Patterns of Antenatal Care Seeking Behavior in South East Nigeria: Exploring Relationship with Age, Education, and Socioeconomic Status

Background: Maternal and infant morbidity and mortality are major public health problems in Nigeria. Although it is well-known that appropriate antenatal care (ANC) is important in reducing maternal morbidity and mortality, there is limited information on inequities on ANC seeking pattern among the pregnant women in Nigeria. Aim: The study was designed to explore inequities due to age, education, and socioeconomic status (SES) of women of childbearing age in seeking ANC services in Nigeria. Subjects and Methods: A household survey was conducted in 10 randomly selected villages in Nnewi, Anambra State, South-East Nigeria. An interviewer-administered questionnaire was used to collect relevant data from 420 women of childbearing age from the villages. The effects of age, education, SES, and ANC seeking behavior were analyzed. Results: It was found that 61.4% (254/420) of the respondents attended ANC clinic at least 6times. Although most of the respondents sought ANC in formal health, a greater percentage utilized private hospitals/clinics more than public health facilities. Age (P < 0.01), educational level (P < 0.001), and SES (P < 0.01) had statistically significant effects on respondents’ antenatal clinic attendance and choice of facilities. The highest SES group was more likely to utilize teaching hospitals and private clinics than other SES groups. Conclusions: There were inequities due to SES, educational level, and age of respondents in the pattern of ANC seeking behavior. These inequities could negate the achievement of millennium development goals (MDGs). Interventions that would address the inequities should be developed and implemented if the health-related MDGs are to be achieved.KEY WORDS: Antenatal care, health seeking behavior, inequities, Nigeria, women of childbearing ag

Industrial design and simulation of a JIT material handling system

A Just-in-Time (JIT) Material Handling System attempts to manufacture products from start to finish by rearranging the factory floor layout away from batch production toward a product layout using flow lines. One of the most accepted JIT production methods used in this work is known as the Kanban system. Kanbans are used to operate a pull system of material control that links all supplying operations to a final assembly line. The ultimate goal of this system is the conversion of raw materials at the Juhel Oral Drug Process plant into finished products with lead time equal to processing time. The flows in the manufacturing model include: the flow of materials, the flow of information, and the flow of cost. These flows create the value streams. Components of the value stream can be value-add or waste, depending on the operating conditions. The simulation model developed in this research work is based on the single-card pull system developed at the Drug Process Plant. This model consists of three blocks (workstations) where there is a buffer located between two workstations. In this model, the material moves according to the Kanban rule. If Kanbans arrive and the material is available, the workstation starts processing the material. This research demonstrates that the design of the JIT system can significantly affect key manufacturing performance measures. JIT implementation cannot provide significant benefits if setup time and variability remain high as well as if the company is not able to optimise the production facilities by product mix. Based on the result from this work, JIT is not based upon rigid concepts. Therefore, successful implementation depends largely on the company’s ability to identify problems, creativity and efforts. The application of single-card pull system coupled with the use of the trigger point results in simpler mechanisms for operating the system