Knowledge and Practice of the Referral System under the National Health Insurance Scheme among Medical and Dental Practitioners of A Large-Accredited Facility in Kano, Nigeria.

BACKGROUND: Studies on healthcare professionals' knowledge about the National Health Insurance Scheme (NHIS) are scarce. Therefore, we assessed the knowledge and practice of the NHIS referral system among Medical and Dental practitioners in a tertiary hospital in Northwest Nigeria. METHODS: This cross-sectional study involved 242 medical and dental practitioners randomly selected from nine departments for over 6-weeks. A structured self-administered questionnaire was used to collect data. Data were analyzed using descriptive and inferential statistics. RESULTS: The respondents' mean age was 35.7±6.0 years; they were predominantly males (64.9%). Their mean overall knowledge score was 58.9±23.0%, with 66.9% of respondents having inadequate overall knowledge of the NHIS referral system. Practice department (Fishers 2 exact, P=0.0019), perceived knowledge of the referral system (ꭓ =8.169, P=0.004), and having been referred as an enrolee (ꭓ2 = 6.358, P=0.012) were associated with overall-knowledge. Obstetrics-and-Gynaecology (odds ratio[OR]=0.29, 95% confident interval [CI] [0.88-0.98]), Dental and-Maxillofacial-Surgery (OR=0.08, 95%CI[0.01-0.98]), and Otorhinolaryngology (OR=0.18, 95%CI[0.04-0.80]) respondents were less likely to have adequate overall-knowledge.Although 56.2%, 50.4%, 20.7%, and 89.7% were enrolees, had received treatment as enrolees, had been referred as enrolees and treated other enrolees, respectively, an unimpressive proportion had sighted a referral letter (64.9%) or authorization code on the letter (25.2%), referred an enrolee from their department previously (51.2%) or used the NHIS referral form to write referrals (38.8%). CONCLUSION: The overall knowledge of the NHIS referral system was inadequate. The practice of the referral system was below expectation. Therefore, training medical and dental practitioners on the NHIS referral system is necessary. Training should target those who are least likely to have adequate overall knowledge.

CONTEXTE: Les études sur les connaissances des professionnels de la santé concernant le Régime d'assurance maladie national (NHIS) sont rares. Nous avons donc évalué les connaissances et la pratique du système de référence du NHIS parmi les médecins et dentistes d'un hôpital tertiaire du Nord-Ouest du Nigeria. MÉTHODES: Cette étude transversale a impliqué 242 médecins et dentistes sélectionnés de manière aléatoire dans neuf départements pendant plus de 6 semaines. Un questionnaire structuré auto-administré a été utilisé pour recueillir des données. Les données ont été analysées à l'aide de statistiques descriptives et inférentielles. RÉSULTATS: L'âge moyen des répondants était de 35,7 ± 6,0 ans ; ils étaient principalement des hommes (64,9 %). Leur score moyen global de connaissances était de 58,9 ± 23,0 %, avec 66,9 % des répondants ayant une connaissance globale insuffisante du système de référence du NHIS. Le département de pratique (test exact de Fisher, P=0,0019), la connaissance perçue du système de référence (ꭓ 2 =8,169, P=0,004) et avoir été référé en tant qu'adhérent (ꭓ 2 = 6,358, P=0,012) étaient associés à la connaissance globale. Les répondants en obstétrique-gynécologie (rapport des cotes [OR]=0,29, intervalle de confiance à 95 % [IC] [0,88-0,98]), en chirurgie dentaire et maxillo-faciale (OR=0,08, IC à 95 % [0,01-0,98]), et en oto-rhino-laryngologie (OR=0,18, IC à 95 % [0,04-0,80]) étaient moins susceptibles d'avoir une connaissance globale adéquate. Bien que 56,2 %, 50,4 %, 20,7 % et 89,7 % étaient adhérents, avaient reçu un traitement en tant qu'adhérents, avaient été référés en tant qu'adhérents et avaient traité d'autres adhérents, respectivement, une proportion peu impressionnante avait vu une lettre de référence (64,9 %) ou un code d'autorisation sur la lettre (25,2 %), avait référé un adhérent de leur département précédemment (51,2 %) ou avait utilisé le formulaire de référence du NHIS pour écrire des références (38,8 %). CONCLUSION: La connaissance globale du système de référence du NHIS était insuffisante. La pratique du système de référence était en deçà des attentes. Par conséquent, la formation des médecins et dentistes sur le système de référence du NHIS est nécessaire. La formation devrait cibler ceux qui sont moins susceptibles d'avoir une connaissance globale adéquate. MOTS-CLÉS: Connaissances et Pratiques, Professionnels de la santé, Régime national d'assurance maladie, Nigeria, Renvoi.

