Browsing by Author "Adams, O."

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Gender Impacts of Small-Scale Farm Households on Agricultural Commercialisation in Oyo State, Nigeria
(British Journal of Economics, Management & Trade, 2013) Adenegan, K.O.; Adams, O.; Nwauwa, L.O.E.
Integrated sustainable childhood Pneumonia and infectious disease reduction in Nigeria (INSPIRING) through whole system strengthening in Jigawa, Nigeria: study protocol for a cluster randomised controlled trial
(BioMed Central Ltd, 2022) King, C.; Burgess, R. A.; Bakare, A. A.; Shittu, F.; Salako, J.; Bakare, D.; Uchendu, O. C.; Iuliano, A.; Isah, A.; Adams, O.; Haruna, I.; Magama, A.; Ahmed, T.; Ahmar, S.; Cassar, C.; Valentine, P.; Olowookere, T. F.; MacCalla, M.; Graham, H. R.; McCollum, E. D.; Falade, A. G.; Colbourn, T.
Background: Child mortality remains unacceptably high, with Northern Nigeria reporting some of the highest rates globally (e.g. 192/1000 live births in Jigawa State). Coverage of key protect and prevent interventions, such as vaccination and clean cooking fuel use, is low. Additionally, knowledge, care-seeking and health system factors are poor. Therefore, a whole systems approach is needed for sustainable reductions in child mortality. Methods: This is a cluster randomised controlled trial, with integrated process and economic evaluations, conducted from January 2021 to September 2022. The trial will be conducted in Kiyawa Local Government Area, Jigawa State, Nigeria, with an estimated population of 230,000. Clusters are defined as primary government health facility catchment areas (n = 33). The 33 clusters will be randomly allocated (1:1) in a public ceremony, and 32 clusters included in the impact evaluation. The trial will evaluate a locally adapted ‘whole systems strengthening’ package of three evidence-based methods: community men’s and women’s groups, Partnership Defined Quality Scorecard and healthcare worker training, mentorship and provision of basic essential equipment and commodities. The primary outcome is mortality of children aged 7 days to 59 months. Mortality will be recorded prospectively using a cohort design, and secondary outcomes measured through baseline and endline cross-sectional surveys. Assuming the following, we will have a minimum detectable effect size of 30%: (a) baseline mortality of 100 per 1000 livebirths, (b) 4480 compounds with 3 eligible children per compound, (c) 80% power, (d) 5% significance, (e) intra-cluster correlation of 0.007 and (f) coefficient of variance of cluster size of 0.74. Analysis will be by intention-totreat, comparing intervention and control clusters, adjusting for compound and trial clustering. Discussion: This study will provide robust evidence of the effectiveness and cost-effectiveness of community-based participatory learning and action, with integrated health system strengthening and accountability mechanisms, to reduce child mortality. The ethnographic process evaluation will allow for a rich understanding of how the intervention works in this context. However, we encountered a key challenge in calculating the sample size, given the lack of timely and reliable mortality data and the uncertain impacts of the COVID-19 pandemic.
Prevalence of pneumonia and malnutrition among children in Jigawa state, Nigeria: a community-based clinical screening study
(BMJ Publishing Group Ltd, 2022) King, C.; Siddle, M.; Adams, O.; Ahmar, S.; Ahmed, T.; Bakare, A. A.; Bakare, D.; Burgess, R. A.; Colbourn, T.; McCollum, E. D.; Olowookere, T.; Salako, J.; Uchendu, O.; Graham, H. R.; Falade, A. G.
Objective To estimate the point prevalence of pneumonia and malnutrition and explore associations with household socioeconomic factors. Design Community-based cross-sectional study conducted in January–June 2021 among a random sample of households across all villages in the study area. Setting Kiyawa Local Government Area, Jigawa state, Nigeria. Participants Children aged 0–59 months who were permanent residents in Kiyawa and present at home at the time of the survey. Main outcome measures Pneumonia (non-severe and severe) defined using WHO criteria (2014 revision) in children aged 0–59 months. Malnutrition (moderate and severe) defined using mid-upper arm circumference in children aged 6–59 months. Results 9171 children were assessed, with a mean age of 24.8 months (SD=15.8); 48.7% were girls. Overall pneumonia (severe or non-severe) point prevalence was 1.3% (n=121/9171); 0.6% (n=55/9171) had severe pneumonia. Using an alternate definition that did not rely on caregiver-reported cough/difficult breathing revealed higher pneumonia prevalence (n=258, 2.8%, 0.6% severe, 2.2% non-severe). Access to any toilet facility was associated with lower odds of pneumonia (aOR: 0.56; 95% CI: 0.31 to 1.01). The prevalence of malnutrition (moderate or severe) was 15.6% (n=1239/7954) with 4.1% (n=329/7954) were severely malnourished. Being older (aOR: 0.22; 95% CI: 0.17 to 0.27), male (aOR: 0.77; 95% CI: 0.66 to 0.91) and having head of compound a business owner or professional (vs subsistence farmer, aOR 0.71; 95% CI: 0.56 to 0.90) were associated with lower odds of malnutrition. Conclusions In this large, representative community-based survey, there was a considerable pneumonia and malnutrition morbidity burden. We noted challenges in the diagnosis of Integrated Management of Childhood Illness-defined pneumonia in this context.