Patients' satisfaction with services obtained from aminu Kano Teaching Hospital, Kano, Northern Nigeria

No Abstract

Prevalence of malaria and practice of prevention among HIV positive pregnant women at Aminu Kano Teaching Hospital(AKTH), Kano)

A total of 360 primigravidae were studied at AKTH. 180 each of similar age and socioeconomic status were used as cases and controls in a prospective study. There was no statistically significant difference in their practice of malarial prevention at booking. The prevalence of malaria in their blood smears at booking was 32.22%, with the HIV infected cases accounting for23.33%, whilst the HIV uninfected accounted for 8.89%The prevalence of clinical malaria was significantly eight times higher and the prevalence of recurrent malaria was twenty six times higher in the HIV infected primigravidae as compared to the HIV uninfected primigravidae. Review of malarial prophylaxis in HIV infected primigravidae is recommended.Keywords: HIV infected, HIV uninfected, Malaria, Multigravidae, Primigravidae

Free maternity services in Kano State impact of free maternity services in Kano State Nigeria

Background: Comprehensive prenatal care, impacts positively on both maternal and perinatal outcome. The free maternity policy increased access to antenatal care and a reduction in maternal mortality in secondary health facilities. The uptake of the services continues to increase at exponential rate in all the facilities across Kano State.Study design/subject: This was a cross sectional study over a period of six months(January to June 2008).The study review the components of all the services offered and the financial implication involved. The providers wereinterviewed together with patients with pre-tested questionnaire to collect information on their perception, problem and satisfaction of the services since its inception in the State in 2001.Main outcome: Utilization of maternity services by the respondents.Results: The main components of the free maternity services are: free stationeries (cards), delivery pack, free treatment of surgical or medical complication of pregnancy, Vesico-vaginal fistula and recto-vaginalfistula.(VVF/RVF) repair and screening of blood. The providers were happy with the programme, but it increased their workload especially from the neighboring states like Jigawa, Katsina and Bauchi, despite reduction in maternal morbidity and mortality (from 2700/100,000 to 950/100,000livebirths). The patients were aware of antenatal/maternity services in the General hospitals across the state, but they now spend longer time in the hospital before being attended to.Conclusion: Improvement of staffing, community participation, increase funding, and introduction of similar services in the neighboring states will improve the quality of care provided and reduce the patient load.Keywords: free maternity, Kano, orthodox facilit

Job satisfaction among resident doctors in a tertiary healthcare facility in Northern Nigeria, a cross sectional

Background: Over the past few years the number of doctors choosing to work abroad or in non-medical professions has been growing. Among those doctors who have remained in the workforce, there is a similar dissatisfaction, reflected in part by a general strike in 2010 by Nigerian doctors especially Association of Resident Doctors (ARD) in favour of higher wages and better working conditions. Job demands and workload of hospital doctors are increasing.The aim of this paper is to assess job satisfaction among junior and senior resident doctors of different specialties in Aminu Kano Teaching Hospital (AKTH) and to compare the level of satisfaction between these two groups of professionals with the purpose of making recommendation for improvement to health human resource managers.Method: This was a cross- sectional study that involved 150 resident doctors of different cadre and specialization between 1st December, 2011 and 28th January, 2012. The questionnaire was used to assess the socio-demographic information of the respondents, job satisfaction and work related conditions.Result: Most of the doctors (41.3%) were aged 31-35 years. The mean age of junior residents was 32.6±3.7 years, while that of senior residents were 35±4 years. This differences was not statistically significant (p=0.094).Most resident doctors (64.2%) worked for 7-9hours daily. All doctors worked for average duration of 9.4±2.6 hours. Junior residents worked for mean duration of 9±2.3 hours while senior residents worked for 9.1±3.2 hours. This was not statistically significant p=0.075. Most of the resident doctors (56.7%) had been in the service of the hospital for 1-3 years. The mean duration of service was 3.5±2.1. Most of the doctors (78%) had 7-9 dependents. The average number of dependents for junior residents was 4±3, while for senior residents was 6±2 and this was statistically significant (p=0.03). The mean number of dependents was 5±3. Most doctors (60%) had their last promotion less 1 year prior to the study with mean of 0.9±0.9years.80.1% of doctors were satisfied with their job, 17.3% were undecided and 5.2% were dissatisfied. More senior residents (82.2%) felt satisfied with their jobs than junior residents (77.9%) and this was statistically significant, p=0.035.Job satisfaction among doctors was more among those who were aged 41-45(100%) but there was a very weak positive correlation (r=0.21) between age and job satisfaction. Job satisfaction was more in those who have worked for at least 4 years with a weak positive coefficient of correlation (r=0.28).Length of service correlates more with job satisfaction than any other factors among doctors.Job satisfaction was highest among resident doctors in chemical pathology and radiology and lowest among resident doctors in obstetrics and gynaecology.Increase in manpower employment by management so as to reduce work hour per day may improve satisfaction among obstetrics and gynaecology residents.Conclusion: Job satisfaction among the doctors in this study was higher when compared with other studies within Nigeria and other developing countries. However, Job satisfaction may increase if physicians experienced more opportunities to advance their careers, team spirit, and better supervision.Keywords: Job Satisfaction, Dissatisfaction, Resident Doctors, Tertiary Healthcare, Northern Nigeria, Cross Sectional SurveyTrop J Obstet Gynaecol, 30 (1), April 201

