Nigerian Journal of Family Practice (NJFP) serves as a repository for cutting-edge, peer-reviewed research in all fields of primary health care and family medicine in a uniquely African context. Encouraging scholarly exchange between family medicine and primary health care researchers and practitioners across Sub-Saharan Africa, NJFP provides a contextual and holistic view of family medicine as practiced across the continent. The journal is indispensable for family medicine specialists, primary health care practitioners and academics from both the developing and developed worlds, and offers an engaging insight into the growth of these disciplines from a distinctly African perspective. Coverage of NJFP includes: Family medicine; Primary health care; District health; Rural health; Health promotion Prevention of disease and disability; Community oriented primary care; Education and training of professionals and health workers in primary health care and family medicine; Medical informatics and information science; Accident & Emergency care; Occupational Health; Travel Medicine etc.
Society of Family Physicians of Nigeria (SOFPON)
RELATIONSHIP BETWEEN MARITAL SATISFACTION AND PSYCHOLOGICAL HEALTH AMONG MARRIED COUPLE IN SOUTH-SOUTH REGION OF NIGERIA.
Background: Marital satisfaction is the largest contributor to overall happiness for married individuals and is strongly associated with physical and psychological wellbeing. Marital satisfaction is so critical to health and happiness that it generally declines over time when problems weigh down on a couple. Couples are expected to assist each other in various aspect of life and if these are not met, it can lead to marital dissatisfaction and invariably divorce or separation. Family stability is crucial and important to every society and nation as a whole. A healthy family atmosphere markedly influences the psychological health of each member of the family. This study is aimed at eliciting a relationship between marital satisfaction and psychological health among patients attending Family Medicine Out-patient Clinic in Delta State University Teaching Hospital, Oghara. Methods: This was a cross-sectional study that adopted a General Health Questionnaire(GHQ 28) as well as Index of Marital Satisfaction (IMS 25) to assess the relationship between psychological health and marital satisfaction respectively among patients recruited using a systematic sampling technique from Family Medicine Out-patient Clinic in Delta State University Teaching Hospital. The information required for the study was collected with the use of researcher-administered questionnaires. The questionnaire was translated into Pidgin and Urhobo languages and reinterpreted back by an external source in order to validate it. Collected data were entered into a spreadsheet and analysed using Statistical Package for Social Sciences (SPSS) Version 22. Results were presented in proportions, mean ± standard deviation and displayed in tables and charts. The relationship between marital satisfaction and psychological health was expressed using Pearson's chisquare. Ap-value was considered significant if less than 0.05. Result: The association between duration of marriage and psychological stability was highly significant; p = 0.001. Over three-fifths 115 (62.5%) of the patients had marital satisfaction whereas 69 (37.5%) of them were not satisfied in their marriage. The majority of the study participants were psychologically stable in their marriage, while 29.4% were unstable. Conclusion: The level of marital satisfaction was moderately high. The relationship between marital satisfaction and psychological health was statistically significant. This shows that marital satisfaction has a positive impact on the psychological health of the couple and vice versa.
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PREDICTORS OF POST-COVID SYNDROME AMONG ADULT PATIENTS WITH COVID -19 INFECTION IN IBADAN, NIGERIA
Background: While most individuals recover from acute Coronavirus disease (COVID-19), a subset experiences persistent symptoms, referred to as post-COVID-19 Syndrome (PCS). Understanding the clinical spectrum and determinants of PCS is essential to provide evidence-based long-term care for COVID-19 survivors. This study aimed to describe the clinical spectrum and predictors of PCS among hospitalized and non-hospitalized COVID-19 patients in Ibadan, Nigeria. Methods: A retrospective cross-sectional study involved 536 adult individuals who tested positive for SARS-CoV-2 via polymerase chain reaction (PCR) in Ibadan, Nigeria. Data, including demographics, symptoms, comorbidities, and quality of life, were collected using a semistructured questionnaire and analyzed with descriptive statistics. Pearson's Chi-square and logistic regression were used to assess associations and predictors of PCS. Results: Among the 536 participants, 98 (18.3%) had PCS. Of these, 67 (68.4%) reported mild symptoms, while 31 (31.6%) experienced severe symptoms. Common symptoms included fatigue/malaise (36.7%), headache (19.4%), cough (17.3%), and sore throat (13.3%). Comorbidities, initial COVID-19 severity, vaccination status pre-infection, treatment location, oxygen supplementation, and ICU care were associated with PCS. Logistic regression revealed that having received a pre-COVID-19 vaccination decreased the odds of PCS by 62.4% (aOR=0.376; 95% CI [0.205, 0.692]). Individuals that experienced PCS had lower quality of life scores (Mean EQ VAS score: 85.8) compared to those without PCS (89.7), with impacts across mobility, self-care, daily activities, pain/discomfort, and anxiety/depression domains in EQ-5D analysis. Conclusion: PCS affects a significant proportion of COVID-19 survivors in Ibadan, Nigeria. Pre-COVID-19 vaccination was associated with a reduced risk of PCS. Understanding the clinical and demographic factors predicting PCS can aid in providing long-term care and support for affected individuals.