Perception of infertility and acceptability of assisted reproduction technology in northern Nigeria.

BACKGROUND: Infertility is a stigmatized reproductive morbidity with severe psycho-social consequences, especially in developing countries. There has been little exploration of the public view of infertility and acceptance of assisted reproduction in these countries, including Nigeria. OBJECTIVE: To determine the public perception of infertility, its causes and factors associated with acceptability of Assisted Reproductive Technologies (ART) in Kano, Northern Nigeria. METHOD: Using interviewer administered questionnaires, a cross-section of 600 adults were interviewed about perceived definition, causes and acceptance of ART. RESULT: Majority of the respondents (n = 577, 99.3%) perceived infertility as a disease. Only 18.1% (n = 105) of the respondents would consider a couple infertile after one year of marriage. Causes of infertility mentioned by participants included paranormal events (n = 535, 92.1%), suprapubic pain (n = 321, 55.2%), induced abortion (n = 187, 32.2%) and sexually transmitted infections (n = 177, 30.5%). A minority of respondents (n = 161,27.7%) of participants mentioned blocked tubes and 24.6% (n = 143) irregular menstrual cycles. Although 36.1% of respondents were aware of ART; only 7.6% were willing to accept it. Being male [adjusted odds ratio (AOR) (95% CI)] 2.1 (1.55.72), childless [AOR (95% CI)] 2.2 (1.35.95), highly educated [AOR (95% CI)] 3.2 (1.326.72) and non-Muslim [AOR (95% CI)] 2.3 (1.23.76) were significant predictors of acceptance ofART. CONCLUSION: Infertility was correctly perceived as a disease, but there were misconceptions about its causes. The low acceptance of ART was influenced by socio-demographic factors. There is a need for sustained targeted information, education and communication regarding new reproductive technologies for fertility management.

A survey of weight perception and social desirability of obesity among adults in Kano Metropolis, Northern Nigeria.

BACKGROUND: Obesity and its complications are emergent health challenges in developing countries including Nigeria. We determined the concordance of perceived with measured weight and assessed the social desirability of obesity among adults in Kano metropolis in northern Nigeria. METHODS: A cross sectional descriptive study was conducted among 400 adults using structured interview questionnaires. RESULTS: Among 386 respondents, 58 (84.1%) of underweight adults, 106 (46.2%) of healthy weight adults, 46 (66.7%) of overweight adults and 16 (84.2%) of obese adults incorrectly perceived their weight category. Sixty (15.5%) participants considered obesity as socially desirable and a sign of good living and affluence. Older respondents (> or = 40 years) (P = 0.0001), Igbo or Yoruba ethnicity (P = 0.0035) and non-formal or primary education (P < 0.0001) were significantly associated with positive view of obesity. However, only ethnicity; Yoruba-Adjusted Odds Ratio (aOR) = 1.60, 95% Confidence Interval (95% CI) (1.20-2.86), P = 0.018, Igbo (aOR = 3.22, 95% CI (1.64-6.3), P =0.005 and educational status; non-formal (aOR = 4.61, 95% CI 1.62-16.9), P = 0.01; primary (aOR = 4.95, 95% CI (1.4-17.8), P = 0.015 remained significant predictors after adjusting for confounding. CONCLUSION: The discordance between perceived and measured weight is worrisome but the low social desirability of obesity should be encouraged. Weight control using periodic weight measurements, nutritional education and physical exercise are paramount.

Patterns and predictors of cigarette smoking among HIV-infected patients in northern Nigeria.