Birth Preparedness, Complication Readiness and Fathers’ Participation in Maternity Care in a Northern Nigerian Community

The role of men in maternity care in Africa is understudied, despite their economic dominance and decision making power. In a patriarchal society like northern Nigeria, pregnancy and childbirth are often regarded as exclusively women’s affairs. Using data from interviewer administered questionnaires and in-depth interviews; we assessedbirth preparedness, complication readiness and male participation in maternity care in Ungogo, a northern Nigerian community. Majority of pregnancies were unplanned (96%). Only 32.1% of men ever accompanied their spouses for maternity care. There was very little preparation for skilled assistance during delivery (6.2%), savings foremergencies (19.5%) or transportation during labour (24.2%). Young paternal age (adjusted odds ratio [AOR] =1.5, 95% confidence interval [CI]=1.2-2.6), formal education (AOR=1.9, 95%CI=1.1-3.4) and non-Hausa Fulani ethnicity (AOR=2.3, 95%CI=1.4-3.3) were independent predictors of male participation in maternity care. There isa need to increase involvement of men in their partner’s maternity care through peer-led, culturally-sensitive community education and appropriate health system reforms.(Afr J Reprod Health 2010; 14[1]:21-32)

Pattern of gynaecological admissions in Aminu Kano Teaching Hospital: A three year review

Concept: Gynaecological admissions form a large proportion of the number of admissions in any Obstetrics and Gynaecological department of our hospitals.Aims and Objectives:This study was conducted in gynaecology ward of AKTH, Kano to review the gynaecological admissions, mortality and efficiency of hospital facility utilization over a period of 36 months (January 2006 to December 2008).Methodology: This is a retrospective review of all patients admitted into the gynecology ward between January, 2006 and December, 2008. Information obtained on socio-dermographic characteristics, diagnosis, hospital stay, bed occupancy, etc were collated and analysed.Results: There were 1717 admissions over the study period, out of which 1225 (71.3%) were emergencies and 494(28.7%) were elective admission for surgery giving an emergency/elective ratio of about 2.5:1. There were 50.5 patients per bed per year with bed occupancy of 13.8%. The commonest diseases responsible for gynaecological admission were abortions (23.1%), followed by medical complications of early pregnancy (19%), gynaeclogical malignancy (11.4%), ectopic pregnancy(6.7%), infertility (5.2%) and pelvic inflammatory disease (3.5%).All the deaths occurred in the emergency group (2.4%). The highest fatality was contributed by gynaecological malignancies, which accounted for 71.4 % of all gynaecological deaths with carcinoma of the cervix as theleading cause (33.2%), followed by ovarian cancer (28.6%). Postabortal sepsis was the third most common cause, contributing 16.7% fatality.Conclusion: Management should improve admission policy, understanding of patient needs in order to increase acceptance of our services.Key Words: Bed occupancy, gynaecological admissions, AKTH, Kano

Sero-prevalence of Hepatitis B Virus Infection and its Risk factors among Pregnant Women Attending Antenatal Clinic at Aminu Kano Teaching Hospital, Kano, Nigeria

