ARTICLES FOR PRESENTATION AT ACEDCAMDS BY THE CASHVILLE GROUP OF COMPANIES AND PARTNERS LED BY DR HENRY EFEGBERE AS THE FOUNDER AND PRESIDENT WORLDWIDE

(A.) ASSESSMENT OF PREVALENCE OF CATEGORIES OF TREATMENT
OF PRIVATE MIX TUBERCULOSIS CONTROL PROGRAMME IN
SOUTHEASTERN NIGERIA
ABSTRACT:
The Federal Ministry of Health of Nigeria for tuberculosis(TB) control programme
recommended for standardization two categories of Directly Observed Therapy Short
course(DOTS). The materials and methods utilized were a descriptive retrospective cohort study
design to analyze secondary data set (2007-2010) of patients accessing prevalence categories of
TB-DOTS treatment and outcomes in two comparable private facilities (Immaculate Heart of
Catholic Church Hospital,IHCCH and Diocesan Anglican Communion Hospital,DACH ) in
Anambra State, Nigeria. The results showed different cured , defaulter, interrupted, death and
failure rates outcomes with different categories of treatment for different period of years for the
two different hospitals. Conclusively, Diocesan Anglican Communion Hospital has higher
chances of Multiple Drug Resistant TB patients compared to Immaculate Heart Catholic Church
Hospital .
Efegbere HA 1,5 , Iortyom TS5, Efegbere EK 5 , Evans R5 , Idowu M5, Joshua A5 , Oyakilome MI
5, Ojo I5, Akpona F5 , Afiadigwe EE 2 , Anyabolu AE 3 , Enemuo HE3, Adogu PO1, Ebenebe
EU 1 , Onyeyili AN4, Ezejiofor OI3, Onyeyili AN 4 , Sani-Gwarzo N 5,6 , Omoniyi A 5,6 , Ilika LI
1 , Igwegbe AO 7, Oyeka CE 8 , Ofili AN 9 , Asuzu MC 10 , Onajole TA 11
1. Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital ,
Nnewi, Anambra State, Nigeria.
2. Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi,
Anambra State, Nigeria.

3. Department of Internal Medicine, Nnamdi Azikiwe University Teaching Hospital,
4. Department of Nursing Services, Nnamdi Azikiwe University Teaching Hospital,
5. Cashville Group of Companies and Partners, worldwide(25 inter-dependent firms).
6. Federal Ministry of Health, Abuja, Nigeria.
7. Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching
Hospital, Nnewi, Anambra State, Nigeria.
8. Department of Statistics, Nnamdi Azikiwe University, Awka Campus, P.M.B. 5001,
Awka , Anambra State, Nigeria.
9. Department of Community Medicine, University of Benin Teaching Hospital, Benin
City, Edo State, Nigeria.
10. Department of Community Medicine, University College Hospital, Ibadan, Oyo State,
Nigeria.
11. Department of Community Medicine and Primary Health, Lagos University Teaching
Hospital, Lagos State, Nigeria.
Name and address of the corresponding authour: Henry A. Efegbere 1, 5
Email of the corresponding author: henryefegbere@gmail.com
Mobile of the corresponding author : +2348035984104
Source of Support- Nil.
Conflict of Interest-None declared.
Copyright: Unpublished
Key words: Pulmonary Tuberculosis, Treatment Category, Treatments Outcomes,

Private Mix
Introduction: WHO grouped patients receiving anti-tuberculosis Directly Observed Therapy
Short course according to the three major treatment categories described by Treatment regimens
administered, however, this study used the standardization of two categories according to the
Federal Ministry of Health of Nigeria.
Materials and Methods: A descriptive retrospective cohort study design used to analyze
secondary data set (2007-2010) of patients accessing prevalence categories of TB-DOTS
treatment and outcomes in two comparable private facilities (Immaculate Heart of Catholic
Church Hospital, IHCCH and Diocesan Anglican Communion Hospital, DACH ) in Nnewi
North Local Government Area, Anambra State, Nigeria.
Results: In IHCCH (Immaculate Heart of Catholic Church Hospital), 43.7% of cured rate
outcomes received only category 1 of treatment; 1.4% of failure rate outcome received only
category 2 of treatment. In DACH(Diocesan Anglican Communion Hospital), 60.4% of cured
rate outcome received category 1 of treatment while 2.1% of that outcome received category 2 of
treatment; no failure rate outcome recorded.
IHCCH had 93.0% of category 1 of treatment with 7.0% of category 2 of treatment; DACH had
95.8% of category 1 of treatment with 4.2% of category 2 of treatment.
Conclusion and Recommendations: Diocesan Anglican Communion Hospital (DACH) has
more chances of Multiple Drug Resistant TB patients compared to Immaculate Heart Catholic
Church Hospital (IHCCH). Therefore, its recommended that in order to eliminate the prevalence
of Multiple Drug Resistant Tuberculosis adequate Gene Expert diagnostics matched with enough
proficient health professionals be made nationally accessible at all levels of health care delivery
that undertake DOTS services. Also, future research to juxtapose findings against WHO

standards for internationalization of local findings. Furthermore, research is to analyse primary
data set for Tuberculosis epidemiological profiling and comprehensiveness.
Acknowledgements: Professors Ibeh CC, Ikechebelu J, Asuzu MC, Onayade A , Onajole TA,
Ofili AN, Okojie E; Drs. Fagbemi I, Omoniyi A (FMoH), Obi-Okaro ,Adinma ED,
Emelumadu, I Modebe, Nwanbueze AN, Ubajaka C, Udigwe I, Omuemu VO, Adeleye, Adams ;
HOD Accounts NAUTH, ?Dr Okoli C; Assistant Director (Principal, SON, NAUTH) Onyejiaka
NN; Pharmacy dept, HOD Pharmacy, Pharm. Obiefuna PE, Pharm. Mrs Egwuatuegwu ; Director
of Administration, NAUTH Mrs Nwofor; HOD Records NAUTH, Okere J; Medical Records
dept NAUTH students , Blessing, Arinze, Godspower Ejenwo; Community Medicine department
residents, Drs. Azuike EC, Ofoegbu C, Igwebike, Administrative Secretary, Mrs Ngozi ; CMD
(Prof. Igwegbe’s) Office NAUTH, Administrative Secretary , Mr. Okeke, Mr. Office; CMAC
(Dr. Afiadigwe’s EE) Office NAUTH, Administrative Secretary, (?name), Mrs Obi, Mrs
Favour; Procurement Department NAUTH, (Assistant Director) Mrs. Ugochukwu, Okpali S.;
Nursing Services Department NAUTH, Okoro James; Administrative dept NAUTH, James; PRO
NAUTH Office, Ngige Kris,Obum; MDCN NAUTH, Dr. Eleje G, ARD NAUTH ,Dr.
Nwajiakor(President),Okham(Secretary);Friends/Associates,Nathaniel,Karen,Nemi,Tarkie,Damij
o,Elohor,Nwaka; Pastors,Adeboye EA,Okenwa B,Udah P,Nkemdili, Nnaka B, Igbokwe I, Ojo I,
REFERENCES
1. World Health Organization. Group at Risk. WHO ‘s report on the tuberculosis
epidemics. Geneva : WHO, 1988.
2.Federal Ministry of Health .National Tuberculosis and Leprosy Control program.
Revised Workers manual 2nd edn., 1998
Wobester W, Yuan L, Naus M. The tuberculosis treatment completion study group.

