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Papers by Ifeanyi Chikezie

Research paper thumbnail of Annual capital cost for OPD and IPD

<p>N/A: Not Applicable.</p

Research paper thumbnail of Additional file 1: Table S1. of Analysing key influences over actorsâ use of evidence in developing policies and strategies in Nigeria: a retrospective study of the Integrated Maternal Newborn and Child Health strategy

Perception of useful evidence for IMNCH strategy development (DOCX 12 kb)

Research paper thumbnail of Key influences over actors’ preferences and use of evidence in policy development: insights from the Nigerian IMNCH strategy

BMC Health Services Research, 2014

Research paper thumbnail of Analysis of cost burden of obstetric care among human immune-deficiency virus (HIV) positive women in Enugu metropolis, South-East Nigeria

Journal of Obstetrics and Gynaecology, 2020

Abstract The cost of obstetric care could hinder the capacity of human immune-deficiency virus (H... more Abstract The cost of obstetric care could hinder the capacity of human immune-deficiency virus (HIV) positive women to receive adequate care during pregnancy and delivery. This study was aimed at determining the relationship between antenatal/delivery care cost and delivery place choice among HIV positive women in Enugu metropolis. This was a cross-sectional study of 232 post-partum HIV-positive women who came for 6-weeks post-natal visit. Data were analysed using SPSS version 20. The ethical clearance number obtained at UNTH on 18/11/2015 was NHREC/05/01/2008BFWA00002458-1RB00002323. The average obstetric care cost among the respondents was N55,405.67 (US$346.28). The delivery cost (p-value-0.043) had positive relationship with delivery place choice. The women's proportion delivered by skilled birth attendants (SBA) was 93.1%. In conclusion, obstetric care cost among HIV positive women in Enugu was high. The high obstetric care cost influenced the delivery place of one-third of them. The choice of ill-equipped health facilities may result in higher risk of HIV transmission. IMPACT STATEMENT What is already known on this subject? The high HIV/AIDs burden in Nigeria could be attributed to poverty, ignorance, corruption and poor implementation of policies targeted at halting the spread of the infection. The cost of obstetric care could hinder the capacity of HIV positive women to receive adequate care during pregnancy and delivery. What do the results of this study add? The cost of antenatal care (p-value = .02) and delivery (p-value = .001) had a significant positive relationship with the choice of place of delivery by the respondents. The proportion of the women delivered by SBA was 93.1%. Approximately 31.9% of the women delivered at the health facilities different from where they had antenatal care. What are the implications of these findings for clinical practice and/or further research? This implies that the obstetric care cost among HIV positive women in Enugu metropolis was catastrophic. Though 93.1% of the respondents were delivered by SBA, the high cost of obstetric care influenced the delivery of one-third of them at centres different from where they had antenatal care. This may lead to women delivering in poorly equipped health facilities, which, in turn, may result in a higher risk of mother-to-child HIV transmission.

Research paper thumbnail of The Economic Burden of Malaria on Households and the Health System in Enugu State Southeast Nigeria

Research paper thumbnail of Building the capacity of users and producers of evidence in health policy and systems research for better control of endemic diseases in Nigeria: a situational analysis

Globalization and Health

Background There is a current need to build the capacity of Health Policy and Systems Research + ... more Background There is a current need to build the capacity of Health Policy and Systems Research + Analysis (HPSR+A) in low and middle-income countries (LMICs) as this enhances the processes of decision-making at all levels of the health system. This paper provides information on the HPSR+A knowledge and practice among producers and users of evidence in priority setting for HPSR+A regarding control of endemic diseases in two states in Nigeria. It also highlights the HPSR+A capacity building needs and interventions that will lead to increased HPSR+A and use for actual policy and decision making by the government and other policy actors. Methods Data was collected from 96 purposively selected respondents who are either researchers/ academia (producers of evidence) and policy/decision-makers, programme/project managers (users of evidence) in Enugu and Anambra states, southeast Nigeria. A pre-tested questionnaire was the data collection tool. Analysis was by univariate and bivariate analy...

Research paper thumbnail of Analysing key influences over actors’ use of evidence in developing policies and strategies in Nigeria: a retrospective study of the Integrated Maternal Newborn and Child Health strategy