The smoking behaviour of persons living with HIV/AIDS in sub-Saharan Africa is poorly documented. We employed a cross-sectional study design to assess the prevalence and predictors of tobacco smoking among HIV-infected patients in northern Nigeria (n = 296). Approximately one quarter of respondents were either current (7.8%) or ex-smokers (17.9%). Smoking rates among HIV-infected women were extremely low. HIV-infected men were at least three times as likely to smoke as their female counterparts living with HIV: adjusted odds ratio (AOR) 3.16, 95% confidence interval (95% CI) 2.17-7.32. Patients with tertiary education were at least twice as likely to smoke compared with their counterparts without formal education (AOR 2.63, 95% CI 1.08-6.67). The preponderance of cigarette smoking among educated HIV-infected men in northern Nigeria offers a unique opportunity for targeted smoking cessation programmes.

Prevalence of female genital mutilation among female infants in Kano, Northern Nigeria.

OBJECTIVES: To determine the prevalence and type of female genital mutilation (FGM) among female infants, reasons and attitude of the mothers to the practice. DESIGN: A cross sectional descriptive study. SETTING: Tertiary centre in Kano Northern Nigeria. METHOD: A Pretested questionnaire was administered for mothers of female infants presenting for routine immunization in Aminu Kano Teaching Hospital (AKTH). A total of 250 questionnaires were administered, but only 200 were properly filled and this was used for the analysis. MAIN OUTCOME MEASURES: Prevalence and type of FGM, reason for and attitude of mothers towards FGM. RESULTS: Twenty-six infants had FGM during the period of study, giving a prevalence rate of 13 %. The mean age at cutting was 8 days ± 7.3. The commonest type of FGM was type I accounting for 96.2 % of the cases. Tradition/culture was the commonest reason for mutilation accounting for 73.1 %, other reasons included; religious in 11.5 %, hygienic in 11.5 % and to preserve virginity in 3.8 %. Traditional barbers were the commonest operators in 80.8 % of cases, followed by the nurse/midwife in 15.4 % of cases. The fathers were the main decision makers in 46.2 %, followed by both parents in 26.9 % and grandparents in 15.4 % of the cases. 84 % of mothers were not in support of the practice. Thirteen percent of the clients would circumcise all their daughters. Forty-eight percent of the clients were of the opinion that FGM cause harm to the victims. Four percent of those whose daughters were yet to be circumcised will do so later. CONCLUSION: Female genital cutting is still practiced in our environment. Educational enlightenment is fundamental in changing public opinion as well as in offering reasonable alternative to FGM. Campaign against the practice of FGM should be encouraged to eradicate its practice.

Predictors of female genital cutting among university students in northern Nigeria.

Female genital cutting (FGC) is a harmful cultural practice that is perpetrated against women and children. Little is known about the extent of this custom among university students in northern Nigeria. Using self-administered questionnaires, we studied the prevalence and determinants of FGC among female university students in Kano, Nigeria (n =359). The prevalence of FGC was 12.1% (95% confidence interval =8.8-15.8%). Awareness and disapproval of FGC among the study population was very high (96% and 91%, respectively). In multivariate regression models, ethnicity and geographic origin were significant predictors of female circumcision. A comprehensive legal and educational framework and the support of civil society, governments and development partners is required to address this form of gender discrimination.

Premarital sexual experience and preferred sources of reproductive health information among young men in Kumbotso, northern Nigeria.

BACKGROUND: Despite well known risks associated with unprotected premarital sex, this phenomenon has not been well explored among young men in rural northern Nigeria. We studied the predictors of premarital sex and preferred sources of sexual and reproductive health information among young unmarried men in Kumbotso, northern Nigeria. METHOD: A cross section of 400 young men were interviewed using structured questionnaires with mostly closed ended questions. RESULTS: Of the 385 respondents, 39 (10.1%) were sexually experienced. Less than half of respondents (48.7%) used a condom at sexual debut, and an equal proportion reported having multiple sex partners. Only 41.0% of sexually experienced respondents reported subsequent consistent condom use Age (adjusted odds ratio [AOR] = 4.12; 95% confidence interval (CI): 2.24-5.20 and educational attainment [AOR = 3.57; 95% CI (1.49-9.10)] were significant predictors of sexual experience. The current versus preferred sources of sexual and reproductive health information included friends (51.3% vs. 93.3%), Islamic school teachers (41.0% vs. 72.7%) and school teachers (8.8% vs. 15.1%). CONCLUSION: Although the prevalence of premarital sex among young men in this community in northern Nigeria as low, those that did engage in such activity were likely to not use condoms and to have multiple partners. Preferred and trusted sources of information included peers and religious leaders. The findings in this study could be used to develop innovative strategies for reaching young men with accurate sexual and reproductive health information.

