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Odu J, Osi K, Nguyen L, Goldstein A, Appel LJ, Matsushita K, Ojji D, Orji IA, Alex-Okoh M, Odoh D, Toma MM, Elemuwa CO, Lamorde S, Baraya H, Dewan MT, Chijioke O, Moran AE, Agogo E, Thomas MP. On-demand mobile hypertension training for primary health care workers in Nigeria: a pilot study. BMC Health Serv Res 2024; 24:444. [PMID: 38594665 PMCID: PMC11005121 DOI: 10.1186/s12913-024-10693-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/07/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Only one out of every ten Nigerian adults with hypertension has their blood pressure controlled. Health worker training is essential to improve hypertension diagnosis and treatment. In-person training has limitations that mobile, on-demand training might address. This pilot study evaluated a self-paced, case-based, mobile-optimized online training to diagnose and manage hypertension for Nigerian health workers. METHODS Twelve hypertension training modules were developed, based on World Health Organization and Nigerian guidelines. After review by local academic and government partners, the course was piloted by Nigerian health workers at government-owned primary health centers. Primary care physician, nurse, and community health worker participants completed the course on their own smartphones. Before and after the course, hypertension knowledge was evaluated with multiple-choice questions. Learners provided feedback by responding to questions on a Likert scale. RESULTS Out of 748 users who sampled the course, 574 enrolled, of whom 431 (75%) completed the course. The average pre-test score of completers was 65.4%, which increased to 78.2% on the post-test (P < 0.001, paired t-test). Health workers who were not part of existing hypertension control programs had lower pre-test scores and larger score gains. Most participants (96.1%) agreed that the training was applicable to their work, and nearly all (99.8%) agreed that they enjoyed the training. CONCLUSIONS An on-demand mobile digital hypertension training increases knowledge of hypertension management among Nigerian health workers. If offered at scale, such courses can be a tool to build health workforce capacity through initial and refresher training on current clinical guidelines in hypertension and other chronic diseases in Nigeria as well as other countries.
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Affiliation(s)
| | - Kufor Osi
- Resolve To Save Lives, New York, USA
| | - Leander Nguyen
- Columbia University Irving Medical Center, New York, USA
| | | | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Kunihiro Matsushita
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Dike Ojji
- Department of Internal Medicine, Faculty of Clinical Sciences, University of Abuja, Abuja, Nigeria
| | - Ikechukwu A Orji
- Cardiovascular Research Unit, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | | | | | | | | | | | - Hasana Baraya
- National Primary Health Care Development Agency, Abuja, Nigeria
| | | | | | - Andrew E Moran
- Resolve To Save Lives, New York, USA
- Columbia University Irving Medical Center, New York, USA
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Gueye DM, Ly AB, Gueye B, Ndour PI, Fullman N, Liu PY, Mbaye K, Diallo A, Diatta I, Diatta SA, Mane MM, Ikilezi G, Sarr M. A consolidated and geolocated facility list in Senegal from triangulating secondary data. Sci Data 2024; 11:119. [PMID: 38267460 PMCID: PMC10808422 DOI: 10.1038/s41597-024-02968-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/15/2024] [Indexed: 01/26/2024] Open
Abstract
Having a geolocated list of all facilities in a country - a "master facility list" (MFL) - can provide critical inputs for health program planning and implementation. To the best of our knowledge, Senegal has never had a centralized MFL, though many data sources currently exist within the broader Senegalese data landscape that could be leveraged and consolidated into a single database - a critical first step toward building a full MFL. We collated 12,965 facility observations from 16 separate datasets and lists in Senegal, and applied matching algorithms, manual checking and revisions as needed, and verification processes to identify unique facilities and triangulate corresponding GPS coordinates. Our resulting consolidated facility list has a total of 4,685 facilities, with 2,423 having at least one set of GPS coordinates. Developing approaches to leverage existing data toward future MFL establishment can help bridge data demands and inform more targeted approaches for completing a full facility census based on areas and facility types with the lowest coverage. Going forward, it is crucial to ensure routine updates of current facility lists, and to strengthen government-led mechanisms around such data collection demands and the need for timely data for health decision-making.
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Affiliation(s)
- Daouda M Gueye
- Institut de Recherche en Santé de Surveillance Epidémiologique et de Formations (IRESSEF), Dakar, Senegal
| | - Alioune Badara Ly
- Centre des Opérations d'Urgence Sanitaire (COUS), Ministère de la Santé et de l'Action Sociale (MSAS), Dakar, Senegal
| | - Babacar Gueye
- Direction de la Planification, de la Recherche et des Statistiques (DPRS), MSAS, Dakar, Senegal
| | - Papa Ibrahima Ndour
- Direction de la Planification, de la Recherche et des Statistiques (DPRS), MSAS, Dakar, Senegal
- Agence Nationale de la Démographie et de la Statistique (ANSD), Dakar, Senegal
| | - Nancy Fullman
- Exemplars in Global Health, Gates Ventures, Seattle, Washington, USA.
