Search This Blog

Saturday, December 28, 2019

Healthcare Disparities in Rural and Remote Areas in America


The rural population in America is estimated to be 15-20% of the whole population. They face healthcare disparities that leads to worse healthcare as compared to urban and suburban regions. This inequities in healthcare is due to economic, social, racial, ethnic, geographic and health workforce factors (Kelleher & Gardner, 2017).

Increase in population and disparity in distance has been proven to be problematic in accessing medical and emergency healthcare services in first world countries such as Canada, United States of America and Australia. Inequities in healthcare accessibility and underutilization of emergency hospital services are a result of geographical distance among rural and remote areas. Meanwhile, there are pressures to downgrade hospital infrastructure, centralize more specialized medical functions to ensure that there is an appropriate level of procedures and quality of care and attempt moving hospitals services to rural areas. Small hospitals in rural and remote regions have struggled to sustain their financial status which has further become a major problem in terms of both capital expenditure and expenses; at the same, maintaining and attracting highly skilled healthcare professionals in remote locations is another challenge of its own. Hospital closure is often considered as a political charge that is restricted by the local population. This implies that primary healthcare is of great significance either by preventing unnecessary hospital admissions or providing the necessary emergency care, which can also be assisted by telemedicine (Rechel et al., 2016).


Kelleher, K. J., & Gardner, W. (2017, April 6). Out of sight, out of mind - behavioral and developmental care for rural children. New England Journal of Medicine, Vol. 376, pp. 1301–1303.

Rechel, B., Džakula, A., Duran, A., Fattore, G., Edwards, N., Grignon, M., … Smith, T. A. (2016). Hospitals in rural or remote areas: An exploratory review of policies in 8 high-income countries. Health Policy, 120(7), 758–769.

Tuesday, September 3, 2019

Prevalence of Corporal Punishment among Nigerian Students Between the Age of 2-14 Years

Related imageChild abuse and neglect is known as a major public health problem diminishing the health and wellbeing of a child and an adolescent across the world. The Centers for Disease Control and Prevention uses the term child maltreatment in a general concept that includes “abuse”, and “neglect” even though the terms “maltreatment and abuse” are mutually used in the literature. According to CDC (2008) this is defined as any act or series of acts of commission1 or omission by a parent2 or other caregiver that results in harm, potential for harm, or threat of harm to a child (Leeb, Paulozzi, Melanson, Simon, & Arias, 2008). Furthermore, World Health Organization defines “Child Abuse and Neglect” as ‘Every kind of physical, sexual, emotional abuse, neglect or negligent treatment, commercial or other exploitation resulting in actual or potential harm to the child’s health, survival, development, or dignity in the context of a relationship of responsibility, trust or power. Several studies have shown that children who have been abused or neglected tend to show signs of developmental issues, impaired cognition, eating and sleeping disorders, poor academic performance, poor relationship, PTSD, depression, suicidal behaviors and themselves may inherit the trait of abusiveness (Olatosi, Ogordi, Oredugba, & Sote, 2018).

For over a century, according to the Nigerian culture, children are perceived to be an instrument or property that has no rights of its own. The belief states that children should be seen on occasions, but not heard; they are not permitted to listen to the discussions of that of an adult or make contributions to their conversation. Not only was the situation prevalent in the Nigerian society, it continued its way into the educational system of the country. Unfortunately, children were only authorized to contribute in a class activity when the teacher deems it as necessary. The educational curriculum in Nigeria is recognized as a means of establishing a free democratic and equal community that is strong, united and independent with a land full of opportunities and potentials for the citizens to grow and prosper (Umobong, 2015).

The African custom detects that the parents are the solely responsible for training their child, and a member of the community also has the right to discipline and correct a child who misbehaves or acted in a wrong way. The parents are to teach their children in a suitable and acceptable way according to the standard of the society. However, in recent times, as a result of the introduction of nursery and pre-schools, parents pushed the responsibilities such as directing, guiding, counselling and role modeling to the academic institution; hence, contributing to the demands of the curricular of the school. Children at the age of two years, who are supposed to be at home to receive the warmth and nurture of a mother are enrolled into schools. The school is therefore faced with managerial challenges on how to manage the children and train them. This eventually leads to the lack of provision of human rights for the children; children are further subjected to physical abuse and neglection; emotional abuse from the teacher and other inhuman treatments (Umobong, 2015).

Academic institutions go beyond gathering children to enroll them for learning sessions; it is a way of addressing behavioral problems among students. Schools are challenged with numerous acts of misconduct from students. Although it has been argued by a lot of teachers that punishment is an answer to misconduct, others tend to enact discipline among the students. Therefore, teachers and academic administrators inflict corporal punishments on students for several reasons. Pupils are beaten for receiving a poor grade in an exam, for talking in the class etc. A considerable number of teachers, administrative staff and parents have the belief that these punishments are essential in the upbringing of a child; to teach the child a lesson or discourage misbehaviors in the future(Yemi, 2018) .

