Disparity in Catastrophic Healthcare Expenditures Across Households’ Income Groups in Nigeria: The Lens of Foster-Greer-Thorbecke Poverty Indices

The Nigeria health care system seems to have continue in the downturn trend as a result of the decay in public health care system and this have continued to drive the rising health care financed by out-of-pocket expenditure health hence, the study examined the disparity in Catastrophic Healthcare expenditures across Households income groups in Nigeria using the Nigeria Health and Demographic Survey 2018. The study employed the Foster-Greer-Thorbecke indices and the logit model. Findings from the study showed that some household and individual characteristics are associated with catastrophic health expenditure in Nigeria. Many households experience catastrophic health payments due to factors such as age, education of household head, health insurance status, geo- political zone, type of health facilities visited, and type of illness suffered. Governments are yet to find fair and innovative ways of financing the health system so as to reduce the financial burden of out-of-pocket payments on households and individuals in Nigeria. There is also urgent need for increased financial protection as well as insurance coverage through small credit and rural households’ contribution scheme as an alternative to the National Health Insurance Scheme to enhance health financing option that could reduce the huge private health cost of out-of-pocket expenditure. There is need for pressure on the legislature to provide a bill that disallow health care tourism for public office holders abroad as way of checkmating the better health care system in Nigeria. Keywords: Health care, Inequality, Income groups, private health cost, households DOI: 10.7176/JESD/13-20-03 Publication date:October 31st 202

A gaming simulation approach to understanding blue ocean strategy development as a transition from traditional competitive strategy

Blue Ocean Strategy (BOS) has attracted a resurgence of interest following various market discontinuities, including digital disruption, the growth of the sharing economy and the development of ecosystems. BOS is a combination of value innovation and new markets, driving sustained higher performance through specific marketing activities, but it is difficult to conceive and implement. We outline five cases that use various transition paths to BOS through white spaces - with product extensions in the existing market. An important part of this transition are ‘blue ocean droplets’ which drive profitable growth through the transition and then onto a successful deployment of a blue ocean strategy. Blue ocean droplets drive profitable growth - simultaneously increasing volume sales, maintaining/increasing prices and maintaining/decreasing costs. We then use an inductive qualitative approach in a multi-team gaming simulation to examine drivers of firm performance. Higher than average performance is driven by repositioning in white spaces and execution of the three blue ocean droplets. Finally, we discuss implications for firms: execute a number of real options to follow one of several transition paths to a full BOS. This approach involves less downside risk than a full BOS approach, but can still be sustainably profitable, while also breaking the traditional value/cost trade-off

Incidence, patterns and severity of reported unintentional injuries in Pakistan for persons five years and older: results of the National Health Survey of Pakistan 1990–94

<p>Abstract</p> <p>Background</p> <p>National level estimates of injuries are not readily available for developing countries. This study estimated the annual incidence, patterns and severity of unintentional injuries among persons over five years of age in Pakistan.</p> <p>Methods</p> <p>National Health Survey of Pakistan (NHSP 1990–94) is a nationally representative survey of the household. Through a two-stage stratified design, 18, 315 persons over 5 years of age were interviewed to estimate the overall annual incidence, patterns and severity of unintentional injuries for males and females in urban and rural areas over the preceding one year. Weighted estimates were computed adjusting for complex survey design using <it>surveyfreq </it>and <it>surveylogistic </it>option of SAS 9.1 software.</p> <p>Results</p> <p>The overall annual incidence of all unintentional injuries was 45.9 (CI: 39.3–52.5) per 1000 per year; 59.2 (CI: 49.2–69.2) and 33.2 (CI: 27.0–39.4) per 1000 per year among males and females over five years of age, respectively. An estimated 6.16 million unintentional injuries occur in Pakistan annually among persons over five years of age. Urban and rural injuries were 55.9 (95% CI: 48.1–63.7) and 41.2 (95% CI: 32.2–50.0) per 1000 per year, respectively. The annual incidence of injuries due to falls were 22.2 (95% CI: 18.0–26.4), poisoning 3.3 (95%CI: 0.5–6.1) and burn was 1.5 (95%CI: 0.9–2.1) per 1000 per year. The majority of injuries occurred at home 19.2 (95%CI: 16.0–22.4) or on the roads 17.0 (95%CI: 13.8–20.2). Road traffic/street, school and urban injuries were more likely to result in handicap.</p> <p>Conclusion</p> <p>There is high burden of unintentional injuries among persons over five years of age in Pakistan. These results are useful to plan further studies and prioritizing prevention programs on injuries nationally and other developing countries with similar situation.</p

Respiratory Diphtheria in Two Children Presenting to A Tertiary Hospital in South–East Nigeria

Respiratory diphtheria is an acute and infectious disease that can progress to cardiac and neurological complications ultimately resulting in increased morbidity and mortality in affected individuals. Diagnosis was made in line with the WHO clinical case definition for Diphtheria. This is a report of two probable cases of complicated respiratory diphtheria presenting within 3 weeks of each other to the Paediatrics Department of Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi, Anambra state, South-East Nigeria. The first patient was a 5-year-old female who presented on referral with a history of fever, throat pain, noisy breathing and facial fullness, in whom bull neck appearance and membrane in the throat was observed. She was tachycardic, in respiratory distress, had elevated jugular venous pulse (JVP), soft tender liver and a greyish membrane in the throat. She was managed as a case of Diphtheric Carditis and discharged after 17 days on admission in stable condition. The second patient was also a 5-year-old, male, who presented with a history of fever, difficulty in swallowing, change of voice (progressing from hoarseness to whispers), cough and staggering gait. Onset of the illness was associated with membrane in the throat, bull neck and stridor. Examination revealed cranial nerve deficits, aphonia, hypotonia and staggering gait. CSF analysis was within normal. He was managed as a case of Diphtheric Neuropathy and was discharged home in stable condition after 16 days on admission. C. diphtheria IGG done 2 weeks post discharge was 0.19 IU/ml. The cases suggest that respiratory diphtheria still occurs in children in our environment. A high index of suspicion is needed to diagnose and properly nurse these children back to health. Keywords: Corynbacterium diphtheriae, Paediatric Pulmonolog

Towards a Chipless and Wireless Passive System for Real‐Time Encoding of the Bladder Volume

Neurogenic bladder and other lower urinary tract dysfunctions represent a significant health hazard and life‐quality impairment in individuals suffering from neurological disorders. A few implantable and wearable technologies have been proposed to partially recover bladder functionality, mostly based on resistive and capacitive strain gauges designed to be surgically placed inside the pelvic cavity. In this work, an alternative proof‐of‐concept device for monitoring the volumetric changes of the bladder is presented, where the sensing element is based on a capacitive linear encoder integrated with a passive wireless radio‐frequency resonator, which can be remotely interrogated. The sliding mechanism at the core of the proposed system allows a wide sensing range without stringent requirements on materials properties and overall device stability

Transition towards market interest rates in Nigeria An empirical assessment

SIGLEGBUnited Kingdo