- Department of Global Health, University of Washington, Seattle, Washington, USA.
| | - Patrick Y Liu
- Exemplars in Global Health, Gates Ventures, Seattle, Washington, USA
| | - Khadim Mbaye
- Agence Nationale de la Démographie et de la Statistique (ANSD), Dakar, Senegal
| | - Aliou Diallo
- Expanded Programme on Immunisation Unit, WHO Country Office Senegal, Dakar, Senegal
| | - Ibrahima Diatta
- Centre des Opérations d'Urgence Sanitaire (COUS), Ministère de la Santé et de l'Action Sociale (MSAS), Dakar, Senegal
| | - Saly Amos Diatta
- Institut de Recherche en Santé de Surveillance Epidémiologique et de Formations (IRESSEF), Dakar, Senegal
| | - Mouhamadou Moustapha Mane
- Institut de Recherche en Santé de Surveillance Epidémiologique et de Formations (IRESSEF), Dakar, Senegal
| | - Gloria Ikilezi
- Exemplars in Global Health, Gates Ventures, Seattle, Washington, USA
| | - Moussa Sarr
- Institut de Recherche en Santé de Surveillance Epidémiologique et de Formations (IRESSEF), Dakar, Senegal
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Macharia PM, Wong KLM, Olubodun T, Beňová L, Stanton C, Sundararajan N, Shah Y, Prasad G, Kansal M, Vispute S, Shekel T, Gwacham-Anisiobi U, Ogunyemi O, Wang J, Abejirinde IOO, Makanga PT, Afolabi BB, Banke-Thomas A. A geospatial database of close-to-reality travel times to obstetric emergency care in 15 Nigerian conurbations. Sci Data 2023; 10:736. [PMID: 37872185 PMCID: PMC10593805 DOI: 10.1038/s41597-023-02651-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/16/2023] [Indexed: 10/25/2023] Open
Abstract
Travel time estimation accounting for on-the-ground realities between the location where a need for emergency obstetric care (EmOC) arises and the health facility capable of providing EmOC is essential for improving pregnancy outcomes. Current understanding of travel time to care is inadequate in many urban areas of Africa, where short distances obscure long travel times and travel times can vary by time of day and road conditions. Here, we describe a database of travel times to comprehensive EmOC facilities in the 15 most populated extended urban areas of Nigeria. The travel times from cells of approximately 0.6 × 0.6 km to facilities were derived from Google Maps Platform's internal Directions Application Programming Interface, which incorporates traffic considerations to provide closer-to-reality travel time estimates. Computations were done to the first, second and third nearest public or private facilities. Travel time for eight traffic scenarios (including peak and non-peak periods) and number of facilities within specific time thresholds were estimated. The database offers a plethora of opportunities for research and planning towards improving EmOC accessibility.
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Affiliation(s)
- Peter M Macharia
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Population & Health Impact Surveillance Group, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
- Centre for Health Informatics, Computing, and Statistics, Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Kerry L M Wong
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Tope Olubodun
- Department of Community Medicine and Primary Care, Federal Medical Centre Abeokuta, Abeokuta, Ogun, Nigeria
| | - Lenka Beňová
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | | | | | | | | | | | | | | | | | | | - Jia Wang
- School of Computing & Mathematical Sciences, University of Greenwich, London, UK
| | - Ibukun-Oluwa Omolade Abejirinde
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Canada
| | - Prestige Tatenda Makanga
- Surveying and Geomatics Department, Midlands State University Faculty of Science and Technology, Gweru, Midlands, Zimbabwe
- Climate and Health Division, Centre for Sexual Health and HIV/AIDS Research, Harare, Zimbabwe
| | - Bosede B Afolabi
- Maternal and Reproductive Health Research Collective, Lagos, Nigeria
- Department of Obstetrics and Gynaecology, College of Medicine of the University of Lagos, Lagos, Nigeria
| | - Aduragbemi Banke-Thomas
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
- Maternal and Reproductive Health Research Collective, Lagos, Nigeria.
- School of Human Sciences, University of Greenwich, London, UK.
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4
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Olakunde BO, Adeyinka DA, Ndukwe CD, Oladele TT, Yahaya HB, Ijaodola OA. Antenatal hepatitis B screening in Nigeria: A comparative analysis with syphilis and HIV. Int J STD AIDS 2021; 32:1290-1297. [PMID: 34387113 DOI: 10.1177/09564624211035922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Nigeria has adopted routine screening of pregnant women for hepatitis B virus (HBV) as part of the interventions to eliminate its vertical transmission. However, there is a dearth of evidence on the coverage of routine antenatal HBV screening as recommended in the national guidelines. This study examined the antenatal HBV screening rate and the positivity rate compared with syphilis and HIV. We conducted a descriptive analysis of the 2019 national HIV/AIDS health sector data. The study included approximately 2.8 million pregnant women who received antenatal care (ANC) in over 6000 health facilities providing prevention of mother-to-child transmission of HIV services in Nigeria. Of the ANC clients, 0.2 million (7.2%) were screened for HBV. At the zonal level, the South West had the highest HBV screening rate (19%), while the lowest rate was in the North East (2.5%). The percentage of pregnant women screened for HBV was lower than those screened for syphilis (16.3%) and HIV (90.3%). Among those screened for HBV, the positivity rate was 5%. The HBV positivity rate ranged from 8.5% in the North Central zone to 1.3% in the South East zone. The positivity rates for syphilis and HIV were 0.4% and 0.5%, respectively. Our results indicate a low antenatal HBV screening rate and a wide disparity compared with HIV and syphilis. This finding highlights the need to understand and address the barriers affecting routine antenatal HBV screening and to strengthen the integration of HBV services into the HIV program in Nigeria.
