Strengthening the Legislature for Effective Performance at the Third Tier of Government in Nigeria

The legislature is a vital organ of government in a democratic regime just as the executive and the judiciary. Unfortunately, the legislature at local government level in Nigeria has become moribund to deliver its vital roles due to a number of challenges such as party politics, appointment of caretaker members into council areas, use of local-state joint account, overbearing of the state government(s) on grassroots activities, and so on. As a result of the above challenges, the legislature at the third tier of government needs to be repositioned for effective service delivery. Hence, this paper examines the challenges of the legislature at the third tier of government with a view to making it more assertive to deliver on its constitutional roles. The study adopts qualitative method in its investigation. Data for the study were gathered from secondary sources and were content analyzed. The study revealed that the legislative activities at the grassroots in Nigeria are below expectation. This paper concludes that if the legislative arm of government is properly strengthened at the grassroots, it is capable of enabling people to receive urgent attention, assist in public engagement, reduce marginalization, and convey higher degree of legitimacy on the legislators for decision making. Keywords: strengthening, the legislature, effective performance, service delivery, third tier of government. DOI: 10.7176/DCS/11-4-05 Publication date: April 30th 202

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways