State of Health Facilities in Communities Designated for Community-Based Health Insurance Scheme in Nigeria: A Case Study of Kwara and Ogun States

Background: Nigerian Government established National Health Insurance Scheme (NHIS) including Community Based Health Insurance Scheme (CBHIS) to reduce out-of-pocket health expenses of enrollees,strengthen and ensure access to quality healthcare services. The functionality of the schemes however, revolves round health facilities being able to meet the expectation of the enrollees.Study Objectives: The study assessed the adequacy of the designated health facilities in offering quality healthcare services to the enrollees or potential enrollees under the CBHIS, and to identify likely challenges Study Design: This is part of a larger prospective cross-sectional study that assessed the implementation of the Community-Based Health Insurance Scheme (CBHIS) in selected local government areas of Kwara in the north central and Ogun in the South Western part of Nigeria.Place and Duration of the Study: Health facilities of selected wards from two Local Government Areas in Kwara and Ogun States were assessed between February and May 2015.Methods: Semi-structured questionnaires and health facility assessment checklist were used to assess services rendered, storage of drugs and the vaccines, manpower, training opportunities, available infrastructures and perceived challenges to smooth operation of health facilities designated for CBHIS.Results:A total of twenty designated health facilities were visited and assessed (Seventeen public and three private). Services claimed to be available at the facilities included clinical, nursing, pharmaceutical and laboratory services. The assessment showed inadequacy of some critical human resources for health. Seventeen of the 20 health facilities (85%) had evidence of recent renovation while 3 (15%) had no evidence of renovation. Twelve (60%) had backup supply of electricity from generator or solar panel. Other challenges that could impede quality healthcare service delivery under the CBHIS were identified. Conclusion: Thestudy showed that inadequate personnel, paucity of training opportunities for health workers, poor infrastructures (lack of ambulance services, poor electricity supply and lack of portable water supply) were the main challenges impeding delivery of quality healthcare services to the CBHIS enrollees patronizing the studied facilities

assessment of the emergency response among health workers involved in the 2010 cholera outbreak in northern Nigeria

The 2010 cholera outbreak in northern Nigeria affected over 40,000 people, with a case fatality rate [CFR] of >/= 3.75%. We assessed the emergency response of health care workers [HCWs] involved in case management. This was a cross-sectional study with data collected through a self-administered questionnaire. Data entry and analysis were performed using Epi info software. A total of 56 HCWs were interviewed. The mean age was 31 years [SD +/- 8.16 years]. The majority of the HCWs [80%; n = 45] were aged 18-39 years. Most were community health extension workers [60%], and 3.6% [n = 2] were medical doctors. Many of the HCWs had less than 2 years of work experience [42%]. Additionally, 82% of the respondents had <1 week of cholera emergency response training, and 50% of the HCWs managed >20 suspected cases of cholera per day. Although 78% of HCWs reported the practice of universal safety precautions, 32% [n = 18] knew HCWs who developed symptoms of cholera during the epidemic, most of which was believed to be hospital acquired [78%]. We also found that 77% [n = 43] of HCWs had no access to the required emergency response supplies. Inadequate training, a lack of qualified HCWs and a limited supply of emergency response kits were reported. Therefore, the government and stakeholders should address the gaps noted to adequately control and prevent future epidemics

College of Radiology, Academy of Medicine of Malaysia position on whole body screening CT scans in healthy asymptomatic individuals (2008)

To date, the College of Radiology (CoR) does not see any clear benefit in performing whole body screening computed tomography (CT) examinations in healthy asymptomatic individuals. There are radiation risk issues in CT and principles of screening should be adhered to. There may be a role for targeted cardiac screening CT that derives calcium score, especially for asymptomatic medium-risk individuals and CT colonography when used as part of a strategic programme for colorectal cancer screening in those 50 years and older. However, population based screening CT examinations may become appropriate when evidence emerges regarding a clear benefit for the patient outweighing the associated radiation risks.