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PubMed2005

[Development of a tool for assessment of local government health policy].

OBJECTIVE: A tool was developed for assessment of health status in communities to help formulate health policy of local governments and allow estimates of magnitude of changes in mortality with modification of selected risk variables. MATERIALS AND METHODS: A total of 25,201 men and 51,776 women aged 40-69 years who underwent health checkups in Ibaraki-ken, Japan, in 1993 were followed through 2002. Risk ratios for all cause, cardiovascular disease, cerebrovascular disease, ischemic heart disease, all cancer, and lung cancer deaths were calculated according to smoking, heavy alcohol consumption, obesity, hypertension, hypercholesterolemia, low high-density lipoprotein cholesterol, and diabetes using a Cox proportional hazards model. Regression coefficients for body mass index, systolic blood pressure, serum total cholesterol, serum high-density lipoprotein cholesterol, and plasma glucose were also calculated by the model with quadratic terms. On the basis of the results, we developed a tool using Microsoft EXCEL, allowing estimation of the magnitude of changes in death rates according to variation in mean and standard deviation values for risk factors by impact fraction. RESULTS: The developed tool facilitates estimation of magnitude of changes in death rates with alteration in exposure rates and means/standard deviations of risk variables with intervention. The best magnitude of decline for all cause mortality with a 50% reduction of exposure to smoking was 10% in men. The magnitudes of decline in cardiovascular disease mortality with a 50% reduction in hypertension were 12% in men and 11% in women. Furthermore, the magnitude of decline in cardiovascular disease mortality if a 10% lowering of mean systolic blood pressure were achieved would be 22% in men and 18% in women. CONCLUSIONS: Our developed tool may be useful to assess health status in communities with cooperation between municipal and prefectural governments.

Adult↗
PubMed1994

Studies on filariasis in Bauchi State, Nigeria. II. The prevalence of human filariasis in Darazo Local Government area.

In an eleven months study of eleven communities of Darazo Local Government Area of Bauchi state, northern Nigeria, 293 (21.7) of 1,349 persons examined harboured various filarial parasites. Of the sampled population, 18%, 1.9%, 1.6%, 0.5% and 0.2% had microfilariae of Onchocerca volvulus, Wuchereria bancrofti, Mansonella perstans, M. streptocerca and Loa loa respectively. Of the 637 females examined, 90 (14.1%) were infected, while 203 (23.5%) of 712 males sampled had filarial infections. The high rate in males was significant (P < 0.001). O. volvulus mf-rate increased gradually from the first decade to the seventh decade of life but declined thereafter. Prevalence of bancroftian filariasis was consistently lower in females of reproductive age, while the distribution of various filarial parasites varied significantly among age groups and communities (P < 0.05). Fishermen (42.9%), farmers (42.4%) and cattle rearers (40.9%) were the most affected occupational categories. Control strategies are highlighted.

Adolescent↗
PubMed1998

Epidemiology of paragonimiasis in Cross River basin, Nigeria: prevalence and intensity of infection due to Paragonimus uterobilateralis in Yakurr local government area.

Prevalence and intensity of paragonimiasis among inhabitants of the Yakurr Local Government Area in the Cross River basin of Nigeria is reported. Diagnosis was based on a single sample detection of eggs of Paragonimus in 5 ml of sputum. 12.27% out of 880 subjects were infected. The infections were due to Paragonimus uterobilateralis. Prevalence of the infection increased with age, up to a peak prevalence of 23.75% (19 out of 108) among subjects between the ages of 17-22 y old. Thereafter, it declined progressively with increase in age to much lower values such that by the age of 53-58 y old, infection had fallen by more than 75%. Prevalence of the infection was significantly higher among females, 13.80% (58 out of 108), than males 11.36% (50 out of 108) (P < 0.009). Intensity of infection (eggs/5 ml sputum) ranged from 12-123 eggs/5 ml.sputum, with subjects between the ages of 17-22 y old being the most heavily infected group. Prevalence and intensity of the infection were positively correlated (P < 0.497). The need for control measures to reduce human suffering due to infections in the area, particularly among women and children is emphasized.

Adolescent↗
PubMed1997

Stress and psychiatric disorders in local government officials in Japan, in relation to their employment level.

In order to explore an association between psychiatric disorders and employment level, 283 local government officials in Japan were asked to complete a questionnaire consisting of a series of psychometric scales. The Daily Hassles Scale, General Health Questionnaire and Burnout Scale were used to measure stress, psychiatric disorders and burnout syndrome, respectively. As a result of canonical correlation analysis, the first canonical correlation indicated that the higher the level of stress under poorer support systems, the greater the likelihood of burnout syndrome. The second canonical correlation indicated that the stronger the support system, the smaller the tendency toward depression. Officials in higher levels of employment were supported less and were more severely depressed than officials at lower levels of employment.

Adult↗
PubMed2004

How do health workers and community members perceive and practice community participation in the Bamako Initiative programme in Nigeria? A case study of Oji River local government area.

