Abstract:

Health programs are often instituted to prevent diseases and to restore or promote health. In many cases, there are gaps between anticipated and attained goals. A case in point is the Nigerian Midwives Service Scheme, where the concept of providing 24 hour coverage of the primary health centers by skilled birth attendants is currently failing to meet the desired targets in certain parts of Nigeria, predominantly the North Eastern and North Western Zones.

This is in spite of adequate funding and organization. This article discusses the barriers to effective implementation of the program and suggests that the gap between goals anticipated during program conceptualization and goals attained after program implementation can be bridged by optimizing innovative health communications to the target audience and applying social marketing techniques to health care delivery in the affected zones. This is in addition to inter-sectoral coordination and collaboration between relevant government ministries and stakeholders.

References:

[1.]   Abimbola, S, Okoli, U, Olubajo, O, Abdullahi, M J and Pate, MA The Midwives Service Scheme in Nigeria. PLoS Med. 2012; 9(5): e1001211. doi: 10.1371/journal.pmed.1001211. PMCID: PMC3341343.

[2.]   Ajumobi, F Underage Marriage: Playing games with child’s rights. Sunday Vanguard. 45-47 www.vanguardngr.com accessed 29/07/2013.

[3.]   Abou Zahr, C Maternal mortality in 1995. WHO/UNICEF/UNFPA. Maternal mortality in 1995: estimates developed by WHO, UNICEF, UNFPA.WHO/RHR01.9. Geneva, World Health Organization.1997.

[4.]   Cheng, H, Kotler, P, and Lee, N. R. Building Partnerships. Social Marketing for Public Health: An Introduction. Jones and Barlett Publishers. LLC. 2009; 8.

[5.]   Cheng, H, Kotler, P, and Lee, N R Edutainment. Social Marketing for Public Health: An Introduction. Jones and Barlett Publishers. LLC.2009; 12

[6.]   Ekwempu CC The influence of antenatal care on pregnancy outcome. Tropical Journal of Obstetrics and Gynecology.1988; I: 67-71.

[7.]   Ezekwem, U Social Practices harmful to women in Nigeria. Tropical Journal of Obstetrics and Gynecology. 2002; 19 S (1): S22-25.

[8.]   Harrison K A Maternal mortality in Nigeria: the real issues. Afr. J. Reprod Health. 1997; 1(1):7–13

[9.]   Harrison, KA The influence of maternal age and parity on childbearing with special reference to primigravidae aged 15 years and under. British Journal of Obstetrics and Gynecology. 1985; 92(S5) 23-31.

[10.]      Hogan, M C, Foreman, K J, Naghavi, M., Ahn, SY Maternal Mortality for 181 Countries, 1980- 2008; a systematic analysis of progress towards Millennium Goal 5. The Lancet.2010; 375 (9726): 1609-1623.

[11.]      HealthNewsNG.com . Nigeria records reduction in infant and maternal mortality rates. http://www.healthnewsng.com/2013/12/nigeria-records-reduction-in-infant-and.html. Accessed on 18/04/2014

[12.]      Inegbenebor, U. Conceptual model for the prevention of maternal mortality in Nigeria Tropical doctor. 2007; 2(37):104-106. PMID: 17540095.

[13.]      Kotler. P Satisfying Both Employees and Customers. Selling Services for Profit. Marketing Management: Analysis, Planning, Implementation, Control.. Ninth Edition. Prentice Hall of India. New Delhi. 1999; 482.

[14.]      Nylander, PPS and Adekunle, AO Antenatal care in developing countries. Hall, MH ed. Antenatal Care. Bailliere’s Clinical Obstetrics and Gynecology. London: Bailliere Tindall, 1990; 4(1):169-186.

[15.]      Osakwe , F. Maternal mortality figure not accurate, says SOGON. National Mirror. http://nationalmirroronline.net/new/maternal-mortality-figure-not-accurate-says-sogon/ Accessed on 18/04/2014.

[16.]      Osubor, K, Fatusi, A, Chiwuzie, J Maternal Health Seeking Behavior and Associated Factors in a Rural Nigerian Community. Maternal and Child Health Journal. 2006; 10 (2); 159-169.

[17.]      Park, K. Maternal and Child health problems. Preventive Medicine in Obstetrics, Pediatrics and Geriatrics. Park’s Textbook of Preventive and Social Medicine. 19th Edition. Prem Nagar Jabalpur. M/s banarsidas Bhanot Publishers. 2007; 415-417.

[18.]      Park, K Models of health education. Communications for health Education. Park’s Textbook of Preventive and Social Medicine. 19th Edition. Prem Nagar Jabalpur. M/s banarsidas Bhanot Publishers.2007; 712-713.

[19.]      Thaddeus S, Maine D Too far to walk: maternal mortality in context. Soc Sci. Med 1994; 38(8):1091-1110. http://dx.doi.org/10.1016/0277-9536 (94)90226-7

[20.]      WHO, UNICEF, UNFPA and the World Bank. Trends in maternal mortality: 1990 to 2010. 2012; Accessed on 22/08/2013.

[21.]      UNESCO High level International Round Table on Literacy “Reaching the 2015 Literacy Target: Delivering on the promise.” National Literacy Action Plan for 2012 -2015. Nigeria. 2012; Accessed on 22/08/2013.

[22.]      Yusuf, MA, Ladan, B, Idris, UA, Halilu, A Comparative Study of the State of Literacy in Nigeria and Cuba. European Scientific Journal. 2013; 9(19): ISSN: 1857 – 7881 (Print) e - ISSN 1857- 743

Abstract:

Serious health effects of lead poisoning have elicited global campaign to eliminate lead use in paint. The major challenge is the dearth of data on lead levels in paints from developing countries. Thus lead levels of paints manufactured and sold in Nigerian market were studied. Lead concentrations from 59 paint samples involving 10 different shades were determined using flame atomic absorption spectrophotometer (AAS).

It was found that 83 % of the enamel paints had higher than the approved levels of lead in some countries which are 90jg/g and 600jg/g. The lead concentrations in the paint obtained ranged from 22.5jg/g to 74175jg/g, with mean value of 6442.88jg/g and median value of 1685jg/g. The concentration of lead was very high in almost all the enamel paints which make up over 80 % of the paint samples.

