Acceptance of immunization by caregivers of children attending a tertiary health facility in Northwestern Nigeria

Introduction: Immunization against childhood diseases is well received in most developed countries; also, countries in the Caribbean and Latin America have attained over 90% immunization coverage unlike the most sub-Saharan African countries, such as Nigeria, which have a dismally low coverage. Our objective is, therefore, to determine the acceptance and willingness to complete immunization of children by caregivers seen in our health facility. Materials and Methods: This study was cross sectional involving caregivers attending the pediatric outpatient clinic of Aminu Kano Teaching Hospital, Kano, Nigeria, during the month of December 2017. This was questionnaire based and was administered by the researchers and trained assistants. It contained 20 questions consisting of both open- and close-ended questions. Results: All respondents were aware of the childhood immunization program and were willing to accept all vaccines for their children. They all believed that immunization was beneficial to their children; 126 (79.7%) respondents could correctly state the advantages of childhood immunization. However, only 18 (11.4%) of the respondents could correctly list the names of the childhood vaccines in the National Programme of Immunization. About 33.5% of respondents reported six visits as the total number of visits for childhood immunization; higher proportion of health workers and those with tertiary educational qualification could correctly list the names of the vaccines given to their children, and these observations were statistically significant (Chi-squared test = 27.786, df = 1, P = 0.000; Fisher's exact test = 12.421, P = 0.004). Conclusion: This study showed that most respondents were willing to accept and complete the immunization schedule; however, there was a significant knowledge gap, especially in listing the names of the vaccines and the expected number of immunization visits.

Trends and correlates of patient satisfaction with services under the National Health Insurance Scheme of Nigeria: A review

Background: In spite of over a decade of operations, the National Health Insurance Scheme (NHIS) of Nigeria has continuously been criticized for its quality of services. Healthcare consumer satisfaction surveys (an important measure of service quality worldwide) in this domain have presented differing accounts of satisfaction with the services of the NHIS from their vantage perspectives. This narrative review aimed at studying the preliminary trends in the utilization of and patient satisfaction with the NHIS services. The correlates of patient satisfaction were also studied. Materials and Methods: We searched local literature whose full texts were accessible using predominantly Google Scholar. Results: We found progressive improvement in scheme enrolment, service utilization, and above-average overall satisfaction scores (i.e., >50% of respondents were satisfied) from most studies. Overall satisfaction scores/ratings were associated patients' level of education, knowledge of the scheme, years of enrolment, facility cleanliness, consultation time, pharmaceutical services, ease in accessing medical records and laboratory results, health worker availability, health worker friendliness, and responsiveness to patients' requests. Conclusion: The observed trajectory in service utilization, satisfaction scores, and their correlates may be useful for strategic planning to improve NHIS services in the country toward universal health coverage

Caregivers' awareness and perception of cardiopulmonary resuscitation: Our experience

Introduction: Adverse health-related events such as cardiac arrest can occur at any location: it is broadly classified as out-of-hospital or in-hospital cardiac arrest. The location of cardiac arrest however affects outcome; the actions of caregivers and bystanders may influence the outcome of witnessed out-of-hospital cardiac arrest; therefore, their knowledge of cardiopulmonary resuscitation (CPR) is relevant. Materials and Methods: This was a questionnaire-based cross-sectional study conducted at the Paediatric Outpatient Clinic and Paediatric Specialty Clinic of Aminu Kano Teaching Hospital. Results: There were 120 (33.3%) males and 240 (66.7%) females, with a male-to-female ratio of 1:2. Only 57 (15.8%) respondents were aware of CPR. However, 69 (19.2%) respondents were aware of chest compression. One hundred and twenty-nine (35.8%) respondents reported that they could perform mouth-to-mouth resuscitation on their own children; however, 66 (18.3%) respondents reported willingness to perform mouth-to-mouth resuscitation on another person's child if the need arose. Only 15 (4.2%) respondents had training on CPR. Six (40%) respondents were trained at school. However, caregivers in the chronic illness subgroup were more willing to perform mouth-to-mouth resuscitation. Caregivers of children with acute illnesses would use palm kernel oil to treat convulsion; however, those of the chronic illness group would mostly use herbs to treat convulsion; this observation was statistically significant (Fisher's exact test = 32.457, P = 0.00). Conclusion: There was poor awareness of CPR among respondents; furthermore, there was lack of willingness to perform CPR by most respondents on children.