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Affiliation(s)
- Babayemi O Olakunde
- Department of Community Prevention and Care Services, 434818National Agency for the Control of AIDS, Abuja, Nigeria.,Center for Translation and Implementation Research, University of Nigeria, Nsukka, Nigeria
| | - Daniel A Adeyinka
- Department of Public Health, National AIDS and STI Control Programme, Federal Ministry of Health, Abuja, Nigeria.,Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Chinwendu D Ndukwe
- Department of Community Prevention and Care Services, 434818National Agency for the Control of AIDS, Abuja, Nigeria.,African Institute of Health Policy and Health Systems, Abakaliki, Nigeria
| | - Tolulope T Oladele
- Department of Community Prevention and Care Services, 434818National Agency for the Control of AIDS, Abuja, Nigeria
| | - Hidayat B Yahaya
- Department of Community Prevention and Care Services, 434818National Agency for the Control of AIDS, Abuja, Nigeria
| | - Olugbengba A Ijaodola
- Department of Public Health, National AIDS and STI Control Programme, Federal Ministry of Health, Abuja, Nigeria
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5
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Udoh A, Akpan M, Ibrahim UI, Lawal BK, Labaran KS, Ndem E, Amorha K, Matuluko A, Tikare O, Ohabunwa U, Kpokiri E. Clinical pharmacy services provided in public sector hospitals in Nigeria: a national survey. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021; 29:471-479. [PMID: 34319400 DOI: 10.1093/ijpp/riab046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 07/01/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Studies show that clinical pharmacy services are effective in optimizing medicines use and patients' outcomes. This study aimed to determine the clinical pharmacy services provided in public sector hospitals in Nigeria. METHODS This was an online survey of 296 primary, secondary and tertiary care hospitals sampled purposively across the 36 States and Federal Capital Territory in Nigeria. Data analysis was conducted descriptively via χ 2 test and multivariate analysis of variance (MANOVA). KEY FINDINGS Responses were obtained from 272 hospitals in the country with a survey completion rate of 88%. This included 55 tertiary, 72 secondary and 145 primary healthcare centres (PHCs). Pharmacists provided pharmaceutical care services in all the tertiary care hospitals, 94% of the secondary and in only 6% of the PHCs surveyed. Most of the secondary and tertiary care hospitals provided medicines information, patient education and counselling, and in-patient dispensing services [n = 97 (79%), 116 (94%), 88 (72%)], respectively. However, fewer than a third reported involvement in multidisciplinary ward rounds, medication chart review and antibiotic stewardship programmes [n = 18 (15%), 33 (27%), 22 (18%), respectively]. Furthermore, medication error reporting and pharmacovigilance services were each routinely provided in only about half of the secondary and tertiary care hospitals [n = 62 (50%)], and this was not associated with the level of care (P > 0.05). CONCLUSIONS The findings of this study demonstrate disparity in clinical pharmacy service availability across the various levels of care in Nigeria and emphasize the need to prioritize their integration within the primary care sector.
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Affiliation(s)
- Arit Udoh
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Mary Akpan
- Faculty of Pharmacy, University of Uyo, Akwa Ibom State, Nigeria
| | - Umar Idris Ibrahim
- Department of Clinical Pharmacy and Pharmacy Practice, Bayero University, Kano, Nigeria.,Department of Clinical Pharmacy and Pharmacy Practice, Ahmadu Bello University, Zaria, Nigeria
| | - Basira Kankia Lawal
- Department of Clinical Pharmacy and Pharmacy Management, Kaduna State University, Kaduna, Nigeria
| | - Kamilu Sarki Labaran
- Department of Clinical Pharmacy and Pharmacy Practice, Ahmadu Bello University, Zaria, Nigeria
| | - Ekpedeme Ndem
- Faculty of Pharmacy, University of Uyo, Akwa Ibom State, Nigeria
| | - Kosisochi Amorha
- Department of Clinical Pharmacy & Pharmacy Management, University of Nigeria Nsukka, Enugu, Nigeria
| | - Ayodeji Matuluko
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Olubukola Tikare
- Department of Pharmacy, Federal Medical Centre, Abuja, Federal Capital Territory, Nigeria
| | - Unoma Ohabunwa
- Department of Pharmacy, Federal Medical Centre, Abuja, Federal Capital Territory, Nigeria
| | - Eneyi Kpokiri
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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6
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Makinde OA, Odimegwu CO. Compliance with disease surveillance and notification by private health providers in South-West Nigeria. Pan Afr Med J 2020; 35:114. [PMID: 32637012 PMCID: PMC7320761 DOI: 10.11604/pamj.2020.35.114.21188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 02/19/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction Private health facilities are important contributors to health service delivery across several low and middle income countries. In Nigeria, they make up 33% of the health facilities, account for more than 70% of healthcare spending and over 60% of healthcare contacts are estimated to take place within them However, their level of participation in the disease surveillance system has been questioned. Methods We conducted a cross-sectional survey of 507 private health facilities in South-West Nigeria to investigate the level of compliance with disease surveillance reporting and the factors that affect their participation. Results We found only 40% of the private health facilities to be complying with routine disease surveillance reporting which ranged from 17% to 60% across the six states in the region. Thirty-four percent of the private health facilities had the requisite data collection tools, 49% had designated professionals assigned to health records management and only 7% of the clinicians could properly identify the three data collection tools for disease surveillance. Some important factors such as awareness of a law on disease surveillance (OR=1.55 95% CI=1.08-2.24), availability of reporting tools (OR=13.69, 95% CI=8.85-21.62), availability of a designated health records officer (OR=3.9, 95% CI=2.68-5.73), and health records officers (OR=10.51, 95%CI=2.86-67.70) and clinicians (OR=2.49, 95% CI=1.22-5.25) with knowledge of disease surveillance system were important predictive factors to compliance with disease surveillance participation. Conclusion Private health facilities are poorly compliant with disease surveillance in Nigeria resulting in missed opportunities for prompt identification and response to threats of infectious disease outbreaks.
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Affiliation(s)
- Olusesan Ayodeji Makinde
- Demography and Population Studies Program, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Viable Knowledge Masters, Plot C114 (Platinum Plaza), First Avenue, Gwarinpa, Abuja, Nigeria
| | - Clifford Obby Odimegwu
- Demography and Population Studies Program, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Mpango J, Nabukenya J. A Qualitative Study to Examine Approaches used to Manage Data about Health Facilities and their Challenges: A Case of Uganda. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2020; 2019:1157-1166. [PMID: 32308913 PMCID: PMC7153096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Availability of an accurate and complete health facility list is fundamental in producing quality and timely data that is sufficient to aid evidence-based decision, resource allocation and planning within the healthcare ecosystem. This study aimed at examining the approaches used in Uganda to manage data about health facilities and the challenges they are facing. We conducted a qualitative study involving 32 interviews with participants from Ministry of Health, government regulatory organizations, district local government, general public, academia, implementing partners and healthcare providers. Our analysis identified four divergent approaches that had five common challenges, namely; lack of a health facility unique identifier, non-standardized, incomplete, inaccurate data, difficulty accessing and using data. Establishing a national central health facility registry to manage the national health facility list would improve patient referrals, facility look-ups, health information exchange, data curation and access and health information system integration.