According to a survey conducted by UNICEF which focused on violence on children by caregivers or family members, authority figures, peers and strangers, showed that over 60% of adults in Nigeria agree with the method of physical punishment as an act of discipline towards children to raise and educate them. 91% of children between the age of 2-14 years have experienced violent discipline such as psychological aggression/physical punishment by a parent or a teacher. Over 30% of Nigerian children have been subjected to severe case of physical punishment from hitting the child on the head, ear or face to hitting the child with objects such as canes or sticks(UNICEF, 2014).
Another survey that studies eye injuries caused from corporal punishments in Nigerian academic settings that involved 172 primary school teachers in Ilorin, Kwara state, Nigeria, indicates that 80% of participants had witnessed students undergo punishments by the teachers with a cane, 46% students were subjected to horse-whip and 30% were slapped by the teacher’s hand; 61% of the students were flogged on their buttocks, while 49% of them on their backs, 52% on the palms of the their hands, 20% on the head and 16% received beatings on their face (Mahmoud, Ayanniyi, & Salman, 2011).


Leeb, R. T., Paulozzi, L. J., Melanson, C., Simon, T. R., & Arias, I. (2008). CHILD MALTREATMENT SURVEILLANCE Uniform Definitions for Public Health and Recommended Data Elements Version 1.0.
Mahmoud, A. O., Ayanniyi, A. A., & Salman, M. F. (2011). Observations of teachers in llorin, Nigeria on their practices of corporal punishment that are potentially injurious to their pupils eyes. Annals of African Medicine, 10(2), 150–154.
Olatosi, O. O., Ogordi, P. U., Oredugba, F. A., & Sote, E. O. (2018). Experience and knowledge of child abuse and neglect: A survey among a group of resident doctors in Nigeria. The Nigerian Postgraduate Medical Journal, 25(4), 225–233.
UNICEF. (2014). HIDDEN IN PLAIN SIGHT A statistical analysis of violence against children. New York, NY.
Yemi, F. (2018). Journal of Education and Practice ISSN (Vol. 9). Retrieved from Online website:

Tuesday, July 16, 2019

Sickle Cell and Thalassemia Disease

Sickle cell disease and thalassemia are both genetic disorders that resulted from genetical errors for hemoglobin-a substance that is made up of protein and iron molecule responsible for carrying oxygen in the red blood cells. These orders can lead to fatigue, jaundice and episodes of pain ranging from mild to very severe. Sickle cell and thalassemia can be inherited especially from parents who pass an abnormal gene. When this occurs, both diseases can be severe or fatal.


Related imageSickle Cell Disease was discovered in the 1900s, formerly known as "peculiar, enlongated sickle-shaped erythrocytes (red blood cells)". Advancement in studies indicated that the pain sickle-cell patient go through is caused from a blockage of tiny blood vessels. Furthermore, several studies concluded that sickle cell disease is caused by an abnormality in the hemoglobin, referred to as "hemoglobin S". This is disease among other identified diseases was the first to be understood by scientists at the biochemical level due to the fact that researchers learned that the abnormal hemoglobin is actually changing form (called sickling) because of a single amino acid error in the hemoglobin S.

The underlying molecular cause of the disease has been understoond for over a century. Yet, progress in translating the knowledge to improvde patient care is slow; that is, reflects the challenges of treating the disease. In United States, health research and treated were neglected among the underserved population where they are more prone in developing the disease. In the early 1970s, just after the civil rights movements that it was recognized the fact that patients with sickle cell disease were an example of racial inequality in the healthcare. In addition to this, the Sickle Cell Disease Association of America was founded and eventually helped to establish the Sickle Cell Amemia Control Act of 1972. The government provided grants for screening research and treatment programs.

New treatment for the sickle cell disease were discovered as scientific progress and technology evolved. The Prophylactic Penicilin Study (PROPS) shows that administering penicilin (an antibiotic) to unsick patients could prevent death caused by serious infections in sickle cell disease. Also, the Multicenter Bone Marrow Transplant Study illustrated that 84% of children who were diganosed with the disease could be cured after receiving  a bone marrow transplant from a matched donor or family member. Mid 1990s, the U.S Food and Drug Administration authorized a new therap called Hydroxyurea as a form of treatment to reduce further complications of the disease. "Hydroxyurea works in part by stimulating the body to resume production of fetal hemoglobin (hemoglobin F), a normal hemoglobin in the fetus that prevents sickling".


