Out-of-Pocket Payment for Healthcare and Implications for Households: Situational Analysis in Yenagoa, Bayelsa State

Background: Healthcare financing remains a critical issue in the on-going discourse on universal health coverage (UHC). This community-based study sought to examine the payment for healthcare and its relationship to indicators of catastrophic health expenditure (CHE) among households (HH) in Yenagoa.Methods: Data was obtained from a cross-sectional survey of  households in two randomly selected communities in Yenagoa. A  pretested, structured, interviewer-administered questionnaire was used to obtain information on HH income, general expenditures and financing for healthcare. HH spending more than 10% total income and 40% non-food expenditure were deemed to have suffered CHE and both CHE thresholds were calculated for the sampled population and compared between payment modes.Results: Responses were received from 525 HHs with median HH monthly income, total and healthcare expenditures of ₦115,000,  ₦112,170 and ₦9,250, respectively. Out-of-pocket (OOP) was the most prevalent (95.6%) mode of payment for healthcare. The incidence of CHE was 32.8% with reference to total income and 12.8% using non-food expenditure threshold. The Catastrophic Overshoots were 7% and -19.9% while Mean Positive Overshoots were 21% and 12% with respect to both thresholds for the entire study population. The  incidence of CHE was significantly higher in HHs with OOP than  insured HHs.Conclusion: OOP was the main payment option for healthcare and exposes significantly higher proportion of HHs to CHE. Findings  support the need to expand the coverage of the social insurance scheme to reduce exposure to financial risks by HHs and achieve UHC in Yenagoa. Keywords: Out-of-pocket; Healthcare financing; Catastrophic Health Expenditure; Households; Yenagoa; Nigeria

Adolescents Health and Management of Sexual Risk Taking Behaviour among Selected Secondary School Students in Osun State, Nigeria.

The study aimed at assessing adolescents health and management of sexual risk-taking behaviorus among selected Senior Secondary School Students in Osun State, Nigeria. A sample of 810 students was selected through multistage sampling technique. A self-designed instrument was used to collect data from the respondents. Apart from the face validity of the instrument, its reliability was determine through the pilot study carried out among 20 Senior Secondary School Students of the Seventh-day Adventist School, Ife, it yielded test retest reliability of 0.82: Data collected were analyzed using descriptive analysis of percentages. The results showed that majority of respondents (74.1%) were between 13-15 years while 7.4% were between ages 19 and 21: 58.9% respondents were Christians, 31.4% Muslims 4.8% traditional religion and 4.9% of respondents did not respond. Majority of respondents (735) 90.8% were not sure of what sexual and reproductive health was all about, while only 24.7 (200) agreed that reproductive health deals with both male and female organs. 25.8% of respondents said they willingly had their first sexual experience, 19.4% said they were persuaded to do it, 14.1% were forced to do it and 0.6% were not sure of how they had the experience. High percentage (52.4% of the respondents took no precautionary measure in their first sexual intercourse. Majority of the sexually active respondents (65.9%) said they over heard or currently experience some signs of STDs such as gonorrhea, syphilis and PID. Similarly, some of these respondents (24.7%) managed these conditions through self medications by buying drugs from the chemists while 26.9% went to hospital for treatment. It was concluded that opportunity should be created through awareness campaign for adolescents to develop awareness on their sexuality. Key words Adolescent, Health management, sexual risk-taking, behaviours, secondary school student

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden

Optimization and development of predictive models for the corrosion inhibition of mild steel in sulphuric acid by methyl-5-benzoyl-2-benzimidazole carbamate (mebendazole)

In this paper, we report the optimization and development of predictive models for the corrosion inhibition of mild steel in sulphuric acid by Methyl-5-benzoyl-2-benzimidazole Carbamate (Mebendazole). Design expert was used to analyze the corrosion inhibition related process parameters, such as corrosion penetration rate, inhibition efficiency, inhibitor concentration, acid concentration, weight loss, and their relationships. An attempt is made to obtain the optimal settings for this corrosion inhibition related process parameters. Design methodology, weight loss measurement, open-circuit potential analysis, Tafel polarization, etc. were used for the evaluation of inhibition efficiency of mebendazole for mild steel in H2SO4. The corrosion inhibition process parameters were optimized and predictive mathematical models developed using the Response Surface Methodology (RSM) using the central composite design (CCD) tool of Design Expert software version 11. Experimental and theoretical corrosion inhibition parameters were used to develop a nonlinear regression model to predict the optimal inhibition efficiency. Also, a quadratic model was generated, with predicted optimum inhibition efficiency of 88.4095% obtained having very near unity desirability of 0.914. The developed model shows that inhibition efficiency is related to the inhibitor concentration, immersion time, and acid concentration. The regression models generated are successfully used to predict the corrosion inhibition behaviour of mebendazole for low carbon steel in sulphuric acid medium