A survey of facilities and human resource for paediatric nephrology training and practice in Nigeria: Resident doctors’ perspective
Notice bibliographique
Résumé
Background: Kidney diseases are emerging as important contributors to non- communicable diseases in children worldwide and they impact negatively on the socioeconomic wellbeing of families and nations. Unlike rich economies of the world there is dearth of facilities and manpower needed for the practice and training in Paediatric Nephrology in resource challenged nations like Nigeria. There are however no data to support this assertion. Objectives: The study sought to provide information on facilities and manpower available for paediatrics nephrology practice and education in the country. Methods: We deployed an indirect, unobtrusive and introspective method to gather needed data using semi structured self- administered questionnaire on resident doctors who fitted well as key informants. Subjects were attendees at the annual Update Course in Paediatrics organised by the National Postgraduate Medical College of Nigeria in 2019. Results: Of the 154 attendees 93 (31 males and 62 females) participated in the study. Fifty four, 34 and 5 respectively were from Federal Teaching Hospitals, Federal Medical Centres and State Teaching Hospitals. Seventeen (31.5%), 14(25.9%) and 12(22.2%) of the residents working in federal teaching hospitals were from the South-south, Northwest and Southeast zones respectively while majority of the residents employed in state facilities were from the Southwest. Northeast and North-central zones had few residents. Facilities for haemodialysis (X2 = 9.58; p= 0.008), renal biopsy (X2 = 27.98; p= 0.000) and tissue handling (X2 = 9.97; p= 0.007) were significantly more in state and Federal Teaching Hospitals compared to Federal Medical Centres. Haemodialysis is not done in a quarter of the hospitals and in places where it was carried out, facilities are not dedicated to children and are not regularly done. One in 4 and two in 5 respondents came from centres where peritoneal dialysis (PD) is carried out with improvised materials. Among a quarter and half of the respondents, PD is respectively not done or seldom carried out. The views of 55.9% and 60.2% of the respondents on practice of Paediatric Nephrology was “fair” and “basic” respectively. Supplementary local and overseas training respectively could be accessed by only 23.7% and 12.9% of the respondents. Dedicated training in nephrology was available in centres hosting only 29% of the respondents. Where available the training was assessed as fair and good by 37.0% and 55.6% of the residents respectively. In the opinion of about half the respondents factors militating against training and practice were manpower/ infrastructural deficits, and lack of commitment of stakeholders. Conclusion and Recommendations: Practice and training in Paediatrics Nephrology in Nigeria is at best basic and limited in scope and depth. They are hamstrung by multiplicity of factors. Advancing their cause in the country would require commitment of all stakeholders through improved funding and programs re-orientation.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».