Background: There is a rising burden of non-communicable diseases (NCDs) in the sub-Saharan Africa, and calls for integration of management of selected NCDs with primary healthcare (PHC) have been unrelenting. Cost-effective interventions for the prevention and control of NCDs can be delivered at PHC facilities in low-resource settings by clinical healthcare workers (HCWs).Aim: This study compared the knowledge of HCWs in PHC facilities regarding the prevention and control of NCDs in rural and urban local government areas (LGAs) of Osun State.Setting: A comparative cross-sectional study was conducted amongst 400 eligible HCWs recruited using a multistage sampling technique in PHC facilities of six rural and six urban LGAs.Methods: A pretested self-administered case-scenarios questionnaire was used to assess the knowledge of HCWs regarding the prevention and control of three selected NCDs (diabetes, hypertension and chronic respiratory diseases). Both descriptive and inferential statistics were conducted.Results: The mean knowledge scores of HCWs regarding the prevention and control of the three NCDs were 17.76 ± 4.41 in rural and 17.62 ± 4.02 in urban LGAs out of 30 maximum scores. The proportion of HCWs with adequate knowledge in the rural LGAs (31.0%) was slightly higher than the urban LGAs (23.0%); however, it was not statistically significant (χ2 = 3.247; p = 0.072). The major determinants of adequate knowledge include cadre of HCWs, location, years in practice with professional certificate, NCD training course attendance and reported experience managing diabetic patients.Conclusion: The HCWs in PHC facilities in rural and urban LGAs of Osun State, Nigeria, had a poor knowledge regarding the prevention and control of NCDs. Training and re-training of less-skilled HCWs in the PHC facilities using relevant WHO NCD protocols and guidelines are imperatives to improve their knowledge about the prevention and control of NCDs.
Background: COVID-19 pandemic has affected virtually all spheres of society. As countries await the COVID-19 vaccine, it is imperative to plan for its financing to ensure high vaccine coverage. This study aimed to determine the willingness to pay for COVID-19 vaccine among adult residents of Osun State.Methods: A cross-sectional analytical study design was employed. Seven hundred and forty-four respondents were enrolled from three selected Local Government Areas using multistage sampling method. An interviewer-administered questionnaire in electronic format (Kobo Collect) was used for data collection while the data was analysed using SPSS version 25. Determinants of willingness to pay for COVID-19 vaccine were assessed using binary logistic regression. A p-value of < 0.05 was considered statistically significant.Results: About one-quarter, 181 (24.3%) were willing to pay for COVID-19 vaccine. The median amount respondents were willing to pay was ₦650 (IQR= ₦1563) [$1.71 (IQR = $3.96)]. Being a healthcare worker (Odds ratio = 2.0, 95% CI =1.085–3.712, p=0.026), perception of susceptibility (Odds ratio = 1.9, 95%CI = 1.232-2.973, p=0.029) and self-efficacy (Odds ratio = 2.5, 95% CI = 1.571 – 4.071, p<0.001) were significant positive determinants of willingness to pay for COVID-19 vaccine. Misconceptions or perceived barriers were not significant determinants of willingness to pay for the vaccine.Conclusion: These findings indicate that there is a need for health promotion interventions to correct misconceptions about COVID-19. Government and private donor interventions may be required to subsidize the vaccine to ensure high vaccine coverage.
Background: There is no consensus on the preferred time to remove urethral catheter post caesarean section. Aim: To compare rate of significant bacteriuria and urinary retention following 8-h (study) and 24-h urethral catheter removal (control) post elective caesarean section. Methods: A randomized controlled trial of eligible participants that underwent elective caesarean section under spinal anaesthesia between March 2019 and November 2019 was conducted. Participants (150 in each arm) were randomly assigned (1:1 ratio) to either 8-h or 24-h group. Primary outcome measures included rates of significant bacteriuria 48-h post-operatively and acute urine retention 6-h post urethral catheter removal. Analysis was by Intention-to-treat. ( www.pactr.org:PACTR202105874744483 ) Results: There were 150 participants randomized into each arm and data collection was complete. Significant bacteriuria was less in 8-h group (3% versus 6.0%; risk ratio (RR): 0.85 CI: 0.60 to 5.66; p = 0.274), though not significant. Acute urinary retention requiring repeat catheterisation was significantly higher in 8-h group (11(7.3%) versus 0(0.0%); RR: 0.07; CI: 0.87 to 0.97; p = 0.001). Mean time until first voiding was slightly higher in 8-h group (211.4 ± 14.3 min versus 190.0 ± 18.3 min; mean difference (MD): 21.36; CI: −24.36 to 67.08; p = 0.203); but patient in this group had a lower mean time until ambulation (770.0 ± 26.1 min versus 809 ± 26.2 min; MD: −38.8; CI: −111.6 to 34.0; p = 0.300). The 8-h group were significantly more satisfied (82/150 (54.7%) versus 54/150 (36.0%); p = 0.001) Conclusions: An 8-h group was associated with significant clinical satisfaction and acute urine retention compared to 24-h removal. The timing of urethral catheter removal did not affect rate of significant bacteriuria and other outcomes
Ife amongst 52 clinical and 50 non-clinically related healthcare managers and administrators. Data collection tool was a semi-structured self-administered questionnaire. Data were analysed using descriptive and inferential statistics of SPSS version 20 with statistical significance determined at p < 0.05. Results: A higher proportion of the non-clinical healthcare managers and administrators were familiar and had used more quantitative techniques than their clinical counterparts. Experience ranked highest as the current method employed by both groups for most decision needing scenarios presented. There was no statistically significant difference in their perceived effectiveness of the current methods guiding decision making. However, a statistically significant difference was found in the methods preferred by both study population only for 'reducing waiting lines, p ¼ 0.015' and in 'maximising the use of human resources, p ¼ 0.017'. Conclusions: Approach to decision making in the Nigerian health sector is still largely experiential and more of a personalised bargaining process. Acknowledgement of the relevance of quantitative techniques by clinical and non-clinically related health managers and administrators as found in this study is hoped to accelerate the adoption of these techniques. It is believed that its application will lead to improved health service delivery and health outcomes.
Background: Vaccine has been identified as the most cost-effective way of fighting COVID-19 pandemic. As most countries await the COVID-19 vaccine for mass administration amidst numerous misconceptions, it is imperative to assess willingness of the masses to take the vaccine. This study aimed to assess the determinants of willingness to uptake COVID-19 vaccines among residents of Osun State.Methods: A descriptive cross-sectional study design was employed. Seven hundred and forty-four respondents were enrolled from three selected local government areas using a multistage sampling method. Interviewer administered questionnaire, structured based on the health belief model and social cognitive theory, in electronic format (Kobo Collect) was used for data collection. Determinants of willingness to take COVID-19 vaccine were assessed using binary logistic regression.Results: About three-quarters (59.1%) of the respondents were willing to take the vaccine. There was a significant association between positive perception and willingness to take COVID-19 vaccine, p<0.001. Being a healthcare worker, having good knowledge of the disease, and willingness-to-pay for the vaccine were significant determinants of willingness to uptake COVID-19 vaccine. Presence of misconception had a negative effect on the uptake of COVID-19 vaccine.Conclusions: To achieve high COVID-19 vaccine coverage, there is a need for health promotion interventions to correct misconceptions about COVID-19. Government and private donor interventions may be required to subsidize the vaccine to care for the populace who are willing to uptake but unable to pay for the vaccine.
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