Factors that affect the uptake of community-based health insurance in low-income and middle-income countries : a systematic protocol

Many people residing in low-income and middle-income countries (LMICs) are regularly exposed to catastrophic healthcare expenditure. It is therefore pertinent that LMICs should finance their health systems in ways that ensure that their citizens can use needed healthcare services and are protected from potential impoverishment arising from having to pay for services. Ways of financing health systems include government funding, health insurance schemes and out-of-pocket payment. A health insurance scheme refers to pooling of prepaid funds in a way that allows for risks to be shared. The health insurance scheme particularly suitable for the rural poor and the informal sector in LMICs is community-based health insurance (CBHI), that is, insurance schemes operated by organisations other than governments or private for-profit companies. We plan to search for and summarise currently available evidence on factors associated with the uptake of CBHI, as we are not aware of previous systematic reviews that have looked at this important topic

EMPLOYEE MOTIVATION AND PUBLIC SECTOR FRAUD: EVIDENCE FROM KWARA STATE, NIGERIA

This study examines the relationship between fraud and employee motivation in the Kwara State public sector with a view to ascertain what will happen to fraud occurrence if good salary, allowances and perquisites, effective working hours, conducive environment, timely promotion are put in place. Multistage sampling technique was used in obtaining the primary data used from 870 respondents selected from 7 local governments in the state and were analysed using Ordinary Least Square Regression and Friedman ANOVA test but interpreted using R2, adjusted R2, Durbin Watson Statistics, F statistics and t statistics. The results show that employee motivational factors (salary, perquisites and regular promotion) can reduce fraud activities among the state employees; this is in consonance with theoretical expectations (Douglas McGregor’s theory Y, Abraham Maslow’s needs theory and Fredric Herzberg’s two-factor theory). Contrarily, allowances, conducive environment and training show a positive relationship with fraud and this is at variance with a-priori expectations. The study recommends that government should improve the working conditions of its employee including the provision of improved salary structure, prompt payment of entitlements and regular promotions as well as provided adequate training to motivate employees towards efficiency, commitment and inhibit fraud inclinations. If all these are in place and erring officials are made to face the full wrath of the law without bias, the state economy in particular and Nigeria economy in general will be better for it.Â

Incidence of Lipolytic Mycoflora in Domestic Wastewater

The decomposition of domestic effluent by mycoflora was investigated. The microbial load enumerated for the period of 13 days, using standard microbiological techniques revealed the average total bacterial count between the range of 1.97 x 106 CFU/ml and 1.25 x 107 CFU/ml, the total coliform count have a mean range between 1.29 x 106 CFU/ml and 0.56 x 107 CFU/ml while the total fungal count showed a mean range of 3.17 x 106 CFU/ml to 2.14 x 107 CFU/ml. One hundred and twenty fungal isolates were obtained from the wastewater with the highest occurred organism as Fusarium moniliforme (19.2% occurrence), followed by Fusarium oxysporium (14.2%) and the least occurred organism Aspergillus versiculor (0.8%). The acidic pH and turbidity values obtained ranged from 3.41 - 5.98 and 1.63 - 1.79 respectively. Only 39 (32.5%) of the fungi isolates showed ability to degrade lipids with varying potentials; of which four (10.3%) were grouped among high and slight lipolysis. Among the lipolytic fungal isolates, Aspergillus spp. showed the highest occurrence of 79.5%, followed by 5.1% occurrence of Penicillium spp., Fusarium spp. and Rhizopus spp. while Absidia spp. and Thermophillus spp. showed the laeast occurrence (2.6%). It is significant that fungi associated with oil-rich wastewater also attribute the potentials of degrading the lipid component of sewages, an advantage in the treatment process. Keywords: Mycoflora, oil-rich wastewater, lipolytic, fung

Perceived Benefits of Improved Practices in Pre Harvest Tomato Production among Farmers in Afijio Local Government Area, Oyo State