EXCLUSIVE BREASTFEEDING: UPDATE ON THE KNOWLEDGE AND PRACTICES OF CARE PROVIDERS AND MOTHERS IN THE MALUKU I AND LEMBA HEALTH ZONES.
Background: Exclusive breastfeeding (EBF) is the practice of feeding newborns and infants only breast milk over six months of age. A child who is not exclusively breastfed for the first 6 months of life is exposed to infectious diseases such as diarrhea and is at high risk of developing malnutrition. According to WHO and UNICEF recommendations, EBF should be practised by every woman with an infant under six months of age. The percentage of EBF practice in the Lemba health zone is low in contrast to Maluku I. This study aim to assess the current knowledge and practices regarding EBF among care providers and mothers in Maluku I and Lemba Health Zones. Methods: Aqualitative case study approach was used to highlight the knowledge and practice of cares providers and in-depth interviews were used to collect data, which were analyzed using Atlas-ti V7 software. Results: The majority of our respondents had a superficial knowledge of EBF and knew the importance of this, but healthcare providers hadn't received appropriate training on EBF. A significant proportion of healthcare providers don't discuss EBF with women during medical appointments and visits. Culture, surroundings, spouse are all factors influencing the non-adherence of these women to the practice of EBF Conclusion: Providers aren't well trained and don't talk enough to women about EBF; work, culture, advertising of artificial milk on the media and the entourage slow down women in Lemba from practicing EBF. This study will help to improve the health of breast-feeding children.
MEDICATION ADHERENCE AND BLOOD PRESSURE CONTROL AMONG HYPERTENSIVE PATIENTS IN A NIGERIAN TERTIARY HOSPITAL: A CROSS-SECTIONAL STUDY
Background: Despite the availability of potent antihypertensive medications blood pressure control remains low worldwide. Poor blood pressure control is known to contribute significantly to the morbidity and mortality among hypertensive patients with developing countries disproportionately affected. There are limited studies locally on relationship between medication adherence and blood pressure control. Aim: To investigate the relationship between medication adherence and blood pressure control among hypertensive patients attending Family Medicine clinic of UNIOSUN Teaching Hospital, Osogbo, Osun State, Nigeria. Methods: A cross-sectional hospital-based study was conducted. Systematic sampling method was used to recruit 300 known adult hypertensive patients from August to November, 2021. Data was collected using a pre-tested interviewer-administered questionnaire and medication adherence was measured using Morisky 8-Item Medication Adherence Questionnaire. Data was analyzed using descriptive and inferential statistics with p-value < 0.05 taken to be statistically significant. Results: This study recorded poor medication adherence among the study participants with 51.3% and 48.7% medium and low medication adherence respectively. Blood pressure control rate (46.7%) was also low. There is a directly proportional relationship between medication adherence and blood pressure control among the participants which was statistically (p= 0.001). Conclusions: Hypertensive patients adhered poorly to antihypertensive medication and the blood pressure control among them was poor.