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Affiliation(s)
- Jonathan Mpango
- School of Public Health, Makerere University, Kampala, Uganda
| | - Josephine Nabukenya
- School of Computing and Informatics Technology, Makerere University, Kampala, Uganda
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8
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Olakunde BO, Adeyinka DA, Olawepo JO, Pharr JR, Ozigbu CE, Wakdok S, Oladele T, Ezeanolue EE. Towards the elimination of mother-to-child transmission of HIV in Nigeria: a health system perspective of the achievements and challenges. Int Health 2019; 11:240-249. [PMID: 31028402 DOI: 10.1093/inthealth/ihz018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 02/28/2019] [Accepted: 03/09/2019] [Indexed: 11/14/2022] Open
Abstract
Despite its scaled-up response for prevention of mother-to-child transmission of HIV (PMTCT), Nigeria still contributes the greatest number of infants infected with HIV worldwide. Drawing on our knowledge, and review of policy documents and research papers, we explored the achievements and challenges in the elimination of mother-to-child transmission of HIV in Nigeria using the WHO's health systems framework. We found that Nigeria has increased the number of PMTCT sites, decentralized and integrated PMTCT care for expanded service delivery, adopted task-shifting to address the shortage of skilled healthcare providers, explored alternative sources of domestic funding to bridge the funding gap and harmonized the health management information system to improve data quality. Some of the challenges we identified included: difficulty in identifying HIV-infected pregnant women because of low uptake of antenatal care; interrupted supplies of medical commodities; knowledge gaps among healthcare workers; and lack of a national unique identifying system to enhance data quality. While there have been some achievements in the PMTCT program, gaps still exist in the different blocks of the health system. Elimination of mother-to-child transmission of HIV in Nigeria will require the implementation of feasible, culturally acceptable and sustainable interventions to address the health system-related challenges.
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Affiliation(s)
- Babayemi O Olakunde
- Department of Occupational and Environmental Health, School of Public Health, University of Nevada, Las Vegas, 4505 S Maryland Pkwy, Las Vegas, NV, USA.,National Agency for the Control of AIDS, Plot 823, Ralph Shodeinde Street, Central Business District, Abuja, Nigeria
| | - Daniel A Adeyinka
- Department of Community Health and Epidemiology, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, Canada.,National AIDS & STIs Control Programme, Federal Ministry of Health, Plot 75, Ralph Sodeinde Street, Central Area, Abuja, Nigeria
| | - John O Olawepo
- Department of Occupational and Environmental Health, School of Public Health, University of Nevada, Las Vegas, 4505 S Maryland Pkwy, Las Vegas, NV, USA
| | - Jennifer R Pharr
- Department of Occupational and Environmental Health, School of Public Health, University of Nevada, Las Vegas, 4505 S Maryland Pkwy, Las Vegas, NV, USA
| | - Chamberline E Ozigbu
- National AIDS & STIs Control Programme, Federal Ministry of Health, Plot 75, Ralph Sodeinde Street, Central Area, Abuja, Nigeria.,Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, USA
| | - Sabastine Wakdok
- National Agency for the Control of AIDS, Plot 823, Ralph Shodeinde Street, Central Business District, Abuja, Nigeria
| | - Tolu Oladele
- National Agency for the Control of AIDS, Plot 823, Ralph Shodeinde Street, Central Business District, Abuja, Nigeria
| | - Echezona E Ezeanolue
- Department of Pediatrics and Child Health, College of Medicine, University of Nigeria, 1, Old UNTH Road, Nsukka, Enugu, Nigeria.,HealthySunrise Foundation, 308 South Jones Blvd, Las Vegas, NV, USA
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Eboreime EA, Idika O, Omitiran K, Eboreime O, Ibisomi L. Primary healthcare planning, bottleneck analysis and performance improvement: An evaluation of processes and outcomes in a Nigerian context. EVALUATION AND PROGRAM PLANNING 2019; 77:101712. [PMID: 31521008 DOI: 10.1016/j.evalprogplan.2019.101712] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 07/17/2019] [Accepted: 09/04/2019] [Indexed: 06/10/2023]
Abstract
Operational planning of interventions defines roadmaps, timelines and resources necessary for translating policies into expected health outcomes along the evidence-policy-implementation continuum. However, bottlenecks often hinder the attainment of objectives and the timely delivery of intervention packages leading to sub-optimal performance of health systems. Bottleneck identification, analysis and removal approaches to planning, which requires key stakeholders' participation, have been recommended to improve health system outcomes in LMICs. This study demonstrates how integration of participatory action research (PAR) within a quality improvement model can help navigate the complexities of health system bottleneck analyses, planning and performance improvement in a Nigerian sub-national context. The study is based on data collected between June 2016 and June 2017, from Chikun LGA in Kaduna State Nigeria. PAR was integrated into a quality improvement model called DIVA (Diagnose-Intervene-Verify-Adjust) applied across selected interventions (eMTCT, Antenatal care, skilled birth attendance, immunization and Integrated Management of Childhood Illnesses). PAR was used to identify and analyse health system bottlenecks, as well as develop, monitor implementation and follow-up on action plans to address them. Evaluations were conducted involving 2 cycles of DIVA. The outputs (bottleneck analysis charts, driver diagrams, operational plans, M/E reports, etc.) from each cycle of the DIVA process were collated and analysed. Bottlenecks identified include availability of human resources for health, availability of health commodities as well as geographical accessibility. These had implications on acceptability and quality of services. Mean Improvements recorded were 20.4%, 14.0% and 10.8% and 11.2%, 7.5%; 5.5% (across eMTCT, maternal health and child health interventions) in the 1 st and 2nd DIVA cycles respectively. This study highlights processes and outcomes of integrating PAR in quality improvement design and operations in health intervention programmes with a focus on health systems strengthening in a Nigerian context. Implementing the DIVA model using a PAR approach may be considered an effective strategy for planning and implementing health interventions in comparable settings.
