BackgroundStillbirth is a major contributor to perinatal mortality and it is particularly common in low- and middle-income countries, where annually about three million stillbirths occur in the third trimester. This study aims to develop a prediction model for early detection of pregnancies at high risk of stillbirth.MethodsThis retrospective cohort study examined 6,573 pregnant women who delivered at Federal Medical Centre Bida, a tertiary level of healthcare in Nigeria from January 2010 to December 2013. Descriptive statistics were performed and missing data imputed. Multivariable logistic regression was applied to examine the associations between selected candidate predictors and stillbirth. Discrimination and calibration were used to assess the model’s performance. The prediction model was validated internally and over-optimism was corrected.ResultsWe developed a prediction model for stillbirth that comprised maternal comorbidity, place of residence, maternal occupation, parity, bleeding in pregnancy, and fetal presentation. As a secondary analysis, we extended the model by including fetal growth rate as a predictor, to examine how beneficial ultrasound parameters would be for the predictive performance of the model. After internal validation, both calibration and discriminative performance of both the basic and extended model were excellent (i.e. C-statistic basic model = 0.80 (95 % CI 0.78–0.83) and extended model = 0.82 (95 % CI 0.80–0.83)).ConclusionWe developed a simple but informative prediction model for early detection of pregnancies with a high risk of stillbirth for early intervention in a low resource setting. Future research should focus on external validation of the performance of this promising model.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1061-2) contains supplementary material, which is available to authorized users.

Inadequacies were found in clinical documentation, especially gross underutilization of discharge summary forms. However, some forms were properly documented, suggesting that hospital healthcare providers possess the necessary skills for quality clinical documentation but lack the will. There is a need to institute a clinical documentation improvement program and promote quality clinical documentation among staff.

There is a lack of effective health information management systems in Nigeria due to the prevalence of cumbersome paper-based and disjointed health data management systems. This can make informed healthcare decision making difficult. This study examined the information technology (IT) skills, utilisation and training needs of Nigerian health information management professionals. We deployed a cross-sectional structured questionnaire to determine the IT skills and training needs of health information management professionals who have leadership roles in the nation's healthcare information systems (n=374). It was found that ownership of a computer, level of education and age were associated with knowledge and perception of IT. The vast majority of participants (98.8%) acknowledged the importance and relevance of IT in healthcare information systems and many expressed a desire for further IT training, especially in statistical analysis. Despite this, few (8.1 %) worked in settings where such systems operate and there exists an IT skill gap among these professionals which is not compatible with their roles in healthcare information systems. To rectify this anomaly they require continuing professional development education, especially in the areas of health IT. Government intervention in the provision of IT infrastructure in order to put into practice a computerised healthcare information system would therefore be a worthwhile undertaking.

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Abstract:The Nigerian healthcare system is characterized with paper-based health information management systems and grossly inadequate IT-skilled healthcare providers. Nonetheless, the emerging digitization and globalization has the potentials to speed up the transformation of the current healthcare systems and revolutionize the provider-consumer relationship between healthcare providers and their teeming patients. This cross-sectional study determined the utilization of computer and the Internet among healthcare providers and trainees in a Nigerian public hospital (n=232). More than half (112, 52 %) of the participants were females and the vast majority (154, 72.3 %) were aged forty years or below with a Mean age of 35 ± 9 years. More than a third (78, 36.6 %) of the participants had used the Internet for over three years and early exposure to computer use did significantly influence (χ2= 3.19; p= 0.00) their current computer use. Updates on professional issues appeared the major reason (98, 46.0 %) for searching the Internet and this was mostly accessed (149, 70.0 %) through cell phone. Google Scholar was the most (154, 72.3 %) deployed search engine and participants were often constrained (93, 43.7 %) to use these technologies by inadequate time due to their busy schedules. For better appreciation of the technologies, participants solicited for further training in health IT. Healthcare providers and trainees at Federal Medical Centre, Bida have good disposition towards computer and Internet use especially to enhance their professional practice and to improve patient care quality. They overwhelmingly indicated interests for further ICT training in order to boost their sources of information for an improved healthcare practice. Any effort made to enrich their sources of information and to enhance their usability of these technologies would be worthwhile.