The Nigeria Government Engagement with the Private Health Sector

In Nigeria, the healthcare sector is divided into primary health which is under the local government’s authority that oversees the Primary Health centers, secondary health which is under the supervision of the State Ministry of Health in charge of the State General Hospitals that cater to primary and secondary healthcare. Tertiary health is supervised by the Federal Ministry of Health that oversees the Federal Medical Centres, the Teaching Hospitals, and Specialist Training Centres. Not to be excluded from Nigeria’s healthcare system are the private clinics and the public-private partnership. The funding for healthcare systems is mainly budgetary allocations from the government. This systemic review was done using secondary literature, policy documents, peer-reviewed literature, and national newspapers, collected using search engines such as Google Scholar, PubMed, and Medline. The review was done over 2-month period from February-April 2024. The literature was arranged in order of relevance and the literature not used was kept aside. The World Health Organization (WHO) has recommended that 11% of a country’s budget be allocated to health. African countries that make up the African Union (AU) recommended that 15% of each member African country’s yearly budget should be committed to providing healthcare services to her citizens. Unfortunately, Nigeria has yet to attain either the WHO target or the AU target while committing an average, of 6% of her budgetary allocation to health. On the other hand, her neighbouring West African country Ghana, has met the average of 15% recommended by AU. The improved National Health Insurance Authority and the government’s partnership with the private health sector in Public-Private Partnership (PPP) is hoped and would improve access to affordable healthcare in general and oral healthcare in particular.

A Baseline Studies on the Nutritional Interplay between HIV Drugs and Kidney, Liver and Heart Indices in Patients Receiving HIV Treatment in North-East Nigeria

Human Immunodeficiency Virus (HIV) patients on Antiretroviral Therapy (ART) have shown impressive improvement and death rates have drastically reduced, even though complications still exist. This research carried out a baseline study to determine the nutritional interplay between HIV-drugs and kidney, liver, and heart indices among subjects undergoing HIV treatment and attending the Medical Out-Patient Department of a Federal Medical Center in the North-Eastern part of Nigeria, using a sample size of 50 individuals both male and female, who have been shown to be HIV positive and have been on ART for over 12 months. Anthropometric data was collected in triplicate, two from patients’ file, and one was measured directly and the average was obtained. The electrolytes were determined by the colorimetric method while total protein and albumin in blood concentration were determined by spectrophotometric method, but globulin and A/G ratio were determined by calculation. TC was determined using Spectrophotometric method while HDL was determined after precipitation of LDL with phosphotungstate and magnesium were calculated from Friedwaldís formular, and TG was measured using the colorimetric enzymatic method. The results showed that the mean systolic and diastolic blood pressure which were 119.9 mmHg ± 17.5, and 76. 6 mmHg ± 10.1 respectively, were with the range of the reference values. The mean body mass index was 25.1 ± 4.9;also within range of the reference value. Major indices from the liver function test were mean ALT which was 36.5 ± 29.4 with a reference value of 7 - 55 U/L;AST was 40.0 ± 32.3, with a reference value of 8 - 48 U/L. The mean value for albumin was 4.6 ± 7.1 with a reference range of 3.5 - 5.0 g/dl, these values also were within the reference range values. The electrolyte test showed all other electrolytes to be within the reference range values except for Zinc which was 19.5 μmol/L, with a normal range of 70 - 100 μmol/L and magnesium which was found to be 0.7 mEq/L, with a normal range of 1.5 - 2.0 mEq/L;Zinc and magnesium play vital roles in over 300 enzymatic reactions, and are known to be important in the immune response. Shortfalls in these minerals could compromise the patients’ recovery process and place them at risk of hearts conditions such as arrhythmia or heart attack among many other conditions. There is a need for an immediate review of these treatments in the direction of Zinc and magnesium, either by supplementation or by diet therapy. HIV patients undergoing ART should be placed under strict Zinc and magnesium-rich diet to avert untimely death among these patients. The controlled study should be done to ascertain the best approach to quell the residue of malnutrition in these patients in order to further improve their nutritional status.

The forehead flap:a valuable option in resource depleted environment

Aim:Reconstruction of orofacial soft tissue defect is often challenging and this is more difficult in resource challenged environment.This retrospective study highlights our experience with the use of forehead flap to overcome some of the challenges of orofacial reconstruction in a resource depleted environment.Methods:A 23-year retrospective analysis of all patients who had orofacial defect reconstruction using forehead flap in our department was undertaken.Information was sourced from patient’s case notes and operating theatre records.Data was analyzed using Statistical Package for Social Sciences(SPSS)version 16(SPSS Inc.,Chicago,IL,USA)and Microsoft Excel 2007(Microsoft,Redmond,WA,USA).Results:A total of 43 patients were managed within the period reviewed and consisted of 31(72.1%)males and 12(27.9%)females.Trauma 24(55.8%)accounted for most defect and the lip was the commonest site of defect.Complete forehead flap was used in 31(72.1%)of cases and when timing of defect repair is considered,delayed reconstruction was the preferred method.Postoperative complications was observed in 8(18.6%)patients and consisted of failed flap in 2(25.0%)patients,tumor recurrence in reconstructed site in 2(25.0%)patients and tumor occurrence in forehead flap donor site in 1(12.5%)patient.Conclusion:The forehead flap remains a reliable option in orofacial soft tissue defect reconstruction.It is easy to raise and can provide coverage for wide defects as far as the paramandibular and submandibular regions.Moreover,it does not require patient repositioning.