“Who wants to be an entrepreneur?” An insight into the profile of individuals interested in entrepreneurship in Nigeria

With current challenges in the global economy, new and innovative strategies are emerging in the bid to stimulate and sustain growth in national economies. Entrepreneurship is one model that is deemed critical to the formulation and implementation of these strategies. Despite this, little is known about the profile of the Nigerian entrepreneur and how they engage with the constantly evolving policy context. This study therefore aimed at better understanding their characteristics as well as how they perceived certain key policies.   A cross-sectional online survey conducted in the first quarter of 2015 yielded a 61% response rate (1235/2017). Majority of the sample were between 26 - 40 years (70%), and were relatively well educated as indicated by the proportion that had at least a Bachelor’s degree (73%).  Most of the respondents were self-employed or in business (62%), but a significant proportion were government workers (20%). Regarding views on government policies, 45% of the sample felt the agricultural sector had potential to make the most impact on national development, while a significantly less proportion had similar opinions about the information technology (16%) and the entertainment (2%) sectors. Majority (46%) indicated that electronic mail was their preferred means of communication with respect to entrepreneurship issues.   Demographically, Nigerian entrepreneurs are similar to their international contemporaries. This study has also confirmed that there is considerable engagement with government policies among this group, particularly those in which entrepreneurship can play a critical role. New insight has emerged regarding engagement with entrepreneurship in Nigeria, which can improve efficiency as well as facilitate the development of contextual and effective policies. For instance, enabling cost effectiveness in communication and facilitating entrepreneurship among government workers. Adopting these approaches in the various relevant policies can help drive growth in the economy and improve other facets of national development. Keywords: Nigeria, Entrepreneur, Development, Polic

Rational Use of Medicines in Nigeria: A Critical Review

Irrational use of medicines is capable of not only limiting access to medicine within a national healthcare system, it can also lead to a waste of scarce resources. In Nigeria, a number of studies exist that have explored rational use of medicines (RUM) in various settings and different conditions. Collectively however, little known is about these studies’ knowledge gaps and areas of concentration. A literature search was carried out in five major databases. Other aspects of the search strategy included scanning of conference abstracts, reference list searching and citation indexing. Articles selected using predetermined criteria were included in the bibliometric review and critical analysis. Majority of RUM studies in Nigeria had been undertaken in the south-western region (52.6%), whereas the north-eastern and north-western regions had the least (7.0% and 3.5% respectively). A significant proportion of RUM studies were carried out in hospital settings (77.0%) neglecting other settings such as community pharmacies where only a small proportion of studies had been carried out (4.1%). Major themes that emerged from the review included hypertension, malaria and prescribing patterns, including the use of antibiotics. Major gaps exist in RUM research in Nigeria. To improve this, stakeholders need to adopt a proactive strategy that includes addressing the gaps identified in this study, as well as instituting other relevant measures, such as developing relevant guideline and training practitioners outlined by the World Health Organisation. Keywords: Nigeria; Rational use of Medicines; Critical Review; Polic

Non-medical prescribing in chronic non-malignant pain

INTRODUCTION: Chronic non-malignant pain poses considerable risk 10 patients and the health service but its management is still inadequate. The introduction of prescribing for nurses and pharmacists suggests that non-medical prescribing can improve some important aspects of healthcare services AIM : To provide new insights and theory regarding how nurses and pharmacists prescribe for chronic pain, together with how the service is perceived by chronic pain patients and to uncover barriers and facilitators encountered when this group is prescribed for. METHOD: A mixed methods strategy was employed in this study. A grounded theory approach was used to collect data from non-medical prescribers and patients. Non-medical prescribes were then surveyed to confirm the emerging theory and determine barriers and facilitators. FINDINGS: The theory ‘safety and support within the prescribing environment’ explains the relationship that non-medical prescribers have with colleagues, patients and other factors in their prescribing environment in their prescribing for chronic pain. Non-medical prescribers are motivated by various factors and may adopt an innovative or conservative approach in their prescribing. Nurses were more likely to engage in informal mentoring relationships, but were limited by their lack of medication knowledge. Pharmacists were limited by a lack o f experience with patients, inaccessibility to formal CPD in paid work time and the threats introduced by concerns around ‘second checking'. Chronic pain patients had strategies to maintain relationships with their prescribers and this relationship influenced the likelihood of considering other measures to cope with their pain. CONCLUSION: Nurses and pharmacists who qualified as prescribers would be more likely to prescribe for chronic pain if they perceived certain essential elements in their prescribing environment. This theory can facilitate assessment of non-medical prescribers’ support, involvement of patients and the development of resources to encourage prescribing

