Adequacy of Technical Facilities for Maternal Health Care Delivery in Public Secondary and Tertiary Facilities in Osun State, Nigeria

Nigeria has one of the highest maternal mortalities and morbidities in the world, and the need to address these challenges continues to engage the attention of relevant stakeholders but very little attention has focused on technological resources within the maternal health research agenda. This study aims to identify and determine the adequacy of the key equipment for emergency obstetric care (EmOC) services in public-sector secondary and tertiary health facilities in Osun State, Southwest, Nigeria. Using a two-stage probability sampling procedure, 7 health facilities based in 6 randomly selected Local government areas (LGAs) were involved in the study. Data were obtained through the use of primary and secondary sources. For primary sources, a questionnaire was administered to 112 health workers and the study also utilized a checklist for equipment inventory. For secondary sources we reviewed existing hospital records on technology acquisition and maintenance. Relevant descriptive and inferential statistics were used for the data analysis. Almost three-fifths (58.1%) of the health workers considered the technical facilities for the delivery of EmOC in their facilities as inadequate, the proportion of health workers with such opinion was significantly higher in secondary compare to tertiary facilities (60.0% vs 40.0%, p=0.003). The inventory review and use of the checklist also showed varying degree of inadequate technical facilities; none of the facilities had all the 26 equipment considered as essential for comprehensive EmOC in functional state. We concluded that the public sector facilities in Osun State have inadequate technical facilities for EmOC; addressing this technological challenge will be critical to improving maternal health outcomes and statistics in Nigeria

Knowledge, Practice and Willingness to Participate in Community Health Insurance Scheme among Households in Nigerian Capital City

Background: Health insurance is a social security system that guarantees the provision of needed health services to persons on the payment of token contributions at regular intervals. The objective of the survey was to determine knowledge, practice and willingness of households in Nigerian Capital City to pay and participate in Community Health Insurance Scheme.Materials and Methods: This descriptive and analytical cross-sectional study was carried out using the multistage cluster sampling technique to obtain data from 300 selected household heads or main financial decision makers. The data was analyzed using EPI-INFO software package. Statistical significance of p < 0.05 and confidence limit of 95% was used.Results: The major findings showed that the level of awareness (13%) concerning Community Health Insurance (CHI) was found to be very low among the respondents. The general principles of CHI were also poorly understood by the respondents. Attitude to the programme was positive as many showed interest in participating and enrolling themselves (97.0%), some family members (96.3%) and entire family members (90.3%).  Borrowing money to settle medical bills in this study has occurred in 30% of instances. Majority of respondents were willing to pay premiums ranging from N450 (96.6%) to N1200 (72.5%) for simple packages that do not include surgery and hospitalization.Conclusions: The community members were willing to participate and enrol if the programme is brought to them. There is a need to adequately subsidize the premiums that respondents were willing to pay in order to meet up with the cost of treatment.Key Words: Willingness, Participate, Community Health Insurance