Burnout Among Doctors and Nurses at The University of Uyo Teaching Hospital, South-South, Nigeria: A Comparative Study

BACKGROUND: Burnout remains a crucial occupational health challenge to healthcare professionals given its immediate and remote harmful effects. Doctors and nurses are highly susceptible to burnout due to the essence and demands of their services. The study aimed to determine and compare the prevalence of burnout among doctors and nurses working at the University of Uyo Teaching Hospital, Southern Nigeria. MATERIALS AND METHODS: A comparative, cross-sectional study of 553 doctors and nurses was conducted using a stratified random sampling technique. A pretested, self-administered MBI - Human Services Survey for Medical Personnel - MBI-HSS (MP) was used for data collection and analysis using IBM Statistical Product and Service Solutions (SPSS) software version 23. The Chi-square and Fisher's exact tests were applied with a statistical significance level set at α<0.05. RESULTS: The mean ages for doctors and nurses were 37.1 ± 5.3 and 39.0 ± 9.2 respectively (p=0.003). Burnout prevalence among doctors was 9.7% compared to 5.5% among nurses (p =0.062). Out of 553 respondents, 247 (46.7%) had high emotional exhaustion (EE), 70 (12.7%) had high depersonalization (DP), and 342 (61.9%) had low personal accomplishments (PA). Furthermore, 132 (47.3%) doctors had high EE, 43 (15.4%) had high DP and 159 (57%) had low PA. While 115 (42%) nurses had high EE, 27 (9.9%) had high DP and 183 (66.8%) had a low PA (p=0.041). Excessive workload (p=0.042) and lengthy years in a workplace position (p=0.002) were significantly associated with burnout among doctors compared to family size (p=0.045) and workplace support or community (p=0.005) among nurses. CONCLUSION: The study found burnout prevalence to be higher among doctors than nurses. Work-related factors contributed significantly to burnout development. Recreating and/or modifying workplace environments is essential to mitigating the adverse effects of burnout among healthcare workers.

CONTEXTE: Le burnout demeure un défi crucial pour la santé au travail des professionnels de la santé compte tenu de ses effets immédiats et à distance. Les médecins et les infirmières sont hautement susceptibles au burnout en raison de la nature et des exigences de leurs services. L'étude visait à établir et à comparer la prévalence du burnout parmi les médecins et les infirmières travaillant à l'Hôpital Universitaire de Uyo, dans le sud du Nigéria. MATÉRIEL ET MÉTHODES: Une étude comparative et transversale a été menée auprès de 553 médecins et infirmières à l'aide d'une technique d'échantillonnage aléatoire stratifié. Une enquête préalablement testée, auto-administrée, l'Inventaire d'épuisement professionnel humain pour le personnel médical (MBI-HSS [MP]), a été utilisée pour la collecte et l'analyse des données à l'aide du logiciel IBM Statistical Product and Service Solutions (SPSS) version 23. Les tests du Chi carré et de Fisher ont été appliqués avec un seuil de signification statistique fixé à α<0,05. RÉSULTATS: Les âges moyens des médecins et des infirmières étaient de 37,1 ± 5,3 et 39,0 ± 9,2 respectivement (p = 0,003). La prévalence de l'épuisement professionnel parmi les médecins était de 9,7 % par rapport à 5,5 % parmi les infirmières (p = 0,062). Sur les 553 répondants, 247 (46,7 %) présentaient un épuisement émotionnel élevé (EE), 70 (12,7 %) présentaient une dépersonnalisation élevée (DP) et 342 (61,9 %) présentaient un faible accomplissement personnel (PA). De plus, 132 (47,3 %) médecins avaient un EE élevé, 43 (15,4 %) avaient une DP élevée et 159 (57 %) avaient un PA faible. Tandis que 115 (42 %) infirmières avaient un EE élevé, 27 (9,9 %) avaient une DP élevée et 183 (66,8 %) avaient un PA faible (p = 0,041). Une charge de travail excessive (p = 0,042) et de nombreuses années passées à un poste de travail (p = 0,002) étaient significativement associées à l'épuisement professionnel parmi les médecins, par rapport à la taille de la famille (p = 0,045) et au soutien au travail ou à la communauté (p = 0,005) parmi les infirmières. CONCLUSION: L'étude a révélé une prévalence plus élevée du burnout parmi les médecins que parmi les infirmières. Les facteurs liés au travail ont contribué de manière significative au développement du burnout. Recréer et/ ou modifier les environnements de travail est essentiel pour atténuer les effets néfastes du burnout chez les travailleurs de la santé Mots-clés: épuisement professionnel, épuisement émotionnel, dépersonnalisation, accomplissement personnel, médecins, infirmières, hôpital Universitaire, Uyo, Nigéria.