This study was designed to investigate the perceived benefits of improved practices in pre-harvest tomato production among farmers in Afijio Local Government Area of Oyo State. Multistage sampling techniques were used to select respondents in the study area, with the aid of structured questionnaire. Descriptive and inferential (PPMC) statistics were used to analyze the data. Majority of the respondents (88.5%) perceived that it has lots of benefits. Also, 82.7% perceived that improved practices minimize post-harvest losses on a medium scale.  Furthermore, 85.6% perceived that improved practices minimize disease infestation on a medium scale, while 84.6% perceive it protects tomato from decaying. Also, 76.9% of the respondents perceive that improve practices helps to retain nutritional content of tomato on a medium scale.  Also, the category of the respondents that had high awareness considered the improved practices to be highly beneficial to them.  The study further concluded that the benefits derived by minority of the respondents influenced most of the respondents to have favorable perception to derivable benefits embedded in improved practices of tomato in the study area.  In addition, the result also revealed significant relationship between awareness and perceived benefits of improved practices in pre-harvest tomato production (r=0.280, p=0.004).  The study therefore recommended that the extension agents should properly train the farmers on the benefits and use of these improved practices. Adequate information should be made available to the tomato farmers on the most recent developments in tomato farming and production (pre harvest and post-harvest). The government should be able to provide adequate and glitch free loan to the farmers to enable them utilize the information and training

Socioeconomic inequalities and family planning utilization among female adolescents in urban slums in Nigeria

Background/statement of problem: Family planning (FP) utilization is important for preventing unwanted pregnancy and achieving optimal reproductive health. However, the modern contraceptive prevalence rate (mCPR) among women of childbearing age is still low in many low- and middle-income countries (LMIC), particularly in Nigeria, despite interventions to increase access and utilization. The low mCPR has been associated with a high prevalence of unwanted pregnancy, unsafe abortion, sexually transmitted infections such as HIV/AIDS, and high maternal and infant mortality in LMIC. Despite existing studies associating high family planning utilization to urban settings relative to the rural areas, the socioeconomic inequality in urban settings, especially among adolescents in urban slums has been given less research attention. This study examines the role of socioeconomic inequality on family planning utilization among female adolescents of various ethnic backgrounds in urban slums in Nigeria. Methods: The study utilized data from the Adolescent Childbearing Survey (2019). A total sample of 2,035 female adolescents of ages 14-19 years who were not pregnant at the time of the study and were resident in selected slums. Associations between socioeconomic inequalities-measured by wealth index, social status, and education-and modern contraceptive use were examined using relative and slope inequality indices, and logistic regression models. Results: The results show that only 15% of the female adolescents in the North, and 19% in the South reported modern contraceptive use. While wealth index and education were important predictors of FP use among adolescents in southern urban slums, only education was important in the North. However, the relative and slope inequality indices further indicate that adolescents with no education and those in the lowest social status group use much fewer contraceptives compared to their counterparts with higher wealth and social statuses. Those with secondary/higher education and the highest social status group, respectively, were more disadvantaged in terms of FP utilization (Education: RII = 1.86, p < 0.05; 95% C.I. = 1.02-2.71; Social Status: RII = 1.97, p < 0.05; 95% C.I. = 1.26-2.68) with results showing a more marked level of disparity when disaggregated by North and South. Conclusion: The persistent socioeconomic inequalities among female adolescents in Nigeria, especially those in the urban slums, have continued to limit their utilization. Policy measure in education, communication and subsidized contraceptives should be intensified for vulnerable female adolescents in the slums