Outcome of pulmonary tuberculosis treatment in the tertiary care setting- Toronto
1992/93 . CMAJ 1999; 160 : 789-794
1. Global Tuberculosis program. Global tuberculosis control. WHO report 1997 1997 ( rep
no WHO /TB/97.225). Geneva : WHO; 1997 : 9-15
2. Global Tuberculosis program. Global tuberculosis control : Surveillance, planning and
financing. WHO report 2005 (rep. No WHO/ HTM/ TB/ 2005.349). Geneva : WHO ;
2005 : 108-111
3. Salami AK, Oluboyo PO. Management Outcome of Pulmonary tuberculosis: A nine year
review in Illorin. West African J Med 2003; 22 : 114-119
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presentation and outcome of tuberculosis in Obafemi Awolowo University Teaching
Hospital, Ile-Ife, Nigeria. J Health Sci 2003 ; 3 : 34-39
5. Stop TB partnership. Available from : www.
Stoptb.org/stop_tb_initiative/amsterdam_conference/ Nigeria_speech. Asp (Accessed on
November 24, 2011).
6. Brudney K, Dobkin J. Resurgent tuberculosis in New York city. Human
Immunodeficiency virus, homelessness and the decline of Tuberculosis control programs.
Am Rev Respir Dis 1991; 144: 745-749
7. Slutkin G. Management of tuberculosis in urban homeless indigents. Public Health Resp
1986: 481-485
8. Jaiswal A, Singh V, Ogden JA. Adherence to tuberculosis treatment : lessons from the
urban settings of Delhi, India. Trop Med Int Health 2003; 8 : 625-633
9. Grzybowsky S, Enaarson D. Results in Pulmonary tuberculosis patients under various
treatment programs condition[in French]. Bull Int Union tuberculosis 1978; 53: 70-75

10. Servin T, Atac G, Gungor G. Treatment outcome of relapse and defaulter pulmonary
tuberculosis patients. In J Tuberc Lung Dis 2002; 6: 320-325.
11. Federal Ministry of Health .National Tuberculosis and Leprosy Control program. Revised
Workers manual 5th edn., 2008 : 1-227
12. Naido S, Taylor M, Jinabhai CC. Critical risk factors driving the Tuberculosis epidemic
in Kwa Zulu –Natal, South Africa. South Africa J Epidemiol Infect 2007; 22 (2,3); 45-49
13. Gerado C, Porfirio D , Diego C. The dynamics of pulmonary tuberculosis in Colima,
Mexico (1999-2002). Scandinavian J of Infec Dis 2005; 37 : 858-862
14. Xu L, Gai R, Liu Z, Cheng J. Socio-economic factors affecting the success of
tuberculosis treatment in six countries of Shandong Province, China. Int J TB L Dis 14
(4) : 440-446.
15. Efegbere HA , Onyeyili AN, Anyabolu AE, Enemuo HE, Igwegbe AO, Efegbere EK,
Adogu PO, Ilika AL, Oyeka CI . Effectiveness of Treatment Outcomes of Public Private
Mix Tuberculosis Control Program in Eastern Nigeria. Journal of Biology, Agriculture
and Healthcare. 2014 Vol 4(1) : 1-7.
Adogu PO, Ilika AL, Oyeka CI . Treatment Outcomes of Private-Private Mix
Tuberculosis Control Program in South-Eastern Nigeria. Public Health Research . 2014;
4(2): 45-50. doi:10.5923/j.phr.20140402.01
Adogu PO, Ilika AL, Oyeka CI . Determinants of Treatment Outcome of Public-Private
Mix Tuberculosis Control Programme in South-Eastern Nigeria. Afromedic Journal
,2014 Jun , Vol. 5 (1): 1-13.
Adogu PO, Ilika AL, Oyeka CI . Determinants of Treatment Outcome of Public Public

Mix Tuberculosis Control Programme in Southeastern Nigeria. American Journal of
Medicine and Medical Sciences, USA. 2015 (in press).
(B.) ASSESSMENT OF PREVALENCE OF CATEGORIES OF TREATMENT OF
PUBLIC MIX TUBERCULOSIS CONTROL PROGRAMME IN SOUTHEASTERN
NIGERIA
ABSTRACT:
The Federal Ministry of Health of Nigeria for tuberculosis(TB) control programme
recommended for standardization two categories of Directly Observed Therapy Short
course(DOTS). The materials and methods utilized were a descriptive retrospective cohort study
design to analyze secondary data set (2007-2010) of patients accessing prevalence categories of
TB-DOTS treatment and outcomes in two comparable private facilities (Immaculate Heart of
Catholic Church Hospital,IHCCH and Diocesan Anglican Communion Hospital,DACH ) in
Anambra State, Nigeria. The results showed different cured , defaulter, interrupted, death and
failure rates outcomes with different categories of treatment for different period of years for the
two different hospitals. In conclusion, Dr TB and Leprosy Control has higher chances of
Multiple Drug Resistant TB patients compared to Nnamdi Azikiwe University Teaching
Hospital.

Name and addresses of the corresponding authour: Henry A. Efegbere 1, 5
Public Mix
Introduction: WHO grouped patients receiving anti-tuberculosis Directly Observed Therapy
Short course according to the three major treatment categories described by Treatment regimens

administered, however, this study used the standardization of two categories according to the
Federal Ministry of Health of Nigeria.
Materials and Methods: A descriptive retrospective cohort study design used to analyze
secondary data set (2007-2010) of patients accessing TB-DOTS treatment by categories in two
comparable facilities (Nnamdi Azikiwe University Teaching Hospital, NAUTH and Department
of Health Services TBL Control Unit Nnewi North L.G.A. Secretariat, DHSTBLU ) as public in
Nnewi North L.G.A., Anambra State.
Results: In NAUTH (Nnamdi Azikiwe University Teaching Hospital) 24.6% of cured rate
outcome received category 1 while 3.9% of that outcome received category 2 of treatment; 0.5%
of treatment failure rate outcome received category 1 of treatment while 0.4% of that rate
outcome received category 2 of treatment. In DHSTBLU (Department of Health Services TBL
Unit), 54.5% cured rate outcome received category 1 of treatment while 13.1% of that outcome
received category 2 of treatment; 3.6% of failure rate outcome received category 1 of treatment
while 1.6% of that rate outcome received category 2 of treatment. NAUTH had 84.9% of
category 1 of treatment with 15.1% of category 2 of treatment; DHSTBLU had 76.0% of
category 1 of treatment with 24.0% of category 2 of treatment.
Conclusion and Recommendations: Conclusively, DHSTBLC has higher chances of Multi-
Drug Resistant patient load than NAUTH . Adequate Gene Expert diagnostics matched with
enough proficient health professionals made nationally accessible at all levels of health care
delivery that undertake DOTS services. Future research to juxtapose local findings against WHO
standards for standardization of local findings.

