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Understanding Procurement and Professional Buyer Requirements

Procurement is one of the most critical yet frequently undervalued functions within modern organizations. Despite controlling 50-65% of organizational budgets, procurement departments are often staffed with personnel lacking formal training, professional certifications, or systematic purchasing knowledge. This disconnect creates a significant vulnerability that impacts profitability, efficiency, and competitive advantage.

PremiumResearchers has supported hundreds of students and researchers across Nigerian universities including UNILAG, University of Ibadan, and Covenant University in investigating procurement challenges and developing evidence-based solutions. Our expertise in academic writing for management, business administration, and supply chain research positions us as a trusted partner for organizations examining their procurement practices.

A professional buyer is responsible for acquiring the right quality and quantity of raw materials, supplies, components, tools, equipment, and services at the right time, from the right source, to the right place, and at the right price. This “six rights of procurement” framework requires systematic knowledge, vendor relationship management, negotiation expertise, market analysis, and ethical decision-making. When non-professionals handle procurement, each of these critical elements suffers.

What Makes a Professional Buyer Different

The distinction between a professional buyer and a non-professional isn’t simply whether someone can purchase items at a market. A professional buyer possesses:

• Formal Education: HND (Higher National Diploma), NIPSM (Nigerian Institute of Procurement and Supply Management), or CIPSM (Chartered Institute of Procurement and Supply Management) certifications
• Systematic Knowledge: Understanding of procurement law, ethical standards, contract management, and vendor evaluation methodologies
• Analytical Capability: Ability to conduct cost-benefit analysis, total cost of ownership calculations, and supplier performance evaluation
• Relationship Management: Skills in negotiating favorable terms, managing supplier relationships, and resolving supply chain conflicts
• Strategic Vision: Understanding how procurement decisions impact organizational strategy, sustainability, and long-term value creation
• Risk Management: Ability to identify supply chain risks, diversify suppliers, and implement mitigation strategies
• Compliance Knowledge: Understanding of regulatory requirements, documentation standards, and audit procedures

A person who can successfully purchase goods in the market possesses transactional purchasing skills, but organizational procurement requires strategic capability that extends far beyond daily transactions.

Critical Problems Created by Non-Professional Buyers

Organizations that rely on non-professional buyers face cascading problems that affect operational efficiency, financial performance, and strategic capability. These problems extend beyond individual purchasing decisions to impact supply chain resilience, vendor relationships, and organizational culture.

1. Excessive Costs and Poor Value Management

Non-professional buyers typically lack price negotiation skills and market knowledge. They accept supplier quotes without comparison shopping, fail to negotiate volume discounts, and overlook total cost of ownership considerations. A professional buyer analyzes not only unit prices but also delivery costs, quality levels, payment terms, and supplier reliability—factors that determine true value. Non-professional buyers purchasing the same materials at prices 15-30% higher than market rates directly reduce organizational profitability.

2. Quality Compromises and Product Defects

Without understanding quality standards, specifications, and testing procedures, non-professional buyers accept substandard materials. This creates downstream problems: manufacturing delays, product defects, customer complaints, and warranty costs. Professional buyers establish clear quality criteria, conduct supplier audits, implement incoming inspection procedures, and maintain vendor scorecards. Non-professional procurement bypasses these safeguards.

3. Supply Chain Disruptions and Production Delays

Non-professional buyers lack demand forecasting skills and supplier reliability assessment capabilities. They fail to maintain adequate inventory levels, lack alternative supplier relationships, and cannot respond to supply disruptions. Professional buyers build supplier diversity, implement just-in-time inventory systems, maintain safety stock for critical materials, and develop contingency plans. When non-professionals manage procurement, organizations experience unexpected stockouts that halt production and damage customer relationships.

4. Poor Vendor Relationships and Limited Leverage

Professional buyer relationships with vendors create partnership opportunities, preferential pricing, improved delivery terms, and collaborative problem-solving. Non-professional buyers treat purchasing as transactional, lacking the credibility and systematic approach to develop strategic supplier relationships. This limits organizational leverage and prevents access to supplier innovations and preferential treatment during market shortages.

5. Ethical Violations and Corruption Risks

Non-professional buyers lack understanding of ethical procurement standards, conflict of interest policies, and internal controls. This creates vulnerability to supplier corruption, personal kickbacks, unauthorized gifts, and biased purchasing decisions. Professional procurement personnel understand ethical frameworks, implement segregation of duties, and maintain transparent documentation. The absence of these safeguards exposes organizations to financial fraud and reputational damage.

6. Documentation and Compliance Failures

Non-professional buyers often maintain inadequate records, fail to document procurement decisions, and don’t follow regulatory compliance procedures. This creates audit failures, regulatory violations, and inability to defend purchasing decisions. Professional procurement processes include detailed documentation, clear approval workflows, and compliance verification that protect organizations during internal and external audits.

Impact on Organizations and Supply Chain Management

The cumulative impact of non-professional procurement extends throughout organizational operations. Manufacturing organizations like PZ Plc—with multiple facilities and complex supply chains—experience particularly severe consequences when procurement lacks professional management.

Financial Impact Analysis

When procurement controls 50-65% of organizational budgets, inefficiencies compound rapidly. Organizations with non-professional buyers typically experience:

• 5-15% cost overruns compared to market benchmarks
• Higher inventory carrying costs due to poor demand forecasting
• Increased waste and obsolescence of materials
• Higher defect rates requiring rework or customer compensation
• Emergency procurement at premium costs to cover supply gaps
• Loss of early payment discounts due to poor cash management

For a manufacturing organization with annual procurement spend of 1 billion naira, inefficient procurement practices translate to 50-150 million naira in preventable losses annually.

Operational and Strategic Impact

Beyond financial metrics, non-professional procurement creates operational friction: production delays, quality issues that damage customer relationships, inability to support organizational growth initiatives, and missed opportunities for supplier-enabled innovation. Organizations cannot implement strategic initiatives like sustainability programs, just-in-time manufacturing, or supplier development when procurement lacks professional capability.

This is particularly critical for multi-facility organizations like PZ Plc, where procurement must coordinate across multiple locations (Aba, Illupeju, and Ikorodu), manage complex logistics, and ensure consistent quality standards. Non-professional procurement at any facility creates inconsistency, prevents knowledge sharing, and undermines organizational strategy.

Professional Standards and Procurement Certifications

Establishing professional procurement requires understanding the certifications and standards that define procurement competency in Nigeria and internationally.

Nigerian Procurement Certifications

NIPSM (Nigerian Institute of Procurement and Supply Management) certification represents the foundational professional standard in Nigeria. NIPSM-certified procurement professionals demonstrate knowledge of procurement law, ethical standards, supplier management, and local regulatory requirements specific to Nigerian business environment.

CIPSM (Chartered Institute of Procurement and Supply Management) certification represents advanced professional standing, requiring extensive experience, continuing education, and demonstrated excellence in procurement practice. CIPSM-chartered practitioners are recognized as senior procurement professionals capable of strategic procurement leadership.

HND (Higher National Diploma) in Procurement or Supply Chain Management provides foundational education in procurement principles, inventory management, supplier relationships, and supply chain coordination. HND holders possess structured knowledge that enables progression toward NIPSM and CIPSM certifications.

International Standards and Best Practices

Professional procurement also aligns with international standards including ISO 9001 (Quality Management), ISO 14001 (Environmental Management), and APICS (Association for Supply Chain Management) frameworks. These standards establish systematic approaches to vendor selection, quality assurance, risk management, and continuous improvement that distinguish professional procurement from ad-hoc purchasing.

Core Competencies for Professional Buyers

Beyond certifications, professional buyers must demonstrate competency across multiple dimensions:

• Market Knowledge: Understanding supplier landscapes, pricing trends, capacity constraints, and competitive dynamics
• Negotiation Skills: Achieving favorable terms while maintaining supplier relationships and fairness
• Contract Management: Drafting clear specifications, managing supplier performance, resolving disputes
• Systems Thinking: Understanding how procurement decisions cascade through supply chain and organizational operations
• Data Analysis: Using procurement data to identify trends, optimize spending, and support decision-making
• Stakeholder Management: Balancing needs of production, finance, quality, and executive leadership
• Continuous Improvement: Implementing process improvements and adopting emerging procurement technologies

Solutions: Implementing Professional Procurement Practices

Addressing non-professional procurement requires systematic change across people, processes, and systems. Organizations must transition from ad-hoc purchasing to structured procurement management.