The objective of this study was to assess the perceptions and practices of health workers and households in relation to community participation in the Bamako Initiative programme (BI). The study was conducted in Oji River local government area of South-East Nigeria where the BI program has been operational since 1993. A pre-tested questionnaire was used to collect information from 20 health workers charged with operating the BI in 20 health centres. In addition, focus group discussions were conducted with members of the district and village health committees. Community participation from both health worker and community perspectives seem to have been enhanced by the introduction of BI, despite some constraints. However, the communities were not involved in core areas of community participation, and the health workers seem to be resisting their participation fully. It is concluded the community participation in BI could be improved if expectations were made explicit. This improvement should take into consideration the desires and priorities of the communities and issues impeding participation should be addressed.

Community Networks↗
PubMed2002

Local governance and community financing of primary care: evidence from Nepal.

Improved community participation in the financing of primary health care (PHC) is important for sustaining quality and availability of care in developing countries. This study asks whether the social status of members on a local support committee is associated with community contributions to PHC. A survey of PHC financing was conducted at 42 health facilities in two rural districts of Nepal (Jumla and Nawal Parasi). Complete data were available for 37 clinics. At each health facility, a trained interviewer collected information from the clinic administrator about the caste characteristics of the Village Development Committees (VDC) and the financial contributions made by VDCs towards the operation of the health facilities. Bivariate and multivariate logistic regression assessed the likelihood of financial contribution as it related to the caste and gender composition of the VDC as well as other characteristics of the VDC and the facility. VDCs with a majority of committee members in castes other than the highest two had higher odds of contributing to the health centre. We conclude that local development committees with a greater representation of middle and low caste members are more likely to contribute financially to the local health facility. Future research must determine the factors that lead some villages to include low caste villagers in local government.

Community Participation↗
PubMedDate not supplied

Prevalence of tsetse fly and ruminant trypanosomosis in Katsina-Ala Local Government Area, Nigeria.

The prevalence of ruminant trypanosomosis and tsetse flies was investigated in Katsina-Ala Local Government Area--a sleeping sickness endemic area--between the valleys of River Benue, Katsina-Ala and Donga in Central Nigeria. Analysis of three hundred and twenty blood samples showed that among semi-nomadic animals, about one cattle (21.3%; 0.213, confidence interval C1 +/- 0.06) and two sheep (38.0%; 0.380, C1 +/- 0.10) out of five carried mature trypanosome infections. Significantly lower (P < 0.05) values (12.5%; 0.125, C1 +/- 0.08) were recorded among peri-domestic West African Cross Red Sokoto (WAD x RS) goats. Trypanosoma vivax was the most prevalent species encountered; it was diagnosed in 10.3% of the ruminant population and responsible for 42.8% of the infections in all animals. Corresponding figures for T. congolense were 5.9% and 24.6%, respectively. T. brucei infections were low in cattle (1.8%) and absent in goats. Males and young stock had lower infection but the difference was not significant (P > 0.05) except between the ages in cattle. Glossina tachinoides was the only tsetse species encountered and responded to acetone odour attractant in biconical traps.

Animals↗
PubMed2002

Local knowledge and attitudes about onchocerciasis in Oji-River local government area of Enugu State, Nigeria.

A total of 556 individuals in Agbalenyi Community of Oji-River local government area of Enugu State, Nigeria were studied using questionnaires, focus group discussions and key informant interviews to determine the socio-cultural factors affecting the transmission of onchocerciasis. The result revealed a low level of knowledge about the cause, prevention and complications of onchocerciasis. Respondents have developed a cultural system around the disease due to long exposure. The majority are aware of the disease which they recognize once their body starts itching or musculoskeletal pain develops but only 64.4, 34.0, 1.4 and 3.6%, respectively attributed chronic itching, nodules, bad vision and leopard skin to blackfly bite. Other perceived causes mentioned include ageing, the type of food eaten, farm work and 'bad blood'. Only 0.8% knew diagnosis could be made through skin snips. Neither Oji-River nor any of the river systems were associated with any of the complications of onchocerciasis. Significant differences in most socio-demographic characteristics were associated with differences in the level of knowledge about the disease.

Adolescent↗
PubMed1995

Studies on filariasis in Bauchi State, Nigeria. 1. Endemicity of human onchocerciasis in Ningi Local Government Area.

The endemicity of human onchocerciasis was assessed in eight rural, at-risk communities in Ningi Local Government Area, Bauchi State, Nigeria, between July 1990 and March 1991. Of the 1536 subjects skin-snipped, 334 (21.7%) were positive for Onchocerca volvulus microfilariae. Surprisingly, there was a significant inverse relationship between prevalence and mean microfilarial load (r = -0.608; P < 0.05). Males were more likely to be infected than females (P < 0.01) and cattle rearers (71.0% infected), farmers (49.8%) and fishermen (40.0%) had significantly higher prevalences than students/schoolchildren, housewives or traders (P < 0.001). Pruritus and itchy eyes were recorded in all age groups and appeared in much younger subjects than any other manifestations of the infection. Prevalence and onchocercal blindness were linearly related to intensity of infection. The epidemiological significance of these findings, in terms of a future community-wide programme of long-term chemoprophylaxis with Mectizan, is highlighted.