Plastic paints (emulsion paint)generally contained low lead levels (22.5 jg/g -80.5 jg/g). Analysis shows that there is no significant difference between the concentration of lead and the colours of the paint sampled. Thus all the paint manufacturers are still using lead containing pigment in their paint production. Efforts should be made by regulatory authority to spearhead campaign to phase out lead use in paint. 

References:

[1.]   Adebamowo, E.O., Clark, C.S., Roda, S., Agbede, O.A., Sridhar, M.K.C., et al 2007.Lead content of dried films of domestic paint currently sold in Nigeria. Science of the Total Environment 388: 116–120.

[2.]   AFP. 2009. China to relocate 15,000 from lead-poisoned area. Available online at http://news.yahoo.com/s/afp/2009afp/healthchinaenvironmentpollutionlead. Retrieved 15th June,2010.

[3.]   American Public Health Association (APHA), 2007.Policy Number: LB-07-01 lead exposure, child health and development, environmental health calling for a global ban on lead use in residential indoor and outdoor paints, children’s products, and all nonessential uses in consumer products adopted at Annual Meeting .Available online at www.apha.org/APHA/CMS_Templates/Policy (Accessed April 7,2010).

[4.]   Canfield et al.2003.Intelligent impairment in children with blood lead concentration below 10jg per deciliter.New England Journal of Medicine16:1517-1526.

[5.]   5)Clark,C.S.,Rampal,K.G.,Thuppil,V.,Roda,S.M.,Succop,P.,Menrath,W.,Chen,C.K.,Adebamowo,E.O.,Agbe de,O.A.,Sridhar,M.K.C.,Adebamowo,C.A.,Zakaria,Y.,El-Safty,A,Shinde,R.M.,Yu,J.,2009. Lead levels in new enamel household paints from Asia, Africa and South America.Environmental Research doi:10.1016/j.envres.2009.07.002

[6.]   CNN,2010.Aid groups say lead poisoning has killed 400 children in Nigeria.Avalaible online at www.articles.CNN..com/2010-10-05/world/nigeria.lead piosoning_1_poisoning-death-toll-nigeria(Accessed 30/12/2010).

[7.]   Gibson,L.1904.A plea for painted railings and painted walls as a source of lead poisoning among Queensland children. Australas Med Gazette 23:149-153

[8.]   International Labour Office ,ILO 1921. Convention 13 concerning the use of white lead in painting. ILO Publication No.13. ILO Publications, Geneva.

[9.]   Jacobs, D.E., Clickner, R.P., Zhou, J.Y., Viet, S.M., Marker, D.A., et al. 2002. The prevalence of lead-based paint hazards in U.S. housing. Environ.Health Perspect. 110: A599–A606.

[10.]      Kumar,A..,and Gottesfeld,P.2008.Lead content in household paints in India. Science of the Total Environment 407:333–337.

[11.]      Kumar,A.2009.Lead levels in New Decorative Paints.A global paint Study

[12.]      Kuruvilla,A.,Pillay,V.V.,Venkatesh,T.,Adhikari,P.,Chakrapani,M.,et al.2004.Portable lead analyzer to locate sources of lead. Indian Journal of Pediatrics 41:495–499.

[13.]      Lawlib.2010.Lead-based paint. Available online at

[14.]      http://www.state.ma.us/subject/about/lead.html(accessed 30/12/2010). 14) Lin, G.Z., Peng, R.F., Chen, Q., Wu, Z.G., and Du, L.2009.Lead in housing paints: an exposure source still not taken seriously for children lead poisoning in China. Environ Res.109(1):1-5

[15.]      15) Markowitz, G.2000.The role of the lead industry in a public Health Tragedy, 1900-1955.American

[16.]      Journal of Public Health 90.1:36-46. 16) Meyer, P.A., McGeehin, M.A., Falk, H., 2003. A global approach to childhood lead poisoning prevention. International Journal of Environment and Health 206: 363–369.

[17.]      Montgomery, M.and Mathee, A.2005.A preliminary study of residential paint lead concentrations in Johannesburg. Environmental Research 98:279–283.

[18.]      Needleman, H. L 2004.Lead poisoning. Annual review of medicine 55:209-222.

[19.]      Nriagu, J. 2009. History in lead and lead poisoning in history :Ingestion of Lead from Spent Ammunition: Implications for Wildlife and human Eds. R. T. Watson, M. Fuller, M. Pokras, and W. G. Hunt .The Peregrine Fund, Boise, Idaho, USA. Pg 10-408

[20.]      20) Onianwa,P.C.2001.Roadside topsoil concentrations of lead and other heavy metals in Ibadan,Nigeria.Soil & sediment contamination 10.6:577-591.

[21.]      Osibanjo, O. A responsibility to safeguard health. In: World Health Organization, editor.

[22.]      Preventing chronic diseases—a vital investment.World Health Organization, Geneva, 2005, pp. viii–ix.

[23.]      Reuters. 2009. China to move residents from lead smelter base-report. Available online at http://www.reuters.com article/rbss Industry Materials Utilities News/id USPEK Retrieved 15th June 2010.

[24.]      The Nigerian Guardian,June 2010

[25.]      SAICM/ICCM/INF/38,2008.

[26.]      US Environmental Protection Agency (US EPA), 2001b. Standard Operating Procedures for Lead in Paint by Hotplate or Microwavebased Acid Digestions and Atomic Absorption or Inductively Coupled Plasma Emission Spectroscopy. EPA, PB92-114172, September 1991.

[27.]      US Environmental Protection Agency (US EPA),2013.Learn about Lead.(http://www2.epa.gov/lead/learn-about-lead,accesses April 24th 2013).

[28.]      Watts, J .2009. Lead poisoning cases spark riots in China. Lancet 374 .9693: 868.

[29.]      WHO,2010.Global Alert and response.Nigeria:mass lead poisoning from mining activities,zamfar state.www.who.int/csr/don/2010_07_07/en/index.html(accessed 30/12/2010).

[30.]      Wilson,J.,Pivetz,T.,Ashley,P.,Jacobs,D.,Strauss,W.,et al.2006.Evaluation of HUD-funded lead  hazard control treatment at 6 years post-intervention. Environmental Research102:237–248.