Maxillofacial Sarcomas in Nigeria

Background: Maxillofacial sarcomas are rare constituting between 4-8% of all malignancies in the region. A few case reports of individual tumours are available while reviews of significant series is lacking. This report presents 80 cases of sarcoma collected over 23 years at a tertiary oral care centre in Kaduna, Nigeria. Method:Retrospective study of all maxillofacial sarcomas in northern Nigeria. Results: There were 406 maxillofacial malignancies of which 80 (20%) were sarcomas. Fourteen histopathologic types were found of which osteosarcoma (28%), chondrosarcoma (17%), rhabdomyosarcoma (12%) and fibrosarcoma (12%) were predominant. The male to female ratio was roughly equal (1.3:1). Patients with sarcoma were between 24 days and 90 years old (mean age 31\ub115 years) with most patients (26%) in the third decade of life. Cases presented with symptoms such as swelling (100%), pain (54%) and tissue ulceration (26%). Surgery was performed for 46% of cases treated while radiotherapy was used for 26%. Some cases refused hospital treatment because of poverty and ignorance while poor medical infrastructure limited treatment options in several cases regarded as advanced lesions. Conclusion: In Northern Nigeria, sarcomas account for 20% of all maxillofacial malignancies with the osteosarcoma as the predominant type. Most affected were people in the third decade of life. Surgery was the main modality used for treatment while some patients had no treatment due to self-discharge and late presentation. The need for improved medical awareness and upgrading of infrastructure was stressed.Fond:les sarcomes de Maxillofacial sont rares constituant entre 4-8% de toutes malignit\ue9s dans la r\ue9gion. Les rapports de quelques cas de tumeurs individuelles sont disponibles pendant que les revues de feuilleton significatif manquent. Ce rapport pr\ue9sente 80 cas de sarcome recueilli par-dessus 23 ann\ue9es \ue1 un centre de soin oral tertiaire \ue1 Kaduna, Nig\ue9ria. M\ue9thode: l'\ue9tude r\ue9trospective de tous les sarcomes de maxillofacial au nord du Nig\ue9ria. R\ue9sultats: il y avait 406 malignit\ue9s de maxillofacial dont 80 (20%) \ue9taient des sarcomes. Ils ont \ue9t\ue9 trouv\ue9s quatorze types histopathologiques dont osteosarcome (28%), chondrosarcome (17%), rhabdomyosarcome (12%) et fibrosarcome (12%) \ue9taient pr\ue9dominant. La proportion de m\ue2le \ue1 femelle \ue9tait \ue1 peu pr\ue8s \ue9gal (1.3:1). Les malades avec le sarcome \ue9taient \ue2g\ue9s d'entre 24 jours et 90 ans (\ue2ge moyen 31\ub115 ans) avec la plupart des malades (26%) dans la troisi\ue8me d\ue9cennie de vie. Les cas pr\ue9sent\ue9s avec les sympt\uf4mes tels qu'accroissement (100%), la douleur (54%) et l'ulc\ue9ration de tissu (26%). La chirurgie a \ue9t\ue9 ex\ue9cut\ue9e pour 46% de cas trait\ue9s pendant que radioth\ue9rapie a \ue9t\ue9 utilis\ue9e pour 26%. Quelques-uns ont refus\ue9 le traitement d'h\uf4pital \ue1 cause de la pauvret\ue9 et l'ignorance pendant que le manque d'infrastructure m\ue9dicale a limit\ue9 les options de traitement dans plusieurs cas consid\ue9r\ue9s comme avanc\ue9s. Conclusion: Au nord du Nig\ue9ria, les sarcomes repr\ue9sentent 20% de toutes malignit\ue9s de maxillofacial avec l'osteosarcome comme le type pr\ue9dominant. Les plus affect\ue9s \ue9taient des gens dans la troisi\ue8me d\ue9cennie de vie. La chirurgie \ue9tait la modalit\ue9 principale utilis\ue9e pour le traitement pendant que quelques malades n'ont pas eu de traitement en raison de fuite et la pr\ue9sentation tardive. Le besoin pour une forte conscience m\ue9dicale et l'am\ue9lioration d'infrastructure a \ue9t\ue9 accentu\ue9

Audit of Oral and Maxillofacial Surgical Conditions Seen At Port Harcourt, Nigeria

