EFFECTIVENESS OF THE BALANCED SCORECARD IN IMPROVING STAFF PERFORMANCE, PATIENT OUTCOMES AND RESOURCE OPTIMIZATION IN LOW- AND MIDDLE-INCOME COUNTRIES: A SYSTEMATIC REVIEW.

Introduction/background: Low- and middle-income countries (LMIC) usually have weak health systems with poor health outcomes. The Balanced Scorecard (BSC) is a strategic management tool widely used to improve healthcare services by aligning operational activities with long-term objectives across four dimensions namely patient, financial, internal process, and learning and growth. While BSC has been adopted in various high-income countries with positive impacts, its effectiveness in improving public health systems in LMIC is still unclear.

Nutritional status of school children in South-west Nigeria: Inferences from a national homegrown school feeding programme.

Background: The School Feeding Programme if properly executed has the capacity to improve the nutritional status of the school children.

Objective: To assess the nutritional status of school children in Ondo State Nigeria given that the National Home-Grown School Feeding Programme (NHGSFP) has been operational in the state for over five years.

Methods: This was a descriptive cross-sectional study.

Response to Letter to the Editor.

The authors respond to the comments raised in the letter regarding Adeniji and Obembe's article on catastrophic health expenditures in sub-Saharan Africa.

Prevalence and trend of TB/HIV co-infection in Suhum Municipality, Ghana.

Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) infections have been identified to form a deadly synergy that is posing serious threats to human health and economic development particularly in Sub-Saharan Africa (SSA). Six years into the end TB strategy, it is imperative to assess HIV detection rate among TB patients in order to determine the prevalence as well as establish the temporal trend of the co-morbidity in the Eastern region of Ghana where the magnitude of HIV and TB/HIV co-morbidity have consistently been noted to be high. The study reviewed records of 840 TB patients retrospectively from January 1, 2009 to December 31, 2018 in Suhum Municipal.

Cardiovascular Disease and Its Implication for Higher Catastrophic Health Expenditures Among Households in Sub-Saharan Africa.

Cardiovascular diseases (CVDs) impose an enormous and growing economic burden on households in sub-Saharan Africa (SSA). Like many chronic health conditions, CVD predisposes families to catastrophic health expenditure (CHE), especially in SSA due to the low health insurance coverage. This study assessed the impact of CVD on the risks of incurring higher CHE among households in Ghana and South Africa.

The microeconomic impact of out-of-pocket medical expenditure on the households of cardiovascular disease patients in general and specialized heart hospitals in Ibadan, Nigeria.

Background: Cardiovascular diseases (CVDs) present a huge threat to population health and in addition impose severe economic burden on individuals and their households. Despite this, there is no research evidence on the microeconomic impact of CVDs in Nigeria. Therefore, this study estimated the incidence and intensity of catastrophic health expenditures (CHE), poverty headcount due to out-of-pocket (OOP) medical spending and the associated factors among the households of a cohort of CVDs patients who accessed healthcare services in public and specialized heart hospitals in Ibadan, Nigeria.

Factors contributing to household wealth inequality in under-five deaths in low- and middle-income countries: decomposition analysis.

Background: The burden of under-5 deaths is disproportionately high among poor households relative to economically viable ones in developing countries. Despite this, the factors driving this inequality has not been well explored. This study decomposed the contributions of the factors associated with wealth inequalities in under-5 deaths in low- and middle-income countries (LMICs).

Exploring the Essential Stroke Care Structures in Tertiary Healthcare Facilities in Rivers State, Nigeria.

This study evaluated the essential stroke care structure available in the two Tertiary Health Facilities in Rives State, Nigeria. This was a descriptive survey involving the (checklist/questionnaire) developed by the World Stroke Organisation to obtain information about the available essential stroke care structure (facilities, equipment, personnel and management protocol) at the two tertiary health facilities (RSUTH & UPTH). The study gathered relevant information, which was summarised into tables and graphs using Microsoft Excel 2016.

Patient's Satisfaction With Quality of Care at a National Health Insurance Clinic at a Tertiary Center, South-South Nigeria.

Introduction: Patient satisfaction is a commonly used indicator for measuring the quality of health care. This study assessed patients' satisfaction with the quality of care at the National Health Insurance Scheme (NHIS) clinic in a tertiary facility.

Methods: It was a descriptive cross-sectional study in which 379 systematically selected participants completed an interviewer-administered, semi-structured questionnaire.

Burden of out-of-pocket payments among patients with cardiovascular disease in public and private hospitals in Ibadan, South West, Nigeria: a cross-sectional study.

Objective: Given that the mechanism for financial protection is underdeveloped in Nigeria, out-of-pocket (OOP) payment for treating cardiovascular disease could impose substantial financial burden on individuals and their families. This study estimated the burden of OOP expenditures incurred by a cohort of patients with cardiovascular disease (CVD) in Ibadan, Nigeria.

