding; ethical oversight; literature search; and statistical support were probed. The coded responses were stored and analyzed using the statistical SPSS software. Results: Fifty-one out of the 90 questionnaires distributed were returned; giving a response rate of 63.3. Research function was rated third by 64.7of the respondents after hospital service (72.5) and teaching (66.0). Advancement of knowledge was the strongest motivating factor for conducting research (78.4). Securing funding (94) and finding time (80) were their major constraints. Only a minority of the respondents; 20and 14; respectfully; positively rated the quality and promptness of the decisions of their institutions' ethical organs in the highest category. Most of their literature search was conducted on the internet (96.1) and they stored and analyzed their research data with commonly available statistical software. Conclusion: Our study respondents regarded research highly but were severely constrained in conducting research by lack of access to sources of funding from within and outside Nigeria and finding time from core hospital functions. We recommend periodic (re)training in research particularly on how to apply for research grants and giving some protected research time for Nigerian medical specialists in order to boost their research function

Observations of Teachers in llorin; Nigeria on their Practices of Corporal Punishment that are Potentially Injurious to their Pupils' Eyes

Objective: To document the observations of elementary school teachers (ESTs) in Ilorin; Nigeria on their practice of some types of corporal punishment (CP) that could result in eye injuries among their pupils. Materials and Methods: A short battery of questions that explored ESTs' observations on attitudes to; and knowledge of some commonly used CP practices was self-administered on 172 consenting teachers from six sampled schools. The potentials for their pupils to sustain eye injuries while receiving such CP practices were inferred from the usage of items with sharp and protruding ends to administer CP; and the application of CP onto pupils' body parts that are in close proximity to the eye such as the head and face. Results: Only 50 of the 172 ESTs favored the practice of CP of pupils by their teachers. Analyses of several potentially moderating variables on this response such as ESTs' ages; years of EST teaching experience; school; and class or grade that EST teaches did not prove significant. Over three-quarters of ESTs (80.2) had ever observed that pupils were being disciplined by ESTs with a cane. About a fifth of them had also bserved that ESTs applied CP to the head (19.8) and the face (16.3) of pupils. Conclusion: Findings suggest that ESTs' commonly employed CP practices have significant injurious potential to their pupils' eyes. It is recommended that CP be abolished in elementary schools; and instead alternative nonabusive methods of disciplining erring pupils by teachers be introduced

Challenges; Attitudes and Practices of the Spectacle Wearers in a Resource-Limited Economy

Purpose: To evaluate challenges; attitudes and practices among spectacle wearers to effect positive change when necessary; and determine positive change in a resource-limited economy. Materials and Methods: A multi-hospital descriptive; cross sectional survey of spectacle wearers was conducted between May 2007 and December 2008 in Nigeria. Results: A total of 214 wearers comprising 43.5males and 56.5females aged 18-84 years were surveyed. The majority of subjects (92.6) had at least secondary education. The wearers' challenges included expensive spectacles (43.0); falling/ scratched/broken lenses (29.4) and fear that spectacles would damage the eyes (23.8). The wearers' attitudes were comprised of consultations with 'road side dispensers' (7) and permitting other individuals to select spectacle frames for them (26). Care and maintaince practices included use of handkerchief; tissue paper; fingers and water to clean spectacles (49.5) and placing spectacles inside spectacle cases (30.4). There were no associations (P 0.05) between gender or literacy levels and who selected the frames for the subjects; caregivers consulted for spectacles; and cleaning materials for spectacles. The placement of spectacles when not in use was significantly associated (P 0.05) with the wearers' gender and literacy levels but not with the length of spectacle wear. Conclusion: Attitudes and practices requiring positive change crossed gender and educational levels among spectacle wearers. The cost of spectacles should be regulated and availability of standard eye care practices would reduce challenges including lens-related defects and quackery. During consultation with a recognized eye care professional; counseling of wearers on positive attitudes/practices as well as allaying fear of spectacle wear is required

Causes and Prevalence of Ocular Morbidity among Primary School Children in Ilorin; Nigeria

Objective: To determine the causes and prevalence of ocular morbidity among primary school children in Ilorin; Nigeria. Materials and Methods: A cross sectional survey of primary school children in 10 randomly selected primary schools within Ilorin; Nigeria was carried out between July 2005 and January 2006. Relevant ocular history and basic ocular examinations were carried out on the children that were selected from a multi-stage sampling process. Results: One thousand three hundred and ninety three pupils were surveyed. There were 689 (49.4) boys and 704 (50.6) girls. The age range was between 4 and 15 years. The mean and modal ages were 10.16 SD 2.5 and 10 respectively. Two hundred and seventy seven pupils had ocular pathology giving a prevalence of 19.9. The two most common ocular disorders found among the pupils were refractive errors and vernal conjunctivitis with prevalence of 6.9and 6.7respectively. Others included genetic / congenital / developmental ocular disorders 39 (2.8); glaucoma / glaucoma suspect 20 (1.4); ocular infections 18 (1.3); and ocular trauma 11 (0.8). More than three-quarters (86.7) of the causes of visual impairment and blindness among the pupils were avoidable (preventable or treatable). Conclusion: The sheer magnitude of avoidable causes of visual impairment and blindness in the study underscores the need for effective school eye-health programmes in developing countries

Appropriateness of Ophthalmic Cases Presenting to a Nigerian Tertiary Health Facility: Implications for Service Delivery in a Developing Country

To assesswhether the ophthalmic cases presenting at aNigerian tertiary eye unit are appropriate for such level of care and also drawnecessary implications for service delivery. : Data on 1;321 consecutive new patients that presented at the ophthalmic clinic of the University of Teaching Hospital; Ilorin; Nigeria between February and July 2005 were reviewed on demographics; referral routes; and reasons for patronage; diagnoses and disease categories. Information on the general situation of health infrastructures prevailing at the surrounding health facilitieswas collected fromkey-informants. One thousand and ninety-one (82.6) presentedwithout any referral and 1;095 (82.9) patronized in order to access perceived good quality of eye care service being rendered. However; only a small proportion of their ailments (191; 14.5) actually required attention at the tertiary level of eye care. The key informants painted a picture of severely-challenged general and health infrastructures particularly at the primary health care facility level An overwhelming majority of ophthalmic patients directly accessed eye care at the tertiary level; even though most of their ailments could have been satisfactorily treated at the lower facilities of health care were the latter to be functioning optimally. A better coordinated and strengthened health care system; particularly at the primary and secondary health care facilities would ease the burden of inappropriate presentations on tertiary health facilities inNigeria