Expectations and experiences of urban and rural in-school adolescents of adolescent reproductive health services in oyo state, Nigeria.

Reproductive health information and services are fundamental to health, well-being and opportunities for women and young people, yet throughout the world, women and youths do not have access to quality reproductive health care thereby exposing them to unplanned pregnancy, teen birth, induced abortion as well as increased exposure to sexually transmitted diseases, HIV inclusive. This study is meant to explore the expectation of adolescents of an adolescent reproductive health services as well as to assess the experiences of those who had visited an ARHS at the centers. It was a descriptive cross-sectional prospective study, analytic in design using a multistage sampling technique where 452 secondary school pupils in both rural and urban communities were interviewed using a pretested validated questionnaire. Data was analyzed using SPSS version 21. Chi square was used to test for association between both rural and urban adolescents in issues relating to their expectation and experiences, with P-value of #x003C;0.05. More of the respondents in the urban communities (73,32.4%) have the expectation that Adolescent Reproductive Health Services (ARHS) should be provided in an existing health service with special attention to adolescents while a larger percentage of those who preferred a special adolescent health institution were from the rural communities (122, 54.2%) which was statistically significant with a P-value of 0.001. More of respondents from the rural communities also expect that contraception services should be provided in an ARHS center while life skill services are expected by more of the respondents from the urban communities (122, 55.6%). More of the rural community respondents (57,25.3%) expect that fee at the ARHS centers should be provided at a subsidized rate while more of the urban dwellers have the expectation that services provided should be free of charge. For respondents who had been to an ARHS center, more of the urban respondents were attended to by a Medical doctor and a large percentage (34, 94.4%) of those who had visited ARHS center before professed to be satisfied with the services rendered there. Expectations from adolescents from ARHS are very high. However, most of them prefer a free of charge service as well as a service area nearer to residential area. Confidentiality and having a young health professional at the service centers cannot be overemphasized in the provision of quality ARHS.

Factors influencing tuberculosis preventive practices among people living with HIV/AIDS enrolled in secondary health facilities in Lagos, Nigeria.

Background information: Tuberculosis is the most potent opportunistic infection leading to deaths among patients with Human Immunodeficiency Virus (HIV). Therefore, knowledge, attitude and practices regarding tuberculosis preventive strategy among People Living with HIV/AIDS (PLWHA) is vital in minimizing the risk of developing TB infection which forms the objective of this study. Methodology: A descriptive cross-sectional study carried out using multi-stage sampling technique in selecting 606 respondents. Data was collected using a semi-structured questionnaire and analysed with SPSS version 23. Result: Of all the respondents, 245 (40.4%) were within 28-37 years, 386 (63.7%) were females and 219 (36.1%) had secondary education. Majority of the respondents 500 (82.5%), 423(69.8%) and 411(67.8%) had positive attitude, good practices and good knowledge respectively. Associated factors were age, marital status, religion, educational status, knowledge and attitude with tuberculosis practices. Respondents between 18-27 years were twice less likely to engage in good TB preventive practices (OR-0.44, 95% CI- 0.25-0.78, p = 0.004). Conclusion: Over half of respondents had good tuberculosis preventive practices, influenced by their socio-demographic characteristics, knowledge and attitude towards TB infection. Preventive efforts need to be strengthened among individuals between 18-27 years of age, non-Christians and those with lower educational status.

Expectations and experiences of urban and rural in-school adolescents of adolescent reproductive health services in Oyo State.

Reproductive health information and services are fundamental to health, well-being and opportunities for women and young people, yet throughout the world, women and youths do not have access to quality reproductive health care thereby exposing them to unplanned pregnancy, teen birth, induced abortion as well as increased exposure to sexually transmitted diseases, HIV inclusive. This study is meant to explore the expectation of adolescents of an adolescent reproductive health services as well as to assess the experiences of those who had visited an ARHS at the centers. It was a descriptive cross-sectional prospective study, analytic in design using a multistage sampling technique where 452 secondary school pupils in both rural and urban communities were interviewed using a pretested validated questionnaire. Data was analyzed using SPSS version 21. Chi square was used to test for association between both rural and urban adolescents in issues relating to their expectation and experiences, with P-value of <0.05. More of the respondents in the urban communities (73,32.4%) have the expectation that Adolescent Reproductive Health Services (ARHS) should be provided in an existing health service with special attention to adolescents while a larger percentage of those who preferred a special adolescent health institution were from the rural communities (122, 54.2%) which was statistically significant with a P-value of 0.001. More of respondents from the rural communities also expect that contraception services should be provided in an ARHS center while life skill services are expected by more of the respondents from the urban communities (122, 55.6%). More of the rural community respondents (57,25.3%) expect that fee at the ARHS centers should be provided at a subsidized rate while more of the urban dwellers have the expectation that services provided should be free of charge. For respondents who had been to an ARHS center, more of the urban respondents were attended to by a Medical doctor and a large percentage (34, 94.4%) of those who had visited ARHS center before professed to be satisfied with the services rendered there. Expectations from adolescents from ARHS are very high. However, most of them prefer a free of charge service as well as a service area nearer to residential area. Confidentiality and having a young health professional at the service centers cannot be overemphasized in the provision of quality ARHS.

Health insurance in private and public health facilities in Southwestern Nigeria: what determines clients´ satisfaction with quality of service?

INTRODUCTION: insured-persons have complained about poor quality of services rendered by health care providers, which has consequently affected their satisfaction with care received. The objectives of this study aimed to identify the determinants of satisfaction and compare the level of clients´ satisfaction with quality of care received in both public and private health care facilities, in Oyo-State, Nigeria. METHODS: this was a cross sectional study, comparative in design. A total number of 300 clients were recruited from selected public and private health facilities in Oyo-state, using a multistage sampling technique. Data were analyzed using IBM SPSS version 24, and the level of significance was set at p-value < 0.05. RESULTS: the mean age of the respondents in private and public health facilities was 39.9 ± 10.0 years and 42.4 ± 10.1 years respectively. About 74% and 41.3% of the enrolees in the public and private health facilities respectively were dissatisfied with waiting time before receiving care with a statically significant difference of p=0.002. Majority of the respondents (82.7%) in the public health facilities and only 42.7% of those using private health care facilities were satisfied with the quality of drugs given to them at their respective pharmacies. This finding was statistically significantly different with p=0.001. Overall level of satisfaction with quality of care was 60% and 40% among enrolees using public and private health facilities respectively. There was a statistically significance difference (p=0.028) between the overall level of satisfaction and the type of health facility used by the clients. The determinants of clients´ satisfaction with quality of care in both private and public health facilities in this study were mainly socio-demographic characteristics; age (p=0.007), level of education (p=0.046) and occupation (p=0.004), the waiting time experience and the type of facility where services were accessed. CONCLUSION: clients attending public health facilities were more satisfied with care received under NHIS, compared with those using private health facilities. Efforts should be made to reduce waiting time and improve quality of drugs in the public and private facilities respectively.

10-year risk for cardiovascular diseases using WHO prediction chart: findings from the civil servants in South-western Nigeria.

BACKGROUND: Globally, cardiovascular diseases (CVDs) have continued to ravage the human existence through the premature deaths of its workforce. Despite this burden, many studies in Nigeria have focused on determining the prevalence of risk factors which alone are insufficient to assess the risk of future cardiovascular events. Therefore, we determined the pattern and predictors of 10-year risk for CVDs in South-western Nigeria. METHODS: We conducted a cross-sectional study among workers at the local government areas (LGAs) of Oyo State. Using a multi-stage sampling technique, we recruited 260 respondents from the LGA secretariats. A pre-tested, interviewer-administered questionnaire was administered to obtain information on the socio-demographics and behavioural attributes. Lipid analysis, anthropometric, blood pressure, fasting blood glucose measurements were done using standard protocols. The respondents' CVD risk was assessed using WHO prediction chart. Data were analyzed using IBM SPSS version 25; bivariate analysis was done using Chi-square and binary logistic regression was used to identify the predictors of 10-year risk for CVDs at 5% level of significance. RESULTS: The mean age of respondents was 46.0 + 6.7 years. The proportion of respondents with good knowledge of risk factors was 57.7%. The prevalence of CVD risk factors were as follows: systolic hypertension (29.6%), visceral obesity (35.8%), diabetes mellitus (18.8%), smoking (5.8%), elevated total cholesterol (55.4%) and physical inactivity (84.6%). The proportion of respondents with low, moderate and high risk of developing CVDs within 10 years was 76.9, 8.5 and 14.6% respectively. Respondents with age ≥ 40 years (aOR = 2.6, 95% CI = 1.3-8.5), management cadre (aOR = 3.8, 95% CI = 1.6-9.6), obesity (aOR = 4.8, 95% CI = 1.2-120), abnormal waist circumference (aOR = 2.8, 95% CI = 1.3-5.2) and physical inactivity (aOR = 2.4, 95% CI = 1.2-4.7) were associated with the higher likelihood of developing CVDs. CONCLUSION: About one-sixth of the respondents had high risk of developing CVDs within the next 10 years and it is likely that it will reduce the productivity of the State. Lifestyle modification and early detection of risk factors through regular screening programmes for those with high CVD risk is therefore recommended.