Assessment of Clients’ Perceived Satisfaction and Responsiveness of Outpatient Health Care Services Within the National Health Insurance Scheme at University of Nigeria Teaching Hospital, Enugu State, Nigeria

Client satisfaction with health service provision within the health insurance schemes are crucial to guide policy and decision making. Further on, the achievement of universal health coverage within the health insurance scheme in Nigeria requires evaluating the extent to which the expectations of those who have utilized health-care services, are met. This study was designed to assess NHIS-enrollees’ satisfaction and the responsiveness of outpatient health care services provided under the NHIS at UNTH, Enugu. This cross sectional descriptive study was carried out between July and September 2018. Data on enrollee’s satisfaction was collected using the standardized Patient Satisfaction Questionnaire, and data on responsiveness was collected using the questionnaire froma responsiveness survey designed by theWHO. The results show that of the 368 NHIS-enrollees in the survey, 269 (73.1%) were satisfied with the services they received and 190 (51.6%) respondents considered the services to be responsive to their needs, with ‘choice of provider’ and ‘autonomy’ ranking the least in domain of service. The factors independently associated with dissatisfaction with the NHIS services at UNTH (at p<0.05) include: having a family size of ≤4, having worked for 10 – 19 years in the civil service, and having >4 dependents. The factors independently associated with non-responsiveness of services within the NHIS at UNTH (at p<0.05) were: male gender, rural residence, having attended the UNTH twice or thrice, and having worked in the civil service for <10 years or for 10 – 20 years. This study concludes that a high proportion of NHIS-enrollees were satisfied with outpatient services within the NHIS; however, NHIS outpatient services were responsive to the needs of only half of the enrollees. It is recommended that poorly performing domains of services are strengthened, especially ‘choice of provider’ and ‘autonomy’; and that factors associated with non-satisfaction and non-responsiveness of outpatient services offered within the NHIS be addressed by orientation, training and local policy solutions. &nbsp

COVID‑19 at the Community Level: What are the Countermeasures?

Although several efforts have been implemented to prevent and control the coronavirus disease 2019 (COVID‑19) pandemic at the population level, varying outcomes have been reported in several quarters, despite the implementation of socio‑behavioral methods commonly at the population level to stop the human‑to‑human transmission. We did a narrative review of relevant articles of identified countermeasures at the population level, for curbing the COVID‑19 pandemic. The key fi ndings were evidence measures such as physical distancing, quarantine, isolation, screening, active case detection, and risk communication if properly implemented. Other countermeasures identified were air disinfection and lockdown restrictions. Air disinfection has a potentially harmful effect on humans, while lockdown restrictions have been counterproductive in many settings. In  conclusion, many of these public health measures are with peculiarities and needs to be contextualized to be effective in curbing the pandemic. Further research and regular assessments are needed on the countermeasures. Keywords: Coronavirus disease 2019, pandemic, prevention, severe acute respiratory syndrome coronavirus

Review of COVID‑19 Vaccine

Coronavirus disease 2019 (COVID‑19) accounts for over 92 million confirmed cases worldwide, with over 2.06 million deaths. In the past year, more than 290 candidate vaccines have been tested; COVID‑19 vaccine  development was sped up, with shortened timeline, due to the urgent global need in the face of the pandemic. In addition, people with the highest risk of contracting the disease, such as health workers with a high risk of exposure, elderlies, and people with underlying comorbidities, were prioritized with vaccination rollout. The article narratively reviewed original and review articles available on PubMed and Google Scholar related to the theme to provide up‑to‑date information. The different templates developed and studied for COVID‑19 vaccines include the whole‑virus vaccine, viral vector vaccine, nucleic acid (deoxyribonucleic acid and ribonucleic acid), and protein subunit vaccine. Myths impede vaccine uptake in this part of the globe. Adopting these myths leads to sharing and spreading, which negatively impacts the prevention of COVID‑19 and vaccine uptake. Adverse event following immunizations (AEFIs) is classified based on severity, from minor to severe. The minor ones are common events that pose no potential health risks to the receiver of the vaccine. The type determines the safety profile, severity, and frequency of AEFIs observed with the vaccine administration. Overall, this pandemichas heightened the global level of threat awareness; it has also provided motivation to prepare for future  pandemics by developing new vaccines

Health, well-being, and burnout amongst Early Career Doctors in Nigeria.

BackgroundEarly Career Doctors (ECDs) in Nigeria are faced with many individual and systemic problems, which consequently adversely affect their health, well-being, patient care and safety.ObjectiveThis study, the second phase of the Challenges of Residency Training and Early Career Doctors in Nigeria (CHARTING II) Study, sought to examine the risk factors and contributors to the health, well-being and burnout amongst Nigerian ECDs.MethodsThis was a study of health, well-being and burnout amongst Nigerian ECDs. Outcome variables included burnout, depression, and anxiety, which were respectively assessed using the Copenhagen Burnout Inventory (CBI) and Oldenburg Burnout Inventory (OLBI), Patient Health Questionnaire (PHQ-9) depression scale, and Generalized Anxiety Disorder (GAD-7) scale. The quantitative data obtained was analysed using the IBM SPSS, version 24. Associations between categorical outcome and independent variables were assessed using chi square, with level of significance set at ResultsThe mean body mass index (BMI), durations of smoking and alcohol consumption of the ECDs were 25.64 ± 4.43 kg/m2 (overweight range), 5.33 ± 5.65 years and 8.44 ± 6.43 years respectively. Less than a third (157, 26.9%) of the ECDs exercised regularly. The most common disease conditions affecting the ECDs were musculoskeletal (65/470, 13.8%) and cardiovascular diseases (39/548, 7.1%). Almost a third (192, 30.6%) of the ECDs reported experiencing anxiety. Male and lower cadre ECDs were more likely than female and higher cadre ECDs to report anxiety, burnout and depression.ConclusionThere is an urgent need to prioritize the health and well-being of Nigerian ECDs, so as to optimize patient care and improve Nigeria's healthcare indices