Abstract:

Access to safe drinkable water has improved over the last decades in almost every part of the world, but approximately one billion people in Africa still lack access to safe water and over 2.5 billion lack access to adequate sanitation. In large parts of the world, humans have inadequate access to potable water and use sources contaminated with disease vectors, pathogens or unacceptable levels of toxins or suspended solids. Drinking or using such water in food preparation leads to widespread acute or chronic illnesses and it is a major cause of death and misery in many countries. As such prevention of water borne diseases is a major health goal in developing countries (Fawell J & Chipman K, 2010).

The health burden of poor water quality is enormous with an estimated 37.7million individuals affected by water-borne diseases; annually 1.5 million children are estimated to die from diarrheal-related diseases each year (WHO, 2012).

The developing countries in the world still face the problem of water scarcity with Africa having the largest number of countries encountering these problems. Due to water scarcity, many families tend to store water in their home for long term use. Most families have inadequate knowledge or are ignorant on the duration of the storage and the type of container or vessel used in the collection and storage of drinkable water.

Inhabitants in Santa town in North West region of Cameroon experience inherent episodes of water shortages all round the year prompting household to fetch, store and consume water from doubtful sources.

A study was carried out to assess the knowledge and practices of the inhabitants of Santa town in the collection and preservation of potable water in order to avert the occurrence of water-borne diseases.

Primary data was collected with the use of a structured questionnaire with open and close-ended questions, administered by the researcher and co-researchers to the study population in the randomly selected quarters using cluster sampling. A sample size of 110 households was recruited for the study.

Results show that 68 (58.18%) of respondents defined drinkable water as water safe enough to be consumed with low risk of harm, 24 (21.8%) defined it as water which originates from pipe borne water while 16 (14.5%) said that it is water from any natural source.

On the criteria used in the identification of unsafe water, 68 (58.18%) said they identified water which is not safe for drinking from its color, taste and odor; on the issue of water protection and preservation from contaminants, 58(52.7%) of the responses were that they lacked containers for their drinking water, 32(29.5%) said they lacked chemicals and filters to treat their water, while 14(12.9%) did not have knowledge in the protection and preservation of potable water while 06 (5.5%) said that the problem they encountered was the presence of children playing around drinkable water sources and water storage containers.

From the data collected, and analysis made it be can be concluded that there exist inadequate knowledge on the protection and preservation of potable water. Their understanding of the notions of hygiene and sanitation, the knowledge and practices on the collection and preservation of potable water are not based on the level of education but on how much public health information they got about drinking water collection, treatment and preservation. So, an up-to-date, knowledge and practices on the collection, treatment and preservation of potable water is necessary for the wellbeing of the Santa community. The Council’s hygiene and sanitation service should take it as duty function to organize regular public health education lectures in social institutions in order to enlighten the community.

References:

[1]. Dorothy. L. Miner (1996) .Water Quality and Waste Management.

[2]. Fawell J, Stanfield G (2010). Drinking water quality and health http://www.wikipedia.org/drinking

[3]. Fawell J, Chipman K.(2010). Endocrine Disrupters, Drinking Water And Public Reassurance. Water environ manage;

[4]. Folifac. F. (2013). Integrated Watershed Management in Cameroon. http://projets.tiguets.org/watermngmt

[5]. Gleick, P.H et al (2007). The world’s water: Biennial Report on Fresh Water Resources. Chicago: Island Press.

[6]. Goss.M, Richard C (2008). Source Water Protection Planning, which supports the education of pathogens from agricultural activity entering water resources.

[7]. Harrigan-Farrelly J. (2012). Status of Source Water Protection, Ground Water Monitoring And Remediation.

[8]. Hillie, T. et al. (2006). Nanotechnology, water, and Development. Dillon, Meridian institute.

[9]. Hoxie NJ, Davis JP et AL (1997) cryptosporidiosis-associated mortality following a massive waterborne outbreak in Milwaukee, W isconsin.AMJ Public Health.

[10]. Hunter P. (1997), Waterborne Diseases. Epidemiology and Ecology. Chichester: Wiley. http://www.everpure.com/issues/iow9000.htod

[11]. Kumar.S.G, Jayarama.S (2009). Issues related to sanitation failure in India and future perspective 2009; 13-104.

[12]. Mackenzie et al (1994). A massive outbreak in Milwaukee of cryptosporidium infection transmitted through the public water supply. New England Journal of Medicine 331,161-167.

[13]. Meinhardt, P.L. (2010). Recognizing water borne disease and the health effects of water pollution: American Water Works Association and Amot Ogden Medical center (Accessed on October 1, 2004 at www.water health connection.org)

[14]. Pandve, T. (2008). Environmental Sanitation: An ignored issue in India. India J.Occup Environ Med.2008, page 12-40.

[15]. World Health Organization (2003).Guidelines for Drinking water Quality, 3^rdedn. www.who.int/water_sanitation_health/GDWQ/draftchemicals/list.htm. Last accessed June 2003.Geneva: WHO.

Abstract:

Background

Medical waste unlike other ordinary waste poses serious health risk to the handlers, health staff, patients and the community. The area of medical waste management is neglected in most health care facilities in Ghana. The main objective of the study was to assess the Medical Waste management practices in Bawku Presbyterian Hospital of the Upper East Region of Ghana.

Methods

The study used structured questionnaires, observation checklist and key informant interview guide to collect data from management staff and waste workers.

Results

It was observed that there was low knowledge about medical waste among waste workers. Medical waste is not segregated, waste containers not coded/labelled, no secured storage area for waste, no budget specifically for medical waste management and no waste management manual in the hospital.

Conclusion

This study has shown that, waste management in the hospital is poor and has health implications to the handlers, staff, patients and visitors.

Keywords: medical waste, Bawku Presbyterian Hospital, waste segregation, waste storage.

References:

[1]. Abdulla F, Qdais HA, Rabi A,. 2008). “Site Investigation on Medical Waste Management Practices in Northern Jordan,” Waste Management, Vol. 28, No. 2

[2]. Al-Emad AA (2011). Assessment of medical waste management in the main hospitals in Yemen. Eastern Mediterranean Health J. 2011,Vol. 17 No. 10.

[3]. Basel Action Network (BAN) (2014). 16. Eleven recommendations for improving medical waste management. Provided to the technical working group of the Basel convention, by the Basel Action Network (BAN), April 12–14, 1999. (http://www.ban.org/library /11REC~1.PDF, accessed 17January, 2014).

[4]. Coker A, Sangodoyin A, Sridhar M, Booth C, Olomolaiye P, Hammond F (2008). Medical waste management inIbadan, Nigeria: Obstacles and prospects. Waste Management 2008; 29(2): 804-811.

[5]. Diaz LF, Savage GM, Eggerth LL (2014). “Alternatives for the Treatment and Disposal of Healthcare Wastes in Developing Countries,” Waste Management, Vol. 25, No. 6, 2005, pp. 626-637. doi:10.1016/j.wasman.2005.01.005 (accessed: 16th January, 2014.

[6]. Environmental Quality Authority (2005). Master Plan for healthcare waste management West Bank/Gaza Strip. Palestinian Authority.

[7]. George LW (2013). Medical Waste Disposal Practices in some Hospitals and Clinical Laboratories in the Accra Metropolis (Ghana). International Institute for Science, Technology and Education (IISTE).Vol.3, No.11, 2013 P 90 – 98.