1. Building Professional Procurement Teams

Hire Certified Professionals: Organizations must recruit procurement personnel with HND, NIPSM, or CIPSM credentials, or provide resources for existing staff to obtain certifications. This signals organizational commitment to professional procurement and ensures personnel possess systematic knowledge.

Continuous Professional Development: Professional procurement requires ongoing learning. Organizations should budget for continuing education, industry conferences, and certification maintenance. Professional procurement personnel continuously enhance knowledge of emerging technologies, regulatory changes, and industry innovations.

Structured Career Paths: Creating advancement opportunities for procurement professionals reduces turnover and builds institutional knowledge. Entry-level purchasing coordinators progress through procurement analyst, senior buyer, procurement manager, and director roles—each requiring increased expertise and certification levels.

2. Implementing Structured Procurement Processes

Formalized Procurement Policies: Organizations must establish written procurement procedures defining authorization limits, approval workflows, documentation requirements, and conflict of interest policies. These policies create consistency, prevent unauthorized spending, and establish accountability.

Vendor Evaluation Methodology: Professional procurement includes systematic vendor evaluation using defined criteria (price, quality, delivery reliability, financial stability, ethical standards). Instead of subjective supplier selection, organizations implement scorecards and evaluation matrices that ensure objective decision-making.

Contract Management Systems: Professional procurement uses clear contracts specifying quality requirements, delivery schedules, pricing, payment terms, and dispute resolution procedures. Contracts protect organizational interests and clarify expectations with suppliers.

Request for Quotation (RFQ) and Tender Processes: Rather than accepting first quotes, professional organizations issue RFQs to multiple qualified suppliers, comparing proposals systematically. For significant purchases, competitive tender processes ensure value and prevent supplier favoritism.

3. Implementing Procurement Technology Systems

Modern procurement requires supporting technology:

• Enterprise Resource Planning (ERP) Systems: ERP systems like SAP, Oracle, or Navision integrate procurement with accounting, inventory, and production. These systems enforce approval workflows, maintain audit trails, and prevent unauthorized purchasing.
• Supplier Management Systems: Dedicated supplier systems maintain vendor databases, performance scorecards, and communication records. These systems enable objective supplier evaluation and relationship management.
• E-Procurement Platforms: Digital procurement platforms automate purchase order creation, supplier communication, and invoice processing. These systems improve efficiency, reduce manual errors, and create audit trails.
• Data Analytics Tools: Analytics platforms analyze procurement spending patterns, identify cost reduction opportunities, and track supplier performance metrics.

4. Establishing Procurement Governance

Procurement Committee: Establish governance structures including procurement committees that oversee strategy, approve major purchases, and address supply chain issues. Including representation from production, quality, finance, and executive leadership ensures balanced decision-making.

Audit and Compliance: Regular internal and external audits verify procurement compliance, identify control failures, and ensure ethical practices. Audit findings drive continuous improvement and accountability.

Performance Metrics: Professional procurement organizations track metrics including cost savings, supplier quality performance, on-time delivery rates, procurement cycle time, and maverick spending. These metrics drive accountability and continuous improvement.

5. Shifting Organizational Culture

Perhaps most importantly, organizations must shift culture to recognize procurement as a strategic function. Executive leadership must:

• Communicate that procurement is strategically important, not a clerical function
• Support procurement with adequate budget, technology, and staffing resources
• Involve procurement in strategic planning and new product development
• Reward procurement excellence and cost savings initiatives
• Hold procurement professionals accountable for results while providing authority to execute

When organizational culture recognizes procurement’s strategic importance, recruiting and retaining professional talent becomes easier and procurement initiatives gain organizational support.

Case Study: PZ Plc’s Procurement Transformation

Peterson Zochonis Industries PLC (PZ Plc) represents a valuable case study for understanding non-professional procurement challenges within Nigerian manufacturing. Established in 1884 by Peter (British) and Zochonis (Greek), PZ Plc incorporated in Nigeria in 1948 and has operated multiple manufacturing facilities including locations in Aba, Illupeju, and Ikorodu.

PZ Plc’s Procurement Context

As a multi-facility manufacturing organization, PZ Plc faces complex procurement requirements: coordinating supplies across three locations, managing diverse supplier bases, maintaining quality consistency, and controlling costs across its manufacturing footprint. The organization’s procurement function handles acquisition of raw materials, packaging materials, chemicals, equipment, and services supporting manufacturing operations.

During industrial attachments and operational research, investigators frequently observe that non-professional buyers within PZ Plc facilities make purchasing decisions without systematic vendor evaluation, inadequate price negotiation, poor quality control, and limited coordination between facilities. These issues create inconsistent practices across locations, duplicated inefficiencies, and inability to leverage consolidated purchasing power.

Identified Procurement Challenges at PZ Plc

Research within PZ Plc typically identifies challenges including:

• Inconsistent purchasing practices across facilities with no standardized procedures
• Lack of formal vendor evaluation methodology resulting in subjective supplier selection
• Inadequate documentation and incomplete procurement records
• Missing coordination between facilities enabling duplicate purchasing and lost economies of scale
• Poor vendor relationships limiting access to preferential pricing and innovative solutions
• Quality issues traced to inadequate supplier specifications and incoming inspection
• Procurement personnel lacking professional certifications or formal supply chain training
• Absence of performance metrics or continuous improvement initiatives in procurement

Recommended Solutions for PZ Plc

Establish Centralized Procurement Governance: PZ Plc should create a centralized procurement function overseeing all facility purchasing while enabling facility-specific flexibility for local requirements. Centralized procurement enables standardized processes, leveraged purchasing power, and best practice sharing.

Implement Structured Vendor Management: Develop centralized vendor database with standardized evaluation criteria, quality performance scorecards, and delivery reliability metrics. This enables objective supplier selection, prevents duplicate vendor relationships, and creates accountability for supplier performance.

Invest in Professional Development: Ensure procurement staff across all facilities obtain NIPSM or CIPSM certifications. Provide training in contract management, negotiation skills, supply chain planning, and quality standards. Create advancement opportunities recognizing procurement as a professional career path.

Deploy Procurement System: Implement ERP system enabling standardized purchase order workflows, approval routing, supplier communication, and audit trails across all facilities. System-enabled procurement prevents unauthorized spending, reduces manual errors, and provides real-time visibility into organizational spending patterns.

Establish Procurement Policies: Document formalized procurement policies defining authorization limits, RFQ requirements, contract standards, and ethical guidelines. Distribute policies across all facilities ensuring consistent application.

Create Performance Accountability: Implement procurement metrics tracking cost savings, supplier quality performance, on-time delivery, and procurement cycle time. Link procurement manager compensation to performance metrics driving accountability and continuous improvement.

Organizations like PZ Plc implementing these solutions typically achieve cost savings of 10-20% within first year, improved quality metrics, and strengthened supplier relationships enabling access to innovations and preferential treatment during supply constraints.

Related Procurement and Supply Chain Resources

For students and professionals investigating procurement, supply chain management, and organizational efficiency, PremiumResearchers provides comprehensive research support across related topics:

• How to Write a Methodology – Essential for procurement research projects
• How to Write Background of the Study – Establishing context for procurement research
• How to Write a Statement of Problem – Defining procurement challenges
• How to Write Significance of the Study – Demonstrating research importance
• How to Write Conclusion for a Project – Concluding procurement research findings
• How Many Chapters Does a Research Project Have – Understanding project structure
• Six Steps to Writing an Excellent Final Year Project – Comprehensive project guidance
• Effective Ways of Writing a Literature Review – Researching procurement literature
• How to Write a Final Year Project Proposal – Planning procurement research
• Project Writing Services – Comprehensive research support for procurement projects
• Academic Writing Services – Professional writing support for all research topics
• How to Hire Expert Project Writers in Nigeria – Finding professional research support

Frequently Asked Questions About Professional Procurement

Chapter one

INTRODUCTION

1.1 Background of the Study

The exchange rate is the value of one currency in relation to another. It determines the relative prices of domestic and foreign commodities, as well as the extent to which the external sector participates in international trade.

