Nigerian family physicians\u27 knowledge of oral diseases and their attitude to oral health care - a pilot study

Objective: Access to oral health care in most developing countries is poor and physicians may be in a better position to facilitate early detection and prompt referrals for oral diseases in such populations. The objective of this study was to assess the oral health knowledge of family physicians in Lagos, Nigeria and to determine their attitudes to oral health care. Method: The study was a cross-sectional, self administered questionnaire survey of family health practitioners in fifty randomly selected private hospitals in Lagos metropolis. The questionnaire assessed knowledge on the aetiology and prevention of dental caries and periodontal diseases as well as oral health related behaviour of the physicians. Result: Eighty-one questionnaires were returned properly filled. Forty-two (51.9%) respondents had ever experienced dental treatments. Nearly all (95.1%) respondents had been consulted by their patients for dental problems. Oral health knowledge was not satisfactory with 54% and 45.7% of them being able to give a correct description of dental caries and periodontal diseases respectively. Physicians who had practiced for ten years or less had better knowledge than those who had practiced for over fifteen years. This was however not statistically significant. Findings also revealed misconceptions about the aetiology of these diseases. Conclusion: Oral health should be included in update courses for medical doctors especially those designated as primary health care providers. Training curriculum of family medicine practitioners should be expanded to include oral health education

Building capacity for African primary Care Research

No abstract availabl

The Physics of Family Medicine as Basis for Training of Family Physicians in West Africa

The biopsychosocial model is a philosophy of clinical care and a practical clinical guide. Philosophically, it is a way of understanding how suffering, disease, and illness are affected by multiple levels of organization, from the social to the subatomic particle using the General System Theory. The aim of this paper was to bring to the attention of doctors the thinking that underpins the unique training of family physicians as specialist in West Africa. A review of relevant literature was done using internet search engines on the subject. Qualitative analysis methods included collation, theme identification and triangulation. Result revealed a major hindrance in the advancement of Family practice in West Africa as a discipline is the insistence on describing it in the terminology of traditional biomedical medicine. The traditional biomedical medicine, the doctor fits the patient's illness into a precise class linking the symptoms and signs with organic pathology and identifying single external causes. He explains the patient's illness in terms of his own worldview during the consultative process by taking a domineering stance on the assumption that he, the doctor has sufficient knowledge and skills about the positive health outcome of the individual patient. On the other hand, Family Medicine interprets symptoms in terms of its own method and objectives. Interpretation of the patient (patient-centered method) rather than the symptoms (disease-centered method) is the crux of clinical competence in family practice. This method is consistent with Einsteinian physics rather than Newtonian physics which are the basis of traditional biomedical medicine. In conclusion, the value of the biosychosocial model is not the discovery of a new scientific law, but the application of medical knowledge to the needs of each patient for which the family physician is adequately trained. This forms the basic science background for the training of family physician in West Africa as envisaged by the founding fathers in the 1980s.. Keywords: Biopsychosocial model, Dualism, Reductionism, Clinical practice, Training, family medicine. The Nigerian Medical Practitioner Vol. 51 (6) 2007: pp. 119-12

Clients satisfaction of antenatal care services in public and private health care facilities in Lagos

Background: Antenatal care involves screening for health and socioeconomic conditions likely to increase the possibility of specific adverse pregnancy outcomes, providing therapeutic interventions known to be effective and educating pregnant women about planning for safe birth. Quality and customer service have been identified as critical strategic issues for both public and private sector organizations. In private sector, customer satisfaction and loyalty are secured through high quality services. Public sector organizations are under constant pressure to improve customer service on a continuous basis. Patient satisfaction has traditionally been linked to the quality of services given and the extent to which specific needs are met.Objective: Aim of the study was to determine and compare factors influencing clients' satisfaction with antenatal care services in public and private primary care facilities.Methods: A descriptive cross-sectional comparative study design was used to recruit 209 respondents each in public and private health facilities in Surulere local government, Lagos state. A questionnaire was used for data collection of socio-demographics and overall satisfaction with care. The data obtained was presented as figures and tables .Chi-square (X2) test was used to test for association between the independent and dependent variables at probability value <0.05 (P-value <0.05). Ethical approval was obtained from Lagos University Teaching Hospital, Health Research and Ethics Committee [LUTH HREC]. Approval for the study was also sought from the authorities of all the selected facilities.Results: The percentage of respondents who were very satisfied with ANC services was higher in private (65.1%) than public (37.3 %). More women (98.6%) would come back in subsequent pregnancy while a lesser proportion (94.7%) in public facilities would come back. More women (98.6%) in private would recommend clinic to others while a lesser proportion (96.7%) in public would do the same.Conclusion: Women receiving antenatal care in private facilities are more satisfied than women attending public health facilities.Keywords: Antenatal care, clients' satisfactio

