Motivation and incentives of rural maternal and neonatal health care providers: a comparison of qualitative findings from Burkina Faso, Ghana and Tanzania.

In Burkina Faso, Ghana and Tanzania strong efforts are being made to improve the quality of maternal and neonatal health (MNH) care. However, progress is impeded by challenges, especially in the area of human resources. All three countries are striving not only to scale up the number of available health staff, but also to improve performance by raising skill levels and enhancing provider motivation. In-depth interviews were used to explore MNH provider views about motivation and incentives at primary care level in rural Burkina Faso, Ghana and Tanzania. Interviews were held with 25 MNH providers, 8 facility and district managers, and 2 policy-makers in each country. Across the three countries some differences were found in the reasons why people became health workers. Commitment to remaining a health worker was generally high. The readiness to remain at a rural facility was far less, although in all settings there were some providers that were willing to stay. In Burkina Faso it appeared to be particularly difficult to recruit female MNH providers to rural areas. There were indications that MNH providers in all the settings sometimes failed to treat their patients well. This was shown to be interlinked with differences in how the term 'motivation' was understood, and in the views held about remuneration and the status of rural health work. Job satisfaction was shown to be quite high, and was particularly linked to community appreciation. With some important exceptions, there was a strong level of agreement regarding the financial and non-financial incentives that were suggested by these providers, but there were clear country preferences as to whether incentives should be for individuals or teams. Understandings of the terms and concepts pertaining to motivation differed between the three countries. The findings from Burkina Faso underline the importance of gender-sensitive health workforce planning. The training that all levels of MNH providers receive in professional ethics, and the way this is reinforced in practice require closer attention. The differences in the findings across the three settings underscore the importance of in-depth country-level research to tailor the development of incentives schemes

A survey of challenges and career aspirations of clinical dental students in Nigerian universities

Objective: The study assessed undergraduate challenges and career aspirations of clinical dental students in Nigerian Universities. Method: A cross-sectional study in which all clinical dental students were evaluated. Data collection was by self-administered questionnaires distributed to the study population, which required demographic information location of dental school, entry qualification, choice of dentistry as a career, assessment of the dental programme and improvements suggest to make a difference in the programme. Result: There were 197 respondents, 98 males (49.7%) and 99 females (50.3%). Male: female was 1:1.01, mean age was 24.9 (+2.8). The majority, 191(97.0 %) were admitted through the Joint Admission Matriculation Board Examinations (JAMB-E). Benin dental school had the highest number of students, 77 (39.1%). One hundred and ninety-four (98.47%) of these Nigerian students were from the southern geo-political zones of the country. Undefined curriculum (23.86%), lack of dental materials (20.3%) and faulty equipment (18.78%) were the commonest constraints reported by the students during the undergraduate training. The need for improved clinical teaching and supervision by consultants was recommended by 31.47% of the students. Significantly more females wanted to specialize in paedodontics (p=0.00) and more males in oral and maxillofacial surgery (p=0.00). Conclusion:  While provision of formal lectures was considered satisfactory in most of the dental schools, a definite need for improvement in the clinical aspect of training was reported by the students. This included chair side teaching and provision of materials for patient management. Lack of a well defined and specific curriculum was perceived as a major problem in some of the dental schools.   Key words: Dental education, students, career aspirations  

Effect of mineral trioxide aggregate and formocresol pulpotomy on vital primary teeth: A clinical and radiographic study

Background: Pulpotomy is the common therapy for cariously exposed pulps in symptom‑free primary molar teeth. Formocresol (FC) is considered the gold standard dressing agent for pulpotomy, but concerns have been raised over the years about its safety. Other alternative pulpotomy agents have been investigated and suggested.Objective: The objective was to evaluate and compare the clinical and radiographic response of FC and white mineral trioxide aggregate (MTA) as pulpotomy materials on primary molars.Materials and Methods: Fifty primary molars, with deep carious lesion that exposed a vital but asymptomatic pulp, in 37 children aged 4-7 years were treated with conventional pulpotomy procedure. The teeth were divided randomly into two groups. Group I (FC) and group II (MTA). The treated teeth were evaluated clinically and radiographically and were followed‑up for 12 months.Results: At the end of the 12 months follow‑up, the clinical success rates for FC and MTA were 81% and 100%, respectively. There was a statistically significant difference (P = 0.04) between the clinical success rates of FC and MTA. While the radiographic success rates for FC and MTA were 81% and 96%, respectively, there was no statistically significant difference between the radiographic success of MTA and FC.Conclusion: White MTA showed a higher clinical and radiographic success rate when compared to FC as a pulpotomy agent in vital primary molars, and it has a potential to become a replacement for FC in primary molars.Key words: Formocresol, mineral trioxide aggregate, primary molars, pulpotom