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Affiliation(s)
- Ejemai Amaize Eboreime
- Department of Planning, Research and Statistics, National Primary Healthcare Development, Agency. 681/682 Port Harcourt Crescent, Area 11, Garki, Abuja, Nigeria; Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, 13-103 Clinical Sciences Building, Edmonton, AB, Canada T6G 2G3.
| | - Obinna Idika
- Obafemi Awolowo University, Ile-Ife. P.M.B 13, Ile-Ife Osun, 220282, Nigeria.
| | - Kasarachi Omitiran
- Health Systems Unit, Lumiere Health Research Consulting. P.O. Box 3460, Garki, Abuja, Nigeria.
| | - Oghenekome Eboreime
- Centre for Infectious Disease Research and Evaluation (CIDRE). P.O. Box 18449, Garki, Abuja, Nigeria.
| | - Latifat Ibisomi
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Research Unit, Nigerian Institute of Medical Research (NIMR), 6, Edmund Crescent off Murtala Mohammed Way P.M.B 2013, Yaba, Lagos, Nigeria.
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10
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Sato R. The impacts of quantity and quality of health clinics on health behaviors and outcomes in Nigeria: analysis of health clinic census data. BMC Health Serv Res 2019; 19:377. [PMID: 31196212 PMCID: PMC6567526 DOI: 10.1186/s12913-019-4141-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 05/02/2019] [Indexed: 11/21/2022] Open
Abstract
Background Past studies have identified that inconvenient access to health clinics is one of the important barriers to health service utilization and health outcomes. However, establishing the link between the lack of access to health clinics and the high maternal and child morbidity and mortality in Nigeria has been a challenge due to the lack of data. This paper overcomes this problem by using the country’s health clinic census data. Methods Using the Nigerian health clinic census, we evaluate the intercorrelation between the quantity and the quality of health clinics available across the country. We also examine the correlation between the access to health clinics and health behaviors/outcomes for residents by merging the health clinic census data with data from the demographic and health survey (DHS). The health clinic census data makes it possible to capture the overall geographical allocation of health services across the country as well as their comprehensive relationship with health outcomes. Results We find a strong positive correlation between the quality of a health clinic and the quantity and quality of neighboring clinics. The high quality clinics are concentrated in areas where the density of clinics is high, and where more of the clinics around them are also of high quality. We also find that an increase in access to health clinics of high quality that are in close proximity is significantly and positively correlated with an improvement in health behaviors as well as health outcomes. Women who are more disadvantaged benefit more from the access to high quality clinics than others. Conclusions Health clinics of good quality are unevenly distributed geographically in Nigeria. The quality of health clinics should be of a level that can support the promotion of recommended health behaviors and achieve improved health outcomes throughout the country. Further studies are necessary to evaluate the optimal distribution of clinics of good quality, given that residents in less populated areas gain a higher marginal benefit from improved access to health service, despite the higher costs of supplying the service in those areas.
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Affiliation(s)
- Ryoko Sato
- Harvard T.H. Chan School of Public Health, 90 Smith St, Boston, MA, 02120, USA.
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11
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Olakunde BO, Adeyinka DA, Olawepo JO, Pharr JR. HIV testing among men in Nigeria: a comparative analysis between young people and adults. AIDS Care 2019; 32:155-162. [PMID: 31137949 DOI: 10.1080/09540121.2019.1622642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
HIV testing among men is critical to ending the HIV epidemic in sub-Saharan Africa. Using the Multiple Indicator Cluster Survey, 2016/2017, we examined the uptake and determinants of HIV testing among sexually active men in Nigeria. A total of 1254 young people (15-24 years) and 7866 adults (25-49 years) were included in the analysis. We conducted binary logistic regression analyses to estimate the odds ratio (OR) and adjusted OR for testing for HIV in the last 12 months preceding the survey. Approximately 18.7% of men had tested for HIV (young people [17%] vs. adult [19%], p=0.125). The overall adjusted model showed that the likelihood of HIV testing was significantly higher among those with at least primary education, currently married, who used condom at last sexual intercourse, who drank alcohol one month preceding the survey, with no discriminatory attitudes towards people living with HIV (PLHIV), exposed to media, in the rich and richest quintiles, and in the North Central Zone. Education, geopolitical zone, and discriminatory attitudes towards PLHIV were the significant factors common to both age groups. Our results suggest that HIV testing among sexually active men in Nigeria is low, and the determinants vary between young people and adults.