NAUTH Office, Ngige Kris,Obum; MDCN NAUTH, Dr. Eleje G, ARD NAUTH ,Dr.
Nwajiakor(President),Okham(Secretary);Friends/Associates,Nathaniel,Karen,Nemi,Tarkie,Damij
o,Elohor,Nwaka; Pastors,Adeboye EA,Okenwa B,Udah P,Nkemdili, Nnaka B, Igbokwe I, Ojo I,
REFERENCES
1. Maimela E. Evaluation of Tuberculosis treatment outcomes and the determinants of
treatment failures in the Eastern Cape Province (2003-2005). A thesis presented to
University of Pretoria, South Africa.2009
2. Akinola AF , Abimbola SO, Afolabi EB. Treatment outcomes among pulmonary
tuberculosis patients at treatment centres in Ibadan, Nigeria. Annals of African Medicine
2009; 8 (2) : 100-104
3. Enwura CP, Emeh MS, Izuehie IS, Enwuru CA, Umeh SI, Agbasi UM.
Bronchopulmonary tuberculosis Laboratory diagnosis and DOTS Strategy outcome in a
rural community. African Journal of clinical and experimental microbiology 2009

4. Antonie D, French CE, Jones J, Watson JM. Tuberculosis treatment outcome monitoring
in England, Wales and Northern Ireland for cases reported in 2001. J Epidemiol
Community Health 2007; 61 : 302-307
5. WHO. Treatment of tuberculosis : guidelines for national programs. 3rd ed. Geneva
2003. Available from URL: http ://www.who.int .(Accessed on July 20,2011).
6. World Bank. Disease Control priorities in Developing countries, 2nd ed; Part II ; selecting
interventions ; Tuberculosis. New York; Oxford University Press 2006.
7. Rodger AJ, Toole M, Lalnuntluangi L, Muana V, Deutschemann P. DOTS –based
tuberculosis treatment and control during civil conflict and an HIV epidemic,
Churachchandpur District, India. Bull WHO vol.80 no.6 Geneva 2002
8. Bulletin of the WHO: Targets for tuberculosis control: how confident can we be about the
data 2007 ; 85; 370-376.
9. WHO . TB/HIV ; A clinical manual.2nd ed. 2004.Available from URL:
http://www.who.int. (Accessed on January 30, 2011 )
10. Department of Health. The South African Tuberculosis control program; practical
guidelines 2000. Available from URL: http://www.doh.org.za (Accessed on June
30,2011).
11. WHO Stop TB Partnership. DOTS Expansion Working Group, Strategic Plan 2006-
2015,2006 ; WHO/HTM/2006.370
12. WHO. Stop TB Partnership. The Stop TB strategy; Building on and enhancing DOTS to
meet the TB-related Millennium Development Goals 2006.
13. Obermeyer Z, Abott –Klafter J, Murray CJL. Has the DOTS Strategy improved case
finding or treatment success ? An Empirical Assessment. PLoS ONE 2008 3(3):
e1721.doi : 10.1371/journal.pone.0001721.

14. Shargie EB, Lindtjorn B. DOTS improves treatment outcomes and service coverage for
tuberculosis in South Ethiopia : a retrospective trend analysis : MBC Public Health 2005;
5: 62
15. Maher D, Hausler HP, Raviglione MC, et al. TB Care in Community organizations in
Sub-Saharan Africa; practice and potential. The Int J Tuberc Lung Dis 1997, 1(3): 276-
283.
16. WHO Community Contribution to TB Care; Practice and Policy 2003 ; WHO/ CDC/
TB/2003.312. [cited 2007 September 26] Available from URL: http://www.who.int.
4(2): 45-50. doi:10.5923/j.phr.20140402.01
,2014 Jun , Vol. 5 (1): 1-13.

(C.) ASSESSMENT OF PREVALENCE OF CATEGORIES OF TREATMENT OF
PUBLIC PRIVATE MIX TUBERCULOSIS CONTROL PROGRAMME IN
SOUTHEASTERN NIGERIA
1 , Igwegbe AO 7, Oyeka CE 8 ,Ofili AN 9 , Asuzu MC 10 , Onajole TA 11

Nigeria.
Public Private Mix
1. Introduction:
WHO grouped patients receiving anti-tuberculosis Directly Observed Therapy Short course
according to the three major treatment categories described by Treatment regimens administered,
however, this study used the standardization of two categories according to the Federal Ministry
of Health of Nigeria.
2. Materials and Methods:
A descriptive retrospective cohort study design used to analyze secondary data set (2007-
2010) of patients accessing TB-DOTS treatment in two groups of comparable public and
private facilities .Nnamdi Azikiwe University Teaching Hospital (NAUTH) and

Department of Health Services Tuberculosis and Leprosy Control Unit Nnewi North
Local Government Area Secretariat (DHSTBLU)) as public facilities. Immaculate Heart
of Catholic Church Hospital and Diocesan Anglican Communion Hospital as private
facilities. All in Nnewi North L.G.A., Anambra State, Nigeria.
3. Results:
In public facilities 31.5% of cured rate outcome received category 1 of treatment while 6.1% of
that outcome received category 2 of treatment; 1.2% of failure rate outcome received category 1
of treatment while 0.7% of that outcome received category 2 of treatment .
In private facilities, 50.4% of cured rate outcome received category 1 of treatment while 0.8% of
that rate outcome received category 2 of treatment; 0.8% of treatment failure rate outcome
received only category 2 of treatment.
4. Conclusion:
The private facilities have more chances of Multiple Drug Resistant TB patients compared to the
public facilities. Therefore, its recommended that in order to eliminate the prevalence of Multi-
Drug Resistant Tuberculosis adequate Gene Expert diagnostics matched with enough proficient
health professionals be made nationally accessible at all levels of health care delivery that
undertake DOTS services. Also, future research to juxtapose findings against WHO standards for
internationalization of local findings.

NAUTH Office, Ngige Kris,Obum;MDCN NAUTH,Dr. Eleje G, ARD NAUTH ,Dr.
Nwajiakor(President),Okham(Secretary);Friends/Associates,Nathaniel, Karen, Nemi G, Tarkie
KO, Damijo M,Elohor,Nwaka; Pastors,Adeboye EA,Okenwa B,Udah P,Nkemdili, Nnaka B,
Igbokwe I, Ojo I,
REFERENCES
2009; 8 (2) : 100-104
3. Enwura CP, Emeh MS, Izuehie IS, Enwuru CA, Umeh SI, Agbasi UM.
Bronchopulmonary tuberculosis Laboratory diagnosis and DOTS Strategy outcome in a
rural community. African Journal of clinical and experimental microbiology 2009
4. Antonie D, French CE, Jones J, Watson JM. Tuberculosis treatment outcome monitoring
in England, Wales and Northern Ireland for cases reported in 2001. J Epidemiol
Community Health 2007; 61 : 302-307

