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Monday, January 09, 2017

AWARENESS AND COVERAGE OF THE NATIONAL HEALTH INSURANCE SCHEME AMONG FORMAL SECTOR WORKERS IN ILORIN, NIGERIA - African Journal of Biomedical Research, Vol. 19, No. 1, 2016, pp. 7-16

A prepayment method for health care financing has been adopted by many developing countries to ensure universal coverage for healthcare. In Nigeria, National health insurance scheme (NHIS) was established in 2005. The aim for this was scheme was to “secure universal coverage and access to adequate and affordable healthcare in order to improve the health status of Nigerians, especially for those participating in the various programs/products of the Scheme”. These policies however only target the formal sector workers mainly and that makes only about 4% of the population.  Furthermore, the enrolment to this coverage in Nigeria is only voluntary, it is not mandatory for people to sign up like in Ghana. The majority of the stakeholders in health insurance is government based.

Nigeria follows the federal system of government where the governance is shared by three levels (the national, state and local government). The states thus have a high degree of autonomy in many sectors that affect the well-being of its residences such as education and health. Earlier studies have shown that age, sex, education and socio-economic status along with other demographic factors are associated with the awareness of the program and the likelihood of people participating in heath promoting services and schemes. It is crucial to assess the different level of coverage of the NHIS among the formal sector  in order to attain lessons that could be used in the expansion of the program.

A cross-sectional, survey was carried out in Ilorin, Kwara state in Nigeria between February and March 2012. Ilorin is the capital of Kwara and has the population of 2371,089 people. Public/ civil servants over the age of 18 years, who were employed by all levels of government were allegeable to the participle. The sampling was taken in two-stage stratified sampling was used to select 370 respondents and using the systematic sampling the respondents were recruited into the study.

The data was analyzed with SPSS, this ethical approval of the study was obtained from Bowen University teaching hospital research ethics committee. The result concludes that majority of the respondents were are of the NHIS. Unfortunately, only 13.5 % of the respondents paid for health care services through NHIS. Furthermore, respondents with post-secondary education and in federal civil services were more likely to be aware of the NHIS program. This means that the program is available and promoted in the higher ranks or socioeconomic status have more access to this information.


Sunday, January 08, 2017

REMOVABLE ORTHODONTIC APPLIANCES: FREQUENCY AND CLEANING AGENTS USED BY STUDENTS AND RECOMMENDED BY DENTISTS - BRAZILIAN JOURNAL OF ORAL SCIENCES, Vol. 15, No. 1, 2016, pp. 21-26

In the last years, the need for orthodontic treatments has increased. Very few studies have investigated the attitudes of dentist towards oral prevention measures. Children who are in the treatment of removable orthodontic appliances (ROA) have a higher risk for proximal caries, gingivitis, and halitosis as compared to children without ROA. The children’s characteristics treated with orthodontic appliances are important and therefore, the dentist recommendation should present alternates to reduce microbiota and prevent other oral diseases.

The study aims to 1) evaluate the prevalence of the ROA use by adolescents from the age of 13 to 19 years in the city of Pelotas. Looking for possible links with socio-demographic factors and hygiene habits 2) to confirm hygiene method prescribed by dentist. The study was conducted in two different stages, the first stage consisted of having telephone interviews. Any dentist on the registered dentist list from the regional council of dentistry of Rio and Brazil dental association, who lived in Pelotas, and worked in treatment involving ROA were included in the study.  The dentist was asked questions regarding the hygiene methods for cleaning acrylic appliances. The second part of the study was student interviews, where children from different socio-economic status were asked questions. Both, public and private school students were included in the sample. The questions consisted of demographic information’s, behavioral habits and characteristics. These data’s collected were then analyzed by the Chi-square test and logistic regression.

Two hundred and thirty-five dentists participated in the study and 9.6 % indicated to brush ROA with soap, 8.0 % advised immersion in hypochlorite, chlorhexidine or peroxide solutions, 6.0 % suggested other cleaning material and 1.6 % suggested Corega tabs. Most dentist, 64%, recommended cleaning the appliances 3 times a day. Thus, dentists (47.2%) reported preferring mechanical methods to clean their ROA. The prevalence of children using ROA was 3.4 % and they also preferred mechanical methods to clean their ROA (89.7 %). Thus, one can conclude that there is a higher frequency of hygiene on the ROA.

This case study concluded that not a lot of people in schools were using removable appliances. The cleaning methods they used was mechanical which was prescribed by doctors. An interesting factor to this study was that they hygiene frequency was considered to have an association with the routine of the use of the appliances with the type of hygiene method.