[8]. Lee BK, Ellenbecker MJ, Moure-Eraso R (2014). “Alter- natives for Treatment and Disposal Cost Reduction of Regulated Medical Waste,” Waste Management, Vol. 24, No. 2, 2004, pp. 143-151. doi:10.1016/j.wasman.2003.10.008 (accessed 14th January, 2014).

[9]. Ministry of Health (2006). MOH Policy and Guidelines for Health Institutions, Accra, Ghana.

[10]. Moawad RK (1997). National survey for the elimination of the solids hospital waste in Lebanon. Beirut, Pharmacy School, Lebanese University.

[11]. Mostafa GMA, Shazly MM, Sherief WI (2007). Development of a waste management protocol based on assessment of knowledge and practice of healthcare personnel in surgical departments. Waste Management 2007; 29 (1): 430-439

[12]. Nagaraju B,Padmavathi GV, Puranik DS, Shantharaj MP, Sampulatha SP. A study to assess the knowledge and practice on biomedical waste management among the health care providers working in PHCs of Bagepalli Taluk with the view to prepare informational booklet. Int J Med Biomed Res 2013;2(1):28-35

[13]. Patwary MA, O’Hare TW, Sarker MH (2011). Assessment of occupational and environmental safety associated with medical waste disposal in developing countries: A qualitative approach.

[14]. Safety science 2011; 49(8-9):1200-1207.

[15]. Silva CE, Hoppe AE, Ravanello MM, Mello N (2014). “Medical Wastes Management in the South of Brazil,” Waste Management, Vol. 25, No. 6, 2005, pp. 600-605. doi:10.1016/j.wasman.2004.03.002 (accessed 12th January, 2014).

[16]. World Health Organization (WHO), (2005). Management of Solid Health Waste at Primary Health Care Centers, a Decision-MakingGuide. Geneva.

Abstract:

The purpose of this study was to assess and compare the knowledge of diabetes mellitus possessed by patients with diabetes and healthy adult volunteers in Penang, Malaysia. A cross-sectional study was conducted in. A 240 sample randomly selected (120 patients with diabetes mellitus and 120 healthy adults at a shopping complex participated in the survey. Data collection was done through face-to-face interviews. A30 items questionnaire facilitated data collection about diabetes mellitus. The results showed that patients with diabetes mellitus were significantly more knowledgeable than the healthy group on the following aspects: risk factors, symptoms, chronic complications, treatment and self-management, and monitoring parameters. Educational level was the best predictive factor for diabetes mellitus and public awareness. In conclusion, knowledge about diabetes mellitus should be improved among the general population. The study has key practice implications as it served as a baseline for the design of educational programmes for diabetics and a health promotion programme for the healthy population in general, and especially for those at high risk. 

References:

[1]. Al-Maskari, F., El-Sadig, M., Al-Kaabi, J.M., Afandi, B., Nagelkerke, N. (2013). Knowledge, Attitude and Practice of diabetic patients  in the United Arab Emirates. PLoS ONE 8(1), e52857.

[2]. Foma, M.A., Saidu, Y., Omaleke, S.A. and Jafali, J. (2013). Awareness of diabetes mellitus among diabetic patients in the Gambia: A strong case for health education and promotion. BioMedCentral Public health 13, 1124.www.biomedcentral.com/1471-2458 accessed 30/04/14

[3]. Gravetter, F. and Wallnau, L. B. (1995).Essentials of Statistics for the Behavioural Sciences 2^nd Ed. New York: West Publishing Company.

[4]. Khan, M. F. A., Khan, M., Malik, F. A., Mushtaq, M., Sarwar, A., Shahid, T., Tahir, N., Tahir, Z., Shafiq, S., Yar, A., and Alam, A. Y. (2009). Investigating the awareness level about diabetes about diabetes mellitus and associated factors in Tarlai (Rural Islamabad).Journal of Pakistan Medical Association 59(1), pp. 798-801.

[5]. Mashige, K.P., Notshweleka, A., Moodley, S.,  Rahmtoola, F.H., Sayed, S.B., Singh, S. and Sardiwalla, Z. (2008). An assessment of the level of diabetic patients’ knowledge of diabetes mellitus, its complications and management in Durban, South Africa. The South African Optometrist 67(3), pp. 95-105. 

[6]. Mohieldein, A. H., Alzohairy, M. A. and Hasan, M. (2011).Awareness of diabetes mellitus among Saudi non-diabetic population in Al-Qassim region, Saudi Arabia.Journal of Diabetes and Epidemiology 2(2), pp. 14-19.

[7]. Morrison, M. K., Lowe, J. M., and Collinst, C. E. (2010).Perceived risk of type 2 diabetes in Australian women with a recent history of gestational diabetes mellitus. Diabetes Medicine 27, pp. 882-886.

[8]. Sabri, A. A., Qayyum, M. A., Saigol, N. U., Zafar, K. and Aslam, F. (2007).

[9]. Tang, Y. H., Pang, S. M.C., Chan, M.F., Yeung, G.S. P. and Yeung, V.F.F. (2008). Health literacy, complication awareness, and diabetic control in patients with type 2 diabetes mellitus. Journal of Advanced Nursing 62(1), 74-83.

[10]. Upadhyay, D. K., Palaian, S., Shankau, P.R. (2007). Knowledge, Attitude, and Practice about diabetes mellitus among diabetes patients in Western Nepal.

[11]. www.who.int.org2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases.

[12]. www.who.int.org(2005). Chronic diseases: A vital Investment. 

Abstract:

The Cameroon Government through the Ministry of Health (MOH) introduced the National Health Management Information System (NHMIS) tool in the country in 1995 to harmonize the data collection process within the health system at all levels(1). Before this time, the MOH had no harmonized tool for health information and the different health facilities within the health system had varied data collection tools. The major role of the NHMIS involved data collection to show case the country’s health status, data quality enhancement and proper definition of each indicator therein, thorough data analysis at all levels of the health system and informed decision making by actors, timely feedback at all levels, enabling access of data at all levels to development partners and prompt epidemiological surveillance and timely intervention in the case of an epidemic (2). The elements of an effective SNIS are its relevance, how it satisfies clearly defined and quantified public health goals, its performance, does it work with efficient methods and tools and competent professionals? its usefulness, how is it used by its targeted audience (decision makers, health professionals, community stakeholders) and its consistency, are the various stakeholders and information sources well-coordinated?

The setting of institutional mechanisms and incentives in order to introduce an evidence base decision making process has been seen by many scholars as important and a major need. Thus Performance based financing at implementation had as one of its principles to strengthen the health system not leaving out the SNIS. In this light, the data reported in the project at the level of the health facility is supposed to be consistent with data reported in the NHMIS. This study sought to find out if this is actually the case on the field.

References:

[1]. Report A. African development fund. 2000;(March).

[2]. Merit I, Process R. Reinforcing the Health Information System to Step up the Viabilization of Health Districts Policy brief July 2010. 2010;(July):1–11.

Abstract:

Most maternal deaths are avoidable through the use of known interventions. However, those interventions are often inaccessible to many of those in need. As with most African communities, Hemorrhage (of which postpartum hemorrhage is most common) is the leading cause of maternal mortality in Adamawa State. Postpartum hemorrhage is mainly caused by complications arising during the third stage of labor. Effective management of the third stage of labor has the potential of significantly reducing maternal mortality. The process, component and the effects of services offered in the management of third stage of labour in Adamawa state has been under-investigated.  Understanding the process and effects of management of third stage of labour and factors associated with poor outcomes is key to designing effective policies and programme to reduce maternal deaths and improve maternal health status[i]. The aim of this research is therefore to fill the gap in present understanding of factors associated with maternal deaths that occur as a result of the management of the third stage of labour in Adamawa State in order to make evidence-based recommendation for improved programmatic intervention.