DEPRESSION AMONG ELDERLY INDIVIDUALS ATTENDING PRIMARY CARE CLINIC IN NORTHWESTERN NIGERIA: PREVALENCE, PATTERN, AND ASSOCIATED FACTORS
Background: Depression represents a major international public health problem for both developed and developing countries. It is associated with increased risk of morbidity, suicide, decreased physical, cognitive and social function, and greater self-neglect which in turn is associated with increased mortality. The aim was to investigate the prevalence, pattern and associated factors of depression among the elderly individuals in a primary care clinic in Northwestern Nigeria. Methodology: The study was a cross-sectional hospital-based study and 391 elderly participants in a primary care clinic of Usmanu Danfodiyo University Teaching Hospital were recruited through systematic sampling technique. Data was collected using pre-tested, structured interviewer-administered questionnaire, Oslo – 3 social support scale and the GDS- 30 was used to screen for depression. Data was analyzed using SPSS version 20. Test of associations was done using Chi- square test and P< 0.05 was considered statistically significant. Results: The prevalence of depression among the elderly was found to be (41.2%) and of these respondents who were depressed, (99.4%) of them had mild depression while (0.6%) had severe depression. Marital status, level of education, occupational status, average monthly income, location of residents, social support,(P-value <0.05) were found to be significantly associated with depression in the elderly. Conclusion: The prevalence of elderly depression was high in primary care with preponderance of mild depression, the study recommends early screening, detection and treatments of depressive disorder in the elderly by primary care physician.
PREVALENCE AND PATTERN OF NEUROLOGICAL DISORDERS IN ADULT PATIENTS SEEN AT AN OUTPATIENT RURAL TERTIARY HOSPITAL SETTING
Introduction: Neurological Diseases (NDs) are common and most disabling leading to significant morbidity and mortality globally particularly in resource constrained settings. This study was aimed at determining the prevalence, distribution and pattern of NDs seen at the outpatient family medicine clinics of Irrua Specialist Teaching hospital (ISTH), Irrua, Edo State, Nigeria. Methods: A descriptive, retrospective review of hospital record was conducted for 1086 adult patients presenting to the general outpatient clinics of ISTH from January to December 2021 using hospital records. The diagnosis as made based on clinical findings and laboratory and radiological investigations using the 10th revision of the International Statistical Classification of Diseases and related Health Problems (ICD 10). Results were analysed using epi info version 3.5.4. level of significance was set at 0.05. Results: The prevalence of neurologic disorders was found to be 2.06%. The age of respondents ranged from 18 to 93 years with a mean age of 46±18 years. They were mostly females 678 (62.4%), married 678 (62.4%) with majority of them being traders 315 (29.0%). The most common disorder among respondents was neuropathy 372 (34.3%) followed by Headache 368 (33.9%), Seizure Disorder 144 (13.3%), Stroke 98 (9.0%) and Migraine 20 (1.8%). There was association between age (p <0.001), marital status (p <0.001) and occupation (p <0.001) with the above neurological disorders. Conclusion: Neurologic disorders were common among the respondents with neuropathy, headache, seizure disorders, stroke and migraine being the most common. The study also found an association between these conditions with age, marital status and occupation.
DOES THE NIGERIAN HEALTH SECTOR NEED FAMILY MEDICINE?
Family medicine plays a vital role in enhancing healthcare delivery, yet its importance remains underrecognized in Nigeria. This article evaluates the relevance of family medicine in Nigerian health care industry where the healthcare system faces significant challenges, including limited access to care, an overburdened tertiary system, and a shortage of healthcare professionals. This article assesses the value of family medicine in the Nigerian healthcare sector, which is beset by a number of problems such as a lack of healthcare experts, a tertiary system that is overworked, and restricted access to care. Family medicine, with its focus on holistic, patient-centered, and continuous care, has the potential to address these gaps, particularly at the primary care level. Family physicians provide comprehensive care that addresses not only physical health but also the psychological and social factors affecting patients. They are crucial in managing common conditions and the rising burden of non-communicable diseases such as hypertension, diabetes, and respiratory illnesses. Additionally, family physicians are integral to maternal and child health, infectious disease control, and mental health services, which are critical public health areas in Nigeria. However, family medicine in Nigeria faces significant challenges, including a shortage of trained family physicians, limited government support, and poor integration into the healthcare system. The preference for specialist care, combined with underinvestment in primary care, undermines the role of family medicine in health system strengthening. To address these challenges, policy reforms are necessary to prioritize the training of family physicians, improve funding for primary care services, and raise public awareness about the importance of family medicine. By enhancing the role of family medicine, Nigeria can improve access to care, reduce pressure on tertiary care facilities, and create a more equitable healthcare system. In conclusion, Family medicine is essential for ensuring sustainable and effective healthcare delivery in Nigeria.