Assessment of level of satisfaction of national health insurance scheme enrolees with services of an accredited health facility in Northern Nigerian

Introduction: Consumer satisfaction is one of the driving goals of goods and service production. Patient satisfaction surveys, as a means of periodic evaluation of the quality of services offered by the National Health Insurance Scheme (NHIS) accredited facilities, is necessary to ensure that the goals of the scheme are achieved and sustained. Materials and Methods: This was a cross-sectional study of 202 respondents randomly selected from NHIS enrolees attending the Staff Clinic of Aminu Kano Teaching Hospital. It assessed respondents' perceived waiting time, level of satisfaction at the clinic's service units, and overall clinic satisfaction using a modified general practice assessment questionnaire. Results: The mean age of respondents was 36.4 ± 8.1 with a near equal sex ratio. They were predominantly civil servants (79.2%) with tertiary education (75.7%). Most respondents (70.3%) felt waiting time was too long; with 79.7% of those, feeling they spend at least 30 min after arrival at the registration unit to see their doctor. A majority of respondents: 90.1%, 86.8%, 79%, 76.8%, 75.9%, 77.5%, and 80.6% were satisfied with the consultation time, doctors' consultation, medical records, pharmacy, laboratory, accounts, and nursing services, respectively. However, 65.8% were satisfied with the overall clinic services. The perceived sufficiency of the consultation time was associated with overall satisfaction (χ2 = 6.199, P = 0.013). Conclusion: Although 65.8% of respondents were satisfied with the clinic services, the perceived clinic waiting time was dissatisfactory; therefore, further studies on the determinants of overall satisfaction may be required if improvement in the proportion of satisfied service consumers is desired by the clinic managers

Common Indications for Major Cardiothoracic Surgeries in Aminu Kano Teaching Hospital; Kano; Nigeria: A 2-Year Review

Background : Although cardiothoracic surgery has made significant progress in Nigeria; more has to be done in the field of open heart surgery to mitigate the currently experienced need for surgery abroad. This communication highlights the common indications for major cardiothoracic surgeries performed over a 2-year period from November 2011 to October 2013 in Aminu Kano Teaching Hospital; Kano. Highlighted are common cardiothoracic problems often encountered in this region and their outcome. This will therefore form the basis for comparison with what is obtainable in other cardiothoracic centers in the country.Objectives: To determine the common indications for major cardiothoracic surgeries and their outcome over a 2-year period in the Aminu Kano Teaching Hospital; Kano.Methodology: Data were retrieved from the operation theater register of our institution and relevant information such as age; sex; indication for surgery; surgical procedure performed and outcome were extracted.Results : A total of 89 major surgeries were performed during the study period. The subjects comprised of 66 males and 23 females; with a male to female ratio of 3:1. Trauma-related chest injuries constituted the major indication (21.4); with nine cases being arrow-related chest injury; which was the most common. A single case of pericardectomy was performed. All surgeries were carried out successfully and patients were discharged except for one mortality recorded following intervention of a case of arrow-related chest injury (5.3).Conclusion : Trauma-related events were the most common indication for major cardiothoracic surgery in our series. Arrow-related injuries were the most common; and these were seen mostly in males

Bilateral congenital absence of the Alae Nasi with bilateral auricular sinuses in an Albinic child

The nose forms from the frontal, medial and lateral nasal prominences of the nasal placode and the maxillary processes. Malformation of the nose is variable; it may be unilateral or bilateral and may be complete absence of the nose called arhinia or isolated absence of the alae narsi. Anomalies of the nose may be associated with defects involving structures that originate from the first and second branchial arches but its association with cutaneous pigmentary disorder and anasarca is a rare occurrence. Therefore a case of a three-month-old girl with such combination is reported