References:

[1]. AKOGUN, O.B.,GUNDIRI, M.A., BADAKI, J.A., NJOBDI, S.Y., ADESINA, O.A., OGUNDAHUNSI, O.A. 2012. Febrile illness experience among Nigerian nomads. Int J Equity Health. 11: p. 5

[2]. UNITED NATIONS 2011. The Millennium Development Goals Report. In: JENSEN, L. (ed.). United Nations

[3]. NJOBDI, S. 2012. Determinants of maternal and child health services utilization among mothers in a rural community in eastern Sudan. Unpublished M.Sc. Thesis.

Abstract:

According to World Bank (2008), the percentage of children under 6 months that were exclusively breast fed in Nigeria was reported to be 17.20% in 2004 and 13.10 % in 2008. This indicates a decline in the practices of exclusive breastfeeding among mothers in the urban and rural settings in Nigeria. Also, a recent survey by the Federal Ministry of Health in Nigeria reveals that 13.1% of Nigerian children under six months are exclusively breastfed.

Hence the need to assess the knowledge, attitude and practices of breastfeeding among mothers in Nigeria using the rural and urban settings in the Federal Capital Territory as a case study.

References:

[1]. Ajibade B.L., Okunlade J. O., Makinde O.Y., Amoo P.O., Adeyemo M.O.A (2013) Factors influencing the practice of exclusive breastfeeding in rural communities of Osun state, Nigeria. European Journal of Business and Management, 5 (15)

[2]. Ajibuah Bolanle Joel (2013), Appraisal of Nursing Mothers’ Knowledge and Practice ofExclusive Breastfeeding in Yobe State, Nigeria. Journal of Biology Agriculture and Healthcare 3 (20)

[3]. Alutu A.N.G. & Orubu A.O. (2005) Barriers to successful exclusive breastfeeding practices among rural and urban nursing mothers in Edo state of Nigeria: Implication for education and counseling. Research review NS 21(2) 27-35 University of Legon, Ghana.

[4]. Awi D.D., Alikor E.A.D., (2006) Barriers to timely initiation of breastfeeding among mothers of healthy full term babies who deliver at the university of Port Harcourt teaching hospital. Nigerian Journal of Clinical Practice, 9 (1): 57 – 64

[5]. Aloysius N. Maduforo and Romanus O. Onuoha; (2011) Relativities of exclusive breastfeeding between urban and rural lactating women in Imo state JORIND 9 (1) ISSN 1596 8308

[6]. Blum LM; (1999) At the Breast. Ideologies of Breastfeeding and Motherhood in the Contemporary United States Boston: Beacon Press

[7]. Chidozie E Mbada, Adekemi E Olowookere, Joel O Faronbi, Folasade C Oyinlola-Aromolaran, Funmilola A Faremi, Abiola O Ogundele, Taofeek O Awotidebe, Adepeju A Ojo and Oluwakemi A Augustine; (2013) Knowledge, attitude and techniques of breastfeeding among Nigerian mothers from a semi-urban community BMC Research Notes 6:552

[8]. Davies, A.A (1997) Socio-cultural factors and the promotion of exclusive breastfeeding in rural Yoruba communities of Osun State, Nigeria Social Science and Medicine 45(1):113 125

[9]. Federal Office of Statistics [Nigeria] and IRD/Macro International Inc.: Nigeria Demographic and Health Survey 2003. Columbia, Maryland: Federal Office of Statistics and IRD/Macro International Inc.; 2004.

[10]. Grassley J, Eschiti V; (2008) Grandmother Breastfeeding supports: What do mothers need and want? Birth 35(4):329-335.

[11]. Gareth J, Richard WS, Robert EB, Zulfiqar AB, and Saul SM; (2003)how many child deaths can we prevent this year? Lancet, 362(9377):65-71.

[12]. Isaton, J. S. (1998) Breastfeeding: from Biology to Policy 2nd Abraham Horwitz Annual Lecture March 1998 United Nations Administrative Committee on Coordination Sub Committee on Nutrition (ACC/SCN)

[13]. Klein, J. D. and the Committee on Adolescence (2005); Adolescent Pregnancy: Current Trends and Issues, Pediatrics 116:pp.281- 286.

[14]. Kingsley E Agho, Michael J Dibley, Justice I Odiase, Sunday M Ogbonmwan; (2011) Determinants of exclusive breastfeeding in Nigeria BMC Pregnancy and Childbirth 11:2

[15]. Kimani-Murage E.W., Madise N.J., Fotso J.C., Kyobutung C., Mutua M.K., Gitau T.M., Yatich N. (2011) Patterns and determinants of breastfeeding and complimentary feeding practices in urban informal settlements, Nairobi Kenya. BMC Public Health, 11:396

[16]. Lauer J, Betran A, Victora C, de Onis M, and Barros A (2011) Breastfeeding patterns and exposure to suboptimal breastfeeding among children in developing countries: review and analysis of nationally representative surveys BMC Medicine 2(1):26

[17]. Nigeria demographic and health survey (2013). National Population Commission, Nigeria.

[18]. Oche M.O., Umar A.S., Ahmed H., Knowledge and practice of exclusive breastfeeding in Kware, Nigeria African Health Sciences; 11(3): 518 – 523

[19]. Olayinka Alade, Musibau Ayoade Titiloye, Frederick Olore Oshiname and Oyedunni Sola Arulogun (2013) Exclusive breastfeeding and related antecedents factors among lactating mothers in a rural community in south west Nigeria. Academic Journals; IJNM Vol. 5(7), pp. 132-138

[20]. Ogunlesi T.A. (2010) Maternal socio-demographic factors influencing the initiation and exclusivity of breastfeeding in a Nigerian semi-urban setting. Maternal Child Health J 14(3):459-465.

[21]. Oweis A, Tayem A, and Froelicher E.S. (2009). Breastfeeding practices among Jordanian women. Int J Nurs Pract 15:32-40.

[22]. Ojo M. Agunbiade and Opeyemi V Ogunleye (2012). Constraints to exclusive breastfeeding practice among breastfeeding mothers in Southwest Nigeria: implications for scaling up. International Breastfeeding Journal 7:5

[23]. Salami L. (2006) Factors influencing breastfeeding practices in Edo state, Nigeria. African Journal of Food Agriculture Nutrition and Development 6(2):1-12.

[24]. Spencer R.L. (2008). Research methodologies to investigate the experience of breastfeeding: a discussion paper. Int J Nurs Stud 45(12):1823-1830.

[25]. The Millennium Development Goals report 2010, United Nations

[26]. UNICEF global databases, 2014

[27]. World Health Organization: The State of Breastfeeding in 33 Countries.

 2010 [http://www.worldbreastfeedingtrends.org/].

[28]. WHO/UNICEF: Global action plan for prevention and control of pneumonia (GAPP). 2009 Volume WHO/FCH/CAH/NCH/09.04.

[29]. WHO and UNICEF (2009) Baby-friendly hospital initiative Revised, Updated and Expanded for Integrated Care. WHO Document Production Services, Geneva, Switzerland.