[31.]      Wright, N .J. Thacher, T. D., Pfitzner, M .A. Fischer, P. R and . Pettifor, J. M. 2005. Causes of lead toxicity in a Nigerian city. Arch Dis Child 90:262-266 

Abstract:

Diabetes mellitus (DM) is the most common disorder of the endocrine glands caused by an inability to produce or use insulin. It is the fourth leading cause of death in the World according to World Health Organization., in Guyana it is among the leading cause of death. (MOH Bulletin)

References:

[1.] Anon, article date: 01 Mar 2010 - 6:00 PST;Think Globally, Act Locally To Reduce Burden Of Diabetic Kidney Disease, Diabetes; Urology / Nephrology; http://www.medicalnewstoday.com/articles/180714.php, Retrieved 22/8/2010).

[2.] Atkins RC, Zimmet P.; Diabetic kidney disease: Act now or pay later. Saudi J Kidney Dis Transpl 2010;21:217-21; http://www.sjkdt.org/article.asp; Retrieved 19/8/10.

[3.] Belle TR, Fraser HS, Adomakoh SA, Walrond ER; April 2002; Economic cost of managing diabetes mellitus in Barbados [conference presentation]; Caribbean Health Research Council, 47th Annual Council and Scientific Meetings, Georgetown, Guyana; http://revista.paho.org; Retrieved 20/8/2010

[4.] Burt VL, Whelton P, Roccella EJ, et al. (March 1995). "Prevalence of diabetics, Results from the Third National Health and Nutrition Examination Survey, 1988-1991". http://hyper.ahajournals.orgRetrieved 2010-08-04.

[5.] Butt Saud, Hall Phillip, Saul Nurko; Diabetic Nephropathy; http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/nephrology/diabetic-nephropathy/; Retrieved 18/8/2010

[6.] Correa-Rotter et al.; (Kidney International (2005) 68, S69–S75; doi:10.1111/j.1523-1755.2005.09813.x); Early detection and prevention of diabetic nephropathy: A challenge calling for mandatory action for Mexico and the developing world; http://www.nature.com/ki/journal/v68/n98s/full/4496442a.html; Retrieved 22/8/10

[7.] UpadhyayDinesh K, et al.; November 26, 2007; Knowledge, Attitude and Practice about Diabetes among Diabetes Patients in Western Nepal; http://www.rmj.org.pk/rmj_jan_jun_2008/original_articles/dm_attitude/pdf.pdf; Retrieved 29/8/10

[8.] EHE Newsletter, Volume 9, Number 5, March 3, 2009, Kidney disease; http://www.eheintl.com/newsletter.jsp; Retrieved 8/26/2010

[9.] GINA;July18, 2008; Diabetes registry established - will allow for easy patient follow, http://www.gina.gov.gy/archive/daily/b080718.html, Retrieved 22/8/2010

[10.]   Gordon Serena; Tuesday, Dec. 29 (HealthDay News); Diabetics Less Prone Now to End-Stage Kidney Disease; http://www.medicinenet.com/script/main/art.asp; Retrieved 22/8/10

[11.]   Gower Timothy; How Diabetes Affects the Kidneys; http://health.howstuffworks.com/how-diabetes-affects-the-kidneys1.htm; Retrieved 9/23/10

[12.]   Holly Kramer, MD1 and Mark E. Molitch, MD2;Screening for Kidney Disease in AdultsWith Diabetes; http://care.diabetesjournals.org; Retrieved 8/22/10

[13.]   Ian H. de Boer and Michael W. Steffes; March 14, 2007; Glomerular Filtration Rate and Albuminuria: Twin Manifestations of Nephropathy in Diabetes; J Am Soc Nephrol 18: 1036-1037, 2007; Last Reviewed: February 27, 2009; http://nkdep.nih.gov/patients/kidney_disease_testing.htm; Retrieved 8/22/10

[14.]   Jamal Soraya, Monday, March 8th; Protect Your Kidneys- Control diabetes;http://malaysia.news.yahoo.com/bnm/20100308/tap-kidney-with-pix-5cdd12e.html; Retrieved 3/18/10

[15.]   Janet Worsley, Norwood and Charles B. Inlander; Diabetic Complications;The Factors Behind Complications of Diabetes;Excerpt from: Understanding Diabetes; http://www.diabetesinfocenter.org/View.aspx?url=diabetic_complications; Retrieved8/18/10.

[16.]   Kumar PJ & Clark M (2002). Clinical Medicine. Pub: Saunders (London), pp. 1069-1121.

[17.]   Pagana, Kathleen Deska. 1998; Mosby's Manual of Diagnostic and Laboratory Tests. St. Louis: Mosby, Inc.; http://medical-dictionary.thefreedictionary.com/Creatinine+Test; Retrieved 3/25/10

[18.]   Perneger Thomas V. , MD, PhD et al.; (Ann Intern Med December 15, 1994 vol. 121 no. 12 912-918); End-Stage Renal Disease Attributable to Diabetes Mellitus; http://www.annals.org/content/121/12/912.full; Retrieved 9/22/10

[19.]   Tetsutani Tamiko 1993; 64:69-74 (DOI: 10.1159/000187281); Nephron; Early Detection of Diabetic Nephropathy and Criteria for the Initiation of Therapy;Published online: December 12, 2008; http://content.karger.com/ProdukteDB/produkte.asp; Retrieved 8/22/10

[20.] WHO; November 2009; Diabetes (Fact sheet N°312); http://www.who.int/mediacentre/factsheets/fs312/en; Retrieved 8/20/2010

[21.]   Worsely et al.; May 24, 2007; Current Diabetes Reports;Thursday; Nephropathy: Worldwide epidemic and effects of current treatment on natural history; (Volume 6, Number 6 / November, 2006 Diabetic); http://www.springerlink.com/content/; Retrieved 8/20/2010

[22.]   Williams, G & Pickup, JC (1998) diagnosis and classification of diabetes mellitus. In: Handbook of Diabetes. Pub: Blackwell Science, Oxford ,pp1-2.

Abstract:

The article by Richard M Scheffler; et all titled; Estimates Of Health Care Professional Shortages In Sub-Saharan Africa By 2015 published in the Health Affairs Journal volume 28, issue 5 of 5 2009 is reviewed. The review considers how the article is written in terms of structure, content and its effectiveness on addressing the issue of shortage of human resources in public. The issue of human resource shortage and brain drain especially in the developing world has been widely discussed, therefore, the relevancy, accuracy, objectivity, clarity of this article with respect to this subject area will be reviewed.