Exchange rate regimes and interest rates continue to be hot topics in international finance and developing countries, with more economies embracing trade liberalisation as a necessary condition for economic progress (Obansa, Okoroafor, Aluko, et Millicent, 2013).

Nigeria’s exchange rates have shifted from regulated to deregulated regimes over time. According to Ewa (2011), the naira exchange rate was very stable between 1973 and 1979, during the oil boom period when agricultural products contributed for more than 70% of the nation’s GDP.

When the Federal Government implemented the Structural Adjustment Policy (SAP) in 1986, the country transitioned from a peg regime to a flexible exchange rate regime in which exchange rates are completely determined by market forces, rather than the prevailing system of managed float, in which monetary authorities intervene in the foreign exchange market on a regular basis to achieve strategic objectives (Mordi, 2006).

Inconsistency in policies and a lack of continuity in exchange rate policies contributed to the naira’s instability (Gbosi 2005).

Value Added Tax (VAT) is one method used by the government to raise internal revenue. This is a tax on the supply of goods and services that is ultimately borne by the end user, but is collected at each stage of the manufacturing and distribution chain.

Exchange rate fluctuations have a substantial impact on the prices of products and services; thus, value added tax is affected by exchange rate fluctuations.

Exchange rate fluctuations have had a negative impact on the Nigerian economy, and various monetary and fiscal policies have been developed to mitigate them.

The Central Bank of Nigeria (CBN) is officially responsible for developing and implementing monetary policy, with a focus on exchange rate stability. Inflation has been cyclical since the mid-1970s, peaking in 1988, 1989, 1992, 1993, 1994, 1995, 1996, 2001, and 2005.

According to Aliyu (2011), an appreciation of the exchange rate leads in increased imports and decreased exports, resulting in less income from value added tax to promote economic growth, whereas depreciation expands exports and discourages imports.

Furthermore, an exchange rate depreciation causes a shift from imported goods to domestic goods, in which case the government generates more revenue through the value added tax to drive economic growth.

Hence, it leads to diversion of wealth from importing countries to countries exporting through a shift in terms of trade, and this tends to have impact on the exporting and importing countries’ economic growth.

In the same spirit, Hossain (2002) concurred that exchange rate serves to connect the price systems of two distinct countries by making it feasible for international trade and also influences on the amount of imports and exports

As well as country’s balance of payments situation. According to Rogoffs and Reinhartl (2004), developing countries benefit more from flexible exchange rate regimes.

1.2 Statement of the Problem

Previous research on the impact of exchange rates and value-added taxes on economic growth produced conflicting conclusions. For example, empirical evidence has shown that real exchange rate fluctuations can influence growth outcomes. Edwards and Levy Yeyati (2003) discovered evidence that nations with more flexible exchange rates and higher value-added taxes grow quicker.

Faster economic growth is significantly associated with real exchange rate depreciation. It has been stated that real undervaluation stimulates economic growth, boosts the profitability of the tradable sector, and leads to an expansion of the tradable share of domestic value added.

A real exchange rate undervaluation acts as a second-best strategy to compensate for the negative consequences of these distortions by boosting the sector’s profitability. Higher profitability supports investment in the tradable sector, which then increases, and promotes economic growth.

1.3 Objectives of the Study

The aims of this investigation are as follows:

Examine the impact of exchange rate fluctuations on Nigeria’s economic growth.

To investigate the relationship between exchange rate fluctuations and the value-added tax.

To investigate the impact of the value-added tax on Nigeria’s economic growth.

1.4 RESEARCH QUESTIONS

How do exchange rate fluctuations affect Nigeria’s economic growth?

What is the relationship between exchange rate fluctuations and value-added tax?

What impact does value added tax have on Nigeria’s economic growth?

1.5 Hypothesis.

HO: There is no significant association between exchange rate fluctuations and value added taxes.

HA: There is a considerable association between exchange rate fluctuations and value added taxes.

1.6 Significance of the Study

The following are the implications of this study:

This study will educate financial industry stakeholders and the general public about the relationship between exchange rate fluctuations and value added tax, as well as how both influence Nigeria’s economic growth.

This study will contribute to the corpus of literature on the effect of personality traits on student academic achievement, thereby serving as the empirical foundation for future research in the field.

1.7 SCOPE/LIMITATIONS OF THE STUDY

This study will look at the relationship between exchange rate fluctuations and value added tax, as well as how the two affect economic growth in Nigeria.

Limitations of the study

Financial constraints- Insufficient funds tend to restrict the researcher’s efficiency in accessing relevant resources, literature, or information, as well as in data collecting (internet, questionnaire, and interview).

Time constraints: The researcher will conduct this investigation while also working on other academic projects. This will reduce the amount of time spent on research.

ABSTRACT

The process of adding additional foods to a child’s diet after the first six months of life is known as weaning. In communities all across the world, early feed introduction and improper weaning techniques are widespread. The purpose of this study was to investigate mothers’ practices and knowledge around infant weaning. They used a descriptive research design. In Ikenne Local Government, there were 260 mothers who attended three primary healthcare centres. The Leslie Kish formula was used to calculate the sample size, and 100 moms were chosen for the study using simple random sampling. Participants’ information was gathered using a specially created questionnaire. By presenting the questionnaire to subject-matter experts, its face and content validity were determined. The Cronbach alpha reliability coefficient was 0.85 after reliability was assessed using the split-half approach. Version 21 of the statistical package for social sciences (SPSS) was used to process the data. Descriptive statistics of mean standard deviation were used to address two study concerns. Using inferential statistics of Pearson correlation at the 0.05 threshold of significance, four hypotheses were examined. According to the survey, 8 moms (8%) had little to no information about weaning their infants, 50 mothers (50%) had moderate awareness, and 42 mothers (42%) had excellent knowledge. Additionally, 3 women (3%) had a high degree of practice weaning their infants, 66 mothers (66%) had a moderate level, and 31 mothers (31%) had a poor level. Mothers’ weaning methods and occupation are significantly correlated (r = 0.035; p = 0.004). While there is no significant correlation between ethnicity and infant weaning practices among mothers (r = 0.036; p = 0.723), there is a significant correlation between mothers’ knowledge level and infant weaning practices among mothers (r = 0.086; p = 0.001), and there is also a significant correlation between mothers’ weaning practices and educational level (r = 0.003; p = 0.000). In conclusion, mothers have a reasonable level of understanding and practice with infant weaning. According to the study, nurses should provide moms with frequent infant weaning training in order to enhance their understanding and proficiency in this area.

CHAPTER ONE

INTRODUCTION

1.1 The Background of the Study 

The process of adding additional foods to a child’s diet after the first six months of life is known as weaning. Communities worldwide frequently engage in practices such as incorrectly weaning infants from breast milk, early introduction of complementary feeding, and infant weaning with supplemental feeds of breast milk substitutes (Inayati, Scherbaum, Purwestri, Hormann, Wirawan, Suryantan, Hartono, Bloem, Pangaribuan, Biesalki, Hoffmann, & Bellows, 2012).

Many issues may arise throughout the weaning process, and there is typically a lack of knowledge about when and how weaning occurs. Children’s growth and development during infancy and early childhood depend on receiving enough nourishment (Ashmika, Deerajen, Prity & Rajesh, 2013).

Since breastmilk is thought to be the best source of nutrition for infants, nursing has been acknowledged globally as being advantageous for both the mother and the child (Ku & Chow, 2010).

According to Hanif (2011), the World Health Organisation (WHO) advises that newborns be nursed exclusively for the first six months of their lives.

After that, they should be given supplemental foods for as long as two years or more. A child’s growth and development are particularly important throughout the first two years of life.

Any harm brought on by nutritional deficits during this time could result in low economic output, altered cognitive development, and degraded academic performance (Kimani-Murage, Madise, Fotso, Kyobutungi, Mutau, Gitau & Yatich, 2011).