The role of pharmacists in eliminating counterfeit medicines in Nigeria

IntroductionOver the years, counterfeit pharmaceuticals have posed immense concerns for global health and patient safety. This menace encompasses various classes of medications. Given the criticality of pharmacists’ interventions in drug distribution and supply, this study aimed at exploring their role in the prevention and control of counterfeit pharmaceutical products in Nigeria.MethodsA cross-sectional study was undertaken, using questionnaires to collect data from pharmacists across various sectors of pharmacy practice in Nigeria. Face and content validity was undertaken on the study tool prior to data collection. Ethical approval was obtained from the National Institute for Pharmaceutical Research and Development Health Research Ethics Committee, and confidentiality was strictly maintained during data collection process. Data were analyzed using Statistical Package for Social Sciences. Descriptive statistical analysis was undertaken and chi square was used to determine association between socio-demographic characteristics and variables.ResultsThe responses comprised 205 (52.6%) female and 185 (47.4%) male participants. Almost all the participants (98.4%) agreed that strict enforcement of drug laws can contribute to adequate control of counterfeit medicines in Nigeria, and majority of the study sample (64.7%) indicated that the poor implementation of these laws was a major factor influencing the preponderance of counterfeit medicines in the country. Two-thirds (63.5%) of the participants supported the need for pharmacists to provide adequate education to patients on strategies to identify counterfeit medicines, and a similar proportion (68.0%) were of the opinion that it was the responsibility of pharmacists to ensure that drugs are purchased from credible sources.ConclusionFindings from this study, in addition to confirming pharmacists’ instrumentality in the fight against counterfeit medicines, identified certain context specific factors that can strengthen the regulation, policy and the entire healthcare system. Government and relevant stakeholders can therefore begin to articulate strategic reforms for contextual policy intervention that address medicines’ counterfeiting, whilst prioritising pharmacists’ role in other critical areas in the healthcare system

Budget practices and the Nigerian Civil Service: new insights from an organisational culture perspective.

Low budgetary implementation in Nigeria suggests a need for better understanding of the Nigerian Civil Service. This study aimed at determining the nature of the Nigerian Civil Service from an organisational culture perspective. Additionally, the study focused on exploring views and experiences of Nigerian civil servants in relation to budgeting and budget practices. Following the relevant ethics and governance approvals, a mixed methods approach was used to collect data from Nigerian civil servants. In the first phase, a questionnaire was used to collect quantitative data from 144 randomly sampled respondents across 6 ministries. The Organisational Culture Assessment Instrument (OCAI) was used to identify the dominant culture in the Nigerian civil service while descriptive statistics, correlation matrix and multiple regression analysis were used to explore attitudes to various budget practices. In the second phase 5 participants that were selected using convenience sampling were interviewed.  A qualitative approach was used to analyse the data with a view to validate findings from the quantitative phase. The study revealed that the Nigerian civil service is underpinned by a model where the hierarchical culture is dominant but with undertones of the clan culture. Key factors that can improve budget processes in Nigeria include better communication, increased participation and the establishment of monitoring processes.  These new insights can help contribute to managing an improvement process as well as developing the service. Keywords: Budget; Civil Service; Nigeria; Organisational Culture; Polic

Treatment of Chronic Hepatitis B infection using Pegylated Interferon and Emtricitabin + Tenofovir: Preliminary Cost Burden and Policy Implications.

Hepatitis B infection remains a major cause of global mortality with Nigeria identified as a country with significant endemicity. Little is however known about the cost burden for managing Hepatitis B infection in this setting, or what policies exist to ensure access to care. A sample of one hundred patients recruited at National Assembly Medical Centre was screened for Hepatitis B. The study aimed at identifying clinical outcomes and economic burden of treating Hepatitis B with a treatment regimen of Pegylated Interferon alfa-2a (PEG-INFalfa-2a) and Emtricitabine + Tenoforvir (ET). Parameters evaluated include viral load (VL), sero-conversion and liver function test (LFT). Direct and indirect medical costs that were determined include laboratory investigations (HBsAg), VL, LFT, drugs and visits. The result showed a 7.2% prevalence of HBsAg. Initial monotherapy with PEG-INFalfa-2a resulted in sero-conversion in 5 out of the 8 treated cases (62.5%) with a drop in VL to an undetected value (less than 20 copies/ml).  In the rest (37.5%), VL rose to a range of 12000 - 35000 copies/ml and elevated liver enzyme [Alanine Transaminase (ALT)] increased to a range of 94-197 u/ml. Therapy switch to ET in treatment phase 2 (non-responsive in phase 1) led to a decrease of VL to 2500-3000 copies/ml. Follow up therapy with PEG-INFalfa-2a resulted in further decrease after 96 weeks.  Mono-therapy with PEG-INFalfa-2a cost N2,395,250 ($14,089.91) while PEG-INFalfa-2a + ET was N4,182,333 ($24,601.96). The treatment of Hepatitis B infection is of significant importance to both individual patients, and the national healthcare system, due to the considerable costs. Considering Hepatitis B infection as a Public Health Emergency will stimulate the relevant policies which can stem the looming epidemic. Keywords: Hepatitis B; Pegylated-interferon; Outcomes; Costs; Polic

Exploring the matrix: knowledge, perceptions and prospects of artificial intelligence and machine learning in Nigerian healthcare

