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Background: Community participation in health programs helps drive collaborations between the formal health structures and informal health system actors in promoting health at the community level. This paper provides new information on the extent of community participation in the planning and implementation of community-based health programs in Nigeria as a trajectory for strengthening the health system. Methods: This was a qualitative study. Data was collected from three located in different geographic zones of Nigeria. Two local governments (rural and urban) with evidence of health programs were purposively selected in each state. Data were collected through in-depth interviews and focus group discussions. The data was transcribed, coded manually and analysed thematically. Results: Several health programs were identified in the community. It was found that while community leaders are hardly involved in conceptualizing and planning health programs, however, they participate in program implementation by mobilizing community resources and encouraging members to take advantage of available health activities. Our findings also showed increased benefits of the involvement of the informal health workers in the health system. Conclusions: Community participation and involvement in health as part of community health system (CHS) activities has led to better and well-improved services, increased willingness to access immunization services. Communities are readily available to contribute to health activities, but they should be involved in the initiation and planning of health activities for ownership and full participation. This would improve health outcomes and contribute to strengthening the community health system.
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BACKGROUND: It is postulated that increased knowledge of patients about diabetes as well as a positive attitude will lead to improved glycaemic control and better outcome. The aim of this study was to determine the knowledge and attitude of diabetic patients in a tertiary hospital in Enugu and the relationship with their glycaemic control.METHODS: A cross-sectional study was done using a structured questionnaire to obtain socio-demographic data and assess knowledge and attitude to diabetes on consecutive patients attending the outpatient clinic in a tertiary hospital. Responses were scored with equal weighting. The fasting blood glucose of the patients was measured and recorded.RESULT: There were 51(60.7%) females and 33 (39.3%) males, with majority (63.1%) in the age range 41 -64 years and 32(38.1%) had only primary education. The mean knowledge score was 6.19 ± 2.08 and 33(39.3%) demonstrated good knowledge. Knowledge did not differ between males and females (p=0.34), but was highest in those with tertiary education (p = 0.02). Positive attitude to the condition was recorded in 63(75%) subjects. There was poor correlation between knowledge and attitude (r = -0.161, p= 0.14). Those with good knowledge scores were 2 times more likely to have good glycaemic control compared with those with poor knowledge; OR = 2.015, p = 0.02. Therewas no significant difference between the glycemic control of those with good attitude and those with poor attitude (p= 0.08).CONCLUSION: Although overall knowledge was poor, patients had a good attitude to their illness. Knowledge, but not attitude was significantly positively associated with glycemic control
Assuntos
Atitude , Diabetes Mellitus , Conhecimento , NigériaRESUMO
Cervical spondylosis is a very common and painful condition affecting many people. The mainstay of treatment of this painful condition has been analgesics which have not proved effective in addition to their untoward complications. Biomechanical studies have shown the potential of neck distraction by traction to be very promising in pain relief and an assessment of high weight cervical traction was done to evaluate its efficacy. Fifty patients including thirty (30) males and twenty (20) females (mean age: 50.46±8.31 years, mean weight: 87.17±14.30 kg, mean height: 1.66±0.12 meters) were available for study on the usefulness of infrared radiation only and a combination of infrared radiation and cervical traction in a cross-over research design at the National Orthopaedic Hospital Enugu. Infrared radiation were applied three times a week for six weeks before a washout period of seven days and then application of cervical traction combined with infrared radiation were done three times a week for six weeks. Pain rating scores were used to evaluate pain relief before, during and after treatment sessions and finally after six weeks. The results of the study showed that cervical traction in combination with infrared radiation was superior (p < 0.05) to infrared radiation alone in the management of cervical spondylosis as there was prolonged relief of pain in those that had cervical traction. It is recommended that high weight cervical traction should always be used in the management of cervical spondylosis.