Risk Factors and Clinical Correlates of Hepatitits B Seroprevalence in Nigerian Children

Introduction: Establishing risk factors for a disease enables early identification of those with the disease (through screening) as well as targeted prevention and control measures. The significance and relative importance of such risk factors may differ based on geographic location and they may change over time with the institution of control measures. In this study we examined the association between HBsAg seropositivity; some risk factors and clinical features.Methodology: Consecutive children aged 2 months to 16 years who were admitted to a Children's Emergency Room were recruited. Data on the presence / absence of risk factors such as previous blood transfusion; scarifications; receipt of unsafe injections and previous surgery were obtained. History to ascertain previous or present history of jaundice and pale coloured stool was obtained. Examination to detect hepatomegaly and spenomegaly was carried out. Blood samples were assayed for HBsAg.Results: Of the 150 children recruited 84(56%) were male. The mean (SD) age of the children was 33.0(39.1) months. HBsAg seropositivity was 13.9%. Circumcision; scarification; ear piercing; history of blood transfusion; receipt of unsafe injections; present/ past history of jaundice and malnutrition were not significantly associated with being seropositive (p0.05).Conclusion: This study did not identify any pathognomonic clinical feature of hepatitis b seroprevalence. The lack of association between HBsAg seropositivity and the studied risk factors may represent a real improvement in infection control measures. Further research is required to ascertain if there are still some unidentified risk factors for hepatitis B transmission in Nigerian children

Hypertension and Diabetes Self-care Activities: A Hospital Based Pilot Survey in Benin City, Nigeria.

AIMS AND OBJECTIVES: The burden of hypertension and diabetes is on the increase globally with its attendant complications. Although self-care activities are critical to the successful management of both conditions, there are only a few reports on such activities, especially in this part of the world. This pilot study was therefore undertaken to assess the self-care activities among hypertensive and diabetic patients in Benin City. PATIENTS AND METHODS: Hypertensive and diabetic patients were consecutively recruited from the out- patient department of the University of Benin Teaching Hospital. The questionnaires were developed based on past assessment scales such as the Hypertension Self-Care Activity Level Effects (H-SCALE) and the Summary of Diabetes Self-Care Assessment (SDSCA) for hypertensive and diabetic participants respectively. RESULTS: A total of 85(32 hypertensive, 24 diabetic and 29 co-morbid hypertensive diabetic) participants completed the study. Only 14 (16.5%) subjects had good self-care practice, 39 (45.9%) had fair practice while poor self-care practice was found in 32 (37.6%) subjects. Adherence to medications, clinic adherence, use of self-monitoring devices, regular exercising and dietician contact were generally low. However, only a relatively few subjects smoked tobacco or took significant alcohol. CONCLUSION: The health-related self-care practice among the patients was generally not good. There was no significant difference in the overall level of self-care among hypertensive, diabetic patients or those with co-morbid conditions. There is need for more aggressive health education aimed at improving the current health-related self-care habits among these patients.

Neonatal jaundice and its management: knowledge, attitude, and practice among expectant mothers attending antenatal clinic at University of Benin Teaching Hospital, Benin City, Nigeria.

