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Background Detection and management of female genital schistosomiasis (FGS) within primary healthcare is crucial for achieving schistosomiasis elimination, however, current technical strategies are not feasible in many settings. In Nigeria, there are currently no established standard operating procedures to support front-line health workers. This article presents an evaluation of piloting an FGS care package in two LGAs of Ogun State, Nigeria. Methods We used quantitative and qualitative analysis, including 46 interviews with patients, health workers and the quality improvement team; observations of training, learning sessions and supervision across 23 heath facilities; and records of patients detected and managed. Results Of 79 women and girls who were screened, 66 were treated and followed up. Health workers assimilated knowledge of FGS and effectively diagnosed and managed patients, demonstrating the feasibility of using symptomatic screening and treatment tools to diagnose and care for women or girls with suspected FGS. Challenges included establishing a referral pathway to tertiary care for patients with complications, insecurity, gender norms that limited uptake and sensitization, the limited capacity of the workforce, conflicting priorities and praziquantel acquisition. Conclusions Simple tools can be used in primary healthcare settings to detect and manage women and girls with FGS. Contextual challenges must be addressed. Sustainability will require political and financial commitments. [ABSTRACT FROM AUTHOR]

Background: Availability of adequate, timely and accurate information on patients' health records in line with standard procedures is critical for enhanced accessibility and utilization of relevant information for successful patients' care. Poor records documentation and management practices adversely affect the quality and effective utilization of health information with negative consequences on healthcare delivery outcomes. The study aimed to examine the health information management practices among health records personnel in two teaching hospitals in Nigeria, for best practices and the extent of alignment to established standards. Methods: The study adopted descriptive cross-sectional survey to examine the procedure for health records documentation and management in the two facilities. A semi-structured questionnaire was used to collect relevant information from respondents, selected by stratified proportionate random sampling technique, to answer the study questions on health records documentation and management practices and the extent of conformity to Standard Operating Procedures (SOPs), established by the Nigerian regulatory body. Data were collected and analyzed using descriptive and inferential statistics. Any procedure that scored below a criterion mean of 2.5 is considered substandard. Level of significance was set at 5%. Results: A total of 142 respondents completed the questionnaires. Ages range from 20-56 years with majority (67.6%) as females. Less than half (44%) of the respondents could use information technology applications adequately, while only a few (21.8%) have undergone specialized training in health information management (HIM). More than half of the respondents (53.5%) do not have requisite qualifications in HIM, lacking opportunities for in-service training. The institutions operate mostly paper-based/manual system of health records documentation and management with unitary system of filing. A number of the procedures scored below the criterion mean of 2.5 indicating significant underperformance below acceptable standards especially at ESUTH. These include; Disease and procedure indexing (2.0); identification and reporting of notable diseases (2.13), attaching of deficiency slip to folder without discharge summary (2.38); weeding of inactive records (2.5); and referring for consultative services (2.5). Conclusion: The study revealed sub-optimal performances in HIM practices among the health records personnel in the study facilities, with gaps in knowledge, infrastructure, policy and practice which is expected to negatively impact healthcare delivery. Findings underscore the need for engagement of qualified professionals, regular in-service training of health records staff as well as expanded use of electronic system in the facilities for enhanced flow of quality HIM, among addressing other identified deficiencies, for efficiency in health service delivery. [ABSTRACT FROM AUTHOR]

Background: Quality laboratory services are needed to direct reasonable malaria case management through malaria microscopy and rapid diagnostic test. This study assessed the existing diagnostic capacities including laboratory structures and systems, human resource, skills and competences, using the standardized WHO/NMEP EQA assessment tool. Methodology: Data were collected by an assessment team using a standardized assessment instrument/checklist drawn from WHO/NMEP assessment tool and analyzed with Open Data Kit (ODK) and Open-source suite of tools on Android mobile devices from September 3-11, 2020. The use of ODK allowed data to be collated offline where internet services were poor or unavailable and uploaded thereafter. Results: Of the 24 laboratory facilities assessed, diagnostic services on malaria are routinely done with combined malaria rapid diagnostic test (mRDT) and microscopy at 17 (65.0%) laboratories, microscopy only at 7 (27.0%) laboratories, while only mRDT was performed in 1 (3.8%) laboratory due to lack of functional microscopes, supplies, or trained personnel in microscopy. In the 24 facilities providing laboratory services, 16 (63.0 %) had one of the staff received basic malaria microscopy and mRDT training in the year prior to the assessment, and 23 (96.0%) of the laboratories had at least one functional electric binocular microscope. None of the laboratory had a good structured quality assurance/quality control procedure or standard operating procedures for either microscopy or mRDT. Conclusion: There were gaps in laboratory services due to lack of well-established quality control framework and ineffective communication system, which could have substantial impacts on the quality and accessibility of malaria diagnosis. These issues can be addressed by improving laboratory services. [ABSTRACT FROM AUTHOR]

