Influence of Customs and Traditions on the Process of Community Development Among Rural Communities in Enugu State, Nigeria

This study examined the influence of customs and traditions on the process of community development among rural communities in Enugu state, Nigeria. Three research questions guided the study. The study adopted a descriptive survey design with a target population of 847 adults comprising 379 traditional rulers and 468 town union presidents in all the 468 communities in the 17 LGAs of Enugu State. The population was taken as a census with no sampling. The study used a self- designed questionnaire and a Focus Group Discussion Guide for data collection which were validated by experts. The internal consistency of the questionnaire was determined using the Cronbach Alpha statistics. The quantitative data collected were analysed using mean statistics and standard deviation while the qualitative data collected via Focus Group Discussion were analysed using content analysis. From the analysed qualitative and quantitative  data, the findings of the study among others showed that the existing customs and traditions prevalent among the various communities in Enugu State, Nigeria are Adult circumcision (Ibe-Epi or Ibe-ugwu)  Masquerade (Mmanwu), Age grade grouping (Uro-Ogbor or Otu-Ogbor),  pouring of libation (Igor-Ofo) , homage to the ancestral fathers’ graves (Igba-Aju), the new yam festival (Iriji or Iwaji), Women August Meeting (Ogbako Umunwanyi Na-August), Soil festival-No farming sacred week (Oriri-Ani Na Nso-Ani), practice of caste system (Ohu or Osu), among others. It was also revealed that the influence of customs and traditions on the planning of community development programmes in Enugu State is evident in the fact that women were excluded from the decision making process in planning community development projects, community members reject projects to be sited in places the people consider forbidden, development programmes are not planned during festivals and the Women August meeting tradition is used as an avenue for planning of community development programmes. Based on the findings of the study, it was recommended among other things that traditional rulers should engage all the organized traditional structure (Igwe in-council, Elders council, women through August meeting platform, age grades and others) to do periodic planning of self-help development projects in their respective communities. Keywords: Customs, Traditions, Community Development DOI: 10.7176/JEP/11-32-08 Publication date: November 30th 2020

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)