Background and objective: Evidence-based practice (EBP) is widely acknowledged as an essential aspect of healthcare delivery. Nurse managers are expected to contribute to the development of organisational cultures promoting EBP. However, there are indications that nurse managers are not necessarily empowered to drive implementation due to hierarchical constraints. This study explores how nurse manager’s position in the hospital hierarchy influences EBP implementation in nursing, in the Nigerian acute care settings.Methods: A qualitative case study methodology is utilised to gather data from two large acute care settings in Nigeria. Drawing on semi-structured interview, twenty-one ward managers and two nurse managers were interviewed. Data were transcribed and inductively analysed to generate four overarching themes.Results: Nurse managers were hugely constrained by lack of autonomy to mobilise resources for EBP related activities. The hierarchical structure of the settings promoted top-down decision-making processes which in turn, limited nurse manager’s visibility in the boardroom. Consequently, nurse managers were excluded from key strategic planning within the organisation and could not drive EBP implementation.Conclusions: Findings highlight need for nurse managers to have greater visibility and managerial influence to enable them create opportunities for implementation of EBP in nursing. Implications for nursing management: Administratively, there is need for nurses to have greater involvement in management. Adequate authority and leadership visibility as well as managerial influence would enable nurse managers create opportunities for successful implementation.

The global prevalence of neonatal infection remains high and accounts for one-third of neonatal deaths (1.5 million), with umbilical cord infection as the major risk factor, especially in low-income countries. 1,2 Hospital-based studies in Nigeria revealed that umbilical cord infections account for about 10% -19% of neonatal admissions, resulting in 30% -49% of deaths in neonates. 3 Nigeria therefore ranks the second highest globally, with 276 000 deaths annually resulting from umbilical cord infection. 4,5 In Cross River State, umbilical infection is responsible for 36% of hospital admissions and 45.2% of neonatal deaths. 6 The situation in Nigeria is also typical of other African countries like Tanzania, with neonatal sepsis accounting for 27% -56% of neonatal mortality annually and umbilical cord infection as the major cause of infection. 7 Umbilical cord infection causing about 30% of neonatal mortality was also reported in a related study. 8 Although cord cleansing after delivery is viewed as mainstay of neonatal care, the substances and method of application are not consistent with the best practice guidelines. 9 The increased neonatal mortality rate occasioned by umbilical cord infection has necessitated the recommendation of chlorhexidine (CHX) gel for cord management, which was first introduced by the World Health Organization (WHO) in Geneva on 29 September 2008 but is still poorly used in communities with high neonatal motility. 10 This is particularly indicated for neonates during the first week of life in countries or settings with high neonatal mortality (≥ 30 neonatal deaths per 1000 live births).Background: Umbilical cord infection contributes significantly to neonatal mortality rate in sub-Saharan Africa. Studies have shown low knowledge of chlorhexidine (CHX) gel for umbilical cord management amongst mothers in low-resource settings, including Nigeria.Objective: The objective of this study was to assess the effectiveness of a supportive-educative nursing intervention programme on knowledge of CHX gel amongst mothers in Cross River State, Nigeria. Methods:A quasi-experimental study design was used, and study participants comprised 168 expectant mothers, who were purposely selected and assigned to randomised control and intervention groups. The instrument for data collection was a researcher-developed structured questionnaire. The data were analysed using Statistical Package for Social Sciences version 23 for descriptive and inferential statistics at significant level was set at p < 0.05. Results:The result showed that at post-test the knowledge score of mothers on CHX gel improved significantly in the intervention group (t 77 = 24.394; p < 0.05). The result showed no significant difference between mothers' demographic variables and knowledge of CHX gel. Conclusion:A supportive-educative nursing intervention programme could effectively improve knowledge of CHX gel for umbilical cord management amongst mothers. This underscores the need to improve mothers' knowledge of CHX gel by healthcare personn...

Climate change is a mounting pressure on private health financing in Africa – directly because of increased disease prevalence and indirectly because of its negative impact on household income. The sources and consequences of the pressure constitute an important area of policy discourse, especially as it relates to issues of poverty and inequality. Relying on a panel dataset involving 49 African countries and the period 2000–2019, as well as a random effect regression analysis, this report shows that climate change has a positive and significant impact on the level of out-of-pocket health expenditure (OPHE) in Africa, and an increase in the level of greenhouse (CO2) emissions by 1% could bring about a 0.423% increase in the level of OPHE. Indirectly, the results show that, compared with the regional average, countries that have higher government health expenditure levels, above 1.7% regional average, and face higher climate change risk may likely record an increase in OPHE. Alternatively, countries with higher per capita income (above the regional annual average of $2300.00) are likely to record a drop in OPHE. Countries with lower climate change risk and a lower than the regional average age dependency (above the regional average of 80.4%) are also likely to record a drop in OPHE. It follows that there is a need for policy alignment, especially with regard to how climate change influences primary health care funding models in Africa.Contribution: The results of this research offer policymakers in-depth knowledge of how climate change erodes healthcare financing capacity of government and shifts the burden to households. This raises concerns on the quality of accessible healthcare and the link with poverty and inequality.

The current study examined psychiatric nurses' views, knowledge, attitudes, organizational readiness, levels of evidence-based practice (EBP), as well as barriers and facilitators to EBP in a Nigerian tertiary neuropsychiatric hospital. This study used a cross-sectional descriptive research approach. Structured questionnaires were administered to all psychiatric nurses ( N = 131) at the hospital. Results showed that psychiatric nurses had an acceptable degree of EBP knowledge and a positive attitude toward EBP. Levels of EBP implementation were below average, and organizational culture and preparation for EBP were moderate. Participants reported a moderate degree of barriers to EBP adoption (mean = 40.08, SD = 9.63), and a high level of assertion to positive facilitators of EBP (mean = 19.88, SD = 4.16). Findings show that although most psychiatric nurses had adequate knowledge and good attitudes toward EBP, certain barriers prevented its application. Thus, there is a need for a policy framework to mitigate existing barriers and improve EBP facilitators in psychiatric nursing practices in Nigeria to improve productivity measures. [ Journal of Psychosocial Nursing and Mental Health Services, xx (xx), xx–xx.]