Knowledge; Attitude; and Infection Control Practices of two Tertiary Hospitals in Port-Harcourt; Nigeria

Background: Surgical site infections (SSIs) are a significant cause of morbidity; emotional stress and financial cost to the affected patients and health care institutions; and infection control policy has been shown to reduce the burden of SSI in several health care institutions. This study assessed the effects of the implementation of the policy in a tertiary hospital in Port Harcourt; Nigeria. Materials and Methods: A cross-sectional; comparative study design was used for the study; with data collected using a structured questionnaire and guided observation of doctors and nurses involved in the management of patients that had caesarean sections in two comparable tertiary hospitals in Port Harcourt-the University of Port Harcourt Teaching Hospital (UPTH) and the Braithwaite Memorial Specialist Hospital (BMSH). Results: There were no statistically significant differences in the designations and length of practice of the respondents in both hospitals (P = 0.77). However; 63.64 of the respondents in UPTH were aware of the infection control committee; compared with none in BMSH. The appropriate timing for the administration of prophylactic antibiotics; and for the removal of the hair at the incision site were observed by 57.58 of the respondents in UPTH were aware of the infection control committee; compared with none in BMSH. The appropriate timing for the administration of prophylactic antibiotics; and for the removal of the hair at the incision site were observed by 57.58 and 69.69 respectively of the respondents in UPTH; compared with 22.86 (P = 0.00) and 0.00 (P = 0.02) in BMSH. The reasons given by the respondents in UPTH for nonadherence to the infection control policy include poor supervision (39.39) and lack of in-service training (21.21); while the respondents in BMSH gave reasons that include inadequate supply of consumables (34.29) and absence of a hospital's policy on infection control (22.88). Conclusion: The implementation of the infection control policy resulted in some improvements in certain infection control practices

Socio-Demographic Characteristics of Alcohol Abusers in a Rural Ijaw Community in Bayelsa State; South-South Nigeria

Background: Causal relationship has been established between alcohol and more than 60 types of disease and injury. Despite this, alcohol is still widely consumed in several communities in Nigeria, and sometimes considered a health tonic. This study described the pattern, prevalence, and factors associated with alcohol abuse in a typical Ijaw community, where alcohol is produced and consumed in large quantities. Materials and Methods: The study was carried out in Okoloba, a rural community in Bayelsa State, South-South Nigeria using an analytical cross-sectional study design. The data were collected from members of the community aged 16 to 65 years, using the Alcohol Use Disorders Identification Test questionnaire and clinical examination for hepatomegaly, tongue tremor, and hand tremor. Results: A total of 322 subjects, comprising 166 men and 156 women were studied. They had an average age of 41.4 ± 2.5 years, were mostly farmers (43.17%), married (66.15%), and had at most primary school education (62.42%). More than 90% of the subjects took alcohol in the preceding year, with more of them (43%) preferring the locally produced drinks. About 33% of the subjects had harmful drinking, while 12.73% had alcohol dependence problem. There is no significant age difference between the alcohol abusers and abstainers/social drinkers (P > 0.05), but alcohol abusers were significantly more likely to be males (P < 0.001), in polygamous marriages (P < 0.00001), had lower educational status (P < 0.0001), likely to be practitioners of the traditional religion (P < 0.0001), and more likely to be engaged in palm wine tapping. Conclusion: Alcohol is widely consumed in the community, but the prevalence of abuse was moderate, mainly due to cultural restrictions. Sales restrictions might be needed as the drinking habits of members of the community change with urbanization

Does the Nigeria Health Care System Need a Primary Gate-Keeper?

Background: The World Health Organization (WHO) is presently focusing more attention on how health systems will become more effective and efficient. Introduction of primary gate-keepers into healthcare systems by some countries has revolutionized their healthcare system. It clearly alters the channels by which patients receive care particularly in countries where specialists are in short supply. Aim: To discuss the role of primary gate-keeping in healthcare systems and to use the experience of some countries with and without a primary gate-keeper function to evaluate the Nigerian healthcare system. Methods: A search of some standard books and relevant articles on primary 'gate-keeping' and healthcare systems using the Google and Yahoo search engine facilities helped to gain access to general information on the title. We also searched the EMBASE and OVIDMEDLINE data bases using the HMIC search strategy template. Results: Healthcare services are delivered within three distinct but increasingly overlapping and fluid subsystems namely; primary; secondary and tertiary care. In the UK and Netherlands healthcare systems; the general practitioner (GP) serves as the primary gate-keeper to other professionals. On the contrary; France; Germany and Nigeria don't have effective primary gate-keeping system. However; in Nigeria family physicians run the general out-patient clinics and serve as a point of first contact and referrals. Conclusion: Gate-keepers are mainly geared towards helping a healthcare system to achieve better health levels. Unlike in the UK and Netherlands; there is no effective primary gate-keeping in the Nigerian healthcare system. Government should make efforts to address this anomaly to allow every person have effective and efficient healthcare services

Experiences and Attitudes of Young Men towards Abortion in a Semi-Urban Community in Rivers State; Nigeria

Background: Most of the studies on abortion focused on the roles and responsibility of women; with very little attention given to the role played by men. Aim: To assess the experiences and attitudes of young men towards abortion in Mgbede Egbema; a semi-urban community in Rivers State; south-south Nigeria. Methods: A descriptive cross-sectional study design was employed; using a structured questionnaire and focus group discussion as study methods. The questionnaire was administered to all the registered male members of the community's youth association; while the focus group discussion was held with members of the youth association's vigilante committee; to gain more insight into the responses contained in the answered questionnaires. Results: A total of 181 questionnaires were administered and retrieved. The average age of the respondents was 23.1 years; and they were mostly single (77.9); with secondary school education (65.8); and combined Christianity with traditional religion (71.3). Almost all (93.4) had a girl friend; but the responsibility of preventing unwanted pregnancy rested almost entirely on the girl (75.7); and in the event of an unwanted pregnancy; 85.1of the respondents would recourse to abortion. Most of the respondents (74.6) would advice their sister to procure an abortion in the event of an out-of-wedlock pregnancy; but only 20.0of them would like to be actively involved in the process of procuring the abortion. All the respondents knew that abortion was illegal in Nigeria; but 47.5thought that the offence did not include the woman; while 29.8thought the offence was committed by the abortion provider alone. Most (64.6) of the respondents felt abortion should not be freely available; but 90.6of them would want the offenders to be prosecuted only in the event of serious complications; or death. Conclusion: There is a broad support for abortion among the respondents; but fears still exists that liberalization might lead to increase demand for the procedure. A review of the nation's abortion law is therefore recommended