Cervical cancer risk perception and predictors of human papilloma virus vaccine acceptance among female university students in northern Nigeria.

Cancer of the cervix is the most common cancer and the leading cause of cancer mortality among women in sub-Saharan Africa. Although a vaccine against human papilloma virus (HPV) is now available, its acceptance among vulnerable women in developing countries is largely unexplored. We studied cervical cancer awareness and HPV vaccine acceptance among 375 female university students in northern Nigeria. A total of 133 participants knew of HPV (35.5%), 202 (53.9%) had heard of cervical carcinoma and 277 (74.0%) were willing to accept HPV vaccination. After adjusting for potential confounders, age (adjusted odds ratio (AOR) = 2.3, 95% confidence interval (CI), 1.47-6.53); medical education (AOR = 3.4, 95% CI, 1.74-6.93); HPV knowledge (AOR = 1.8, 95% CI, 1.38-5.41) and awareness of cervical cancer (AOR = 2.3, 95% CI, 1.52-5.06) were significant predictors of readiness to accept HPV vaccine. Public health education and appropriate communication strategies should be implemented in advance of large scale vaccine introduction to increase awareness and prevent misconceptions about the HPV vaccine.

Domestic refuse management practice in Sokoto: the effect of health education.

AIMS AND OBJECTIVES: Domestic refuse remains a major environmental concern in large cities around the world. Its management also continues to be a major challenge. The aim of this study was to assess the effect of health education on the knowledge, attitude and practices of domestic refuse management (DRM) among community members in Sokoto metropolis. MATERIALS AND METHODS: A quasi experimental study design was employed to investigate two sampled (intervention and control groups) population of 225 subjects in the study areas. RESULTS: The mean knowledge score (%) of the study subjects was high and similar (p=0.82), in both the intervention and control groups at baseline, but differed significantly (p<0.0001) at post-intervention. The mean attitude score (%) was high and similar (p=0.38), in both the intervention and control groups at baseline, but differed significantly (p=0.008) at post intervention. The mean observed practice score (%) was low and similar (p=0.42), in both the intervention and control groups at baseline, but differed significantly (p<0.0001) at post-intervention. CONCLUSION: This study has identified the underlying problem of our DRM system to be inherent in the practice component in the triangulation of knowledge, attitude and practice of DRM. The implications of the study findings for healthcare policy, planning and implementation cannot be over-emphasised.

Patients' satisfaction with services obtained from Aminu Kano Teaching Hospital, Northern Nigeria.

OBJECTIVE: Periodic patient satisfaction surveys provide feedback to hospital management and staff regarding the quality of services rendered. These surveys have become routine as part of total quality management in developed countries. We assessed patient satisfaction with services provided in a teaching hospital in northern Nigeria. METHOD: Structured questionnaires were administered on a cross-section of 201 patients and two focus group discussions were held with patient relatives at Aminu Kano Teaching Hospital. RESULTS: Overall, 83% of the patients were satisfied with the services received from Aminu Kano Teaching Hospital, while the remaining 17% were dissatisfied. Specifically, 88%, 88%, 87% and 84% of the patients were satisfied with patient provider relationship, in-patient services, hospital facilities and access to care. However, 30% and 27% of the patients were dissatisfied with waiting time and cost of treatment respectively. Patients and their relatives complained about delayed appointments, missing folders, missing laboratory results and long appointments for ultrasound and other radiological investigations. CONCLUSION: The high patient satisfaction notwithstanding, health workers need to consider patients as customers by being friendly and reducing waiting time for consultation and investigations. Widespread implementation of the National Health Insurance Scheme will also reduce the cost of services and drugs to patients.

The HIV/AIDS epidemic in Nigeria: progress, problems and prospects.

