ABSTRACT
BACKGROUND: The problem of authentic statistics on maternal and peri-natal mortality has persisted in Nigeria probably because of inadequate involvement of community members in data management. OBJECTIVE: The objective of this study was to improve the accuracy of information on pregnancy outcome in a ward in Lagos state. METHODS: Residents of Ward A of Ikosi-Isheri Local Council Development Area (LCDA) of Lagos State were educated on the importance of accurate health data. Youths selected based on criteria and community-based health care providers, following refresher training on research methods, assisted with the collection, analysis and presentation of data. RESULTS: The records of churches, mosques, Traditional Birth Attendants, the government owned Primary Health Care (PHC) centre and 7 private health facilities in the ward reported no (0) maternal mortality, but 14 out of 633 live births in the latter died, giving a peri-natal mortality of 22.1 per thousand in one year. However, neither the CDAs, nor LCDA nor the state received regular reports on pregnancy outcome. CONCLUSION: Under-reporting or over-estimation of pregnancy outcome can be reduced by involvement of the leaders of Residents Associations and other relevant community members in data management. Data should be collected by smaller units into which a ward is divided and collated at the ward level for transmission to the LGA/LCDA. Feedback to community members will improve awareness about the importance of appropriate antenatal, natal and peri-natal care. Health care providers are also more likely to take prompt action to prevent maternal and peri-natal mortality.
Subject(s)
Community Participation/methods , Maternal Health Services/statistics & numerical data , Maternal Mortality , Perinatal Mortality , Pregnancy Outcome/epidemiology , Primary Health Care/organization & administration , Birth Certificates , Female , Humans , Male , Nigeria/epidemiology , Pregnancy , RecordsABSTRACT
A study was made of the training and performance of village health workers near Lagos, and of the management of the scheme to which they belonged. Among the deficiencies observed were inadequate drug control and poor record-keeping. Nevertheless, the scheme led to a significant extension of primary health care coverage.
PIP: In 1982, the Institute of Child Health and Primary Care (IHCPC) in Lagos, Nigeria, was asked to develop a primary health care (PHC) service for a rural population of about 35,000 people in 56 villages approximately 50 km. from Lagos. A core of volunteer village health workers (VVHW) would be established. A health care center was completed. The 1st step was to encourage village health committees to form. Then VVHS are nominated for training. Initial training lasts 3 weeks and takes place in the community. There have been 4 courses; 82 village health workers have been trained. The trainers are PHC workers connected to the ICHPC who have been trained. The courses cover promotional, curative, and preventive activities. Active learning is encouraged; song and dance are used. At graduation, a formal occasion, certificates and drug kits are given out. They contain essential drugs, which are donated. There are sufficient drugs for 3-6 months. The workers are advised to sell the drugs to the villagers at a small profit. They keep the profit, and get some pay. The rest of the selling price resupplies the drug fund. VVHWs are supervised by a midlevel PHC worker, the community health assistant. The ICHPC field research team interviewed 75 of the 82 VVHWs. The number of patients seen by VVHWs in a month ranged from none to 300; the average was 17.8. 91% of the villages have a VVHW service. The activities of 75 VVHWs during 1 month in relation to selected characteristics in rural Ogun State, 1987 are presented in tabular form. Of the 82 VVHWs who were trained, 10 became nonfunctioning over a period of 4 years. Service management should have attention paid to it. Drug stocks with VVHWs are shown in tabular form. Record keeping was not very good. Active village health committees were interfering with the VVHWs. The role of the village health committees in relation to the VVHWs has now changed, but it is difficult to provide supervision for the VVHWs.
Subject(s)
Community Health Workers/standards , Adult , Clinical Competence , Community Health Workers/education , Female , Humans , Job Description , Male , Middle Aged , NigeriaABSTRACT
Se estudió el adiestramiento y la actuación de los agentes de salud de aldeas próximas a Lagos y la gestión del programa al que pertenecían. Algunos de los fallos observados fueron el insuficiente control de los fármacos y el mantenimiento deficiente de los registros. No obstante, el plan permitió ampliar considerablemente la cobertura de la atención primaria
Subject(s)
Primary Health Care , Health Personnel/education , Community Participation , NigeriaABSTRACT
A study was made of the training and performance of village health workers near Lagos, and of the management of the scheme to which they belonged. Among the deficiencies observed were inadequate drug control and poor record-keeping. Nevertheless, the scheme led to a significant extension of primary health care coverage
Subject(s)
Primary Health Care , Health Personnel/education , Community Participation , NigeriaABSTRACT
The main objective of this study was to determine the degree to which individuals practised self-medication in relation to their educational status. Kalutara, a small town in Sri-Lanka is semi-urban and has a good mixture of literates and illiterates. Important findings include the fact that knowledge of drugs was grossly inadequate, literates self-medicated far more than illiterates and a high percentage of the total sample population by-passed other health personnel in preference for Western trained doctors. Self-medication, though desirable, can be dangerous and should be emphasized as a component of primary health care because (i) it is commonly practised even where health professionals are easily accessible, (ii) it encourages self-reliance for curative, preventive, promotive and rehabilitative care and (iii) literacy, which seems to enhance its practice, is increasing worldwide.
