Assessment of challenges inhibiting effective delivery of health care services among frontline Professional health workers during COVID 19 Lock down in Nigeria

This is a cross-sectional survey of challenges inhibiting health care service provision during COVID 19 lockdown. Data collected with a pretested online self-administered questionnaire included age, gender, occupation, place of practice, physical distance practices, utilization of telemedicine, income and other concerns that may have inhibited their practices during the COVID 19 lockdown. Data were analyzed using a statistical package for social sciences (SPSS) version 26.0 with the level of significance set at p<0.05. Chi square goodness of fit test was used to analyze the association between means and qualitative variables. Results: Response rate from 599 questionnaires was 481 (78%) with physiotherapists (n=108, 23%); nurses (n=106, 22%); doctors (n=86, 18%); laboratory technicians (n=87, 18%) and pharmacists (n=94, 19%); in public sector (n=318, 66%) and private practitioners (n=163, 34%). During the "lockdown" patients interacting with health professionals in private practice decreased except increases for laboratory technicians (11.91%) and pharmacists (68.35%). Social distancing was feasible by pharmacists and laboratory technicians, but interactions by nurses, physiotherapists and doctors were compromised. Telemedicine was used mostly by doctors (n=42, 48.8%), and physiotherapists (n=50, 46.3%). Health professionals experienced mental stress 428 (89%); anxiety 176 (37%); feared infection 333 (69%) and 232 (48%) of transmitting to their families; 307 (64 %) had challenges with personal protective equipment. Suggestions were: alternate accommodation or longer shifts with less working days 111 (37%); a hazard allowance 244 (51%) and counseling 238 (49%). Conclusion: Private practitioners reported a loss of income with all health professionals indicating the "lockdown" and COVID-19 compromised health delivery, health services, and individuals' health. Health professionals suggested a hazard allowance, alternate accommodation, and dedicated counseling for health professionals during the pandemic.

Satisfaction with pharmacy services and its relationships with the control of selected chronic diseases / La satisfacción con los servicios de farmacia y sus relaciones con el control de enfermedades crónicas seleccionadas

OBJECTIVE: To assess the level of satisfaction with pharmacy services and whether satisfaction/dissatisfaction had any effect on two common chronic diseases. Proper control of chronic diseases requires a management regime which includes promotive, preventive, curative and rehabilitative services through primary, secondary and tertiary preventive intervention measures and a wide range of support services. METHODS: A cross-sectional descriptive study with both quantitative and qualitative components was designed to collect data from among all diabetic and hypertensive patients (n = 150) attending 3 health centres in the parish of St Thomas on the days that data were being collected. The questionnaires were interviewer administered. Qualitative data were obtained from focus group discussions which explored themes related to the objectives. RESULTS: Though there was overall satisfaction with the pharmacy services studied, the level of control ofthe two diseases was unsatisfactory. There was no relationship between hypertension control and satisfaction with pharmacy services while the relationship with diabetes mellitus control was limited to a very weak negative association with the rating of the pharmacists' instructions on how to take the prescribed medications. CONCLUSION: "Satisfactory Pharmacy Services " could be improved by the employment of additional staff, improvement in how drugs are stocked, greater availability of generic drugs and more utilization ofhealth cards.

OBJETIVO: Evaluar el nivel de satisfacción con los servicios de farmacia, e investigar si la satisfacción o la insatisfacción tienen algún efecto en dos enfermedades crónicas comunes. El control apropiado de las enfermedades crónicas requiere un régimen de tratamiento que incluye servicios promovedores, preventivos, curativos y rehabilitadores a través de medidas de intervención preventiva primaria, secundaria y terciaria, así como una amplia variedad de servicios de apoyo. MÉTODOS: Se diseñó un estudio descriptivo transversal con componentes cuantitativos y cualitativos, a fin de recopilar datos de entre todos los pacientes diabéticos e hipertensos (n = 150) que asistían a 3 centros de salud en el distrito de Saint Thomas en los días en que se recogían los datos. Las encuestas fueron aplicadas por el entrevistado. Se obtuvieron datos cualitativos de discusiones de grupo focal, en las que se exploraban temas relacionados con los objetivos. RESULTADOS: Aunque había satisfacción global con los servicios de farmacia estudiados, el nivel de control de las dos enfermedades fue poco satisfactorio. No había ninguna relación entre el control de la hipertensión y la satisfacción con los servicios de farmacia, en tanto que la relación con el control de la diabetes mellitus se limitó a una asociación negativa muy débil con la evaluación de las instrucciones de los farmacéuticos sobre cómo tomar los medicamentos prescritos. CONCLUSIÓN: "Los Servicios Satisfactorios de Farmacia"podrían mejorar mediante la introducción de personal adicional, el mejoramiento en cuanto a cómo organizar el almacén de medicamentos, mayor disponibilidad mayor de medicamentos genéricos, y más utilización de tarjetas de salud.