[30]. World Bank report on exclusive breastfeeding (2008). http://www.tradingeconomics.com/nigeria/exclusive-breastfeeding

Abstract:

The clinical trial application (CTA) approval in the European Union (EU) member state has been subject to national legislation. Due to this the assessment of a CTA that was filed simultaneously in several EU member states often resulted in varying final decisions and unnecessary delays. Sometimes country-specific modifications to the application often occurred due to changes requested by the different regulatory/competent authorities (RA/CA) and ethics committees (EC). Sometimes a clinical trial might even be approved in one member state and rejected in another. The whole procedure could be extremely time-consuming and the country-specific modifications risk the scientific value of clinical trial results. The Voluntary Harmonisation Procedure (VHP) offers sponsors of multinational clinical trials involving three or more EU member states a harmonised procedure for the regulatory assessment of clinical trial authorisation applications. The Voluntary Harmonisation Procedure makes it possible to obtain a coordinated assessment of an application for a clinical trial that is to take place in several European countries.

Keywords: Clinical trials, Volutary Hormionsiation Procedure (VHP), Clinical trial application (CTA), Regulatiory authority approval, Europran Union (EU)

References:

[1]. Official Journal of the European Union, OJ L 121, 1.5.2001, p. 34.

[2]. Annabel Bonsu, et al, Regulatory Rapporteur – Vol 8, No 3, March 2011

[3]. ‗One voice for clinical trials in Europe, an interview with Dr Hartmut Krafft‘, Regulatory Rapporteur, July-August 2010.

[4]. http://www.hma.eu/fileadmin/dateien/Human_Medicines/01-About_HMA/Working_Groups/CTFG/2010_03_VHP_Guidance_v2.pdf

[5]. The annual European Medicines Agency review of the year and outlook for 2011. A joint meeting between TOPRA and the European Medicines Agency, London, 6-7 December 2010.

[6]. http://www.pharmatimes.com/article/11-10-25/Growing_appetite_for_EU_s_Voluntary_Harmonisation_Procedure.aspx

[7]. Guidance document for a Voluntary Harmonisation Procedure (VHP) for the assessment of multinational Clinical Trial Applications (Version 2). Clinical Trials Facilitations Groups. March 2010. Available at http://www.hma.eu/uploads/media/VHP_version_2_March_2010.pdf

[8]. http://www.marsdd.com/dms/entrepreneurtoolkit/Regulatory-PDFs/Clinical_Trial_Authorization_EU.PDF

[9]. Guidance document for a Voluntary Harmonisation Procedure (VHP) for the assessment of multinational Clinical Trial Applications Version Sponsor 1.1. Pilot Phase proposed by CTFG.

[10]. http://laegemiddelstyrelsen.dk/en/topics/side-effects-and-trials/clinical-trials/news/voluntary-harmonisation-procedure-vhp-fo--plications.aspx

[11]. Harmonised requirements for non-investigational medicinal products in CTA submissions – Draft submitted for public consultation. June 2010. at: http://ec.europa.eu/health/files/clinicaltrials/pc_final_en.pdf

[12]. Public consultation on draft guidance– Harmonised requirements for non investigational medicinal products in CTA submissions. September 2010.

Abstract:

A total of 340 specimens from 192 (56.5%) male and 148 (43.5%) females attending tuberculosis clinics in Abuja metropolis were analysed by five different laboratory techniques (ZN Direct, ZN Bleach, LJ slants, BACTEC and Serology TB) for the diagnosis of Mycobacterium tuberculosis. Comparative analysis of results at P=0.05, revealed that there was a statistical significant (X2=127.1, P<0.001) difference between the diagnosistic performance of the five laboratory techniques. A follow-up analysis based on the 95% confidence interval of pair differences in proportion between the five techniques indicated that the BACTEC assay was the major source of the difference(P<0.001) in pair methods. Comparison of the 95% confidence limit of pair differences in diagnostic specificity of Mycobacterium tuberculosis between ZN-BACTEC and other methods confirmed (P<0.001) the high detection rate of BACTEC. It was observed that BACTEC had the highest detection rate (61.2%), followed by LJ (31.2%), then ZN Bleach (30.3%) and ZN Direct (28.8%), while Serology had only 25.3% ZN BACTEC appeared to the most reliable, and time effective combination. ZN Bleach should be encouraged in poor resource settings in lieu of the conventional three standard smears for ZN Direct. The use of Serologic TB kit alone for the diagnosis of tuberculosis should be discouraged.

Keywords: Mycobacterium tuberculosis, BACTEC, Laboratory and Serology.

References:

[1]. Baker F. J. and Breach M. R. ;(1980) Mycobacteria: In medical microbiological techniques. Butterwort and co.ltd. 183-195.

[2]. Centre for Disease Control and Prevention, (1992). National action plan to combact multidrug- resistant tuberculosis. MMWR; 41 (NO. RR-11).

[3]. Centre for Disease Control and Prevention, (1995). Laboratory Practices for Diagnosis of Tuberculosis-United State in 1994; MMWR 44 (31); 587-589.

[4]. David N. Memurray, (1996). Mycobacteria and Norcardia: In Medical Microbioligy. 4th Edition. Samuel Brown (ed). The University of Texas Medical Branch Publishers, Galverston USA; 423-439.

[5]. Doern G.V. (1996) Diagnosis Mycobacteriology where are we today? J. Clin Microbiol; 34 : 1873 -1876.

[6]. Dye C., Schede S., Dolin P., Pathania V., Raviglione M.C., (1999).Consensus statement. Global burden of tuberculosis: estimated incidence, prevalence and mortality by country. WHO Global Sureveillance and Monitoring Project. JAMA; 269: 898-903-World Health Organisation(2002).

Abstract:

Background – Chronic disease has now become a major contributor to mortality, the increase in risk factors has had serious impact on health. Much attention has been paid to healthy lifestyle and the need for behavior change. Behavior is transitioning in many developing countries due to urbanization, improved income and access to technological advances. This has resulted in increase in risk factors such excessive alcohol consumption, smoking and inactivity. More persons are seeking processed and prepackaged meals and consuming more food leading to obesity.

Objective – The objective of the project is to provide a critical look at the social and cultural factors and how they impact health. To explore how health promotion and there interventions impact on the prevalence of these risk factors.

Method – This study will explore at least 10 published articles on this topic the impact of risk factors on health and strategies used to reduce the occurrence of these factors. This review will provide information required to provide recommendations to address prevention of risk factor development.

Results – Results across different studies show that lifestyle behavior influences the development of risk factors. Unhealthy behavior like smoking, excessive alcohol consumption and inactivity is associated with obesity, elevated blood pressures and ultimately the development of chronic illnesses like cardiovascular disease and cancer.

Conclusion – Risk factors such as smoking, alcohol consumption and inactivity influence the occurrence of chronic illnesses. Surveillance for risk factors must be done and health education must be used as an intervention strategy to prevent the development of risk factors to reduce mortality. 

References:

[1]. Murray CJ, Lopez AD. The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Disease, Injuries and Risk Factors in 1990 and Projected to 2020. Harvard School of Public Health; 1996. World Health Organization, and the World Bank. Geneva: World Health Organization.