References:

[1.] Yohannes Kinfu, Mario R dal Poz, Hugo Merce and david B Evans. 2008. The health worker shortage in Africa: are enough physicians and nurses being trained. Bulletin of the WHO 2009; 87:225-230.

[2.] Shortage of healthcare workers in developing countries - Africa

[3.] Health Worker shortages and global justice. Accessed online 09 February 2014. www.milibank.org.

[4.] Health Worker Shortages and inequalities: The Reform of united States Policy.

[5.] WHO, “About the Global Health Atlas,” http://apps.who.int/globalatlas. Accessed 09 February 2013. 

Abstract:

One of the indispensible components in the war against HIV/AIDS is the voluntary counseling and testing and this has acquired global recognition. This study was done to ascertain the knowledge, attitudes and practices of VCT among rural dwellers in Kogi State Nigeria. Data were obtained through questionnaires administered to 250 participants who were selected through quota and convenience sampling and were analyzed manually. Finding shows that the awareness of VCT in this area is 79% with the highest source of information as mass media (79%). 52% agreed to receive VCT if offered.. 14% have accessed VCT services before this study.

References:

[1.] Alemayehu B (2010). Knowledge attitude and practice of voluntary counseling testing for HIV among university students, Tigray, Northern Ethiopia. MEJS 2(1):108-118.

[2.] Cartoux M, Msellati P, Meda N, Welffans-Ekra C, Mandelbrot L, Leroy V, Van de Perre P, Dabis F (1998). Attitude of pregnant women towards HIV testing is Abidjan, Cote d'ivoire and Bobo-Dioulasso, Burkina Faso. AIDs, 12(17):2337-2344.

[3.] Charles MP, Kweka EJ, Mahande AM, Barongo LR, Shekalaghe MJ (2009). Evaluation of uptake and attitude to voluntary counseling and testing among health care professional students in Kilimanjaro region, Tanzania. BMC Public Health, 9:128 doi: 10.1186/1471-2458-9-128.

[4.] Denison JA, Lungu N,Dunnet-Dagg WA, McCanley M, Sweat MD(2006). Social relationships and adolescents HIV counseling and testing decisions in Zambia. Horizons Research Summary. Washington DC Population council

[5.] GHS (2009) Annual Report 2009: National AIDS/STI control programme Ghana Med.J.42 ():8-15

[6.] Holmes CN, Preko PO, Bolds R, Baidoo J, Jolly PE (2008). Acceptance of voluntary counseling testing and treatment for HIV among pregnant women in Kumasi, Ghana.

[7.] Ikechebelu IJ, The knowledge, attitude and practice of voluntary counseling and testing for HIV AIDS among undergraduates in a polytechnic in south east Nigeria . Niger J. med.2006 Jul- Sept;15(3):245-9

[8.] Kalichman SC, Simbayi LC, (2003). HIV testing attitudes, AIDS stigma and voluntary HIV counseling and testing in a black township in Cape Town South Africa. Sex Transm Infect 2003,79:442-447,doi:10.1136/sti.79.6.442

[9.] Manirankuda L, Lovs J, Alo TA, Colevinders R, Nostlinger C (2009l. "It is better not to know". Perceived barriers to HIV voluntary counseling and testing among sub-Saharan migrant in Belgium. Aids Educ. And Prevention, 21(6):582-593

[10.]   Morin SF, Khumale Sekutuwa G, Charlebois ED, Routh J, Fritz K, Lane T, Vaki T, Fiamma A, Coates TJ (2006). Removing barriers to knowing HIV status: same day HIV testing in Zimbabwe. Acquired Immune deficiency syndrome, 41 (2):218-224.

[11.]   NACP/GHS (2010) Behavioural surveillance survey 2006. Adults quarterly Technical Bulletin on HIV/AIDS -STIs in Ghana.17 (4):1-12.

Abstract:

The Ghana National Health Insurance Scheme (NHIS) is to assure equitable and universal access for all residents of Ghana to an acceptable quality package of essential health care services without out-of pocket payment. The objective of this study is to examine the perceptions and experiences of health care providers and clients in the Upper East Region of Ghana regarding the NHIS. The study was cross-sectional and Patient exit interviews, in-depth interviews and focus group discussions (FGDs) were used to collect data. The NHIS was seen by all participants of the study to be beneficial. It led to an increase in the utilization of health care services for the insured and mobilized health resources for facilities. Insured clients reported verbal abuse, long waiting times, not being physically examined and discrimination in favour of the uninsured and the rich. Providers think that the insured were abusing their services by frequenting the facilities, and sometimes faking illness to collect drugs for their uninsured relatives. The biggest challenge was the delay in reimbursement of claims as a result; providers were not able to purchase drugs and non-drug supplies threatening the sustainability of the NHIS.

References:

[1.] Agyepong, I.A. and Adjei, S. (2008). Public social policy development and implementation: a case study of the Ghana National Health Insurance scheme.Health Policy Plan. 23(2):150-160.

[2.] Arhinful, D. (2003). The solidarity of self-interest: social and cultural feasibility of rural health insurance in Ghana. In Research report 71. Leiden, Netherlands: African Studies Centre.

[3.] Bassili, A. Omar, M. and Tognoni, G. (2001). The adequacy of diabetic care for children in a developing country. Diabetes Res ClinPract, 53(3):187-199. PubMed Abstract | Publisher Full Text

[4.] Bawku Municipal Health Insurance Scheme. (2012). Annual Report. Bawku

[5.] Boateng, A.R. National health insurance Authority. (2008). Mobilising the private sector to develop a sustainable health care economy in Africa.

[6.] Bruce, E., Narh-Bana, S. and Agyepong, I. (2008). Community satisfaction, equity in coverage and implications for sustainability of the dangme west health insurance scheme.In Technical Report Series No 9. [Accra Ghanaian Dutch Collaboration for Health Research and Development]

[7.] De Allegri, M., Sanon, M., and Sauerborn, R. (2006). “To enrol or not to enrol?”: A qualitative investigation of demand for health insurance in rural West Africa.SocSci Med, 62(6):1520-1527. PubMed Abstract | Publisher Full Text

[8.] Devadasan, C. et al. (2008). Community health insurance schemes & patient satisfaction - evidence from India.