THE POTENTIAL ROLE OF AI IMPROVING HEALTH CARE DELIVERY IN LOW- AND MIDDLE-INCOME COUNTRIES (LMICS).
This paper explores the transformative potential of artificial intelligence (AI) in enhancing healthcare delivery in low- and middle-income countries (LMICs), focusing on its applicability, challenges, and pathways for integration. The study is structured around three core objectives: examining current AI applications in Low- and Middle-Income Countries and their potential adaptations; investigating how AI can address pressing health challenges such as resource allocation and disease management; and identifying barriers to AI adoption, including technological infrastructure, data privacy concerns, and workforce training deficits. AI technologies have demonstrated significant efficacy in diagnostics, disease surveillance, and resource optimization, exemplified by mobile health (mHealth) solutions that extend healthcare access to underserved populations. However, the successful implementation of AI in LMICs is impeded by insufficient data quality, lack of robust infrastructure, and ethical considerations. By drawing on lessons from developed nations and emphasizing public-private partnerships, this study proposes strategies to overcome these obstacles, ensuring that AI can be harnessed effectively to improve health outcomes. The findings highlight the need for context-specific AI solutions and collaborative efforts among stakeholders to realize the full potential of AI in achieving equitable and efficient healthcare systems in LMICs.
HIDDEN IN PLAIN SIGHT: HYPERTHYROIDISM SHROUDED AS GASTROINTESTINAL DISTRESS IN A DIABETIC PATIENT.
Thyroid hyperfunction usually manifests with typical symptoms such as palpitations, fatigue, heat intolerance, excessive sweating and polydipsia. Atypical presentation with gastrointestinal disorders in a known diabetic patient in a resource-poor environment could lead to misdiagnosis. Delay in diagnosis and treatment may occur due to a lack of classical symptoms of hyperthyroidism occurring on a background of immunosuppression due to diabetes mellitus (DM) in an environment where infectious causes of gastrointestinal symptoms abound. We report a case of a 53-year-old, known DM patient with no prior history of hyperthyroidism, who presented with spurious diarrhoea that eventually led to the diagnosis of hyperthyroidism. The report highlighted the importance of recognition of thyroid disorder in DM in the midst of confounding symptoms. It further emphasized that diarrhoea can present as a lone clinical feature of thyroid hyperfunction in some patients. Furthermore, it underscored the need for TSH levels monitoring after commencement of metformin therapy in diabetic patients.
KNOWLEDGE, ATTITUDE AND INFECTION CONTROL PRACTICES AMONG HEALTHCARE PROFESSIONALS IN SELECTED PRIMARY HEALTHCARE CENTRES IN URBAN AREAS OF LAGOS STATE.
Background: Infection is a serious issue encountered in healthcare delivery services worldwide. Healthcare workers are exposed to the risk of occupational infection following accidental exposure to blood or body fluids. Studies have shown disparity in knowledge of infection transmission and control, its interpretation and application among healthcare workers at the primary healthcare level in particular. This study determined the knowledge, attitude and practice of infection control among healthcare workers in primary healthcare (PHCs) centers in Surulere LGA. Methods: A cross-sectional study carried out among PHCs in Surulere LGA using a simple random sampling technique. The PHCs are composed of doctors, pharmacy technicians, nurses, community health officers, community extension workers, junior community health extension workers and laboratory technologists. The questionnaires consisting of participants demography, working experience, professions, presence of infection control committee, exposure to training on infection control, knowledge and practice of infection control, were analyzed. Data entry and analysis was done using Epi info software version 7.2.3.1 Results: Most of the respondents (77.3%) were females and female to male ratio was 3:1. Close to half of the respondents (43.6%) have less than 5 years of working experience. Among the professions, the nurses constituted a predominant proportion (27.3%) while among all the professions combined, 97.3% of them had good knowledge of infection control. All the respondents had above average positive attitude towards infection control. Atotal of 86.4% of the respondents had good infection control practice Ahigh proportion of the respondents (75.5%) have training on infection control while 95.5% of the respondents are aware about infection control guidelines. There was a significant association between knowledge and practice of infection control (p<0.001). There was a statistically significant association between age, years of work experience, occupation and overall knowledge. There was a statistically significant association between the level of education, occupation and overall practice of infection control. Conclusion: Majority of the respondents had good knowledge of infection control and positive attitude. Adequate provision of appropriate safety kits and their timely replacement should be made. It was recommended Health workers should regularly update their knowledge and practice regarding infection prevention activities during continuous professional development, to be coupled with adequate provision and timely replacement of appropriate safety kits when worn-out to all cadres of staff based on their job schedule.
