Subject(s)
Cardiovascular Diseases/epidemiology , Cluster Analysis , Hospitals , Risk Assessment , Risk Factors , TeachingABSTRACT
Background: In an effort to increase tuberculosis (TB) case detection; the Kaduna State TB program in Nigeria started Public-Private Mix (PPM DOTS) in 2002. This study assessed and compared the TB case management practices and treatment outcomes of the public and private health facilities involved in the TB program. Methods: A comparative cross-sectional descriptive study was carried out in 5 private and 10 public health facilities providing TB services for at least two years in the four Local Governments Areas in Kaduna State where both public and private health facilities are involved in the TB program. The heads of the health facilities were interviewed and case notes of all the 492 TB patients registered in these facilities between January 2003 and December 2004 reviewed. Results: Except for the lower use of sputum microscopy for diagnosis; adherence to national TB treatment guidelines was high in both private and public health facilities. The private health facilities significantly saw more TB patients; an average of 51 patients per health facility compared to 23 patients in the public health facilities. There was better completion of records in the public health facilities while patient contact screening was very low in both public and private health facilities; 13.1and 12.2respectively. The treatment success rate was higher among patients managed in the private health facilities (83.7) compared to 78.6in the public health facilities. Conclusion: Private health facilities adhere to national guidelines had higher TB patient case load and better treatment outcome than public health facilities in Kaduna State. PPM-DOTS should be scaled-up and consolidated
Subject(s)
Directly Observed Therapy , Disease Management , Public-Private Sector Partnerships , Treatment Outcome , TuberculosisABSTRACT
Background: In an effort to increase tuberculosis (TB) case detection; the Kaduna State TB program in Nigeria started Public-Private Mix (PPM DOTS) in 2002. This study assessed and compared the TB case management practices and treatment outcomes of the public and private health facilities involved in the TB program. Methods: A comparative cross-sectional descriptive study was carried out in 5 private and 10 public health facilities providing TB services for at least two years in the four Local Governments Areas in Kaduna State where both public and private health facilities are involved in the TB program. The heads of the health facilities were interviewed and case notes of all the 492 TB patients registered in these facilities between January 2003 and December 2004 reviewed. Results: Except for the lower use of sputum microscopy for diagnosis; adherence to national TB treatment guidelines was high in both private and public health facilities. The private health facilities significantly saw more TB patients; an average of 51 patients per health facility compared to 23 patients in the public health facilities. There was better completion of records in the public health facilities while patient contact screening was very low in both public and private health facilities; 13.1and 12.2respectively. The treatment success rate was higher among patients managed in the private health facilities (83.7) compared to 78.6in the public health facilities. Conclusion: Private health facilities adhere to national guidelines had higher TB patient case load and better treatment outcome than public health facilities in Kaduna State. PPM-DOTS should be scaled-up and consolidated
Subject(s)
Directly Observed Therapy , Disease Management , Public-Private Sector Partnerships , TuberculosisABSTRACT
Background: Malaria accounts for 1 million deaths among children under five annually. It has been shown that improving home treatment and preventing delays in seeking treatment; by teaching women to respond promptly when their children have fever; can decrease malaria related complications and mortality. This study looks at the impact of health education on knowledge of malaria: its recognition; treatment and prevention among caregivers of children under five in Jengre; North Central Nigeria. Methods: The study was a community based intervention study conducted in three stages: A pre- intervention stage; where 150 caregivers; were selected through a multistage sampling technique from the households containing children under five. Information for the baseline was collected through an interviewer administered semi-structured questionnaire. The intervention consisted of a series of health education sessions designed based on findings from the pre-intervention stage. The post-intervention impact assessment was conducted using a modified version of the questionnaire used in the pre intervention stage. Results: Malaria was recognized as one of the diseases that cause fever in community by all the respondents. Sixty-one (40.6) had adequate knowledge concerning malaria causation; transmission; prevention and treatment. Twenty eight (56) of respondents reported Self-treatment. There was a statistically significant relationship between years of formal education and first line treatment option (P=.012). Thirty-four (68) mothers acted within eight hours of onset of fever. The intervention had an effect on perception (P.001); knowledge (P.001); malaria preven- tion practice (P