Professional Oral Prophylaxis: Assessment of Practice by Oral Health Professionals in Southeastern Nigeria

Background: Professional oral prophylaxis reduces plaque and calculus levels and improves oral health. This study identified the practice of routine scaling and polishing among oral health professionals. Methodology: This was a cross‑sectional study of 73 oral health professionals who attended the Southeast Oral Health Forum at Onitsha, Anambra State, Nigeria. Data on sociodemographic profile, the undertaking of scaling and polishing of the teeth, reasons for the scaling and polishing, recommendation of scaling and polishing to their patients, and duration of recall were recorded. Data analysis was done using SPSS Version 21. The association between demographic profile and practice of scaling and polishing at 6 months’ interval was tested using the Chi‑square test at a significance level of P < 0.05. Results: The study participants were 43 (58.9%) males and 30 (41.1%) females, and the age range was 23–56 years. All (100.0%) oral health professionals in the study had undertaken scaling and polishing previously. Many respondents (75.3%) scaled and polished routinely twice a year, while 90.6% recommended the procedure to their patients at six months’ interval to enable them monitor their patients’ oral hygiene (85.9%). Those aged 21–30 years (75.0%) (P < 0.001) and < 5 years in clinical practice (74.3%) (P = 0.01) undertook scaling and polishing at six months’ interval or less. Lack of time (34.5%) was the main reason that prevented oral health professionals from  undertaking scaling and polishing. Conclusion: Dental therapists have had scaling and polishing done more than dentists and dental technologists within the last six months. Age and duration of clinical practice were significantly associated with obtaining scaling and polishing at 6 monthly intervals, whereas lack of time was a major reason for not undergoing six monthly scaling and polishing. Keywords: Calculus, dental professionals, oral prophylaxis, plaque&nbsp

Demand and supply analysis for maternal and child health services at the primary healthcare level in Nigeria.

BACKGROUND: The low demand for maternal and child health services is a significant factor in Nigeria's high maternal death rate. This paper explores demand and supply-side determinants at the primary healthcare level, highlighting factors affecting provision and utilization. METHODS: This qualitative study was undertaken in Anambra state, southeast Nigeria. Anambra state was purposively chosen because a maternal and child health programme had just been implemented in the state. The three-delay model was used to analyze supply and demand factors that affect MCH services and improve access to care for pregnant women/mothers and newborns/infants. RESULT: The findings show that there were problems with both the demand and supply aspects of the programme and both were interlinked. For service users, their delays were connected to the constraints on the supply side. On the demand side, the delays include poor conditions of the facilities, the roads to the facilities are inaccessible, and equipment were lacking in the facilities. These delayed the utilisation of facilities. On the supply side, the delays include the absence of security (fence, security guard), poor citing of the facilities, inadequate accommodation, no emergency transport for referrals, and lack of trained staff to man equipment. These delayed the provision of services. CONCLUSION: Our findings show that there were problems with both the demand and supply aspects of the programme, and both were interlinked. For service users, their delays were connected to the constraints on the supply side

Inequities in incidence, morbidity and expenditures on prevention and treatment of malaria in southeast Nigeria

<p>Abstract</p> <p>Background</p> <p>Malaria places a great burden on households, but the extent to which this is tilted against the poor is unclear. However, the knowledge of the level of the burden of malaria amongst different population groups is vital for ensuring equitable control of malaria. This paper examined the inequities in occurrence, economic burden, prevention and treatment of malaria.</p> <p>Methods</p> <p>The study was undertaken in four malaria endemic villages in Enugu state, southeast Nigeria. Data was collected using interviewer-administered questionnaires. An asset-based index was used to categorize the households into socio-economic status (SES) quartiles: least poor; poor; very poor; and most poor. Chi-square analysis was used to determine the statistical significance of the SES differences in incidence, length of illness, ownership of treated nets, expenditures on treatment and prevention.</p> <p>Results</p> <p>All the SES quartiles had equal exposure to malaria. The pattern of health seeking for all the SES groups was almost similar, but in one of the villages the most poor, very poor and poor significantly used the services of patent medicine vendors and the least poor visited hospitals. The cost of treating malaria was similar across the SES quartiles. The average expenditure to treat an episode of malaria ranged from as low as 131 Naira ($1.09) to as high as 348 Naira ($2.9), while the transportation expenditure to receive treatment ranged from 26 Naira to 46 Naira (both less than $1). The level of expenditure to prevent malaria was low in the four villages, with less than 5% owning untreated nets and 10.4% with insecticide treated nets.</p> <p>Conclusion</p> <p>Malaria constitutes a burden to all SES groups, though the poorer socio-economic groups were more affected, because a greater proportion of their financial resources compared to their income are spent on treating the disease. The expenditures to treat malaria by the poorest households could lead to catastrophic health expenditures. Effective pro-payment health financing and health delivery methods for the treatment and prevention of malaria are needed to decrease the burden of the disease to the most-poor people.</p

Oral health-seeking behavior among different population groups in Enugu Nigeria.