MEDICATION ADHERENCE AND ITS ASSOCIATION WITH SOCIO-DEMOGRAPHICS,PERCEIVED FAMILY SUPPORT AND BLOOD PRESSURE CONTROL AMONG ADULTS HYPERTENSIVE PATIENTS IN RURAL SOUTHWESTERN NIGERIA
Background: Perceived Family support and blood pressure control are important outcome measures to medication adherence in clinical trials. However, there is limited research on this topic among adult hypertensive patients in rural Southwest Nigeria. This study determined the pattern of medication adherence, blood pressure control and perceived family support and ascertained the determinants of medication adherence among adult hypertensive patients attending a tertiary hospital in rural Southwestern Nigeria. Methods: Hospital-based cross-sectional study was conducted on 282 hypertensive patients on follow up using systematic random sampling technique. Standardized semi-structured interviewer administered questionnaire was employed to seek information on respondents' sociodemographic characteristics. Adherence level was determined using the Morisky's Medication Adherence Scale, while Perceived Social Support family (PSS-Fa) scale was employed to assess the level of respondents' perceived family support. Data were analyzed using SPSS 20. Multivariate logistic regression analysis was used to identify the determinants of medication adherence. Results: The majority of the respondents had high medication adherence (61.0%), good controlled blood pressure (60.6%), and strong perceived family support (56.0%). Being a middle age (p<0.05), formal education (p<0.01), civil servants (p<0.001), higher income level (p<0.001), higher pill burden (p<0.001), normal BMI (p=0.012, controlled blood pressure (p<0.001) and strong perceived family support (p<0.001) were the independent determinants of medication adherence. Conclusion: The pattern of medication adherence, perceived family support and blood pressure control were good. The findings would assist the stakeholders at improving adherence to medication among patients with hypertension in rural Southwest Nigeria.
NAUSEA AND VOMITING OF PREGNANCY AND ITS CONTROL MEASURES AS SEEN IN TWO TERTIARY CARE FACILITIES IN SOUTHWEST NIGERIA
Background: Due to the concerns about the possible harmful effects of medications on foetuses, pregnant women prefer to control the symptoms of Nausea and Vomiting during pregnancy by personal, familial, and traditional measures. The Objective of the study is to identify the control measures that pregnant women use with NVP and determine its impact on their daily lives. Method: A cross-sectional descriptive survey of pregnant women at two Hospitals in Osun state was conducted. Five hundred pregnant women were recruited, and data was collected using a pre-tested questionnaire to elicit information on socio-demographic characteristics, control measures of NVP and its impact on daily life. Frequencies and proportions were generated for socio-demographic variables, control measures of NVP and its effects on everyday life. Results: 352 (70.4%) women experienced the symptoms of NVP. The most frequently taken agent for the control of NVP was chewing gum 145 (41.2%). Other interventions include sweets 82 (23.2%), bitter kola 72 (20.5%), prescription and over-the-counter (OTC) drugs 63 (17.9%), bitter leaf 54 (15.3%), ginger 43 (12.2%) and kola nut 29 (8.2%). NVP affected the daily activities of 53.8%, while 81.9% were discouraged from getting pregnant again due to the symptoms. However, 18 (5.1%) have ever considered terminating a pregnancy due to NVP. Conclusion: There was a high incidence of NVP among the respondents. Most respondents perceived that NVP affected their daily lives with a severe impact on their intent to become pregnant again.