This is an inherite blood disorder characterized by low hemoglobin and fewer red blood cells in the body compared to normal. In 1925, Thalassemia or Mediterranean Anemia was first described by a Detroit physician who studied Italian children with severe anemia (low levels of red blood cells), poor growth, huge abdominal organs and early childhood death. In 1946, the cause of thalassemia was discovered to be an abnormal structure in the hemoglobin. The body destroys the red blood cells, resulting to Anemia. The body tries to make red blood cells quicker than normal as a means of compensating for the loss; however, this can lead to other thalassemia complications such as bone abnormalities and spleen enlargement.

Related imageIn the year if 1960, doctors started transfusing fresh red blood cells to patients with thalassemia every month to treat the disease. This mitigated most of the symptoms in childhood and had a huge impact in the survival rate of thalassemia patients; this treatment is currently in practiced. Nonetheless, since blood contains a large amount of iron, most patients died during their teenage years from the damaged caused by too much iron. Moreover, researched discovered that surplus iron amount can be removed from the body through by a drug called desferoxamine. The drug has prevented iron-induced heart disease and has improved the life expectancy of patients. Recently, there is availability of two oral drugs that aid in removing iron, which has improved the quality of life of the patient with excess iron from blood transfusion for thalassemia. On the other hand, specialized imaging test can detect iron in the heart and also permit patient to be treated to prevent iron-related heart failure.


Tuesday, July 9, 2019

Violation Of Human Rights in Nigeria: What Is Going On Now!

Infringement of human rightsIn Nigeria, human rights are being violated by the justice system such as the police. These days, the police have broken the code of conduct of human rights that includes unlawful killings, torture and other ill-treatment as well as enforced disappearances. The conflict in Niger Delta poses as a threat to the safety and lives of the Nigerian residents. Human right advocates and journalists are intimidated and harassed for expressing their voice. Women still face the violence, which is widespread across the country, and unfortunately the government has shown no interest so whatever to protect the rights of the children. Furthermore, millions of citizens face eviction in the country.  

Although the government has given its pledges to foresee the challenges in the criminal justice system of Nigeria, there is little or no progress to address the issue. The Nigerian Police Force (NPF) has no regard for human rights; people are subjected to illegal killings by the police either during or before arrest, or along the streets. A majority of the armed forces that perform such crimes are left unjustified by the legal system of Nigeria (the court).  


Saturday, February 2, 2019

Understanding The Aboriginal People

The residential schools were government owned and sponsored by a religious system established to assimilate the aboriginal children in the Euro-Canadian tradition. Despite the fact that the first residential facilities were in the New France, it was usually referred to as a custodial school that was introduced after the
1880s. Originally created by the Christian churches, the Canadian government attempted not just to educate them and convert their culture and adapt them into the Canadian society, but the residential schools also disrupted the lives of the native population and communities; thereby, resulting to a long-term problem among the indigenous persons.  

The institution forcefully separated children from their families for a long period of time and banned them to recognize their Aboriginal heritage and culture or speak their native languages. The children were critically sanctioned if they did not obey the strict rules enforced by the school. The children faced abuse from the staff of the residential school staff such as physical, sexual, emotional, and psychological abuse. They were taught with an inferior curricular structure, which is normally taught up to the 5th grade. These lessons were focused mainly on manual labor in agriculture, light industry (e.g woodworking), domestic work such as laundry and sewing. Furthermore, any studies indicated that a lot of children were beaten and strapped, shackled on their beds and the rest of the children were punished by having needles shoved on their tongues as a consequence of speaking their language. These abuses were also followed with overcrowding, poor sanitation and inadequate food and access to healthcare. The medical inspector PH Bryce reported 24% of death rate among the aboriginal population within the school around the year of 1907.  


Sunday, December 9, 2018

Lymphomas Cancer in Nigeria

Lymphomas are a heterogeneous group of neoplasms of lymphoid tissues, each with distinct clinicopathological features that varies to different response to treatment1 

The finding from the report of Ferlay showed that the cancer rate occurring in Sub-Saharan Africa, Hematolymphoid Malignancies has merged as a major cause of morbidity and mortality with lymphomas and other hemotologic malignancies such as leukemia and multiple myeloma together accounted for 8.7% of incident cancer diagnoses and 9.9% of cancer deaths in 2008. Annual incidence has estimated a rate as low as 30,000 and as high as 278,000 of Non-Hodgkin Lymphoma (NHL) in Sub-Saharan Africa. This has made it one of the most common cancers in the region. Other studies have indicated that in most Nigerian Tertiary Hospitals, Lymphomas, mostly NHL are ranked among the leading cancers2 