Background: Pregnant women infected with hepatitis B virus (HBV) can transmit the infection to their fetuses and newborns. Neonates who contract the HBV have about 90% risk of developing chronic HBsAg carriage (HBsAg: hepatitis B surface antigen) and chronic liver disease. Neonatal immunization interrupts this vertical and perinatal transmission.Objectives: To determine the seroprevalence of HBsAg among pregnant women attending the antenatal clinic at Aminu Kano Teaching Hospital (AKTH) and to identify potential risk factors associated with HBV infection.Materials and Methods: A case control study was conducted involving a total of 303 pregnant women attending the antenatal clinic at AKTH and 303 nonpregnant women of childbearing age. Blood sample was collected from each woman and the serum tested for the presence of HBsAg using latex rapid agglutination slide test kit (Cal-Tech Diagnostic Inc., USA) in the laboratory of the hospital. Reactive samples were stored at -20ºC and further confirmed for HBsAg using enzyme-linked immunosorbent assay (ELISA) kits (Bio-Rad, France). HBsAg-positive samples were tested for hepatitis B e antigen (HBeAg) using ELISA kits (Orgenics, Israel). A pretested, structured questionnaire was used for the collection of sociodemographic data and possible risk factors. Results: The prevalence of HBsAg among pregnant women and nonpregnant women were 7.9 and 7.6%, respectively. There was no statistically significant difference in the prevalence of HBsAg in pregnant and nonpregnant women. The presence of HBeAg was statistically significant among both pregnant and nonpregnant women who tested positive for HBsAg. The risk factors associated with HBV infection were blood transfusion, ear piercing, history of an affected sibling with HBV infection, tattooing, and abortion among pregnant women.Conclusion: The prevalence of HBsAg in this study was not statistically different in pregnant and nonpregnant women. There was a high level of HBeAg infection among pregnant women who tested positive for HBsAg. History of an affected sibling with HBV infection, tattoo, and abortion were significant risk factors for HBV infection. Keywords: Africa, hepatitis B, pregnancy, risk factor

Response to the meningococcal meningitis epidemic (MME)at Aminu Kano Teaching Hospital, Kano (2008-2009)

No Abstract

Going to scale: design and implementation challenges of a program to increase access to skilled birth attendants in Nigeria

This is the final version. Available from BMC via the DOI in this record.Background: The lack of availability of skilled providers in low- and middle- income countries is considered to be an important barrier to achieving reductions in maternal and child mortality. However, there is limited research on programs increasing the availability of skilled birth attendants in developing countries. We study the implementation of the Nigeria Midwives Service Scheme, a government program that recruited and deployed nearly 2,500 midwives to rural primary health care facilities across Nigeria in 2010. An outcome evaluation carried out by this team found only a modest impact on the use of antenatal care and no measurable impact on skilled birth attendance. This paper draws on perspectives of policymakers, program midwives, and community residents to understand why the program failed to have the desired impact. Methods: We conducted semi-structured interviews with federal, state and local government policy makers and with MSS midwives. We also conducted focus groups with community stakeholders including community leaders and male and female residents. Results: Our data reveal a range of design, implementation and operational challenges ranging from insufficient buy-in by key stakeholders at state and local levels, to irregular and in some cases total non-provision of agreed midwife benefits that likely contributed to the program’s lack of impact. These challenges not only created a deep sense of dissatisfaction with the program but also had practical impacts on service delivery likely affecting households’ uptake of services. Conclusion: This paper highlights the challenge of effectively scaling up maternal and child health interventions. Our findings emphasize the critical importance of program design, particularly when programs are implemented at scale; the need to identify and involve key stakeholders during planning and implementation; the importance of clearly defining lines of authority and responsibility that align with existing structures; and the necessity for multi-faceted interventions that address multiple barriers at the same time.International Initiative for Impact Evaluatio

Randomised Controlled Double-Blind Non-Inferiority Trial of Two Antivenoms for Saw-Scaled or Carpet Viper (Echis ocellatus) Envenoming in Nigeria

Snake bite threatens millions of poor rural folk throughout Africa. In Nigeria, as in many countries of sub-Saharan Africa, it takes a terrible toll on human life and limb. Over the years, the news for those exposed to snake bite has been generally bad: withdrawal of antivenom manufacturers, increasing cost and, most recently, the marketing of ineffective or fake antivenoms in the region. Our paper reports encouraging results achieved by two antivenoms created as a direct consequence of the present crisis in antivenom supply for Africa. They have been assessed in the most powerful trial ever attempted in this field. The trial showed that in people with non-clotting blood following carpet viper bite, the commonest cause of snake bite morbidity and mortality in the West African savannah, administration of the antivenoms- EchiTAb G and EchiTAb Plus-ICP led to permanent restoration of blood clotting in 76% and 83% of the patients within 6 hours, respectively. Generally mild early adverse reactions were recorded in 19% and 26%, respectively. Both antivenoms proved effective and acceptably safe and can be recommended for treating carpet viper envenoming in Nigeria