Quality assessment in higher education in Nigeria: input, process and outcome approaches

Sustainability of any meaningful growth at all levels in any nation is achieved through education. Consequently, higher education is where the knowledge that sustains a nation is nurtured. This thus underscores the importance of quality in higher education. If this is the core mandate in National Policy on Education, who then defines what constitute quality in this context, how is it assessed, maintained and how have all these played out in higher education system in Nigeria. This contributory piece towards a quest for quality education in Nigeria therefore seeks to attempt addressing these questions through the prism of the input, output and outcome approaches with a view to suggesting direction for actualizing quality in higher education in Nigeria

Determinants and Differentials of Maternal Reproductive Health Outcomes in Nigeria: A Review of National Demographic Health Survey Data from 1999 to 2013

Women in Sub-Saharan Africa face significant clinical and socio-demographic challenges that translate to poor health outcomes including high maternal morbidity and mortality. Nigeria being the most populous nation in Africa bears a significant burden of both communicable and non-communicable diseases. This study aimed to determine the trends and differentials in indices fuelling poor health outcomes in Nigeria. The study was a review and trend analysis of maternal reproductive health indicators obtained from the Nigeria National Demographic and Health Survey (NDHS) data from 1990 to 2013 including secondary data from WHO, UNICEF and the World Bank. The life expectancy at birth was 54.5 years with an estimated infant mortality rate of 75 per 1000 live births, child mortality rate of 88 per 1,000 live births, under-5 mortality rate of 157 per 1,000 live births and a maternal mortality ratio (MMR) of 545 per 100,000 live births. Contraceptive prevalence was 22% among women in the wealthiest quintile and 3% among those in the poorest quintile.  Only 3% of women with no education used modern contraception as compared to 24% of women with tertiary education. Most of the maternal deaths were due to preventable causes which were largely related to poverty, inimical socio-cultural beliefs and practices as well as clinical factors like haemorrage, hypertension, and indirect causes like inadequate human resource for health, user charges, cultural pregnancy/childbirth beliefs and myths. A community-based participatory research using both qualitative and quantitative methods may shed more light on the non-clinical factors fueling high MMR in Nigeria. Keywords: Maternal and Child Health, maternal mortality, contraceptio

Artemether-lumefantrine versus artesunate plus amodiaquine for treating uncomplicated childhood malaria in Nigeria: randomized controlled trial

BACKGROUND: The therapeutic efficacy of artesunate plus amodiaquine and artemether/lumefantrine were assessed in an area of Nigeria with high levels of Plasmodium falciparum resistance to chloroquine and sulphadoxine-pyrimethamine. PARTICIPANTS: Children aged 6 to 59 months with uncomplicated P. falciparum infection and parasite density 1,000 to 200,000 parasites/μL enrolled following informed consent by parents. METHODS: Eligible children were randomly assigned to receive either a 3-day course of artesunate (4 mg/kg) plus amodiaquine (10 mg/kg) or 6-dose course of artemether/lumefantrine (20/120 mg tablets) over three days. Patients were followed up with clinical and laboratory assessments until day 14 using standard WHO in-vivo antimalarial drug test protocol. RESULTS: A total 119 eligible children were enrolled but 111 completed the study. Adequate clinical and parasitological response (ACPR) was 47 (87.0%) and 47 (82.5%) for artemether-lumefantrine (AL) and artesunate+amodiaquine (AAMQ) respectively (OR 0.7, 95% confidence interval 0.22 to 2.22). Early treatment failure (ETF) occurred in one participant (1.8%) treated with AAQ but in none of those with AL. Two (3.7%) patients in the AL group and none in the AAQ group had late clinical failure. Late parasitological failure was observed in 9 (15.8) and 5 (9.3%) of patients treated with AAQ and AL respectively. None of participants had a serious adverse event. CONCLUSION: Artemether-lumenfantrine and artesunate plus amodiaquine have high and comparable cure rates and tolerability among under-five children in Calabar, Nigeria

Commentaries on ‘Hand washing for preventing diarrhoea’, with a response from the review authors

944-950These are commentaries on a Cochrane review, published in this issue of EBCH, first published as: Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA. Hand washing for preventing diarrhoea. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD004265. DOI: 10.1002/14651858.CD004265.pub2

Socio-demographic determinants of mammography uptake among women of 40 years and above in Calabar, South-South, Nigeria: a cross-sectional study

INTRODUCTION: mammography has the potential for identifying high risk women with breast cancer. Early detection is important in reducing mortality and morbidity, and crucial for better prognosis. Mammography is poorly practiced in Nigeria. This study assessed the association between socio-demographic characteristics and uptake of mammography among women ≥40 years. METHODS: a cross-sectional descriptive study design was employed and data was collected from 365 consenting participants in Calabar, Nigeria, using pre-tested questionnaire. SPSS Version 20 was used for data entry and analysis. The results were descriptively presented by frequencies and percentages. Pearson Chi-Square (χ2) analysis was performed to detect the association between variables at 5% level of significance (p-value of ≤0.05). RESULTS: only 9.9% of participants had a mammography, majority 90.1% never had. Uptake was highest among respondents with tertiary education, married, Civil/Public Servants, and those in the high income level categorization. Educational status, marital status, occupation and age were not statistically significantly associated with mammography uptake (p>0.05). Only religious denominational affiliation (p = 0.02) and income level (p = 0.002) were statistically significantly associated with uptake. Barriers to uptake were poor knowledge about mammography (49.8%), psychosocial (37.8%), economic (17.1%) and health systems (11.5%). Key facilitators to uptake were encouragement/counselling by health workers (44.0%) and presence of breast problems (37.4%). CONCLUSION: mammography uptake in Calabar, Nigeria was extremely low. Therefore, regular awareness campaigns targeting women at faith-based settings, and provision of mammography screening services at subsidized rates will enhance knowledge level and uptake of mammography