PARENTS’ AND TEACHERS’ PERCEPTIONS OF PROCESSED FOODS IMPACT ON CHILD HEALTH-Brazilian Journal in Health Promotion, Vol. 28, No. 1, 2015, pp. 16-22

Brazil has been actively doing research of the impacts of process foods on the human health. A recent study aimed to gain the opinions of parents and teachers on the processed foods effects on children’s health. Brazil has seen a shift in nutritional profiles, with a significant increase in diseases relating to nutritional excess. This is associated with the development of the country, which is improving the living conditions for some people in the society. Furthermore, with technological advancement and modernity, issues such as obesity are being a serious health problem.

 The convenience of processed food has become part of the children eating habits. The study aimed to analyze the relation of childhood obesity and the influence of processed food. By looking at the role of media and advertisement that appeal to children's imagination such as animals, character references for children. These advertisement techniques result in children consuming unhealthy foods, and the parents are unaware of the risk of these foods.


 This qualitative study was conducted with 19 parents and 11 teachers of the public child day care in the municipality of Ceara State. Ceara State has a population o of about 25,000 people. This study was conducted from January to September 2010 by having four focus groups. These groups were audiotaped and transcribed as well. The purpose of the groups was to focus the research and formulate a) precise question, b) bring complementary information such as the group's beliefs, attitudes, perceptions and c) develop and hypothesis for the future studies.

 Results state that the teachers have seen a change in the trend of eating behavior of children attending their daycares. They stated that these changes are influenced by commercial that aggravates the consumption of processed foods instead of healthy food options. These commercials are creating a “cult of the new and modern”. Furthermore, even though free meals are provided at the school, the children can buy processed food as it is available at schools. The availability and affordability of processed foods near the school entrance have a strong emotional appeal and compete with the meals offered at the school. Also, even though parents understand the issues and problem of processed foods, they still give unhealthy food to their children. The idea of eating to service has decreased. The availability to buy food has become a status issue where people “live to eat” instead of “eating to live”.

 The study urges for the need for international that is focused on school and family to prevent intimate consumption of processed foods. Similar studies conducted by Monterio et al., (2010) looked at how processed foods in Brazil and being replaced by ultra-processed foods with very little nutritious value. They have also suggested that governments and health authorities should use methods such as legislation, statutory regulations to stop and reverse the replacement of minimally processed foods and processed culinary ingredients by ultra-processed food production.


 Reference:

 Monteiro, C.A., Levy, R.B., Claro, R.M., de Castro, I.R.R. and Cannon, G. (2010) ‘Increasing consumption of ultra-processed foods and likely impact on human health: evidence from Brazil’, Public Health Nutrition, 14(1), pp. 5–13. doi: 10.1017/S1368980010003241.

Monday, October 24, 2016

The young, educated, minorities and the poor move out from south central Ethiopia - African Population Studies, Vol. 30, No. 2, 2016, pp. 2296-2305

Migration takes place due to many "Pull Factors" such as better living conditions, better job opportunity, and an overall better life and many "Push Factors" such as unequal access to assets, income, education, healthcare, house ownerships or natural disasters. These natural and manmade factors affect migration rates where communities, individuals, and families move from one area to another. Migration studies conclude that males, youth, people who don’t own property, religious and ethnic minorities, and educated people are highly likely to migrate out of small cities. Furthermore, migration flows also create dramatically during famines.

Guraghe that is one of the most densely populated zones in Ethiopia. A rapid population growth, low cropping intensity, and fragmental rural land holdings have created a surplus of labor. Due to the economic development witnessed in Ethiopia, people are moving into urban hubs. The study was conducted in Butajira district of Guraghe zone that is located in the Southern nation in an arid and semi-arid area geographically. The district not only had Guraghe tribe predominantly inhabiting it, Silti and Mareko were also other major ethnic groups living in the area. There is a cyclical famine that takes place in the district, it is concerning as the time between the famines has shortened drastically.

This study looks at outmigration of people from 10 sample neighborhoods in south central Ethiopia to measure the incidence of outmigration among different population groups. Furthermore, ten sampled kebeles based on proportion to size technique were placed, first, a baseline population and housing census were conducted in 1987. Then, a continues monthly registration event took place monthly till 1999.

Results suggested that there was a 3.97 incidence of out-migration per 100 persons and 95% CI over the 22 years study period. High out migrations were observed among the youth aged 15-19 and 20-29 at the incidence rate of 7/25 and 6.26 per 100 persons. On the contrary, the incidence rate was only 1.94 and 2.08 among adults between the age of 40-49 years and 50 plus.

