Preferred approach to performance improvement among stakeholders in the health insurance industry in Southwest Region of Nigeria: Implications for Universal Health Coverage

Background: Population coverage of the National Health Insurance Scheme (NHIS) of Nigeria is low. This study aimed to assess the capacity gaps of personnel in the health insurance industry in southwest Nigeria as well determined the approach to improvement.Methods: This was a cross-sectional survey conducted in the health insurance industry in southwest Nigeria. Survey tool adapted was the World Health Organization adopted Hennessy-Hicks Training Needs Analysis Questionnaire with a set of 30 tasks which are important to the job performance of personnel in the health insurance industry. From the register made available by stakeholders, there were a total of 275 personnel in the industry in the zone. A total population of all available personnel in all the organizations were recruited into the study. Data analysis was done using the guideline provided in the Hennessy-Hicks Training Needs Analysis Questionnaire.Results: Only 32 (13.7%) reported having a training background in health-related degrees, 119 (50.9%) had work-related (actuarial science) training while 148 (63.3%) has had a form of on-the-job actuarial science and related training. The training course approach was generally preferred to organisational change in all items.Conclusion: This study showed that there were gaps in the capacity of personnel in the health insurance industry. Training course was the preferred approach to addressing these. While not neglecting organizational change, stakeholders in Nigeria and in similar settings are advised to pay more attention to personnel training to improve performance.Keywords: Performance; Improvement; Health insurance; Universal health coverage; Trainin

Prevalence and Determinants of Unintended Pregnancies in Malawi

Available statistics indicate high levels of unintended pregnancies in Africa. This study examines the prevalence and determinants of unintended pregnancies in Malawi based on 2,144 pregnant women extracted from the 2010 Malawi Demographic and Health Survey. Data were analyzed using univariate, bivariate and multinomial logistic regression models. Nearly 43% of the pregnancies were unintended of which 25% were mistimed. Multivariate analysis indicated that mistimed pregnancies are significantly influenced by the age of the respondent, fertility preference and number of children ever born. Among the variables that significantly increased the likelihood of unwanted pregnancies are age of respondent, wealth status, fertility preference, and region of residence even though potential confounding factors were used as control. The study recommends the strengthening of family planning services in order to reduce the level of unintended pregnancies. Focus should be on couples in Central Region and those having large number of childre

Geospatial distribution and bypassing health facilities among National Health Insurance Scheme enrollees: implications for universal health coverage in Nigeria.

BACKGROUND: This study was carried out to enable an assessment of geospatial distribution and access to healthcare facilities under the National Health Insurance Scheme (NHIS) of Nigeria. The findings will be useful for efficient planning and equitable distribution of healthcare resources. METHODS: Data, including the distribution of selected health facilities, were collected in Ibadan, Nigeria. The location of all facilities was recorded using Global Positioning System and was subsequently mapped using ArcGIS software to produce spider-web diagrams displaying the spatial distribution of all health facilities. RESULTS: The result of clustering analysis of health facilities shows that there is a statistically significant hotspot of health facility at 99% confidence located around the urban areas of Ibadan. The significant hotspot result is dominated by a feature with a high value and is surrounded by other features also with high values. Away from the urban built-up area of Ibadan, health facility clustering is not statistically significant. There was also a high level (94%) of bypassing of NHIS-accredited facilities among the enrollees. CONCLUSIONS: Lopsided distribution of health facilities in the study area should be corrected as this may result in inequity of access to available health services

Bio-Diesel Based Additive for Enhancing Flow of Emulsion in Pipeline

Emulsions are difficult to transport in the oil and gas industry due to its water content and high viscosity property, thus a need arises to break these emulsions down into lighter emulsions that would make it a lot more suitable for transportation. In this research, biodiesel was synthesized and used to break down relatively viscous emulsion samples into lighter emulsion samples. An apparatus was designed with the aim of determining the flowrate of four different samples in different proportions and compositions: 80% oil and 20% water (sample A), 90% sample A + 10% of biodiesel by volume (sample B), 75% of sample A + 25% of biodiesel by volume (sample C), 60% of sample A + 40% biodiesel by volume (sample D). The results showed that it was possible to significantly increase the flow of emulsions by injecting biodiesel, which was acted as a surfactant, resulting in the lowering of the surface tension of the emulsion sample. The relevance of this research work is validated as it proffers a solution to the transportation of heavy oil and emulsions from all over the world possessing the non-Newtonian flow behavior, which results in serious problems related to its transportation

Digital Education

Digital education is the process of using digital technology in teaching and learning. Teachers are under pressure to use digital technologies in teaching students and prepare them for work in a globalized digital economy. Digital education prepares students for becoming digital citizens by making them acquire skills for navigating and existing in the digital world. This paper provides a brief introduction to digital education

Shifts in age pattern, timing of childbearing and trend in fertility level across six regions of Nigeria: Nigeria Demographic and Health Surveys from 2003-2018.