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Affiliation(s)
- Babayemi O Olakunde
- School of Public Health, University of Nevada, Las Vegas, NV, USA.,National Agency for the Control of AIDS, Abuja, Nigeria
| | - Daniel A Adeyinka
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada.,National AIDS & STIs Control Programme, Federal Ministry of Health, Abuja, Nigeria
| | - John O Olawepo
- School of Public Health, University of Nevada, Las Vegas, NV, USA.,Caritas Nigeria, Abuja, Nigeria
| | - Jennifer R Pharr
- School of Public Health, University of Nevada, Las Vegas, NV, USA
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Bhattacharya AA, Umar N, Audu A, Felix H, Allen E, Schellenberg JRM, Marchant T. Quality of routine facility data for monitoring priority maternal and newborn indicators in DHIS2: A case study from Gombe State, Nigeria. PLoS One 2019; 14:e0211265. [PMID: 30682130 PMCID: PMC6347394 DOI: 10.1371/journal.pone.0211265] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 01/07/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Routine health information systems are critical for monitoring service delivery. District Heath Information System, version 2 (DHIS2) is an open source software platform used in more than 60 countries, on which global initiatives increasingly rely for such monitoring. We used facility-reported data in DHIS2 for Gombe State, north-eastern Nigeria, to present a case study of data quality to monitor priority maternal and neonatal health indicators. METHODS For all health facilities in DHIS2 offering antenatal and postnatal care services (n = 497) and labor and delivery services (n = 486), we assessed the quality of data for July 2016-June 2017 according to the World Health Organization data quality review guidance. Using data from DHIS2 as well as external facility-level and population-level household surveys, we reviewed three data quality dimensions-completeness and timeliness, internal consistency, and external consistency-and considered the opportunities for improvement. RESULTS Of 14 priority maternal and neonatal health indicators that could be tracked through facility-based data, 12 were included in Gombe's DHIS2. During July 2016-June 2017, facility-reported data in DHIS2 were incomplete at least 40% of the time, under-reported 10%-60% of the events documented in facility registers, and showed inconsistencies over time, between related indicators, and with an external data source. The best quality data elements were those that aligned with Gombe's health program priorities, particularly older health programs, and those that reflected contact indicators rather than indicators related to the provision of commodities or content of care. CONCLUSION This case study from Gombe State, Nigeria, demonstrates the high potential for effective monitoring of maternal and neonatal health using DHIS2. However, coordinated action at multiple levels of the health system is needed to maximize reporting of existing data; rationalize data flow; routinize data quality review, feedback, and supervision; and ensure ongoing maintenance of DHIS2.
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Affiliation(s)
- Antoinette Alas Bhattacharya
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Nasir Umar
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Ahmed Audu
- State Primary Health Care Development Agency, Gombe, Nigeria
| | - Habila Felix
- State Primary Health Care Development Agency, Gombe, Nigeria
| | - Elizabeth Allen
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Joanna R. M. Schellenberg
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Tanya Marchant
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
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13
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Meribole EC, Makinde OA, Oyemakinde A, Oyediran KA, Atobatele A, Fadeyibi FA, Azeez A, Ogbokor D, Adebayo O, Adebayo W, Abatta E, Adoghe A, Adebayo SB, Mahmoud Z, Ashefor G, Adebayo SB, Yisa IO, Balogun A, Chukwujekwu O, Dalhatu I, Jahun I, Bamidele S, Johnson DO, Ibrahim M, Akpan F, Aiyenigba B, Omaha OI, Terpase A, Ottih C, Adelakin O, Mullen S, Orobaton N. The Nigerian health information system policy review of 2014 : the need, content, expectations and progress. Health Info Libr J 2018; 35:285-297. [PMID: 30417971 DOI: 10.1111/hir.12240] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 10/02/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Nigeria's national health information system (HIS) data sources are grouped into institutional and population based data that traverse many government institutions. Communication and collaboration between these institutions are limited, fraught with fragmentation and challenges national HIS functionality. OBJECTIVES The objective of this paper was to share insights from and the implications of a recent review of Nigeria's HIS policy in 2014 that resulted in its substantial revision. We also highlight some subsequent enactments. REVIEW PROCESS AND OUTCOMES In 2013, Nigeria's Federal Ministry of Health launched an inter-ministerial and multi-departmental review of the National Health Management Information System policy of 2006. The review was guided by World Health Organization's 'Framework and Standards for Country Health Information Systems'. The key finding was a lack of governance mechanisms in the execution of the policy, including an absent data management governance process. The review also found a multiplicity of duplicative, parallel reporting tools and platforms. CONCLUSION Recommendations for HIS Policy revisions were proposed to and implemented by the Federal Government of Nigeria. The revised HIS policy now provides for a strong framework for the leadership and governance of the HIS with early results.
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Affiliation(s)
| | - Olusesan Ayodeji Makinde
- MEASURE Evaluation, John Snow Inc., Abuja, Nigeria.,Viable Knowledge Masters, Abuja, Nigeria.,Demography and Population Studies Program, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | | | | | | | | | | | | | | | | | | | | | - Greg Ashefor
- National Agency for the Control of AIDS, Abuja, Nigeria
| | | | | | | | | | - Ibrahim Dalhatu
- US Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Ibrahim Jahun
- US Centers for Disease Control and Prevention, Abuja, Nigeria
| | | | | | | | | | | | | | | | - Chibuzo Ottih
- National Primary Healthcare Development Agency, Abuja, Nigeria
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Makinde OA, Meribole EC, Oyediran KA, Fadeyibi FA, Cunningham M, Hussein-Fajugbagbe Y, Toye F, Oyemakinde A, Mullen S. Duplication of effort across Development Projects in Nigeria: An example using the Master Health Facility List. Online J Public Health Inform 2018; 10:e208. [PMID: 30349626 PMCID: PMC6194105 DOI: 10.5210/ojphi.v10i2.9104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Duplication of effort across development projects is often the resultant effect of poor donor coordination in low- and middle- income countries which receive development assistance. This paper examines the persistence of duplication through a case study of health facility listing exercises in Nigeria. METHODS Document reviews, key informant interviews, and a stakeholder's meeting were undertaken to identify similar health facility listing exercises between 2010 and 2016. RESULTS As an outcome of this process, ten different health facility listing efforts were identified. DISCUSSIONS Proper coordination and collaboration could have resulted in a single list grown over time, ensuring return on investments. This study provides evidence of the persistence of duplication, years after global commitment to harmonization, better coordination and efficient use of development assistance were agreed to. CONCLUSIONS The paper concludes by making a proposal for strategic leadership in the health sector and the need to leverage information and communications technology through the development of an electronic Health Facility Registry that can archive the data on health facilities, create opportunity for continuous updates of the list, and provide for easy sharing of the data across different country stakeholders thereby eliminating duplication. KEYWORDS Aid Effectiveness, Donor coordination; Health Facilities; Health Information System; Health Systems; International Cooperation; Master Facility List.