The study concluded that the young people aged 15-29 had out-migration at the higher rates which could be to find a better education, job, and marital arrangements. Out-migration was also higher among educated individuals compared to land owners and people who were married. Single people have less social and economic obligations giving them an opportunity to move. The study suggests that the local government should consider having strategies to ensure that the young have employment and housing opportunities in order to ensure that there is less out migrations.

The young, educated, minorities and the poor move out from south central Ethiopia - African Population Studies, Vol. 30, No. 2, 2016, pp. 2296-2305

Migration takes place due to many "Pull Factors" such as better living conditions, better job opportunity, and an overall better life and many "Push Factors" such as unequal access to assets, income, education, healthcare, house ownerships or natural disasters. These natural and manmade factors affect migration rates where communities, individuals, and families move from one area to another. Migration studies conclude that males, youth, people who don’t own property, religious and ethnic minorities, and educated people are highly likely to migrate out of small cities. Furthermore, migration flows also create dramatically during famines.

Guraghe that is one of the most densely populated zones in Ethiopia. A rapid population growth, low cropping intensity, and fragmental rural land holdings have created a surplus of labor. Due to the economic development witnessed in Ethiopia, people are moving into urban hubs. The study was conducted in Butajira district of Guraghe zone that is located in the Southern nation in an arid and semi-arid area geographically. The district not only had Guraghe tribe predominantly inhabiting it, Silti and Mareko were also other major ethnic groups living in the area. There is a cyclical famine that takes place in the district, it is concerning as the time between the famines has shortened drastically.

This study looks at outmigration of people from 10 sample neighborhoods in south central Ethiopia to measure the incidence of outmigration among different population groups. Furthermore, ten sampled kebeles based on proportion to size technique were placed, first, a baseline population and housing census were conducted in 1987. Then, a continues monthly registration event took place monthly till 1999.

Results suggested that there was a 3.97 incidence of out-migration per 100 persons and 95% CI over the 22 years study period. High out migrations were observed among the youth aged 15-19 and 20-29 at the incidence rate of 7/25 and 6.26 per 100 persons. On the contrary, the incidence rate was only 1.94 and 2.08 among adults between the age of 40-49 years and 50 plus.

The study concluded that the young people aged 15-29 had out-migration at the higher rates which could be to find a better education, job, and marital arrangements. Out-migration was also higher among educated individuals compared to land owners and people who were married. Single people have less social and economic obligations giving them an opportunity to move. The study suggests that the local government should consider having strategies to ensure that the young have employment and housing opportunities in order to ensure that there is less out migrations.

Wednesday, October 05, 2016

Dengue in an area of the Colombian Caribbean - Revista Colombia Médica, Vol. 46, No. 1, 2015, pp. 3-7

    Dengue is a tropical infection that is caused by the bite of the Aedes aegyti mosquito vector.  In recent years, the incident of dengue is considerably on a rise around the world.  Many cases of dengue are underreported or misclassified. A recent estimate indicates that there are 390 million people being infected by dengue per year. Due to its high epidemiological and economic impact, dengue takes the fifth place in the list of unattended tropical disease.

    In Colombia, dengue is an endemic disease and the four serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) have been reported.  The study describes the frequency and severity of dengue in the department of Cordoba in Colombia’s Caribbean. Based on a retrospective study, two data sources, the database from the direction of health in Cordoba and clinical register of patients with hemorrhagic fevers and fevers of unknown origin were analyzed.

    Results stated that the mean incidence of dengue between 2003 and 2010 was 36.5 cases/105 inhabitants and the mean incidence of severe dengue was 4.7 cases/105 inhabitants (CI95%: 4.3–5.0). Mean mortality rate due to dengue was 0.3 cases/105 inhabitants.  One thing to note was a significant difference between the dengue cases found in urban and rural populations. Twenty-six point two percent of cases were in populations that had to affiliation to the health system

   The study summarizes that the incidence of cases summarized for health authorities is not consistent with the behavior of the diseases being transmitted by the vector. Corrections made for the sub-reporting shows results that are closer to reality, between 18.5 and 521.6 cases/ 10 inhabitants. Thus there was an observation of deficiencies in vector management where the etiological diagnosis is made in a low proportion. Furthermore, one could highlight that there is a problem of access to health care and quality of health services provided, as there is a low capacity for diagnosing and in treatment provided.


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