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Biomedical subjects

A Ikeme

Publications and source records attributed to A Ikeme.

5 recordsLinked to original sources
PubMed2005

Where do people from different socio-economic groups receive diagnosis and treatment for presumptive malaria, in south-eastern Nigeria?

The relationship between the socio-economic status (SES) of a household and its sources of malaria diagnosis and treatment was explored in south-eastern Nigeria. One aim was to see if, as seems likely, the poorest people generally seek care from 'low-level' providers, such as traditional healers and community-based healthworkers, because of their severe budget constraints. Interviewer-administered questionnaires were used to collect information from 1197 randomly selected respondents from four villages where malaria is holo-endemic. An index was used to categorize the study households into SES quartiles. The self-diagnosis of presumptive malaria and the use of patent-medicine dealers for treatment were very common among all the SES groupings. Compared with the other interviewees, however, the least-poor were significantly more likely to rely on laboratory tests for diagnosis and to visit hospitals when seeking treatment for presumptive malaria. The most-poor, in contrast, were significantly more likely to seek treatment from traditional healers or community-based healthworkers. Thus, even though the use of low-level providers was so common, there was still evidence of wealth-related inequity--in terms of the probabilities of the good diagnosis and treatment of malaria. Improvements in the quality of malaria diagnosis and treatment by the providers patronised by the most-poor villagers would help to redress this inequity, at least in the short- to medium-term.

Community Health Services↗
PubMed1997

Involving the private sector in improving obstetric care, Anambra State, Nigeria. The Enugu PMM Team.

PRELIMINARY STUDIES: Of 11 facilities providing obstetric services in the Njikoka Local Government Area, four were private, for-profit institutions. Focus group discussions in seven communities revealed a preference for private facilities due to flexible payment schedules, proximity, reliable availability of a medical doctor and poor quality government services. Each of the private facilities had one doctor and one midwife and the bulk of patient care was performed by health aides with no formal midwifery training. INTERVENTIONS: In 1992, 15 aides from the private facilities were trained in the recognition and management of obstetric complications. The training consisted of one week of classroom instruction and two weeks of practical training in local missionary hospitals. RESULTS: Improvements were assessed by a written test. The percent of trainees obtaining a passing test mark increased from 33% (pre-training) to 61% (post-classroom) to 77% (post-practicum). COSTS: The cost of this intervention was approximately US $18,000. CONCLUSIONS: Auxiliaries' skills can be improved with classroom and practical training. The involvement of private sector institutions is important where they provide a substantial proportion of emergency obstetric services. However, maintaining improvements requires sustained efforts.

Allied Health Personnel↗
PubMed1997

Establishing a blood bank at a small hospital, Anambra State, Nigeria. The Enugu PMM Team.

PRELIMINARY STUDIES: A facility review at Enugu-Ukwu General Hospital in Anambra State revealed limited blood transfusion and no blood storage capabilities. Focus groups indicated fears and misconceptions in the population regarding risks of blood donation and transfusion. INTERVENTIONS: In 1994, a blood bank was established, including a refrigerator, backup generator, reagents and supplies. Refresher training was provided to the laboratory technologist. A public education campaign was launched one year later to encourage blood donation and dispel fears of transfusion. RESULTS: Voluntary blood donations in the hospital increased from zero units before the program to 15 in 1995. Transfusions increased from three in 1993 to 17 in 1995. Eight of the 17 were for obstetric cases. No donations or transfusions occurred until six months after the establishment of the blood bank. Problems encountered in obtaining the cooperation of hospital management may partly explain the delayed response. COSTS: The cost of establishing the blood bank was US $8800: 51% material costs and 42% training. CONCLUSIONS: Improving the availability of blood at small hospitals need not be very expensive. Community education activities may increase blood donation, but sustained efforts are likely to be required. Ministry of Health (MOH) involvement is important to the success of interventions in government hospitals.

Blood Banks↗
PubMed1997

Community contact persons promote utilization of obstetric services, Anambra State, Nigeria. The Enugu PMM Team.

PRELIMINARY STUDIES: Focus group discussions revealed delay in seeking and reaching emergency care as a factor contributing to maternal mortality in Njikoka Local Government Area. INTERVENTIONS: After obstetric services at local hospitals had been upgraded, 48 community contact persons were recruited. They were trained to improve community awareness of obstetric complications and to facilitate referral of women with complications. They were responsible for establishing links with pregnant women, improving access to transport, and mobilizing the community to donate blood. RESULTS: Over 18 months, community contact persons referred 18 women with major obstetric complications for treatment at health facilities. Fifty-two pregnant women were referred for other reasons. A total of 129 women were assisted by the community contact persons. This number declined sharply over time, from 60 in the first half of 1994 to 16 in the first half of 1995. COSTS: The community contact persons intervention cost approximately US $635, with 64% coming from project funds, 25% from government and 11% from the community. CONCLUSIONS: Community contact persons can perform a valuable role in facilitating referral of women with obstetric complications and supporting health education activities.

Female↗