Health Research Policy and Systems, 2016

Background: Evidence-informed policymaking has been promoted as a means of ensuring better outcom... more Background: Evidence-informed policymaking has been promoted as a means of ensuring better outcomes. However, what counts as evidence in policymaking lies within a spectrum of expert knowledge and scientifically generated information. Since not all forms of evidence share an equal validity or weighting for policymakers, it is important to understand the key factors that influence their preferences for different types of evidence in policy and strategy development. Method: A retrospective study was carried out at the national level in Nigeria using a case-study approach to examine the Nigerian Integrated Maternal Newborn and Child Health (IMNCH) strategy. Two frameworks were used for conceptualization and data analysis, namely (1) to analyse the role of evidence in policymaking and (2) the policy triangle. They were used to explore the key contextual and participatory influences on choice of evidence in developing the IMNCH strategy. Data was collected through review of relevant national documents and in-depth interviews of purposively selected key policy and strategic decision makers. Thematic analysis was applied to generate information from collected data. Results: The breadth of evidence used was wide, ranging from expert opinions to systematic reviews. The choice of different types of evidence was found to overlap across actor categories. Key influences over actors' choice of evidence were: (1) perceived robustness of evidencecomprehensive, representative, recent, scientifically sound; (2) roles in evidence process, i.e. their degree and level of participation in evidence generation and dissemination, with regards to their role in the policy process; and (3) contextual factors such as global agenda and influence, timeline for strategy development, availability of resources for evidence generation, and lessons learnt from previous unsuccessful policies/plans. Conclusion: Actors' preferences for different types of evidence for policy are influenced not only by the characteristics of evidence itself, but on actors' roles in the evidence process, their power to influence the policy, and the context in which evidence is used.

Research paper thumbnail of Investigating client perception and attitude to decentralization of HIV/AIDS treatment services to primary health centres in three Nigerian states

Health Expectations, 2015

Background The opinions of consumers in decentralization provide insights into possible levels of... more Background The opinions of consumers in decentralization provide insights into possible levels of improvement in access and uptake of services. Objectives The study examined clients' perception and attitude towards decentralization of antiretroviral treatment services from central hospitals to primary health centres (PHCs). Methodology A cross-sectional survey was undertaken in three states in Nigeria. A total of 1265 exit interviews were conducted with HIV/AIDS clients in nine health facilities. Findings About a third of all the respondents were not comfortable with receiving ART services in a PHC facility close to where they live. The reasons given by 385 respondents who would not want their treatment centres near were as follows: fear of disclosure, 299 (80.4%); fear of being discriminated against, 278 (74.3%); and satisfaction with care received at current facility, 278 (74.3%). However, more than 90% of respondents in all three states felt that decentralization of ART services to PHCs would be beneficial in controlling HIV/ AIDS in Nigeria; the difference in respondents' perception across the three state was found to be statistically significant (P < 0.001). Conclusion The findings imply that scaling-up of treatment services to PHCs would be widely accepted, and probably result in increased uptake. However, this must be accompanied by targeted behaviour change interventions for clients who for the fear of disclosure and stigma would still not access care from proximate facilities.

Research paper thumbnail of Annual capital cost for OPD and IPD

<p>N/A: Not Applicable.</p

Research paper thumbnail of Additional file 1: Table S1. of Analysing key influences over actorsâ use of evidence in developing policies and strategies in Nigeria: a retrospective study of the Integrated Maternal Newborn and Child Health strategy

Perception of useful evidence for IMNCH strategy development (DOCX 12 kb)

Research paper thumbnail of Key influences over actors’ preferences and use of evidence in policy development: insights from the Nigerian IMNCH strategy

BMC Health Services Research, 2014

Research paper thumbnail of Analysis of cost burden of obstetric care among human immune-deficiency virus (HIV) positive women in Enugu metropolis, South-East Nigeria

Journal of Obstetrics and Gynaecology, 2020

Abstract The cost of obstetric care could hinder the capacity of human immune-deficiency virus (H... more Abstract The cost of obstetric care could hinder the capacity of human immune-deficiency virus (HIV) positive women to receive adequate care during pregnancy and delivery. This study was aimed at determining the relationship between antenatal/delivery care cost and delivery place choice among HIV positive women in Enugu metropolis. This was a cross-sectional study of 232 post-partum HIV-positive women who came for 6-weeks post-natal visit. Data were analysed using SPSS version 20. The ethical clearance number obtained at UNTH on 18/11/2015 was NHREC/05/01/2008BFWA00002458-1RB00002323. The average obstetric care cost among the respondents was N55,405.67 (US$346.28). The delivery cost (p-value-0.043) had positive relationship with delivery place choice. The women's proportion delivered by skilled birth attendants (SBA) was 93.1%. In conclusion, obstetric care cost among HIV positive women in Enugu was high. The high obstetric care cost influenced the delivery place of one-third of them. The choice of ill-equipped health facilities may result in higher risk of HIV transmission. IMPACT STATEMENT What is already known on this subject? The high HIV/AIDs burden in Nigeria could be attributed to poverty, ignorance, corruption and poor implementation of policies targeted at halting the spread of the infection. The cost of obstetric care could hinder the capacity of HIV positive women to receive adequate care during pregnancy and delivery. What do the results of this study add? The cost of antenatal care (p-value = .02) and delivery (p-value = .001) had a significant positive relationship with the choice of place of delivery by the respondents. The proportion of the women delivered by SBA was 93.1%. Approximately 31.9% of the women delivered at the health facilities different from where they had antenatal care. What are the implications of these findings for clinical practice and/or further research? This implies that the obstetric care cost among HIV positive women in Enugu metropolis was catastrophic. Though 93.1% of the respondents were delivered by SBA, the high cost of obstetric care influenced the delivery of one-third of them at centres different from where they had antenatal care. This may lead to women delivering in poorly equipped health facilities, which, in turn, may result in a higher risk of mother-to-child HIV transmission.