INTRODUCTION: Neonatal Jaundice (NNJ) is a common disorder worldwide and one of the important contributors to the high neonatal morbidity and mortality in Sub-Saharan Africa. Severe neonatal jaundice leads to brain damage or even death in otherwise healthy newborns. The objective of the study was to assess the knowledge, attitude and practice of expectant mothers about neonatal jaundice and its management. MATERIALS AND METHODS: The study was descriptive cross-sectional, carried out among 389 expectant mothers who were attending the antenatal clinic at the University of Benin Teaching Hospital. A structured, Pre-tested, researcher administered questionnaire was used to interview the respondents. Data was analysed using SPSS version 15. RESULTS: The mean age of the expectant mothers was 30.5 (SD 4.9) years. Fifty-five (14.1%) of respondents had previous experience with NNJ, 8 (2.1%) lost babies due to NNJ. 334 (85.9%) were aware of the condition, 381 (77.4%) knew how to recognize the symptoms of NNJ, 279 (71.7%) knew a correct method of treatment of NNJ. A large proportion of the expectant mothers 261 (67%) knew some complications of NNJ. Two hundred and five (52.7%) did not know any danger sign of complications of NNJ. Three hundred and fifty five (91.3%) had good attitude towards its management. Majority of expectant mothers whose previous babies had NNJ took the babies to the hospital for treatment. A large proportion also expressed their willingness to seek medical attention if their babies were to develop the condition. Their knowledge of neonatal jaundice was significantly influenced by their level of education and the number of their previous babies who had NNJ. CONCLUSION: This study revealed that expectant mothers attending antenatal clinic at UBTH had good knowledge of the treatment and complications of NNJ but inadequate knowledge of the causes and danger signs of the condition. Their attitude and practice towards the management of NNJ was good. It is therefore recommended that Health care providers should give more health education on NNJ to the expectant mothers during antenatal visits.

JOB SATISFACTION AND PSYCHOLOGICAL HEALTH OF MEDICAL DOCTORS IN CALABAR, SOUTHERN NIGERIA.

BACKGROUND: Employees should be happy at their work, considering the amount of time they devote to it throughout their working life. There is paucity of data on the job satisfaction and psychological health of medical doctors in Nigeria. OBJECTIVE: To assess the level of job satisfaction and its relationship to psychological health among medical doctors in a southern city of Nigeria. DESIGN: A cross-sectional descriptive survey. SETTING: Three major public hospitals in Calabar, Nigeria. SUBJECTS: Medical doctors who had worked for at least six months in the hospitals. RESULTS: Response rate was 73.0%. More than half (56.7%) of the respondents expressed overall satisfaction with their job. Inadequate pay and work overload were the most commonly mentioned reasons for job dissatisfaction. About a fifth of the respondents were at increased likelihood of psychological disorder. There was a statistically significant negative correlation between job satisfaction scores and GHQ scores. Satisfied respondents were least likely to have psychological disorder. CONCLUSION: Causes of job dissatisfaction among medical doctors should be addressed to improve their psychological health.

Neonatal Jaundice and its Management: Knowledge; Attitude; and Practice among Expectant Mothers Attending Antenatal Clinic at University of Benin Teaching Hospital; Benin City; Nigeria

Introduction: Neonatal Jaundice (NNJ) is a common disorder worldwide and one of the important contributors to the high neonatal morbidity and mortality in Sub-Saharan Africa. Severe neonatal jaundice leads to brain damage or even death in otherwise healthy newborns. The objective of the study was to assess the knowledge; attitude and practice of expectant mothers about neonatal jaundice and its management. Materials and Methods: The study was descriptive cross-sectional; carried out among 389 expectant mothers who were attending the antenatal clinic at the University of Benin Teaching Hospital. A structured; Pre-tested; researcher administered questionnaire was used to interview the respondents. Data was analysed using SPSS version 15. Results: The mean age of the expectant mothers was 30.5 (SD 4.9) years. Fifty-five (14.1) of respondents had previous experience with NNJ; 8 (2.1) lost babies due to NNJ. 334 (85.9) were aware of the condition; 381 (77.4) knew how to recognize the symptoms of NNJ; 279 (71.7) knew a correct method of treatment of NNJ. A large proportion of the expectant mothers 261 (67) knew some complications of NNJ. Two hundred and five (52.7) did not know any danger sign of complications of NNJ. Three hundred and fifty five (91.3) had good attitude towards its management. Majority of expectant mothers whose previous babies had NNJ took the babies to the hospital for treatment. A large proportion also expressed their willingness to seek medical attention if their babies were to develop the condition. Their knowledge of neonatal jaundice was significantly influenced by their level of education and the number of their previous babies who had NNJ. Conclusion: This study revealed that expectant mothers attending antenatal clinic at UBTH had good knowledge of the treatment and complications of NNJ but inadequate knowledge of the causes and danger signs of the condition. Their attitude and practice towards the management of NNJ was good. It is therefore recommended that Health care providers should give more health education on NNJ to the expectant mothers during antenatal visits

Prevalence of occupational accidents/Injuries among health care workers in a federal medical centre in southern Nigeria.

