Over the past decade, effective school health programme has attracted much attention in addressing various issues pertaining to school age children. This study assessed the implementation of school health programme in selected public secondary schools in Ibadan metropolis, Nigeria. Key informant interviews of 21 school head teachers were conducted while observational checklist/proforma was used to document the components of school health programme being implemented. Data from key informant interviews were analyzed using thematic approach. The assessment of the implementation of the various components of the school health programme revealed that school-feeding services and sanitary conditions could be better implemented in majority of the schools. Implementation was poor, most especially in the areas of school health services and healthful school environment. Reported reasons for poor implementation from key informant interviews were lack of funds and inadequate health facilities. Concerted efforts are required to intensify awareness campaign on National School Health Policy. The implementation of School Health Programme should be strengthened through advocacy to relevant stakeholders for provision of funds and health facilities.
Background
Childhood immunization rate is lowest in the core-North Nigeria. We examined the relationship between inequality in household wealth and complete childhood immunization in that part of the country.
Methods
A cross-sectional survey was conducted among 4079 mothers with children 12–23 months of age. Children were considered ‘fully-immunized’ if they received all the vaccines included in the immunization schedule. Data were analyzed using descriptive statistics and logistic regression models (α=5.0%).
Results
About 39% and 5.0% children of the rich and poor received complete immunization respectively. Also, 64.2% and 49.6% children of the rich women received BCG and DPT 3 compared to 15.9% and 8.7% observed among the children of the poor. Higher proportion of children from poor households (40.6%) received no immunization than 20.8% found from the rich households. The likelihood of receiving complete immunization was 1.95(C.I=1.35–2.80, p<0.001) times higher among the children of the rich than the poor. Other important predictors of childhood immunization were age, religion, media access, working status, husband's education, prenatal attendants and delivery place.
Conclusion
Disparities existed in childhood immunization between the poor and rich in the core-North part of Nigeria. Policy makers should institute effective interventions that will assist children from poor households to improve their immunization access.
IntroductionPrimary health care is widely accepted as the first point of care; yet, individuals requiring healthcare engage in self-referrals to higher levels of care thereby by-passing primary care. Little is known of the extent to which self-referrals are carried out when care is needed. This study thus sought to determine the prevalence of self-referral, its patterns and factors influencing self-referrals amongst federal civil servants in Southwestern Nigeria.MethodsA cross-sectional study was carried out among 300 federal civil servants who were interviewed using validated and pre-tested interviewer-administered semi structured questionnaires. Data was analyzed using univariate and Chi-square test at level of significance set at P <0.05.ResultsMean age of the respondents was 39.96 ± 9.1 years with majority being married (80.7%); 90.7% completed tertiary education (and 76.7 % were middle grade (7-12) level officers. Most (60.0%) of the respondents had ever engaged in self-referral. Malaria was the commonest health problem (39.7%) for self-referral to secondary or tertiary facilities. Desire for quality service (35.7%) and competent staff (35.2%) were the commonest reasons for self-referral to a higher level of health care. More female respondents (76.0%) compared to male respondents (64.0%) significantly engaged in self-referral (p = 0.02, X2 = 5.14). Respondents having good knowledge of referral practices engaged less in self-referral compared to those with poor knowledge. (p = 0.02, X2 = 5.43).ConclusionHaving good knowledge of referral practices and being male are positively associated with referral practices. Creating awareness and improving knowledge on referral practices with special emphasis on women population are desirable strategies for encouraging the use of primary health care as first of point of contact with health systems.
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