IntroductionThis study investigates the oral health-seeking behaviour of households and its influence on demand for dental caries treatment services in Enugu state Nigeria.MethodsA quantitative descriptive cross-sectional study was used to explore the oral health seeking pattern of 378 urban and 348 rural household respondents in Enugu state Nigeria. The study explored dental caries treatment-seeking, oral health behavior of respondents using the three dynamics of the Andersen and Newman health utilization model; predisposing, enabling and need factors.FindingsRecommendations from community members (48.9%), severity of disease (22.1%), and cost of treatment (19.4%) all influenced where oral healthcare was first sought. Gender and type of occupation, influenced positive oral health-seeking behavior (pConclusionThe findings suggest that interventions to create increased oral health awareness targeted at education on preventive strategies, appropriate time and place to seek oral health care and dental caries treatment, as well devising and implementing health financing options such as dental insurance would enable individuals to seek appropriate treatment for dental caries on time. In addition, it will reduce the proportion of people visiting unorthodox healthcare providers for their oral health problems or choosing cheaper but inappropriate treatment options

Using community participation to assess demand and uptake of scaling and polishing in rural and urban environments

Abstract Background One of the control tools for periodontal disease besides individual home care is professional oral prophylaxis that is, Scaling and Polishing (S&P).The aim of this study is to assess the effect of oral health awareness on the demand and uptake of scaling and polishing among dwellers of rural and urban environments. Methods This interventional study was conducted in Enugu, Nigeria. A questionnaire was used to obtain data on demographic details, presenting complaints and requests, and prior dental visits from consenting attendees in 4 community outreaches. The number of those demanding for scaling of teeth at point of presentation was extracted from their requests. Oral health talk was then given as the intervention for the study. Periodontal assessment was done using Community Periodontal index (CPI) and participants who received scaling thereafter were recorded. Data were analyzed with SPSS [version 20] employing Chi square to compare categorical variables and p was significant at ≤0.05. Multiple regression analysis of factors affecting oral health awareness was done and outcome of intervention was determined by percentage difference in number of participants demanding and receiving S&P. Results A total of 454 participants enlisted for the study. The outreaches served as first point of contact with dental professionals for 383 (84.4%) participants. 60 (80%) and 15 (20%) participants demanded for scaling in the urban and rural locations respectively (p = 0.00). Out of 78 with CPI 3 score, only 8 (10.3%) demanded for S&P but uptake was by 73 (93.6%) [p = 0.00]. Outcome of oral health intervention was 80.6% difference among those with periodontitis. Multiple regression analysis of factors showed that participants’ locations, that is, rural or urban, was the only factor that significantly affected oral health awareness (C.I = 0.183–0.375, p = 0.000). Conclusion Demand for scaling was sub-optimal but the uptake was satisfactory. Rural or urban location of the participants significantly influenced their oral health awareness. The keenness to take up scaling suggests benefits accruing from the oral health education. Appropriate health policies and planning could help bridge the gap between rural and urban areas and strengthen gains from this study

Additional file 1: of Using community participation to assess demand and uptake of scaling and polishing in rural and urban environments

Map of Enugu State. Map of Nigeria highlighting Enugu State and Map of Enugu with 17 LGAS. (DOCX 52 kb

Health system responses and capacities for COVID-19 in Nigeria: A scoping review

Background: Nigeria is in short supply of health workforce and equipment needed to manage the infected COVID-19 individuals. The rate of occurrence of new cases of infection has the capacity to further deplete the human resources in the sector, putting a dent in the fight against the spread of the virus. This study aims to determine the capacity of Nigerian health systems to respond to COVID-19. Materials and Methods: This was a scoping review of media documents, official documents and journals, published from 1st December 2019 to 31st December 2021. Online media reports were sourced from major newspapers on FACTIVA (Vanguard, Punch, Guardian, The Nation, Business Day, and Premium Times) that reported national and state level health system responses to COVID-19. We also reviewed other online news sources that have consistently reported health systems response to COVID-19 in Nigeria. Some of these are Nigeria Health Watch, APO Africa Newsroom, Federal Ministry of Health newsletter, and national media. Results: By December 31st, 2020, Nigeria had 70 free laboratories controlled by the government. These comprised 31 federal laboratories, 30 state, 3 military, 2 Non-Governmental Organization (NGO), 2 UN and 2 private labs. In 2019, Nigeria's IHR score at point of entry 1 & 2 was 3 and 1. Routine capacities established at points of entry was improved, however, effective public health response at point of entry, remained the same. Which supports the low response capacity of the country. Nigeria's average score across the JEE 2019 had increased to 7% (from 39% in 2017 to 46% in 2019) - four new indicators and 20 indicators with improved scores from 2017. Conclusion: Nigeria's health system response and capacity to handle COVID-19 is quite poor and grossly inadequate. There is a need to increase the number of health workforce in the country and institute adequate accountability mechanisms to ensure prudent and focused management of health funds