BACKGROUND: Health care workers (HCWs) are prone to occupational accidents and injuries such as needle pricks in the course of their day to day activities in the health care setting. OBJECTIVE: To determine the prevalence of needle sticks and other occupational exposures among HCWs in a Nigerian tertiary hospital. METHODS: This was a descriptive cross sectional design involving all the doctors, and all laboratory workers and a selection of nurses. A structured, pre-tested, selfadministered questionnaire was the tool for data collection. RESULTS: A total of 167 HCWs made up of 47 (28.1%) doctors, 100 (59.9%) nurses and 20 (12.0%) laboratory workers were interviewed. Twenty-five (53.2%) doctors, 53 (53.0%) nurses and 10 (50.0%) laboratory workers making a total of 88 (52.7%) HCWs had had needle pricks, while 28 (59.6%) doctors, 53 (53.0%) nurses and 8 (40.0%) laboratory workers making a total of 89 (53.3%) have had blood splashes. A higher proportion of nurses 54 (54.0%) had cuts from drug ampoules than doctors (34.0%) while 16 (36.2%) doctors had glove perforation during surgery compared to nine (9.0%) nurses. Only 43 (25.7%) HCWs reported to the staff clinic after sustaining accidents/injuries. CONCLUSION: The prevalence of needle sticks and other occupational accidents/injuries among HCWs in the Federal Medical Centre, Asaba, Nigeria is high. There is also a high rate of non-reporting of these injuries to relevant authorities. All health facilities should have a written injection safety policy and a post-exposure protocol and HCWs should be continually educated on them.

Oral health knowledge, attitude and practices among Nigerian primary school teachers.

BACKGROUND: A multi-disciplinary approach is needed for effective dental education of children. Teachers can be used as oral health educators but only if they have a good knowledge, attitude and practice of oral health. This study's main objective was to compare the oral health knowledge, attitude and practices of public and private primary school teachers and to determine the proportion of teachers presently involved with oral health education of school children. METHOD: The study was carried out on 320 private and 320 public school teachers in Benin-City, Nigeria, using self-administered questionnaire. RESULTS: The result revealed that the teachers involved in this study generally had positive attitude to oral health. Many of the two groups of primary school teachers had poor oral health practices. Only 42.4% of the respondents have ever been to the dentist for routine dental checkup or treatment. About 87.6% of teachers still use potentially traumatic materials for interdental cleaning and 60% of teachers consume regularly various forms of refined sugar. Over 90% of the two groups of teachers are presently involved in teaching their pupils basic oral health education although they have a poor knowledge of the aetiology of the two most common oral diseases. The teachers' major source of oral health information is the dentist. CONCLUSION: Similar pattern of incomplete oral health knowledge, inappropriate oral practices but positive oral health attitude was observed among the two groups of the studied teachers. This observation suggests that the primary school teachers can serve as oral health educators after organized training to heighten their oral health knowledge and perfect their oral practices.

Knowledge and practice of standard precautions among health care workers in the Federal Medical Centre, Asaba, Delta State, Nigeria.

AIMS AND OBJECTIVES: Health care workers (HCWs) are exposed to blood and other body fluids in the course of their day to day activities in the health care setting. Standard precautions are designed to reduce the risk of transmission of microorganisms from both recognized and unrecognised sources. This study is to determine the knowledge and practice of standard precautions among health care workers in Federal Medical Centre, Asaba, Delta State, Nigeria. SUBJECTS AND METHODS: This descriptive, cross sectional study was carried out among Health Care workers in Federal Medical Centre Asaba, Delta State. A total population of all the doctors and laboratory workers was used while the nurses were selected using a stratified sampling method. A semi-structured, self-administered questionnaire was the tool for data collection. RESULTS: A total of 167 respondents participated in this study. The mean age of the HCWs was 36.9 ± 6.8 years made up of 47 (28.1%) doctors, 100 (59.9%) nurses and 20 (12.0%) laboratory workers. There were more females (65.3%) than males (34.7%) in the study. One hundred and thirty seven (82.0%) respondents had heard about standard precautions. Only 63 (37.7%) of them had correct knowledge of it. There was fair practice and adherence to the standard precautions by those who knew of it. CONCLUSION: Findings from this study emphasised the need for intensive enlightenment programme to educate health care workers on various aspects of standard precautions and infection control programmes and policies.

