Constraints; Challenges and Prospects of Public-Private Partnership in Health-Care Delivery in a Developing Economy

Background: In Nigeria; concerns on the quality and financing of health-care delivery especially in the public sector have initiated reforms including support for public-private partnerships (PPP) at the Federal Ministry of Health. Likewise; Enugu State has developed a draft policy on PPP since 2005. However; non-validation and non-implementation of this policy might have led to loss of interest in the partnership. Aim: The aim of this study was to provide evidence for planning the implementation of PPP in Enugu State health system via a multi-sectoral identification of challenges; constraints and prospects. Subjects and Methods: Pre-tested questionnaires were administered to 466 respondents (251 health workers and 215 community members); selected by multi-stage sampling method from nine Local Government Areas of Enugu State; Nigeria; over a study period of April 2011 to September 2011. Data from the questionnaires were collated manually and quantitative data analyzed using SPSS version 15 (Chicago; IL; USA). Results: Only 159 (34.1; 159/466) of all respondents actually understood the meaning of PPP though 251 (53.9) of them had claimed knowledge of the concept. This actual understanding was higher among health workers (57.8; 145/251) when compared with the community members (6.5; 14/215) (P 0.001). Post-PPP enlightenment reviews showed a more desire for PPP implementation among private health-care workers (89.4; 101/113) and community leaders/members (55.4; 119/215). Conclusion: PPP in health-care delivery in Enugu State is feasible with massive awareness; elaborate stakeholder's engagements and well-structured policy before implementation. A critical challenge will be to convince the public sector workers who are the anticipated partners to accept and support private sector participation

Copper and Selenium Status of Healthy Pregnant Women in Enugu; Southeastern Nigeria

Background: Copper and selenium are important trace elements in man. They function as antioxidants and play roles in oxido-reductase reactions. Several imported multivitamin preparations are given to our women during pregnancy and lactation to correct possible deficiencies. Objective: The aim of the study is to determine the serum level of these micronutrients (selenium and copper) in a cross section of pregnant women in Enugu; southeastern Nigeria. Materials and Methods: A cross section of 130 healthy pregnant women at different trimesters of pregnancy and 30 non-pregnant controls were selected from two health facilities in Enugu; southeastern Nigeria. Serum from the samples collected was assayed for copper and selenium using atomic absorption spectrophotometer. Results: The mean copper level increased (P = 0.018); while the selenium level decreased (P 0.0001) as pregnancy advanced. Conclusion: High copper levels indicate that supplementation should not be undertaken during normal pregnancy. Dietary intake should be modified to ensure optimal selenium levels during pregnancy