CORRELATES OF OBESITY AND FUNCTIONAL DISABILITY AMONG SENIOR CITIZENS AT USMANU DANFODIO UNIVERSITY TEACHING HOSPITAL, SOKOTO EXPERIENCE.
Background: The study assessed the relationship between obesity and functional disability in elderly. Materials and method: A descriptive sectional study was conducted at Usmanu Danfodiyo University Teaching Hospital. Systemic sampling technique was employed and structured interviewer administered questionnaire was administered among 319 participants. Data was collected on socio-demographics, functionality, assessment and anthropometrics (weight and height and BMI) of the respondents were also taken. Data was analyzed using IBM SPSS version 21 statistical software. Results: The mean age of the respondents was 65.9 ± 6.7. There was a statistically significant relationship between obesity and ADL disability (0.001).The prevalence of obesity was 17.6% with majority having obesity class 1(11.3). Conclusions: Obese elderly have twice the risk of having disability in self-care. Therefore, it needs to be tackled for prevention and management of disability in elderly
RETROSPECTIVE ANALYSIS OF HISTOLOGICAL TYPES AND LATERALITY OF BREAST CARCINOMA IN A TERTIARY HOSPITAL IN SOUTHWEST NIGERIA
Background: Breast carcinoma is the most common cancer among women worldwide and is a leading cause of death among women. It has various histological types, which differ in their clinical and pathological features. In Nigeria, it accounts for over 25% of all cancer cases. The evolving nature of breast cancer calls for a continuous study of the histological types, distribution patterns, and unique characteristics as it may reveal new insights and variations. Therefore, this study aimed to determine the histological types, age distribution, and laterality of breast carcinoma cases at the UNIOSUN Teaching Hospital (UTH) Osogbo. Methods: This study was a retrospective analysis of all cases of breast carcinoma diagnosed histologically at the UTH Osogbo over 10 years. Information on patients age, laterality, and histological type of breast carcinoma was obtained from the records of the Department of Pathology. The histological types were classified according to the World Health Organization (WHO) classification system and data was analyzed using descriptive statistics. Results: A total of 519 cases of breast carcinoma were diagnosed histologically. The mean age of the patients was 50.1 years (SD=12.4), with a range of 12-90 years. The highest number of cases (32%) were in the age group of 41-50 years, followed by 29.5% in the age group of 31-40 years. Invasive ductal carcinoma (NOS) was the most common histological type, accounting for 93.6% of cases. Other types were metaplastic carcinoma (2.7%), invasive mucinous carcinoma (1.3%), lobular carcinoma (1%), and medullary carcinoma (0.4%). Regarding laterality, 53% of the cases were in the left breast, 44% in the right breast, and 3% were bilateral. Conclusion: Invasive ductal carcinoma (NOS) was the most common histological type. Breast cancer was common among those aged 41-50 years and in the left breast. The results of this study could be useful for the development of breast cancer screening programs and treatment strategies in Nigeria.
ASSOCIATION BETWEEN HYPERTENSION AND LUNG FUNCTION AMONG ADULT PATIENTS ATTENDING THE GENERAL OUTPATIENT CLINIC OFA TERTIARY HOSPITAL IN SOUTHWEST NIGERIA.