Stress and psychological health of medical students in a Nigerian university.

OBJECTIVE: Physician job satisfaction is one indicator of the overall health of our health care delivery system. Excellent but dissatisfied physicians could decide to leave the practice of medicine or highly talented students could opt for different careers if the perception that medicine is not a fulfilling career exists. This study aims to investigate the level of course satisfaction, its relationship to psychological disorder and presence/absence of stress among medical students. Physician job satisfaction is one indicator of the overall health of our health care delivery system. Excellent but dissatisfied physicians could decide to leave the practice of medicine or highly talented students could opt for different careers if the perception that medicine is not a fulfilling career exists. This study aims to investigate the level of course satisfaction, its relationship to psychological disorder and presence/absence of stress among medical students. MATERIALS AND METHODS: A cross-sectional study was conducted among 410 medical students of the University of Benin, Nigeria. The respondents completed a self-administered questionnaire and a standard instrument The General Health Questionnaire (GHQ 28). RESULTS: The response rate was 93.9%. Two hundred and forty four (63.4%) of respondents were satisfied with their course, 331 (86.0%) of them felt medicine was stressful. There was also a statistical significant difference in the level of stress among the various levels of medical students. One hundred and twenty three (31.9%) medical students indicated that they would not study medicine again if given a second chance. One hundred and twelve (29.1%) medical students had psychological disorder. More dissatisfied students had psychological disorder than satisfied students and this difference was found to be statistically significant. CONCLUSION: The level of perceived stress among medical students was found to be high and a significant number of students had psychological morbidity. There is a need to identify and correct the causes of dissatisfaction among these groups of students in order to improve on the psychological state of the students. Stress management training is also required as majority of the medical students found the course stressful.

Psychological morbidity, job satisfaction and intentions to quit among teachers in private secondary schools in Edo-State, Nigeria.

BACKGROUND: Teachers are an inseparable corner stone of the society and their satisfaction will affect the quality of service they render. Poor job satisfaction could result in job stress and this could affect their psychological health. This study aims to ascertain the level, causes of job dissatisfaction, intentions to quit and psychological morbidity among teachers in private secondary schools in a developing country. METHODS: A cross-sectional study was conducted among teachers (392) in private secondary schools in Benin-City, Edo-State Nigeria, between June 2003 to November 2003. A total population of 400 teachers who had spent at least one year in the service were included in the study. The respondents completed a self-administered designed questionnaire and a standard instrument--The General Health Questionnaire (GHQ 28) RESULTS: The response rate was 98%. Fifty-eight (14.8%) of the respondents had psychological morbidity (GHQ score of 4 and above). One hundred and seventy-eight (45.4%) teachers were very satisfied or satisfied with their jobs. A significant number (45.9%) of teachers would want to quit their jobs. The proportion of teachers with GHQ score 4 and above increased with the level of dissatisfaction but this was not found to be statistically significant. Poor salary was found to be the main cause of job dissatisfaction and major reason for wanting to quit the job. CONCLUSION: This study shows a low level of job satisfaction among Nigerian teachers. Poor salary was the major cause of job dissatisfaction and intention to quit. Further work need to be done to ascertain the association of psychological morbidity and job dissatisfaction.

Splenic enlargement and abdominal scarifications in childhood malaria: beliefs, practices and their possible roles in management as seen in Benin City, Nigeria.

