An assessment of primary health care costs and resource requirements in Kaduna and Kano, Nigeria

IntroductionThe availability of quality primary health care (PHC) services in Nigeria is limited. The PHC system faces significant challenges and the improvement and expansion of PHC services is constrained by low government spending on health, especially on PHC. Out-of-pocket (OOP) expenditures dominate health spending in Nigeria and the reliance on OOP payments leads to financial burdens on the poorest and most vulnerable populations. To address these challenges, the Nigerian government has implemented several legislative and policy reforms, including the National Health Insurance Authority (NHIA) Act enacted in 2022 to make health insurance mandatory for all Nigerian citizens and residents. Our study aimed to determine the costs of providing PHC services at public health facilities in Kaduna and Kano, Nigeria. We compared the actual PHC service delivery costs to the normative costs of delivering the Minimum Service Package (MSP) in the two states.MethodsWe collected primary data from 50 health facilities (25 per state), including PHC facilities—health posts, health clinics, health centers—and general hospitals. Data on facility-level recurrent costs were collected retrospectively for 2019 to estimate economic costs from the provider’s perspective. Statewide actual costs were estimated by extrapolating the PHC cost estimates at sampled health facilities, while normative costs were derived using standard treatment protocols (STPs) and the populations requiring PHC services in each state.ResultsWe found that average actual PHC costs per capita at PHC facilities—where most PHC services should be provided according to government guidelines—ranged from US$18.9 to US$ 28 in Kaduna and US$15.9 to US$ 20.4 in Kano, depending on the estimation methods used. When also considering the costs of PHC services provided at general hospitals—where approximately a third of PHC services are delivered in both states—the actual per capita costs of PHC services ranged from US$20 to US$ 30.6 in Kaduna and US$17.8 to US$ 22 in Kano. All estimates of actual PHC costs per capita were markedly lower than the normative per capita costs of delivering quality PHC services to all those who need them, projected at US$44.9 in Kaduna and US$ 49.5 in Kano.DiscussionBridging this resource gap would require significant increases in expenditures on PHC in both states. These results can provide useful information for ongoing discussions on the implementation of the NHIA Act including the refinement of provider payment strategies to ensure that PHC providers are remunerated fairly and that they are incentivized to provide quality PHC services

Prevalence of Trachoma in Kano State, Nigeria: Results of 44 Local Government Area-Level Surveys.

PURPOSE: We sought to determine the prevalence of trachoma in 44 Local Government Areas (LGAs) of Kano State, Nigeria. METHODS: A population-based prevalence survey was conducted in each Kano LGA. We used a two-stage systematic and quasi-random sampling strategy to select 25 households from each of 25 clusters in each LGA. All consenting household residents aged 1 year and above were examined for trachomatous inflammation-follicular (TF), trachomatous inflammation-intense (TI) and trichiasis. RESULTS: State-wide crude prevalence of TF in persons aged 1-9 years was 3.4% (95% CI 3.3-3.5%), and of trichiasis in those aged ≥15 years was 2.3% (95% CI 2.1-2.4%). LGA-level age- and sex-adjusted trichiasis prevalence in those aged ≥15 years ranged from 0.1% to 2.9%. All but 4 (9%) of 44 LGAs had trichiasis prevalences in adults above the elimination threshold of 0.2%. State-wide prevalence of trichiasis in adult women was significantly higher than in adult men (2.6% vs 1.8%; OR = 1.5, 95% CI 1.3-1.7; p = 0.001). Four of 44 LGAs had TF prevalences in 1-9-year-olds between 10 and 15%, while another six LGAs had TF prevalences between 5 and 9.9%. In 37 LGAs, >80% of households had access to water within 30 minutes round-trip, but household latrine access was >80% in only 19 LGAs. CONCLUSION: Trichiasis is a public health problem in most LGAs in Kano. Surgeons need to be trained and deployed to provide community-based trichiasis surgery, with emphasis on delivery of such services to women. Antibiotics, facial cleanliness and environmental improvement are needed in 10 LGAs

Development and Standardization of a Substitute Triangular Prism for Creative Physics and Basic Science Instructions

The Nigerian National Policy on Education requires that education given to students should inculcate sound scientific knowledge for reflective thinking. However, our science classroom instructions generally and physics in particular, today, learners are not giving the desired experiences due to lack of instructional materials. To change the status quo, this study developed  a substitute triangular prism using plastic materials and water. The study employed one shot experimental group design to test the functionality as well as standardize the material. thirty students were made to locate the image of the rays through the improvised triangular prism and find the refractive index (RI) of the material. The RIs obtained by the students were compared with that of water using the one sample t-test. The results revealed no significant difference in the students observed RIs and that of water (1.33). This confirms the functionality of the improvised materials and their Ability to instill the desired skills in learners. It is recommended that teachers should not limit their improvisation to the classroom only, but should seek for avenues to standardizing the materials and making them available for others to use. Keywords: Development, Standardization, triangular prism, refractive index DOI: 10.7176/JEP/13-15-10 Publication date:May 31st 202