Nigeria is Africa's most populous country, and is home to the third largest number of persons living with HIV/ AIDS in the world. Poverty, stigma, discrimination, and a poorly coordinated health system constitute major barriers to HIV treatment and prevention efforts. The purpose of this paper is to review the current status of the HIV/AIDS epidemic in Nigeria, analyze the challenges facing provision of HIV/AIDS services, examine the prospects of attaining universal access to HIV prevention, treatment, care and support, and advance recommendations for developing quality, sustainable and efficient HIV/AIDS services in Nigeria. HIV programs in Nigeria must emphasize sustainability of current foreign-donor driven treatment and prevention initiatives by engaging all segments of the society and enhancing community leadership and ownership of the programs.

Pre-clinical and preliminary dose-finding and safety studies to identify candidate antivenoms for treatment of envenoming by saw-scaled or carpet vipers (Echis ocellatus) in northern Nigeria.

The aim of this study was to identify candidate antivenoms with specific activity against the venom of the saw-scaled or carpet viper (Echis ocellatus) in northern Nigeria, where bites by this species cause great morbidity and mortality but where effective antivenoms have become scarce and unaffordable. Selected antivenoms were destined to be compared by randomised controlled clinical trials (RCTs). Standard pre-clinical neutralisation assays were carried out in rodents. We included two licensed antivenoms of established clinical efficacy and 6 candidate antivenoms. Although 6 of the tested antivenoms showed promising efficacy, all but 3 were excluded from further study because of inadequate pre-clinical efficacy or because they were unavailable or unaffordable for the anticipated RCTs. Median effective doses (ED(50)) of the remaining three candidate antivenoms suggested that the following doses might neutralise the maximum observed venom yield of 24.8 mg (dry weight) of venom milked from captive E. ocellatus: 10 ml of MicroPharm "EchiTAb G" (ET-G) antivenom; 30 ml of Instituto Clodomiro Picado "EchiTAb-Plus-ICP" (ET-Plus) antivenom; 50 ml of VacSera, Cairo "EgyVac" antivenom. A preliminary clinical dose-finding and safety study of these three antivenoms was carried out in 24 patients with incoagulable blood after E. ocellatus bites who were not severely envenomed. A 3+3 dose escalation design was employed. Initial doses of 10 ml ET-G and 30 ml ET-Plus restored blood coagulability in groups of 6 patients with early mild reactions (pruritus only) in not more than one third of them. EgyVac antivenom did not fulfil efficacy or safety criteria in 12 patients. On the basis of these results, ET-G and ET-Plus were selected for comparison in a RCT.

Response to the meningococcal meningitis epidemic (MME) at Aminu Kano Teaching Hospital, Kano (2008-2009).

In December 2008 an outbreak of Meningococcal Meningitis swept across sub Saharan Africa with Nigeria, especially its northern states worst affected. The management of Aminu Kano Teaching Hospital constituted an Emergency Preparedness & Response (EPR) committee. Over the course of 18 weeks from 5 January 2009 to 15 May 2009, AKTH managed 222 cases of suspected meningitis with 14 deaths (case fatality rate [CFR] of 6.3%). Twenty three per cent (23%) were microbiologically proven as meningococcal meningitis while 9% were confirmed to be pneumococcal meningitis. Male to female ratio was 1:1 with most patients (81%) aged below 14 years. The epidemic peaked in weeks 10 and 13 with 38 admissions in the respective weeks. Meningococcemia with purpura fulminans, post meningitic immune complex cutaneous vasculitis and polyarthritis were observed. Control measures instituted included provision of free ceftriaxone, chemoprophylaxis to contacts, vaccines to staff/families, and creation of dedicated isolation wards. Clinical management guidelines were developed and hospital staffs were also enlightened. Lessons learnt included the difficulty of discriminating between nosocomial transmission and community clusters; relative increase in pneumococcal meningitis during the epidemic; unreliability of penicillin/chloramphenicol; the utility of internet for communication; and the inadequacy of vaccines to meet staff & public demand.

Management audit for Primary Health Care Facilities in Plateau State.

