ABSTRACT
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
Subject(s)
Delivery of Health Care , Health Care Reform , Healthcare Financing , Public-Private Sector PartnershipsABSTRACT
There are several problems militating against satisfactory residency training in Nigeria. These problems may not be effectively identified and resolved if the opinion of the trainee doctors is ignored. Objectives: To review surgical residents' perspectives of their training program in South-eastern Nigeria; with the aim of suggesting evidence-based innovative changes to enable the programs meet global trends and standards. Materials and Methods: A total of 90 semi-structured and pre-tested questionnaires were evenly distributed (30 per hospital) to the surgical residents at three tertiary healthcare facilities in South-eastern Nigeria. Information sought included sociodemographic variables; level in the residency training; rating of program and different aspects; learning environments/opportunities; and suggestions on ways to improve either part or overall program. Results: Analysis of 56 properly completed questionnaires (response rate=62.2) shows that the respondents were aged 29 to 53 years [mean(SD) = 35.3(1.7)]; mostly males (91.1) and junior residents (75). A significant majority of residents (47 or 83.8) rated the surgical residency training in their respective centers as inadequate. Grand rounds were roundly criticized as having misplaced objectives and tending toward fault-finding by Consultants. Suggested interventions for improvement included enhanced supervision/mentoring/teaching by senior colleagues; inclusion of didactic lecture sessions; research trainings; and foreign postings. Conclusion: There exist gaps between expectations of surgical residents and the training offered. These create needed support for an evidenced-based review of surgical residency training program to enable it meet the aspirations of trainees and the ever-changing trend in Medicine. More studies on surgical residents covering other regions of Nigeria; and including the trainers (Consultants); will be of immense value
Subject(s)
Curriculum , Internship and Residency , Nigeria , Surgical Procedures, Operative , TeachingABSTRACT
Introduction: Malaria is a major public health problem in Nigeria; with adverse outcomes on the poor; pregnant women and children living in rural communities. A major component of current intervention in roll back malaria (RBM) initiative is vector control and insecticide-treated nets (ITNs). Aims and Objective: This research studied the impact of free distribution of ITNs on malaria parasitemia in a rural community in Nigeria. Materials and Methods: This is a longitudinal survey involving 990 pregnant and nursing mothers who received free ITNs between February 2007 and September 2008. Blood samples were collected at contact; then every 2 months to check for malaria parasites using standard methods. Result: There was a sustained but insignificant rise in asymptomatic malaria parasitemia post-distribution of ITNs. Conclusion: We conclude that ITN intervention remains important in malaria prophylaxis but must be complemented with awareness campaigns and other vector control strategies
Subject(s)
Insecticide-Treated Bednets , Nurses , Plasmodium , Pregnant Women , Rural PopulationABSTRACT
Introduction: Malaria is a major public health problem in Nigeria; with adverse outcomes on the poor; pregnant women and children living in rural communities. A major component of current intervention in roll back malaria (RBM) initiative is vector control and insecticide-treated nets (ITNs). Aims and Objective: This research studied the impact of free distribution of ITNs on malaria parasitemia in a rural community in Nigeria. Materials and Methods: This is a longitudinal survey involving 990 pregnant and nursing mothers who received free ITNs between February 2007 and September 2008. Blood samples were collected at contact; then every 2 months to check for malaria parasites using standard methods. Result: There was a sustained but insignificant rise in asymptomatic malaria parasitemia post-distribution of ITNs. Conclusion: We conclude that ITN intervention remains important in malaria prophylaxis but must be complemented with awareness campaigns and other vector control strategies