Building capacity of primary health care workers and clients on COVID-19: Results from a web-based training.

BACKGROUND: Health care workers (HCWs) in the first line of care play critical roles in providing the correct information about the coronavirus disease to the community. The objective of the study was to determine the effect of virtual training on the knowledge, attitude, and preventive practices among PHC workers and their clients in the prevention and control of coronavirus disease. METHODS: A quasi-experimental intervention virtual training, using a before and after design amongst HCWs and clients was conducted at primary health care facilities in two Local Government Areas of Lagos State. The study instruments were pre-tested questionnaires for both HCWs and their clients. which investigated knowledge of symptoms, modes of disease transmission, methods of prevention, and preventive practices. Changes in knowledge, attitudes, and practices were compared pre-and post-intervention. The level of significance was set at p < 0.05. RESULTS: Sixty-three HCWs (out of 100 recruited at baseline) and 133 clients (out of the initial 226) completed the study. The mean ages of the HCWs and clients were 39.2±9.9 and 30.9±5.0 years respectively. At the baseline, the HCW's knowledge was good in the domains of symptoms, modes of transmission, and preventive measures. The training led to a higher but not significant (p> 0.05) increase in the level of knowledge. Contact with trained HCWs was found to lead to significantly (P < 0.001) higher levels of knowledge, attitudes, and preventive practices. amongst clients. CONCLUSION: The training was effective in improving the knowledge of both the trained HCWs and their clients.

Maternal and child health service readiness among primary health care facilities in Ekiti, Nigeria.

BACKGROUND:  The availability of adequate infrastructure, diagnostic medical equipment, medicines and commodities and well-trained medical personnel are essential for the effective delivery of health care services. AIM:  This study assessed maternal and child health (MCH) services' specific readiness by type and location of the health facility and compared the readiness between urban and rural primary health care (PHC) facilities in Ekiti State, Nigeria. SETTING:  The study was conducted amongst the heads (officers in charge) of PHC facilities in Ekiti State, Nigeria between August 2020 and October 2020. METHODS:  A descriptive cross-sectional study in which all PHC facilities were conducted and data were collected with the aid of the Service Availability and Readiness Assessment (SARA) tool using the KoboCollect app. Data were cleaned and coded on Microsoft Excel 2016 and exported to Stata SE 12 for analysis. The level of significance was set at p  0.05. RESULTS:  Overall, the MCH readiness score amongst PHC facilities was 47% (0.47 ± 0.18). About half (52%) of the facilities had necessary and relevant equipment. Health facilities located in urban areas had more medicines and commodities compared with those of rural areas (0.51 ± 0.16 vs 0.45 ± 0.17, p  0.05). Primary health care facilities in Ekiti North I had an overall higher service readiness score (0.63 ± 0.19) compared with other federal constituencies (p  0.001). CONCLUSION:  The overall MCH-specific service readiness in Ekiti State was relatively low. Strategies to address the identified gaps for a smooth journey towards the achievement of Universal Health Coverage (UHC) are recommended.

10-Year Mortality Pattern Among Cancer Patients in Lagos State University Teaching Hospital, Ikeja, Lagos.

BACKGROUND: Globally, cancer is a major leading health problem with an estimated 10 million incidences and 6 million cancer deaths annually. In Nigeria, an estimated 72,000 cancer deaths occur annually, and 102,000 new cases are diagnosed from its population of 200 million people. These are, however, estimates, it is necessary to document the yearly trends and patterns of cancer mortality with regards to the different regions in the country. METHODOLOGY: we conducted this study at the Lagos State University Teaching hospital (LASUTH), Ikeja, Lagos to document mortality patterns from 2009 to 2018. Data extracted included those from the patient's case notes, admission and death registers, and death certificates. we also had records from the hospital records department and medical wards. We then documented cancer mortality over the study period. RESULTS: A total number of 6,592 deaths were recorded over ten years, and 1,133 cases were cancer-related deaths. This number puts the percentage of cancer-related deaths at 17.2%. Male patients accounted for 54.0%, and female patients are 46.0%. Breast cancer accounted for the highest mortality, followed by prostate cancer. The highest number of deaths were recorded in 2010 at 821, followed by 2011 at 799, 2015 at 780, and the least in 2017 at 513. There is also a significant general increase in odds of mortality with an increase in decades of life. CONCLUSION: This study shows that about one in five deaths, over the last ten years, from this tertiary institution, is related to a cancer diagnosis. Even though a yearly decline in the number of cancer deaths was noticed, probably due to increased awareness and governmental intervention, the percentage still remains high.