[2]. Murray CJL, Lopez AD, Harvard School of Public Health, World Health Organization, World Bank. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge, MA: Published by the Harvard School of Public Health on behalf of the World Health Organization and the World Bank; Distributed by Harvard University Press; 1996

[3]. World Health Organization. The world health report 2003: shaping the future. Geneva: World Health Organization; 2003

[4]. National Health Expenditure Data, Historical. http://www.cms.hhs.gov/NationalHealthExpendData/02_NationalHealthAccountsHistorical.asp#TopOfPage

[5]. Chronic Disease Overview. http://www.cdc.gov/NCCdphp/overview.htm

[6]. Omran A. The Epidemiologic Transition: A Theory of the Epidemiology of Population Change. The Milbank Quarterly. 1971; 49(4):509–38. [PubMed]

[7]. Paez KA, Zhao L, Hwang W. Rising out-of-pocket spending for chronic conditions: a ten-year trend. Health Aff (Millwood) 2009; 28:15–25. doi: 10.1377/hlthaff.28.1.15. [PubMed] [Cross Ref]

[8]. Chronic Disease Overview. http://www.cdc.gov/NCCdphp/overview.htm

[9]. D. Stuckler, Population Causes and Consequences of Leading Chronic Diseases: A Comparative Analysis of Prevailing Explanations Milbank Q. Jun 2008; 86(2): 273–326 doi: 10.1111/j.1468-0009.2008.00522.x PMCID: PMC2690359

[10]. Reddy K, Shah B, Varghese C, Ramadoss A. Responding to the Threat of Chronic Diseases in India. The Lancet. 2005; 366(9498):1744–49. [PubMed]

[11]. Cutler D, Glaeser EL, Shapiro JM. Why Have Americans Become More Obese? Journal of Economic Perspectives. 2003; 17:93–118.

[12]. Bull World Health Organ. Risk factors for noncommunicable chronic diseases in women in China: surveillance efforts Sep 1, 2013; 91(9): 650–660. doi: 10.2471/BLT.13.117549. PMCID: PMC3790222

[13]. Yu W. National Disease Surveillance Points System – death cause surveillance 2010Beijing: Military Medical Science Press; 2012

[14]. Asia Pacific Cohort Studies Collaboration The burden of overweight and obesity in the Asia-Pacific region. Obes Rev. 2007; 8:191–6. doi: 10.1111/j.1467-789X.2006.00292.x. [PubMed] [Cross Ref]

[15]. Jeemon P, Prabhakaran D et al Impact of comprehensive cardiovascular risk reduction programme on risk factor clustering associated with elevated blood pressure in an Indian industrial population Indian J Med Res. Apr 2012; 135(4): 485–493. PMCID: PMC3385231

[16]. Sturm R, An R , Patel D. et al The Effects of Obesity, Smoking, and Excessive Alcohol Intake on Health Care Expenditure in a Comprehensive Medical Scheme S Afr Med J. Author manuscript; available in PMC Nov 1, 2013.Published in final edited form as:S Afr Med J. Sep 30, 2013; 103(11): 840–844.PMCID: PMC3807241NIHMSID: NIHMS515015

[17]. Reif S, Larson M et al, Chronic disease and recent addiction treatment utilization among alcohol and drug dependent adults Subst Abuse Treat Prev Policy. 2011; 6: 28. Published online Oct 18, 2011. doi: 10.1186/1747-597X-6-28PMCID: PMC3220629

[18]. Sabia S, Singh Manoux A et al, Influence of individual and combined healthy behaviours on successful aging CMAJ: Canadian Medical Association Journal Canadian Medical Association CMAJ. 2012 Dec 11; 184(18):1985-92. doi: 10.1503/cmaj.121080. Epub 2012 Oct 22

[19]. Fleischer. N, Diez Roux. Et al A, Social Patterning of Chronic Disease Risk Factors in a Latin American City J Urban Health. Nov 2008; 85(6): 923–937. Published online Oct 2, 2008. doi: 10.1007/s11524-008-9319-2 PMCID: PMC2587655

[20]. Gilmore AB, McKee M. Moving East: How the Transnational Tobacco Companies Gained Entry to the Emerging Markets of the Former Soviet Union. Part II: An Overview of Priorities and Tactics Used to Establish a Manufacturing Presence. Tobacco Control. 2004; 13:151–60. [PMC free article] [PubMed]

[21]. Kannel WB. Risk stratification in hypertension: new insights from the Framingham Study. Am J Hypertens. 2000;13:3S–10S. [PubMed]

[22]. Kim BJ, Kim BS, Sung KC, Kang JH, Lee MH, Park JR. Association of smoking status, weight change, and incident metabolic syndrome in men: a 3-year follow-up study. Diabetes Care. 2009; 32:1314–6. [PMC free article] [PubMed

[23]. Jeemon P, Prabhakaran D et al Impact of comprehensive cardiovascular risk reduction programme on risk factor clustering associated with elevated blood pressure in an Indian industrial population Indian J Med Res. Apr 2012; 135(4): 485–493. PMCID: PMC3385231

[24]. Mayosi BM, Flisher AJ, Lalloo UG, et al. The burden of non-communicable diseases in South Africa. Lancet. 2009; 374(9693):934–947. [ http://dx.doi.org/10.1016%2FS0140-6736%2809%2961087-4] [PMID:19709736] [PubMed]

[25]. Kaplan GA, Keil JE. Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation. 1993; 88(4):1973–1998. [PubMed]

[26]. Leeder S, Raymond S, Greenberg H, Liu H, Esson K. A race against time: the challenge of cardiovascular disease in developing economies. New York City, NY: Columbia University; 2004

[27]. Singh RB, Pella D, Mechirova V, et al. Prevalence of obesity, physical inactivity and under nutrition, a triple burden of diseases during transition in a developing economy. The Five City Study Group. Acta Cardiol. 2007;62(2):119–127 doi:10.2143/AC.62.2.2020231. [PubMed]

[28]. Report of the Formal Meeting of Member States to conclude the work on the comprehensive global monitoring framework, including indicators, and a set of voluntary global targets for the prevention and control of noncommunicable diseases. Geneva: World Health Organization; 2012. Available from: http://apps.who.int/gb/ncds/pdf/A_NCD_2-en.pdf[accessed 15 June 2013].

[29]. Mark TL, Levit KR, Coffey RM, McKusick DR, Harwood HJ, King EC, Bouchery E, Genuardi JS, Vandivort-Warren R, Buck JA, Ryan K. National Expenditures for Mental Health Services and Substance Abuse Treatment, 1993-2003. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2007. 

Abstract:

No study has analyzed the extent of weight reducing ability among the “peroxisome proliferator activated receptor-gamma” (PPAR-γ) activating ARBs – Telmisartan and Irbesartan in black hypertensive of African origin. This retrospective cohort study was designed to delineate the extent of weight reducing effect of these PPAR-γ activating ARBs and how it correlates with BP reduction observed with these ARBs in black hypertensive. A total of 26 case notes of patients (15 men, 11 women; mean age 58.9±1.8 years) with diagnosis of hypertension were reviewed and the study attained a power of 96%. The patients whose case notes were reviewed were naïve to ARBs before commencing either telmisartan or irbesartan and did not have any metabolic disease like diabetes or thyroid disease which could interfere with body weight reading. They all took either telmisartan 80mg or irbesartan 150mg for at least a 6 month review period. Body weight were significantly reduced more in the telmisartan (n = 13) treatment group compared to the irbesartan (n = 13) treatment group [change from baseline; -1.51±0.46Kg (-1.68%), P=0.006 vs. -0.96±0.15Kg (-1.05%), P<0.001]. Both treatment effectively controlled blood pressure (mean BP after 6 months treatment: Telmisartan 126/83mmHg; Irbesartan 133/84mmHg). In the telmisartan group there were no correlation between either change in SBP and change in body weight (r = -0.220, P = 0.471) or change in DBP and change in body weight (r = -0.050, P = 0.870), but a significant positive correlation was observed between both change in SBP and change in body weight (r = 0.538, P = 0.058) and change in DBP and change in body weight (r = 0.610, P = 0.027) in the irbesartan treatment group. Both telmisartan and irbesartan reduced body weight in hypertensive black patients and this reduction in body weight may contribute to the power demonstrated by irbesartan to get patients to BP goal. Hence hypertensive blacks could also benefit from the established end-organ protection benefits of both telmisartan and irbesartan.

