Creating a Functional Health System for Nigeria

Background: Health systems are more than static health facilities. The World Health Organization has identified six building blocks of the health  system namely: human resources for health, service delivery, medicines, vaccines and technology, health information, health financing and  leadership and governance. This paper examines the Nigerian health system and posits that it is not functional.Discussion: The dysfunctional state is a result of chronic neglect of both the building blocks of the health system and the wider determinants of  health such as education, sanitation, and food security in addition to the lack of synergy between the health and non-health sectors.Conclusion: Creating a functional health system in Nigeria does not require fresh policies rather the political will and commitment of resources to  improve the quality of life of the citizens in the non-health sector and the implementation of the numerous policies and strategies in the health  sector. Adequate attention should be paid to primary health care

Utilizing The ICF-CY as a Conceptual Framework to Examine Physical Activity and Dietary Behaviors among Adolescents with Down Syndrome

Introduction: Research has shown that obesity among children and adolescents is disconcerting in the Southeast United States. Additionally, children and adolescents with intellectual and developmental disabilities especially those with DS have an exacerbated risk of obesity. Despite the elevated risk of obesity for this population, very few studies have investigated factors that influence healthy eating and engagement in physical activity among children and adolescents with DS. The purpose of this study was to identify facilitators and barriers concerning healthy eating and physical activity for adolescents with DS. Methods: Adolescents with DS along with their parents were recruited from a local DS group of the National Down Syndrome Society and a county school system. Thirteen parents completed surveys pertaining to the dietary, physical activity and social behaviors of their adolescents with DS. The body fat of all thirteen adolescents was assessed using skinfold measurements, bioelectrical impedance analysis and Body Mass Index. Twenty-five interviews with parents and their adolescents with DS aged 10-17 years took place. The theoretical framework was the Social Ecological Model. The World Health Organization International Classification of Functioning, Disability and Health for Children and Youth served as the conceptual framework for this study and acted as the coding guide. Results: Facilitators were engagement in physical activity with family, sports such as dance or cheer, parental management of diet and fitness, close relationships with health professionals and being physically active with peers. Barriers were competitive sports, low motivation to be physically active, multitasking, pain, food aversions, weight maintenance issues and parents not promoting fruit and vegetable consumption. Discussion: The results of this study depict facilitators and barriers to healthy eating and physical activity for adolescents with DS. Although the results are not generalizable, the information from this study can be used to develop and implement tailored programs to better assist adolescents with DS and their families in combatting obesity and meeting the special needs of this population

Building consumers’ trust in electronic retail platforms in the Sub-Saharan context: an exploratory study on drivers and impact on continuance intention

Lack of trust can have a negative influence on consumers’ willingness to use electronic retail (e-tail) platforms especially in countries with weak regulations and poor consumer rights. This paper examined factors that can be employed to build consumer trust and continuance intention to use e-tail platforms in Sub-Saharan Africa. Data were collected from 207 respondents and analyzed using structural equation modelling with the PLS software. The results show that information quality, perceived usefulness, hedonic motivation and perceived risk have a significant influence on consumers’ trust in e-tail platforms. The study contributes to the existing body of knowledge that guides efforts for implementation of actions in weak institutional contexts characterized by institutional voids such as those experienced in Sub-Saharan African countries. Finally, the study provides insights that can help managers of e-tail platforms to effectively foster the development of trust in their communities

The Knowledge Attitude and Practice of Contraceptives by Undergraduates in Lagos Nigeria.

There is a high mortality rate associated with teenage pregnancy, abortion and complications related to abortion among university undergraduates. The awareness and practice of contraception such as; natural method, barrier method, hormonal method and traditional method were studied among university undergraduates in Lagos state using structured questionnaire. Sources of information on contraception were also studied alongside choice and use of contraceptive among undergraduates. The result showed that the major source of information on contraceptives was peer group followed by electronic media, parental contribution on this issue was low. 98% of our respondents had good knowledge about contraceptives, their attitude towards contraceptive was also positive but its use was low with only about 54% practicing contraception and this is probably due to discrimination against adolescent and young adults by family planning providers and low parental influence on contraceptives. Keywords: Awareness, Contraceptives, Practice, Undergraduates

Case report: Calcified chronic subdural haematoma in an elderly Nigerian

Calcified chronic subdural haematoma [CCSDH] is a rare complication of the relatively more common condition of Chronic Subdural Haematoma (CSDH). We present the case of a 68yr old man referred with a 2 week history of sudden onset Right hemi paresis generalized tonic clonic seizures and aphasia. There was a history of mild head injury 7 years prior to presentation and computerized tomographic scan showed features suggestive of a Calcified Chronic Subdural Haematoma. He deteriorated rapidly prior to surgical intervention and had an emergency craniotomy with evacuation of the lesion performed. Unfortunately patient died 12 hours post operatively never having woken up after the operation. An acute subdural haematoma was discovered at post mortem

Prevalence of and Risk factors for Stunting among School Children and Adolescents in Abeokuta, Southwest Nigeria

Stunting adversely affects the physical and mental outcome of children. The objectives of the study were to determine the prevalence of and risk factors associated with stunting among urban school children and adolescents in Abeokuta, Nigeria. Five hundred and seventy children aged 5-19 years were selected using the multi-stage random-sampling technique. Stunting was defined as height-for-age z-score (HAZ) of <-2 standard deviation (SD) of the National Center for Health Statistics reference. Severe stunting was defined as HAZ of <-3 SD. The mean age of the children was 12.2+3.41 years, and 296 (51.5%) were males. Ninety-nine (17.4%) children were stunted. Of the stunted children, 20 (22.2%) were severely stunted. Identified risk factors associated with stunting were attendance of public schools (p<0.001), polygamous family setting (p=0.001), low maternal education (p=0.001), and low social class (p=0.034). Following multivariate analysis with logistic regression, low maternal education (odds ratio=2.4; 95% confidence interval 1.20-4.9; p=0.015) was the major contributory factor to stunting. Encouraging female education may improve healthcare-seeking behaviour and the use of health services and ultimately reduce stunting and its consequences

Profile and outcome of patients with post-neonatal tetanus in a tertiary centre in south west Nigeria: any remarkable reduction in the scourge?