AIMS AND OBJECTIVES: To achieve sustainable reduction in malaria burden in Africa, cultural practices that foster increased malaria burden must be addressed. In Edo state Nigeria, scarification/tattooing on the left hypochondrium presumably over an enlarged spleen arising mainly from malaria is widely practiced. This practice is deleterious, diversionary and causes complications. To evaluate the beliefs and practice, regarding abdominal wall scarification in children and within the context of malaria control. This was carried out among experienced women in child care selected from Egor Local Government Area of Edo State, Nigeria. METHODS: Information relating to beliefs, knowledge and their practices including possible socio-cultural/economic determinants were obtained with use of questionnaires in a cross-sectional and descriptive study. RESULTS: Of the 400 questionnaires administered 394 were responded to. The modal age bracket was 26-30 years. (Range, 18 - 56 years) Respondents were mainly Binis, Esan, and Ibos amongst others. About 27.0% of respondents considered the spleen a "bag of worms". Other views included "collection of bad blood", 27.2% and as a sickness of its own, 14.7%. Named causes of splenomegaly were fever, 59.6% and evil spirit, 15.5%. Over 45.0% of respondents would consult the herbalists for splenomegaly. Less educated (chi(2) = 40.0, p< 0.005), women over 40 years of age (chi(2) = 13.5, p < 0.05) and Esan/Bini ethnic groups (chi(2) = 15.6, p < 0.05) are more prone to the practice. Reasons for widespread use included perceived effectiveness, low cost and accessibility. Information on scarification was obtained mainly from family members, 49.5%; neighbours, 25.1%; and friends/colleagues, 16.7%. CONCLUSION: Practice of scarification is deep rooted and widespread in the study location. It has potentials to negate efforts involved in malaria control. Education including public enlightenment campaign should effectively check the practice.

Splenic enlargement and abdominal scarification in childhood malaria. Beliefs, practices and their possible roles in management in Benin City, Nigeria.

BACKGROUND: To achieve sustainable reduction in malaria burden in Africa, cultural practices that foster increased malaria burden must be addressed. In Edo state Nigeria, scarification/tattooing on the left hypochondrium presumably over an enlarged spleen arising mainly from malaria is widely practiced. This practice is deleterious, diversionary and causes complications. AIMS AND OBJECTIVES: This was a cross-sectional and descriptive study to evaluate the beliefs and practice, regarding abdominal wall scarification in children and within the context of malaria control; It was carried out among experienced women in child care selected from Egor Local Government Area of Edo State, Nigeria. METHODS: Information relating to beliefs, knowledge and their practices including possible socio-cultural/economic determinants were obtained with use of questionnaire. RESULTS: Of the 400 questionnaires administered 394 were responded to. The modal age bracket was 26 - 30 years (Range, 18 - 56 years) Respondents were mainly Binis Esan and Ibos amongst others. About 27.0% of respondents considered the spleen a "bag of worms". Other views included "collection of bad blood" 27.2% and as a sickness of its own, 14.7%. Named causes of splenomegaly were fever, 59.6% and evil spirit, 15.5%. Over 45.0% of respondents would consult the herbalists for splenomegaly. Less educated (X2 = 40.0, p<0.005), women over 40 years of age (X2 = 13.5, p< 0.05) and Esan/Bini ethnic groups (X2 = 15.6, p <0.05) are more prone to the practice. Reasons for widespread use included perceived effectiveness, low cost and accessibility. Information on scarification was obtained mainly from family members, 49.5%, neighbours, 25.1%; and friends/colleagues, 16.7% CONCLUSION/RECOMMENDATIONS: Practice of scarification is deep rooted and widespread in the study location. It has potentials to negate efforts involved in malaria control. Education including public enlightenment campaign should effectively check the practice.

Knowledge of malaria and the practices towards its control among urban dwellers in Benin City.

OBJECTIVE: To determine the knowledge of malaria and its control methods among urban dwellers in Benin City, Edo State with a view to making recommendations on its prevention. METHODS: The study was of a cross-sectional descriptive type, using multi-stage sampling technique. Semi-structured questionnaires were researcher-administered and data analysed by means of the Computer Programme for Epidemiologic Research (CPER). RESULTS: The indices of the knowledge of malaria were generally high. 92.5% had correct knowledge about the symptoms, 98.0% its mode of transmission, all the respondents knew at least one method of its preventive measures and 87.0% knew about therapy with chloroquine and other drugs. There was however, poor knowledge of the new artemisinin-based combination therapy (10.6%) and the Roll Back Malaria Initiative (31.5%). In spite of the positive findings on the knowledge, the practice of preventive measures were poor with only 27.8% using door and window nettings, 0.8% using insecticide treated mosquito nets and 25.6% using insecticides. CONCLUSION: Despite the availability of extensive sources of health information, there is the need for appropriate health education to stimulate positive changes in both knowledge and practice of malaria control. In addition, the campaign to " Roll Back Malaria" requires intensification.