Key words: Hypertension; Telmisartan; Irbesartan; Body weight; Adiponectin; PPAR-γ.

References:

[1]. AHA. American Heart Association. Metabolic “footprint” may be new measure of obesity risk in kids. 4TH annual conference on cardiovascular diseases, epidemiology and prevention, 2004.

[2]. Burt, V.L., Whelton, P., Roccella, E.J., Brown, C., Cutler, J.A., Higgins, M., et al. Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey. 1988-1991. Hypertension, 1995, 25(3), 305-313.

[3]. Clasen, R., Schupp, M., Foryst-Ludwig, Anna., et al. PPAR gamma-activating angiotensin type-1 receptor blockers induce adiponectin. Hypertension, 2005, 46(1): 137-143.

[4]. Derosa, G., Cicero, A.F., D`Angelo, A., et al. Telmisartan and irbesartan therapy in type 2 diabetic patients treated with rosiglitazone: effects in insulin resistance, leptin and tumor necrosis factor-alpha. Hypertens Res., 2006, 11: 849-56.

[5]. De lasHeras, N., Martin-Fernandez B, Miana M, et al. The protective effect of irbesartan in rats fed a high fat diet is associated with modification of leptin-adiponectin imbalance. J Hypertens, 2009, 6(Suppl.): S37-41.

[6]. Fasshauer, M., Paschke, R., Stumvoll, M. Adiponectin, obesity and cardiovascular disease. Biochimie, 2004, 86: 779-784

[7]. He, J., Whelton, PK., Appel, LJ., Charleston, J., Klag, MJ. Long-term effects of weight loss and dietary sodium reduction on incidence of hypertension. Hypertension, 2000, 35: 544-9.

[8]. HOPE Investigators. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high risk patients. N Engl J Med., 2000, 342: 145-53.

[9]. Kearney, P.M., Whelton, M., Reynolds, K., Muntner, P., Whelton, P.K. Global burden of hypertension: analysis of worldwide data. Lancet, 2005, 365: 217–23.

[10]. Koh, K.K., Quon, M.J., Han, S.H., et al. Vascular and metabolic effects of combined therapy with ramipril and simvastatin in patients with type 2 diabetes. Hypertension, 2005, 45: 1088-1093.

[11]. Lewis, E.J., Hunsicker, L.G., Clarke, W.R., et al. for the Collaborative study group. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med., 2001, 345(12): 851-860.

[12]. Makita, S., Abiko, A., Naganuma, Y., Moriai, Y., Nakamura, M. Effects of telmisartan on adiponectin levels and body weight in hypertensive patients with glucose intolerance. Metabolism, 2008, 10: 1473-1478.

[13]. Mori, H., Okada, Y., Arao, T., Nishida, K., Tanaka, Y. Telmisartan at 80mg/day increases high-molecular-weight adiponectin levels and improves insulin resistance in diabetic patients. AdvTher, 2012, 29(7): 635-44.

[14]. Negro, R., Formoso, G., Hassan, H. The effects of irbesartan and telmisartan on metabolic parameters and blood pressure in obese, insulin resistant, hypertensive patients. J Endocrinol Invest., 2006, 29(11): 957-61.

[15]. ONTARGET Investigators, Yusuf, S., Teo, K.K., et al. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med., 2008, 358:1547–1559.

[16]. Ouedraogo, R., Ging, Y., Berzins, B., Wu, X., Mahadev, K., Hough, K., Chan, L., Goldstein, B.J., Scalia, R. Adiponectin deficiency increases leucocytes endothelium interactions via upregulation of endothelial cell adhesion molecules in vivo. J Clin Invest., 2007, 117: 1718-1726.

[17]. Parving, H-H., Lennert, H., Brochner-mortensen, J., Gomis, R., Andersen, S., Avner, P. The effect of irbesartan on the development of diabetic nephropathy in patients with type-2 diabetes. N Engl J Med., 2001, 345(12): 870-78.

[18]. Parhofer, K.G., Munzel, F., Krekler, M. Effect of the angiotensin receptor blocker irbesartan on metabolic parameters in clinical practice: the DO-IT prospective observational study. Cardiovascular Diabetology, 2007, 6: 36-41.

[19]. THPCRG Investigators (Trials of Hypertension Prevention Collaborative Research Group). Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure. The Trials of Hypertension Prevention, phase II. Arch Intern Med., 1997, 157: 657-67.

[20]. World Health Report (2002) Reducing risks, promoting healthy life. World Health Organization, Geneva, Swit-zerland. http://www.who.int/whr/2002/en/whr02_en. Pdf

Abstract:

The article "Pharmacovigilance on sexual enhancing herbal supplements" by Bhagavathula et al., 2014 is a scientific paper on Pharmacovigilance published in the Journal of Pharmacovigilance –an open access journal. It explores one of the prevailing issues of global interest in the field of pharmacovigilance: Pharmacovigilance of Sexual enhancing herbal supplements. The article is a divided into main parts; the main body and the reference section. This review critically reviews the article's structure, authority, currency, stability, objectivity and it relevance to Clinician and Clinical Researchers. The review will first summarize the article and then critique the article on the basis of its authority, accuracy, currency, relevance, objectivity, stability and the data analysis. The review will analyze all the relevant data and information provided by the article before commenting on the credibility and the reliability of the article. Overall, the article is well written and relevant to Clinicians, Clinical Researchers and the general population.

References:

Abstract:

Afghanistan's health status was one of the worst in the world before 2002 ( UNICEF 2002) Fortunately after that there are many change during the recent years with some positive intervention and revised Basic Package of Health Services ( BPHS) by ministry of public health of Afghanistan and decreased maternal and children mortality rate, The under-5 mortality rate for Afghanistan excluding the South zone for the 2-6 years prior to the survey is 97 deaths per 1,000 births, and the infant mortality rate is 77 deaths per 1,000 births(Afghanistan Mortality Survey( AMS 2010).

References:

[1]. Afghanistan Mortality Survey( AMS 2010).

[2]. http://measuredhs.com/pubs/pdf/FR248/FR248.pdf

[3]. Basic Package of Health Services ( BPHS) ministry of public health of Afghanistan

[4]. http://moph.gov.af/Content/Media/Documents/HISToolsinAfghanistan,Oct201212112012104152552553325325.pdf

[5]. Gozarah district hospital document

[6]. http://moph.gov.af/Content/Media/Documents/CHSCURRICULUMFINALIZEDBYCBHCFINALMARCH,2011English412201310527842553325325.pdf

[7]. Community based health care ministry public health of Afghanistan (Community Health Supervisors manual )

[8]. Gozara survey Catchment Area Annual Census ( CAAC0 2005).

Abstract:

Kenya is making efforts to be ethical in handling research involving human beings and laws have been enacted to that extent. There is still room for improvement by establishing the code of ethics for public health practitioners and developing an effective curriculum for training public health officers.

The Public health officers’ professional body need to speed up the enactment of the code of ethics in order to hold the public health practitioners to account for their actions and also get protection for their well intended actions to promote good health and prevent disease.

