If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -The purpose of this paper is to extend the body of knowledge on health care facilities management (FM) by investigating the extent to which public hospitals in Nigeria have fared in terms of outsourced FM services. Design/methodology/approach -The paper relied on two strands of methodology common with pragmatic research. Questionnaire survey (QS) used data from 74 respondents representing 74 hospitals, while 3 of the 74 hospitals involved in the QS were selected based on their willingness to enter the case study interview. Data collected were analysed using descriptive statistics (QS) and using narrative techniques by discussing themes, sub-themes and interconnecting themes through a chronology of events, as in grounded theory. Findings -Findings revealed that most public hospitals do not have a policy framework for outsourcing in general and FM services in particular, giving room for duplication of functions and non-establishment of functional FM units to handle FM activities, while six FM services are outsourced in all the hospitals. Cleaning, security and catering services received the highest satisfaction ratings, while plant maintenance services, however, received the least satisfaction rating. Originality/value -The paper provides the first ever survey based on empirical evidence about the state of FM services outsourced in Nigeria's public hospitals. The survey suggests a relatively low level of usage of outsourcing for its services, as only a handful of FM services are outsourced in most of the hospitals.

Background: Antenatal care is one of the four pillars of safe motherhood and its benefits in preventing adverse feto-maternal outcome is proven. Commencement of antenatal care early has been shown to be key for this benefit to be fully realized. The aim of this study was to determine the antenatal booking pattern of pregnant women and its determinants in our environment.Methods: A cross sectional study of women attending the booking clinic in the University of Uyo Teaching Hospital, Akwa Ibom State, Southern Nigeria over a three-month period.Results: The mean age of the respondents was 28.5 years. The mean gestational age at booking was 18.3 weeks. The majority of the patients were married (94.1%). 68.1% had a post-secondary education. 33.5% of patients were nultiparous, while 3.5% were grand multiparous. The majority of patients (72.4%) booked late for antenatal care. Age group, marital status, mode of delivery was not significantly associated with timing of booking. High levels of patient’s education, high levels of husband’s education as well as grand multiparity were significantly associated with late booking (P<0.05). Majority (65.4%) of patients claimed that it was safe to book at any time during pregnancy.Conclusions: The majority of women booked late for antenatal care. In our study, we have found that general and health education, subsidisation of cost for antenatal care and introduction of focused antenatal care will help to reverse this trend.

Iron deficiency is the major cause of anaemia in pregnancy and indeed the major cause of anaemia worldwide. 3 A study conducted among pregnant women in Northern Nigeria reported a prevalence of 64%, 4 a much higher prevalence of 95% was reported in Ghana. 5

Context: Primary health care (PHC) is the cornerstone of the Nigerian National Health Policy. The national policy on PHC under one roof is undergoing implementation nationwide as a means of strengthening the PHC system. Akwa Ibom State (AKS) is set to commence full implementation of the policy. Aims: The aim of the study was to assess the existing human resource and infrastructure in PHC facilities in AKS. Settings and Design: A descriptive cross-sectional study was carried out in 18 facilities selected from the three senatorial zones of AKS, Nigeria. Subjects and Methods: A rapid assessment of selected PHC facilities based on a checklist adapted from the minimum standards for PHC as provided by the National PHC Development Agency. The results were analyzed using Excel and presented in tables. Results: A total of 18 health facilities were included in the study. Human resources available were 276 full time core health workers, of which 48 (17.4%) were volunteer workers. There was inequitable distribution in district and facility type as 122(44.2%) work in Ikot Ekpene Senatorial district and 242 (87.7%) of them work in the Operational Base. Basic lifesaving equipment such as resuscitation sets was unavailable in more than 50% of the health facilities. Conclusions: There are absolute deficit and inequitable distribution of available human resources in AKS PHCs. Basic-lifesaving equipment is grossly inadequate. There is an urgent need for more health workers to be employed and provision of basic equipment for the PHCs.