Research paper thumbnail of The Economic Burden of Malaria on Households and the Health System in Enugu State Southeast Nigeria

Research paper thumbnail of Building the capacity of users and producers of evidence in health policy and systems research for better control of endemic diseases in Nigeria: a situational analysis

Globalization and Health

Background There is a current need to build the capacity of Health Policy and Systems Research + ... more Background There is a current need to build the capacity of Health Policy and Systems Research + Analysis (HPSR+A) in low and middle-income countries (LMICs) as this enhances the processes of decision-making at all levels of the health system. This paper provides information on the HPSR+A knowledge and practice among producers and users of evidence in priority setting for HPSR+A regarding control of endemic diseases in two states in Nigeria. It also highlights the HPSR+A capacity building needs and interventions that will lead to increased HPSR+A and use for actual policy and decision making by the government and other policy actors. Methods Data was collected from 96 purposively selected respondents who are either researchers/ academia (producers of evidence) and policy/decision-makers, programme/project managers (users of evidence) in Enugu and Anambra states, southeast Nigeria. A pre-tested questionnaire was the data collection tool. Analysis was by univariate and bivariate analy...

Research paper thumbnail of Analysing key influences over actors’ use of evidence in developing policies and strategies in Nigeria: a retrospective study of the Integrated Maternal Newborn and Child Health strategy

Health Research Policy and Systems, 2016

Background: Evidence-informed policymaking has been promoted as a means of ensuring better outcom... more Background: Evidence-informed policymaking has been promoted as a means of ensuring better outcomes. However, what counts as evidence in policymaking lies within a spectrum of expert knowledge and scientifically generated information. Since not all forms of evidence share an equal validity or weighting for policymakers, it is important to understand the key factors that influence their preferences for different types of evidence in policy and strategy development. Method: A retrospective study was carried out at the national level in Nigeria using a case-study approach to examine the Nigerian Integrated Maternal Newborn and Child Health (IMNCH) strategy. Two frameworks were used for conceptualization and data analysis, namely (1) to analyse the role of evidence in policymaking and (2) the policy triangle. They were used to explore the key contextual and participatory influences on choice of evidence in developing the IMNCH strategy. Data was collected through review of relevant national documents and in-depth interviews of purposively selected key policy and strategic decision makers. Thematic analysis was applied to generate information from collected data. Results: The breadth of evidence used was wide, ranging from expert opinions to systematic reviews. The choice of different types of evidence was found to overlap across actor categories. Key influences over actors' choice of evidence were: (1) perceived robustness of evidencecomprehensive, representative, recent, scientifically sound; (2) roles in evidence process, i.e. their degree and level of participation in evidence generation and dissemination, with regards to their role in the policy process; and (3) contextual factors such as global agenda and influence, timeline for strategy development, availability of resources for evidence generation, and lessons learnt from previous unsuccessful policies/plans. Conclusion: Actors' preferences for different types of evidence for policy are influenced not only by the characteristics of evidence itself, but on actors' roles in the evidence process, their power to influence the policy, and the context in which evidence is used.

Research paper thumbnail of Investigating client perception and attitude to decentralization of HIV/AIDS treatment services to primary health centres in three Nigerian states

Health Expectations, 2015

Background The opinions of consumers in decentralization provide insights into possible levels of... more Background The opinions of consumers in decentralization provide insights into possible levels of improvement in access and uptake of services. Objectives The study examined clients' perception and attitude towards decentralization of antiretroviral treatment services from central hospitals to primary health centres (PHCs). Methodology A cross-sectional survey was undertaken in three states in Nigeria. A total of 1265 exit interviews were conducted with HIV/AIDS clients in nine health facilities. Findings About a third of all the respondents were not comfortable with receiving ART services in a PHC facility close to where they live. The reasons given by 385 respondents who would not want their treatment centres near were as follows: fear of disclosure, 299 (80.4%); fear of being discriminated against, 278 (74.3%); and satisfaction with care received at current facility, 278 (74.3%). However, more than 90% of respondents in all three states felt that decentralization of ART services to PHCs would be beneficial in controlling HIV/ AIDS in Nigeria; the difference in respondents' perception across the three state was found to be statistically significant (P < 0.001). Conclusion The findings imply that scaling-up of treatment services to PHCs would be widely accepted, and probably result in increased uptake. However, this must be accompanied by targeted behaviour change interventions for clients who for the fear of disclosure and stigma would still not access care from proximate facilities.