Beyond drug treatment: a cross-sectional assessment of palliative care services for people living with HIV/AIDS at public health facilities, Abuja, Nigeria

AbstractPhysicians, nurses and allied health staff play very vital roles in addressing palliative care (PC) needs of people living with HIV/AIDS (PLWHA). The healthcare professionals’ experiences determine the success of palliative care delivery. There is paucity of data on palliative care for PLWHA. For this reason, we assessed the knowledge, attitude and practice of palliative care for PLWHA and associated factors among health care professionals.We conducted a cross-sectional descriptive study among healthcare workers (HCWs) in public health facilities in the Federal Capital Territory, Nigeria between February and May, 2017. Multistage sampling technique with proportionate-to-size allocation was used to determine facility sample size and HCWs per professional discipline. Data were collected with questionnaires adapted from Palliative Care Quiz for Nursing, Frommelt Attitude toward Care of the Dying and practical questions adapted from PC standard guidelines. Univariate analysis was done to compute frequencies and proportions. Odd’s ratios were calculated to assess the statistical association between variables and P-value ≤ 0.05 was considered significant. Multivariate analysis was conducted on variables that were significant with bivariate analysis. Epi-Info software was used for statistical analyses.The mean age of the 348 participants was 37.5 years (SD: ±8.9) and 201 (57.8%) were female. Thirty-six (10.3%) participants had good knowledge, 344 (98.9%) had favourable attitude and 90 (25.9%) had good practice of PC for PLWHA. Major determinants of good knowledge of PC include being a doctor (aOR = 2.70; 95%CI: 1.28 - 5.56). Determinants of good practice of palliative care include possessing a minimum of a bachelor degree (aOR=2.30; 95%CI : 1.05-5.08) and practicing in a tertiary hospital (aOR=6.67; 95%CI : 3.57-12.5).HCWs had favourable attitude towards PC for PLWHA despite an overall poor knowledge and practice. We recommended quality in-service training and continuous education on palliative care for HCWs.

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Effects of COVID-19 on Maternity Services in Selected Public Health Facilities from the Priority MNCH Counties in Kenya

Nursing and Health Care ◽

10.33805/2573.3877.154 ◽

2021 ◽

pp. 6-10

Author(s):

Matiang’i M ◽

Okoro D ◽

Ngunju P ◽

Oyieke J ◽

Munyalo B ◽

...

Keyword(s):

Public Health ◽

Open Data ◽

Health Facilities ◽

P Value ◽

Chi Square ◽

Cross Sectional ◽

Maternity Services ◽

Neonatal Deaths ◽

Public Health Facilities ◽

Care Services

Background: Covid-19 is a rapidly evolving pandemic, affecting both developed and developing countries. Maternity services in low resource countries are adapting to provide antenatal and postnatal care midst a rapidly shifting health system environment due to the pandemic. Objectives: The objective of the study was to determine the effect of COVID-19 on maternity services in selected levels III and IV public health facilities within five MNCH priority counties in Kenya. Method: A two-stage sampling approach was used to select health facilities. The study employed cross-sectional and observational retrospective approaches. Data was collected from Maternity facilities managers and registers in a total of 28 levels III and IV facilities. Open Data Kit (ODK) formatted tools were used to collect data. Data was analysed using STATA Version 15. Descriptive statistics, Chi-square and fishers exact tests were used to analyse data. For all tests, a p-value <0.05 was taken as statistically significant. Results: A total of 31 midwifery managers were interviewed and a total of 801 maternity records (400 before COVID and 401 during COVID-19 pandemic) were reviewed from levels III (66%) and IV (34%) facilities. The managers indicated that Antenatal Care (ANC) visits had reduced (67.9%), referrals of mothers with complications got delayed (29%), mothers feared delivering in hospitals (64.5%). The managers reported that New-born care services were most affected by the pandemic (54.8%) followed by ANC services (45.2%). Facility records revealed a 19% higher ANC attendance before COVID than during the pandemic. Neonatal deaths increased significantly during Covid-19 period ((P=0.010) by 38%. Live births significantly increased during the pandemic (p <0.0001). Significant increases also observed in mothers who developed labour complications (p=0.0003) and number of mothers that underwent caesarean sections (p <0.001) during the pandemic period. Conclusion: The fear of the Covid-19 pandemic had a cross-cutting effect on utilisation of maternity services.

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