Client perception of service quality at the outpatient clinics of a General hospital in Lagos, Nigeria

Introduction: service quality assessments have assumed increasing importance in the last two  decades. They are useful in identifying gaps in services been provided with the ultimate aim of guaranteeing quality assurance. The objective of this study was to assess the client perception of service quality at the outpatient clinics of Randle General hospital, Lagos.Methods: a descriptive cross sectional study was conducted from March to May 2013. A multistage  sampling technique was used to select respondents and data was collected with the aid of modified  SERVQUAL questionnaires. The data was analysed with aid of EPI-INFO 2002 and statistical significance was set at a P value 0.05 for statistical significance.Results: total of 400 respondents were interviewed. The mean age was 40 years with a standard  deviation of 15.2 yrs. The highest mean score of 4.35 out of a possible maximum of 5 was recorded in assurance domain while the lowest mean score of 4.00 was recorded in the responsiveness domain. The overall mean score of all the domains was 4.20 with standard deviation of 0.51. Overall majority (80.8%) of respondents rated the overall service quality as good/ very good. After linear regression, the assurance domain was the most important predictor of the overall perceived service quality (p< 0.001).Conclusion: the overall perceived service quality was good. The major deficiencies were in the  responsiveness domain and especially the waiting time. The hospital management should implement measures to improve the responsiveness of services by ensuring prompt delivery of services.Key words: Client perception, service quality, outpatient clinics

Parents’ knowledge of car safety and practices amongst school children in an urban community of Lagos, Nigeria

No fewer than 1.2 million deaths globally are attributed to road traffic crashes yearly, with low- and middleincome countries contributing disproportionately to these deaths. Children are a vulnerable road user group, and riding unrestrained is a significant risk factor for death and injury among child car passengers. This studyaimed to determine child car safety knowledge and practices among parents of children attending a private school in an urban setting in Lagos, Nigeria. A descriptive study, using observations of child car safety practices, and a survey of parental knowledge and attitudes of child car safety, were conducted simultaneously amongst children 0-10 years riding in cars to school. Data was analysed using Epi Info Version 3.5.1. A total of 127 cars were observed as children were being dropped off at school. The proportion of child passengers aged 0 - 10 years restrained by any device was 6.3%, with only 2.4% of these children being appropriately restrained for age; 19.7% of observed child passengers rode in the front seat. Awareness of car safety seats among parents was high at 85%. However, less than 40% of respondents knew the correct age to commence use of child restraints, seat belts, or front seating. The reason most cited for non-use of child restraints was unavailability (24.1%). Despite the high level of awareness about car safety seats, parental knowledge of specific child passenger safety issues and practices were poor. Targeted interventions are needed to bridge the gap between awareness, knowledge and practice in this population.Keywords: child, motor vehicle passenger, car restraints, adults, knowledge and attitude, road safet

Improving the practice and patterns of exclusive breastfeeding in Lagos state, Nigeria: an evidence synthesis, quantitative survey, and theory-informed qualitative study

Exclusive breastfeeding is critical to support adequate growth and development and reduce infant mortality. Despite interventions to promote exclusive breastfeeding and other recommended infant feeding practices in Nigeria, rates remain suboptimal. This thesis aimed to explore interventions, barriers, and facilitators to exclusive breastfeeding up until 6 months in Lagos state, Nigeria, through three interlinked studies. The systematic review found that a wide range of interventions to support exclusive breastfeeding in a range of settings in low- and middle-income countries (LMICs) increased rates approximately twofold. Findings from the survey of Health Care Professionals in public health facilities showed critical gaps in knowledge and attitudes, especially managing breastfeeding problems and attitude towards addition of water or formula feeds during the first six months. The qualitative study employed the Capability-Opportunity-Motivation Behaviour (COM-B) model for behaviour change as its underpinning theoretical framework. Facilitators of exclusive breastfeeding identified included knowledge of its benefits, personal determination to exclusively breastfeed, and availability of a strong family/HCP support system: barriers included perceived need to give water, perception of breastmilk insufficiency, need to return to work, and lack of support for exclusive breastfeeding from significant others. These findings indicate the need for commitment from all stakeholders towards the implementation and upscaling of breastfeeding programs in a coordinated manner to increase exclusive breastfeeding in Nigeria