Nuances of reproductive decisions by women in a rural community of Lagos, Nigeria.

INTRODUCTION: inadequate utilization of maternal health services due to limited reproductive decision-making capacity could be contributory to high maternal mortality in developing countries. This study sought to assess nuances of reproductive decisions by women in a rural community of Lagos, Nigeria. METHODS: this descriptive, cross-sectional house to house survey was part of a study conducted in April 2015 on females selected from 298 households chosen based on geographical clusters by simple random sampling. The study instrument was adapted from a USAID-funded project and was interviewer-administered. Data entry and analysis were performed with the aid of Epi-info™ 7.0.8.3 statistical software and ethical approval was obtained for the study. RESULTS: spousal age difference was less than 10 years for about half (51.3%) of the respondents. The majority (91.6%) of the respondents had received antenatal care during pregnancy and jointly decided with their spouses on place of care. The most commonly used contraceptives were the pills (23.5%), injectables (16.8%) and condoms (13.8%). Spousal disapproval regarding the use of family planning was almost nil at 1%. Employment status as a socio-economic factor did not significantly affect respondents´ involvement in decision-making. However, there were statistically significant associations between spousal age differences and some indicators of autonomy such as respondents´ involvement in health care decisions and the determinant on choice of antenatal care provider. CONCLUSION: women´s reproductive independence and involvement in health decisions could result in reduction of maternal ill-health and mortality whilst promoting higher male involvement and better maternal health.

Hand hygiene practices in the context of Ebola virus disease: A cross-sectional survey of Lagos residents.

BACKGROUND: The Ebola virus disease outbreak that ravaged parts of West Africa has been described as the most severe acute public health emergency seen in modern times. Hand washing was promoted among other measures for infection prevention. OBJECTIVE: This study assessed the awareness of Ebola virus disease and hand-washing practices among Lagos residents, southwest Nigeria. METHODS: A descriptive cross-sectional study was used. A total of 1982 respondents aged 18 ⩾ years were selected using a multi stage sampling technique. An interviewer-administered, pre-tested questionnaire was used for data collection between August and November 2015. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 22, with level of significance set at 0.05. RESULTS: Almost all (97.3%) respondents were aware of Ebola virus disease, with over half of respondents having heard about it from television. A majority of 1890 (95.4%) respondents were aware of the importance of hand washing in disease prevention. Similarly, high proportions of respondents were aware they should wash their hands after an outing, toilet use, touching pets, before and after meals, while 1628 (82.1%) of respondents knew to wash their hands after a hand shake. However, less than half of respondents (38.8%) always washed their hands after handshakes. DISCUSSION: A majority of respondents surveyed were aware of Ebola virus disease and hand washing, but the practice of hand washing, which is key in prevention of infection, lagged behind the knowledge of the respondents.

How does the public perceive healthcare workers in Lagos? A comparison of health workers in public and private health facilities.

BACKGROUND: The perception of healthcare workers (HCWs) by community members is dependent on the quality of services rendered by HCWs and contributes to utilisation. The objective of the study was to assess the perception of health workers in both public and private facilities by residents of Lagos State. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted using mixed-methods approach. Respondents (n = 2000) were selected using a multistaged sampling technique from four local government areas. An interviewer-administered, pre-tested questionnaire developed for the study was used for data collection and focus group discussions were held. Domains assessed included competence, work attitudes, interpersonal skills and unethical behaviour. A perception index was generated. Data were analysed using the Statistical Package for the Social Sciences version 22, with level of significance set at 0.05 for quantitative data and ATLAS.ti software (Scientific Software, Berlin; version 7) for qualitative data. RESULTS: At least seven out of ten participants (>71%) perceived the HCWs highly in the areas of professional competence, attitude to work, responsiveness and interpersonal skills. Out of a maximum of 12, doctors had the highest mean perception index (10.6 ± 1.9), laboratory scientists had 10.1 ± 2.1, pharmacists had 10.0 ± 2.3 and nurses had 9.6 ± 2.7. A larger proportion of respondents had a significantly better perception of workers in private facilities more than those in government facilities. CONCLUSION: Perception of health workers was high and was better in privately owned facilities. Periodic retraining of health workers and regular assessments of health facilities are recommended.