6. World Bank. Disease Control priorities in Developing countries, 2nd ed; Part II ; selecting
interventions ; Tuberculosis. New York; Oxford University Press 2006.
7. Rodger AJ, Toole M, Lalnuntluangi L, Muana V, Deutschemann P. DOTS –based
tuberculosis treatment and control during civil conflict and an HIV epidemic,
Churachchandpur District, India. Bull WHO vol.80 no.6 Geneva 2002
8. Bulletin of the WHO: Targets for tuberculosis control: how confident can we be about the
data 2007 ; 85; 370-376.
9. WHO . TB/HIV ; A clinical manual.2nd ed. 2004.Available from URL:
http://www.who.int. (Accessed on January 30, 2011 )
10. Department of Health. The South African Tuberculosis control program; practical
guidelines 2000. Available from URL: http://www.doh.org.za (Accessed on June
30,2011).
2015,2006 ; WHO/HTM/2006.370

4(2): 45-50. doi:10.5923/j.phr.20140402.01
,2014 Jun , Vol. 5 (1): 1-13.
(D.) DETERMINANTS OF TREATMENT OUTCOMES OF PUBLIC MIX
TUBERCULOSIS CONTROL PROGRAMME IN SOUTH-EASTERN NIGERIA

ABSTRACT:
No reliable method exist to predict which patient will complete Tuberculosis (TB) treatment,
however, failure to complete treatment has been associated with several factors including alcohol
abuse. The materials and methods utilized were a retrospective cohort study design used to
analyze secondary data set (2007-2010) of patients accessing determinants of Tuberculosis –
Directly Observed Therapy Short Course (TB-DOTS) outcomes in two comparable public
facilities (Nnamdi Azikiwe University Teaching Hospital, NAUTH and Department of Health
Services Tuberculosis and Leprosy Control Unit Nnewi North Local Government Area,
DHSTLCU ) , Anambra State. Multivariate Logistic Regression was used to analyze for
determinants. The results showed in 2007-2010 the determinants of treatment outcome at
NAUTH were year, category of treatment and sex of patient for defaulter treatment rate outcome
just as the results varied for failure ,death ;success, among other rates outcomes. In DHSTBLU,
the determinants were year and category of treatment for cured rate outcome; only year for
transferred-out rate outcome; only age for treatment failure rate outcome. Conclusively,
determinants of treatment outcomes at NAUTH were year, category of treatment, sex and HIV
status of patient while at DHSTLCU, the determinants were year, category of treatment and age.
1 , Igwegbe AO 7, Oyeka CE 8 , Ofili AN 9, Asuzu MC 10 , Onajole TA 11

Nigeria.
Copyright: This version is nontrivially significantly different from that published by
American Journal of Medicine and Medical Sciences, USA

Key words: Pulmonary Tuberculosis, Determinants, Treatments Outcomes, Public Mix
Background: No reliable method exist to predict which patient will complete Tuberculosis (TB)
treatment, however, failure to complete treatment has been associated with several factors
including alcohol abuse, drug abuse ,homelessness, HIV/AIDS infection , non-compliance to
anti-tuberculosis treatment due to a poor correlation between patient and programme needs and
priorities, relatively long period of treatment, the need for multiple drugs and socio-economic
factors .
Materials and Methods: A retrospective cohort study design used to analyze secondary data set
(2007-2010) of patients accessing determinants of Tuberculosis –Directly Observed Therapy
Short Course (TB-DOTS) outcomes in two comparable public facilities (Nnamdi Azikiwe
University Teaching Hospital, NAUTH and Department of Health Services Tuberculosis and
Leprosy Control Unit Nnewi North Local Government Area [L.G.A.] Secretariat, DHSTLCU )
in Nnewi North L.G.A., Anambra State.
Multivariate Logistic Regression was used to analyze for determinants.
Results: Patients mean age 35.0±3.3. There were 69% (1000 patients) and 57%(250 patients)
males at NAUTH and DHSTLCU respectively.
In 2007-2010 the determinants of treatment outcome at NAUTH were year, category of
treatment and sex of patient for defaulter treatment rate outcome; year and category of treatment
for transferred-out rate outcome; category of treatment for failure rate outcome; year and HIV
status of patients for death rate outcome; year and category of treatment for success rate
outcome. In DHSTBLU, the determinants were year and category of treatment for cured rate
outcome; only year for transferred-out rate outcome; only age for treatment failure rate outcome.

Conclusion: Determinants of treatment outcomes at NAUTH were year, category of treatment,
sex and HIV status of patient while at DHSTLCU, the determinants were year, category of
treatment and age. Therefore, its recommended, further research to focus on the determinants for
disaggregated respective years, identify centre-specific factors associated with poor treatment
outcome ,emphasise the place of treatment success rate and analyse primary data set for
Tuberculosis epidemiological profiling and comprehensiveness .
Igbokwe I, Ojo I.
REFERENCES

2009; 8 (2) : 100-104
2015,2006 ; WHO/HTM/2006.370
4(2): 45-50. doi:10.5923/j.phr.20140402.01
,2014 Jun , Vol. 5 (1): 1-13.

9. Stop TB . A position paper: A call for Public –Private Mix to strengthen TB Control in
Nigeria.2011: 1-4
10. National Tuberculosis and Leprosy Control Programme 2009 Annual Report. Federal
Ministry of Health Abuja. Federal Ministry of Health publication. May 2010.1-21.
11. Ukwuaja KN, Ifebunadu NA, Osakwe PC, Alobu I. Tuberculosis Treatment Outcome and
its Determinants in a Tertiary care setting in Southeastern Nigeria. Niger Postgrad Med J
2013 Jun; 20(2): 125-129.
(E. ) EVALUATION OF THE ECONO-SYNERGISTIC MODEL OF INTERNATIONAL
RESEARCH NETWORK & SCHOOL ON HEALTH SYSTEM MANAGEMENT AND
ECONOMICS IN SOUTH-EASTERN NIGERIA
ABSTRACT:
The concerns of escalating multiple disease burdens (epidemiological transition) with limited
donor funds and debates of sustainability are legitimate due to the magnitude of expenditure on
health services. Methodologically, the leadership of the Cashville Group of Companies and
Partners had partnership with the Nnamdi Azikiwe University Teaching Hospital (NAUTH)
Management Board. The results were formation and operationalization of inter-dependent
twenty-five firms, all profitably thriving. Conclusively, the workability of the model is in no
doubt successful, customizable and adaptable to any system, for internally generated revenue.