In the first two years of life, the main proximal causes of malnutrition include inadequate breastfeeding and supplemental feeding practices, as well as high rates of morbidity from infectious illnesses.

A child benefits from breastfeeding in the short and long term. It enhances mental and motor development, lowers newborn mortality and infection rates, and guards against obesity and metabolic disorders in later life (WHO, 2010).

In order to meet the infant’s nutritional needs and promote optimal growth, development, and health, the WHO advises exclusive breastfeeding throughout the first six months, starting from the first hour of birth (Kimani-Murage et al., 2011).

To fulfil the changing demands of the developing baby, the mother is recommended to start feeding nutritionally adequate, safe, and appropriately-fed supplemental foods at six months of age and to continue breastfeeding for at least two years.

Selecting light, nutrient-dense foods for simple absorption is necessary since weaning is the process of progressively introducing foods other than breast milk into a baby’s diet, first to supplement it and eventually to wean them completely off of it.

The bulk of nutrition issues in rural areas are caused by improper weaning food, however you can subsequently replace light, nutritious food with thicker feed by following hygienic preparation procedures (Shadia & Bedor, 2013).

Weaning habits and breastfeeding predictors differ between and within nations. Infant feeding issues such vomiting, diarrhoea, colic, and unwillingness to eat are factors that affect the weaning process (Ashmika et al., 2013).

These elements provide difficulties for moms, which may have a direct or indirect impact on the feeding schedule. The researcher will conduct a study on mothers’ newborn weaning practices and knowledge in the Ikenne local government area of Ogun State in light of the reasons that were found, namely the improper weaning from breast milk and the early introduction of supplemental feeding.

1.2 Statement Of The Problem

One of the most improperly implemented processes in children’s developmental phases has been weaning. It has been noted that some mothers give their babies nourishment other than breast milk as soon as they are born, while others wait until the child is older than nine months. In both situations, the baby suffers.

According to WHO (Hanif, 2011), a child can still benefit from nursing and still get the nutrients they need from supplementary foods if they are weaned gradually between the ages of six months and two years.

However, as supplemental foods are added to the children’s diet, over half of the mothers (52%) weaned their children suddenly, while only 11.6% did so gradually (Somiya, 2014). One of the most important phases of a child’s life is the weaning process.

It is the time when a child who used to eat mostly milk switches to eating adult food. Malnutrition typically occurs around this time for many children, but if this dietary transition is well-planned and goes easily, there won’t be any problems. Every year, 10 million children under the age of five pass away (Somiya, 2014).

Malnutrition from inadequate weaning accounts for almost half of the fatalities. Nearly two-thirds of the deaths may be avoided with proper health services in place. The switch from breastfeeding to family foods continues to be the most susceptible time for undernutrition.

Children who are malnourished frequently lose valuable mental abilities. They get sick more frequently. If they live, they might develop physical or mental impairments that endure a lifetime (Dinesh & Sushilkumar, 2011).

Infants are at risk for malnourishment, development retardation, infections, illnesses, and increased mortality due to poor weaning food quality and inappropriate weaning techniques (Somiya, 2014).

It is expected that food would be properly cooked with the necessary nutrients, and that it will have the right texture and temperature. Malnutrition and disease may result if appropriate weaning techniques are not understood, as well as if the child’s hunger needs are not recognised.

As a result, the weaning phase is a delicate time when the infant needs close attention and monitoring to preserve health (Somiya, 2014).

Since a mother is the most significant person in a baby’s life for both physical and psychosocial care and development, learning about weaning can help mothers improve their weaning practices.

The most important formative relationship for a child is that between a mother and her infant. In order to avoid moms from making incorrect assumptions about the weaning process and timing, it is necessary to provide them with adequate education, useful information, and weaning knowledge.

The educational requirements for properly weaning infants can be carried out by nurses. Thus, a study on mothers’ knowledge and practices regarding infant weaning in Ogun State’s Ikenne Local Government Area is necessary.

1.3 The Purpose Of The Study

This study’s primary goal is to investigate the knowledge and habits of mothers in Ogun State’s Ikenne local government area about infant weaning. The particular goals are to:

1. ascertain the mothers’ level of knowledge regarding infant weaning at the three primary healthcare centres in the Ikenne Local Government Area;

2. evaluate moms who frequent three primary healthcare centres in the Ikenne Local Government Area for their level of infant weaning practices;

3. evaluate how mothers who attend three primary healthcare centres in the Ikenne Local Government Area relate their occupation to their newborn weaning behaviours;

4. determine how mothers who visit three primary healthcare centres in the Ikenne Local Government Area relate to their ethnicity and how they wean their infants;

5. Examine how mothers who attend three primary healthcare centres in the Ikenne Local Government Area relate to their educational attainment and infant weaning practices.

6. To find out how mothers’ knowledge and infant weaning practices at three primary healthcare centres in the Ikenne Local Government Area relate to one another.

1.4 Research Questions

The following enquiries were addressed:

1. To what extent do mothers who attend three primary healthcare centres in the Ikenne Local Government Area know about infant weaning?

2. How many moms who frequent the three primary healthcare centres in the Ikenne Local Government Area practise baby weaning?

1.5 Theories

The following theories were examined at the significance level of 0.05:

HO1. Among mothers who visit three Primary Healthcare Centres in the Ikenne Local Government Area, there is no discernible correlation between occupation and infant weaning practices.

HO2. Among mothers who visit three Primary Healthcare Centres in the Ikenne Local Government Area, there is no discernible correlation between ethnicity and infant weaning methods.

HO3. Among mothers who attend three Primary Healthcare Centres in the Ikenne Local Government Area, there is no discernible correlation between educational attainment and infant weaning practices.

HO4. Mothers’ knowledge levels and infant weaning habits at three primary healthcare centres in the Ikenne Local Government Area do not significantly correlate.

1.6 The Scope of the Study

The knowledge and habits of mothers in Ogun State’s Ikenne Local Government Area about infant weaning were the subject of this study. Participant recruitment is a limitation of the study.

1.7 Rationale for the Research

In addition to providing baseline data for future research on mothers’ infant weaning knowledge and practices, the study would assist in demonstrating that mothers’ knowledge and practices are inadequate.

Additionally, this study would aid in offering suggestions for addressing mothers’ deficiencies in infant weaning habits and understanding.

The study would also aid health institutions and the government at the federal, state and municipal level to design measures to improve infant weaning knowledge and practices among mothers.

1.8 Operational Definition of Terms

Weaning: introduction of extra food to a child’s diet after the first six months of life.

Mother: Women who has a child with age from birth to 24 months.

Knowledge: Mothers comprehension of newborn weaning as determined by knowledge score.

Practice: Mothers activity about newborn weaning as indicated by practice score.

Infants: youngsters aged from birth to 24 months of age.

Ikenne local government area: A local government area in Ogun state.

Abstract

In the Amassoma community of Bayelsa state, the purpose of this study was to investigate mothers’ awareness and acceptability of oral rehydration therapy in the treatment of diarrhoea in children aged 0 to 5.

The goals of this study served as a guidance. Questionnaires and library research were used to gather data for the study, which used a descriptive and explanatory design.

Both primary and secondary data sources were employed, and the data was analysed at the 5% level of significance using the chi square statistical technique. The results were displayed as percentages and frequency tables.

ABSTRACT

The purpose of the study, Psychoactive Substance Use Among Young People, was to ascertain the prevalence and usage trends of psychoactive substances among Nigerian youth. In order to gather data from secondary sources, such as published articles and journals, the study used an exploratory research design (p < 0.05). Based on data collected, the study found that substance misuse is highly prevalent among youth and suggested ways to address the impact of substance addiction on human communities. The actions of people under the influence of one or more psychoactive drugs have been connected to a considerable number of premature fatalities and accidents (Shelly, 2010). varied agencies have varied perspectives on drug misuse. Substance abuse, according to Neeraja (2011), is the dependence on drugs or other chemicals that has negative effects on one’s physical and emotional well-being or the welfare of others. Substance abuse is defined by Smelzer, Bare, Hinkle, and Cheever (2008) as a maladaptive pattern of drug use that can disrupt daily living and result in bodily and emotional harm. According to these definitions, substance abuse is defined as the misuse of one or more medications that may be prescribed by a medical professional with the goal of changing a person’s feelings, thoughts, or behaviour. It is linked to negative outcomes, such as physical and psychological harm to the individual. According to the African Symposium (2010), substance abuse is defined as the inappropriate use or application of drugs by an individual who is not properly informed about the substances and does not have a valid prescription from a licensed medical professional. Psychoactive substances are the main emphasis of this definition. All drugs have the potential to be abused to the point that the user becomes addicted because they are unable to quit using them in spite of the negative consequences on their social, personal, and financial lives. Although it was formerly thought to be a problem of a “select few,” substance addiction has become so serious that it now affects women, children, and persons living in rural areas in addition to the typical features of abusers being male, adult, and urban (Rocha, 2009). These abusers mistakenly think that using drugs improves their mood, performance, etc. The welfare of society is seriously threatened by the issues that this act brings with it (Ajala, 2009).

