Constraints; Challenges and Prospects of Public-Private Partnership in Health-Care Delivery in a Developing Economy

Background: In Nigeria; concerns on the quality and financing of health-care delivery especially in the public sector have initiated reforms including support for public-private partnerships (PPP) at the Federal Ministry of Health. Likewise; Enugu State has developed a draft policy on PPP since 2005. However; non-validation and non-implementation of this policy might have led to loss of interest in the partnership. Aim: The aim of this study was to provide evidence for planning the implementation of PPP in Enugu State health system via a multi-sectoral identification of challenges; constraints and prospects. Subjects and Methods: Pre-tested questionnaires were administered to 466 respondents (251 health workers and 215 community members); selected by multi-stage sampling method from nine Local Government Areas of Enugu State; Nigeria; over a study period of April 2011 to September 2011. Data from the questionnaires were collated manually and quantitative data analyzed using SPSS version 15 (Chicago; IL; USA). Results: Only 159 (34.1; 159/466) of all respondents actually understood the meaning of PPP though 251 (53.9) of them had claimed knowledge of the concept. This actual understanding was higher among health workers (57.8; 145/251) when compared with the community members (6.5; 14/215) (P 0.001). Post-PPP enlightenment reviews showed a more desire for PPP implementation among private health-care workers (89.4; 101/113) and community leaders/members (55.4; 119/215). Conclusion: PPP in health-care delivery in Enugu State is feasible with massive awareness; elaborate stakeholder's engagements and well-structured policy before implementation. A critical challenge will be to convince the public sector workers who are the anticipated partners to accept and support private sector participation

Enhancing data management skills of primary health care workers in enugu state, Nigeria.

OBJECTIVE: The objective of this study was to evaluate the outcome of a training scheme on data collection, recording, reporting and utilisation practices among primary health care workers in Enugu State. METHODS: This is a "before and after" intervention study conducted among 107 Primary Health Care (PHC) workers in Enugu State. A multistage sampling technique was used. A pre-tested, semi-structured questionnaire and an observation checklist were the instruments used in data collection pre and post-intervention. RESULTS: The workers in this study pre-intervention recorded data using health management information system (HMIS) forms, registers and exercise books. Seven (77.8%) and 6(66.2%) of the study and control health centres respectively kept monthly health center copies of HMIS form 000. These forms and registers were neither completely and correctly filled nor were kept up-to-date. Post-intervention, the reported and observed practices improved significantly (p<0.001) in the study unlike in the control health centress. Pre-intervention, none of the health centres entered data into the register 1-2weeks prior to this study and none remitted same monthly to the monitoring and evaluation units of the LGAs. Post-intervention, early data entry, reporting and local uses of data improved significantly (p<0.001) in the study group unlike in the control group. CONCLUSION: The data management skills of PHC workers studied were generally inadequate pre-intervention. Training greatly enhanced their overall data management skills.

Cardiac risk indices of staff of Federal University Of Technology Owerri, Imo State, Nigeria.

Non-communicable diseases are the major health burden in the industrialized countries and are increasing rapidly in the developing countries owing to demographic transitions and changing lifestyles among the people. Cardiovascular diseases (CVD) are increasingly becoming a great cause of morbidity and mortality. A total of 100 senior and 141 junior staff in Federal University of Technology, Owerri (FUTO), Imo State, Nigeria was randomly selected for a study on cardiac risk factors. A questionnaire was used to record cardiac risk indices like age, heredity, body mass index (BMI), tobacco smoking, exercise, serum cholesterol estimation, systolic blood pressure and sex. There was no significant difference between the senior and junior staff in sex distribution (P = 0.71), family history of CVD (P = 0.34), smoking habit (P = 0.85) and serum cholesterol (P = 0.89). Senior staff had significantly higher values in age distribution (P < 0.001), presence of systolic hypertension (P<0.001) and overweight (P < 0.001). Senior staff workers, were however, significantly less involved in moderate exercise than junior staff (P < 0.001). The senior staff had a significantly higher total score in CVD risk scoring than junior staff (chi2 = 7.25; P = 0.01). In conclusion, the risk of CVD among staff of FUTO is high especially among the senior staff. Health education campaign targeted at improving life style is strongly recommended.