Copyright: This version is nontrivially significantly different from that soon to be published
by Journal of Economics and Sustainable Development, USA
Introduction: The concerns of escalating disease burden with limited donor funds and debates
of sustainability are legitimate due to the magnitude of expenditure on health services which

account for as much as 5 % of GDP and between 5% and 10% of government expenditures in
developing countries , though this falls below the Abuja target of 15% of government
expenditure allocated to the health sector.1,2
Methodology: The leadership of the Global Community Health Foundation empathized with the
situation of incessant under-subventions to public health facilities including NAUTH initiated
this hybridized model of sustainability as alternative to funding of institutions ,the NAUTH in
particular. The Global Community Health Foundation and partners had partnership with the
Nnamdi Azikiwe University Teaching Hospital (NAUTH) Management Board.
The Steering Committee constituted of the GCHF and NAUTH management.
The agreed approaches were institutionalization of sustainability instruments by research,
interprofessional journals, Businesses, Institutes, Centres and schools.
Results: The tripartite public-private partnership model inspired the realization of the following
independent business models, which are have been incorporated at the Corporate Affairs
Commission of the Federal Government of Nigeria. Some of the firms thereby inspired by this
model are/were: International Institute of Leadership, Management and Economics
LTD/GTE;International Institute of Science, Education and Technology LTD/GTE;International
Centre of Leadership, Management and Economics LTD/GTE;The Journal of Global
Community Inter-professional Practices LTD; Cashville Multipurpose Cooperative Society
International LTD; Cashville Microfinance Bank LTD (with Nigeria nationwide and
worldwide coverage);International Association of Professionals of Leadership, Management and
Economics; International Association of Professionals of Science, Education and Technology;
International Association of Consultants of Leadership, Management and
Economics;International Association of Professionals of Science, Education and Technology;
Cashville Consults LTD/GTE; The Brethren Centre International Ministry; Cashville University

with pilot proposed locations in Delta and Anambra States, Nigeria; Aminu Kano-Cashville
University with pilot proposed locations in Kano and Katsina States, Nigeria; Global Community
University with pilot proposed locations in Abuja and Nasarawa States, Nigeria); The three
models of universities names shall be systematically up-scaled to all countries of Africa based on
outcomes of the pilot programming of about five years in Nigeria; Cashville Modular Refineries
with proposed location in Kano, Bauchi, Benue and Ekiti States of Nigeria. The model of
refinery name shall be systematically up-scaled to all countries of Africa based on outcomes of
the pilot programming of about five years in Nigeria;Cashville Agricultural Village. The Pilot
projects shall be in FCT-Abuja and Anambra States of Nigeria. The model of that name shall be
systematically up-scaled to all countries of Africa based on outcomes of the pilot programming
of about five years in Nigeria; Cashville Trade Centre. The Pilot projects shall be in FCT-Abuja
and Anambra States of Nigeria. The model of that name shall be systematically up-scaled to all
countries of Africa based on outcomes of the pilot programming of about five years in Nigeria;
Cashville Industrial Park. The Pilot projects shall be in FCT-Abuja and Anambra States of
Nigeria. The model of that name shall be systematically up-scaled to all countries of Africa
based on outcomes of the pilot programming of about five years in Nigeria; Cashville Insurance
Ltd.
Conclusion and Recommendations: The workability of the model is in no doubt successful,
customizable and adaptable to any system, more so that the up-scalability increased from the
Eastern Nigeria to different geo-political zones of Nigeria. Therefore, recommendable, its is
highly needfulness to boost income generating activities (IGA) of health and non-health
facilities. It’s not limited to health professionals only. Its universally friendly. It enforces
management of resources in an economic manner. All systems should embrace it for
sustainability of resources.

Igbokwe I, Ojo I.
REFERENCES
1. Winslow, C.E.A. (1920) The Untitled field of Public Health. Modecine 2 : 183-191
2. Leighton, C. & Makinen, M.(1999) Health Sector reforms in Sub-Sahara Africa .In paper
presented in a workshop. Addis Ababa, Ethiopia; 1999
3. World Bank. World Development Report 1993: Investing in health. Oxford University
Press, Oxford.1993.

4. Makan B, Valentine N, and Kirigia JM.Looking back and Looking ahead: South Africa”s
1995/1996 health budget. 1996: Budget Watch.2:4
5. Murray CJL and Frenk JA. WHO framework for health systems performance assessment.
GPE Discussion paper no 6. Geneva: WHO .1996
6. WHO. The WHO Report 2000: health systems improving performance. Geneva:
WHO:2000
7. Kirigia JM, Sambo LG and Lambo E.A RE PUBLIC HOSPITALS IN Kwazulu/Natal
Province of South Africa technically efficient? African Journal of Health Sciences 2000,
7(3-4): 25-32.
8. World Bank: The Millennium Development Goals for health : rising to the challenges.
Washington DC, World Bank ; 2004
9. Ghana Macroeconomics and Health: Scaling –Up Health Investments for Better Health,
Economic Growth and Accelerated Poverty Reduction. Report of the Ghana
Macroeconomics and Health Initiative ; 2005
(F.) EFFECTIVENESS OF TREATMENT OUTCOMES OF PUBLIC PRIVATE MIX
TUBERCULOSIS CONTROL PROGRAM IN EASTERN NIGERIA
ABSTRACT:
Effective tuberculosis treatment has been shown to have significant effect on the control of
tuberculosis. Methodologically, descriptive statistics with a retrospective cohort study design
used to analyze secondary data set(2007-2010) of patients accessing TB-DOTS treatment in two
facilities (Nnamdi Azikiwe University Teaching Hospital, NAUTH and Department of Health
Services Tuberculosis and Leprosy Control Unit Nnewi North Local Government Area,
DHSTLCU ) as public health facilities and other two facilities (Immaculate Heart of Catholic
Church Hospital, IHCCH and Diocesan Anglican Communion Hospital, DACH) as private

health facilities in Nnewi North, Anambra State. Using WHO standards the health facilities
adjudged as efficient were: in 2007-2010, private facilities like public facilities using different
indicators were efficient at different periods. In conclusion, private health facilities were more
effective than public health facilities over the four period.

Nigeria.
Copyright: This version is nontrivially significantly different from that published by Journal
of Biology, Agriculture and Health, USA
Introduction: Effective tuberculosis treatment has been shown to have significant effect on the
control of tuberculosis.Completion of treatment of active cases is therefore the most important
priority of tuberculosis control programmes.
Methodology: Descriptive statistics with a retrospective cohort study design used to analyze
secondary data set(2007-2010) of patients accessing TB-DOTS treatment in two facilities
(Nnamdi Azikiwe University Teaching Hospital, NAUTH and Department of Health Services
Tuberculosis and Leprosy Control Unit Nnewi North Local Government Area (L.G.A.)
Secretariat, DHSTLCU ) as public health facilities and other two facilities (Immaculate Heart of
Catholic Church Hospital, IHCCH and Diocesan Anglican Communion Hospital, DACH) as
private health facilities in Nnewi North L.G.A., Anambra State.

Results: Gender of patients were male: female54%(1016 patients) : 46% (883 patients) and
53%(63 patients) : 47%(56 patients) in public and private health
facilities respectively . Using WHO (1996) standards the health facilities adjudged as efficient
were: in 2007,private facilities using the indicator of treatment failure rate; private facilities
using the indicator of death rate; public facilities and private facilities using the indicator of
transfer-out rate ; public facilities using the indicator of treatment completion rate. In 2008,
effective health facilities were: private health facilities using the indicator of failure rate; public
and private health facilities using the indicator of transfer-out rate; private facilities using the
indicator of treatment completion rate. In 2009, effective health facilities were public and private
health facilities using indicator of treatment failure rate; public and private health facilities using
the indicator of death rate; public and private facilities using the indicator of transfer out; public
and private facilities using the indicator of treatment completion rate. In 2010, effective health
facilities were: private health facilities using the indicator of cure rate; private facilities using the
indicator of death rate ; public and private facilities using the indicator of transfer-out; public
facilities using the indicator of treatment completion rate.
Conclusion and Recommendations: private health facilities were more effective than public
health facilities by the several indicators over the four year period. Thus, its recommended,
future research is needful to use primary and secondary data sets in assessment of TB control
program effectiveness; technical efficiency assessment using non-parametric statistics will assess
the validity of assessing effectiveness using only the WHO standards; identify centre-specific
factors associated with poor treatment outcome; institutionalizing a reward system for effective
TB-DOTS facilities will engender healthy competition in the Public Private Mix for sustained
effectiveness; the Monitoring and Evaluation tools especially the treatment card for data capture
should be improved upon for comprehensiveness of patients socio-economic history.
Keywords: Tuberculosis, Effectiveness, Treatments Outcomes, Public Private Mix

