American Journal of Public Health Research

To determine the incidence of maternal mortality associated with non utilization of obstetric services and how socio-demographic and medical factors influence the deaths of pregnant women. A retrospective study of information extracted from hospital records on live birth, antenatal attendance, age at death, parity, educational level and cause of death was reviewed, the study covered data from thirty General hospitals in both urban and rural areas in Kano state for a period of 6 years from 1^st January 2005 to 31^st December 2010. Data collected was analyzed for pattern of antenatal care, hospital live delivery, age at death, obstetric causes of death and maternal mortality ratio. There were 2,310,727 antenatal attendance 1,886,932 live deliveries and 3,062 maternal death during the period under review given a maternal mortality ratio (MMR) of 1625/100,000 live deliveries. It was also discovered that mean age at death for pregnant women for urban areas was 28.8 years and rural 27.6 years. Both antenatal and hospital live deliveries had irregular pattern. The major direct causes of death in urban area was eclampsia and bleeding cases while in rural areas bleeding cases followed by eclampsia and obstructed labor and then anemia were more prevalent.

American Journal of Public Health Research. 2014, 2(2), 62-67. DOI: 10.12691/ajphr-2-2-5
Pub. Date: April 15, 2014

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Can Leadership Behaviour Affect Quality & Safety (Q & S) in Complex Healthcare Environments?

by Peter Bohan

Original Research

It is clear that leadership behaviour of executives in healthcare is considered to be of prime importance (Burke 2006), with key elements such as strategy, structure and process being vital for team and organisational effectiveness (Yammarino et al, 2008). This research identified that the executives interviewed in a Northwest acute Trust were clear on what type of leadership behaviour is expected of them; seeing themselves as transformational, setting clear goals and expecting the best from their teams. They also identified elements of autocratic and transactional leadership behaviour were required frequently in the achievement of targets such as waiting times and productivity. There was an acute recognition of the tensions between Q&S and the target-driven approach required by commissioners and the current financial climate within the National Health Service. External drivers for Q&S included losing foundation trust status which may result in loosing independence and being placed under special measures by monitor and receiving financial penalties. It was acknowledged the commissioners of services have huge power and influence over the direction of where the organisation concentrates effort to influence policy which could also provide tension with the Q&S strategy. Finance and ‘doing more for less’ are constant themes, with competition to keep Q&S on the agenda. Q&S has a reputation for being problematic, many executives believed changing the organisational culture requires evaluation and effective engagement of staff. The aim of this paper is to analyse the complex relationships between leadership behaviour and Q&S. The experiences of executives provide insight into the Q&S agenda within Healthcare through change and dealing with complex issues including targets, motivation, behaviour, leadership, change and organisational culture.

American Journal of Public Health Research. 2014, 2(2), 56-61. DOI: 10.12691/ajphr-2-2-4
Pub. Date: April 08, 2014

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Glucose-6-Phosphate Dehydrogenase (G6pd) Deficiency and Sickle Cell Trait among Blood Donors in Nigeria

by Omisakin C.T, Esan A.J, Ogunleye A.A, O. Ojo-Bola, Owoseni M.F and Omoniyi D.P

Original Research

This study is being aimed to determine the prevalence of glucose-6-phosphate dehydrogenase deficiency and sickle cell trait among blood donors. Blood donation from glucose-6-phosphate dehydrogenase (G6PD)-deficient and sickle cell trait (SCT) donors might alter the quality of the donated blood during processing, storage or in the recipient′s circulatory system. It has been proposed that several biochemical changes and depletion in the antioxidant defense system occur on storage of G6PD-deficient blood. Red blood cells collected from sickle cell trait donors frequently occlude white blood cells reduction filters; the main cause of this filtration failure is haemoglobin polymerization. A total of 314 blood donor samples were collected from prospective and healthy blood donors after proper screening. Glucose-6-Phosphate dehydrogenase was determined using two standard methods; methaemoglobin reduction test and fluorescent spots test; haemoglobin variants were determined using cellulose acetate electrophoresis at alkaline PH 8.6. Out of the 314 blood donors, 80 (25.5%) were G6PD deficient, 104 haemoglobin variants AS, AC and SC were 82 (78.8%), 21 (20.2%) and 1 (1.0%) respectively. Commercial blood donors had highest G6PD deficient and highest haemoglobin variants. Age group 25-34 had highest G6PD deficient prevalence while age group 15-24 had highest haemoglobin variants. Transfusion with G6PD-deficient blood carries a potential risk of hemolytic complications, especially if it is used for exchanged blood transfusion in neonates. On the other hand, the blood donated from SCT donors, apart from its undesired effects if transfused to sickle cell disease patients, also leads to WBC filtration failure.