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Affiliation(s)
- Olusesan Ayodeji Makinde
- MEASURE Evaluation, JSI Abuja, Nigeria
- Viable Knowledge Masters, Abuja, Nigeria
- Demography and Population Studies Program, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Emmanuel C Meribole
- Department of Health Planning, Research and Statistics, Federal Ministry of Health, Abuja, Nigeria
| | | | - Fadeke A Fadeyibi
- Department of Health Planning, Research and Statistics, Federal Ministry of Health, Abuja, Nigeria
| | | | | | - Femi Toye
- Department of Health Planning, Research and Statistics, Federal Ministry of Health, Abuja, Nigeria
| | - Akin Oyemakinde
- Department of Health Planning, Research and Statistics, Federal Ministry of Health, Abuja, Nigeria
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15
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Makinde OA, Odimegwu CO. A qualitative inquiry on the status and adequacy of legal instruments establishing infectious disease surveillance in Nigeria. Pan Afr Med J 2018; 31:22. [PMID: 30918549 PMCID: PMC6430840 DOI: 10.11604/pamj.2018.31.22.14119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 08/03/2018] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION The threat of devastating disease outbreaks is on the rise with several outbreaks recorded across the world in the last five years. The intractable Ebola Virus Disease outbreak in West Africa which spread to Nigeria was a reawakening point. This study aims to review the status and adequacy of the legal framework for disease surveillance in Nigeria. Methods: a mixed methods approach comprising of document reviews and key informant interviews was used in data collection. METHODS A mixed methods approach comprising of document reviews and key informant interviews was used in data collection. RESULTS Fourteen key informants from the federal ministry of health (FMOH) and six States were interviewed. Five legal instruments were identified and reviewed. The Quarantine Act of 1926 remains the active National Law on disease surveillance in Nigeria. An Integrated Disease Surveillance and Response Policy (IDSR) was developed in 2005 as the means for achieving the International Health Regulations (IHR). All six states claimed to have adopted the national IDSR policy though none could present a domesticated version of the policy. Key informants were concerned that Nigeria does not yet have an adequate legal framework for disease surveillance. CONCLUSION The legal instruments establishing disease surveillance in Nigeria require strengthening and possibly enactment as a National Law in order to address emerging disease threats.
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Affiliation(s)
- Olusesan Ayodeji Makinde
- Demography And Population Studies Program, Schools of Public Health and Social Sciences, University of The Witwatersrand, Johannesburg, South Africa
- Managing Partner, Viable Knowledge Masters, 22 Olusegun Obasanjo Street, Peace Court Estate, Lokogoma, Abuja Federal Capital Territory Nigeria
| | - Clifford Obby Odimegwu
- Demography And Population Studies Program, Schools of Public Health and Social Sciences, University of The Witwatersrand, Johannesburg, South Africa
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16
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Makinde OA, Sule A, Ayankogbe O, Boone D. Distribution of health facilities in Nigeria: Implications and options for Universal Health Coverage. Int J Health Plann Manage 2018; 33:e1179-e1192. [PMID: 30091473 DOI: 10.1002/hpm.2603] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 07/04/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Nigeria is considering adopting Universal Health Coverage (UHC) as an official policy target to ensure access to quality health care services for her population without financial hardship. To facilitate discussion on the topic, the President of Nigeria convened a UHC summit in March 2014 to discuss Nigeria's options and strategies to achieve UHC. A strategy for achieving UHC requires analysis of the available infrastructure to deliver the services. We review the geographic and sectoral distribution of health facilities in Nigeria and discuss implications on the UHC strategy selected. METHODS Secondary analysis of data from the Federal Ministry of Health's facility register was performed to assess the geographic and sectoral distribution of health facilities in Nigeria. Additionally, an extensive literature review was conducted to understand UHC strategies used by various countries and the associated health facility requirements. RESULTS Primary health facilities make up 88% of health facilities in Nigeria while secondary and tertiary health facilities make up 12% and 0.25%, respectively. There are more government-owned health facilities than privately owned health facilities (67% vs 33%). Secondary health facilities are predominantly privately owned. The ratio of public to private health facilities is much higher in the northern part of the country than in the southern part. CONCLUSIONS The distribution of health facilities across Nigeria is nonuniform. As such, a UHC strategy must be responsive to the variation in health facility distribution across the country. Additional investments are needed in some parts of the country to improve access to tertiary health facilities and leverage private sector capacity.
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Affiliation(s)
- Olusesan Ayodeji Makinde
- Viable Knowledge Masters, Abuja, Nigeria.,MEASURE Evaluation, John Snow Inc., Abuja, Nigeria.,Demography and Population Studies Program, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Abayomi Sule
- Healthcare Programmes, Tillit MSME Microservices, Lagos, Nigeria
| | - Olayinka Ayankogbe
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - David Boone
- MEASURE Evaluation, John Snow Inc., Arlington, Virginia
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Olutomi YS, Bassey E. An appraisal of the prevention of mother-to-child transmission of hepatitis B virus health system in Nigeria. ACTA ACUST UNITED AC 2017. [DOI: 10.5897/jphe2017.0978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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18
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Ojo AI. Repositioning health information management practice in Nigeria: Suggestions for Africa. HEALTH INF MANAG J 2017; 47:140-144. [PMID: 28978245 DOI: 10.1177/1833358317732008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The significance of health information management practice to the effectiveness of a healthcare delivery system cannot be overemphasised. A well-structured and coordinated health information management system has been known to generate the information needed for decision-making at all levels of healthcare delivery. However, the state of health information management in Nigeria, as is the case in most African countries, is a cause for concern. Observation and past studies have highlighted challenges facing the practice of health information management in Africa to be centred around the quality of professional training, inadequately qualified practitioners, disgruntled practitioners, government's indifference towards the practice, lack of policies and inadequate technological infrastructure among others. This article examines some of the challenges facing health information management practice in Nigeria and makes recommendations that may uplift the profession.
