Inter-professional rivalry in Nigerian health sector: a search for a potential beginning

Background: Inter-professional rivalry (IPR) in Nigerian health sector has become a common practice for over a decade due to abuse of the existing laws and ethics governing the operations of the professional cadres manning the health institutions in the country. This has led to incessant strikes by the different cadres in the hospitals across the country, thereby affecting the quality of services delivered by all the categories of healthcare staff. This study was aimed at identifying the initial source of the problem by interviewing the students of the Faculty of Basic Medical Sciences of Bayero University Kano (BUK) and that of Yusuf Maitama Sule University (YUMSUK) and those that have passed their examinations and joined the clinical and allied science departments in Bayero University Kano. The Faculty of Basic Medical Sciences is the initial confluent point where all medical and students of allied sciences receive their training together especially in the first and second year of their training. Method: A random sampling method was used to select the subjects. Two hundred questionnaires were distributed but 139 (69.5%) students at various levels of training filled and returned the questionnaire. Results: Females constituted 62 (44.6%), while the male were 77 (55.4%). Those in level 4 and 6 dominated the study with 55 (39.6%) and 41 (29.5%) respectively. Medical students and students of Physiology program constituted 42(30.2%) and 23(16.5%) respectively. Majority of the students 126 (90.6%) chose their respective courses without external influence and 85 (61.2%) believed that their course of study has a supportive role in the health care system. Up to 63 (45.3%) believed there is no superiority among the various courses of study. Of the factors fueling superiority feelings among students, 70 (50.4%) did not provide any reason, while those that believe professional bodies encourage it constituted 40 (28.8%), followed by teachers 11 (7.9%) and students themselves 10 (7.2%). Superiority feelings lead to rivalry among the various programs as opined by 78 (56.1%), chaos in the health sector 26 (18.7%) and poor patients management 12 (8.6%). Majority, 61 (43.9%) believed that rivalry in health sector can be prevented by giving uniform opportunity to all professional group. Conclusion: It is clear that half of the students interviewed were not aware of superiority feeling among the different programs of study. However, professional bodies rank first among the factors fueling superiority feeling during undergraduate training. Superiority feeling has negative effects on the healthcare system, one of which is rivalry among the healthcare staff and it can be avoided by giving uniform opportunity to different professional groups

Using scenarios to explore conflict management practices of nurse unit managers in public hospitals

Background: Workplace conflict is common among nurses globally. Learning how to manage it may reduce related adverse consequences.Inappropriate management of conflict is attributed to decreased productivity, poor morale and financial loss for organisations. Nurse unit managers can play a key role by effectively managing workplace conflict in the units.Aims and objectives:To explore how nurse unit managers managed conflict in public hospitals. Subsequently to make recommendations on how to optimise conflict management skills of nurse unit managers.Methods: A qualitative, explorative, descriptive and contextual study was conducted to explore how nurse unit managers managed conflict based on a scenario provided to them. Purposive sampling was used to select nurse unit managers working in three public hospitals. Eleven nurse unit managers participated in the study. Data was collected in two phases. In phase one; a conflict scenario was developed in consultation with experienced nurse managers. The conflict scenario was used during phase two, which involved individual face-to-face semi-structured interviews with nurse unit managers until data saturation.Tesch's method of thematic synthesis was utilised to analyse data. Literature review was undertaken to ascertain what is considered as an appropriate intervention in conflict management.Findings: Three themes emanated: nurse unit managers managed conflict appropriately, nurse unit managers avoided the conflict and nurse unit managers managed conflict inappropriately.Conclusion: While some of the nurse unit managers managed conflict appropriately, additional and continuous education and training is required to optimise the capacity and develop their conflict management competency. The findings could be integrated into orientation, training and preparation of nurse managers by healthcare organisations and educational institutions

Determinants of HIV/AIDS in Armed Conflict Populations

"More than 40 million people worldwide have been infected with human immunodeficiency virus (HIV) since it was first reported in 1981. Over 25 million of these have lost their lives to the disease. Most of the studies related to HIV/AIDS have been conducted in stable populations across the globe. Few of these studies have been devoted to displaced populations; particularly those in areas of conflict. Displaced populations that are forced to leave their homes in most cases find themselves in unfamiliar territories; often poor and hungry. Many of them become refugees and internally displaced people (IDPs). The objective of this review was to address a number of different social determinants of HIV/AIDS in displaced populations in areas of conflict. A comprehensive review of peer reviewed literature published in eng between 1990 and 2010 obtained through an open search of PUBMED database using key words such as ""HIV and war""; ""HIV/AIDS and conflict""; ""AIDS and security"" was conducted. Twelve different studies that looked at the implications of HIV/AIDS in conflict or displaced populations were retrieved. The review revealed that there were various factors influencing conflict and HIV/AIDS such as forced population displacement; breakdown of traditional sexual norms; lack of health infrastructure; and poverty and powerlessness of women and children. Social determinants of increased HIV/AIDS prevalence in displaced populations are scarcity of food; poverty; insecurity of displaced populations and gender power differentials."

Assessing Interventions Available to Internally Displaced Persons in Abia State; Nigeria

Internally displaced persons are faced with several problems; such as sexual violence; and deserve appropriate intervention; especially in view of the increasing prevalence of HIV/AIDS and other infections in Nigeria. This study attempts to assess interventions offered by governmental authorities and organizations to internally displaced persons and to identify gaps in services as well as to identify what needs to be strengthened. Method: The author reviewed relevant published and unpublished documents and collected data by interviews with semi-structured questions. Twenty-five organizations and government and police departments and 55 internally displaced persons were interviewed.Results: None of the organizations; including governmental institutions; provided social services or assistance in prevention of HIV/AIDS to internally displaced persons. The main services provided by 17 (68) organizations to 43 (78.2) of internally displaced persons were provision of food; clothing and money; but these were provided on an ad hoc basis. Only 3 organizations (12) included spiritual counseling and resolution of communal conflicts in their services. Conclusion: The fact that most organizations; including the government; do not have services for internally displaced persons indicates lack of support for internally displaced persons. The government should be urged to include these people in most prevention services; including HIV/AIDS prevention and treatment. This should help reduce the national prevalence of HIV/AIDS