[9.] Franco, I.M.et al. (2008). Effects of mutual health organizations on use of priority health-care services in urban and rural Mali: a case–control study. Bull World Health Organ, 86(11):830-838. PubMed Abstract | Publisher Full Text | PubMed Central Full Text

[10.]   Ghana Statistical Service. (2008). Ghana Living Standards Survey: Report of the Fifth Round GLSS 5. Accra: Ghana Statistical Service.

[11.]   Gobah, Freeman, F.K., Liang, Z. (2011). The national health insurance scheme in Ghana: prospects and challenges: a cross-sectional evidence.Global Journal of Health Science.,3(2).

[12.]   Gnawali, D.P. (2009). The effect of community-based health insurance on the utilization of modern health care services: Evidence from Burkina Faso. Health Policy Plan, 90:214-222.

[13.]   Government of Ghana. (2003). National health insurance Bill, Memorandum. Accra.

[14.]   James CD, Hanson K, McPake B, Balabanova D, Gwatkin D, Hopwood I, et al.: To retain or remove user fees? Reflections on the current debate in low- and middle-income countries.Appl Health Econ Health Policy 2006, 5:137-153. PubMed Abstract | Publisher Full Text

[15.]   Ministry of Health (2007). Annual Report, Accra, Ghana.

[16.]   National health Insurance Authority (2009). Annual report, Accra, Ghana.

[17.]   National health Insurance Authority (2010). Annual report, Accra, Ghana

[18.]   Palmer, N. (2004). Health financing to promote access in low income settings—how much do we know?Lancet 2004, 364:1365-1370. PubMed AbstractPublisher Full Text

[19.]   Zebilla District Health Insurance Scheme. (2012). Annual Report. Zebilla.

Abstract:

Obesity is an urgent and growing global health problem of critical concern. The causes of this epidemic are complex and multifactorial, but fundamentally lead to an excess calorie intake and inadequate energy expenditure. Modern lifestyles, incorporating altered eating patterns, access to cheap, highly palatable, energy-dense yet nutritionally-poor foods, sedentary life-style and labour-saving devices which reduce physical activity have hugely accelerated the problem during the latter part of the 20^thcentury. Obesity is a complex condition, with serious social and psychological dimensions, affecting virtually all ages and socioeconomic groups . The health consequences range from increased risk of premature death, to serious chronic conditions that reduce the overall quality of life. Of special concern is the increasing incidence of childhood obesity. The literature has been extensively reviewed to give an overview of the causes, the health problems associated with this disorder, the mode of assessment of the degree of obesity, its consequences, various methods of managing obesity with particular emphasis on dieting, exercise and the possible use of drugs (anorexiants) as well as surgery. 

References:

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[2.] Beazley J. M(1995): The influence of maternal weight. In : Textbook of obstetrics and Gynaecology for Postgraduates. 5th Edition. Blackwell S. C. Pub. London Oxford Ed. pp 316 – 317.

[3.] Bertam S. R. Venter I, Stewart R. I(1990). Weight loss in obese women –Exercise v dietary intervention. South African. Medical Journal, 78: 15

[4.] Bonow R. O, Eckel R. H(2003). Diet, obesity and cardiovascular risk. New England Journal of Medicine , 348: 2057 – 2058.

[5.] Camargo C. A. Jr, Weiss S. T. Zhange S, Willette W. C and Speizer F. E(1999). Prospective study of body mass index, weight change and risk of adult – onset asthma in women. Arch- ives of internal Medicine , 159: 2582.

[6.] Carey V. J. Walters E. E and Colditz G A(1997) Body fat distribution and risk of non-insulin dependent diabetes mellitus in women : The nurse’s Heath study. American Journal of Epidemiology , 145: 614.

[7.] Cedergren M.I ( 2004 ), Maternal obesity and the risk of adverse pregnancy outcome. Obstetrics and Gynecology, 103 : 219 – 224.

[8.] Chagnon Y. C, Rankinen T, Synder E. E. Weisnagel S. J. Perusse L(2003).The human obesity gene map: The 2002 up date. Obesity Research 2003 11: 313 – 367.

[9.] Cook S, Weitzma, M. Auinger P, Nguyen M and Dietz W. H(2003). Prevalence of a metabolic syndrome phenotype in adolescents: Findings from third National Heakth and Nutrition Examination Survey, 1988 – 1994. Archives of Pediatrics and Adolescent Medicine, 157: 821 – 827.

[10.]   Dattilo A.M, Kris-Etherton P M(1992). Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis. American. Journal of Clinical Nutrition. 56: 320-328.

[11.]   Froguel P, Lern-Mark A, Clement K and Boutin P(2003). GAD 2 on chromosome 10p 12 is a candidate gene for human obesity. Plos Biology, 1 (3):1 –11.

[12.]   Friel S, Chopra M and Satcher D(2007). Unequal weight: equity-oriented policy responses to the global obesity epidemic. British Medical Journal 335: 1241-1243

[13.]   Ioannides-Demos L L, Proietto J, Tonkin A M and McNeil J J(2006). Safety of drug therapies used for weight loss and treatment of obesity. Drug Saf 29(4):277-302

[14.]   James W. P. T(1991) Treatment of obesity and quality of life. Medicographia, 13 (2) 19 – 22

[15.]   Larasson B, Svardsudd k, Welin L., Wilhelmsen L(1984). Abdominal adipose tissue distribution. Obesity and risk of cardiovascular disease and death. British Medical Journal, 288: 1401 – 1404.

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Abstract:

The socio-economic status of individuals, households and community play a key role in their health status especially for those in rural areas amongst which the pauper dwells. The fact that out-of-pocket(OOPs)expenses especially amongst the rural poor leads to more poverty/impoverishment, indebtedness and or death calls for strategic and highly efficient health financing measures to resolves issues around OOPs. This study thus, seeks to understand the relationship between the socio-economic status of rural dwellers in Ejigbo LGA and out-of-pocket expenses made on their healthcare.