Gross Alpha and Beta Radioactivity of Water from Gubi Dam Water Treatment Plant Gubi Village, Bauchi

In this research work, a total of 25 replicate samples from the study area comprising source water, treated water, as well as water from some boreholes around Gubi dam and Gubi water treatment plant, were collected for the analysis using Gas-flow Detector Dual Phosphor (counting system) method to determine the gross alpha and beta concentrations. The results showed that the values for the gross alpha and beta measurements were found to be (7.057E-03Bq/ m3 ), ( 1.0253E-02 Bq/ m3) and (2.693E-02 Bq/ m3) for samples from the dam, treated water and the borehole respectively. Furthermore, the mean concentrations were also determined to be (4.11E-02Bq/ m3), (3.74E-02Bq/ m3) and (1.0756E-01Bq/ m3). The study revealed that water from Gubi dam whether treated, untreated or groundwater around the dam purses no radiological hazards for agricultural and other domestic uses

Exploring faradaic and non-faradaic electrochemical impedance spectroscopy approaches in Parkinson's disease diagnosis

Parkinson's disease is a neurodegenerative condition defined by the progressive death of dopaminergic neurons in the brain. The diagnosis of Parkinson's disease often uses time-consuming clinical evaluations and subjective assessments. Electrochemical Impedance Spectroscopy (EIS) is a useful technique for electroanalytical devices due to its label-free performance, in-situ measurements, and low cost. The development of reliable diagnostic tools for Parkinson's disease can be significantly enhanced by exploring novel techniques like faradaic and non-faradaic EIS detection methods. These techniques have the ability to identify specific biomarkers or changes in electrochemical properties linked to Parkinson's disease, allowing for an early and accurate diagnosis. Faradaic EIS detection methods utilize redox processes on the electrode surface, while non-faradaic EIS methods rely on charge transfer or capacitive properties. EIS can identify biomarkers or changes in electrical properties as indicators of Parkinson's disease by measuring impedance at different frequencies. By combining both faradaic and non-faradaic EIS approaches, it may be possible to obtain a comprehensive understanding of the electrochemical changes occurring in Parkinson's disease patients. This may lead to the development of more effective diagnostic techniques and potentially opening up new avenues for personalized treatment strategies. This review explores the current research on faradaic and non-faradaic EIS approaches for diagnosing Parkinson's disease using electrochemical impedance spectroscopy

Determinants of mortality among patients with drug-resistant tuberculosis in northern Nigeria.

BACKGROUND:Drug-Resistant tuberculosis (DR-TB) is estimated to cause about 10% of all TB related deaths. There is dearth of data on determinants of DR-TB mortality in Nigeria. Death among DR-TB treated cohorts in Nigeria from 2010 to 2013 was 30%, 29%, 15% and 13% respectively. Our objective was to identify factors affecting survival among DR-TB patients in northern Nigeria. METHODS:Demographic and clinical data of all DR-TB patients enrolled in Kano, Katsina and Bauchi states of Nigeria between 1st February 2015 and 30th November 2016 was used. Survival analysis was done using Kaplan-Meier and multiple regression with Cox proportional hazard modeling. RESULTS:Mean time to death during treatment is 19.2 weeks and 3.9 weeks among those awaiting treatment. Death was recorded among 38 of the 147 DR-TB patients assessed. HIV co-infection significantly increased probability of mortality, with an adjusted hazard ratio (aHR) of 2.35, 95% CI: 1.05-5.29, p = 0.038. Treatment delay showed significant negative association with survival (p = 0.000), not starting treatment significantly reduced probability of survival with an aHR of 7.98, 95% CI: 2.83-22.51, p = 0.000. Adjusted hazard ratios for patients started on treatment more than eight weeks after detection or within two to four weeks after detection, was beneficial though not statistically significant with respective p-values of 0.056 and 0.092. The model of care (facility vs. community-based) did not significantly influence survival. CONCLUSION:Both HIV co-infected DR-TB patients and DR-TB patients that fail to start treatment immediately after diagnosis are at significant risk of mortality. Our study showed no significant difference in mortality based on models of care. The study highlights the need to address programmatic and operational issues pertaining to treatment delays and strengthening DR-TB/HIV co-management as key strategies to reduce mortality

Integration of microfluidic channel on electrochemical-based nanobiosensors for monoplex and multiplex analyses: An overview