Unerupted maxillary central incisors: a case report and review of the literature

Missing or unerupted central incisors in a child can have a major impact on oro-facial aesthetics. This may be a source of great psychological concern to child and parents by virtue of its prominent anterior location. Non-eruption could be due to hereditary and local environmental factors. Surgical and/or orthodontic intervention is often required in the management of the condition especially after six months since the eruption of the contra lateral tooth. In this report, a nine year old boy presented with unerupted maxillary right central and lateral incisors. The management involved clinical, radiographic and orthodontic assessment. A diagnosis of hyperplastic gingivae preventing eruption of the incisors was made. Removal of the obstruction and exposure of the crowns of the teeth resulted in their spontaneous eruption and subsequent alignment in the maxillary arch. It is concluded that teeth which have not erupted six months after their normal eruption time be examined radiographically. Early removal of causative factors leads to better prognosis This mixed dentition anomaly of tooth eruption was conservatively managed by paedodontists Keywords: Unerupted maxillary incisors, managementNigerian Dental Journal Vol. 16 (1) 2008: pp. 26-3

Research Productivity of ]unior Academic Staff at a Tertiary Medical College in South West, Nigeria

No Abstract

Risk factors associated with early childhood caries (ECC) in Nigerian children

No Abstrac

Managing oral bleeding in children with hereditary bleeding disorders: case series and a review of literature

Bleeding disorders are mostly of genetic or hereditary origin in children. Dental consultations sought by patients with bleeding disorders may follow trauma, dental infections or may be insidious. The present report is on five cases managed at the Paedodontic unit of the Child Dental Health Clinic of the Lagos University Teaching Hospital. The report gives a review of some of the challenges faced in the dental management of patients with hereditary bleeding disorders and the treatment options for the different oral presentations. Four of these patients had haemophilia A and the other had von Williebrand disease. All the patients presented with bleeding gingivae secondary to either physiologic processes of eruption, infective or traumatic dental conditions. The management of the patients was comprehensive with a multidisciplinary approach. The prevention of traumatic and infective dental conditions is an important part of oral health care in individuals with hereditary bleeding disorders. This would reduce the need for treatment and should reduce the number of emergency visits.Key words: Haemophilia, von Willebrand disease, gingival bleeding, dental managemen

Community health workers’ knowledge and practice in relation to pre-eclampsia in Ogun State, Nigeria: an essential bridge to maternal survival

Background: Pre-eclampsia is a leading cause of maternal and fetal morbidity and mortality worldwide. Early detection and treatment have been instrumental in reducing case fatality in high-income countries. To achieve this in a low-income country, like Nigeria, community health workers who man primary health centres must have adequate knowledge and skills to identify and provide emergency care for women with pre-eclampsia. This study aimed to determine community health workers’ knowledge and practice in the identification and treatment of pre-eclampsia, as they are essential providers of maternal care services in Nigeria. Methods: This study was part of a multi-country evaluation of community treatment of pre-eclampsia. Qualitative data were obtained from four Local Government Areas of Ogun State, in south western Nigeria by focus group discussions (N = 15) and in-depth interviews (N = 19). Participants included a variety of community-based health care providers - traditional birth attendants, community health extension workers, nurses and midwives, chief nursing officers, medical officers – and health administrators. Data were transcribed and validated with field notes and analysed with NVivo 10.0. Results: Community-based health care providers proved to be aware that pre-eclampsia was due to the development of hypertension and proteinuria in pregnant women. They had a good understanding of the features of the condition and were capable of identifying women at risk, initiating care, and referring women with this condition. However, some were not comfortable managing the condition because of the limitation in their ‘Standing Order’; these guidelines do not explicitly authorize community health extension workers to treat pre-eclampsia in the community. Conclusion: Community-based health care providers were capable of identifying and initiating appropriate care for women with pre-eclampsia. These competencies combined with training and equipment availability could improve maternal health in the rural areas. There is a need for regular training and retraining to enable successful task-sharing with these cadres. Trial registration NCT01911494 .Medicine, Faculty ofOther UBCNon UBCObstetrics and Gynaecology, Department ofReviewedFacult