This cross sectional study was carried out Utilizing an interviewer administered questionnaire to 1280 respondents who were selected using stratified random sampling of respondents in structures and households. SPSS version 21 was used to analyse the data obtained. Level of Educational attainment, income/earnings per month and occupation were scaled and cumulated to obtain the socio-economic scale/status

Majority of respondents belong to the lower socio-economic class, and had up to secondary level education. More than half of the rural dwellers earn between ₦10,000 ($62.5 US). In this study, 64.4% of respondents spent ₦5,000 ($31.25 US) or less on their health through out-of-pocket spending (OOPs) in 3 months consequently about ₦1,666.66 ($10.41 US) in a month.

A statistically significant correlation was found between SES of respondents in rural area and their OOPs on healthcare. An increase in SES revealed an increase in OOPs. A significant relationship was found between the SES of respondents and the OOPs on healthcare which was a reflection of educational status, occupation and income/earnings of community members. This survey also reveals that the poorer the people, the less they spend on their healthcare owing to the fact that they have low earnings/income. Hence, there is need for more efficient risk pooling mechanisms in order to assure equity in healthcare service delivery.

References:

[1.] Ataguba, John E. (2008) Community Health Insurance Scheme as a viable option for rural population in Nigeria Paper submitted to the Centre for the Study of African Economies (CSAE) Department of Economics, University of Oxford. Health Economics Unit, University of Cape Town and Department of Economics, University of Nigeria, Nsukka, Feb 2008

[2.] Dr. Suni Pal Singh’s Socio-Economic classification presentation on (Slide share forum a web based forum)

[3.] Onwujekwe et al. (2010) Investigating determinants of out-of-pocket spending and strategies for coping with payments for healthcare in southeast Nigeria. BMC, Health service Research, 2010 10:67

[4.] Shankar Reddy Dudala and Arlappa N. (2013). An Updated Prasad’s Socio Economic Status Classification for 2013. Int Journal of Research and Development of Health. April 2013; Vol 1(2)

Abstract:

This paper presents a critical discourse on sexuality in Ghana. It examines the religious, constitutional and legal arguments on sexuality. It also examines the issue of sexuality (Homosexuality) as a normal or an abnormal behaviour, private or public matter, as well as the place of morality in sexual matters. All these were examined in respect of power relations and law. The study used a letter written by the Christian Council of Ghana, internet news sources, and some responses that were gathered via informal discussions.

The study used various theoretical tools such as perspectives of queer theorists, Foucault, and Brock’s writing on sexuality to interpret and interrogate the data. The paper explores the clashes in the legal orders i.e. it shows how the Ghana Criminal Code and other traditional norms criminalize ‘Unnatural Carnal Knowledge’ intercourse whilst at the same time the constitution and other international laws guarantee the right to freedom from discrimination. These legal ordersbring into sharp focus issues of legal pluralism as the normative orders contradicts a statutory order whilst at the same time the statutory orders clash each other. The study also shows that whilst the dominant group considers homosexuality as an abnormal sexual behaviour homosexuals through the theoretical perspectives consider their sexual orientation as one of the terrain towards sexual citizenship.

The study further shows how ‘power’ permeate the whole sexual discourse as to who even determines morality. The paper concludes by settling on recommending a balanced approach to dealing with homosexuality rather than adopting an abusive approach.

References:

[1.] Bonilla, D. (2006). La Constitución Multicultural, Siglo del Hombre Editores – Instituto Pensar – Universidad de los Andes, Bogotá

[2.] Brock, D. (2013). ‘Sexual Regulation’ in Deborah Brock, Amanda Glasbeek, Carmela Murdocca, eds. Representation and Regulation,forthcoming 2014, University of Toronto Press.

[3.] Christian Council of Ghana

[4.] Cossman, B. (2008). Sexual Citizenship. Princeton University Press

[5.] Denike, M. (2010). ‘Homonormative Collusions and the Subject of Rights: Reading Terrorist Assemblages’ Feminist Legal Studies: Issue 10: 85-100.

[6.] Duggan, L. (2002). The new homonormativity: The sexual politics of neoliberalism. In Materializing democracy: Toward a revitalized culture politics, ed. Russ Castronovo, and Dana D. Nelson, 175-194. Durham, NC: Duke University Press.

[7.] Dworkin, R. (1967).‘The Model of Rules’, University of Chicago Law Review 35: 14-46.

[8.] Finnis, J. (1980). Natural Law and Natural Rights (Oxford: Clarendon Press).

[9.] Foucault, M. (1978). The History of Sexuality (Volume One) Random House: 1-49.

[10.]   Gardner, J. (2008). Law and Morality

[11.]   Kymlicka, W. (1995). Multicultural Citizenship: A Liberal Theory of Minority Rights, Clarendon Press & Oxford University Press.

[12.]   McWhorter, L. (2004). Sex, Race, and Biopower: A Foucaudian Genealogy: Hypatia, Vol. 19, No. 3: 38-62.

[13.]   Merry, S. (1988). Legal pluralism’, Law and Society, Vol. 22, no. 5: 881.

[14.]   Moore, S. F. (1978). ‘Law and social change: the semi-autonomous social field as an appropriate subject of study’, Law as Process: An anthropological approach: 56.

[15.]   Mutua, M. (2008). Human Rights: A Political and Cultural Critique, Pennsylvania Studies in Human Rights: ISBN 978-0-8122-2049-0.

[16.]   Nikolas, R. &Valverde M. (1998). ‘Governed by Law? Social and Legal Studies7:4, 541-551.

[17.]   Postema (1996). ‘Law’s Autonomy and Public Practical Reason’, in Robert George (ed), The Autonomy of Law (Oxford: Oxford University Press 1999).

[18.]   Sanders, D. (1996). Getting Lesbian and Gay Issues on the International Human Rights Agenda, Human Rights Quarterly 18.1: 67-106.

[19.]   Somerville, S. (1994). ‘Scientific Racism and the Emergence of the Homosexual Body’,Journal of the History of Sexuality: 243-266.

[20.]   Stoler, A. (2002). Carnal Knowledge and Imperial Power: Race and the Intimate in Colonial Rule. University of California Press. Berkeley. ISBN: 0-520-23111-2: 78.

[21.]   Sullivan, M. L. (1989). “Absent Fathers in the Inner City”, Annuals of the American Academy of Political and Social Science 501: 48-58.