Background: The worldwide pattern of oral and maxillofacial surgical conditions has been rarely reported despite its significance in head and neck medicine. The Niger Delta region comprises 9 of the 36 states in the Federal Republic of Nigeria. There are scanty reports on oral and maxillofacial surgical diseases from the region despite its 95% contribution to Nigeria\u2019s oil-revenue. Methods: This retrospective survey of oral/maxillofacial surgical cases seen at a referral center in Port Harcourt, a city in the Niger delta region of Nigeria. Results: Between 2000 and 2004, our center offered specialized maxillofacial surgical services to 86 patients coming from 5 states in the Niger delta region. These patients made up 20% of all patients seen at the department within the period. There were 110 indications for surgical interventions. Most were complaints of trauma (46.4%). The rest were tumors and allied lesions (39.0%) and cysts (12.7%). Ratio of male to female patients was 1.7:1 while patients were aged between 9 and 85years (mean 31.2years, standard deviation \ub115.4). Most (n\u2009=\u200963, 73%) had surgical treatment while a significant proportion (19%) defaulted. Seventy -nine surgical procedures were performed (69 primary and 10 secondary). Primary procedures included maxillo-mandibular fixation (31.9%) and enucleation of tumor/cyst (17.4%). While our series of 86 cases over 4years appears low, there is likelihood that oral and maxillofacial surgical conditions are as common in the Niger Delta region as in other parts of Nigeria. There is scarcity of skilled manpower and equipments for the management of oral maxillofacial surgical conditions in the region. Health promotion activities are needed to improve awareness for early diagnosis of these conditions. Also, poverty alleviation measures need to be effective as defaults were often due to inability to pay for treatment. Conclusion: In many parts of the Niger Delta region of Nigeria, oral and maxillofacial surgical diseases are not uncommon causes of morbidity. However, many parts of the region lack requisite manpower for prevention and curative health activities. Defaults from hospital treatment were due to preference for traditional (unorthodox) measures and financial inability. Poverty alleviation measures need to be stepped up while the state of medical infrastructure should be enhanced in the region.Introduction: La tendance mondiale de la situation de la chirurgie buccale et maxillo a \ue9t\ue9 rarement signal\ue9e en d\ue9pit de son importance dans le domaine de m\ue9decine de la t\ueate et du cou. La r\ue9gion du Niger Delta comprend 9 des 36 Etats de la R\ue9publique F\ue9d\ue9rale du Nig\ue9ria. Il y peu de rapports sur la maladie de la chirurgie buccale et maxillo dans la r\ue9gion en d\ue9pit de sa 95% contribution au revenu p\ue9trolier du Nig\ue9ria. M\ue9thodes: Cette \ue9tude r\ue9trospective des cas d\u2019oral/chirurgie maxillo vus \ue0 un centre de referral \ue0 Port Harcourt, une ville dans la r\ue9gion du Niger Delta au Nig\ue9ria. R\ue9sultats: Entre 2000 et 2004, notre centre a offert des services sp\ue9cialis\ue9s de chirurgie maxillo au 86 patients venant de 5 Etats dans la r\ue9gion du Niger Delta. Ces patients repr\ue9sentaient 20% de tous les patients vus dans le D\ue9partement au cours de cette p\ue9riode. Il y avait des indications pour 110 interventions chirurgicales. La plupart des plaintes ont \ue9t\ue9 des traumatismes (46,4%). Les autres \ue9taient des tumeurs et des l\ue9sions connexes (39,0% et des kystes (12,7%, Proportion sexe masculine \u2013 sexe f\ue9minin \ue9tait 1. 7:1 des patients. Alors que les patients \ue9taient \ue2g\ue9s entre 9 et 85 ans (moyenne de 31,2 ans, l\u2019\ue9cart \u2013 type +- 15,4). La plupart (n = 63, 73%) ont eu une intervention chirurgicale tandis que une proportion importante (19%) \ue9tait en d\ue9faut. Soixante-dix neuf interventions chirurgicales ont \ue9t\ue9 r\ue9alis\ue9es (69 primaires et 10 secondaires). Des protocole primaires inclus de fixation maxillo-mandibulaires (31,9%) et l\u2019\ue9nucl\ue9ation de la tumeur / kyste (17,4%). Bien que notre s\ue9rie de 86 cas pendant une dur\ue9e de 4 ans appara\ueet faible, il est probable que la chirurgie buccale et maxillo conditions sont aussi fr\ue9quente dans la r\ue9gion du Niger Delta comme dans d\u2019autres r\ue9gions du Nig\ue9ria. Il y a p\ue9nurie de main-d\u2019\u153uvre qualifi\ue9 et des \ue9quipements pour la gestion de la chirurgie maxillo-orale dans la r\ue9gion. Les activit\ue9s de la promotion de la sant\ue9 sont n\ue9cessaires pour am\ue9liorer la sensibilisation pour le diagnostic pr\ue9coce de ces affections. Aussi, des mesures doivent \ueatre efficaces parce que le probl\ue8mes est souvent due \ue0 l\u2019impossibilit\ue9 de payer pour se faire soigner. Conclusion: Dans de nombreuses parties de la r\ue9gion du Niger Delta du Nig\ue9ria, les maladies de la chirurgie buccale et maxillo ne sont pas rare comme attribuable pour la cause de la morbidit\ue9. Toutefois, de nombreuses parties de la r\ue9gion, manquent de la main-d\u2019\u153uvre n\ue9cessaire pour effectuer la pr\ue9vention et de soins curatifs. Manquement de l\u2019h\uf4pital de traitement \ue9taient dues \ue0 la pr\ue9f\ue9rence des mesures traditionnelles (orthodoxe), ainsi que un probl\ue8me d\u2019incapacit\ue9 financi\ue8res. Des mesures d\u2019att\ue9nuation de la pauvret\ue9 doivent \ueatre intensifi\ue9s alors que l\u2019\ue9tat de l\u2019infrastructure m\ue9dicale devrait \ueatre renforc\ue9e dans la r\ue9gion