Introduction: The incidence of tetanus has remained unacceptably high in developing countries. We aimed to describe the profile and outcome of children with tetanus admitted at the Lagos State University Teaching Hospital (LASUTH), Ikeja. Methods: A prospective and cross-sectional study of children aged 1 month to 12 years of age admitted with clinical diagnosis of tetanus, between January 2011 and December 2013, at the Paediatric department of LASUTH. The age, sex, presenting complaint, immunization status, portal of entry, socio-economic class, complications, duration of admission and outcome of the subjects were analyzed using Microsoft Excel supplemented with Statistical Package for Social Sciences (SPSS) version 17.0. Level of significance set at p&lt; 0.05. Results: A total of 49 subject participated in the study. Male: Female ratio was 1.7: 1.0. mean age ± SD of 6.5± 3.2 years. Only 24.5% of the subjects were fully immunized, lower limb injury was the most common portal of entry (34.7%). Majority (79.6) were of the middle and lower social classes. Most of the subjects (67.3%) presented with generalised spasm. Only 1 patient (2.0%) did not have trismus. Case fatality rate was 4.1%. Conclusion: Tetanus is still prevalent among children in our environment. It is commoner among those with no immunization or incomplete immunization, commoner in those in the middle and lower social class. Lower limb injury was the most common portal of entry. Trismus was a common presenting feature. There is a need to develop programmes with will help improve compliance to immunization

Vector Autoregressive Modeling of COVID-19 Incidence Rate in Nigeria

With the outbreak of COVID-19, a lot of studies have been carried out in various science disciplines to either reduce the spread or control the increasing trend of the disease. Modeling the outbreak of a pandemic is pertinent for inference making and implementation of policies. In this study, we adopted the Vector autoregressive model which takes into account the dependence that exists between both multivariate variables in modeling and forecasting the number of confirmed COVID-19 cases and deaths in Nigeria. A co-integration test was carried out prior to the application of the Vector Autoregressive model. An autocorrelation test and a test for heteroscedasticity were further carried out where it was observed that there exists no autocorrelation at lag 3 and 4 and there exists no heteroscedasticity respectively. It was observed from the study that there is a growing trend in the number of COVID-19 cases and deaths. A Vector Autoregressive model of lag 4 was adopted to make a forecast of the number of cases and death. The forecast also reveals a rising trend in the number of infections and deaths. The government therefore needs to put further measures in place to curtail the spread of the virus and aim towards flattening the curve

Comparison of Vector Autoregressive Model (VAR) And Bayesian Vector Autoregressive Model (BVAR) Models for Modelling Economic Growth

The study attempted to develop forecasting model for inflation as well as IPP growth in a multivariate time series Bayesian framework, known as Bayesian Vector Autoregressive (BVAR) model. The main advantage of using this model is the incorporation of prior information which may boost the forecasting performance of the model. The results revealed that the diagnostics results of the models are appear to be satisfactory and out of sample percentage root mean square error (PRMSE) for WPI for four quarters is 1.4932 percent, whereas, for IIP, it is 4.2508 percent. Further, for selecting the a suitable values for lambda and theta, we have tried various combination for these parameters between 0 to 1 and based on PRMSE, we found that lambda=0.3 and theta=0.9 are suitable values for BVAR(2). Therefore, BVAR(2) with lambda=0.3 and theta=0.9 was fitted. From the results, it can be observed that, out of sample PRMSE has been reduced while using BVAR in both the cases i.e. for WPI as well as IIP.Based on the comparison of forecasting performance of VAR and BVAR model, measured in terms of out-of-sample percentage root mean square error, it was found that BVAR model performed better than VAR model in case of inflation as well as IPP growth forecas

Prevalence of and Risk factors for Stunting among School Children and Adolescents in Abeokuta, Southwest Nigeria

Stunting adversely affects the physical and mental outcome of children. The objectives of the study were to determine the prevalence of and risk factors associated with stunting among urban school children and adolescents in Abeokuta, Nigeria. Five hundred and seventy children aged 5-19 years were selected using the multi-stage random-sampling technique. Stunting was defined as height-for-age z-score (HAZ) of 64 -2 standard deviation (SD) of the National Center for Health Statistics reference. Severe stunting was defined as HAZ of 64-3 SD. The mean age of the children was 12.2\ub13.41 years, and 296 (51.5%) were males. Ninetynine (17.4%) children were stunted. Of the stunted children, 20 (22.2%) were severely stunted. Identified risk factors associated with stunting were attendance of public schools (p&lt;0.001), polygamous family setting (p=0.001), low maternal education (p=0.001), and low social class (p=0.034). Following multivariate analysis with logistic regression, low maternal education (odds ratio=2.4; 95% confidence interval 1.204.9; p=0.015) was the major contributory factor to stunting. Encouraging female education may improve healthcare-seeking behaviour and the use of health services and ultimately reduce stunting and its consequences