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Ayodeji Makinde O, Mami MI, Oweghoro BM, Oyediran KA, Mullen S. Investing in health information management: The right people, in the right place, at the right time. Health Inf Manag 2016; 45:90-6. [PMID: 27105478 DOI: 10.1177/1833358316639447] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2015] [Indexed: 11/17/2022]
Abstract
AIM To describe the process adopted to review the academic curriculum for training health information management professionals in Nigeria. CONTEXT Health information management professionals are responsible for managing patients' health service records and hospital information systems across health facilities in Nigeria. An assessment found many are inadequately skilled in information and communications technology (ICT) skills believed to be needed for them to play leadership roles in hospital information systems and function effectively. This was traced to a dearth of relevant ICT courses in their academic training curriculum. CASE STUDY A review of the curriculum for training health information management professionals was instituted following an agreed need to address these issues. LESSONS LEARNED Health records management is evolving across the world including the developing countries. This advancement requires evolution of training programs to meet the increasing application of ICT in this sector. CONCLUSION After several sessions, a new curriculum that addresses all the identified educational deficiencies has been developed. It is believed that this step will help improve the quality of training programs.
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Affiliation(s)
- Olusesan Ayodeji Makinde
- Viable Knowledge Masters, Nigeria MEASURE Evaluation/John Snow Inc., Nigeria Demography and Population Studies Program, Schools of Public Health and Social Sciences, University of the Witwatersrand, South Africa
| | | | - Benson Macaulay Oweghoro
- Health Records Officers Registration Board of Nigeria, Abuja, Nigeria Department of Library, Archives and Information Management, University of Ibadan, Ibadan, Nigeria
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Mokuolu OA, Ntadom GN, Ajumobi OO, Alero RA, Wammanda RD, Adedoyin OT, Okafor HU, Alabi AD, Odey FA, Agomo CO, Edozieh KU, Fagbemi TO, Njidda AM, Babatunde S, Agbo EC, Nwaneri NB, Shekarau ED, Obasa TO, Ezeigwe NM. Status of the use and compliance with malaria rapid diagnostic tests in formal private health facilities in Nigeria. Malar J 2016; 15:4. [PMID: 26728037 PMCID: PMC4700573 DOI: 10.1186/s12936-015-1064-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 12/22/2015] [Indexed: 11/17/2022] Open
Abstract
Background
Nigeria has the largest number of malaria-related deaths, accounting for a third of global malaria deaths. It is important that the country attains universal coverage of key malaria interventions, one of which is the policy of universal testing before treatment, which the country has recently adopted. However, there is a dearth of data on its implementation in formal private health facilities, where close to a third of the population seek health care. This study identified the level of use of malaria rapid diagnostic testing (RDT), compliance with test results and associated challenges in the formal private health facilities in Nigeria. Methods
A cross-sectional study that involved a multi-stage, random sampling of 240 formal private health facilities from the country’s six geo-political zones was conducted from July to August 2014. Data were collected using health facility records, healthcare workers’ interviews and an exit survey of febrile patients seen at the facilities, in order to determine fever prevalence, level of testing of febrile patience, compliance with test results, and health workers’ perceptions to RDT use. Results Data from the 201 health facilities analysed indicated a fever prevalence of 38.5 % (112,521/292,430). Of the 2077 exit interviews for febrile patients, malaria testing was ordered in 73.8 % (95 % CI 71.7–75.7 %). Among the 1270 tested, 61.8 % (719/1270) were tested with microscopy and 38.2 % (445/1270) with RDT. Compliance to malaria test result [administering arteminisin-based combination therapy (ACT) to positive patients and withholding ACT from negative patients] was 80.9 % (95 % CI 78.7–83 %). Compliance was not influenced by the age of patients or type of malaria test. The health facilities have various cadres of the health workers knowledgeable on RDT with 70 % knowing the meaning, while 84.5 % knew what it assesses. However, there was clearly a preference for microscopy as only 20 % reported performing only RDT. Conclusion In formal private health facilities in Nigeria there is a high rate of malaria testing for febrile patients, high level of compliance with test results but relatively low level of RDT utilization. This calls for improved engagement of the formal private health sector with a view to achieving universal coverage targets on malaria testing.
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Affiliation(s)
- Olugbenga A Mokuolu
- Department of Paediatrics and Child Health, College of Health Sciences, University of Ilorin, Ilorin, Kwara, Nigeria.
| | - Godwin N Ntadom
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria.
| | - Olufemi O Ajumobi
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria.
| | | | | | - Olanrewaju T Adedoyin
- Department of Paediatrics and Child Health, College of Health Sciences, University of Ilorin, Ilorin, Kwara, Nigeria.
| | | | | | | | | | - Kate U Edozieh
- Foundation for Charity and Community Health Nigeria, Abuja, Nigeria.
| | - Tolulope O Fagbemi
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria.
| | - Ahmad M Njidda
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria.
| | | | - Emmanuel C Agbo
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria.
| | - Nnamdi B Nwaneri
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria.
| | - Emmanuel D Shekarau
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria.
| | - Temitope O Obasa
- Department of Paediatrics and Child Health, College of Health Sciences, University of Ilorin, Ilorin, Kwara, Nigeria.
| | - Nnenna M Ezeigwe
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria.
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