Design And Settings: This study used a descriptive cross-sectional study design.

Factors Affecting Utilization of the National Health Insurance Scheme by Federal Civil Servants in Rivers State, Nigeria.

The National Health Insurance Scheme (NHIS) of Nigeria was established in 2005. This study assessed the utilization of health care and associated factors amongst the federal civil servants using the NHIS in Rivers state. This was a descriptive cross-sectional study using self-administered questionnaires.

Caring for Children with Congenital Heart Diseases:Economic Burden of Pre-Surgical Management on Nigerian Families.

Background And Objectives: Managing children with Congenital Heart Disease (CHD) attracts enormous cost especially in resource-poor settings like Nigeria. This study sought to determine the healthcare costs of pre-surgical management of CHD and describe its catastrophic effects on households.

Methods: Using a semi-structured interviewer-administered questionnaire, caregivers of children with CHD were interviewed.

The bypassing of healthcare facilities among National Health Insurance Scheme enrollees in Ibadan, Nigeria.

Background: Bypassing occurs when patients knowingly visit a health facility other than the one they live nearest to. In Ibadan, southwest Nigeria, the majority of enrollees in the National Health Insurance Scheme (NHIS) receive medical care in just 12% of the available NHIS-accredited facilities. Given that enrollees access healthcare services at highly subsidized rates under the scheme, this study aimed to determine the factors responsible for the observed distribution of enrollees across these health facilities.

Consumption function and price elasticity of tobacco demand in Nigeria.

Introduction: Tobacco consumption remains a major threat to population and public health globally. In response, an increase in the taxes levied on tobacco products has been found to be an effective intervention for controlling their use. In Nigeria, studies assessing the impact of excise taxes on tobacco use are less advanced.

Enrollees' Knowledge and Satisfaction with National Health Insurance Scheme Service Delivery in a Tertiary Hospital, South West Nigeria.

Background: Social health insurance scheme provides a platform for mobilizing revenue for health and enhances universal health-care coverage. In addition, knowledge about patients' satisfaction with health care under the scheme will help in identifying gaps and provides evidence toward strengthening the scheme. This study assessed enrollees' knowledge about the National Health Insurance Scheme (NHIS) and satisfaction with health services provided under the scheme.

Protective Effect of Azadirachta indica and Vitamin E Against Arsenic Acid-Induced Genotoxicity and Apoptosis in Rats.

Sodium arsenite (NaAsO) is one of the major environmental toxicants with severe toxicological consequences in some developing and developed countries. Rats in Group A received normal saline. Genotoxicity and apoptosis were induced by single intraperitoneal injection of 10 mg/kg sodium arsenite to rats in Groups B-F.

What factors influence the average length of stay among stroke patients in a Nigerian tertiary hospital?

Introduction: Increased emphasis is being laid on ensuring that health resources are efficiently utilized, especially in resource-constrained settings such as in Nigeria. One of the main indices of how efficiently a health institution is being run is Length of Stay (LOS), which is likely to be higher in chronic diseases such as stroke and diabetes. Stroke is a chronic disease that is currently on the rise in Low and Middle income countries (LMICs) who are also characterized by constraint of health resources.

Global analysis of strategies to tackle antimicrobial resistance.

Background: Antimicrobial resistance (AMR) is a global public health issue driven by inappropriate use of antimicrobials resulting in decreased efficacy on the background of an extremely limited pipeline for new antibiotics. We sought to analyse the effectiveness of key policies and strategies in tackling AMR globally and identify gaps in these.

Method: The scope, magnitude, history and drivers of AMR were reviewed using supporting evidence.

Self-referral patterns among federal civil servants in oyo state, South-Western Nigeria.

Introduction: Primary health care is widely accepted as the first point of care; yet, individuals requiring healthcare engage in self-referrals to higher levels of care thereby by-passing primary care. Little is known of the extent to which self-referrals are carried out when care is needed. This study thus sought to determine the prevalence of self-referral, its patterns and factors influencing self-referrals amongst federal civil servants in Southwestern Nigeria.

A cost analysis of road traffic injuries in a tertiary hospital in south-west Nigeria.

This study examines the burden of road traffic injuries (RTIs) among road crash victims in a tertiary hospital in Ibadan, Nigeria. The study adopted a purposive sampling method to obtain primary data. Interview was done with 266 RTI victims who were admitted to the University College Hospital, Ibadan and discharged between March and May, 2015, using a structured questionnaire.

Status of emergency obstetric care in a local government area in south-south Nigeria.

This study assessed the status of the availability and performance of emergency obstetric care (EmOC) in 12 functional public health facilities out of the existing 19 in Gokana Local Government Area of Rivers State in south-south Nigeria, prior to the midwives service scheme (MSS) launch in 2009. No facility qualified as basic EmOC, while one had comprehensive EmOC status. Signal functions that required supply of medical consumables were performed by more facilities than services that required special training, equipment and maintenance.