Knowledge, attitude and practice of school health programme among head teachers of primary schools in Egor Local Government Area of Edo State, Nigeria.

BACKGROUND: School health program (SHP) is an important component of the overall health care delivery system of any country. In developing countries such as Nigeria where infant and early childhood mortality is high its importance cannot be overemphasized. For this reason and the recent action plan of the Federal Government of Nigeria concerning SHP, the knowledge, attitude and practice of SHP among head teachers of primary schools in a Local Government Area in Nigeria was evaluated. METHODS: A pre-tested questionnaire designed to evaluate the knowledge attitude and practice of SHP by the researchers was administered by assistants to 133 head teachers of 104 private and 29 public primary schools in Egor Local Government Area of Edo State, Nigeria. The School premises were also inspected to check provision of pipe borne water, sick bay, toilet facilities and the adequacy of the school environments among other things. RESULTS: None of the head teachers had adequate knowledge of SHP. 93.1% from private compared to 48.3% from public schools had poor knowledge of SHP (chi2 = 56.86, p < 0.05). A favorable attitude was demonstrated by all the teachers. Up to 40.4% of private compared to 31.0% of public schools have SHP. Overall 27.7% of the schools had no toilet facility, 33.3% had pit latrine while 40.0% had water closet. Only 25.6% had hand washing facilities. Regarding health services, 51.0% of private schools compared to 27.6% of public schools perform medical inspection of the pupils. Similarly 39.4% private compared to 3.4% public schools have sick bay (chi2 = 11.11; p < 0.05). A total of 16.5% of the schools undertake medical screening of food handlers/vendors, while 20.2% private compared to 3.4% public schools screen food handlers/vendors (chi2 = 4.47; p < 0.05). CONCLUSION: The poor status of SHP in Nigeria may be attributed to failure of policy enunciation, poor primary health care base and lack of supervision.

Indices of patient satisfaction in an African population.

INTRODUCTION: Patient satisfaction as a vital component of health outcome remains an area of interest and need in health care. Some indices of patient satisfaction, viz adequacy of information and explanations given to patients as well as the attitudes of doctors and nurses, were evaluated in a tertiary health facility in Nigeria. METHODS: This cross-sectional study was conducted between July 2002 and September 2002. It involved a total of 250 patients (male = 101, female = 149, mean age = 36.2 years +/-19.7) drawn from all admission wards in the University of Benin Teaching Hospital. Data were collected using a questionnaire developed by the authors. Data were analysed descriptively and analytically. RESULTS: The results reveal a need for improved provision of information and explanations of procedures and investigations to patients. Doctors were found to have a significantly higher rating on friendliness compared with nurses. RECOMMENDATION: It is recommended that effort should be made to provide adequate information and explanations to patients in the course of treatment, irrespective of the circumstances of admission.

Job satisfaction and psychological health of doctors at the University of Benin Teaching Hospital.

BACKGROUND: Studies on job satisfaction and health have mainly been carried out among Caucasian populations. Similar studies are lacking in Nigeria. AIM: To investigate the level of job satisfaction and its relationship to psychological disorder amongst Nigerian doctors. METHODS: All 190 doctors at the University of Benin Teaching Hospital were invited to participate in a cross-sectional study. The respondents completed two self-administered questionnaires, a specifically designed (25-item) questionnaire and a standard instrument--the General Health Questionnaire (GHQ 28). RESULTS: One hundred and fifty-two doctors responded, giving a response rate of 80%. Twenty-one (14%) doctors had a GHQ score of 4 and above, and were at increased likelihood of having a psychological disorder. Fifty-four per cent were either very dissatisfied or dissatisfied with their jobs, while 30% were very satisfied or satisfied with their jobs. The proportion of doctors with GHQ scores of 4 or above increased with the level of dissatisfaction although this was not statistically significant. The crude odds ratio of psychological disorder (GHQ score 4 and above) in dissatisfied respondents compared to satisfied respondents was 2.2 (95% confidence interval = 0.6-8.4). The odds ratio remained non-significant after controlling for the presence of adolescent children, stress outside work and length of service. CONCLUSION: This study showed a high rate of job dissatisfaction among Nigerian doctors compared to their European and North American counterparts. The reason for this is not altogether obvious. Further research is needed to determine the causes of job dissatisfaction amongst Nigerian doctors.