CHAPTER ONE

INTRODUCTION

Background of the Study 

All around the world, people and society are heavily burdened by psychoactive substance use and dependence. According to the 2010 World Health Report, the use of psychoactive substances accounts for 8.9% of the overall burden of disease.

According to the report, the burden of disease in 2010 was caused by alcohol at 4%, tobacco at 4.1%, and illegal drugs at 0.8%. Numerous health and social issues contribute significantly to the burden associated with substance use and dependency.

Large-scale seizures of cocaine, heroin, cannabis, and amphetamine-type stimulants have been reported worldwide, according to data from the World Health Organisation (2011). The degree of cultivation in the nations of origin and the success or failure of trafficking organisations determine the availability of cocaine, heroin, and cannabis.

Nevertheless, there always appears to be plenty for users, even with higher levels of law enforcement activity. An estimated 200 million individuals use illegal substances of some kind, according to UNODC figures from 2011.

The use of psychoactive substances is a social issue that has rapidly expanded in educational institutions, particularly among students in secondary school (Neeraja, 2011).

Because it negatively impacts the lives and academic performance of the participating pupils as well as the harmonious operation of the overall social system, this social issue is regarded as a matter of grave concern.

Psychoactive drug use and other related issues are detrimental to their ability to survive, function well, feel happy, etc. The welfare of society is seriously threatened by the issues that this act brings with it (Ajala, 2009).

CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

The Internet and wireless cellphones are becoming aspects in the communication and information environment in practically every developing country (Digital opportunity Initiative, 2001).

In the previous two decades, radio and televisions grew quite ubiquitous and played key roles in reproductive health. Now information Communication Technology represents the next big wave of innovation. It comprises ‘mobile web’ Personal Digital Assistant (PDA) and short Message Service (SMS) (WAJU, 2003).

The Internet provides people in otherwise information starved surroundings with an unrivalled resource and window on the wide world. It enhances interaction between health professionals and customers, and regulates demand for services; enable health organisation and government update information for more swiftly for surveillance (SCIPICH, 1999).

Gustafon et al (1999) noticed that interactive website providing personalised Reproductive Health Information and other services can be beneficial in helping client manage diseases, get health care or provide aid in modifying behaviour.

How have reproductive health professional in Nigeria embrace information communication Technology? American Nurses Association ANA, 2001 and 2003 stated that information communication Technology which has influenced greatly in reproductive health indeveloped countries has left their counterpart in Nigeria lagging behind.

Moreso Sayki (2003) supported information communication technology as a cure to lower this significant financial expense of training and retraining trainers among reproductive health experts (for instance, in life saving skills (LSS)) and sustaining the network of specialists. This needs a vivid examination of skill capacity of reproductive health workers in general Hospital, Ikot Ekpene.

One of the most obvious problems of health communication in the 21st century is the introduction of Information Communication Technology (ICT). The globe is undergoing communication revolution (Jackson and Duffy, 1998). Publications, radio and television are now reaching billions of people around the world in what is quickly becoming a worldwide electronic Communication village.

Radio, television, and the global system for mobile telecommunication (GSM) are now directly and unrestrictedly available to millions of households in developing nations.

Additionally, databases are now available online and on CD-ROM. They can take the place of libraries, go where none previously existed, and alter almost every facet of healthcare delivery.

Akinumiju and Fabumni (1997) claim that modern information access has transformed communication and created direct connections between individuals and groups on a scale never before achievable.

Piotrow et al. (1997), for example, described how Chinese doctors, perplexed by a dying woman’s condition, posted her clinical symptoms online and sent out a general call for a proper diagnosis to hospitals worldwide. Eighty additional doctors confirmed the diagnosis within the same day after a U.S. physician sent the accurate diagnosis.

What impact has the digital divide had on the field of reproductive health? It has been noted by Piotrow et al. (1997) that the rich and the poor have a wider disparity in access to electronic information.

Reproductive health professionals must therefore act as their advocates to ensure effective delivery of reproductive health services, as those who need them the most (particularly in rural areas) may have the least access.

Additionally, a lot of reproductive health programs rely on factual information that is conveyed to the public and healthcare professionals in a way that is both memorable and useful enough for them to use when necessary.

ICT has been observed by Pobjola (1992) to enhance practitioners’ access to clinical information and the calibre of clinical procedures. It is a useful tool for updating providers’ knowledge, facilitating prompt referrals and consultations, and acting as a repository for reproductive health data.

It is affordable and has the potential to greatly enhance reproductive health outcomes to connect dispersed or decentralised health systems, as is the case in Nigeria and Akwa Ibom State in particular (DOl, 2001).

In addition to improving supply and referral systems (particularly in emergency situations), epidemiological monitoring systems, and reducing isolation, the ability to communicate swiftly and directly via cell phone, email, the Internet, and other means has also improved efficiency, saved time for both clients and providers, and given Nigerian reproductive health professionals better access to opportunities and trustworthy information, putting them on par with their international counterparts.

Consequently, the purpose of this study is to examine the information-seeking behaviour of reproductive health specialists at General Hospital Ikot Ekpene.

Additionally, an attempt is made to evaluate these professionals’ information and communication technology (ICT) utilisation status in light of their background characteristics, which include remoteness, low welfare status, and a lack of adequate ICT facilities.

1.2 Statement Of The Problem 

There is mounting evidence that, in the correct circumstances, ICTs can significantly improve reproductive health. Hospitals in Nigeria are increasingly becoming ICT driven and are utilizing certain level of ICT in their operation.

And greater access to information and new ideas on reproductive health is inspiring client to ask for and expect more from providers.

The ability of providers to meet these challenges depends on their electronic readiness status.

What is the level of awareness/utilization of ICT by reproductive health professionals?

What are the information seeking attributes of these professionals?

Thus, this research is envisioned to access the consumption status of ICT by Reproductive Health professionals in General hospital, Ikot Ekpene

ABSTRACT

Patients’ attitudes regarding the use of radiology changing rooms and facilities were evaluated in this study. In 2012, a survey study was carried out at the x-ray departments of the National Orthopaedic Hospital (NOHE), Niger Fondation Hospital (NFH), and University of Nigeria Teaching Hospital (UNTH) in Enugu. Convenient sampling was utilised to collect data from 120 respondents for four study topics, each with at least three items. Mean score tables were used for statistical analysis of the data. Grand mean values for study questions 1, 2, 3, and 4 were 2.4, 2.9, 3.1, and 2.9, respectively, according to the analysis. The results showed that patients’ willingness to use the changing rooms is influenced by their physical surroundings; that patients’ opinions about radiology changing rooms and changing facilities are impacted by the inadequate facilities in the x-ray changing rooms; that patients’ opinions regarding the use of radiology changing room facilities are influenced by their concerns about the hygienic conditions of the x-ray changing gowns; and that x-ray changing gowns have an impact on patients’ privacy. Patients’ attitudes in the three hospitals are influenced by the general physical environment of the x-ray changing rooms, the facilities in the x-ray changing rooms influence the attitudes of the patients, and the patients’ perception of dignity in the use of changing gowns contributes to the attitudes of the patients in the three hospitals, according to the mean score comparison of the physical environment of the x-ray changing rooms, facilities in the x-ray changing rooms, and patients’ perception of dignity in the use of changing gowns. The radiology department will be able to address patient resistance and unfavourable opinions regarding the use of radiology changing rooms and facilities thanks to this study.