Nigeria's population is projected to increase from 200 million in 2019 to 450 million in 2050 if the fertility level remains at the current level. Thus, we examined the shifts in the age pattern of fertility, timing of childbearing and trend in fertility levels from 2003 and 2018 across six regions of Nigeria. This study utilised the 2003, 2008, 2013, and 2018 Nigeria Demographic and Health Survey datasets. Each survey was a cross-sectional population-based design, and a two-stage cluster sampling technique was used to select women aged 15-49 years. The changes in the timing of childbearing were examined by calculating the corresponding mean ages at the birth of different birth orders for each birth order separately to adjust the Quantum effect for births. The Gompertz Relational Model was used to examine the age pattern of fertility and refined fertility level. In Nigeria, it was observed that there was a minimal decline in mean children ever born (CEB) between 2003 and 2018 across all maternal age groups except aged 20-24 years. The pattern of mean CEB by the age of mothers was the same across the Nigeria regions except in North West. Nigeria's mean number of CEB to women aged 40-49 in 2003, 2008, 2013 and 2018 surveys was 6.7, 6.6, 6.3 and 6.1, respectively. The mean age (years) at first birth marginally increased from 21.3 in 2003 to 22.5 in 2018. In 2003, the mean age at first birth was highest in South East (24.3) and lowest in North East (19.4); while South West had the highest (24.4) and both North East and North West had the lowest (20.2) in 2018. Similar age patterns of fertility existed between 2003 and 2018 across the regions. Nigeria's estimated total fertility level for 2003, 2008, 2013 and 2018 was 6.1, 6.1, 5.9 and 5.7, respectively. The findings showed a reducing but slow fertility declines in Nigeria. The decline varied substantially across the regions. For a downward change in the level of fertility, policies that will constrict the spread of fertility distribution across the region in Nigeria must urgently be put in place. [Abstract copyright: Copyright: © 2023 Olowolafe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Physicochemical and microbiological evaluation of acidmodified native starch derived from Borassus aethiopum (Arecaceae) shoot

Purpose: To evaluate the physicochemical properties and microbiological quality of Borassus aethiopum shoot acid-modified starch (AMS) for potential pharmaceutical applications.Methods: Modification of Borassus aethiopum native starch (NS) was carried out using 6 % w/v HCl at 37 ± 2 oC for 192 h. The AMS was characterised for their morphological, micromeritics, rheological, thermal properties as well as their microbiological quality using standard protocols.Results: AMS demonstrated increased aqueous solubility, crystallinity and slight increase in flow properties. There was a reduction in swelling and hydration capacities, amylose content as well as viscosity of the modified starch. Scanning electron microscopy analysis showed that the integrity of the modified starch granules were maintained and there was no disruption of the granular structure. Fourier transform infrared spectrophometer data confirmed the hydrolysis of NS with the increase in the intensity of the O-H stretch. AMS met United States Pharmacopoeia requirements in terms of microbiological quality, however, there was presence of Aspergillus niger.Conclusion: Modification of Borassus aethiopum shoot starch by acid treatment led to desirable improvement in some of its physicochemical properties which could improve its functional properties in pharmaceutical industries.Keywords: Native starch, Acid-modified starch, Borassus aethiopum, Microbiological quality, Physicochemical propertie

Pancreatic and Gastric Plasmacytoma Presenting with Obstructive Jaundice, Diagnosed with Endoscopic Ultrasound-Guided Fine Needle Aspiration

Pancreatic plasmacytoma is a rare disorder which may present with obstructive jaundice. Only eighteen cases have been reported in the English language literature. We present the first case of pancreatic plasmacytoma and gastric plasmacytoma diagnosed with endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). A 75-year-old male with a known history of multiple myeloma presented with obstructive jaundice and a pancreatic mass. A concomitant gastric mass due to gastric plasmacytoma was seen. The diagnosis was established via EUS-FNA of the pancreatic mass. Pancreatic plasmacytoma should be suspected in patients with a history of myeloma. EUS-FNA is a safe and effective modality in the diagnosis of pancreatic plasmacytoma. Radiation therapy should be the first-line of therapy in treating pancreatic plasmacytomas

Maternal education and diarrhea among children aged 0-24 months in Nigeria

Childhood diarrhea remains a problem in countries like Nigeria where access to potable water, good hygiene and sanitation are lacking. Maternal education is an important determinant of health status of under-five children. Very few studies have investigated the relationship between maternal education and diarrhea in children in Nigeria. Therefore, this study was implemented to fill the gap. The study design was cross-sectional and 2013 National Survey was used. Children aged 0-24 months were investigated and the dependent variable was diarrhea status of the index child in the last two weeks prior the survey. The main independent variable was maternal education. Data were analyzed using Chi-square and Logistic regression models (α=0.05). Diarrhea prevalence was 13.7% and higher (15.5%) among children of women who have no formal education, and mothers living in the North East region of Nigeria experienced the highest prevalence (26.4%). Children whose mothers had no formal education were 2.69(CI= 1.800-4.015, p<0.001) more likely to have diarrhea as compared to those who had higher education. Maternal education is an important predictor of diarrhea among children aged 0-24 months in Nigeria. Policies to reduce diarrhea among children in Nigeria should target children of the illiterate, less educated mothers and those living in the North-West.Keywords: Maternal Education, Childhood diarrhea, Nigeri