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Background: Community Based Health Insurance (CBHI) scheme is aimed at reducing out of pocket spending on health care services, ensuring final risk protection to all, especially the poor and the most vulnerable, improvement of quality of health care services, access and utilization as well as the promotion of equity. Objective: This research was aimed at determining willingness to participate in a community-based health insurance scheme among rural households in Katsina State. Method: A cross-sectional descriptive study was conducted in December 2016 among households of Batagarawa LGA, Katsina State. We used a pre-tested, electronic, semi-structured interviewer-administered questionnaire to obtain data from households that were selected using a multistage sampling technique and we analyzed the data using STATA version 13. Results: Most, (28.5%) of the respondents were in the age range of 30-39 years with a mean age of 35.5 years. Males were the dominant household heads (93%). Most were married (90%). Most, (90.5%) of households were willing to pay for a community-based health insurance scheme with a median premium of 100 Naira per household member per month. Conclusions: The high proportion of households willing to pay for the scheme should inform the decision of policy makers to design and maintain Community Based Health Insurance Scheme to improve access to and utilization of quality health care services.

Evidence-based data are fundamental in enhancing the delivery of sustainable and resilient water and sanitation services in informal settlements of urban cities in low- and middle-income countries (LMICs). This paper describes the water and sanitation service situation of an urban informal settlement of Freetown, Sierra Leone's capital city. Data were collected from 385 households through a cross-sectional design. More than 80% of the respondents use sachet water as the main drinking source and 59% use protected wells for non-drinking needs. One-third (32%) of the respondents use unimproved sanitation services. Lined pit latrines are the most used facilities (39%), followed by hanging toilets (14.3%). Sanitation facilities mostly shared (69.6%) with a poor hygiene level and the risk of using them at night are reported as main threats. These findings point to the need for greater priority for investments and improvements for safely managed water and sanitation services. HIGHLIGHTS Water and sanitation access mainly provides limited service levels.; Sachet water is the main source for drinking.; Access to piped water is limited in the community and available taps provide water during the rainy season.; Wells are the main sources for domestic water needs.; Pit latrines and hanging toilets are the most dominant in the community.;

There are over 8,000 globally threatened tree species. For each species, there is a different story behind why they are threatened and what values we stand to lose if we do not find the means to save them. Mahogany, a member of Meliaceae, is a small genus with six species. Its straight, fine and even grain, consistency in density and hardness makes it a high valued wood for construction purposes. The bitter bark is widely used in traditional medicine in Africa. The high demand for bark has also led to the total stripping of some trees, complete felling of larger trees to get the bark from the entire length of the tree and bark removal from juvenile trees. These species are now threatened with extinction due to selective and polycyclic logging, and also excessive bark removal. The natural regeneration of mahogany is poor, and mahogany shoot borer Hypsipyla robusta (Moore) attacks prevent the success of plantations within the native area in West Africa. In developing countries, most of the Khaya species exists in the wild state; therefore, the regeneration and long-term conservation are at the mercy of the vagaries of nature and the profit driven herb collectors and timber merchants. It becomes urgently necessary by government of developing countries to place ban on further harvesting of mahogany species to allow the remaining few trees of mahogany in the forest to recuperate and produce substantial seeds for regeneration.