Adolescent↗
PubMedDate not supplied

Job satisfaction among primary health care workers in three selected local government areas in southwest Nigeria.

BACKGROUND: The primary health care system in Nigeria has been impaired by lack of dedicated workers who are willing to work in the rural areas. This study was carried out to examine factors that enhance job satisfaction among health workers in the primary health care system in Nigeria. METHOD: The study is a cross-sectional descriptive study conducted in May 2002. The respondents were selected from three local government areas in southwest Nigeria by multistage sampling technique. A standardized structured pre-coded close-ended self-administered questionnaire to collect relevant information on their socio-demographic characteristics and extent of job satisfaction of respondents. RESULT: A total of 125 health workers were interviewed in all. The mean score on job satisfaction was 26.15 out of the total possible score of 49. There was no statistically significant relationship in job satisfaction among the various cadres of health workers considered (p = 0.824). A larger proportion (66.4%) of the health workers were involved with the community based preventive services when compared with the health centre based curative care 33.4% (p < 0.05), there is however no significant difference in satisfaction between this two groups of personnel (p = 0.133). Age and marital status were found to be statistically significant in relation to job satisfaction (p = 0.000 and 0.034 respectively). CONCLUSION: The study shows no significant difference in job satisfaction among the various cadres of health workers in southwest Nigeria. However age and marital status were found to be significant factors influencing job satisfaction among the primary health care workers in Nigeria.

Adult↗
PubMedDate not supplied

Designing a health education programme for the prevention and control of diarrhoea diseases at primary health care (PHC) level for local government (LGA) workers.

BACKGROUND: Diarrhoea diseases are a major cause of morbidity and mortality in developing countries especially among children. Diarrhoea diseases have [corrected] been linked to specific behavioural practices and host factors that increase susceptibility such as failure to breastfeed until at least one year of age, malnutrition and immunodeficiency state e.g. AIDS. The objective of this paper is to design a training method for the prevention and control of diarrhoea diseases for Local Government (LGA) workers. METHODS: This is a descriptive programme design for training highlighting the various steps essential for training on the prevention and control of diarrhoea diseases to LGA workers at the Primary Health Care (PHC) level. RESULTS: Programme design for the purpose of improving skills, knowledge and practices involves planning, implementation and evaluation. Planning involves identifying training needs by the collection and analysis of information related to specific need of each LGA worker at PHC level, setting training objectives and identifying the content of training (curriculum design). Implementation is the use of training methods such as methods of providing information, method of providing examples and methods of promoting practices. Evaluation involves the assessment of the immediate outcome of training and impact of training program. CONCLUSION: This training is important because every health or health-related worker who is in close contact with the people has the potential to influence the knowledge, attitude and health practices of the people with whom he or she works in the prevention and control of diarrhoea diseases.

Diarrhea↗
PubMed1992

Socioeconomic correlates of mortality and hospital morbidity differentials by Local Government Area in Sydney 1985-1988.

OBJECTIVE: To determine the magnitude of differentials in mortality and hospital morbidity by Local Government Area (LGA) in Sydney (1985-1988), and to correlate these with LGA indicators of socioeconomic status. DESIGN: Cross-sectional group-based comparative study of mortality and hospital separations, and a group-based correlations analysis in relation to socioeconomic indicators. OUTCOME MEASURES: Mortality--life expectancy at birth, infant mortality, 0- to 4-year mortality, age-standardised 15- to 64-year mortality (all-cause and various causes), sex-specific (except infant and 0- to 4-year mortality). Hospital morbidity rates--0- to 4-year hospital separations, age-standardised 15- to 64-year hospital separations (all-cause and various causes), sex-specific. STUDY FACTORS: Census-derived LGA proportions of immigrants, Aborigines, professionals, unskilled workers, unemployed persons, those with a university degree and those having no qualifications, and the composite Ross Indicator. RESULTS: Considerable differences in mortality and hospital morbidity by LGA in Sydney were found. Males had higher mortality and lower rates of hospital separation than females. LGA differentials were most obvious for adults, with little variation noted for infants or children. Most socioeconomic indicators were highly correlated with adult mortality and hospital morbidity in the expected direction, particularly indicators of low socioeconomic status. The unemployment rate, proportion Aboriginal, proportion unskilled, proportion unqualified, and the Ross Indicator were the most highly correlated variables. CONCLUSIONS: There are persistent differentials by LGA in mortality and hospital morbidity in Sydney which are strongly associated with socioeconomic status. The Ross Indicator was found to be a useful composite indicator. The high correlations of mortality and hospital morbidity with the unemployment rate raise the question of to what extent this is due to illness and premature mortality in the unemployed. Monitoring of health status differentials needs to continue if progress towards Health For All targets is to be evaluated.

Adolescent↗