CHAPTER ONE

INTRODUCTION

Anybody who receives medical attention is considered a patient. Most of the time, the patient is sick or hurt and need medical attention from a doctor, advanced practice registered nurse, or other healthcare professionals.

One He also contributes next to nothing to the therapy process since he is uninformed about and even afraid of the medical tests and procedures that are required to help him recover.

The fairly peculiar hospital setting has an impact on his mindset. He may not know how to improve the diagnosis because he is not familiar with the medical setting.

As a result, he can be terrified of both the diagnostic facilities and the diagnostic procedures. As a result, the patient requires professional assistance and reassurance during the diagnostic processes.

As a psychological concept, attitude is characterised as a persistent system of pro or con action inclinations, emotional responses, and positive or negative evaluations with regard to social objects (a patient is an excellent illustration of this).

Therefore, attitude is composed of three components: behaviour, belief, and emotion. Therefore, a patient’s attitude reflects his or her assessment, sentiments, and response to the hospital setting in general and the radiology department in particular.

His attitude is influenced by a number of things, including the patient’s awareness and educational background. The uneducated patient may perceive all of the radiology department’s accessories as contaminated. Therefore, good communication is essential to winning the patient’s trust. 3.

The radiology (x-ray, mammography, CT, etc.) examination room is located fairly close to the changing room. Its goal is to assist the patient in getting ready for the x-ray examinations, regardless of how well-versed they are in the diagnostic processes.

The preparation involves making sure the patient is wearing a changing gown that will prevent any clothing or other personal belongings from influencing the diagnosis during the x-ray examination.

Every x-ray machine needs a cubicle that is well-ventilated and well-lit. Each changing room or changing cubicle also has a mirror, clothes hooks, a changing gown, and a bench.

For patients who use wheelchairs, a larger dressing room might also be available. Curtains should be used in place of doors in every room. There may also be restrooms available11.

The purpose of this study is to evaluate patients’ attitudes regarding the use of these changing rooms and their amenities.

The process of collecting and considering data in order to make consistent, well-informed decisions to enhance comprehension of a situation—in this case, the attitudes of patients towards using the changing room and its contents—is known as assessment.

These public (UNTH, & NOHE) and private (MEMPHY’S HOSP & NIGER FOUND.) hospitals in Enugu state will serve as case studies for this evaluation.

CHAPTER ONE

INTRODUCTION

Background of the Study 

With a growing population and fewer or no resources, health systems in both developed and developing nations are under pressure to provide better services [Namgada 2008].

This is brought on by a greater number of illnesses, a demand for the highest calibre of care, enhanced access to a variety of health services, understanding of one’s rights, and advanced medical technology.

The following are necessary for health care systems to provide health services to patients/clients: adequate qualified health workers, proper equipment, financial resources, and effective health policies [Olade, 2005].

Providing high-quality care is the main objective of all health systems; nonetheless, some variables appear to impede efforts to reach this objective as much as possible.

The quality and results of care have been found to be impacted by the worldwide scarcity of health professionals and the standard of healthcare providers, for instance (Olade, 2005).

A 2009 report by the World Health Organisation reveals that in many developed nations, there are between 1000 and 100,000 employees per 100,000 people. It is between 100 and 100,000 in poor nations.

As of December 2010, Nigeria has 128,918 registered nurses and 52,408 doctors on the medical register, according to a survey on the country’s health workforce [Labran, Mafe, Onajole & Lambo, 2011].

Nigeria has a population of approximately 160 million, according to the World Health Organisation (2009). Based on the facts above, the projected ratio of health professionals to the population is doctors: 1:3052 and nurses: 1:1241.

According to Ozcan and Horby (2004), there hasn’t been enough qualified health workers in Africa, as well as in many other parts of the world, thus it’s important to make good use of the few resources.

There is a severe lack of medical staff in the majority of Nigerian hospitals today, according to Okoronkwo (2005); the staff that is there is unable to effectively attend to the patients’ requirements due to an overwhelming workload.

This suggests that even while the need for healthcare is growing, hospitals are unable to supply enough staff to deal with the demand. Thus, the quality of care declines and the workload for current employees rises.

Aside from the lack of medical professionals, most health systems in developing nations also struggle with the proper staffing mix in the provision of healthcare services (McGillis, 2005).

In healthcare facilities, the term “staff mix” describes the combination of several types of health workers [from the same or distinct professional disciplines] who are employed to provide patient care.

The overall quality of care in healthcare facilities is influenced by the mix of staff members [McGillis, 2005]. In terms of human resource management, the standard procedure is to assign the appropriate number of health personnel, who possess the necessary knowledge, abilities, and disposition, to carry out the appropriate tasks in the appropriate location at the appropriate time in order to meet the established health goals [Mark and Staton, 2003: International Council of Nurses (ICN), 2006].

The staff-to-patient ratio is the determinant of the care process in a particular unit or facility. This staff mix ratio may be expressed as the ratio of available personnel to patient population, years of professional experience, professional qualifications, number of years of service in a unit, or cadre of staff (junior/senior).

The typical staff-to-patient ratio, contingent on unit size, is 1:4-6 patients (Needleman, 2005). The ratio is 1:2–3 in more critical care units.

For various staff cadres and depending on the unit and kind of patient managed, the Nursing and Midwifery Council of Nigeria (N&MCN, 2005) states that the staff/patient ratio in clinical practice should be 1:4-5 for general wards and 1:1-3 for intensive care units.

Patients are given the best care and are released at the appropriate time when a unit has the appropriate amount of staff members (Cheryl and Clark, 2007). Higher staff-to-patient ratios, according to Aiken [2007], guarantee that patients receive the proper direct care.

In-depth evaluation and continuous monitoring of clinical changes are also capabilities of the staff. Employees have more time to track alterations in patients’ conditions and provide prompt assistance for issues that are found. All of these are anticipated to have an effect on the care result.

Quan [2006] asserts that a patient’s outcome is an observable change brought about by their exposure to therapies or the care environment. It is the outcome of an illness, a medication, a therapy, or an incident.

In medical and surgical instances, the results include a change in the patient’s functional status, either positively or negatively, throughout the hospital stay, as well as the occurrence of unpleasant events such as infection, pressure ulcers, urinary tract infections, and medical errors.

Research has indicated that the mix of staff and the quality of care are related. According to Strasser (2005), positive outcomes are linked to well-trained staff, staff training and experience, higher levels of therapy, more intense care, overall staffing levels, teamwork, and team order and organisation.

Conversely, adverse outcomes are linked to inadequate hiring and retention, absenteeism or delayed care, inadequate facilities and supplies, inadequate administrative management, the severity of the illness (acute or chronic), and co-morbidity variables (Anderson, Weiner & Khatusky, 2006).

Both Bolton (2001) and Needleman (2005) noted that the staff-to-patient ratio and care outcome are significantly correlated. They emphasised that when the right number of staff members are assigned to patients, the likelihood of adverse events such as the development of pneumonia, pressure ulcers, failure to rescue, deep vein thrombosis, death, urinary tract infections, and shock is decreased.

Others include shorter hospital stays, medical mistakes, healthcare expenses, and infection or disintegration of surgical wounds. According to Suzanne and Smeltzer [2010], patients’ overall health, the risks associated with a particular surgery, concurrent conditions like diabetes mellitus that may impact wound healing, chronic smoking, unnecessary invasive procedures, post-operative pain management, nutritional status, immune status, and other factors may also have an impact on the patient’s outcome of care.

These investigations were mostly carried out in industrialised nations. Data on staff mix and patient outcomes is scarce, both in Nigeria and throughout Africa. This study looked at patient outcomes and staff composition in Enugu State’s state and federal teaching hospitals.

Statement Of The Problem

The two teaching hospitals in Enugu State are the University of Nigeria Teaching Hospital Ituku/Ozalla (UNTH) and Enugu State University Teaching Hospital, Parklane Enugu (ESUTH).

They offer health services, training, and research. Patients and consumers from both inside and outside the state use these medical facilities.