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Son preference is a global phenomenon that is influenced by personal, conjugal, socioeconomic and cultural factors. Objectives: This study was designed to determine child-sex preference of women among an obstetric population in Nigeria, and to obtain the reasons for such choices. Materials and Methods: A 15-item questionnaire was used to obtain information from the respondents on their child-sex preference and factors that influenced such preferences. Results: Four hundred and fifty-three women with a mean age of 29.07 + 4.70 were surveyed. Most (428, 94.5%) were married, 448 (98.9%) were Christians, 404 (89.2%) were booked attending antenatal care in the centre, and 289 (63.8%) had attained post-secondary level of education. The vast majority 294 (64.9%) of the mothers preferred to have male children in the index pregnancy. About half 223 (49.2%) of the mothers would stop trying to have their preferred child-sex after 4 attempts. The majority (171, 37.7%) of the mothers made their child-sex preference in order to attain gender balance in the family, while 129 (28.5%) of them made their preference to ensure inheritance. Mothers whose reasons for child-sex preferred were "for inheritance", "to satisfy husband", and "to consolidate marriage" significantly preferred sons, p = 0.000. Conclusion: This study has confirmed Nigeria as a patriarchal society, where women prefer to have male children as against daughters, although, the trend was towards the attainment of child-sex balance in the composition of offspring in the family. Mothers' preferences for sons in this study were significantly influenced by patriarchal considerations.

The malaria rapid diagnosis testing (RDT) landscape is rapidly evolving in health care delivery in Nigeria with many stakeholders playing or having potential for critical roles. A recent UNITAID grant supported a pilot project on the deployment of quality-assured RDTs among formal and informal private service outlets in three states in Nigeria. This paper describes findings from a series of stakeholder engagement meetings held at the conclusion of the project. The agreed meeting structure was a combination of plenary presentations, structured facilitated discussions, and nominal group techniques to achieve consensus. Rapporteurs recorded the meeting proceeding and summaries of the major areas of discussion and consensus points through a retrospective thematic analysis of the submitted meeting reports. Key findings indicate that private providers were confident in the use of RDTs for malaria diagnosis and believed it has improved the quality of their services. However, concerns were raised about continued access to quality-assured RDT kits. Going forward, stakeholders recommended increasing client-driven demand, and continuous training and supervision of providers through integration with existing monitoring and supervision mechanisms.

Introduction. Hypertension is a major global cause of cardiovascular disease and death with rising worldwide prevalence, particularly in low-income countries. With low awareness, poor treatment, and low control of hypertension in Africans, there is an increased number of patients with target organ damage (TOD), especially chronic kidney disease (CKD), as a consequence of hypertension. The aim of our study is to assess the prevalence of CKD from studies in Africa reporting TOD related to hypertension. Methods. We performed a search of PubMed/MEDLINE, Web of Science, EBSCOhost, and African Journals Online (AJOL) for studies reporting on CKD as TOD in patients with hypertension. The pooled estimate of CKD was then presented by subregions, age group, eGFR equations, and urban or rural location. Results. We identified 1,334 articles from which 12 studies were included for quantitative analysis. The studies included 5297 participants from 6 countries (Ghana, Nigeria, Uganda, Tanzania, Democratic Republic of Congo, and South Africa). The pooled prevalence of CKD was 17.8% (95% CI 13.0–23.3%), and CKD was significantly more prevalent in West Africa (21.3% (95% CI: 16.1–27.0); p < 0.0001 ) and in studies conducted in urban settings ( p < 0.001 ). CKD prevalence was not significantly different by type of GFR equation or age. Conclusion. This study reports a high prevalence of CKD related to hypertension with a higher prevalence in urban than rural areas. This emphasizes the role of hypertension in causing kidney damage, and the need for strategies to improve awareness, treatment, and control of hypertension in Africans. This study is registered with PROSPERO registration number CRD42018089263.