Background Microfluidic devices have evolved into low-cost, simple, and powerful analytical tool platforms. Herein, an electrochemically-based microfluidic nanobiosensor array for monoplex and multiplex detection of physiologically relevant analytes is reviewed. Unlike other analyte detection methods, microfluidics-based embedded electrochemical nanobiosensors are portable, custom electrochemical readers for signal reading. Methods Microfluidic devices and electrochemical sensors can be integrated into monoplex or multiplex systems. The integrated system is simple to use and sensitive, and so has great potential as a powerful tool for profiling immune-mediated treatment responses in real time. It may also be developed further as a point-of-care diagnostic device for conducting near-patient tests using biological samples. Therefore, using mutiplex analysis, a biosensor array may detect multiple analytes in a sample solution and provide different outputs for each analyte. A microfluidic electrochemical nanobiosensor, for example, can detect urine glucose, lactate, and uric acid. The microfluidic array of integrated nanobiosensors and electrochemical sensors enables fast and cost-effective selection of high-quality and statistically significant diagnostic data at the point of care. The multiplex analytical test is an important molecular tool for academic research as well as clinical diagnosis. Although key approaches for analysing numerous analytes have been developed, none of them are suitable for point-of-care diagnostics, especially in situations with limited resources. Significant findings In this study, monoplex and multiplex microfluidic assays for rapid measurement of single and multiple analytes at the point of care are presented. Since this test can analyse both single and multiple analytes, it is exceptionally specific, easy to use, and inexpensive. The ability of integrated electrochemical-based microfluidic devices with single channel and multiple channels systems to perform monoplex and multiplex analysis simultaneously and independently is the novelty of this review

Table_1_An assessment of primary health care costs and resource requirements in Kaduna and Kano, Nigeria.docx

IntroductionThe availability of quality primary health care (PHC) services in Nigeria is limited. The PHC system faces significant challenges and the improvement and expansion of PHC services is constrained by low government spending on health, especially on PHC. Out-of-pocket (OOP) expenditures dominate health spending in Nigeria and the reliance on OOP payments leads to financial burdens on the poorest and most vulnerable populations. To address these challenges, the Nigerian government has implemented several legislative and policy reforms, including the National Health Insurance Authority (NHIA) Act enacted in 2022 to make health insurance mandatory for all Nigerian citizens and residents. Our study aimed to determine the costs of providing PHC services at public health facilities in Kaduna and Kano, Nigeria. We compared the actual PHC service delivery costs to the normative costs of delivering the Minimum Service Package (MSP) in the two states.MethodsWe collected primary data from 50 health facilities (25 per state), including PHC facilities—health posts, health clinics, health centers—and general hospitals. Data on facility-level recurrent costs were collected retrospectively for 2019 to estimate economic costs from the provider’s perspective. Statewide actual costs were estimated by extrapolating the PHC cost estimates at sampled health facilities, while normative costs were derived using standard treatment protocols (STPs) and the populations requiring PHC services in each state.ResultsWe found that average actual PHC costs per capita at PHC facilities—where most PHC services should be provided according to government guidelines—ranged from US$18.9 to US$ 28 in Kaduna and US$15.9 to US$ 20.4 in Kano, depending on the estimation methods used. When also considering the costs of PHC services provided at general hospitals—where approximately a third of PHC services are delivered in both states—the actual per capita costs of PHC services ranged from US$20 to US$ 30.6 in Kaduna and US$17.8 to US$ 22 in Kano. All estimates of actual PHC costs per capita were markedly lower than the normative per capita costs of delivering quality PHC services to all those who need them, projected at US$44.9 in Kaduna and US$ 49.5 in Kano.DiscussionBridging this resource gap would require significant increases in expenditures on PHC in both states. These results can provide useful information for ongoing discussions on the implementation of the NHIA Act including the refinement of provider payment strategies to ensure that PHC providers are remunerated fairly and that they are incentivized to provide quality PHC services.</p

Assessment of health-care research and its challenges among medical doctors in Nigeria

Introduction: Health‑care research in Nigeria has been growing over the years but is constrained by many difficulties. This study aimed to identify the challenges encountered in health‑care research and suggest policies to address these problems. Materials and Methods: It was a cross‑sectional study of medical doctors who have been involved in health‑related researches. All participants filled a self‑administered online questionnaire comprising 31 questions in five sections. The responses were analyzed using the Google forms and the Statistical Package for the Social Sciences software version 23. Results: The mean age of the study participants was 41.0 ± 8.4 years. Three‑quarters of the respondents (75.5%) worked in teaching hospitals. Nearly all (96.6%) carried out their studies using personal funds and only one in 10 had been involved in high‑budget projects (≥₦1,000,000). The generation of quality researches was impeded by the restriction of literature review to free online journals (93.2%), incomplete health records (88.0%), limited access to research kits (65.7%), limited use of advanced statistical analysis (29.8%), and challenges with obtaining ethical approval (21.2%). Despite the average online visibility of these researches (52.2%), only 28.5% stated that it has been locally adopted to influence medical practice in their center. Conclusion: There is a wide disparity in research capacity among hospital tiers. It is important to leverage on and expand existing partnerships to provide institutional access to premium literature, offer robust, and assessable financial support for the conduct of high‑quality researches and provide a framework to bridge the gap in the use of these works to influence practice change in Nigeria