Introduction: Globally, hypertension is considered a public health problem affecting over 1.3 billion individuals of which 60% need reminders to take medication to achieve adherence, optimal blood pressure and avert complications. Literature shows electronic short message reminders (eSMS) improved medication adherence., Objective: To determine the effect of e-SMS reminders on medication adherence among hypertensive patients in Katsina State., Methods: A quasi-experimental study was employed to determine the effect of e-SMS reminders on medication adherence among 252 control and 252 intervention groups selected using a multistage sampling technique. e-SMS reminders were sent to the intervention group only. Data was collected using a pretested interviewer-administered questionnaire, and analysed using IBM-SPSS-25, while medication adherence was assessed using the 8-item Modified Morisky Adherence Scale., Results: The commonest respondents' age group was 40-49 years (23.8%) and Male-Female ratio was 0.8:1 Majority were Hausas (97.6%) by tribe and Muslims (98%). Adherence in the study group was 59.5% and 75.9% (P<0.001) that of the control group was 63.1% and 66% at pre and post-intervention stages respectively. Factors associated with adherence in the intervention group were sex, occupation, insurance coverage, and being in the 4th wealth quintile. e-SMS reminder increased adherence in the intervention groups by >16% (P<0.001) In the control group, males were 3.4 times more likely to adhere to medication than females (aOR 3.4; 95% CI 1.4-8.3) while in the intervention group, business tycoons were 3 times more likely to adhere to medication than other occupations (aOR 3.7; 95% CI 1.006-13.75;)., Conclusion: e-SMS reminders significantly increased adherence to the intervention. Determinants of adherence were occupation, male sex, insurance coverage, and being in the 4th wealth quintile. It is recommended that the State Hospital Management Board integrate e-SMS reminders as part of hypertension treatment protocols due to their potential to improve medication adherence., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2024 by West African Journal of Medicine.)

Introduction: Medication errors (MEs) are important, often overlooked forms of medical error that are associated with morbidity and mortality in health care settings. Among health care workers, knowledge, attitude and perception may affect reporting of MEs., Aim: The aim of this study was to determine the level of knowledge and perception of MEs among health care workers in Ahmadu Bello University Teaching Hospital, Zaria., Methodology: A cross-sectional study was conducted among 138 health care workers selected randomly through a stratified sampling. Their responses were collected using pre-tested, self-administered questionnaires and analysed using the Statsitical Package for the Social Sciences. The numerical variables were summarised as means and standard deviations, whereas categorical variables were presented as frequencies and percentages. The Chi-square test was used to test for associations at P < 0.05., Results: All the respondents heard of MEs and up to 108 (78.3%) correctly defined them. While only 121 (87.7%) respondents had fair to good knowledge about MEs, all of them had good perception of them. Major types of MEs known by the respondents were knowledge-based errors (79.7%), rule-based errors (52.9%), action-based errors (67.4%) and memory-based errors (55.8%). The causes of MEs identified were communication problems (88.4%), poor organizational knowledge transfer (63.8%), heavy workload (80.4%) and not reading instructions carefully (63.0%). There was no statistically significant association between the level of knowledge on MEs and sociodemographic characteristics of the respondents., Conclusion: Knowledge and perceptions of MEs were good among our respondents. Adequate mechanism (s) should be put in place to encourage the reporting of MEs whenever they occur to promote patient safety and improve health outcomes.

Context: Neonatal sepsis is an important cause of morbidity and mortality of newborns, especially in developing countries., Aims: Our study determined the prevalence of neonatal sepsis and its predisposing factors among neonates admitted in Ahmadu Bello University Teaching Hospital (ABUTH)., Settings and Design: This was a cross-sectional descriptive study conducted in ABUTH., Subjects and Methods: The data were abstracted from the case notes of neonates admitted from May 2017 to May 2018. A pretested pro forma was used to abstract the data., Statistical Analysis Used: Odds ratios and multivariate logistic regression were used to determine the factors associated with neonatal sepsis among the study population., Results: The prevalence of neonatal sepsis was 37.6%. Escherichia coli was the most commonly isolated organism. Neonates 0-7 days of age were 2.8 times less likely to develop neonatal sepsis than older neonates. Babies born with an Apgar score of <6 within the 1 st min were 2.4 times more likely to develop neonatal sepsis than those whose Apgar score was higher. Neonates of mothers who had urinary tract infection during pregnancy were 2.3 times more likely to have had sepsis and those whose mothers had premature rupture of membranes were 4.6 times more likely., Conclusions: The prevalence of neonatal sepsis was high among the neonates studied. Neonatal and maternal factors were associated with sepsis in the neonates. These findings provide guidelines for the selection of empirical antimicrobial agents in the study site and suggest that a continued periodic evaluation is needed to anticipate the development of neonatal sepsis among neonates admitted., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Nigerian Medical Journal.)

