Background and Objective: The informal sector population in developing nations has low health coverage from Community Based Health Insurance (CBHI) and problems such as limited awareness about the potential impact of prepayment health financing and the limited resources to finance health care can impede success. This study assessed the community based health insurance scheme uptake and determinants in Olowora, Lagos State. Methods: This was a descriptive cross sectional study carried out in July 2010 in all households of 12 out of 41 streets in Olowora,by multistage sampling. Four hundred and sixteen interviewer-administered questionnaires were completed and returned. Analysis was by Epi- info version 3.5.1 software. Results: Although 75.5% of respondents were aware of the Community Health Insurance scheme at Olowora, just about half (49.5%) of them had good knowledge of the scheme. A substantial proportion (44.2%) of respondents did not believe in contributing money for illness yet to come, and majority (72.3%) of such respondents prefers payment for health care when ill. While about half (53%) of respondentshad enrolled into the community health insurance scheme, 45.6% of those who had not enrolled were not aware of the scheme. Lack of money was the main reason (51.5%) why some enrollees had defaulted. Conclusion: The study identified information gaps and poor understanding of the scheme as well as poverty as factors that have negatively affected uptake. The scheme management has to re-evaluate its sensitization programmes, and also strengthen marketing strategies with special emphasis on the poor.

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Background and Objective: Negative outcomes in patient care such as death can be an unpleasant experience not only for the affected relatives but also for the members of health care team involved in caring for the patients. If the death is unexpected, doctors are particularly affected as they often lead the health team and have had to make important decisions in the course of the patient care. The impact of such experience may be significant on the emotional well being of doctors'. This study aimed to determine the effects of unexpected death of patient on doctors in various specialties of a teaching hospital in Lagos. Methods: The study was cross-sectional and descriptive in nature. The subjects were specialist doctors or residents in training from 7 clinical departments in the Lagos University Teaching Hospital. Using a convenience sampling, a total of 143 doctors were included in this survey. All respondents completed a socio-demographic questionnaire which collected bio-data details, details of professional practice and experience related to patient death. Traumatic symptom recall was assessed using a Post Traumatic Stress Disorder (PTSD) Symptom Recall questionnaire. Results: Respondents were 143 in number, 56.6% from surgical specialties and 43.4% were of the non-surgical specialties. Over 95% were unaware of any institutional guidelines in place for directing how to handle challenges faced following patient loss. Over 94.4% admitted to loosing a patient suddenly before and about 69% had experienced such a loss in the past 1year. About half (58.7%) felt their performance was affected following sudden death of a patient. In exploring for retrospective recall experiences of symptoms following patients loss, 11(7.7%) of the doctors met the criteria suggestive of past PTSD symptoms. Almost half (43.4%) of the subjects desired any kind of support after patients death. Others expressed feelings of incompetence (25.9%), 56.6%, needed to use medication and 42% had appetite problems after the loss. There were no statistically significant differences between surgical and non-surgical specialties. Conclusion: There are mental health and emotional effects following unexpected patient death among doctors. Routes for support and institutional guidelines are encouraged in tertiary institutions of care. Such guidelines should be made available for doctors and other members of the health team.

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Background and Objective: Nigeria has one of the highest maternal and child death rates in the world. Postnatal care is one of the major interventions recommended to reduce maternal and newborn deaths globally. The aim of this study is to determine the utilization of postnatal health services and identify the factors which affect this utilization among mothers of under-fives in Lagos. Methods: This was a cross-sectional study among women of child bearing age in Lagos using structured, interviewer-administered questionnaire. Six hundred women selected by multi stage sampling method were interviewed and data analyzed with EPI-info Version 3.5.1. Results: Two thirds (66.2%) of the respondents utilized postnatal health services. Factors which significantly influenced postnatal health services utilization were: number of children (p=0.031), maternal education (p=0.001), religion (Fisher's exact p= 0.004), number of antenatal care visits (p<0.001) and skilled attendance at birth (p<0.001). Maternal occupation and time taken to the health facility were not significant determinants of utilization. Conclusion: Utilization of postnatal care services was high but not optimal. Interventions to increase family planning use and improve maternal educational status should be undertaken as well as increasing use of focused antenatal care and skilled delivery services.

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Background and Objective: Adequate antenatal care and skilled obstetric assistance during delivery are important strategies that significantly reduce maternal mortality and morbidity. This study aimed to assess the awareness, attitudes and perception of orthodox health care centres among pregnant women patronizing traditional birth attendants in Mushin and Lagos Island local government areas of Lagos state. Methods: The survey was a community-based descriptive cross-sectional survey that employed interviews to collect data from 300 antenatal care attendees of seven traditional birth attendants' clinics in Lagos Island and Mushin local government areas between December 2010 and January 2011 using a structured questionnaire. Results: The women ranged in age from 17-43 years with a mean age of 27.6 ± 4.6 SD and most of them were primigravidas (41.5%), married (88%) and traders (44.1%). Most of the women (61%) and their husbands (56.7%) had completed their secondary education. The majority (81.7%) of respondents were aware of a modern health facility around where they lived, the most commonly known being private hospitals (43.7%). Most of them (67.3%) were aware of antenatal care services provided at these facilities but only 31.3% had ever made use of the antenatal services. Most of the women were not willing to deliver in hospitals because they didn't like the attitude of the health workers (37.3%) and because it was far from their houses (12.7%); the majority (75%) preferring to deliver with traditional birth attendants because they give good service. However, almost all (98.5%) of the women that had children took them to the orthodox health facilities for immunization, primarily the primary health care centers (55.7%). Conclusion: Traditional birth attendants are patronized by a wide array of women who are aware of orthodox health facilities but have a negative attitude towards their services. Improvements in communication and interpersonal skills of modern health care providers and collaboration between modern health care providers and traditional birth attendants are recommended in order to have better maternal and child outcomes in Nigeria.

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Background and Objective: Non - communicable diseases (NCDs) are the leading cause of morbidity and mortality in many developed and developing countries. Nigeria is experiencing an epidemiological transition with a double burden of communicable and non communicable diseases. This study was carried out to assess the knowledge, attitude and practice of bankers in Lagos Island Local Government Area on healthy lifestyle in relation to the prevention and control of NCDs. Material and Methods: Cross sectional descriptive design was employed. Multistage sampling technique was used to collect information from 260 consenting bankers using pretested, interviewer administered questionnaires. The questionnaire collected information on biodata, knowledge, attitude and practice. Data obtained was analyzed using Epi info version 3.5.3 Results: The mean age of 260 the respondents was 33.5 ± 5.7 years. Only 26.9% had good knowledge of healthy lifestyle while 87.3% had good attitude towards healthy lifestyle. Only 9.7% consumed healthy diet, while majority 88.0% and 72.7% had good practice regarding tobacco smoking and alcohol consumption respectively. Gender was a significant predictor of alcohol use, 55.8% of the study population engaged in adequate physical activity, while very few (3.8%) of the respondents engaged in healthy lifestyle. Conclusion: Although the bankers had good attitude towards healthy lifestyle, their knowledge and practice of healthy living was poor. The management of every bank should invest in periodic health promotion and wellness programs that will promote all the components of healthy living for their employees.

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