REFERENCES
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epidemics. Geneva : WHO, 1988.
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Revised Workers manual 2nd edn., 1998.
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9. Brudney K, Dobkin J. Resurgent tuberculosis in New York city. Human
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treatment programs condition[in French]. Bull Int Union tuberculosis 1978; 53: 70-75
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Workers manual 5th edn., 2008 : 1-227
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in Kwa Zulu –Natal, South Africa. South Africa J Epidemiol Infect 2007; 22 (2,3); 45-49
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(4) : 440-446.

4(2): 45-50. doi:10.5923/j.phr.20140402.01
,2014 Jun , Vol. 5 (1): 1-13.
(G.) PREVALENCE OF HEALTH WORKERS SATISFIED WITH THEIR JOB IN
SOUTH-EASTERN NIGERIA.

The objective of this study was to assess prevalence of health workers with job satisfaction in
South-eastern Nigeria. Methodologically, descriptive , cross sectional study design was utilized.
The self-administered questionnaire used by participants was adapted from The Minnesota
Satisfaction Questionnaire Short Form to assess job satisfaction .Results showed there was no
difference between overall level of satisfaction using the Minnesota Satisfaction Questionnaire
Short Form and perception rating of respondents. Conclusively, the study showed a high level of
job satisfaction among health workers, hence, the recommendation, improvement in various
domains of job dissatisfaction in order to reduce attrition and high turn-over of workers.
1 , Igwegbe AO 7, Oyeka CE 8 , Ofili AN9 , Asuzu MC 10 , Onajole TA 11

Introduction : There has been several studies on prevalence of workers with their job
satisfaction among different groups of workers in different fields but very few of such studies
have been carried out specifically among Health workers in south-eastern Nigeria.
Objective: To assess prevalence of health workers with job satisfaction among Health
Workers in South-eastern Nigeria.
Methodology : This descriptive , cross sectional study was conducted in May, 2014. The self-
administered questionnaire used by participants was adapted from The Minnesota Satisfaction
Questionnaire Short Form to assess job satisfaction .

Results: One hundred and forty five out of the 150 workers eligible for the study completely
filled and returned their questionnaires. There was no difference between overall level of
satisfaction using the Minnesota Satisfaction Questionnaire Short Form and perception rating of
respondents, thus, about 64.1 % of respondents were either satisfied or very satisfied with their
jobs while 35.9 % of workers were either dissatisfied or very dissatisfied. About 50.4% of
workers were above 40 years of age, and 62.1% were married. There were more females (73%)
than males (26%). Almost all workers were Christians as well as were of Igbo origin in tribe.
Conclusion: The study showed a high level of job satisfaction among Health workers.
Recommendation: Improvement in various domains of job dissatisfaction in order to reduce
attrition and high turn-over of workers is highly recommended.
Keywords: Prevalence, job satisfaction; health workers; Nigeria

Igbokwe I, Ojo I.
REFERENCES
1. Friedman JP. Baron’s Dictionary of Business Terms. 4th ed. Baron’s Educational Series: New
York. 2007:1-1011
2. Okaro AO, Eze CU, Ohagwu CC. Survey of Job satisfaction among radiographers in South-
Eastern Nigeria. European Journal of Scientific Research 2010; 39 (3): 448-456.
3. Jennifer L, Kettle RN. Factors affecting job satisfaction in the registered nurse. Health
Science Journal.2009; 2(4): 23-29.
4. Gothe H, Koster A, Storz P, Nolting H, Haussler B. Job satisfaction among doctors.
Haudtsch Arztebl 2007; 104 (20): 1394-9.
5. Donuk B. The comparison of the job satisfactions of the sport managers who work in private
and public sectors. Selcuk Universitesi Sosyal Bilimler Enstitusu Dergisi 2009; 21: 179-185.
6. Ezeja EB, Azodo CC, Ehiezele AO, Ehigiator O, Oboro HO. Assessment of work satisfaction
and working conditions of Nigerian health workers. Int. J. Biomed & Hlth. Sci. 2010; 6 (3):
143-150.
7. Ofili AN, Asuzu MC, Isah EC, Ogbeide O. Job satisfaction and psychological health of
doctors at the University of Benin Teaching Hospital. Occupational Medicine . 2004; 54:
400-403.
8. Murrels T, Robinson S, and Griffiths P. Job satisfaction trends during nurses early career.
BMC Nursing 2008; 7: 7.
9. Omolase CO Seidu MA Omolase BO Agborubere DE. Job satisfaction among Nigerian
Ophthalmologist : an exploratory study. Libyan J Med 2010 , 5: 4629

10. Amoran OE, Omokhodion FO, Dairo MD, Adebayo AO. Job satisfaction among Primary
Health Care workers in three selected local government areas in southwest Nigeria. Niger J
Med. 2005 ; 195-199
11. Al-Eisa IS, Al-Muta MS, AL-Abduljalil HK. Job satisfaction of Primary Health Care
physicians at Capital Health Region, Kuwait. MEJFM. 2005; 3 (3) : 2-5
12. Liu JA, Wang QI, Lu ZX. Job satisfaction and its modelling among Township Health
Centre employees: a quantitative study in poor rural China. BMC Health Service. 2010; 23:
43-51.
13. Obionu CN. Primary health care in developing countries. 2nd ed. Enugu. Evanseenio; 2007:
1-386.
14. World Health Organization. Alma Ata 1978 Primary Health Care. Geneva: WHO, 1978: 1-
80.
15. World Health Organization. The World Health Report 2008-Primary Health Care : Now
more than ever.2008: 1-4.
16. Federal Ministry of Health of Nigeria. Revised National Health Policy: Abuja. 2004: 1-66.
17. Mosadeghrad AM, Ferlie E, Rosenberg D. A study of the relationship between job
satisfaction, organizational commitment and turnover intention among hospital employees.
Health Serv Manage Res 2008; 21: 211-227.
18. Society for Human Resource Management (SHRM). Employee job satisfaction:
Understanding the factors that make work gratifying. Mumbai, India. 2009: 1-52.
19. Mojoyinola JK. Effects of Job stress on health, personal and work behaviour of nurses in
public hospitals in Ibadan metropolis, Nigeria. Ethno-Med. 2008; 2(2): 143-148.
20. Blengen MA. Nurses job satisfaction: a meta-analysis of related variables. Nur Res. 1993;
42(1) : 36-41.

