BackgroundAs part of its Family Planning 2020 commitment, the Nigerian government is aiming for a contraceptive prevalence rate of 36% by 2018, and in 2014, approved a policy to allow community health extension workers (CHEWs), in addition to doctors, nurses, and midwives, to provide contraceptive subdermal implants. There is a lack of rigorous evidence on the safety of long-acting reversible contraceptive provision, such as implants, among lower cadres of health providers.ObjectiveThis study aimed to compare implant provision by CHEWs versus nurses and midwives up to 14 days post insertion.MethodsThe quasi-experimental, noninferiority study will take place in public sector facilities in Kaduna and Ondo States. In each state, we will select 60 facilities, and from these, we will select a total of 30 nurses and midwives and 30 CHEWs to participate. Selected providers will be trained to provide implant services. Once trained, providers will recruit a minimum of 8125 women aged between 18 and 49 years who request and are eligible for an implant, following comprehensive family planning counseling. During implant insertion, providers will record data about the process and any adverse events, and 14 days post insertion, providers will ask 4410 clients about adverse events arising from the implant. Supervisors will observe 792 implant insertions to assess service provision quality and ask clients about their satisfaction with the procedure. We will conclude noninferiority if the CI for the difference in the proportion of adverse events between CHEWs and nurses and midwives on the day of insertion or 14 days post insertion lies to the right of −2%.ResultsIn September and October 2015, we trained 60 CHEWs and a total of 60 nurses and midwives from 12 local government areas (LGAs) in Kaduna and 23 LGAs in Ondo. Recruitment took place between November 2015 and December 2016. Data analysis is being finalized, and results are expected in March 2018.ConclusionsThe strength of this study is having a standard care (nurse and midwife provision) group with which CHEW provision can be compared. The intervention builds on existing training and supervision procedures, which increases the sustainability and scalability of CHEW implant provision. Important limitations include the lack of randomization due to nurses and midwives in Nigeria working in separate types of health care facilities compared with CHEWs, and that providers self-assess their own practices. It is unfeasible to observe all procedures independently, and observation may change practice. Although providers will be trained to conduct implant removals, the study time will be too short to reach the sample size required to make noninferiority comparisons for removals.Trial RegistrationClinicalTrials.gov NCT03088722; https://clinicaltrials.gov/ct2/show/NCT03088722 (Archived by WebCite at http://www.webcitation.org/6xIHImWvu)
Background: As part of its Family Planning 2020 commitment, the Nigerian government is aiming for a contraceptive prevalence rate of 36% by 2018, and in 2014, approved a policy to allow community health extension workers (CHEWs), in addition to doctors, nurses, and midwives, to provide contraceptive subdermal implants. There is a lack of rigorous evidence on the safety of long-acting reversible contraceptive provision, such as implants, among lower cadres of health providers.Objective: This study aimed to compare implant provision by CHEWs versus nurses and midwives up to 14 days post insertion. Methods:The quasi-experimental, noninferiority study will take place in public sector facilities in Kaduna and Ondo States. In each state, we will select 60 facilities, and from these, we will select a total of 30 nurses and midwives and 30 CHEWs to participate. Selected providers will be trained to provide implant services. Once trained, providers will recruit a minimum of 8125 women aged between 18 and 49 years who request and are eligible for an implant, following comprehensive family planning counseling. During implant insertion, providers will record data about the process and any adverse events, and 14 days post insertion, providers will ask 4410 clients about adverse events arising from the implant. Supervisors will observe 792 implant insertions to assess service provision quality and ask clients about their satisfaction with the procedure. We will conclude noninferiority if the CI for the difference in the proportion of adverse events between CHEWs and nurses and midwives on the day of insertion or 14 days post insertion lies to the right of −2%.
Using a novel combination of methods and datasets from two national funding agency contexts, this study explores whether review sentiment can be used as a reliable proxy for understanding peer reviewer opinions. We measure reviewer opinions via their review sentiments both on specific review subjects and on proposals’ overall funding worthiness with three different methods: manual content analysis and two dictionary-based sentiment analysis algorithms (TextBlob and VADER). The reliability of review sentiment to detect reviewer opinions is addressed by its correlation with review scores and proposals’ rankings and funding decisions. We find in our samples that 1) review sentiments correlate with review scores or rankings positively, and the correlation is stronger for manually coded than for algorithmic results; 2) manual and algorithmic results are overall correlated across different funding programmes, review sections, languages, and agencies, but the correlations are not strong; 3) manually coded review sentiments can quite accurately predict whether proposals are funded, whereas the two algorithms predict funding success with moderate accuracy. Results suggest that manual analysis of review sentiments can provide a reliable proxy of grant reviewer opinions, whereas the two SA algorithms can be useful only in some specific situations. Peer Review https://publons.com/publon/10.1162/qss_a_00156
Task sharing is a strategy with potential to increase access to effective modern contraceptive methods. This study examines whether community health extension workers (CHEWs) can insert contraceptive implants to the same safety and quality standards as nurse/midwives. We analyze data from , clients of CHEWs and nurse/midwives who participated in a noninferiority study conducted in Kaduna and Ondo States, Nigeria. Adverse events (AEs) following implant insertions were compared. On the day of insertion AEs were similar among CHEW and nurse/midwife clients-. percent and . percent, adjusted odds ratio (aOR) . ( percent CI .-.)-but noninferiority could not be established. At follow-up . percent of CHEW clients and . percent of nurse/midwife clients experienced AEs. There was strong evidence of effect modification by State. In the final adjusted model, odds of AEs for CHEW clients in Kaduna was . ( percent CI .-.) compared to nurse/midwife clients, and . ( percent CI .-.]) in Ondo. Noninferiority could not be established in either State. Implant expulsions were higher among CHEW clients (/) compared to nurse/midwives (/). Results show the feasibility of training CHEWs to deliver implants in remote rural settings but attention must be given to provider selection, training, supervision, and follow-up to ensure safety and quality of provision.
Purpose: To assess the awareness and satisfaction of online renewal of practice licence among pharmacists in Nigeria.Methods: This was a cross-sectional study among pharmacists in Nigeria. Participants were recruited through; online (via social media platforms) or in person at Pharmacists Council of Nigeria (PCN) office during application for renewal of license.Results: A total of 878 participants completed the survey. Of this, 97.4 and 79.9 % were aware and satisfied with the online process, respectively. The respondents rated the process as excellent (19.1 %), fair (22.2 %), good (55.0 %) and poor (3.6 %). Most of the reported challenges included linking payment of association dues with license renewal, poor customer service and password retrieval.Conclusions: The level of awareness and satisfaction of the online renewal of annual licence among pharmacists in Nigeria is high. Measures are still needed to improve the online application process. Keywords: Pharmacists Council, Online, Licence, Pharmacist, Practice
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