BACKGROUND: The health care system in Nigeria has been developed at three levels, the extension of health care to all people has been an objective of all National Health Systems for many years since the Alma - Ata conference on Primary Health Care (PHC) in 1978. Decades after the take off of PHC in all parts of this country, the goal of health for all and beyond is still far from being attained. METHOD: The management activities of Primary Health Care Facilities in Plateau State were investigated. A multistage sampling method was used to select 30 PHC facilities from 10 randomly selected LGAs out of the 17 Local Government Areas (LGAs) of Plateau State. All the heads, the secretaries and the chief matrons of the selected facilities were interviewed using self-administered structured questionnaires. Responses were scored using a dichotomous scale and categorized into poor, fair, good and excellent performances, and analyzed using Epi info 2.3.05 2003 statistical software. RESULTS: Out of the 90 workers interviewed, 68.9% were females and 85.6% were married. Seventy four point four percent of the respondents were between 30-44 years of age, and 43.3% of the workers worked at the Basic Health Clinics (BHCs) while 20% of them worked in Comprehensive Health Centre (CHCs). Up to 40% of the LGAs had poor management performance, while the remaining 60% performed only fairly. Overall, PHC facilities in Langtang north did better in management of their facilities, while Shendam LGA scored least in management performance. In this study, no significant difference in scores of the various management activities between the LGAs was observed (F = 7.084, p > 0.05). However, a statistically significant difference in scores of management activities between the various types of PHC facilities was observed (F = 2.81, p < 0.05). CONCLUSION: The management staff in most of the primary health care facilities lack resources at their disposal and this hinders the efficient and effective running of the facilities. Lack of transportation and poor maintenance of those available would seem to be the major constraint to the effective running of the health facilities.

Envenoming after carpet viper (Echis ocellatus) bite during pregnancy: timely use of effective antivenom improves maternal and foetal outcomes.

The report describes successful management of 10 women in 2nd and 3rd pregnancy trimesters with EchiTab IgG antivenom after carpet viper (Echis ocellatus) envenoming. All women survived but foetal loss in a victim with delayed presentation and a case of mild hypersensitivity reaction were recorded. Excellent outcomes can be achieved in rural and semi-nomadic populations without specialized care and immediate access and provision of effective antivenoms is paramount in curtailing snakebite maternal morbidity, mortality and foetal loss.

Use of protective eyewear among surgeons in a tertiary hospital in northern Nigeria.

The study was a prospective study during which a hand-held lens was used to examine the goggles of all surgeons who used them during surgery at Aminu Kano Teaching Hospital, Kano, Nigeria. Only 169 (54.8%) of the 308 surgeons used eye protection during surgery. There was at least a bloodstain on 70 (41.4%) of the goggles. There is need to enforce universal precautions during surgery to protect the eyes of surgeons from blood drops of the patient being operated.

Postpartum beliefs and practices in Danbare village, Northern Nigeria.

Postpartum cultural beliefs and practices are widely prevalent in northern Nigeria. Using a cross-sectional survey, we set out to examine contemporary postpartum beliefs and practices among a cohort of 300 mothers in Danbare village, northern Nigeria. Common postpartum practices included sexual abstinence (100%), physical confinement (88%), hot ritual baths (86%), nursing in heated rooms (84%) and ingestion of gruel enriched with local salt (83%). The majority of mothers (93%) believed that these practices made them stronger and helped them regain their physiologic state. Most respondents believed that non-observance could lead to body swelling, foul-smelling lochia and perineal pain. Mothers with formal education were significantly more likely to believe that these practices were non-beneficial compared with those mothers without formal education (odds ratio (OR) = 9.9, 95% confidence interval (CI) = 3.6 - 28.8). Almost half of the respondents (49%) said they would continue with these practices. In conclusion, women are still holding on to postpartum cultural beliefs and practices in northern Nigeria. However, educated women could act as useful agents of change towards the elimination of practices harmful to the health of mothers and their children.

Compliance to antiretroviral therapy among AIDS patients in Aminu Kano Teaching Hospital, Kano, Nigeria.

