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Biomedical subjects

C O Akpala

Publications and source records attributed to C O Akpala.

8 recordsLinked to original sources
PubMed2004

Community satisfaction with the quality of maternal and child health services in southeast Nigeria.

OBJECTIVES: To assess community perception, practices and satisfaction with the quality of maternal and child health services and the willingness and ability to pay for the services, after the introduction of the Bamako initiative programme. DESIGN: A cross sectional study using pre-tested questionnaire and focus group discussions was undertaken in May 1999. Variables explored were rating of quality of services, level of satisfaction with the services and willingness to pay for quality improvements as well as ability to pay for services. SETTING: Oji-river local government area of Enugu State, Nigeria. SUBJECTS: A random sample of 405 households from a sample frame of primary health care house numbers and another purposive sample of women and males were involved. RESULTS: Most respondents (90.6%) rated the services to be at least good. Another 95.9%, 94.3% and 95.8% of the respondents were, satisfied with the childhood immunisation, antenatal care and childbirth services respectively. Eighty nine percent of respondents were willing to pay for health services if drugs were readily available, while 92.4% would pay if there is overall improvement in quality. Majority of them were also able to pay for services. However, long waiting queues, providers' behaviours and lack of doctors militated against the utilisation of maternal and child health services. CONCLUSION: Bamako initiative programme improved drug availability and physical appearance of the health centres thereby leading to high levels of consumer satisfaction and people are willing and able to pay for primary health care services if there are quality improvements, as the Bamako initiative achieved. Continuous improvement of services, especially constant drug availability would motivate people to pay for services.

Adult↗
PubMed2000

How do rural households perceive and prioritise malaria and mosquito nets? A study in five communities of Nigeria.

The aim of this study was to determine households' levels of prioritization and perception of malaria, ordinary mosquito nets and insecticide-treated nets (ITNs). A cross-sectional survey was conducted in five malaria holo-endemic communities in Enugu State, South-eastern Nigeria. The household heads or the representatives from randomly selected households were interviewed, using a pre-tested interviewer-administered questionnaire. The majority of the respondents had a good knowledge about malaria and the use of ordinary mosquito nets to prevent malaria. However, few knew about the existence of ITNs. Most respondents also stated that malaria was a priority problem and perceived some risk of contracting it. Despite the high level of knowledge about the use of mosquito nets, only 14.0%, 15.7%, 9.6% and 8.0% of the respondents from four of the communities had ever purchased any type of mosquito nets, except in Orba where the proportion was 50.3%. However, more than 80% in all the communities expressed a desire to buy insecticide-treated mosquito nets for the prevention of mosquito bites. There was considerable knowledge about malaria and the use of mosquito nets to prevent it. There were also high levels of prioritization of the disease, mosquito nets and ITNs which signalled the possibility of establishing sustainable community-based ITN programmes, especially as households wanted to buy the ITNs.

Adult↗
PubMed1998

Willingness to pay for community-based ivermectin distribution: a study of three onchocerciasis-endemic communities in Nigeria.

OBJECTIVE: To determine the willingness to pay (WTP) for local ivermectin distribution in a community financing framework. METHOD: Contingent valuation in three communities in Nigeria, using randomly selected household heads. WTP was elicited using a bidding game, and for collecting information on the households' socio-economic status, level of knowledge, priority ranking and perception of risk of contracting the disease, structured questionnaires were used. Ordinary least squares (OLS) multiple regression analysis was used to analyse factors associated with WTP. RESULTS: Between 92.1% and 93.3 % of respondents were willing to pay amounts ranging from 5 Naira (US$ 0.06) to 100 Naira (US$ 1.25) (median: 20 Naira, US$ 0.25) in the three communities, more than three times the modelled unit direct cost of distributing ivermectin by the communities themselves. Occupation of the respondent, marital status, average monthly expenditure on health care, manifestations of onchocerciasis, the type of savings scheme embarked on by the respondent, age-group, level of education and type of property were statistically significant (P < 0.05) variables affecting WTP. CONCLUSION: This study shows that there is WTP for local ivermectin distribution in the three study communities, and that it should be assessed before instituting community-directed treatment with ivermectin.

