Report on the first year of biomedical operational research of the AMC-CPCD within participating clinics in Nigeria in the Health Insurance Fund Nigeria project

Main findings of the inventory phase

Cumulative enrollment at the end of February 2008 was 36,579 in total. The mean number of enrolled family members is 4.3 in Kwara and 1.4 in Lagos. A total of 13,410 (laboratory) investigations, 45,818 clinical diagnoses, and 151,274 individual treatments were recorded. It is found that infectious diseases, metabolic diseases and antenatal care are the most frequent reasons for clinic visits. Other important observations include:

• Collection of quality (medical) data is still proving to be a challenge. Good-quality data are vital for the management and evaluation of the project.
• In Lagos it analysis has shown that adults are the most frequent users of the health care services. This is different from the conventional utilization distribution and could be a signal for adverse selection
• Patients presenting with fever of unknown origin are too often presumptively diagnosed with and treated for malaria / typhoid fever.
• The most frequent pediatric diagnoses are diarrhea and respiratory infections.
• Metabolic diseases are frequently diagnosed. Diabetes mellitus is relatively more frequent in Lagos compared to Kwara.
• Antenatal care is a frequent reason for clinic visits.