Investigating determinants of out-of-pocket spending and strategies for coping with payments for healthcare in southeast Nigeria

<p>Abstract</p> <p>Background</p> <p>Out-of-pocket spending (OOPS) is the major payment strategy for healthcare in Nigeria. Hence, the paper assessed the determinants socio-economic status (SES) of OOPS and strategies for coping with payments for healthcare in urban, semi-urban and rural areas of southeast Nigeria. This paper provides information that would be required to improve financial accessibility and equity in financing within the public health care system.</p> <p>Methods</p> <p>The study areas were three rural and three urban areas from Ebonyi and Enugu states in South-east Nigeria. Cross-sectional survey using interviewer-administered questionnaires to randomly selected householders was the study tool. A socio-economic status (SES) index that was developed using principal components analysis was used to examine levels of inequity in OOPS and regression analysis was used to examine the determinants of use of OOPS.</p> <p>Results</p> <p>All the SES groups equally sought healthcare when they needed to. However, the poorest households were most likely to use low level and informal providers such as traditional healers, whilst the least poor households were more likely to use the services of higher level and formal providers such as health centres and hospitals. The better-off SES more than worse-off SES groups used OOPS to pay for healthcare. The use of own money was the commonest payment-coping mechanism in the three communities. The sales of movable household assets or land were not commonly used as payment-coping mechanisms. Decreasing SES was associated with increased sale of household assets to cope with payment for healthcare in one of the communities. Fee exemptions and subsidies were almost non-existent as coping mechanisms in this study</p> <p>Conclusions</p> <p>There is the need to reduce OOPS and channel and improve equity in healthcare financing by designing and implementing payment strategies that will assure financial risk protection of the poor such pre-payment mechanisms with government paying for the poor.</p

Comparison of Pawpaw (Carica Papaya) and Mango (Mangifera Indica) Leaves Extracts for Antitrypanosomal Activites

These studies aimed at confirming our former work on antitrypanosomal effects of Mangifera indica (mango) and Carica papya (Pawpaw) leaves in experimental animals infected with T. brucei and identify which one of them is superior as an antiparasitic agent. It was also designed to carry out further fractionation of the better of the two to identify the chemical component responsible for the observed activity. There is evidence from our data that the pawpaw extract has a greater antitrypanosomal effect then the mango extract. On further fractionation of the pawpaw extract, the bulk of the antiparasitic effect was found to be located in the alkaloid fraction. NQJHM Vol. 14 (3&4) 2004: pp. 294-29

Evaluation of Anti-diabetics and Cardiovascular Effects of Parinari curatellifolia Seed Extract and Anthoclista vogelli Root Extract Individually and Combined on Postprandial and Alloxan-Induced Diabetic Albino Rats

Objective: To study toxicity, anti-diabetic and cardiovascular effects of hydro-ethanolic extracts of Parinari curatellifolia seed extract and Aristolochia vogelii roots extract and (1:1) mixture of the above two extracts. Materials and Methods: Twenty Wister strain albino rats were randomly assigned to four groups; A, B, C and D with each consisting of five animals received extracts as follows: Group I, P. curatellifolia and A. vogelli mixture (1:1) (500 mg/kg bwt); Group II, A. vogelli (500 mg/kg bwt); Group III, P. curatellifolia seed extract (500 mg/kg bwt); Group IV, 0.5 ml (2% w/v) acacia solution and served as control. After 30 min, the animals were each administered orally with 40% (w/v) glucose at a dose of 1ml /100 g bwt. Blood glucose levels were then monitored at 30, 60, and 120 min. intervals and reported as the average glucose level of each group. Another set of twenty five rats (diabetic rats) were randomly distributed into five groups of five animals each while the additional sixth group was the positive control consisting of five normal rats. Treatments were as follows: Group I, diabetic treated with A. vogelli at a dose of 500 mg/kg bwt; Group II, diabetic treated with P. curatellifolia at a dose of 500 mg/kg bwt; Group III, diabetic treated with glibenclamide 600μg /kg bwt; Group IV, diabetic treated with mixture of Parinari curatellifolia and A. vogelli (1:1) (500 mg/kg bwt); Group V, diabetic untreated (control negative) while group VI was the positive control. Results: A significant reduction in postprandial sugar level was observed after 30 min in all treatments. The extracts individually and in combined form also showed effective decrease in plasma glucose levels on the diabetic rats. There were significant reductions (p<0.05) in low density lipoprotein (LDL)-cholesterol levels and significant increase (p<0.05) in high density lipoprotein (HDL)–cholesterol in the treated diabetic group compared to the negative control. Furthermore, significant reductions in aspartate aminotransferases (AST) and alanine aminotransferases (ALT) levels were observed in the treated diabetic animals compared to the untreated. Also significant reduction in the creatinine and increase in the protein levels respectively were observed in the treated diabetic groups. Conclusion: The results showed that the respective extracts and the extract mixture had both good hypoglycaemic activity and beneficial effects on cardiovascular risk factors

AGRICULTURE AND BIOLOGY JOURNAL OF NORTH AMERICA Antihyperglycaemic and antihyperlipidaemic effects of aqueous ethanol extract of Tapinanthus globiferus leaves and Treculia africana root bark and their mixture on alloxan diabetic rats

ABSTRACT The plants Treculia africana and Tapinanthus globiferus are ethnobotanically used in the treatment of various diseases including diabetes and heart diseases. Diabetes mellitus is a disease characterized by hyperglycemia and hyperlipidemia which leads to an increased risk of atherosclerosis and other cardiovascular diseases. The effects of aqueous ethanol (96%) extracts of T. africana leaves and Tapinanthus globiferus plants and their mixture, in an equal proportion, were evaluated on postprandial glycemic status. Four groups of normal rats were treated with the extracts at a dose 250mg/kg each, their mixture (1:1), at a dose of 500 mg/kg body weight, 0.5ml of acacia (2%w/v) and then charged with glucose (40%) at a dose of 1 ml/100 g body weight. Plasma sugar contents were analyzed from the blood collected from the tail vein at 30, 60, 90 and 120 min intervals. Also glycemic status and serum lipid profiles of normal and Alloxan-induced diabetic rats were evaluated. Five groups of alloxan-induced diabetic (150 mg/kg ip) rats were treated with the extracts and the (1:1) mixture at a dose of 500 mg/kg, respectively for 21 days. Significant reduction (p≤0.05) in both postprandial blood glucose but not in alloxan-induced diabetes blood glucose levels, triglyceride levels, low density lipoprotein (LDL) level, and increase in high density lipoprotein (HDL) level were observed in the mixture. This scientific finding does not support the basis for the herbal use of mixture of T. africana and Tapinanthus globiferus in the management of diabetes and heart diseases