Tobacco use amongst out of school adolescents in a Local Government Area in Nigeria

Abstract Introduction Out-of-school adolescents are often neglected when planning for tobacco prevention programmes whereas they are more vulnerable. Few studies exist in Nigeria about their pattern of tobacco use to serve as the basis for effective policy formulation. Method A sub sample of 215 out of school adolescents was analyzed from a descriptive cross sectional study on psychoactive substance use amongst youths in two communities in a Local Government Area in Nigeria which used a multi-stage sampling technique. Results Males were 53% and females 47%. Only 20.5% had ever used tobacco while 11.6% were current users. Males accounted for 60% of current users compared to 40% amongst females. Of current users, 84% believed that tobacco is not harmful to health. In addition, the two important sources of introduction to tobacco use were friends 72% and relatives 20%. Use of tobacco amongst significant others were: friends 27%, fathers 8.0%, relatives 4.2% and mothers 0.5%. The most common sources of supply were motor parks 52% and friends 16%. Conclusion The study showed that peer influence is an important source of introduction to tobacco use while selling of tobacco to adolescents in youth aggregation areas is common. We advocate for a theory based approach to designing an appropriate health education intervention targeted at assisting adolescents in appreciating the harmful nature of tobacco use in this locality. A point-of-sale restriction to prevent adolescent access to tobacco in youth aggregation areas within the context of a comprehensive tobacco control policy is also suggested. However, more research would be needed for an in-depth understanding of the tobacco use vulnerability of this group of adolescents.Peer Reviewe

Towards evidence-based marketing: The case of childhood obesity

Contentious commodities such as tobacco, alcohol and fatty foods are bringing marketing under scrutiny from consumers and policymakers. Yet there is little agreement on whether marketing is harmful to society. Systematic review (SR), a methodology derived from clinical medicine, offers marketers a tool for providing resolution and allowing policymakers to proceed with greater confidence. This article describes how SR methods were applied for the first time to a marketing problem -- the effects of food promotion to children. The review withstood scrutiny and its findings were formally ratified by government bodies and policymakers, demonstrating that SR methods can transfer from clinical research to marketing

An inter-country comparison of unofficial payments: results of a health sector social audit in the Baltic States

<p>Abstract</p> <p>Background</p> <p>Cross-country comparisons of unofficial payments in the health sector are sparse. In 2002 we conducted a social audit of the health sector of the three Baltic States.</p> <p>Methods</p> <p>Some 10,320 household interviews from a stratified, last-stage-random, sample of 30 clusters per country, together with institutional reviews, produced preliminary results. Separate focus groups of service users, nurses and doctors interpreted these findings. Stakeholder workshops in each country discussed the survey and focus group results.</p> <p>Results</p> <p>Nearly one half of the respondents did not consider unofficial payments to health workers to be corruption, yet one half (Estonia 43%, Latvia 45%, Lithuania 64%) thought the level of corruption in government health services was high. Very few (Estonia 1%, Latvia 3%, Lithuania 8%) admitted to making unofficial payments in their last contact with the services. Around 14% of household members across the three countries gave gifts in their last contact with government services.</p> <p>Conclusion</p> <p>This social audit allowed comparison of perceptions, attitudes and experience regarding unofficial payments in the health services of the three Baltic States. Estonia showed least corruption. Latvia was in the middle. Lithuania evidenced the most unofficial payments, the greatest mistrust towards the system. These findings can serve as a baseline for interventions, and to compare each country's approach to health service reform in relation to unofficial payments.</p

Report on the Establishment of an Automated Information System for the Indian Health Service

The Indian Health Service (IHS) was mandated to improve its data systems for management purposes and took action to better manage its information systems. The Resource and Patient Management System (RPMS) is capable of data integration throughout the IHS and provides the framework for a uniform national data system and automated management information system. Information systems coordination is provided through the Information Systems Advisory Council (ISAC), Professional Specialty Groups (PSG), Data Management Taskforce (DMT), and Area Information Systems Coordinators (ISC) to address the diverse information systems issues. The tribal consultation process on information systems is carried out through full tribal participation in the ISAC, PSG\u27S, DMT and interaction with the Area ISC\u27S. A goal adopted by the IHS was to integrate existing and new systems into a single database structure. This report presents the activities conducted, activities to be completed, and funds needed to complete the implementation of an automated management information system as required by Public Law 100-713, Section 602. The report specifies the extent of management involved to improve financial management, including the ability to generate data on cost, and the degree to which service unit directors and tribal health personnel have been involved in the planning and design of the management information systems, and its planned implementation.The standard cost accounting system approach has been assessed for applicability to IHS facilities and found to have a questionable cost/benefit ratio. Computer systems with security software have been deployed in the hospitals and health centers for the installation of core clinical software. Eighty-nine percent (89%) of the hospitals and health centers have installed computer systems and a majority of these are implementing the RPMS core clinical software package. The IHS activities which have been undertaken to establish the AMIS are: (1) the establishment of RMS planning and management, and coordination of information systems development; (2) the establishment of a patient care information system core package of software; (3) the installation process of the initial hardware systems and core clinical software at the point of patient care; and (4) the initiation of consultation with tribes and key management for planning and design of information systems. The IHS followed three basic principles in undertaking the activities to implement the RPMS: (1) established an overall framework and purpose for guiding data collection; (2) utilized automation for program efficiency and effectiveness; and (3) conducted a systematic approach for information integration. There are five requirement to implement RPMS into Indian Health Service area: (1) Hospitals and Clinics Technical Support; (2) Information System Development and Technical Support; (3) Appropriate Computer Systems; (4) National Database; and (5) Telecommunications Network. The cost structure for assessing, coordinating, and phasing existing data into an integrated data system closely matched the IHS resource structure, thus allowing for coordination of growth and internal capacity development. The IHS is progressing from a collection of system-specific information systems concentrated at Area Offices and the national data center to an integrated information system based at the point of patient care. By the end of FY 89, computer systems with Patient Registration software will have been installed at 89% of the IHS and tribal hospitals and health centers that account for 90% of the patient workload. A majority of IHS health care facilities are implementing an IHS-core clinical package consisting of an automated Patient Registration, Outpatient Pharmacy, Maternal & Child Health Immunization, Dental, Ambulatory Patient Care, and Contract Health System.The Indian Health Service initiated a pilot program to test the feasibility of expanding the program to all IHS hospitals. The sites selected for pilot testing were the Clinton, OK, Albuquerque, NM, and Parker, AZ, hospitals. The study has been initiated and will be completed within 9 months. The test sites have begun to collect data. This data will be submitted to Chicago for processing and the first reports are expected in mid-summer (1990).In the next 5 years. $71,000,000 is estimated to be needed to complete implementation by the IHS and$18,000,000 will be needed on a recurring basis to maintain, keep current, and meet the changing information needs of the system. Tribal facilities outside the scope of IHS will require an estimated $8,600,000 in funding over five years and$3,400,000 on a recurring basis to support the projected implemented systems

Financial assistance by geographic area.

Description based on: Fiscal year 1980.Mode of access: Internet.Vols. for -1979 issued by the Dept. of Health, Education, and Welfare, Office of the Assistant Secretary, Comptroller