[22.]   Terry, J. (1995). ‘Anxious Slippages Between “Us and Them” A Brief History of the Scientific Search for Homosexual Bodies’ Deviant Bodies: Critical Perspectives on Difference in Science and Popular Culture Jennifer Terry and JacqulineUrla, eds.Indianna University Press: 129-169.

[23.]   Taylor, C. (1994). The Politics of Recognition, in Amy Gutman (ed) Multiculturalism: Examining the Politics of Recognition, Princeton University Press.

[24.]   1992 Constitution of the Republic of Ghana

[25.]   1960 Criminal Code (Act 29): Acts of Ghana, First Republic < Available at: http://www.africanchildforum.org/clr/Legislation%20Per%20Country/ghana/ghana_criminal_1960_en.pdf retrieved on 03/01/2014>

Abstract:

To have a vibrant and productive economy in any nation, it becomes imperative that the health and safety of her workers must be given priority attention by the worker himself, employer and the government. Because of the increasing industrialization, infrastructural developments and modernization taking place in developing countries particularly like Nigeria. These factors have not only increased the job opportunities in and around the country but at the same time increased the incidence of morbidity and mortality of workers.

And so it is important that the worker has an in depth knowledge and understanding of the nature of the job with regards to the health hazard exposures peculiar to the job and the safety measures to be undertaken even before accepting the job. More so, safety officers, factory and industrial managers etc. need to appreciate the need to know all that is involved in the job in order to make the workplace a safe and conducive one for the worker and achieve high productivity.

This paper attempts to highlight a lot of occupational hazards that occur among both the formal and informal Nigerian workers, reasons for their occurrences, safety measures, lapses on the part of the employer and reveals the laxity on the part of government to enact and enforce occupational safety and health laws.

References:

[1.] Achalu, E.I. (2000). Occupational Health and Safety. Lagos: Simarch Nigeria Limited: Splendid Publishers

[2.] Asogwa, S.E. (2007). A guide to Occupational Health Practice in Developing Countries. Enugu. Snaap Press Ltd.

[3.] Burdine JN, McLeroy KR (1992). Practitioners use of theory: Example of safety education. Health Educ. Quart. 19(3).

[4.] Folashade Omokhodion (2009) Occupational Health in Nigeria Oxford journals occupational medicine volume 59 Issue 3 pp201

[5.] Henderson, V. and Nite, G. (1978). Principles and Practices of Nursing. (6th Ed) New York. Macmillan Publishing Co. Inc

[6.] Linda Eroke, ( 2013) Nigeria: Promoting Health and Safety of Employees in the Workplace This Day AllAfrica Media.

[7.] National Population Commission (NPC) [Nigeria] and ORC Macro. Nigeria Demographic and Health Survey 2003. Calverton, MD: National Population Commission and ORC Macro; 2004.

[8.] Oluyomi Ola-David (2012 ) Occupational Health and Safety for Informal Sector Workers: The Case of Street Traders in Nigeria. : IAABD 2012 Conference Proceedings

Abstract:

In response to the HIV/AIDS epidemic, social marketing programmes have made condoms accessible, affordable and acceptable to low-income populations and high-risk groups. Corporate marketing is used for social purpose then it’s called social marketing. In some areas this has become successful but in other few areas it given negative effect. This primary study has been done to First measure the effect of social marketing and second if social marketing, specially what type of media, would be an effective way to disseminate the information of HIV/AIDS, RTI/STI and condoms to the vulnerable population.

This has been done on truckers (n=200), MSM (n=30), FSW (n=30). Questionnaire was made and FGDs were conducted. It was found that career is the priority of truckers & FSW and friends were priority of MSM. Truckers have radio as source of information. MSM and FSW were having Cellular phone to get information of their clients and friends. Approximately 78% truckers, 70% MSM, 48% FSW were aware about condom through social marketing (See Table 1). Only 63% truckers, 47% MSM, 12% FSW were aware of HIV/AIDS, and 58% trucker, 41% MSM, 5% FSW were using condom for prevention of HIV/AIDS, rest were for any other purpose.

Social marketing programmes do not operate in air; government support is a key component of a successful programme. So government should support to MSM, FSW in legal. There is urgent need to have more social marketing of female condom & its use, and public private partnership model to improve health of vulnerable group. Corporate sector should provide support to Government as their Corporate Social Responsibility (CSR).

References:

[1.] Pandey A, Benara SK, Roy N, et al. Risk behaviour, sexually transmitted infections and HIV among long-distance truck drivers: a cross-sectional survey along national highways in India. AIDS 2008;22(Suppl 5):S81e90.

[2.] Promoting condoms by social marketing in a village in rural rajasthan, India. Gehlot I, Haag A, Mora C, Rajpurohit H, Shah R, Shah S, Jaiswal L, Harsh J, Tanna R, Engineer V; International Conference on AIDS (15th : 2004 : Bangkok, Thailand). Int Conf AIDS. 2004 Jul 11-16; 15: abstract no. C10926. FXB Indian Operations, Mumbai, India.

[3.] Singh IN, Malaviya AN. Long distance truck drivers in India: HIV infection and their possible role in disseminating HIV into rural areas. Int J STD AIDS 1994;5:137e8.

[4.] Subramanian T. HIV, sexually transmitted infections and sexual behaviour of male clients of female sex workers in Andhra Pradesh, Tamil Nadu and Maharashtra, India:results of a cross-sectional survey. AIDS 2008;22(Suppl.5):S69e79.

[5.] Tsui AO, Ochoa LH. Service proximity as a determinant of contraceptive behavior: evidence from cross-national studies of survey data. Chapel Hill: University of North Carolina, Carolina Population Center, 1989. (Carolina Population Center papers no 89-05).

[6.] Yu S. The life-course approach to health. American Journal of Public Health. 2006;96(5):768. Grier S, Bryant CA. Social marketing in public health. Annu. Rev. Public Health. 2005;26:319-339. Accessed January 5, 2010. Available at arjournels.annual.reviews.org.

Abstract:

Nigeria, with a population of 140 million people accounting for 47% of the population of West Africa, has a moral responsibility to lead the continent towards achieving the Millennium Development Goals (MDGs). Yet its health system is ranked 187th of 191 WHO member states. Lending credence to this ranking are health indices such as an infant mortality rate of 101 per 1000; maternal mortality rates ranging from 500 per 100,000 in the South West to 800 per 100,000 in the North East, perinatal mortality rate of 48 per 1000 and child mortality rate of 205 per 1000.

