Preparedness and response of a tertiary hospital to the COVID-19 pandemic in Nigeria: challenges, opportunities and lessons.

Africa was the last continent to be affected by the COVID-19 pandemic. Much of the discourse on Africa's response captured in scientific journals revolves around nations, public health agencies and organizations, but little is documented about how individual healthcare facilities have fared. This article reports the challenges faced in a tertiary hospital in Nigeria, including space constraints, diagnostic challenges, shortages in personal protective equipment and health worker infections. The opportunities and strengths that aided the response are also highlighted. The lessons learned will be useful to similar facilities. More information about health facility response at various levels is needed to comprehensively assess Africa's response to the pandemic.

A 6-Month Review of Medical Admissions in a Nigerian Teaching Hospital

Purpose: To provide an overview of morbidity and mortality in the medical wards of a teaching hospital and to generate discussions among staff members with a view to improving patient outcomes and data handling. Methods: A retrospective survey of admissions and mortalities in the medical wards of the University of Benin Teaching Hospital was undertaken from 1st January to 30th June 2006; using ward Record and Change books; and copies of death certificates. Morbidity data were assessed for two medical wards and mortalities for all medical admissions within the period under review were evaluated. Results: Health information was managed entirely manually. Data sources were quite often inaccessible or mutilated; and the utility of available data was limited by incomplete and incorrect documentation. No clinical coding of morbidities or mortalities was available. Human immunodeficiency virus (HIV) infection and its complications accounted for significantly more female than male admissions (26.1and 16.2respectively; p=0.005); and for more female than male deaths (34.6and 29.6respectively; p 0.0001). Most deaths occurred between midnight and the start of the working day; with a second peak during prime working hours. Conclusions: Less than optimal health information management was apparent in the health facility studied. Mortality among the patients was highest in HIV-infected patients than other diseases. Capacity building and appropriate infrastructural development is required to improve the management of vitally important health information

Prescription writing in public and private hospitals in Benin City, Nigeria: the effects of an educational intervention.

BACKGROUND: Writing a prescription is a vital part of the process of rational therapeutics; a badly written prescription could undermine a clinical consultation. OBJECTIVES: To determine how far prescriptions meet accepted standards, identify factors underlying poor prescription writing, intervene by educational methods, and evaluate the effects of intervention. METHODS: Prescriptions (1,197) were collected retrospectively from 40 doctors (public and private hospitals). Handwriting was assessed using a rating scale. Intervention was by face-to-face education and group seminar in public hospitals, and face-to-face education only in private hospitals, with impact evaluation 4 to 6 weeks later. Non-parametric statistics were used to assess differences in means for pre- and post-intervention values. RESULTS: At baseline, more prescriptions from private hospitals had hospitals' addresses (p=0.005) and patients' ages (p=0.015); more from public hospitals were signed (p=0.001) and 20% of prescriptions were clearly legible. Post-intervention, more prescriptions from public hospitals were signed (p=0.017); more from private hospitals had the doses (p=0.04) and routes (p=0.05) of administration, and the intervention group in private hospitals wrote patients ages more frequently than controls (p=0.05). Doctors who had group seminar wrote frequencies and routes of administration (p=0.03 and 0.04 respectively) more than those who had face-to-face education. Handwriting worsened (p=0.04, 0.02 in public and private hospitals respectively). Poor quality of prescriptions was blamed partly on heavy workload and non-availability of prescription order blanks. CONCLUSIONS: Prescriptions lacked details and most were not clearly legible. Intervention resulted in modest changes, which in public hospitals were more significant among doctors who had group seminars.