The Nigerian society is rapidly becoming urban as a result of a multitude of push and pull factors. This has generated urban health crises among city dwellers notably the urban poor. A systematic search of published literature in English was conducted between 1960 and 2015. Published peer review journals, abstracts, Gray literature (technical reports, government documents, reports, etc.), inaugural lectures, and internet articles were reviewed. Manual search of reference lists of selected articles were checked for further relevant studies. The review showed that the pace of urbanization is unprecedented with cities such as Lagos having annual urban growth rate of 5.8%. Urbanization in Nigeria is mainly demographically driven without commensurate socioeconomic dividends and benefits to the urban environment. This has created urban health crises of inadequate water safe supply, squalor and shanty settlements, sanitation, solid waste management, double burden of diseases and inefficient, congested, and risky transport system. In conclusion, when managed carefully, urbanization could reduce hardship and human suffering; on the other hand, it could also increase poverty and squalor. Some laws need to be amended to change the status of poor urban settlements. Urban health development requires intersectoral approach with political will and urban renewal program to make our urban societies sustainable that promote healthy living.

Context: The association between antiphospholipid antibodies (APAs) and pregnancy loss has been established and now considered as a treatable cause of pregnancy loss. Data on the prevalence of APA in patients with recurrent pregnancy loss are scarce in our environment., Aims: To determine the prevalence of APA in pregnant women with and without recurrent fetal wastage., Settings and Design: Antenatal clinic of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. A cross-section analytical study., Subjects and Methods: Eighty-five antenatal patients with recurrent fetal loss (cases) and an equal number of antenatal patients without recurrent fetal loss (control) matched for age were studied. Their sociodemographic data obtained and blood samples analyzed for lupus anticoagulant (LA) using activated partial thromboplastin time, direct Russel's viper venom time, hexagonal phospholipids, and IgG anticardiolipin antibody (ACA) using enzyme-linked immunosorbent assay., Statistical Analysis Used: Data were analyzed with Statistical Package for Social Sciences (version 17) by univariate analysis and Chi-square test., Results: The age range of the patients was 18-42 years with a median of 30 years. The prevalence of APA was 14.1% and 4.7% among the cases and controls, respectively. The prevalence of LA was 7.1% and 1.2% among the cases and controls, respectively, whereas ACA was 8.2% and 3.5%, respectively. However, one of the cases was positive for both APA and ACA, giving a prevalence of 1.2%.  , Conclusions: The prevalence of APA among antenatal patients with recurrent pregnancy loss was, at least, 3 times higher than that of normal antenatal clients. APA should be included in the investigation protocol of women with recurrent fetal wastages in our setting.

Background: Tetanus, a disease that is largely preventable, is still a major public health problem in the developing world and is associated with high morbidity and mortality. There is a paucity of published literature on adult (non-neonatal) tetanus in this study area in Nigeria., Methods: This was a study describing the clinical characteristics of patients who were clinically diagnosed with tetanus in Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, northwest of Nigeria between January 2001 and December 2014., Results: A total of 91 cases were reviewed. The mean patient age was 20 years, and male to female ratio 2.9:1. The majority (88%) of patients were < 40 years old. The mean onset period was 19 days, nearly all patients (96.7%) had generalized tetanus, and the commonest presenting signs were spasm (93.4%) and trimus (78.0%). The most common site of injury was lower limbs (64.8% of cases). The complication rate was 71.4% and case fatality was 48.4%., Conclusion: Tetanus is still a major public health problem in our setting and affects the younger age group with a high case fatality rate. The incidence of tetanus can be reduced drastically by an effective and sustained immunization program.