Clients Expectations And Perception Of Quality Of Antenatal Care Services In Public And Private Health Care Facilities In Surulere Local Government Lagos

Background: Antenatal care is an important health service which detects and reduces the risk of complications among pregnant  women. The quality of care is likely to influence effective utilization and compliance with interventions. Lack of adequate quality of antenatal care is a major public health problems contributing significantly to high morbidity and mortality of pregnant women.  Identification of the gaps between expectation and perception of quality of antenatal services will improve antenatal care.Objective: The aim of this study was to determine and compare factors that influence clients expectations and perception of quality of antenatal care services in public and private primary care facilities.Method: This is a comparative, cross-sectional study that assessed the factors that influence client's perception of quality of antenatal care services on public and private primary health care facilities on Surulere Local Government. Data was collected using an adapted Servqual instrument questionnaires administered by interviewers to 418 women receiving antenatal care services selected through systematic sampling. Data was analysed with Epi-Info version 7.0.9.7 .Result: The mean aggregate expectation and perception scores were higher in the private health facilities (82.21 and 82.18) than public  health facilities (80.43 and 79.65). Proportions with positive expectation and perception were higher in the private health facilities (49.8% and 55.5%) than public health facilities (28.2% and 20.6%). The proportion with positive perception was significantly lower than the proportion with positive expectation in public health facilities.Conclusion: The women receiving antenatal care in private health facilities had higher positive expectation and perception of quality of care than women receiving antenatal care in public health facilities. Keywords: Perception, Expectation, Quality, Antenatal car

Laboratory Survey of Significant Bacteriuria in a Family Practice Clinic – Is the Spectrum of Causative Agents Changing?

Urinary tract infection correlates with significant bacteriuria. Empiric and definitive therapy depends on the sensitivity pattern of the causative agents, so it is essential to keep abreast of changes in the causative organisms. This study was carried out to determine the causative agents of significant bacteriuria and their antibiotic sensitivity pattern. Mid stream urine specimens were collected from all patients attending the Family Medicine Clinic of the Lagos State University Teaching Hospital, Ikeja Lagos in July and August of 2005. The urine specimens were transported on ice to the Medical Microbiology and Parasitology Department of the College of Medicine, Idi-Araba. Significant bacteriuria was determined by the standard loop method. Culture was performed on MacConkey agar (oxoid) and blood agar base (Oxoid) and Isolates were identified by standard laboratory methods. Antibiotic sensitivity was by disc diffusion method. Four hundred and fifty urine specimens surveyed for bacteria were from 251 females (55.8%) and 199 males (44.2%) with age range 13 to 89 years. Ninety four patients (20.9%) had significant bacteriuria and 14 were symptomatic, making the prevalence rate of symptomatic bacteriuria 3.1%. Out of 91 patients who had been on antibiotics, a significantly higher proportion (52%) had bacteriuria while only 13.4% of those who had not been on antibiotics had bacteriuria. Klebsiella and Enterobacter species were more commonly isolated than E. coli. Most of the isolates were resistant to cotrimoxazole (89%), tetracycline (69.1%) and amoxicillin (88.1%). Sensitivity rates to the urinary antiseptics ranged from 54.2 to 55.9%. Many of the bacteria were sensitive to ofloxacin(92.9%), ciprofloxacin(84.7%), cefotaxime(72.9%), ceftriaxone(86.4%) and ceftazidime(88.1%). Sensitivity to the aminoglycosides ranged from 57.7 to 59.3%. The spectrum of isolates in this study and the high rate of antibiotic resistance suggest that many patients in this population will probably benefit more from treatment of UTI based on routine antibiotic sensitivity testing rather than empiric therapy.. Keywords: Asymptomatic bacterivria, significant bacterivria, antibiotic sensitivity, antibiotic resistance, laboratory survey. Nigerian Journal of Health and Biomedical Science Vol. 6 (1) 2007: pp. 52-5

Attitudes and practices of students of health sciences of the college of medicine, University of Lagos, Nigeria towards people living with HIV/AIDS (PLWHAS)

No Abstract.Nigerian Quarterly Journal of Hospital Medicine Vol. 11(1-4) 2001: 20-2