The current ethical debate is the tetanus toxoid vaccine which is laced with HCG hormone at 1 in every four. The government has been ready to explain the reason for the presence of HCG in the vaccine.

Key Words: Public Health, Ethics, National Legislation, NACOSTA, Tetanus toxoid, HCG

References:

[1]. Adele L. (2007) The UNESCO Universal Declaration on Bioethics and Human Rights: Perspectives from Kenya and South Africa

[2]. Callan, D. Jennings , B. (2002) : Ethics and Public Health: Forging a Strong Relationship. Am. J. Pub Health, Feb. vol. 92 no. 2

[3]. CDC (2008) : Public health code of ethics

[4]. Fox, E. , Myers, S. , & Pearlman, R. , A. , (2007) . “Ethics Consultation in United States Hospitals: A National Survey”. The American Journal of Bioethics, 7 (2) , 13-25.

[5]. MOH (2012) : Kenya Health Policy 2012-2015

[6]. MOH (2002) : National Nutrition Action Plan 2002- 2007

[7]. National academy of sciences (2007) : Public health secrecy and ethics

[8]. NACOSTI (2009) : Bio ethics Committee

[9]. GOK (2012) : The Public Health Act 2012, Laws Of Kenya Chapter 242.

[10]. GOK (2010) : The Constitution of Kenya

[11]. WORLD MEDICAL ORGANIZATION (1996) : Declaration Helsinki. BMJ (7 DEC) 313 (7070) : 1448-1449

[12]. WHO (2009) : International Health Regulations (2005)

[13]. GOK (2007) : Work Injury Act 

Abstract:

Background

In 2010, community based health insurance scheme (CBHIS) was launched in the Federal Capital Territory (FCT) of Nigeria. Little is known about the knowledge and perception of the rural dwellers of the FCT about the scheme. This study aimed to evaluate the knowledge and perception of healthcare consumers towards CBHIS in FCT.

Methods

A descriptive cross sectional study of 287 household heads was done. Systematic random sampling was used. Information was collected using a semi-structured, interviewer administered questionnaire. Data was analysed with SPSS version 21.

Results

Male respondents were 175(61%),242(84.3%) were aware of the existence of CBHIS, 126(82%) of enrollee also enrolled their dependents. Annual payment of health insurance premium was preferred by 91(59.9%) of enrolled respondents, 92(60.1%) enrolled in the scheme because they perceived it to be a cheap way to access healthcare. No proper understanding was the reason why 33(28.4%) of those aware of the scheme did not enroll themselves or their dependents. Only 124 (55.1%) were satisfied with the overall services provided to them by their health care provider (HCP).More males 102(81.6%) were satisfied with HCP services. Among respondents with secondary/tertiary education 18(81.8%) were satisfied with their HCP compared to 47(38.2%) of those who had no formal education, p<0.001. 47(85.5%) respondents in the richest wealth quintile were satisfied compared with only 13(52%) in the lowest category, p<0.001.

Conclusion

There is a need to educate the community members on principle of health insurance and improve access to health services under the scheme.

Key words: CBHIS, Health insurance, rural communities, knowledge, perception

References:

[1]. World Health Organization (WHO). The world health report: health systems financing: the path to universal coverage. Geneva, Switzerland. WHO, 2010.

[2]. Ngowu, R., Larson, J. S. and Kim, M. S (2008). Reducing child mortality in Nigeria: A case study of immunization and systemic factors. Social Sciences and Medicine 67 (1): 161-164

[3]. Falegan, I. J. (2008). Healthcare financing in the developing world: is Nigeria’s National Health Insurance Scheme a Viable Option? Jos Journal of Medicine 3 (1).

[4]. Meessen, B., Van Damme, W., Tahobya, C. K., Tibouti, A. Poverty and user fees for public health care in low-income countries: lesion from Uganda and Cambodia. Lancet 2006, 368(9954):2253-2257.

[5]. Wagstaff A: Social Health Insurance Re-examined. Health Economics 2010, 19:503–517

[6]. Carrin G, Waelkens M. P, Criel B. Community-based health insurance in developing countries: a study of its contribution to the performance of health financing systems. Trop Med Int Health. 2005; 10(8):799-811.

[7]. Kamau Njoroge and Njiru Haron. Community based health insurance schemes: Lesson from rural Kenya. Journal of Health Care for the Poor and Underserved. 2014; 25(1): 192-203. DOI: 10.1353/hpu.2014.0023.

[8]. Sepehri AS, Sarma W, Simpson. Does non-profit health insurance reduce financial burden? Evidence from the Vietnam Living Standards Survey Panel. Health Economics 2006; 15(6):603-16.

[9]. Jutting J. P. The Impact of Health Insurance on the Access to Health Care and Financial Protection in Rural Developing Countries: The Example of Senegal. Health, Nutrition and Population Discussion Paper. 2001. Washington. The World Bank.

[10]. Jutting, J. P. Do Community-based health insurance schemes improve poor people’s access to health care? Evidence from rural Senegal. World Development. 2004; (32) 2: 273-288.

[11]. Gamble-Kelley A, Diop F, Makinen M. Approaches for scaling up community-based health financing schemes. Bethesda, MD: Partners for Health Reform Plus Project. 2006. Cambridge. Abt Associates Inc. PubMed

[12]. Jehu-Appiah, C Aryeetey, G., Agyepong, I., Spaan E. and Baltussen, R. Household perceptions and their implications for enrolment in the National Health Insurance Scheme in Ghana. Health Policy and Planning 2012; (27): 222–233. Doi:10.1093/heapol/czr032

[13]. Onwujekwe, O., Onoka, C., Uzochukwu, B., Nkoli, U. Nnnena, T., Eze, S., Kirigia, J. and Petu, A. Preferences for benefit packages for community-based health insurance: an exploratory study in Nigeria. BMC Health Services Research 2010, 10:162

[14]. Mulupi, S., Kirigia, D., Chuma, J. Community perceptions of health insurance and their preferred design features: implications for the design of universal health coverage reforms in Kenya. BMC Health Services Research 2013; 13: 474. Doi:10.1186/1472-6963-13-474

[15]. Jean Jacques N Noubiap et al. Community-based health insurance knowledge, concern, preferences and financial planning for health care among informal sector workers in a health district of Douala, Cameroon. Pan African Medical Journals. 2013; 16:17. Doi:10.11604/pamj.2013.16.17.2279.

[16]. De Allegri, M., Sanon, M., Bridges, J. and Sauerborn, R. Understanding consumers’ preferences and decision to enrol in community-based health insurance in rural West Africa. Health Policy 76 (2006) 58–71.

[17]. Banwat, M. E., Agbo, H. A., Hassan, Z., Lassa, S., Osagie, I. A., Ozoilo, J. U., Ogbonna, C. Community based health insurance knowledge and willingness to pay; A survey of a rural community in North Central zone of Nigeria. Jos Journal of Medicine, 2012; (6): 1.

[18]. Uzochukwu, B.S.C., Onwujekwe, O.E., Eze, S., Ezuma, N., Obikeze, E.N and Onoka, C.A. Community Based Health Insurance Scheme in Anambra State, Nigeria: an analysis of policy development, implementation and equity effects. The Consortium for Research on Equitable Health Systems (CREHS) 2009.

[19]. Odeyemi Isaac, A. O. Community-based health insurance programmes and the national health insurance scheme of Nigeria: challenges to uptake and integration. BMC Health Services Research 2013; (2) 12: 237.

