Olayinka O. Ayankogbe

Family medicine training in sub-Saharan Africa: South–South cooperation in the Primafamed project as strategy for development

Background. Health-care systems based on primary health care (PHC) are more equitable and cost effective. Family medicine trains medical doctors in comprehensive PHC with knowledge and skills that are needed to increase quality of care. Family medicine is a relatively new specialty in sub-Saharan Africa. Objective. To explore the extent to which the Primafamed South–South cooperative project contributed to the development of family medicine in sub-Saharan Africa. Methods. The Primafamed (Primary Health Care and Family Medicine Education) project worked together with 10 partner universities in sub-Saharan Africa to develop family medicine training programmes over a period of 2.5 years. A SWOT (strengths, weaknesses, opportunities and threats) analysis was done and the training development from 2008 to 2010 in the different partner universities was analysed. Results. During the 2.5 years of the Primafamed project, all partner universities made progress in the development of their family medicine training programmes. The SWOT analysis showed that at both national and international levels, the time is ripe to train medical doctors in family medicine and to integrate the specialty into health-care systems, although many barriers, including little awareness, lack of funding, low support from other specialists and reserved support from policymakers, are still present. Conclusions. Family medicine can play an important role in health-care systems in sub-Saharan Africa; however, developing a new discipline is challenging. Advocacy, local ownership, action research and support from governments are necessary to develop family medicine and increase its impact. The Primafamed project showed that development of sustainable family medicine training programmes is a feasible but slow process. The South–South cooperation between the ten partners and the South African departments of family medicine strengthened confidence at both national and international levels.

Determinants of young people’s sexual behaviour concerning HIV and AIDS in the practice population of a university health centre in Lagos, Nigeria

Abstract Background AIDS has been a scourge of universities in Africa for a long time. This study was launched at ground-level to fight the dreaded disease by concentrating on young people and to counter the ignorance that surrounds the disease even in numerous African universities. This study of the student community was carried out by family doctors at the University Health Department to determine the prevalence of the determinants of young peoples reproductive health behaviour. Objectives This study is aimed at determining young peoples sexual behaviour concerning HIV and AIDS in the practice population of a university in Lagos, Nigeria. Method Self-administered 63-item questionnaires were distributed amongst 2000 randomly selected students of the University of Lagos, Lagos, Nigeria in September 2005, using a semi-structured form of the Comprehensive Youth Survey questionnaire, developed by FOCUS (led by Pathfinder International, Futures Group International and Tulane University School of Public Health). Results The age distribution of the respondents was designated in the age groups of 15–19 years (15.8%), 20–24 years (60.1%), 25–29 years (19.6%), 30–34 years (2.8%). Demographics of note were that 88.3% of the fathers of the respondents were literate and that 94.5% of the fathers earned more than one US

Distribution of health facilities in Nigeria: Implications and options for Universal Health Coverage

per day. The majority of the respondents (99.1%) indicated adherence to one religious faith or the other and 58.8% believed definitely that religion shaped their attitudes about sexual intercourse and sexuality. More than half (64.0%) denied having had sex at all in the three months preceding the study. Furthermore, 68.8% affirmed that it was common amongst friends of their age to use condoms. A significant number of respondents (65.5%) thought that their friends have drunken alcohol. Almost all of the respondents (94.3%) had a positive perception of their family. Conclusion The Programming for HIV and AIDS Reduction on university campuses in Africa should be conducted comprehensively rather than monothematically and should, take into consideration the five thematic areas of behaviour change communication amongst young people concerning their reproductive health.

ICPC-2 defined pattern of illnesses in a practice-based research network in an urban city in West Africa

BACKGROUND Nigeria is considering adopting Universal Health Coverage (UHC) as an official policy target to ensure access to quality health care services for her population without financial hardship. To facilitate discussion on the topic, the President of Nigeria convened a UHC summit in March 2014 to discuss Nigerias options and strategies to achieve UHC. A strategy for achieving UHC requires analysis of the available infrastructure to deliver the services. We review the geographic and sectoral distribution of health facilities in Nigeria and discuss implications on the UHC strategy selected. METHODS Secondary analysis of data from the Federal Ministry of Healths facility register was performed to assess the geographic and sectoral distribution of health facilities in Nigeria. Additionally, an extensive literature review was conducted to understand UHC strategies used by various countries and the associated health facility requirements. RESULTS Primary health facilities make up 88% of health facilities in Nigeria while secondary and tertiary health facilities make up 12% and 0.25%, respectively. There are more government-owned health facilities than privately owned health facilities (67% vs 33%). Secondary health facilities are predominantly privately owned. The ratio of public to private health facilities is much higher in the northern part of the country than in the southern part. CONCLUSIONS The distribution of health facilities across Nigeria is nonuniform. As such, a UHC strategy must be responsive to the variation in health facility distribution across the country. Additional investments are needed in some parts of the country to improve access to tertiary health facilities and leverage private sector capacity.

Conceptual and Contextual Paradigm of the Family as a Unit of Care

ABSTRACT Background In optimising the health of individuals, families and communities, attention should be focused on the clinical processes at medical facilities based in the community. Networks of general and family practices offer this unique opportunity. In establishing the burden of diseases in a community, the traditional classification used is the International Classification of Diseases. This study uses the International Classification of Primary Care. The aim of the study was to document the pattern of illnesses presenting in general/family physician practices in a city in Nigeria. Method A nine-item interviewer-administered questionnaire containing closed-ended questions was administered to 881 patients presenting at 67 private general/family practice clinics/hospitals in 15 local government areas of urban Lagos by trained general practitioners, using the ICPC-2 pager, which asks for socio-demographic information, reasons for the presentation, and the provisional diagnosis within a 24-hour period. Results Children younger than five years accounted for 20.4% of those presenting, while 25- to 39-year-olds accounted for 44.4%. Geriatric patients (60 years and older) comprised 3.0%. Social classes 1 to 4 accounted for 36.8% of the patients, while social classes 5 to 8 accounted for 43.2%. Of all the patients, 18.7% earned less than 1 US

Pattern of Obstetric Mortality In A Voluntary Agency Hospital In Abeokuta South West Nigeria

/day. The seven topmost reasons for visiting the medical practice/clinic/hospital were: General and unspecified 23.1%; pregnancy, child bearing and family planning 13.9%; respiratory problems 10.9%; problems related to the digestive system 9.6%; musculoskeletal 5.6%; Skin 4.4%; and neurological problems 4.2%. Conclusion The skills of general/family practitioners in West Africa and on the rest of the continent should concentrate on general and unspecified illnesses, routine and emergency maternal and child care, and problems related to the respiratory, digestive, musculoskeletal, skin and neurological systems.