Adult↗
PubMed1994

An evaluation of the knowledge and practices of trained traditional birth attendants in Bodinga, Sokoto State, Nigeria.

To improve Maternal and Child Health services especially in the rural areas, a programme to train traditional birth attendants (Ungo Zoma) was established by the Sokoto State government of Nigeria in 1975. The impact of the training programme on the knowledge and practices of traditional birth attendants (TBAs) in a rural community in the state was studied. Seventy-four TBAs, consisting of 43 trained and 31 untrained attendants, were interviewed. Statistically significant differences were observed in the proportion of both groups of TBAs able to recognize high risk pregnancies and deliveries for referral to health institutions. In contrast to the trained attendants, none of the untrained TBAs offered any of the following Maternal and Child Health services: antenatal care, advice on immunization of children or their mothers during pregnancy, and family planning. Suggestions for improving the knowledge and practices of the TBAs in Sokoto as well as in other communities wishing to embark on similar programmes are offered.

Adolescent↗
PubMed1993

Perinatal mortality in a northern Nigerian rural community.

87 perinatal deaths which occurred out of 1484 births in a rural area of Northern Nigeria over a 9 month period were reviewed. The perinatal mortality rate was 58.6 per 1000 births. Babies born to very young adolescent mothers aged between 10-14 years had the highest perinatal mortality of 375 per 1000 births. Statistically significant relationships were also established between perinatal mortality and parity, educational status of the mother and birth weight. The leading cause of perinatal death was birth trauma which accounted for 48% of all perinatal deaths. Strategies for the reduction of perinatal mortality in the rural community are highlighted.

Adolescent↗
PubMed1991

Medical education and primary health care in Nigeria: the Sokoto University experience.

Despite the acknowledgement and adoption of the Alma-Ata declaration by majority of the countries of the world as a strategy for achieving Health For All, medical educational systems often remain as ivory towers from the health service system. This traditional system of medical education does not adequately prepare doctors in developing countries for their expected leadership role in meeting the health needs for their communities through primary health care. In Nigeria, primary health care forms the basis for an official health policy aimed at meeting the health care needs of the entire population particularly those in the rural areas. This article, while highlighting the need for integration of medical education and the primary health care services, also examines the structural relationships between the two components at the Sokoto University in Nigeria, a West African country with one of the oldest medical educational system in the area.

Community Medicine↗
PubMedDate not supplied

Compliance to correct dose of chloroquine in uncomplicated malaria correlates with improvement in the condition of rural Nigerian children.

Non-compliance to correct dosing is thought to be one of the main causes of treatment failure of chloroquine in the home management of childhood malaria. There are few studies of compliance to drugs used for tropical diseases. In order to study compliance in the rural setting, chloroquine syrup was packaged with a novel pictorial insert for compliance to correct dosing. Compliance was assessed in a field trial in September 1996-December 1997, involving 632 children with uncomplicated malaria in Udi local government area in Nigeria. Written informed consent was obtained from mothers/guardians before children were enrolled in the study. There were 3 arms to the trial: control villages (group I) received chloroquine syrup without further intervention, group II received a pictorial insert with chloroquine syrup, and group III received chloroquine syrup, the pictorial insert and verbal instructions. Each group was made up of 3 health centres. Compliance was assessed by volumetric measurement of the chloroquine syrup left in 30-mL bottles and by questionnaires administered to mothers/helpers of the children. Control villages recorded full compliance for 36.5 +/- 4.4% of the children, group II for 51.9 +/- 7.9% and group III for 73.3 +/- 4.2%. There was a significant correlation (P < 0.0001) between full compliance, improvement and time for improvement of the condition. This study is deemed important because it focuses on children, who bear the greatest burden of malaria. It is unique for introducing a pictorial insert that illiterate villagers, who may not understand the use of age or weight in drug dispensing, may utilize as a substitute.

Antimalarials↗