Background: Poor lung function is a predictor of all-cause and cardiac mortality. Identifying and modifying risk factors is mandatory for reducing cardiovascular complications among hypertensive patients. Lung function however is not routinely assessed as a cardiovascular risk. The study aimed to compare the lung function parameters among hypertensive and normotensive patients at the general outpatient clinic of a tertiary hospital in southwest Nigeria. Method: A comparative study of 105 hypertensive and 105 normotensive patients, aged 40-60 years. An interviewer-administered questionnaire was used to obtain data on socio-demographic characteristic and medical history. Anthropometric measurement was obtained and spirometry was performed. The level of significance was set at p< 0.05. Result: A significantly higher proportion of the hypertensive group (33.3%) had poor lung function compared with the normotensive group (21.0%), p=0.044. Logistic regression analysis showed uncontrolled blood pressure (OR: 2.995, {1.243-7.171}) as the most significant predictor of poor lung function and waist circumference above normal (OR: 4.579, {1.136-18.465}), the most significant factor associated with poor lung function in the hypertensive and normotensive groups respectively. Conclusion: Uncontrolled blood pressure predicted poor lung function, thus lung function assessment as well as ensuring blood pressure control should be advocated among hypertensive patients for prevention of a decline in lung function
KNOWLEDGE OF MOTHERS ON PREVENTION OFANAEMIA IN CHILDREN UNDER 5 YEARS OF AGE IN THE PROVINCIAL CITY OF KINSHASA, DRC
Background: Early management of anaemia remains a major public health issue worldwide. In Kinshasa, DRC, the delay in the management of anaemia is associated with a high mortality rate. Parents' lack of knowledge of the signs of anaemia and inappropriate attitudes have been blamed elsewhere for this delay. The aim of this study was to assess mothers' knowledge of anaemia in children aged 0-59 months in the provincial city of Kinshasa. Methods: This was a cross-sectional study conducted in 6 health zones of Kinshasa among 639 mothers of children aged 0-59 months selected through multistage sampling. Data collection was done using a pre tested semi structured interviewer administered questionnaire and the data was analysed using SPSS version 24. Ethical approval was obtained from the Protestant University, Congo. Results: The predominant age group was 20 to 24 years (28.0%), the majority of mothers were married (57.2%) and had completed their secondary education in 61% of cases. Less than half of the children (41.4%) had a history of anaemia at the time of the survey. The majority of mothers (92.9%) had heard about anaemia through various sources of information, including family/friends (72.9%), health professionals (18.05%), television (5.7%), radio (0.7%) and school (2.65%). More than half of the mothers (59.4%) said they had seen publicity about anaemia either at the health centre (64.5%), on television (25.5%) or on the radio (3.0%). Overall the majority of mothers (62.5%) had good knowledge of their child's anaemia. The majority of mothers (92.1%) would bring their child to the health centre in case of anaemia, 18.3% and 16.3% would give iron and iron derivatives respectively. Conclusion: Anaemia is not an unknown disease among mothers of children under 5 years old in Kinshasa. However, the participation of health personnel in informing them about this disease remains insufficient. This level of knowledge must be improved by community awareness activities.
DECOLONIZING THE AFRICAN HEALTH SYSTEMS; THE REQUIRED STRATEGIC SHIFTS AND LEADERSHIP
A health system refers to all organizations, people and actions whose primary intent is to promote, restore or maintain health. The key social goal of a health system is to increase the average level of health of the population and reduce health inequities. Decolonization is the change that colonized countries undergo when they become politically independent. Understanding the historical context of health helps us to respond more appropriately to the health challenges of today. All the African countries adopted Primary Health Care to improve their health outcomes. However lack of proper policy trust, insufficient political commitment, failure to achieve equity in access to primary care components, slow economic development, unbalanced resource distribution, poor inter-sectoral action for health, weak information systems, lack of accurate baseline data, rapid demographic and epidemiological changes, centralized planning and management with the exclusion of the communities and other stakeholders have accounted for its slow progress in Africa. Adoption of the global agenda for health has not seen translated gains for the masses. An African health system for Africans by Africans that responds to the needs of our people is what will bring gains for the masses. Attempts to improve the health status of African people must be linked to regaining political, cultural, economic independence and selfdetermination as individuals, families, communities and nations. The methodology used in this review involved identifying credible and relevant studies using multiple data bases and search engines such as Google search, PubMed and Medline search. Extensive notes were made during literature search and the sources and their references were noted. An unbiased and critical evaluation of every piece of evidence was under taken. The articles selected were those that met the scope and guidelines of the research such as the geography and period under consideration, from precolonial, colonial and postcolonial Africa. Another literature search was done after completing the writing of the study to ensure that no recent study was left out while the research was on-going. The paper concludes that, as a solution to Africa's health challenges, major strategic shifts including adopting systems thinking approach, engendering adaptive leadership, evidence-based policies, re-conceiving accountability and reducing vertical programmes among others are suggested.