BackgroundArtificial intelligence technology can be applied in several aspects of healthcare delivery and its integration into the Nigerian healthcare value chain is expected to bring about new opportunities. This study aimed at assessing the knowledge and perception of healthcare professionals in Nigeria regarding the application of artificial intelligence and machine learning in the health sector.MethodsA cross-sectional study was undertaken amongst healthcare professionals in Nigeria with the use of a questionnaire. Data were collected across the six geopolitical zones in the Country using a stratified multistage sampling method. Descriptive and inferential statistical analyses were undertaken for the data obtained.ResultsFemale participants (55.7%) were slightly higher in proportion compared to the male respondents (44.3%). Pharmacists accounted for 27.7% of the participants, and this was closely followed by medical doctors (24.5%) and nurses (19.3%). The majority of the respondents (57.2%) reported good knowledge regarding artificial intelligence and machine learning, about a third of the participants (32.2%) were of average knowledge, and 10.6% of the sample had poor knowledge. More than half of the respondents (57.8%) disagreed with the notion that the adoption of artificial intelligence in the Nigerian healthcare sector could result in job losses. Two-thirds of the participants (66.7%) were of the view that the integration of artificial intelligence in healthcare will augment human intelligence. Three-quarters (77%) of the respondents agreed that the use of machine learning in Nigerian healthcare could facilitate efficient service delivery.ConclusionThis study provides novel insights regarding healthcare professionals' knowledge and perception with respect to the application of artificial intelligence and machine learning in healthcare. The emergent findings from this study can guide government and policymakers in decision-making as regards deployment of artificial intelligence and machine learning for healthcare delivery

Maerua angolensis DC: evaluation of the oral acute and sub-chronic toxicity profile of its freeze-dried leaves infusion extract

Maerua angolensis is a shrub/small tree that grows up to about 10 m tall. The plant is widely distributed in tropical Africa and used in various ethnomedicinal applications across the region. The objective of this study is to investigate the oral safety profile of the infusion extract of Maerua angolensis (IEMa) in laboratory animals. Hippocratic screening was adopted to evaluate the acute toxicity profile using 2000 mg/kg of IEMa, p.o. in mice. The sub-chronic toxicity was performed by daily oral administration of IEMa (800 mg/kg) in Wistar rats for 28 days and clinical observations and toxicological related parameters were recorded. After the treatment period, blood was collected for hematological and biochemical analysis, and organs were removed for macroscopic analysis. The agent exhibited mild symptoms and no mortality recorded in the Hippocratic screening. In the sub-chronic test, few changes in urine output, platelets counts and alkaline phosphatase were observed, but are within the physiological ranges for this animal specie. The results shows that IEMa does not present oral toxicity thereby displaying a wide safety margin for therapeutic use

History, Evolution and Future of Starch Industry in Nigeria

Starch industry has progressed into a business that is worth billions of dollars globally, as they have been found useful in the food, textile, biofuel, plastic and the pharmaceutical industries. Nigeria can be the largest producer of starch in the world. Her major sources are roots and tubers (cassava, yam, cocoyam and potato), cereals (maize, sorghum, millet and rice) and fruits (banana, plantain and breadfruit). Although, all the starch crops are abundantly produced in Nigeria, only less than 1% is processed into high quality starch for industrial processes. This chapter therefore examines the past, the progression and the current state of the starch industry in Nigeria and the roles the government and relevant stakeholders must play in order to revolutionize the industry in Nigeria

Policies and practices in Nigeria’s pharmaceutical sector: A mixed methods exploration of stakeholders’ perspectives on strategic reforms

Background: Policies and practices are key factors that determine development in any sector. In the Nigerian setting however, there is lack of evidence that the pharmaceutical sector is embedded with contextual policies and practices that can expedite development in the system. This inadvertently has an impact as regards access to medicines for the citizenry. This study therefore aimed at adopting a bottom-up approach in gathering insights into stakeholders’ perspectives on policies and practices in Nigeria’s pharmaceutical sector, and how they influence Medicines’ Security and consequent access to healthcare. Methods: Data were collected using a self completion questionnaire which was administered to stakeholders present during an event held in Abuja, the capital of Nigeria, which focused on improving the Nigerian pharmaceutical sector. A total number of 82 questionnaires were administered to participants. Following retrieval of questionnaires, quantitative data were subjected to descriptive and inferential analyses, whilst textual data were analysed using thematic analysis approach. Results: Of the 82 questionnaires administered, response rate was 92.68%. Two-thirds of the participants were males (69.7%). A quarter of the study participants were between the ages of 41 and 50 years, whilst those above 50 years represented the most populous proportion of the sample (38.2%). A considerable proportion (48%) of the study participants indicated that current policy ecosystem was hostile for pharmaceutical sector growth and development. Also, majority (97.3%) of the study participants indicated that increased investment in health research could stimulate the development of the pharmaceutical sector. Majority of the study participants indicated the need for collaboration between pharmaceutical companies, research institutes and the petrochemical industry. Conclusion: This study consequently identified several critical factors that could stimulate development in the sector, including increased funding of research; stringent implementation of existing policies; and prioritisation of pharmaceutical sector by government and other key stakeholders