There is thus an urgent need to foster effective collaboration and partnership with all relevant stakeholders to improve the health systems in Nigeria.

This paper explores challenges and possible solutions relating to health systems strengthening in Nigeria including health policies, governance, organization and financing of health services, health workforce production and health service delivery.

References:

[1.] Bennett S and Gilson L. 2001. Health Financing: designing and implementing pro-poor policies, DFID Health Systems Resource Centre.

[2.] Cassels A., Janovsky K. 1998. Better health in developing countries: are sector-wide approaches the way of the future? The Lancet, 1998, 352:1777–1779.

[3.] Chernichovsky C. 2000. The Public-Private Mix in the Modern Health Care System - Concepts, Issues, and Policy Options Revisited. Ben-Gurion University of the Negev and NBER.

[4.] Department for International Development. 2005. From commitment to action: Health.

[5.] Disease Control Priorities Project 2. Strengthening Health Systems Chapter 3. 2006 The International Bank for Reconstruction and Development / The World Bank.

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[9.] Federal Ministry of Health. 2004. Health Sector Strategic Development and Reforms Initiatives for Nigeria. Abuja Annex 1(a)

[10.]   Federal Ministry of Health.1988.The National Health Policy and Strategy to Achieve Health for All Nigerians. Lagos: FMOH.

[11.]   Federal Office of Statistics. 2004. Core Welfare Indicators Questionnaire Survey: Combined 6-States Main Report. Abuja, FOS, State Statistical Agencies of Abia, Cross River, Gombe, Kebbi, Osun, and Plateau: pg. 16-20.

[12.]   Federal Republic of Nigeria. 1981. Fourth National Development Plan 1981-85. Lagos: The National Planning Office, Federal Ministry of National Planning, 272-287.

[13.]   Federal Republic of Nigeria.1979. The Constitution of the Federal Republic of Nigeria. Enugu: Government Printing Department.

[14.]   Federal Republic of Nigeria.1999. The Constitution of the Federal Republic of Nigeria. Abuja: Government Printing Department.

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[31.]   SWAP - A sector-wide approach (SWAP) is a method of working that brings together governments, donors, communities and other stakeholders within any sector.

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Abstract:

BACKGROUND

METHODS

A cross sectional study on screening for refractive error in school children was carried out in a primary school in Ikeja Local Government Area of Lagos State between November and December, 2012. The study population were school age children from primary 1-6 and the pupils age was 5–11 years. Near acuity was done at 40cm and distance visual acuity for each eye was assessed by an intern Optometrist at 6 meters distance. Those with visual acuity of 6/12 or less were presented with a pinhole and the test repeated. Improvement of visual acuity with pinhole was considered refractive error. Penlight examination was carried out to check for external examination and opthalmoscopy was done under dim illumination to check the internal status of the eye. The isihara chart was used to assess the color vision.

RESULTS

A total of 580 (340 females and 240 males) Pupils were examined. Of these, 506 pupils (87.24%) had no refractive error but 74 pupils ( 12.76%) had refractive errors including amblyopia and color vision defects. Myopia was found to be highest refractive 51.35%, followed by hyperopia 29.73%, astigmatism 10.81%, amblyopia 2.70% and color vision 5.41%.

CONCLUSION

A significant refractive errors was observed among primary school children aged 5-11years at a prevalence of 12 .76%. Refractive errors can affect a child academic performance in school and could lead to permanent visual disabilities in adult life if not detected and treated early. Therefore, there is a need to have regular and timely vision screening in primary school children at least at the commencement of school so as to defect those who may suffer from visual impairment. Eye health education and regular vision screening are very crucial in the prevention of visual impairments among school age children.

References:

[1.] A Children’s Eye Health Guide, the National Society to Prevent Blindness, 1987.

[2.] Balogun M. Vision screening among primary school Children in Lagos mainland. Dissertation for the award of a fellowship of the National Postgraduate medical College in Ophthalmology. 1999

[3.] Chuka-Okosa CM. Refractive error among students of a post primary institution in a rural community in south eastern Nigeria. W Afr J Med. 2005;24:62–65.[PubMed]

[4.] Faderin MA, Ajaiyeoba AI. Refractive errors in primary school children in Nigeria. Nig J Ophthal. 2001;9:10–14.

[5.] Gilbert C, Foster A. Childhood Blindness in the Context of vision 2020 - the right to Sight. Bulletin of WHO. 2001;79:227–232. [PMC free article][PubMed]

[6.] Ibeimo Opurin and Chinyere Nnenne Pedro-Egbe. Screening of Primary School Children For Refractive Error in South South Nigeria. Ethiop J Health Sci. 2012 July; 22(2): 129–134. PMCID: PMC3407836

[7.] Nkanga DG, Dolin P. School vision screening program in Enugu, Nigeria: Assessment of referral criteria for error of refraction. Nig J Ophthal. 1997:34–40.

[8.] Prevent Blindness America and the American Academy of Pediatrics. Preschool Vision Screening for Healthcare Professionals. 2005.

[9.] Wedner SH, Ross DA, Balira R, Kaji L, Foster A. Prevalence of eye diseases in primary School children in rural area of Tanzania. Br J Ophthalmol. 2000;84:1291–1297. [PMC free article][PubMed]

[10.]   Woddell K. Spherical refraction for general eye workers. Community eye health Journal. 2000;13:6–8. [PMC free article][PubMed]

Abstract:

Air pollution is a significant cause of morbidity and mortality. The greatest health impacts from air pollution worldwide occur among the poorest and most vulnerable populations. The amount of exposure in terms of the number of people, exposure intensity and time spent exposed is far greater in the developing world (Smith, 1993); approximately 76% of all global particulate matter air pollution occurs indoors in the developing world

References:

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[5.] Alakpodia, I.J., 1995. The oil industry and the economic environment of the Niger Delta. Paper Presented at the 30th Annual Conference, Nigeria Geographical Association, at the University of Benin, Benin City, Nigeria

[6.] Anderson, I., 2005. Niger River Basin: A Vision for Sustainable Development. The World Bank, pp: 131

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