21. Saane NV, Sluiter JK, Verbeek JHAM, Frings-Dresen MHW. Reliability and validity of
instruments measuring job satisfaction- a systemic review. Occupational Medicine.2003; 53:
191-200.
22. Job satisfaction :en .wikipedia.org/wiki (accessed 2011 June 11)
23. Job descriptive index : www.humanresources.hrvinet.com (accessed 2011 June 13)

(H.) PREVALENCE OF FACTORS AFFECTING JOB SATISFACTION OF
HEALTH WORKERS IN SOUTH-EASTERN NIGERIA.
ABSTRACT:
The aim of this study was to assess factors affecting job satisfaction of Health Workers in
South-eastern Nigeria. Methodologically, this study used descriptive , cross sectional study
design. Results showed there was no difference between overall level of satisfaction using the
Minnesota Satisfaction Questionnaire Short Form and perception rating of respondents.
Conclusively, there high level of job satisfaction among Health workers. Improvement in various
domains of job dissatisfaction in order to improve effective and efficient utilization of resources
among workers is highly recommended.

Nigeria.
Introduction : There has been several studies on factors affecting job satisfaction among
different groups of workers in different fields but very few of such studies have been carried out
specifically among Health workers in south-eastern Nigeria.
Objective: To assess factors affecting job satisfaction of Health Workers in South-eastern
Nigeria.

administered questionnaire used by participants was adapted from The Minnesota Satisfaction
Questionnaire Short Form to assess job satisfaction.
Factors that influenced the workers’ level of job satisfaction were age, marital status, tribe ,
educational qualification and ranks/ cadre. Of the 18 domains of job satisfaction , workers were
dissatisfied with salary, other benefits, skills utilization, motivation, career development and rate
of promotion at work.
Conclusion: The study showed a high level of job satisfaction among Health workers.
Recommendation: Improvement in various domains of job dissatisfaction in order to improve
effective and efficient utilization of resources among workers is highly recommended.
Keywords: factors, job satisfaction; health workers, Nigeria

Igbokwe I, Ojo I.
REFERENCES
Centre employees: a quantitative study in poor rural China. BMC Health Service. 2010;
23: 43-51.
3. Obionu CN. Primary health care in developing countries. 2nd ed. Enugu. Evanseenio;
2007: 1-386.
4. World Health Organization. Alma Ata 1978 Primary Health Care. Geneva: WHO, 1978:
1-80.

6. Federal Ministry of Health of Nigeria. Revised National Health Policy: Abuja. 2004: 1-
66.
satisfaction, organizational commitment and turnover intention among hospital
employees. Health Serv Manage Res 2008; 21: 211-227.
10. Blengen MA. Nurses job satisfaction: a meta-analysis of related variables. Nur Res.
1993; 42(1) : 36-41.
instruments measuring job satisfaction- a systemic review. Occupational Medicine.2003;
53: 191-200.
14. Kebriaei A, Moteghed MS: Job satisfaction among community health workers in
Zahedan district, Islamic Republic of Iran. La Revue de Sante de la Mediterannee
Orientale. 2001; 15: 5-7.
15. Bodur S. Job satisfaction of health care staff employed at health centres in Turkey.
Occup. Med. 2002; 52 (6): 353-355.
16. Ofili AN. A comparative study of job dissatisfaction among doctors and nurses at the
University of Benin Teaching Hospital, Benin City, Edo State, Nigeria. Project report,
Faculty of Community Health, West African Postgraduate Medical College, April
1998;90.

17. Willis-Shattuck M, Bidwell P, Thomas S, Wyness L, Blaauw D, Ditlopo P.Motivation
and retention of health workers in developing countries: a systematic review. BMC
Health Services Research.2008; 8: 247.
18. Chen LC, Boufford JI. Fatal flows-Doctors on the move. N Engl J Med 2005; 353: 1850-
1852.
19. Ebuehi OM , Campbell PC. Attraction and retention of qualified health workers to rural
areas in Nigeria: a case study of four LGAs in Ogun State Nigeria .Rural Remote
Health.2011; 11: 1515.
20. Ali N. Factors affecting overall job satisfaction and turnover retention. Journal of
Managerial Sciences. 2005; 2(2): 239-252.
21. Rehab Measures: General Health Questionnaire(GHQ) -28.
www.rehabmeasures.org/Lists/RehabMeasures/DispForm.aspx?ID=909:1-3(accessed
February 26,2014).

(I.) ASSESSING JOB STRESS AND PSYCHOLOGICAL HEALTH OF HEALTH
WORKERS IN SOUTH-EASTERN NIGERIA.
ABSTRACT:
The objective of this study was to assess job stress and psychological health of health workers
in South-eastern Nigeria. Methodologically, this study utilized descriptive , cross sectional study
design. Results revealed the proportion of workers with psychological disorder increased with
the level of dissatisfaction but this was not statistically significant. The proportion of workers in
this study with psychological disorder increased with the proportion of workers stressed up and
this association was statistically significant. Conclusively, there is association between stress and
psychological disorder. Improvement in various domains of job dissatisfaction in order to reduce
job stress and psychological disorder among workers is highly recommended.
1 , Igwegbe AO 7, Oyeka CE 8 , Ofili AN 9 ,Asuzu MC 10 , Onajole TA 11

Nigeria.
Introduction : There has been several studies on job stress and psychological health among
different groups of workers in different fields but very few of such studies have been carried out
specifically among Health workers in southeastern Nigeria.

Objective: To assess job stress and psychological health of Health Workers in South-eastern
Nigeria.
administered questionnaire used by participants was adapted from a study by Ofili et al to assess
job stress and The General Health Questionnaire 28 to assess psychological health disorder.
filled and returned their questionnaires. About 50.4% of workers were above 40 years of age,
and 62.1% were married. There were more females (73%) than males (26%). Almost all workers
were Christians as well as were of Igbo origin in tribe.
Using the General Health Questionnaire (GHQ) thirty one percent of workers had score of 4 and
above, and were at increased likelihood of having a psychological disorder. About 74.5% of
workers were stressed up with 26 % of workers having their source of stress from outside their
jobs. The proportion of workers with psychological disorder increased with the level of
dissatisfaction but this was not statistically significant.
The proportion of workers in this study with psychological disorder increased with the
proportion of workers stressed up and this association was statistically significant.
Conclusion: The study showed there is association between stress and psychological disorder.
Recommendation: Improvement in various domains of job dissatisfaction in order to reduce job
stress and psychological disorder among workers is highly recommended.
Keywords: Job stress; psychological disorder; health workers; Nigeria

Igbokwe I, Ojo I.
REFERENCES
23: 43-51.
2007: 1-386.
1-80.

66.
1993; 42(1) : 36-41.
53: 191-200.
Orientale. 2001; 15: 5-7.
Occup. Med. 2002; 52 (6): 353-355.

