Post Covid-19 Agenda: Maximizing human resources for health towards Universal Health Coverage in Africa

Aim: To analyse options for maximising the capacity of human resources for health to achieve Universal Health Coverage (UHC) in Africa. Methods: Articles were retrieved from a Pubmed search and additional snowballing was conducted to provide other relevant sources. Further utilizations were made of Campbell's modified framework of the Human Resources for Health (HRH) and Universal Health Coverage with the WHO labour market dynamics framework for Universal Health Coverage. Four sub-themes viz improved HRH performance, Labour Market Factors, Rural Health Workers Retention Factors, and Information Technology Factors were analysed. Results: Labour market factors such as the dynamics of demand and supply of health workers determine the availability of health workers. Supportive supervision enables the health workers to improve in their performance and enhance optimised utilisation of available resources. This supervision can be more effective by complementing it with tools such as information technology that focus on improving the quality of health care, considering the growth in the number of internet and broadband users in the continent. Conclusion: Expanding the training opportunities for health workers and also increasing the funding to human resources for health are useful policy options to consider. Cost-effective approaches such as a focus on community health committees which stimulate the demand for health services in rural communities to tackle the disproportionate distribution of health workers should be considered in the context of the uncertain economic aftermath of the covid-19 outbreak. Sources of Funding Nil Acknowledgement We express profound gratitude to Prof Flavia Senkubuge for providing technical help and writing assistance during the preparation of this manuscript. We also appreciate Dr. Aborisade Adetayo for assisting with editing of the manuscript. Conflicts of Interest The authors declare no conflict of interest. Author Contributions MIA drafted the entire manuscript. ICE provided a critical review and made substantial contributions to the design of the manuscript. &nbsp

Post Covid-19 Agenda: Maximizing human resources for health towards Universal Health Coverage in Africa

Aim: To analyse options for maximising the capacity of human resources for health to achieve Universal Health Coverage (UHC) in Africa. Methods: Articles were retrieved from a Pubmed search and additional snowballing was conducted to provide other relevant sources. Further utilizations were made of Campbell's modified framework of the Human Resources for Health (HRH) and Universal Health Coverage with the WHO labour market dynamics framework for Universal Health Coverage. Four sub-themes viz improved HRH performance, Labour Market Factors, Rural Health Workers Retention Factors, and Information Technology Factors were analysed. Results: Labour market factors such as the dynamics of demand and supply of health workers determine the availability of health workers. Supportive supervision enables the health workers to improve in their performance and enhance optimised utilisation of available resources. This supervision can be more effective by complementing it with tools such as information technology that focus on improving the quality of health care, considering the growth in the number of internet and broadband users in the continent. Conclusion: Expanding the training opportunities for health workers and also increasing the funding to human resources for health are useful policy options to consider. Cost-effective approaches such as a focus on community health committees which stimulate the demand for health services in rural communities to tackle the disproportionate distribution of health workers should be considered in the context of the uncertain economic aftermath of the covid-19 outbreak. Sources of Funding Nil Acknowledgement We express profound gratitude to Prof Flavia Senkubuge for providing technical help and writing assistance during the preparation of this manuscript. We also appreciate Dr. Aborisade Adetayo for assisting with editing of the manuscript. Conflicts of Interest The authors declare no conflict of interest. Author Contributions MIA drafted the entire manuscript. ICE provided a critical review and made substantial contributions to the design of the manuscript. &nbsp

Spreading Oro-fascial Infections: Is the Trend in Burden Changing?

Spreading orofacial infections are often encountered and managed by oral and maxillofacial surgeons. Several factors have been attributed to this spread. It has been reported to be the leading cause of death in maxillofacial patients seen in most hospitals, especially in a resource constraint country like Nigeria. The current study aims to assess factors that contribute to the disease burden of patients with orofacial infection. The case files of 101 patients who were diagnosed clinically of spreading orofacial infections with radiographic confirmation of involved tooth/teeth managed at the LASUTH and OAUTHC Ile Ife over twelve months. The following information was obtained in a prospective study using a proforma; patients’ demographics, underlying morbidity, teeth involved, site location, fascial spaces involved, treatment, and outcome. Patients with incomplete data were excluded. All patients had adequate rehydration followed by incision and drainage or decompression as the case required before administration of empirical antibiotics via the intravenous route. Data were analyzed using IBM SPSS version 21.0. One hundred and one cases were retrieved for the study. There was an almost equal gender distribution of males 51 (50.05%) and females 50 (49.50%). The female to male ratio of 1.02:1.00. The age range was 12-82 years, the mean age for females and males was (17.6 ± 0.448). The majority of the cases were in the 21-40 age group. A significant percentage (95.0%) of the patients were managed as in-patients. The majority of the death 8 out of 12 were recorded among the age group 51-82 years. Mandibular teeth were more affected compared to the maxillary teeth. Though not statistically significant (p=0.054). The lower right first and second molar (17.82%) each were mostly implicated in the mandible while the maxillary upper right second molar tooth (one-third of the total number of maxillary teeth affected) was the most implicated tooth in the maxilla. Twenty-five of the patients had underlying medical conditions with diabetes mellitus being the commonest (66.7%) among the patients under review. Majority of the patients presented with multiple facial spaces involvement with Ludwig’s angina being the commonest presentation. The submandibular space was the most involved space both in single and multiple spaces involvement. The mortality recorded were in patients with Ludwig’s angina, temporal and parapharyngeal space involvement. Seven (58.33%) out of the recorded death had involvement of more than four fascial spaces. The commonest treatment offered was incision and drainage with the extraction of the offending tooth/teeth. There was a positive correlation between the length of hospital stay and the duration of drain in-situ. Fascial space infections in a resource- and personnel-scarce setting still confers a great burden on management. The need for quick surgical intervention, aggressive and adequate antibiotics administrations, high protein nutritional support, and co-managing of patients with other medical teams in controlling associated morbidities are very essential to a good outcome