ABSTRACT
Aims: National Health Insurance Scheme became operational in Nigeria over eight years ago; yet, population coverage is below 20% and healthcare services are provided ineffectively and inefficiently. Satisfaction surveys might be part of useful interventions required to increase universal healthcare coverage and improve optimal access and success of the scheme. Study Design: A cross-sectional, exploratory study. Place and Duration of Study: Federal Secretariat, Ibadan, Nigeria. 4 weeks of the month of July, 2011. Methodology: 380 eligible federal staff completed a self-administered modified SERVQUAL questionnaire, which assessed satisfaction domains of healthcare provider services (competence), staff attitude and waiting time. Clients’ experiences were related to a health facility visit in the last three months preceding the survey and assessed on a 5-point Likert scale of “very poor = 1”, “poor = 2”, “good = 3”, “very good = 4” and “excellent = 5”. Associations between dependent and independent variables were subjected to Chi-square test and logistic regression at P-value of 0.05. Results: 201 (52.8%) male and 179 (47.2%) female participated in the study. Their mean age was 42.5±8.0 years. Most frequently health conditions for which services were sought were malaria (52.9%), medical check-up (5.8%) and dental problem (2.9%). 55.6% of participants were satisfied with drug services, 56.2% with healthcare provider services, 77.8% with waiting time and 51.7% with staff attitude. Education and type of health facility were predictors of satisfaction with healthcare provider services. Length of years of enrolment was a predictor of satisfaction with waiting time while length of years and grade level attained in service were predictors of satisfaction with staff attitude. Conclusion: Periodic documentation of experiences of enrollees in relation to satisfaction domains of social insurance is useful as it could help identify and prioritise appropriate interventions required to improve its effectiveness and efficiency.
ABSTRACT
Worldwide; adolescents are disproportionately affected by violent behaviours. The nature and extent to which Nigerian adolescents have perpetrated and experienced violence has not been fully investigated. This cross-sectional survey assessed experience and perpetration of physical; sexual and psychological violent behaviours among school-based adolescents. A total of 1366 students (50.4 females and 49.6 males) randomly selected from six public secondary schools in Ibadan; Nigeria were interviewed using a 36-item questionnaire. Respondents answered questions regarding demographic profile; sexual behaviour; and the extent to which they had experienced or perpetrated physical; sexual and psychological violent behaviours. The lifetime experience of at least one of the three forms of violence was 97.9: physical violence ranked first (94.4); followed by psychological (77.6) and sexual violence (34.9). The most common types of these forms of violent behaviours experienced were slaps (84.5); unwanted touch of breast and backside (22.7) and being belittled (63.2). Approximately 8 of the study group haave had sex and 25 of sexually active respondents claimed that their first sexual encounter occurred in coercive circumstances. The predictors of experience of violence among males were use of alcohol; witnessing domestic violence; involving in work and parental use of alcohol. Among females parental use of alcohol and being young were predictors of violence. Reports of perpetration of physical; sexual and psychological violence among males were 75.3; 44.9 and 13.3 respectively. Comprehensive interventions targeting students; teachers and parents are recommended to address this problem