Browsing by Author "Adebayo, A. M."

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Acceptability of Child Adoption and adoption services among civil servants in Ibadan, Nigeria
(Pan African Medical Journal (PAMJ), 2020) Nwachukwu, C. C.; Cadmus, E. O.; Nwachukwu, A. C.; Adebayo, A. M.; Owoaje, E. T.
Child adoption provides an opportunity for children to have new families and for parents to have children. Its acceptance by the society, however, may affect people’s decision to adopt. This study was conducted to determine the attitude and acceptability of child adoption and adoption services among 403 civil servants in Oyo State Secretariat, Ibadan in February and May, 2008.Self-administered questionnaire was used to collect data. Likert scale of score range 1-5 was used to measure respondents’ attitudes. Each positive attitude answer was given a score of 5, while each negative attitude answer had a score of 1. Total scores were computed for each respondent. Attitudinal scores within the range of 16-50 and 51-80 were considered negative and positive respectively. The mean age of respondents was 40.2 ± 9.7 years. Sixty five percent had tertiary education. Overall, 45.9% had positive attitude to adoption. A higher proportion of respondents who had tertiary education (56.3%) were supportive of adoption compared to the others. About 65.0% would support or encourage a relation to adopt a child while 68.5% would recommend adoption to a childless couple. Males, (57.2%), were more willing to support a relation who would like to adopt compared with females, (65.6%). The main reason for non-support of adoption by 32.4% of respondents was that they believed that the childless couples would have their biological children. Efforts should be made to improve the acceptability of adoption.
Contextual factors influencing the roles of patent medicine vendors in the provision of injectable contraception services in Nigeria
(Springer Nature, 2023) Adebayo, A. M.; Oluwasanu, M. M.; Okunade, F. T.; Ajayi, O. O.; Akindele, A. O.; Ajuwon, A. J.
Background Patent medicine vendors (PMVs) play vital roles in the delivery of family planning services in Nigeria and other developing countries. There is a growing recognition of the need to integrate them into the formal health care system as a strategy to increase the contraceptive prevalence rate and achieve universal health coverage.Though promising, the success of this proposition is largely dependent on a critical analysis of the factors which influence their operations. This study was designed to identify the contextual factors influencing the provision of injectable contraceptive services by PMVs and the broader effects of their activities on the health system to inform similar interventions in Nigeria. Methods This was a qualitative study guided by the UK Medical Research Council’s Framework for Complex Interventions. Twenty-seven in-depth interviews were conducted among officials of the association of PMVs, health workers, government regulatory officers and programme implementers who participated in a phased 3-year (2015–2018) intervention designed to enhance the capacity of PMVs to deliver injectable contraceptive services. The data were transcribed and analyzed thematically using NVIVO software. Results The contextual factors which had implications on the roles of PMVs were socio-cultural and religious, the failing Nigerian health system coupled with government regulatory policies. Other factors were interprofessional tensions and rivalry between the PMVs and some categories of health care workers and increasing donors’ interest in exploring the potentials of PMVs for expanded healthcare service provision. According to the respondents, the PMVs bridged the Nigerian health system service delivery gaps serving as the first point of contact for injectable contraceptive services and this increased contraceptive uptake in the study sites. A negative effect of their operation is the tendency to exceed their service provision limits, which has spurred a planned tiered PMV accreditation system. Conclusions This study has highlighted the contextual factors which define the roles and scope of practice of PMVs involved in injectable contraceptive service provision. Strategies and interventions aimed at expanding the healthcare delivery roles of PMVs must be encompassing to address the broader contextual factors which underpin their capacities and functions.
General and tuberculosis-specific service readiness in two states in Nigeria
(Springer nature, 2020) Oluwasanu, M. M.; Hassan, A.; Adebayo, A. M.; Ogbuji , Q. C.; Adeniyi, B. O.; Adewole, D. A.; Ladipo, O. A.; Ajuwon, G. A.; Ajuwon, A.
Background: Tuberculosis is the world’s deadliest infectious disease and a leading cause of death in Nigeria. The availability of a functional healthcare system is critical for effective TB service delivery and attainment of national and global targets. This study was designed to assess readiness for TB service delivery in Oyo and Anambra states of Nigeria. Methods: This was a facility-based study with a mixed-methods convergent parallel design. A multi-stage sampling technique was used to select 42 primary, secondary, and tertiary healthcare facilities in two TB high burden states. Data were collected using key informant interviews, a semi-structured instrument adapted from the WHO Service. Availability and Readiness Assessment tool and facility observation using a checklist. Quantitative data were analysed using descriptive and inferential statistics while qualitative data were transcribed and analysed thematically. Data from both sources were integrated to generate conclusions. Results: The domain score for basic amenities in both states was 48.8%; 47.0% in Anambra and 50.8% in Oyo state with 95% confidence interval [− 15.29, 7.56]. In Oyo, only half of the facilities (50%) had access to constant power supply compared to 72.7% in Anambra state. The overall general service readiness index for both states was 69.2% with Oyo state having a higher value (73.3%) compared to Anambra with 65.4% (p = 0.56). The domain score for availability of staff and TB guidelines was 57.1% for both states with 95% confidence interval [− 13.8, 14.4]. Indicators of this domain with very low values were staff training for the management of HIV and TB co-infection and training on MDR -TB. Almost half (47.6%) of the facilities experienced a stock out of TB drugs in the 3 months preceding the study. The overall tuberculosis-specific service readiness index for both states was 75%; this was higher in Oyo (76.5%) than Anambra state (73.6%) (p = 0.14). Qualitative data revealed areas of deficiencies for TB service delivery such as inadequate infrastructure, poor staffing, and gaps with continuing education on TB management. Conclusions: The weak health system remains a challenge and there must be concerted actions and funding by the government and donors to improve the TB healthcare systems.