1998;90.
1852.
Health.2011; 11: 1515.
February 26,2014).
22. Odebunmi SO. Assessment of job satisfaction among Primary Health Care workers in
Lagos Island Local Government Area. Master of Public Health ( MPH) project,
University of Lagos, Lagos State, Nigeria. June 2011: 1-50

(J.) INVESTIGATING HOW JOB STRESS AND PSYCHOLOGICAL HEALTH
RELATE TO JOB SATISFACTION OF HEALTH WORKERS IN SOUTH-
EASTERN NIGERIA.
ABSTRACT:
The aim of this study was to investigate how job stress and psychological health relate to job
satisfaction of health workers in Southeastern Nigeria. Methodologically, descriptive , cross
sectional study design was used. Results demonstrated the proportion of workers with
psychological disorder increased with the level of dissatisfaction but this was not statistically
significant. The proportion of workers in this study with psychological disorder increased with
the proportion of workers stressed up and this association was statistically significant. Stress
increased with the level of dissatisfaction but this was not statistically significant. Conclusively,
there is association between stress and psychological disorder but no association between job
satisfaction and any of stress and psychological disorder. Improvement in various domains of
job dissatisfaction in order to reduce job stress and psychological disorder among workers is
highly recommended.
1 , Igwegbe AO 7, Oyeka CE 8 ,Ofili AN 9 , Asuzu MC 10 , Onajole TA 11

Nigeria.

Introduction : There has been several studies on job stress, job satisfaction and psychological
health among different groups of workers in different fields but very few of such studies have
been carried out specifically among Health workers in southeastern Nigeria.
Objective: To assess job stress, job satisfaction and psychological health of Public Primary
Health Care Workers in Southeastern Nigeria.
administered questionnaire used by participants was adapted from a study by Ofili et al to assess
job stress, The Minnesota Satisfaction Questionnaire Short Form to assess job satisfaction and
The General Health Questionnaire 28 to assess psychological health disorder.
Factors that influenced the workers’ level of job satisfaction were age, marital status, tribe ,
educational qualification and ranks/ cadre. Of the 18 domains of job satisfaction , workers were
dissatisfied with salary, other benefits, skills utilization, motivation, career development and rate
of promotion at work.
Using the General Health Questionnaire (GHQ) thirty one percent of workers had score of 4 and
above, and were at increased likelihood of having a psychological disorder. About 74.5% of
workers were stressed up with 26 % of workers having their source of stress from outside their

jobs. The proportion of workers with psychological disorder increased with the level of
dissatisfaction but this was not statistically significant.
The proportion of workers in this study with psychological disorder increased with the
proportion of workers stressed up and this association was statistically significant. Stress
increased with the level of dissatisfaction but this was not statistically significant.
Conclusion: The study showed a high level of job satisfaction among Public Primary Health
Care workers. While there is association between stress and psychological disorder there is no
association between job satisfaction and any of stress and psychological disorder.
Recommendation: Improvement in various domains of job dissatisfaction in order to reduce job
stress and psychological disorder among workers is highly recommended.
Keywords: Job stress; job satisfaction; psychological disorder; health workers

Igbokwe I, Ojo I.
REFERENCES
23: 43-51.
2007: 1-386.
1-80.
66.

1993; 42(1) : 36-41.
53: 191-200.
Orientale. 2001; 15: 5-7.
Occup. Med. 2002; 52 (6): 353-355.
1998;90.
1852.

Health.2011; 11: 1515.
February 26,2014).
22. Odebunmi SO. Assessment of job satisfaction among Primary Health Care workers in
Lagos Island Local Government Area. Master of Public Health ( MPH) project,
University of Lagos, Lagos State, Nigeria. June 2011: 1-50

(K.) PREVALENCE OF ATTITUDE OF TEAM BUILDING AMONG HEALTH
WORKERS IN TWO FEDERAL TERTIARY HEALTH FACILITIES IN SOUTHERN
NIGERIA.
ABSTRACT :
Team building has been found to improve the effectiveness and efficiency of workforce in the
healthcare system generally. The aim of this study was to assess training on team building on the
attitude of health workers in two federal tertiary health facilities in Southern Nigeria.
The materials and methods used included a quasi-experimental study. Multistage sampling
technique was used to select a total of 242 subjects from ten categories of professionals of study
group (Nnamdi Azikiwe University Teaching Hospital) and control group (Federal Medical
Centre). The study phases were pre-intervention, intervention and post-intervention. There was
also statistical significant difference across all variables as determined by chi-square test
(p<0.01) between the pre-intervention and post-intervention phases of study group . In
conclusion, team building was effective in improving attitude of health workers in healthcare in
the study tertiary health facility.
1. Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital
, Nnewi, Anambra State, Nigeria.

5. Cashville Group of Companies and Partners, worldwide (25 inter-dependent firms).
10. Department of Community Medicine, University College Hospital, Ibadan, Oyo
State, Nigeria.
Name and address of the corresponding authour: Henry A. Efegbere 1, 5

Introduction : Team building has been found to improve the effectiveness and efficiency of
workforce in the healthcare system generally.
Objective: To assess training on team building on the attitude of health workers in two federal
tertiary health facilities in Southern Nigeria.
Materials and Methods: This was a quasi-experimental study carried out between November
2013 and February 2014. Multistage sampling technique was used to select a total of 242
subjects from ten categories of professionals of study group (Nnamdi Azikiwe University
Teaching Hospital, NAUTH Nnewi) and control group (Federal Medical Centre , FMC Asaba)
with 121 subjects in each group. The study consisted of a pre-intervention, intervention and post-
intervention phases. Subjects participated in the study using same self-administered
questionnaire for study and control groups at pre-intervention and post-intervention (three
months interval) phases. The training intervention instituted used a mix of conceptual framework
of the Health Belief Model and others.
Results: At pre-intervention phase baseline information on the 15 variables of knowledge and
attitude of team building were collected. This consisted of respondents that believed team
building may result to benefits in their organization, those that may participate in team building
if given an opportunity, those that may recommend it to improve inter-professional working
relationship, those that believed it may be a waste of time and money, those that may recommend
it to resolve conflict, those that believe to be an effective team member the attitude competencies
to possess may include (a)assertive behaviour,(b) cooperative attitude and (c) courage to
disagree.
During the intervention phase , training on team building was successfully conducted in three
days for study group.

At post-intervention phase, the same data collected during the pre-intervention phase was
collected again at each site. The data from each site was analyzed separately and the results were
compared. The attitude towards team building among health workers at pre-intervention phase
for study and control groups for the eight variables showed that respondents with appropriate
responses were more than 50% for the two groups except for two variables which are the belief
to be an effective team member the attitude competencies to possess should include assertive
behaviour where respondents that agreed to it were 36.6% and 75.6% for study and control
groups respectively while the other variable the belief to be an effective team member the
attitude competencies to possess should include courage to disagree where those that agreed to it
were 47.6% and 59.3% for study and control groups respectively. Proportion of respondents with
appropriate responses were more in control group than the study group for all variables of
attitude.
There was also statistical significant difference across all variables as determined by chi-square
test (p<0.01) between the pre-intervention and post-intervention phases of study group with the
exception of 1 variable whereas there was statistical significant difference in only 2 variables
between the pre-intervention and post-intervention phases of control group .
Conclusion: Proportion of respondents with appropriate responses were more in control group
than study group for all 8 variables of attitude at pre-intervention phase. Team building was
effective in improving attitude of health workers in healthcare in the study tertiary health
facility.
Recommendation: The Federal Ministry of Health of Nigeria should formulate and implement
policy on attitude of team building for the three tiers of healthcare delivery in Nigeria.
Keywords: Training, Team building, Attitude , health workers

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