Analyses of Willingness to Practice Agriculture as Enterprise among Students of Tertiary Institutions in Ibadan, Oyo State

This study investigated willingness to practice agriculture as enterprise among students of tertiary institutions in Oyo State. A Multi-stage sampling technique was used to elicit data from 112 selected respondents in the study area. Data were collected using a well structured questionnaire and analyzed with the use of descriptive (frequency counts, percentages, and mean) and inferential statistic (Chi-square and Pearson Product Moment Correlation). The results showed that majority of the respondents were within the age range of 21-25 years, with majority males, whom were single in the study area. Furthermore, results revealed that majority of the respondents had low interest in agricultural enterprise preference and high constraint associated with respondents willingness to engage in agricultural enterprise in the study area. Majority of the respondents had positive willingness to practice agricultural enterprise in the study area. There was significant relationship between selected socio-economic characteristics of the respondents except Gender and Marital status. It is therefore recommended that government should motivate agricultural students by providing Youth Empowerment programmes and services directed to improve their willingness to engage in agricultural enterprises

Massive subgaleal haematoma in a 5 year old child – A case report

Subgaleal haematoma (SH) is a collection of blood between the bony skull and the loose connective tissue. It is almost a diagnosis confined to the neonatal age group with very few occurring beyond the age. Presentation could be sudden or chronic as deterioration in the cardio pulmonary status,shock, skin changes, airway obstruction and neurological sequealae.While assisted delivery with birth trauma are recognized causal factorsin the neonate, trauma to the head and blood related disorders have been reported to be major causes in older children and adults. Usually, the Small SH resolves spontaneously while the massive ones require active management; often with neuro surgical intervention. It also needs identifying the cause so as to treat and prevent a recurrence. We present a case of massive SH in a 5 year old mentally subnormal child with seizure disorder with a favourable outcome

Experimental Study on Performance Enhancement of a Photovoltaic Module Using a Combination of Phase Change Material and Aluminum Fins—Exergy, Energy and Economic (3e) Analysis

The electrical performance of a photovoltaic (PV) module is hugely affected by its tempera-ture. This study proposed a passive cooling mechanism for the cooling of a PV panel. The proposed cooling system is made up of a combination of aluminum fins and paraffin wax integrated at the PV panel’s rear side. The average temperature for the cooled panel for the entire period of the experiment is 36.62◦C against 48.75◦C for the referenced PV module. This represents an average reduction of 12.13◦C for the cooled panel. The average power for the cooled panel is 12.19 W against 10.95 W for the referenced module which is 11.33% improvement. The electrical efficiencies for the cooled panel and the referenced modules are 14.30% and 13.60%, respectively, representing an improvement of 5.15% in the electrical efficiency. The cooled solar PV module had an average exergy efficiency of 7.99% compared to 5.61% for the referenced module. In terms of the economics, the results from the computations show that LCOE of the cooled panel can range between 0.198 and 0.603 $/kWh, while that of the referenced module ranges from 0.221–0.671$/kWh depending on the number of days it operates. © 2021 by the authors. Licensee MDPI, Basel, Switzerland