Between the year 1960 and 1975 an estimate of 100 patients with Non-Hodgkin's Lymphoma were admitted to the University College Hospital in Ibadan, Nigeria. The related cases were analysed in respective to the clinical findings, histological classification and response to therapy. Majority of the patients (87%) had reticulum cell sarcoma with a high ratio of men than women (2:1). The applied therapy consisted mainly of single-agent chemotherapy, but a few of the patients had either surgical excision combined with chemotherapy or multiple-agent chemotherapy. The derived results were poor as a result of high default rate, late presentation, inadequate supply of drugs and the lack of radiotherapeutic facilities3 

“The contemporary management of these neoplasms requires that they are accurately diagnosed, categorized by sub-typing according to the WHO system of classification”4. These classifications are multiparametric approach requiring clinical, morphological, immunological, cytogenetic and molecular techniques. The impact of this can be reflected in the resource-rich settings where treatment of those malignancies is increasingly related with unprecedented rates of long-term cure and control. Diagnosis of lymphomas cancer remains as a big challenge in Sub-Saharan Africa, because of inadequate facilities5 

Thursday, October 25, 2018

Leukemia in Children-Canada

Leukemia is the most commonly diagnosed cancer in children in Canada.
It can take several years to collect and confirm cancer data, so the number of new cancer cases and deaths from recent years may not be available for some time. The most recent data available are provided.
The most recent incidence and mortality statistics for leukemia in children aged 0 to 14 years are from 2009 to 2013.
  • 1,445 Canadian children were diagnosed with leukemia.
  • 145 Canadian children died from leukemia.
  • 1,130 Canadian children were diagnosed with acute lymphoblastic leukemia and 59 died from it.
  • 180 Canadian children were diagnosed with acute myelogenous leukemia and 57 died from it.

Children with leukemia and their parents may have questions about prognosis and survival. Prognosis and survival depend on many factors. Only a doctor familiar with a child’s medical history, type of cancer, characteristics of the cancer, treatments chosen and response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognosis is the doctor’s best estimate of how cancer will affect the child, and how it will respond to treatment. A prognostic factor is an aspect of the cancer or a characteristic of the child that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together and they both play a part in deciding on a treatment plan and a prognosis.
Prognostic factors can vary depending on whether the child has acute lymphoblastic leukemia (ALL) or acute myelogenous leukemia (AML)

Tuesday, October 23, 2018

Canadian Healthcare Funding

The Canadian healthcare system is predominately public, with 70% of healthcare funding coming from the public-sector and the remaining 30% from the private-sector (Canadian Institute for Health Information, 2016). It is estimated that health spending in Canada will be $228.1 billion in 2016, or approximately 11.1% of GDP, the majority of which goes to hospitals (29.5%), drugs (16%) and physicians (15.3%) (Canadian Institute for Health Information, 2016). Since 2005, physician compensation as a portion of total health spending has increased but since 2014, the share has slowed and is now maintaining levels comparable to those of the late 1980s (Canadian Institute for Health Information, 2016).
Spending on healthcare varies across Canada, but on average provinces spend approximately 38% of their total budgets on healthcare (Canadian Institute for Health Information, 2016). Per capita spending in 2016 for all of Canada is projected to be $6,299, but spending by province ranges from $5,822 in Québec to a high of $7,256 in Newfoundland and Labrador (Canadian Institute for Health Information, 2016).
Global Budget is the most common healthcare funding in Canada, where a fixed amount of payment is allocated to a provider (such as the health authority or hospital), which covers the operating expenses for a period of time, usually a year. Most Canadian provinces have their healthcare regionalized-the local or regional health authorities are responsible for the delivery of primary health services. In most province, the government allocates funding to health authorities through a global budget and many health authorities, in turn, use global budgets to fund specific groups of services. In Canada, most hospitals, long-term care facilities, publicly-funded rehabilitation facilities and mental and public health programs are funded under global budgets (Sutherland et al., 2013). Funding amounts are typically based on factors such as historical budgets, inflation and politics, and are provided irrespective of the number of patients or levels of demands on resources (Sutherland & Repin, 2012).
Global budget is an effective means of controlling healthcare expenditure growth by the use of spending "caps". It provides financial predictability for administrators and policy makers (Wolfe & Moran, 1993Antioch & Walsh, 2004). Its only weakness is the impetus to meet the budget target. Providers may restrict the access to services or limit the number of hospital admissions. Global budgets covers little incentive for innovation or improve the healthcare efficiency (Sutherland & Crump, 2011), since global budgets do not provide opportunities for increased revenue of patient, healthcare providers have no incentive to shorten patient lengths of stay or to discharge patients to lower cost healthcare settings (Sutherland et al., 2013). Global budgets do not promote coordination across service providers in acute and post-acute settings, creating a fragmented healthcare system that is often associated with inefficiencies and reduced quality of care (Sutherland & Crump, 2011Sutherland & Repin, 2012).