Thirty-five years (1986–2021) of HIV/AIDS in Nigeria: bibliometric and scoping analysis

Background Acquired immunodeficiency syndrome (AIDS) is an acquired defect of the cellular immunity associated with the infection by the human immunodeficiency virus (HIV). The disease has reached pandemic proportion and has been considered a public health concern. This study is aimed at analyzing the trend of HIV/AIDS research in Nigeria. Method We used the PUBMED database to a conduct bibliometric analysis of HIV/AIDS-related research in Nigeria from 1986 to 2021 employing “HIV”, “AIDS”, “acquired immunodeficiency syndrome”, “Human immunodeficiency virus”, and “Nigeria” as search description. The most common bibliometric indicators were applied for the selected publications. Result The number of scientific research articles retrieved for HIV/AIDS-related research in Nigeria was 2796. Original research was the predominant article type. Articles authored by 4 authors consisted majority of the papers. The University of Ibadan was found to be the most productive institution. Institutions in the United States dominated external production with the University of Maryland at the top. The most utilized journal was PLoS ONE. While Iliyasu Z. was the most productive principal author, Crowel TA. was the overall most productive author with the highest collaborative strength. The keyword analysis using overlay visualization showed a gradual shift from disease characteristics to diagnosis, treatment and prevention. Trend in HIV/AIDS research in Nigeria is increasing yet evolving. Four articles were retracted while two had an expression of concern. Conclusion The growth of scientific literature in HIV/AIDS-related research in Nigeria was found to be high and increasing. However, the hotspot analysis still shows more unexplored grey areas in future

Oral hygiene practices and utilization of oral healthcare services among in-school adolescents in Calabar, Cross River State, Nigeria

Introduction: oral health mirrors an individual´s general health, hence, proper care should be taken to prevent oral diseases and conditions. An estimated 3.9 billion people worldwide are affected by oral conditions, and adolescents are at increased risk due to diet choices and hormonal changes. This study aimed at determining the oral hygiene practices, awareness and utilization of oral healthcare services among in-school adolescents in Calabar Municipality. Methods: a descriptive cross-sectional study design was employed in studying these variables among in-school adolescents (10-19 years) in secondary schools (JSS1-SSS2) using a self-administered, semi-structured questionnaire. Data were entered and analyzed with EPI-Info. Cross tabulations of variables were conducted using Chi-square test with significance level of 5%. Results: a total of 335 students participated in the study with 228 (68.1%) and 136 (40.6%) reporting that they are aware of and have utilized oral healthcare services (OHS), respectively. There was no statistically significant association between age (p=0.923), gender (p=0.351) and type of school (p=0.497) respectively with awareness and utilization of OHS. Toothache/pain and presumed good dental health respectively were the main reasons for the usage and non-utilization of these services. Time-to-use of oral health services after the onset of toothache/pain was within five days (75.7%). Conclusion: the utilization rate of OHS did not match up to the level of awareness of these services with pain being the main driver for utilization. Increased awareness of oral healthcare through health education and oral healthcare demonstrations among adolescents is highly recommended as part of school health programs

Effectiveness and tolerability of standardized milk based, standardized non-milk based and hospital-based formulations in the management of moderate acute malnutrition in under-five children: A randomized clinical trial

Introduction : Moderate acute malnutrition (MAM) is a leading cause of under-five morbidity and mortality globally. Supplementary feeding is a strategy recommended by WHO for managing the condition.Objective: To evaluate the effectiveness and tolerability of standardized milk-based formulation (SMBF), standardized non-milk based formulation (SNMBF) and hospital-based formulation (HBF) in under-fives with MAM.Method: This was an open label randomized clinical trial in which eligible children aged 6 – 59 months with MAM were assigned to receive the SMBF, SNMBF or HBF at 50% of their daily caloric requirement with their regular family diet for four months. Their baseline characteristics and anthropometric indices were noted. They were followed up on two weekly basis during which further assessments were performed. The analysis for effectiveness and tolerability of the formulations were based on “per protocol”.Results: A total of 687 children were screened and 188 enrolled. Seventy children received SMBF, 63 received SNMBF while 55 received HBF. There were 54/70 (77.1%), 57/64 (89.1%) and 46/55 (83.6%) evaluable participants in the SMBF, SNMBF and HBF group respectively. Recovery from MAM was 43/54 (79.6%), 40/57 (70.2%) and 32/46 (69.6%) in the SMBF, SNMBF and HBF group respectively. Normal nutritional status was attained by 13 (24.0%), 10 (17.6%) and 5 (10.9%) children in the SMBF, SNMBF and HBF group respectively. Diarrhea and skin rashes were the main features of poor tolerability.Conclusions: The formulations were effective in managing MAM in childhood but the SMBF was the most effective. Diarrhea and skin rashes were the main features of poor tolerability

Guideline recommendations for hand hygiene in community settings: scoping review protocol

A scoping review protoco