Background: Nigeria's health sector aims to ensure that the right number of health workers that are qualified, skilled, and distributed equitably, are available for quality health service provision at all levels. Achieving this requires accurate and timely health workforce information. This informed the development of the Nigeria Health Workforce Registry (NHWR) based on the global, regional, and national strategies for strengthening the HRH towards achieving universal health coverage. This case study describes the process of conceptualizing and establishing the NHWR, and discusses the strategies for developing sustainable and scalable health workforce registries.Case Presentation: In designing the NHWR, a review of existing national HRH policies and guidelines, as well as reports of previous endeavors was done to learn what had been done previously and obtain the views of stakeholders on how to develop a scalable and sustainable registry. The findings indicated the need to review the architecture of the registry to align with other health information systems, develop a standardized data set and guidance documents for the registry including a standard operating procedure to ensure that a holistic process is adopted in data collection, management and use nationally. Learning from the findings, a conceptual framework was developed, a registry managed centrally by the Federal Ministry of Health was developed and decentralized, a standardized tool based on a national minimum data was developed and adopted nationally, a registry prototype was developed using iHRIS Manage and the registry governance functions were integrated into the health information system governance structures. To sustain the functionality of the NHWR, the handbook of the NHWR that comprised of an implementation guide, the standard operating procedure, and the basic user training manual was developed and the capacity of government staff was built on the operations of the registry.Conclusion: In establishing a functional and sustainable registry, learning from experiences is essential in shaping acceptable, sustainable, and scalable approaches. Instituting governance structures that include and involve policymakers, health managers and users is of great importance in the design, planning, implementation, and decentralization stages. In addition, developing standardized tools based on the health system's needs and instituting supportable mechanisms for data flow and use for policy, planning, development, and management is essential. [ABSTRACT FROM AUTHOR]

The development of high-rise buildings is a current trend in developed cities to answer the challenges of population growth, adding aesthetic value, and optimal use of land. Lagos particularly is one of the fastest growing cities in the world with Gross Domestic Product (GDP) and Internally Generated Revenue (IGR) in Nigeria, which suggests the need for multiple complex buildings, and the need for their maintenance cannot be overemphasised. This maintenance aspect requires tremendous work due to the complexity attached and several strategies springing up. Different studies reveal that both performance measurements and factors are essential aspects in evaluating maintenance management. Thus, this study seeks to explore performance elements that could improve maintenance. Personnel attitude, maintenance policy, maintenance review, and maintenance implementation were measured relative to computerised maintenance management system (CMMS) performance. With a random sampling technique, a sample of 134 Facility Management (FM) practitioners involved in high-rise office buildings was used to assess the effects of CMMS deployment. Results were analysed by Partial Least Squares Structural Equation Modelling (PLS-SEM). Findings from this study highlighted an indirect effect size and a large predictive relevance of personnel attitude as a critical factor for a smooth maintenance execution procedure of 12.59% and a standard operating procedure (SOP) of 15.64% on maintenance implementation to contribute 28.36% to performance. This paper uncovers the place of personnel attitude in determining effective maintenance. [ABSTRACT FROM AUTHOR]

Background: Adherence to standard precautions (SP) is critical to reducing the burden of nosocomial infections. Objective: We assessed the knowledge and practice of SP among healthcare workers (HCWs). Methodology: A cross-sectional study was conducted among HCWs in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi Anambra State, Nigeria using self-administered questionnaire and key informant interview. Results: Mean age and employment duration of subjects were 33.4±11.9 and 6.0 ± 6.7 years, respectively. Majority of the 341 HCWs had heard about SP (82.1%) and agreed that it should be applied to all patient care (78.0%). Only 45.7% of them correctly cited ≥2 components of SP. Two-third of participants reported that SP was poorly practiced in their unit mainly due to inadequate supply of materials (63.1%), inadequate staff training/retraining (62.2%), inadequate support by management (51.4%) and unavailable standard operating procedures (SOPs) on SP (37.8%). Compliance with SP and specifically, personal protective equipment (PPE) use were 65.1% and 76.2%, respectively. Profession (p=0.023), awareness about SP (p<0.001), SOP display in prominent places (p<0.001) and regular supply of running water (p<0.001) were significantly associated with SP compliance. Key informant interview revealed lack of written SP policies or its communication to HCWs, lack of training/retraining of HCWs and lack of materials required for SP practice. Conclusion: Knowledge of basic concept and practice of SP was not satisfactory among HCWs. Major barriers to SP were lack of materials, training and active support by hospital management. Awareness, SOP display in prominent places and regular supply of running water positively influenced SP compliance. Having written policies and communicating such to all HCWs, consistent supply of necessary materials, intensified training, and regular supervision are recommended. [ABSTRACT FROM AUTHOR]