American Journal of Public Health Research. 2014, 2(2), 51-55. DOI: 10.12691/ajphr-2-2-3
Pub. Date: April 06, 2014

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Bacterial Contamination and Public Health Risk Associated with the Use of Banks’ Automated Teller Machines (Atms) in Ebonyi State, Nigeria

by Stanley Chukwudozie Onuoha and Kayode Fatokun

Original Research

Contamination of environmental objects and surfaces is a common phenomenon. Human beings have a marked tendency to pick up microorganisms from environmental objects, and specially the hand has been shown to play a role in the transmission of organisms. The ATM machine is likely to be contaminated with various microorganisms due to their vast contact by multiple users. This study was aimed to investigate ATM as a potential source of bacterial contamination. The study was conducted from August to October, 2013 and it involved collection of samples by using cotton swabs, culturing on different media such as nutrient agar, MacConkey as well as identifying the isolated organisms using its colonial, morphological and biochemical characteristics. The results of the study indicated that some of the Automated Teller Machines were positive for the presence of microorganisms as indicated: Staphylococcus auerus 4 (28.57%), Coagulase-negative staphylococcus 3 (21.43%), Streptococcus species 2 (14.29%), Pseudomonas species 1 (7.14%), Enterobacter species 1 (7.14%) and Escherichia coli 3 (21.43%). The antibiogram study was done using Kirby Bauer disc- diffusion method and the results showed that majority of the bacteria were highly resistant to standard antibiotics. Susceptibility of isolates ranged from 6.25% to of 25.0%, indicating that most of the antibiotics used were ineffective. Staphylococcus. aureus, Streptoccus spp and P. aeruginosa showed 68.75% resistance to the antibiotics, whilst E. coli (56.25%), Enterobacter spp (50%) and CNS showed 18.75% susceptibility each. Overall, Gentamicin was the most effective antibiotic, while Ofloxacin, Clindamycin, Cefixine, Levofloxacin and Ciprofloxacin were least effective. Hand washing after ATM usage and proper cleaning regimen should be practiced to reduce contamination on the ATMs.

American Journal of Public Health Research. 2014, 2(2), 46-50. DOI: 10.12691/ajphr-2-2-2
Pub. Date: March 17, 2014

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The Dual Dimension of the Global Governance of Health

by Caterina Di Costanzo

Original Research

Although there is a large body of literature that deals with questions relevant to the global governance of health, the legal studies have proved slower in providing systematic approaches to interpreting and analyzing the global governance of health. The case of global governance of health offers a number of interesting insights that ought to advance legal as well as political debates. We begin by briefly outlining the scope and nature of the dual dimension of global governance of health (GHG), arguing that the main challenge for contemporary GHG is to reestablish within the health policy framework the linkage between health care interventions and the underlying socioeconomic context. The understanding of the relationships between health and development as confirmed in the Tallin Charter on Health and Wealth adopted by all WHO (World health organization) European Member States in 2008 is the underpinning of the shift towards more horizontal and inclusive approaches (strategies such those of “The new European policy for health – Health 2020: Vision, values, main directions and approaches” of the Who Europe – 2011 – named “a whole-of-society approach” and “a whole-of-government approach”). In the second part of the paper, we explore recent inputs into the GHG discourse from a wide spectrum of actors, ranging from the WHO to nongovernmental organizations (NGOs). We suggest that in their varying hues, these actors have attempted to reintroduce the wider social concerns constitutive of a more integrated approach to health law, which would locate specific interventions within a broader project of socioeconomic transformations.

American Journal of Public Health Research. 2014, 2(2), 36-45. DOI: 10.12691/ajphr-2-2-1
Pub. Date: February 27, 2014

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