ObjectivesThis qualitative study explores Nigerian health care professionals’ concepts of good dying/a good death and how telemedicine technologies and services would fit the current Nigerian palliative care practice.Materials and MethodsSupported by the Centre for Palliative Care Nigeria (CPCN) and the University College Hospital (UCH) in Ibadan, Nigeria, the authors organized three focus groups with Nigerian health care professionals interested in palliative care, unstructured interviews with key role players for palliative care and representatives of telecom companies, and field visits to primary, secondary and tertiary healthcare clinics that provided palliative care. Data analysis consisted of open coding, constant comparison, diagramming of categorizations and relations, and extensive member checks.ResultsThe focus group participants classified good dying into 2 domains: a feeling of completion of the individual life and dying within the community. Reported barriers to palliative care provision were socio-economic consequences of being seriously ill, taboos on dying and being ill, restricted access to adequate medical–technical care, equation of religion with medicine, and the faulty implementation of palliative care policy by government. The addition of telemedicine to Nigeria’s palliative care practice appears problematic, due to irregular bandwidth, poor network coverage, and unstable power supply obstructing interactivity and access to information. However, a tele-education ‘lite’ scenario seemed viable in Nigeria, wherein low-tech educational networks are central that build on non-synchronous online communication.DiscussionNigerian health care professionals’ concepts on good dying/a good death and barriers and opportunities for palliative care provision were, for the greater part, similar to prior findings from other studies in Africa. Information for and education of patient, family, and community are essential to further improve palliative care in Africa. Telemedicine can only help if low-tech solutions are applied that work around network coverage problems by focusing on non-synchronous online communication.
BackgroundLatex condoms for men have been documented to offer high efficacy as both a contraceptive and protection against sexually transmitted diseases. This equally establishes the importance of continued research on female condoms. This study aims to investigate the perceived confidence to use the female condoms amongst undergraduate female students from selected tertiary institutions from Ibadan Southwestern Nigeria.MethodsThe study was a descriptive cross-sectional survey involving 388 female undergraduate students selected through a multistage sampling technique. The survey was carried using pre-tested semi-structured questionnaires. Quantitative data were analyzed using the Statistical Package for the Social Sciences to generate frequencies, cross tabulations of variables at 5% level of significance.ResultsMean age of respondents 18.26 ± 3.45 with most students being 20–24 years (55.2%), single (92.8%), Yorubas (85.6%) and from the polytechnic institutions (41.0%). Only 10.8% had good perceived confidence to use a female condom. Perceived confidence was significantly higher amongst other ethnicities (19.59 ± 3.827) compared to Yoruba ethnicity (18.04 ± 3.337) (F = 9.935; p < 0.05). Likewise, students from the Polytechnic campuses exhibited significantly higher mean scores (18.81 ± 3.187) compared to others (F = 3.724; p < 0.05). Perception towards the condom was a significant factor that influenced the confidence to use a female condom (F = 9.896; p < 0.000).ConclusionsConcerted efforts are advocated to improve the low perception exhibited towards the use of female condoms and the low perceived confidence to its utilization. This would help to transfer the decision making and control to women thus contributing to their empowerment and increased protection from unplanned pregnancies and sexually transmitted diseases.
Background Universal access to quality and affordable medicines is one of the targets of the Sustainable Development Goals (SDGs). Access to essential medicines is defined as the availability of medicine at an affordable price in public and private health institutions including retail pharmacies in the proximity of less than an hour from the home of the population. The dependence on importation to meet the drug needs of an expanding population has implications on the growth of the local pharmaceutical industry, availability, and affordability of essential medicines in the country. This study aims to understand the dynamics of tariffs and tax policy on local drug production in the pharmaceutical industry in Nigeria. Methods This was a qualitative study involving the use of Key Informant Interviews (KIIs). A total of 15 stakeholders were interviewed. Interviews conducted were analysed thematically. The data generated were analysed using Atlas.Ti version 8.2. Results Assessment of the pharmaceutical industry sub-sector underscores myriads of challenges facing the industry and explains why the pharmaceutical industries in Nigeria are performing sub-optimally. Key stakeholders in the sector expressed concern about the fact that substantial percentage of drugs consumed in Nigeria are imported. Local manufacturers are underperforming due to several factors. Some highlighted factors were unfriendly tax environment, high cost of production, infrastructural deficit, low patronage from the government, and lack of access to low-interest rate loans. However, tax incentives and tax cuts are proven strategies to encourage and facilitate the growth of entrepreneurs in the pharmaceutical industry. Conclusions Stakeholders’ perspective of implications of the tax environment on the pharmaceutical sector of Nigeria revealed the unfriendliness of the government policy to local manufacturers. Although the checklist for availability and prices of essential medicines in Osun state, Nigeria revealed that the pre-selected drugs were available in the facilities, the observed prices further affirmed the relative difficulty that is experienced by local manufacturers to compete with imported brands of the same drugs.
Despite the established roles and influence of men on women"s uptake and utilization of reproductive health care interventions, the degree of involvement with intimate issues within the household which could help to understand male involvement and support remains an under-researched topic. The aim of this study was to investigate the degree of involvement at the family level of men within sub-urban communities of Ibadan in South-West Nigeria. A cross sectional survey design was conducted among 380 men selected from sub-urban communities in Ibadan, Oyo State using multi-stage sampling. Data was obtained using pretested, semi-structured, interviewer administered questionnaires. Data were analysed using descriptive statistics, bivariate analysis and logistic regression with level of significance set at 5%. Mean age of respondents was 41.1 ± 7.6 years. Men who were knowledgeable of spouse"s menstrual cycles and ovulation dates were significantly more likely to have supported some form of public health intervention before (p<0.001). Age over 30, above secondary education, and men aware of menstrual dates of spouse were significant predictors of reproductive health interventions. Men who were aware of menstrual cycles of spouse were 96.6% more likely to be supportive or involved in reproductive health matters compared to those who were not (OR =0.034; 95% CI = 0.02 -0.07; p<0.001). Involvement of men at family level as demonstrated in this study serves to influence and explain the level of involvement with reproductive health. Further research investigating other proximal factors that influence male participation is recommended. (Afr J Reprod Health 2017; 21[3]: 76-88).Keywords: reproductive health, health disparities, male involvement, menstrual cycle, ovulatory cycles, fertility RésuméEn dépit des rôles établis et de l'influence des hommes sur la prise en charge des femmes et l'utilisation des interventions en matière de soins de santé de la reproduction, le degré de participation aux problèmes intimes au sein du ménage qui pourrait aider à comprendre l'implication et le soutien des hommes demeure un sujet de recherche insuffisamment étudié. L'objectif de cette étude était d'étudier le degré d'implication au niveau familial des hommes dans les communautés sub-urbaines d'Ibadan dans le sud-ouest du Nigéria. Une étude transversale a été menée auprès de 380 hommes sélectionnés parmi les communautés suburbaines d'Ibadan, dans l"État d'Oyo, en utilisant un échantillonnage en plusieurs étapes. Les données ont été obtenues à l'aide de questionnaires pré-testés, semi-structurés et administres à partir des interviews. Les données ont été analysées en utilisant des statistiques descriptives, une analyse bivariée et une régression logistique avec un niveau de signification fixé à 5%. L'âge moyen des répondants était de 41,1 ± 7,6 ans. Les hommes qui connaissaient bien les cycles menstruels et les dates d'ovulation des épouses étaient beaucoup plus susceptibles d'avoir soutenu une forme d'intervention de santé publique ...
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