Background: There is both higher mortality and morbidity from cancer in low and medium income countries (LMICs) compared with high income countries (HICs). Clinical trial activities and development of more effective and less toxic therapies have led to significant improvements in morbidity and mortality from cancer in HICs. Unfortunately, clinical trials remain low in LMICs due to poor infrastructure and paucity of experienced personnel to execute clinical trials. There is an urgent need to build local capacity for evidence-based treatment for cancer patients in LMICs.Methods: We conducted a survey at facilities in four Teaching Hospitals in South West Nigeria using a checklist of information on various aspects of clinical trial activities. The gaps identified were addressed using resources sourced in partnership with investigators at HIC institutions.Results: Deficits in infrastructure were in areas of patient care such as availability of oncology pharmacists, standard laboratories and diagnostic facilities, clinical equipment maintenance and regular calibrations, trained personnel for clinical trial activities, investigational products handling and disposals and lack of standard operating procedures for clinical activities. There were two GCP trained personnel, two study coordinators and one research pharmacist across the four sites. Interventions were instituted to address the observed deficits in all four sites which are now well positioned to undertake clinical trials in oncology. Training on all aspects of clinical trial was also provided.Conclusions: Partnerships with institutions in HICs can successfully identify, address, and improve deficits in infrastructure for clinical trial in LMICs. The HICs should lead in providing funds, mentorship, and training for LMIC institutions to improve and expand clinical trials in LMIC countries. [ABSTRACT FROM AUTHOR]

Background: The Institute of Human Virology Nigeria (IHVN) – Human Heredity and Health in Africa (H3Africa) Biorepository (I-HAB) seeks to provide high-quality biospecimens for research. This depends on the ability of clinical research sites (CRS) – who provide biospecimens – to operate according to well-established industry standards. Yet, standards are often neglected at CRSs located in Africa. Here, I-HAB reports on its four-pronged approach to empower CRSs to prepare high-quality biospecimens for research. Objectives: I-HAB sought (1) to assess a four-pronged approach to improve biobanking practices and sample quality among CRSs, and (2) to build human capacity. Methods: I-HAB partnered with two H3Africa principal investigators located in Nigeria and Ghana from August 2013 through to May 2017 to debut its four-pronged approach (needs assessment, training and mentorship, pilot, and continuous quality improvement) to empower CRSs to attain high-quality biospecimens. Results: Close collaborations were instrumental in establishing mutually beneficial and lasting relationships. Improvements during the 12 months of engagement with CRSs involved personnel, procedural, and supply upgrades. In total, 51 staff were trained in over 20 topics. During the pilot, CRSs extracted 50 DNA biospecimens from whole blood and performed quality control. The CRSs shipped extracted DNA to I-HAB and I-HAB that comparatively analysed the DNA. Remediation was achieved via recommendations, training, and mentorship. Preanalytical, analytical and post-analytical processes, standard operating procedures, and workflows were systematically developed. Conclusion: Partnerships between I-HAB and H3Africa CRSs enabled research sites to produce high-quality biospecimens through needs assessment, training and mentorship, pilot, and continuous monitoring and improvement. [ABSTRACT FROM AUTHOR]

Background. Persistent wild poliovirus transmission in Nigeria constitutes a major obstacle to global polio eradication. In August 2012, the Nigerian national polio program implemented a strategy to conduct outreach to underserved communities within the context of the country's polio emergency action plans.Methods. A standard operating procedure (SOP) for outreach to underserved communities was developed and included in the national guidelines for management of supplemental immunization activities (SIAs). The SOP included the following key elements: (1) community engagement meetings, (2) training of field teams, (3) field work, and (4) acute flaccid paralysis surveillance.Results. Of the 46 437 settlements visited and enumerated during the outreach activities, 8607 (19%) reported that vaccination teams did not visit their settlements during prior SIAs, and 5112 (11.0%) reported never having been visited by polio vaccination teams. Fifty-two percent of enumerated settlements (23 944) were not found in the existing microplan used for the immediate past SIAs.Conclusions. During a year of outreach to >45 000 scattered, nomadic, and border settlements, approximately 1 in 5 identified were missed in the immediately preceding SIAs. These missed settlements housed a large number of previously unvaccinated children and potentially served as reservoirs for persistent wild poliovirus transmission in Nigeria. [ABSTRACT FROM PUBLISHER]