The need for gender specific tobacco control strategies: KAP survey findings on environmental tobacco smoke exposure among women in the reproductive age group / Necesidad de estrategias de control del tabaco específicas por género hallazgos de la encuesta CAP acerca de la exposición al humo del tabaco ambiental entre mujeres en el grupo de edad reproductiva

OBJECTIVE: The study was done to assess knowledge, attitudes and practices of women within the child bearing age with regard to smoking and exposure to environmental tobacco smoke (ETS) on children's health. SUBJECTS AND METHODS: A cross-sectional study with quantitative and qualitative components was designed to collect data from women in the child-bearing age. The sample comprised of persons from the two largest combined family planning and antenatal clinics in Kingston, Jamaica. RESULTS: The women surveyed had a fair level of knowledge about ETS health risks, negative attitudes to smoking in general, and most supported a ban on smoking in public places. Significant knowledge differences existed between young and older women and between smokers and non-smokers. CONCLUSION: Women with the highest level of knowledge were the non-smokers: of the low knowledge score group (current smokers), 50% were in the 15-24-year age range. There is a need for more public education on smoking and the consequences ofenvironmental tobacco smoke exposure on children s health.

OBJETIVO: El estudio fue realizado para evaluar los conocimientos, actitudes y prácticas de las mujeres en edad de procrear, en relación con el hábito de fumar y la exposición al humo de tabaco ambiental (HTA) sobre la salud de los niños. SUJETOS Y MÉTODOS: Se diseñó un estudio transversal con componentes cuantitativos y cualitativos con el propósito de recopilar datos de las mujeres en edad fértil. La muestra abarcó personas de las dos clínicas más grandes en Kingston, que combinan la atención prenatal con la planificación familiar. RESULTADOS: Las mujeres encuestadas tenían un nivel razonable de conocimientos acerca de los riesgos del HTA para la salud, actitudes negativas hacia el hábito de fumar en general, y la mayoría apoyaban la prohibición de fumar en lugares públicos. Se hallaron diferencias significativas en el conocimiento existente entre las mujeres jóvenes y mayores, así como entre las fumadoras y no fumadoras. CONCLUSIÓN: Las mujeres con el más alto nivel de conocimientos fueron las no fumadoras. Del grupo de bajo puntaje de conocimiento (actuales fumadoras), el 50% estaban en el rango de edad de 15-24 años. Existe una necesidad de mayor educación pública acerca del hábito de fumar y las consecuencias de la exposición al humo de tabaco ambiental sobre la salud de los niños.

Preliminary determination of median lethal dose of Azadirachta indica (A. ) Juss bark extract against Boophilus microplus

The study was carried out in order to determine the effective dose of Azadirachta indica as an acaride. From a range of effective doses, nine (9) test doses ranging from zero (0) parts per million to one hundred and fifty parts (150) per million were selected. The test species Boophilus microplus was subjected to a standard bioassay. A dose response curve was plotted of percentage mortality of B. microplus against logarithmic dosage of A indica. The lethal dose, LD50 and LD100 were also determined. The LD50 was 30.20 parts per million and LD100 was found to lie between 80 and 100 parts per million. Regression analysis was performed to verify correlation of data. The data proved to be linear with a correlation coefficient of 0.89. The results of this study indicate that when the dose required to achieve 50 percent mortality is compared to average yield of A. indica bark extract obtained in previous studies (Maharaj et al 2003), the extract appears to be feasible with respect to production for use as a prospective pesticide. This is an important point for consideration as the failure in the commercialization of many plant products is often due to the yields being too low. The bark extract of Azadirachta indica has thus far proven to be worthy of consideration for further development as a phytoacaricide

Curriculum development in community health: drift or shift?

The curriculum in community health is best described as eclectic and dynamic. Its relevance is maintained by its response to the macro-environment; this response, whether innovative or otherwise, may be incremental on the one hand or feature wholesale change consequent on radical rethinking on the other. This paper reviews the content of the emerging curriculum in community health at the University of the West Indies, Jamaica, and attempts to discern the process of change and the factors which have informed these developments.

The prevalence of health insurance in a Jamaica suburb and its correlations with service utilisation

The prevalence of health insurance in a low-income Jamaican community was determined from a systematic sample of 103 households. A household prevalence for health insurance of 32 pro cent was found. Differentials in health service utilisation were more striking for private preactitoner services where the highest correlations with coverage was found (r=0.346, p < 0.001). A negative correlation (r=-036, N.S. with local health centre utilisaion was obtained. For every 100 people attending a private facility, 33 had health insurance coverage. The level of health insurance coverage in the community and its impact on service utilisation would suggest the possibility of harsh economies in the health sector, forcing consumers in low-income groups to seek a buffer for the expenses incurred from needs unmet by the public services. Part of this favourable prevalence of health insurance may also be due to job-related coverage