According to the 2008 medical records report, the number of patients arriving at the hospitals for general and special care has increased since UNTH moved to its permanent location in 2007, which is roughly 21 kilometres from Enugu city. Prior to 2007, UNTH had 90,000 patients annually.

Following the move to Ituku/Ozalla in 2008–2010, the number of cases at the medical institution increased by 200,000. The entire burden at the hospital inevitably increased as patient patronage increased over time.

Patients have also flocked to ESUT as a result of Park-lane General Hospital Enugu’s gradual transformation into a specialist hospital in 2006 and then into a teaching hospital.

Prior to 2006, the ESUT medical records indicated that 50,000 patients visited the clinic each year. According to the 2009 medical record report, there were 75,000 patients on average each year in special clinics and units.

Between 2007 and 2009, 200 nurses and 150 doctors were employed at UNTH, according to the Administrative Personnel Record [2011] report.

Between 2007 and 2010, 104 nurses and 109 doctors were employed, according to the ESUTH administrative personnel record [2011] report. Nevertheless, these staffing levels are insufficient to satisfy.

CHAPTER ONE

INTRODUCTION

1.1 The Background of the Study 

The individual’s nutritional status is determined by the discrepancy between food intake and utilisation. Nutritional status will either directly or indirectly reflect changes in food consumption and biological utilisation. Undernutrition, overnutrition, or adequate nutritional status are all possible.

Malnutrition is defined as both inadequate and excessive nutrition. A number of reasons, including as the primary care provider’s hectic schedule or the inability to offer enough food and necessary medical treatment to maintain normal nutritional status, may have an impact on the under-five child’s nutritional condition.

The factors influencing nutritional status might vary by area, community, or even time. Determining the nutritional status and the underlying causes is crucial in order to provide the appropriate recommendations or address any nutritional issues in a given location.

Governmental and non-governmental organisations have worked to maintain normal nutritional status both domestically and abroad, yet inadequate nutrition is still a major cause of disease and a shorter life expectancy.

Mamulwar, Rathod, Jethani, Dhone, Bakshi, Lanjewar, et al. (2014) state that 25% of children under five suffer from stunting. Numerous elements have been linked to affect nutritional status.

Disease and poor nutrition are viewed as immediate causes, but there are also underlying causes, like as food security, the mother’s nurturing behaviours, a healthy environment, and the evaluation of medical facilities.

According to Asegedech (2014), the fundamental causes of the underlying causes are also thought to be socioeconomic and political circumstances.

Since this stage of life is thought to be crucial for proper growth, the nutritional status of children under five is extremely important (Badake, Maina, Mboganie, Muchemi, Kihoro, Chelimo, & Mutea, 2014).

A serious medical disease known as undernutrition is defined by a lack of bodily nutrition (energy, vital proteins, lipids, vitamins, and minerals in a diet) due to insufficient food intake or improper digestion.

Every year, diseases that are preventable and even easily treat claim the lives of almost 10 million children under the age of five. Due to their weak economies, developing nations account for the majority of these diseases and fatalities (Black, Morris & Bryce, 2003).

More than 30% of all children under five die from malnutrition (United Nations Children’s Fund (UNICEF), 2009). Badake, Maina, Mboganie, Muchemi, Kihoro, Chelimo, and Mutea (2014) state that measuring children’s growth is a useful way to examine their development. It also provides information about local food security and evaluates quality health care.

In order to enhance nutrition, several programs and interventions in various areas have been required due to poor nutritional status. Following this, professionals from a variety of disciplines are planning and assessing diverse nutrition-related interventions (Macias & Glasauer, 2014).

One of the simplest ways to evaluate the effectiveness of nutrition-focused programs is to evaluate nutritional status, which may be done in a number of ways.

Determining a person’s nutritional status requires a thorough understanding of their diet and the factors that influence their eating habits. Numerous factors can then be linked to the nutritional status.

CHAPTER ONE

INTRODUCTION

1.1 The Background of the Study 

Maternal and infant morbidity and mortality are significantly influenced by the quality of prenatal treatment and the location of birth. Concerns and recurring issues throughout the year have focused on maintaining and raising the standard of treatment in healthcare facilities.

When patients express satisfaction with the quality of their care, managers, policymakers, and healthcare professionals can use this information to guide efforts to enhance quality (Beattie, Lauder, Atherton, Murphy 2014).

According to Tobin-West and Anastasia (2016), quality evaluation is a crucial component of quality assurance, which focusses on identifying obstacles and difficulties in a system rather than only poor performance.

According to reports, pregnancy and childbirth problems claim the lives of 289 000 women annually on average. Additionally, problems during the newborn period and early childhood illnesses caused the deaths of around 6.6 million children under the age of five (World Health Organisation (WHO), 2013). By providing high-quality and optimal maternity and child health care in medical institutions, these deaths can be avoided.

Due to a significant disparity between the scope and quality of healthcare offered in facilities, efforts to improve maternal and child health outcomes have not made much headway, despite notable accomplishments in certain areas of reproductive, women’s, and children’s health interventions over the years (WHO, UNICEF, 2014).

The Global Strategy for Every Woman and Child and other international programs place a high priority on quality of care.

Every year, problems from pregnancy, childbirth, and/or the six weeks following delivery claim the lives of over 500,000 women and girls.

According to the United Nations Millennium Development Goals (2009), the majority of these deaths occur in less developed nations, making childbirth one of the most dreaded experiences for women of childbearing age.

Some people are concerned about this because statistics indicate that maternal mortality from pregnancy and delivery is rising in low- and middle-income nations (United Nations Children Fund (UNICEF) Nigeria, 2014).

In a similar vein, Nigeria has a 1 to 13 probability of death from pregnancy and childbirth. In Nigeria, 145 women in their reproductive years and 2,300 children under five pass away per day. Based on these numbers, Nigeria was ranked as the second-largest contributor to maternal and under-five mortality worldwide.

Nigeria’s coverage and quality of health care services, which still fall short of expectations for women and children, may have avoided many of these deaths.

About 35% of deliveries are handled by medical professionals, and less than 20% of Nigerian health institutions offer emergency obstetric care (Eoc), according to a 2014 United Nations International Children Fund (UNICEF) report.

The goal of a national health strategy created for Nigerians in 1988 was to provide high-quality healthcare for everyone. The policy has been reviewed over the years to improve the quality of health care services throughout the country due to emerging health challenges and the need to focus on new trends (Nigeria Demographic Survey, 2013).

For this population, high-quality reproductive care must be provided through a health delivery system that aims to lower maternal morbidity and mortality (United States Agency for International Development (USAID), 2013).

In 1966, the Donabedian model was created to evaluate healthcare services and care quality. The model, which was updated in 1988, uses three categories—structure, procedure, and outcomes—to offer information regarding the quality of care.

The setting in which care is provided, including hospital facilities, personnel, funding, and equipment, is referred to as the structure. Transactions between patients and medical staff during the course of providing healthcare are included in the process.

The term “outcomes” describes how healthcare affects a patient’s health and level of satisfaction. Since then, other frameworks for evaluating the quality of healthcare have been developed, such as the Bamako Initiative and the Quality of Care Framework recommended by the World Health Organisation (WHO), but the Donabedian Model remains the most widely used framework for doing so today (Lawson and Yazdany 2012).

Key indicators for quality in maternal, newborn, and child health care were developed in 2013 by the World Health Organisation and the Partnership for Maternal, Newborn, and Child Health using the Donabedian model.

Care given to a woman during pregnancy, childbirth, and the postpartum period is known as maternal health care, and it is essential to both the mother’s and the child’s survival and well-being.

With the goal of reducing maternal death and disability, it includes a wide range of services such as family planning, prenatal, intrapartum, and postpartum care (Franny, 2013).

A neglected but crucial strategy for lowering maternal deaths and helping developing nations reach Sustainable Development Goal 3 (SDG 3), which is good health and well-being, particularly for women, is to improve the quality of obstetric care provided in facilities (Van den Broek and Graham 2009).

With 25% of maternal mortality occurring in developing nations, postpartum haemorrhage is the leading cause of maternal deaths worldwide. Then come obstructed labour (7%), sepsis (8%), and hypertensive disorders in pregnancy (PE/E) at 15%.2

There are effective therapies for screening, preventing, and treating obstetric and infant problems, and competent providers may easily offer these in facilities.