BACKGROUND: Non-compliance with antiretroviral treatment has serious consequences for prognosis and may lead to the development of resistant strains of the virus. This study assessed the level of compliance to antiretroviral treatment, identified factors associated with compliance and reasons for non-compliance among AIDS patients in a Teaching Hospital in Northern Nigeria. METHODS: A pre-tested structured interview questionnaire was administered on a cross-section of 263 AIDS patients seen at Aminu Kano Teaching Hospital, Kano. Patient's reported consumption of antiretroviral drugs was compared with the Physician's prescription in the seven-day period preceding the interview. RESULTS: Only 142 (54.0%) of the 263 respondents took at least 80% of the antiretroviral drugs prescribed. Sixty-one (23.2%) did not miss any dose of the drugs. Univariate analysis showed that a significantly higher proportion (58.7%) of patients with formal education were compliant compared to 26.3% of those without formal education (chi2 = 13.7 df = 1 P < 0.01). The educated patient was four times more likely to be compliant [O.R = 3.97, 95% CI = 1.75-9.24]. In contrast, age and sex variables had no significant influence on compliance among these patients. Main reasons for non-adherence to medication include non-availability of drugs (40.6%), forgetfulness (23.9%) and lack of funds (15.8%). CONCLUSIONS: The average compliance observed in this study could be improved by ensuring a steady supply of affordable antiretroviral drugs, better patient-provider communication and enhanced social support for these patients.

Awareness and Practice of Cervical Cancer Screening among Female Health Professionals in Murtala Mohammed Specialist Hospital, Kano.

BACKGROUND: Cervical cancer, although largely preventable, remains the most common cause of cancer mortality among women in the developing world. Other members of the community see health care workers as models, therefore their attitudes and actions are predictors of societal health behaviour. OBJECTIVES: We assessed the knowledge, attitude and practice regarding prevention of cervical cancer among female health professionals in a secondary health facility in Kano, Nigeria. METHODS: A structured questionnaire was administered on 230 female respondents in the various health professions including doctors, pharmacists, nurses and laboratory technologists in Murtala Mohammed Specialist hospital, Kano. RESULTS: Over 60% of the respondents were able to correctly identify all the important aetiological factors associated with cervical cancer, while a similar figure knew the important signs and symptoms of the disease. Up to 94.7% of the respondents had a positive attitude towards Pap smear while 8.2% disapproved of it. Only 20.8% of the respondents have had a Pap smear done previously. Married respondents were more than four times likely to have had a previous Pap smear compared to their single counterparts. (X(2) = 13.3 df=1 P = 0.0003)[O.R=4.8, 95% confidence interval= 1.9 -14.4]. In contrast, religion appeared to have no significant influence on the practice (X(2)= 0.87 df=1 P=0.35). CONCLUSIONS: Despite a moderately high level of knowledge of cervical cancer screening and positive attitude towards it, the uptake of Pap smear was low. There is a need for continuing education to improve uptake of these services by health professionals so as to serve as a motivating factor for the public. Key words: cervical cancer screening, pap smear, female health workers, knowledge, practices.

Computing knowledge, attitude and skills among healthcare professionals in Aminu Kano Teaching Hospital, Nigeria.

BACKGROUND: Health care professionals can no longer ignore the application of information technology to health care. This study was carried out to assess computing knowledge, attitude and skills among health care professionals and identify associated factors. METHODS: A cross section of 200 health care professionals- consisting of 64 doctors, 90 nurses, 35 laboratory scientists and 11 pharmacists in Aminu Kano Teaching Hospital were interviewed using a pre-tested, structured, closed-ended self-administered questionnaire. RESULTS: Only 181 (90.5%) of the respondents returned the completed questionnaires. Twenty six percent of the respondents had formal computer training whereas 34.8% owned a personal computer. Overall, 84 (46.4%) of the respondents had good knowledge of computing. Specifically, 41(66.0%), 5 (50.0%), 14 (51.0%) and 24 (30.0%) of these were doctors, pharmacists, laboratory scientists and nurses respectively. Computing knowledge was highest among doctors and lowest among nurses. These differences were statistically significant (chi2 = 19.1 df = 3 P < 0.01). Age, gender, computer ownership and formal computer training significantly influenced computing knowledge. Most healthcare professionals 160 (88.4%) had positive attitude towards computing and this was significantly influenced by respondent's age and previous computer training. Only 41 (22.7%) of the health care professionals had good computing skills and this was significantly associated with computer ownership (P < 0.01) and formal computer training (P < 0.01). CONCLUSION: Half of the healthcare professionals had good computing knowledge, majority had a positive attitude while many were quite deficient in computer skills. Computer loans and in-house computing courses were recommended to prepare our healthcare professionals for the challenges of the information technology age.