Demand for Health Care Services and Child Health Status in Nigeria- A Control Function Approach

Nigeria has experienced significant increase in economic growth in the last decade yet the health indicators are very poor particularly in the rural sector where poverty incidence is high. The study attempts to provide insights into the determinants of health status and the demand for health care in Nigeria. Using the 2008 DHS data, the effect of the demand for health care service as a complement to other unobservable factors that affect health status of children is explored based on the complementary hypothesis. The data was analyzed using different estimation procedures and the result of the control function is explained. The demand for immunization for children is significant in explaining child health. This expectedly induces the use of other health enhancing inputs and behaviours. In poor families, immunization was not significant. Also, older children and those residing in the rural areas suffer more from poor health but educated mothers have healthier children. Policy recommendation is that the immunization coverage area be increased. In addition, improving education among women will enhance the demand for health inputs and improve the health of their children particularly for the poor and those residing in the rural areasKey words: complementarity, control function, immunization, Nigeria, underweight

Rubella IgG antibody in women of child-bearing age in Oyo state.

230 females of childbearing age from four different towns in Oyo State were screened for rubella specific IgG antibody using a sandwich ELISA test kit. Rubella IgG was detected in 215 (93.5%) of the females. 96% of the non-pregnant, 87.5% of the primigravida and 76% of the multigravida screened positive to the antibody. Ogbomoso, Ibadan, Oyo and Iseyin respectively had 96.1%, 94.2%, 90.5% and 88.2% of their samples positive for the rubella IgG antibody in them. It is imperative for the government to ensure that rubella vaccine is made available and routine so as to avert the risk of congenital rubella syndrome. African Journal of Clinical and Experimental Microbiology Vol. 9 (2) 2008 pp. 78-8

The Acceptance and the Perception of Mastectomy by Males whose Spouses are Diagnosed with Breast Cancer in South Western, Nigeria: Are male spouses an obstacle?

Of several modalities of treatments available for breast cancers, mastectomy is the most dramatic and traumatic. This is because it involves the removal of an organ of a woman's sexuality and with the attendant risk of marital disharmony. This study investigated the perception and the acceptance of mastectomy among male spouses of female patients with breast cancers. We prospectively recruited 108 participants from two teaching hospitals and a private hospital in South Western, Nigeria. The study recruited spouses of female patients newly diagnosed with breast cancers that were yet to have surgery. Relevant data were obtained through interview of the participants by the authors. The mean age of participants in the study was 44.34(±5.7) years. Less than half (48.1%) of the participants accepted the procedure for their female spouses prior to counseling which rose up to 84.3% after counseling. The main reason for declining mastectomy was disfigurement. Age greater than 65 years (p=0.0274), previous knowledge of mastectomy (p=0.0107) and counseling (p<0.001) were associated with higher acceptance rate while educational status, religion and social class showed no statistical significant difference. Spouses of patients with locally advanced diseases accepted mastectomy more readily for their female partners as compared to those with early and metastatic diseases (p<0.001). About 79% of those who accepted the procedure prior to counseling would exhibit negative behavior toward their partners. Majority of male spouses of females with breast cancers would not readily accept mastectomy for their female spouses and would have negative perception of their partners after mastectomy. We thus recommend that health care workers should involve men in breast cancer related education.Keywords: Acceptance, mastectomy, male spouse, female breast cancer and obstacl

The Nigerian national blindness and visual impairment survey: Rationale, objectives and detailed methodology.

BACKGROUND: Despite having the largest population in Africa, Nigeria has no accurate population based data to plan and evaluate eye care services. A national survey was undertaken to estimate the prevalence and determine the major causes of blindness and low vision. This paper presents the detailed methodology used during the survey. METHODS: A nationally representative sample of persons aged 40 years and above was selected. Children aged 10-15 years and individuals aged <10 or 16-39 years with visual impairment were also included if they lived in households with an eligible adult. All participants had their height, weight, and blood pressure measured followed by assessment of presenting visual acuity, refractokeratomery, A-scan ultrasonography, visual fields and best corrected visual acuity. Anterior and posterior segments of each eye were examined with a torch and direct ophthalmoscope. Participants with visual acuity of < = 6/12 in one or both eyes underwent detailed examination including applanation tonometry, dilated slit lamp biomicroscopy, lens grading and fundus photography. All those who had undergone cataract surgery were refracted and best corrected vision recorded. Causes of visual impairment by eye and for the individual were determined using a clinical algorithm recommended by the World Health Organization. In addition, 1 in 7 adults also underwent a complete work up as described for those with vision < = 6/12 for constructing a normative data base for Nigerians. DISCUSSION: The field work for the study was completed in 30 months over the period 2005-2007 and covered 305 clusters across the entire country. Concurrently persons 40+ years were examined to form a normative data base. Analysis of the data is currently underway. CONCLUSION: The methodology used was robust and adequate to provide estimates on the prevalence and causes of blindness in Nigeria. The survey would also provide information on barriers to accessing services, quality of life of visually impaired individuals and also provide normative data for Nigerian eyes

Bacteremia among febrile patients attending selected healthcare facilities in Ibadan, Nigeria

Background The relative contribution of bacterial infections to febrile disease is poorly understood in many African countries due to diagnostic limitations. This study screened pediatric and adult patients attending 4 healthcare facilities in Ibadan, Nigeria, for bacteremia and malaria parasitemia. Methods Febrile patients underwent clinical diagnosis, malaria parasite testing, and blood culture. Bacteria from positive blood cultures were isolated and speciated using biochemical and serological methods, and Salmonella subtyping was performed by polymerase chain reaction. Antimicrobial susceptibility was tested by disk diffusion. Results A total of 682 patients were recruited between 16 June and 16 October 2017; 467 (68.5%) were Conclusions The study demonstrates that bacteria were commonly recovered from febrile patients with or without malaria in this location. Focused and extended epidemiological studies are needed for the introduction of typhoid conjugate vaccines that have the potential to prevent a major cause of severe community-acquired febrile diseases in our locality.</p