[20]. Basaza, R., Criel, B., Van der Stuyft, P. Community health insurance in Uganda: why does enrolment remain low? A view from beneath. Health Policy. 2008(87) 172– 184. Doi:10.1016/j.healthpol.2007.12.008.

[21]. Dixon, J., Tenkorang, E. Y. and Luginaah, I. Ghana’s National Health Insurance Scheme: a national level investigation of members’ perceptions of service provision. BMC International Health and Human Rights 2013, 13:35.

[22]. Bjorn Ekman, 2004. Community-based health insurance in low-income countries a systematic review of evidence. Health Policy and Planning; 19(5): 249-270.

[23]. Afolabi, M. O., Daropale, V. O., Irinoye, A. I. and Adegoke, A. A. Health-seeking behaviour and student perception of health care services in a university community in Nigeria. Health 2013; (5):817-824.

[24]. McIntyre D, Garshong B, Mtei G, et al. Beyond fragmentation and towards universal coverage: insights from Ghana, South Africa and the United Republic of Tanzania. Bull World Health Organ. 2008; 86(11): 871–876.

[25]. Onwujekwe, O., Onoka, C., Uzochukwu, B., Okoli, C., Obikeze, E. and Eze, S. Is community- based health insurance an equitable strategy for paying for healthcare? Experiences from southeast Nigeria. Health Policy 92 (2009) 96–102.

[26]. Federal Capital Territory (FCT) Demographic and Household Survey tool. 2011. Retrieve from http://fctsurvey.org.ng/on 28/09/2014.

[27]. Cochran, W. G. Sampling techniques (3^rd ed.). New York, NY: John Wiley and Sons, 1977.

[28]. IBM SPSS Statistics for Windows, Version 21.0. IBM Corp. Released 2012. Armonk, NY: IBM Corp

[29]. National Population Commission (NPC) [Nigeria] and ICF International. 2014. Nigeria Demographic and Health Survey 2013. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF International

[30]. National Population Commission (NPC) AND ICF Macro. Nigeria Demographic and Health Survey 2009.

Abstract:

This paper investigates the relevance of financial statements on Rural and Community Bank performance. Rural banks are the main source of financial service in rural sub- Saharan Africa and their services are mostly patronized by persons with little or no level of education. The study is therefore examining their level of knowledge on financial performance of the rural bank in which they are investing. The data was collected from a sample of one hundred and eighty respondents using questionnaires and face to face interviews conducted with management staff of the bank and used for analysis. The statistical tools employed in assessing the relevance of financial statements on the performance of Atwima Mponua Rural Bank were Mean distribution, coefficient of variation and regression analysis. The results indicate that the bank has been giving account statement quarterly or yearly to its customers. Findings of the study indicate that the bank post its annual financial statement to customers or post it on the bank’s notice board. Then, it is found that the bank organized annual general meetings to explain its financial statement to its customers. It is therefore concluded that there is no evidence to ascertain that knowledge on financial statement is relevant to organizational performance. It is recommended that this study will be extended to other rural banks in the country to help assess the findings of this study.

Keywords: Financial Statements, Performance, Atwima Mponua Rural Bank, Case study

References:

[1]. Aboagye, A. Q & J. Otieku, (2010).Are Ghanaian MFIs’ Performance Associated with Corporate Governance?, Corporate Governance, Vol 10, No.3, 307-320

[2]. Berger, A.N.& Humphrey, D.B. (1997).Efficiency of financial institutions: International survey and directions for future research, European Journal of Operational Research, Vol. 98, pp 175-212

[3]. Birley, S. &Niktari, N. (1995). The Failure of Owner-Managed Businesses: The Diagnosis of Accountants and Bankers, ICAEW

[4]. Bolton, J.E. (1971). Report of the Committee of Enquiry on small firms. Bolton Report Cmnd. 4811. London: HMSO.

[5]. Casu, B ,Molyneux, P & Girardone, C (2006). Introduction to Banking, Prentice Hall/ Financial Times, London

[6]. Collis, J. &Jarvis, R. (2002).Financial Information and the Management of Small Private Companies, Journal of Small Business and Enterprise Development, Vol. 9, No. 2, pp: 100 -110

[7]. Everingham, G.K., Kleynhans, J.E. &Posthumus, L.C. (2003).Introductory GAAP. 3rd Ed. Juta: Landsdowne.

[8]. Halkos, G. &Salamouris, D. (2004).Efficiency measurement of the Greek commercial banks with the use of financial ratios: a data envelope analysis approach, Management Accounting Research, Vol. 15, No. 2, pp 201- 224

[9]. Hatif, M.,& Al-Zubaidi, F. (2000). Individual investors’ level of understanding and using of accounting information in Baghdad’s financial market: An empirical study. Jarash Journal for Research and Studies, 4, 2.

[10]. Jooste, L. (2006).Cash Flow ratios as a yardstick for evaluating financial performance in African businesses, Managerial Finance, Vol. 32, No. 7, pp: 569 -576

[11]. Kirkpatrick, C ,Murinde, V &Tefula, M (2007).The measurement and determinants of x-inefficiency in commercial banks in Sub-Saharan Africa, European Journal of Finance Vol. 14, No. 7, pp 625-639

[12]. Kiyota, H (2009). Efficiency of Commercial Banks in Sub-Saharan Africa: A Comparative Analysis of Domestic and Foreign Banks. A paper prepared for the CSAE conference 2009 on “Economic Development in Africa” held at the University of Oxford

[13]. Lacewell, S. K. (2003). Do Efficient Institutions Score Well Using Ratio Analysis? An Examination Of Commercial Banks in The 1990s, Journal of Commercial Banking and Finance, Vol. 2, pp 17-33

[14]. Largay, J. A. III. & C. P. Stickney (1980).Cash Flows, Ratio Analysis and the W.T. Grant Company Bankruptcy, Financial Analysts Journal, Vol. 36, No. 4: 51-54.

[15]. Lee, T. A. (1982). Laker Airways - the Cash Flow Truth, Accountancy, Vol. 93, No. 1066, pp. 115-116.

[16]. Melse, E. (2013).What color is your balance sheet? The relevance and explanatory power of wealth accounts, Emerald Group Publishing Limited, Vol. 12, No. 4, 2004, pp: 17 -32

[17]. Naser K., Nuseibeh R., Al-Hussaini A. (2003).Users’ Perceptions of Various aspects of Kuwaiti Corporate Reporting, Managerial Auditing Journal, Vol. 18, No. 6/7, pg. 599 - 617

[18].Owen, E (2013) Finance & General Administration, Oak Hill Business Business, Partners.

[19].Owusu-Frimpong, N. (1999). Patronage behaviour of Ghanaian bank Customers, Journal of Bank and Marketing, Vol.17, No.7, pg. 335 – 341

[20].Samad, A. (2004).Bahrain Commercial Bank’s Performance during 1994-2001 Credit, Financial Management Review Vol. 10, No. 1, pp 33-40

[21].Seiford, L., M and Zhu, J (1999).Portability and Marketability of the Top 55 U S, Commercial Banks Management Science, Vol. 45, No. 9, pp 1270-1288

[22].Tarawneh, M (2006).A Comparison of Financial Performance in the Banking Sector: Some Evidence from Omani Commercial Banks”, International Research Journal of Finance and Economics, Vol. 3, pp 103-112

[23].The Ghanaian Times (2010). Rural Banks Supervision Weak – UN Survey, September 2, Back Page 34.

[24].The Ghanaian Times(2010).Citizen Rural Bank urges to reverse losses, September 23, pg. 21