Hospital workers' opinions on the predisposing factors to blood-related work accidents in Central Hospital, Benin City, Edo State, Nigeria.

INTRODUCTION: Hospital workers are prone to accidental injuries during their day-to-day activities at work. These accidental injuries are of importance because many of these predispose the workers to blood-borne infections. METHODS: A total of 242 hospital workers at Central Hospital, Benin City, Edo State participated in a cross-sectional study carried out between June and August 1999 aimed at finding out the predisposing factors to blood-related work accidents. The study group consisted of 53 doctors, 34 laboratory workers and 155 nurses. All doctors and laboratory workers at Central Hospital were involved in the study, while 50% of the nursing population were involved in the study. The nurses were selected using a stratified random sampling method. The respondents completed a pretested self-administered questionnaire. RESULTS: The results showed that the four main factors responsible for accidents among the hospital workers were: non-availability of protective measures; desire to hasten the procedure; type of procedure; and use of inadequate/inappropriate equipment. The major factor responsible for accidents at work among hospital workers was non-availability of protective measures. RECOMMENDATIONS: It is therefore recommended that adequate materials and equipment should be provided. This study could be further validated using a qualitative study design (focus group discussions).

Knowledge of disease notification among doctors in government hospitals in Benin City, Edo State, Nigeria.

STUDY OBJECTIVE: Notifiable diseases are conditions where regular, frequent and timely reporting of individual cases is considered necessary for the prevention and control of the disease. They can be classified into immediate, routine, international, and occupational notifiable diseases. Despite its importance, notification suffers some setbacks, as shown by worldwide studies. This study was carried out from August to November 1999 to assess the knowledge of disease notification among doctors at the University of Benin Teaching Hospital and Central Hospital, Benin City, Edo State, Nigeria. DESIGN: A cross-sectional study design was used, and a self-administered questionnaire, which was pretested, was used to collect data. SETTING: All doctors from the University of Benin Teaching Hospital and Central Hospital, Benin City, Edo State, Nigeria were included in the study. PARTICIPANTS: In total, 134 doctors participated in the study. MAIN RESULT: Only 11.9% of doctors had a good knowledge of disease notification. Thirty-one (23.1%) doctors knew where to obtain notification forms, and 32 (23.9%) knew how to complete these forms. CONCLUSION: Knowledge of disease notification among doctors in these major institutions is poor. It has therefore been recommended that quarterly seminars should be conducted to update doctors' knowledge and serve as reminders about disease notification.

Knowledge and practice of universal precautions among nurses in central hospital, Benin-City, Edo State, Nigeria.

Nurses are faced with professional hazards such as needle pricks and blood-borne infections in their day to day activities in the work place. This study is aimed at finding out the knowledge and practice of universal precautions among nurses at the Central Hospital, Benin City, Edo State, Nigeria. One hundred and fifty-five (155) nurses participated in the cross-sectional study. The nurses were selected using the stratified random sampling method. The nurses had a poor knowledge about universal precautions as only 34.2% of nurses had heard about universal precautions. There was also a poor observance of universal precautions. Knowledge of measures to be taken after the occurrence of occupational accidents/ injuries was also poor, as only 26(16.8%) nurses would report puncture injuries to the clinic, only 13(8.4%) nurses would screen patients for HIV antibody after consent when they sustain work related accident/injuries. Twelve (7.7%) nurses would screen patient to determine hepatitis B status of patient while only 8(5.2%) nurses would go for medical check-up/immunisation with hepatitis B vaccine.