Sexual Violence Among Out-of-School Female Adolescents in Lagos, Nigeria

Sexual violence against females is a public health problem. This descriptive cross-sectional study sought to determine the prevalence of sexual violence among out-of-school female adolescents in Lagos, Nigeria and examine the context in which it occurs. Three hundred and fifty adolescents, between the ages of 10 and 19 years, working in Sandgrouse market, Lagos, were selected using cluster sampling. Data were collected using an interviewer-administered questionnaire. Almost half (42.9%) of the respondents have had sexual intercourse, and median age at initiation was 17 years. Forced initiation was reported by 15.8%, and 36.3% reported that first intercourse was due to coercion. Among the sexually active, only 12.3% stated that “it is what they desire.” Majority of respondents (64.1%) believe that rape is common in their community, and 18% of the sexually active have experienced rape. Out-of-school adolescents in this community are at risk of sexual violence. The factors that make them vulnerable need to be addressed

Perceptions and experiences of maternity care workers during COVID-19 pandemic in Lagos State, Nigeria;:a qualitative study

BACKGROUND: The COVID-19 (coronavirus disease 2019) pandemic challenges provision and access to essential maternity care in low-resilience health systems. The aim of this study was to explore maternity healthcare workers’ experiences of, and perceptions about providing maternity care during the COVID-19 outbreak in Lagos State, Nigeria. METHODS: This qualitative study conducted individual, remote, semi-structured interviews with midwives and traditional birth attendants (TBAs). Eligible participants spoke English, and provided maternity care during COVID-19 in Lagos, Nigeria. Participants were recruited via purposive and snowball sampling, from primary health facilities in seven Local Government Areas of Lagos State. Interview transcripts were analysed thematically following the framework method. RESULTS: Sixteen midwives (n = 11) and TBAs (n = 5) were interviewed from March to April 2021. Two overarching themes were identified from the data. ‘Maternity care workers’ willingness and ability to work during the COVID-19 pandemic’ outlined negative influences (fear and uncertainty, risk of infection, burnout, transport difficulties), and positive influences (professional duty, faith, family and employer support). Suggestions to improve ability to work included adequate protective equipment, training, financial support, and workplace flexibility. ‘Perceived impact of COVID-19 on women’s access and uptake of maternity care’ highlighted reduced access and uptake of antenatal and immunisation services by women. Challenges included overstretched health services, movement and cost barriers, and community fear of health facilities. Participants reported delayed healthcare seeking and unattended home births. Midwives and TBAs identified a need for community outreach to raise awareness for women to safely access maternity services. Participants highlighted the responsibility of the government to improve staff welfare, and to implement public health campaigns. CONCLUSIONS: Despite disruption to maternity care access and delivery due to COVID-19, midwives and TBAs in Lagos remained committed to their role in caring for women and babies. Nevertheless, participants highlighted issues of understaffing and mistrust in Lagos’ underfunded maternity care system. Our findings suggest that future resilience during outbreaks depends on equipping maternity care workers with adequate working conditions and training, to rebuild public trust and improve access to maternity care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-08009-y

Parental knowledge, attitude and practice regarding infant teething in rural and urban communities in southwest Nigeria: a comparative study

Background: Many parents still associate teething with one symptom or the other with the possibility of overlooking a potentially fatal condition because the condition is labelled as teething. This study was designed to assess and compare the knowledge, attitude and practice regarding infant teething among parents in a rural and an urban community in Lagos, Nigeria.Methods: A comparative cross-sectional study was conducted in a household survey of 400 respondents in a rural and an urban community. Respondents were selected by multistage sampling. Data was collected using an interviewer-administered questionnaire and analysed using SPSS version 20.Results: The proportion of respondents with good knowledge was significantly higher in the urban (72.5%) than in the rural area (58.5%) and secondary education was significantly associated with good knowledge in both areas (p<0.05). Higher education and occupation were significantly associated with positive attitude towards teething in both areas (p<0.05). The proportion of respondents with good practice regarding infant teething was significantly higher in the urban area (94.5%) than in the rural area (84.5%) [p=0.001].Conclusion: There was better knowledge and practice among parents in the urban than the rural area. Community education, particularly in rural areas, is recommended to dispel myths and false beliefs about teething.Keywords: Teething problems; Infants; Knowledge; Attitude; Practic