However, reducing maternal and neonatal deaths worldwide requires both high quality and coverage of these therapies.

According to international data, having a trained delivery provider present and receiving high-quality care are the most crucial factors in lowering maternal and early newborn death (USAID/MCHIP 2013).

Poor maternal and child health indicators have been a persistent problem in Nigeria since the 1990s, and numerous interventions have been put in place to buck the trend and guarantee that Nigeria offers high-quality maternal and child health care (Kana, Doctor, Peleteiro, Lunet, & Barros, 2015).

Nonetheless, a number of intervention reports have shown conflicting results regarding the obstacles, difficulties, and dangers to obtaining high-quality maternity and paediatric healthcare in Nigeria. Nigeria has only reduced under-five mortality by an average of 1.2% year since 1990, according to UN mortality figures, and it has been noted that the country is falling behind in achieving MDG 4.

Additionally, Nigeria had to have achieved a 10% annual reduction rate in the five years preceding up to 2015 in order to accomplish MDG 4 (Rajaratnam, Marcus, Flaxman, Wang, Levin-Rector, Dwyer, et al., 2010).

at order to enhance the health outcomes of mothers, babies, and children, it is crucial to improve and ensure the quality of health care services at medical facilities. Developing strategies for quality is a crucial part of scaling up interventions in this regard (WHO, 2013).

1.2 The Statement Of The Problem 

Maternal and child morbidity and mortality are significantly influenced by the quality of care received during pregnancy and the location of delivery (United States Agency for International Development (USAID), 2013).

Every year, nearly half a million women and girls worldwide pass away due to complications during conception, delivery, or the six weeks following childbirth.

According to the United Nations Millennium Development Goals (2009), the majority of these fatalities occur in developing countries.

In Nigeria, the chance of dying during pregnancy and childbirth is 1 in 13, and many of these deaths might have been prevented with adequate coverage and high-quality treatment for mothers and children (United Nations International Children Fund (UNICEF), 2014).

Poor quality healthcare services have been associated to higher rates of maternal and newborn death and morbidity (USAID, 2013). Inadequate access to reproductive health services is a significant problem in Nigeria, as evidenced by rising death rates (WHO Nigeria, 2014).

Due to a significant discrepancy between coverage and the standard of care given in medical facilities, there has been little progress in improving maternal and paediatric outcomes, despite advancements in expanding the coverage of several important reproductive, maternal, newborn, and child health interventions over the past 20 years (WHO, UNICEF, 2014).

Clinical practice has also shown that, despite the abundance of healthcare resources in the area, many cases of avoidable pregnancy and delivery difficulties are nevertheless reported daily in the teaching hospital in Ile-Ife.

It is crucial to raise the standard of facility-based health care services and make quality a key element of expanding treatments to enhance the health of expectant mothers, babies, and kids (WHO, 2013).

Therefore, in order to attain Sustainable Development Goal 3 (SDG 3), which is good health and well-being, it is necessary to assess the maternal and child healthcare services provided at Ile-Ife healthcare facilities for quality care.

1.3 The Objectives of the Study

This study’s primary goal is to use the Donabedian model for quality care to assess the quality of maternal and child healthcare services at a few chosen healthcare facilities in Ile-Ife.

The particular goals are to:

1. evaluate, using the Donabedian model, the organisation of maternity and child healthcare services in Ile-Ife’s primary and secondary healthcare institutions;

2. determine, using the Donabedian model, the maternal and child healthcare services process in Ile-Ife’s primary and secondary health facilities;

3. Using the Donabedian paradigm for quality care, evaluate the client’s satisfaction (outcome) with the maternity and child healthcare services provided in Ile-Ife’s primary and secondary healthcare facilities.

4. Identify the types of employees providing maternity and paediatric care at Ile-Ife’s main and secondary healthcare facilities.

1.4 Research Questions

The study provided answers to the following research questions:

1. How are the healthcare services for mothers and children organised at a few Ile-Ife health facilities?

2. How do some medical facilities in Ile-Ife handle maternal and paediatric healthcare services?

3. How satisfied are patients with the maternity and paediatric healthcare services provided at Ile-Ife’s primary and secondary healthcare facilities?

4. Which staff members are providing maternity and paediatric healthcare services in Ile-Ife’s medical facilities?

1.5 Theories

The 0.05 threshold of significance was used to evaluate the following hypotheses.

HO1: There is no significant variation between the structure of Maternal and Child

medical care in Ile-Ife’s primary and secondary healthcare facilities.

HO2: The procedures for maternal and paediatric healthcare do not differ much.

primary and secondary healthcare establishments’ services.

HO3: The client’s pleasure (result) does not significantly differ between

Healthcare services for mothers and children in primary and secondary healthcare facilities in the island

Ife.

1.6 The Scope of the Study

This study’s scope was restricted to Ile-Ife primary and secondary healthcare facilities, as well as nursing mothers of children aged 0–1 who visited infant welfare clinics at particular Ile-Ife healthcare facilities. The four local governments of Ile-Ife—Ife Central, Ife East, Ife South, and Ife North, respectively—are taken into consideration in this study.

1.7 Significance of the Research

The World Health Organisation Report (WHO 2008) states that there is still a significant gap between industrialised and developing nations in terms of maternal and neonatal morbidity and mortality.

In order to reduce maternal and child mortality and accomplish Sustainable Development Goal 3 (SDGs), which is Good Health and Well-Being, the results of this study may thus aid in making recommendations to enhance the quality of healthcare services for mothers and children.

Through stakeholder collaboration, the findings could help the Federal Ministry of Health implement measures to enhance the quality of healthcare services for mothers and children.

The results could help National Health Planning and Budgeting with bettering healthcare facility structure, staff training and retraining, monitoring, and supply and transportation service for timely referrals in healthcare facilities.

The results might offer helpful details about how to collaborate with regional and global organisations to play a complementary role in maternal and paediatric healthcare services.

The study’s findings could be used to push medical practitioners even harder to pinpoint the variables affecting the standard of maternity and paediatric healthcare in Nigeria and where improvements are needed.

The results could contribute to the body of information already in existence and help Nigeria reach its objective of providing high-quality healthcare services for mothers and children.

1.8 Definition of Terms 

Quality of Care: Pregnancy, childbirth, and postpartum care provided to women at Ile-Ife healthcare facilities according to the Donabedian Model of quality care, which encompasses the organisation, procedure, and results of maternal and child health care services.

Maternal and child healthcare refers to the treatment provided in Ile-Ife medical facilities to a pregnant woman from the moment of conception until the baby is delivered, as well as to the infant from birth to two years of age.

Health Professionals: Based on their education or credentials, midwives, nurses, community health officers, and community health extension workers offer maternal and child healthcare services in Ile-Ife healthcare facilities.

Nursing Mothers: Women with children aged 0–1 who have received treatment during pregnancy, birth, and the postpartum period, as well as family planning, vaccinations, and baby care, and who attend immunisation clinics during the study period at certain health facilities in Ile-Ife.

General hospitals and comprehensive health centres are examples of secondary healthcare facilities in Ile-Ife, as are Primary Healthcare Centres (PHCs).

Donabedian Model: Avedis Donabedian created this conceptual model of quality care in 1966, and it was re-examined in 1980 and 1988. The model, which was created to evaluate the quality of care in clinical practice, contains three categories—structure, procedure, and outcome—where data can be collected to measure the quality of healthcare services.

The physical infrastructure, personnel, and material resources that are available at basic and secondary healthcare institutions for maternal and paediatric healthcare services in Ile-Ife are referred to as the structure.

Process: This refers to the treatment and other activities carried out by medical professionals in maternal and child health services.

It includes all interactions between medical staff and patients, including relationships and respectful maternity care during interactions, as well as all acts of maternal and child healthcare delivery (antenatal, intranatal, postnatal, neonatal, and children’s care, among others) in healthcare facilities in Ile-Ife.

Result: Mother satisfaction with care obtained in Ile-Ife primary and secondary healthcare institutions is a measure of the impact of maternal and child healthcare services.