Validation of the Donabedian Model of Health Service Quality in Selected States in Nigeria

BACKGROUND

Every citizen of a nation has the basic constitutional right to quality health care. However, there is a dearth of literature on the validity and reliability of the Donabedian conceptual model of health service quality in Nigeria.

AIM

The current paper focused on validating the Donabedian model of quality health service in selected states in Nigeria.

METHODS

This is a prospective study of 479 health workforce consisting of 204 physicians, 180 nurses, and 95 health information management officers in three geopolitical zones in Nigeria. A multistage sampling technique was used to select respondents. Data were collected through a semi-structured questionnaire with a response rate of 87%. The overall reliability test of the variables yielded α =0.938. Data gathered was analyzed descriptively for the socio-demographic characteristics and Relative Importance Index (RII) to rank the criteria according to their relative importance.

RESULTS

Findings from the study reveal that the (RII) of all the items in the study instrument exceeded the universally acceptable threshold of 0.5, indicating a high level of care in Federal Tertiary Hospitals in Nigeria with regards to structure, process, and outcomes.

CONCLUSION

The study underscored the need for the adoption of the Donabedian model in the three other geopolitical zones in Nigeria for a generalized conclusion on the validity and reliability of the Donabedian conceptual model of health service quality. We recommended that research studies on health service quality should be anchored on Donabedian conceptual model as a way to increase awareness of the relevance of the model in improving clinical care in Nigeria.

Self-Management Practices among Diabetic Women of Reproductive Age in a Tertiary Hospital, Osun State, Nigeria

PURPOSE: To investigate self-management practices of diet, exercise, medication, and self-monitoring of blood glucose among diabetic women of reproductive age in OAUTHC. METHODS: This study employed a descriptive design. A total enumeration of 185 diabetic women of reproductive age in a tertiary hospital in Osun state constituted a sample size. A self-structured questionnaire with 40 items under 5 sections and a check list for recording glyceamic control measures were used for data collection. The data retrieved from the respondents were analyzed using the Statistical Package for Social Sciences (SPSS) version 23. Results were presented as frequencies, mean and standard deviation. RESULTS: The findings from the study revealed a moderate level of dietary intake (mean = 2.80), moderate physical exercise (mean = 2.80), moderate medication intake (mean = 2.13) and moderate self-management practices (mean = 2.85) on 5points Likert scale. DISCUSSION: The findings of the study were compared with previous studies and the researchers showed how the relevant theories that guided the study were used to explain the findings. CONCLUSION: It was concluded that most of the women had moderate practice of diet, exercise, medication and self- monitoring of blood glucose as shown in their past medical history.

Health workforce and governance: the crisis in Nigeria

BACKGROUND

In Nigeria, several challenges have been reported within the health sector, especially in training, funding, employment, and deployment of the health workforce. We aimed to review recent health workforce crises in the Nigerian health sector to identify key underlying causes and provide recommendations toward preventing and/or managing potential future crises in Nigeria.

METHODS

We conducted a scoping literature search of PubMed to identify studies on health workforce and health governance in Nigeria. A critical analysis, with extended commentary, on recent health workforce crises (2010-2016) and the health system in Nigeria was conducted.

RESULTS

The Nigerian health system is relatively weak, and there is yet a coordinated response across the country. A number of health workforce crises have been reported in recent times due to several months' salaries owed, poor welfare, lack of appropriate health facilities and emerging factions among health workers. Poor administration and response across different levels of government have played contributory roles to further internal crises among health workers, with different factions engaged in protracted supremacy challenge. These crises have consequently prevented optimal healthcare delivery to the Nigerian population.

CONCLUSIONS

An encompassing stakeholders' forum in the Nigerian health sector remain essential. The national health system needs a solid administrative policy foundation that allows coordination of priorities and partnerships in the health workforce and among various stakeholders. It is hoped that this paper may prompt relevant reforms in health workforce and governance in Nigeria toward better health service delivery in the country.