An appraisal of the barriers to client involvement in health and safety in Nigeria's construction industry

Purpose The purpose of this paper is to present the findings of a study that identified and assessed the barriers to client involvement in health and safety (H&S) in the Nigerian construction industry. Design/methodology/approach On the basis of literature review and a pilot study, structured questionnaires were designed and administered to clients and their representatives in ongoing construction projects in Nigeria. Descriptive and inferential statistics were then adopted while analysing the data. Findings The research reveals that the major barriers to client involvement in H&S in Nigeria’s construction industry focus on the gaps created by lack of H&S legislation in specifying client roles and responsibilities in H&S, trust and confidence in the supply chain, low levels of awareness at various levels, procurement issues, the attitudes of the various members of the project team and resource-related issues. In total, 20 barriers to client involvement in H&S were identified and assessed. Practical implications Policy makers will find the study beneficial as it provides a good understanding of the issues to address while making policies that seek to involve the client in H&S in Nigeria. Originality/value While the findings offer insight on the barriers to client involvement in H&S in Nigeria’s construction industry, the study also contributes to the discourse in developing countries. The paper recommends transparent steps in procurement, H&S legislation that factors in economic incentives and community and financial institutions contributions to involving clients in H&S. The study is the first attempt to investigate the barriers to client involvement in construction H&S in Nigeria, contributing to the dearth of H&S literature in Nigeria

The three pillars of institutional theory and IFRS implementation in Nigeria

This study explores the effects of the three pillars of institutional theory in shaping the activities of institutional entrepreneurs and other social actors during IFRS implementation in Nigeria. This study uses document analysis method to achieve the objectives of the study. This study finds that IFRS implementation in Nigeria witnessed some progression from regulative to normative to cognitive pillar building. The regulation on IFRS implementation was initiated top-down rather than through lobbying from professional accounting bodies and the public. Changes in the regulatory framework brought some improvement to corporate financial reporting practices such as the timing of corporate filings of audited financial reports. However, the implementation process is laden with conflicts and power struggle among institutional actors. These conflicts and power struggles led the President of Nigeria to sack the Board of the Financial Reporting Council of Nigeria (FRC), the reconstitution of the Board and appointment of a Chairman for the Board of the FRC. IFRS implementation process resulted in power redistribution among institutional actors, which led to resistance, tensions, and conflicts among institutional actors. The conflicts arise from the need of actors to legitimate their activities and secure their positions. The three institutional pillars are key components of a change process and the actor’s social position affects their capability to act as an institutional entrepreneur. This finding should provide foundational knowledge that will inform practitioners, researchers, and regulators in developing countries on how institutional actors shape the approach to corporate reporting regulations

Treatment of uncomplicated malaria at public health facilities and medicine retailers in south-eastern Nigeria

Background: At primary care facilities in Nigeria, national treatment guidelines state that malaria should be symptomatically diagnosed and treated with artemisinin-based combination therapy (ACT). Evidence from households and health care providers indicates that many patients do not receive the recommended treatment. This study sought to determine the extent of the problem by collecting data as patients and caregivers leave health facilities, and determine what influences the treatment received. Methods: A cross-sectional cluster survey of 2,039 respondents exiting public health centres, pharmacies and patent medicine dealers was undertaken in urban and rural settings in Enugu State, south-eastern Nigeria. Results: Although 79% of febrile patients received an anti-malarial, only 23% received an ACT. Many patients (38%) received sulphadoxine-pyrimethamine (SP). A further 13% of patients received an artemisinin-derivative as a monotherapy. An estimated 66% of ACT dispensed was in the correct dose. The odds of a patient receiving an ACT was highly associated with consumer demand (OR: 55.5, p < 0.001). Conclusion: Few febrile patients attending public health facilities, pharmacies and patent medicine dealers received an ACT, and the use of artemisinin-monotherapy and less effective anti-malarials is concerning. The results emphasize the importance of addressing both demand and supply-side influences on malaria treatment and the need for interventions that target consumer preferences as well as seek to improve health service provision. © 2011 Mangham et al; licensee BioMed Central Ltd

Suboptimal management of severe menopausal symptoms by Nigerian Gynaecologists: a call for mandatory continuing medical education for physicians

<p>Abstract</p> <p>Background</p> <p>Effective management of menopause is an important way to improve the quality of life of the increasing number of older women. The study sought to find out if Nigerian Gynaecologists offer effective treatment for severe menopausal symptoms.</p> <p>Methods</p> <p>126 Nigerian Gynaecologists representing the six health zones of Nigeria were interviewed to determine the menopausal symptoms they had ever encountered in their practices, frequency of the symptoms, treatments ever offered for severe symptoms including their attitude to, and practice of hormone replacement therapy.</p> <p>Results</p> <p>A Nigerian Gynaecologist encountered an average of one patient with menopausal symptoms every three months (range: 0-3 patients per month). The commoner symptoms they encountered were hot flushes (88%), insomnia (75.4%), depression (58.0%), irritability (56.3%), night sweats (55.6%) and muscle pains (54.8%) while urinary symptoms (16.7%) and fracture (1.6%) were less common. Treatments ever offered for severe symptoms were reassurance (90.5%), anxiolytics (68.3%), analgesics (14.3), HRT (7.9%), Vitamins (4%), Beta-blockers (3.2%) and Danazol (2.4%). These treatments were offered as a matter of institutional traditions rather than being based on any evidence of their efficacy.</p> <p>Conclusion</p> <p>The result revealed that most Nigerian Gynaecologists prefer reassurance and anxiolytics for managing severe menopausal symptoms instead of evidence-based effective therapies. A policy of mandatory continuing medical education for Nigerian physicians is recommended to ensure evidence-based management of gynaecological problems, including menopause.</p

Socio-demographic factors and edentulism: the Nigerian experience

BACKGROUND: The rate of total edentulism is said to be increasing in developing countries and this had been attributed mainly to the high prevalence of periodontal diseases and caries. Several reports have shown that non-disease factors such as attitude, behavior, dental attendance, characteristics of health care systems and socio-demographic factors play important roles in the aetiopathogenesis of edentulism. The aim of this study was to assess the relationship between socio-demographic factors and edentulism. METHODS: A total of 152 patients made up of 80 (52.6%) males and 72 (47.4%) females who presented in two prosthetic clinics located in an urban and a rural area were included in the study. The relationship between gender, age, socio-economic status and edentulism in this study population was established. RESULTS: No significant relationship between gender and denture demand was noted in the study. The demand for complete dentures increased with age while the demand for removable partial dentures also increased with age until the 3(rd )decade and then started to decline. A significant relationship was found between denture demand and the level of education with a higher demand in lower educational groups (p < 0.001). In addition, the lower socio-economic group had a higher demand more for prostheses than the higher group. CONCLUSIONS: The findings in this study revealed a significant relationship between socio-demographic variables and edentulism with age, educational level and socio-economic status playing vital roles in edentulism and denture demand