No abstract

Background: This study assessed the validity and reliability of healthcare workers' knowledge, attitudes, and practices instrument for uncomplicated malaria (HKAPIUM) for evaluation of healthcare workers' knowledge, attitudes, and practices (KAP) on uncomplicated malaria management in primary healthcare (PHC) facilities in Plateau state, Nigeria. Methods: Relevant variables from literature, malaria treatment guidelines for Nigeria, and World Health Organization (WHO) were used to generate and present the items for the draft HKAPIUM scale, which was first screened by six experts before administered to 121 respondents who filled and returned immediately. The data were sorted and analyzed using Rasch measurement model (Bond & Fox software ®). Results: The outcome of the initial screening showed high items content validity indices (I-CVI) (0.83-1.00) and high scale-CVI (S-CVI) {universal agreement (UA) within the experts (S-CVI/UA) (0.67-0.89) and the average CVI [S-CVI/Ave (0.94-0.98)]} for relevance, clarity, simplicity, and comprehensiveness. The Rasch analysis outputs showed good items' reliability for the three factors (KAP) > 0.9 with high separation index values of > 2.0; however person reliability were poor (< 0.6) which were confirmed by their low separation values. Goodness of fit statistics indicated nine items not fitting the model based on the suggested fit index values of 0.6 to 1.5, and ± 2 for mean square (MNSQ) and standardized Z-score (Zstds) respectively, and 0.3 to 0.7 for "point-measure correlation coefficients" (PTMEA Corr). Deletion of misfit items resulted in the items and persons' reliabilities falling above the minimum accepted limit of 0.6, with their separation values were all in the range of 1 and 2 which were acceptable. Similarly, fit index values for MNSQ infit and outfit, and Zstd parameters items in the new scale were all within the acceptable range of 0.6 to 1.5, and ±2 respectively, in addition to the positive PTMEA Corr as further confirmation of the items' fitness to the model.

No abstract

Background: Knowledge and competence of community pharmacists in HIV care, are essential for translating the goals of differentiated care into improved outcomes. Aims: To assess the knowledge and competence of community pharmacists in Jos, for differentiated HIV care and services. Study Design: Cross-sectional questionnaire survey. Place and Duration of Study: Community pharmacies in Jos North and Jos South local government areas of Plateau state, North-Central Nigeria, between September to November, 2018. Methodology: We included community pharmacists who responded to six items on knowledge of HIV therapeutics with each correct answer recording a score of 1 and zero for wrong answers. Respondents with a correct score of 5 or 6 represent good knowledge. We examined competence on a 36 item scale graded 1 for weak competence and 5 for strong competence. Factor analysis; reduce the 36 scale items down to competency domains. Frequencies and percentages for reported competencies were presented. In addition, aggregated scores for each of the competency domains were used to compare respondents based on years of experience, educational level and employment status in community pharmacy. All levels of significance were set at p≤ 0.05. Results: 73 out of 110 community pharmacists responded to the questionnaire. Of these, only 25% reported good level of knowledge in HIV therapeutics. 69% reported strong competency in identifying drug therapy problems, 31% inter-professional and patient communication. There was statistically significant difference in competency domains based on years of practice experience and employment status p<0.05. Respondents with 10 years or less of practice experience recorded higher mean ranked scores compared to those with 11 or more years. Similarly, employed pharmacists recorded higher mean ranked scores than those who owned their business. Conclusion: Overall, respondents reported low knowledge and weak competency in HIV care emphasizing the need for specialized training before implementation of differentiated care model.

The present study assessed the dimensionality and item difficulty targeting to person ability of HKAPIUM scale using Rasch Wright map approach. A HKAPIUM instrument (Cronbach’s alpha = 0.71) containing eighteen (18)-items was administered to 121 trained healthcare professionals involved in the management of uncomplicated malaria in 24 selected primary health care (PHC) facilities in Plateau state, Nigeria. The respondents filled and returned the instrument and the data was analyzed using Bond&Fox software®. The Rasch principal components analysis (Rasch-PCA) of the item residuals indicated variance explained values of 52 (knowledge), 41.1 (attitudes), and 55.4 (practices) and eigenvalues of the first contrast as 1.2, 1.8, and 1.5, respectively, which were within acceptable values thatindicated the unidimensionality of the three constructs of the HKAPIUM scale. The result showed moderate items difficulty levels for all the three constructs. The mean person ability levels of respondents with-respect-to knowledge-related items were low, while their mean person ability levels in endorsing the attitudes and practices-related items were good. The study revealed unidimensionality of the 3 constructs of HKAPIUM scale, with observed mismatch between item difficulty levels of the constructs with most of the person ability levels of the respondents.

HIV is a complex and multifaceted entity, especially in terms of the biopsychosocial model of disease. For decades, its biological characteristics have consistently outstripped our human ability to understand its molecular and pathogenic complexities. The psychosocial, legal and ethical implications are equally devastating, requiring concerted global debates and commitments on the subject of human rights. While the Universal Declaration of Human Rights (UDHR) was adopted as an instrument that guarantees and safeguards the inherent dignity and equality of every being, and as a framework for bettering the relationship between a government and its citizenry, the translation of the declaration into practical law, and its subsequent implementation, has suffered continual debates, hitches and neglect worldwide. [1] To what extent has Nigeria implemented policies protecting any of the 'rights' it purports to defend? It is evident that in Nigeria, HIV-positive people are denied employment and even access to healthcare on the basis of stigmatisation. [2] Mandatory HIV testing as a prerequisite for surgery, and even worse, the refusal of treatment to patients infected with the virus, is ethically unacceptable worldwide. [3] In India, such practice was criticised and said to have no public health justification, as it has the potential to drive vulnerable and possibly HIV-positive people out of HIV/AIDS intervention programmes. [4] Thomas [3] showed that even when the government had issued guidelines in compliance with the UDHR charter, they were rarely enforced, resulting in the widespread practice of mandatory HIV testing, with practitioners maintaining that the risk of transmission is not zero, despite universal precautions. While surgeons could argue the case on the basis of their risk of infection, mandatory testing leads to stigmatisation and discrimination. Conversely, in the developed world, many clients treat infected health practitioners with distrust, a situation that led the American College of Surgeons (ACS) to release a guideline to resolve the stalemate. [5] This study assessed the practice of mandatory HIV testing, HIV testing without consent and disclosure of test results in Nigeria.

With a prevalence rate of 3.1%, Nigeria has a generalized HIV/AIDS epidemic. Like much other developing countries, Nigeria has to collaborate with development partners to fight the HIV/AIDS scourge. This review assesses the impact of foreign aid initiatives on the fight against HIV/AIDS in Nigeria. It examines Nigeria's capacity and willingness to independently own a sustainable provision of HIV/AIDS care in the country. This paper assesses the outcomes of the HIV/AIDS scheme. Our review indicates that foreign aid initiatives were responsible for the rapid scale-up in HIV/AIDS services and improvement in morbidity and mortality rates. While foreign aids have

No abstract