Preference for private hospital-based maternity services in inner-city Lagos, Nigeria: An observational study

Objectives To determine factors associated with maternal preference for delivery in private hospitals in an urban community in sub-Saharan Africa.Methods A cross-sectional study of socio-demographic and obstetric characteristics of mothers and their newborns attending Bacille Calmette-Guérin (BCG) immunization clinics in inner-city Lagos, Nigeria. Factors associated with delivery in private hospitals were determined using multivariable logistic regression analyses.Results Of the 3296 mothers enlisted for this study 1659 (50.3%) delivered in private hospitals and 1637 (49.7%) in public hospitals. Government hospitals had a higher proportion of doctors at delivery. Use of private obstetric services was significantly associated with ethnicity, religion, social class and obstetric history. Infants delivered at private hospitals were significantly more likely to be undernourished and have severe hyperbilirubinemia but less likely to be preterm and at no greater risk of hearing loss.Conclusions Current global strategies to expand facility-based deliveries in order to reduce maternal and child mortality rates need to be complemented by improved regulatory/supervisory framework at country levels to better serve mothers and their offspring in urban areas who may opt for private hospitals usually lacking adequate obstetric and pediatric facilities against the backdrop of the rapid urban transition in Africa.Maternal health Urban health Health-seeking behavior Immunization clinics Developing country

Community health workers experiences and perceptions of working during the COVID-19 pandemic in Lagos, Nigeria - A qualitative study

BACKGROUND: Community Health Workers are globally recognised as crucial members of healthcare systems in low and middle-income countries, but their role and experience during COVID-19 is not well-understood. This study aimed to explore factors that influence CHWs’ ability and willingness to work in the COVID-19 pandemic in Lagos. DESIGN: A generic qualitative study exploring Community Health Workers experiences and perceptions of working during the COVID-19 pandemic in Lagos, Nigeria. METHODS: 15 semi-structured, in-depth, video interviews were conducted with Community Health Workers purposively sampled across seven of Lagos’ Local Government Areas with the highest COVID-19 burden. Interviews explored Community Health Workers’ attitudes towards COVID-19, its management, and their experiences working in Lagos. Data was analysed thematically using the framework method. RESULTS: Three main themes were identified. 1. Influences on ability to undertake COVID-19 Role: Trust and COVID-19 knowledge were found to aid Community Health Workers in their work. However, challenges included exhaustion due to an increased workload, public misconceptions about COVID-19, stigmatisation of COVID-19 patients, delayed access to care and lack of transportation. 2. Influences on willingness to work in COVID-19 Role: Community Health Workers’ perceptions of COVID-19, attitudes towards responsibility for COVID-19 risk at work, commitment and faith appeared to increase willingness to work. 3. Suggested Improvements: Financial incentives, provision of adequate personal protective equipment, transportation, and increasing staff numbers were seen as potential strategies to address many of the challenges faced. CONCLUSION: Despite Community Health Workers being committed to their role, they have faced many challenges during the COVID-19 pandemic in Nigeria. Changes to their working environment may make their role during disease outbreaks more fulfilling and sustainable. International input is required to enhance Nigeria’s policies and infrastructure to better support Community Health Workers during both current and future outbreaks

sj-docx-1-dhj-10.1177_20552076221150072 - Supplemental material for Telemedicine ready or not? A cross-sectional assessment of telemedicine maturity of federally funded tertiary health institutions in Nigeria

Supplemental material, sj-docx-1-dhj-10.1177_20552076221150072 for Telemedicine ready or not? A cross-sectional assessment of telemedicine maturity of federally funded tertiary health institutions in Nigeria by Tolulope F Olufunlayo, Oluwadamilola O Ojo, Obianuju B Ozoh, Osigwe P Agabi, Chuks R Opara, Funmilola T Taiwo and Olufemi A Fasanmade, Njideka U Okubadejo in Digital Health</p