Knowledge of malaria prevention among pregnant women and female caregivers of under-five children in rural southwest Nigeria.
(PeerJ, Inc., 2015) Adebayo, A. M.; Akinyemi, O. O.; Cadmus, E. O.
Introduction. The morbidity and mortality from malaria are still unacceptably high in the developing countries, especially among the vulnerable groups like pregnant women and under-five children, despite all control efforts. The knowledge about the preventive measures of malaria is an important preceding factor for the acceptance and use of malaria preventive measures like Insecticide Treated Nets (ITN) by community members. Therefore, this study assessed the knowledge of malaria prevention among caregivers of under-five children and pregnant women in a rural community in Southwest Nigeria. Methodology. This is part of a larger malaria prevention study in rural Southwest Nigeria. A descriptive cross-sectional survey was conducted among pregnant women and caregivers of under-five children in Igbo-Ora, a rural town in Southwest Nigeria using a semi-structured, interviewer-administered questionnaire. Information was obtained on knowledge of malaria prevention, and overall composite scores were computed for knowledge of malaria prevention and ITN use. Data were analyzed using SPSS version 16. Associations between variables were tested using a Chi-square with the level of statistical significance set at 5%. Results. Of the 631 respondents, 84.9% were caregivers of under-five children and 67.7% were married. Mean age was 27.7 }6.3 years with 53.4% aged between 20 and 29 years. Majority (91.1%) had at least primary school education and 60.2% were traders. Overall, 57.7% had poor knowledge of malaria prevention. A good proportion (83.5%) were aware of the use of ITN for malaria prevention while 30.6% had poor knowledge of its use. Respondents who were younger (<30 years), had at least primary education and earn <10,000/per month had significantly poor knowledge of ITN use in malaria prevention. Majority (60.0%) respondents had poor attitude regarding use of ITNs. Conclusion. This study showed that the knowledge of malaria prevention is still low among under-five caregivers and pregnant women in rural Southwest Nigeria despite current control measures. There is a need for concerted health education intervention to improve the knowledge of rural dwellers regarding malaria prevention, including the use of ITN. This will go a long way to improving the reported low level of ownership and utilization of ITN in the rural areas.
Ownership and utilisation of insecticide-treated mosquito nets among caregivers of under-five children and pregnant women in a rural community in Southwest Nigeria
(Pacini Editore Srl., 2014) Adebayo, A. M.; Akinyemi, O. O.; Cadmus, E. O.
Introduction. Malaria still constitutes a serious public health problem in Nigeria despite control efforts. The use of Insecticide Treated Net (ITN) has been proven to be an effective preventive modality in the control of malaria but its utilisation has been shown to be low. This study assessed the ownership and utilization of ITN in Igbo-Ora, a rural community in Ibarapa Central Local Government Area (LGA) of Oyo State, Southwest Nigeria. Methods. A descriptive cross-sectional survey among female caregivers of under-five children and pregnant women was conducted using semi-structured interviewer-administered questionnaire. Data were analyzed using SPSS version 16. Results. Among 631 respondents that participated, 84.9% were caregivers of under-five children. Mean age was 27.7 ± 6.3 years with 53.4% between 20-29 age group. Majority, 91.1% had at least primary education, 60.2% were traders and 69.7% were married. Most respondents, 71.8% had at least one type of mosquito nets. Among those that had, 85.4% had window/door net, 25.2% untreated mosquito net while only 15.5% had ITN. Overall, 11.1% of the respondents had ITN among which 78.6% had ever slept under an ITN. Among those that had ever slept under an ITN, slightly less than half, 49.1% slept under an ITN the previous night. Less educated respondents were five times more likely to use ITN (95% CI = 1.24-21.28). Conclusions. This study revealed very low ownership and utilization of ITNs. There is need to improve on the knowledge of community members of the relevance of ownership and utilisation of ITN in malaria prevention.
Process evaluation of an intervention to improve access to injectable contraceptive services through patent medicine vendors in Nigeria: a mixed methods study
(Springer Nature, 2021) Oluwasanu M. M.; Adebayo, A. M.; Okunade, F. T.; Ajayi, O.; Akindele, A. O.; Stanback, J.; Ajuwon, A. J.
Background: The low utilisation of modern contraceptives in many low- and middle-income countries remains a challenge. Patent medicine vendors (PMVs) that operate in the informal health sector, have the potential to address this challenge. Between 2015 and 2018, the Population Council, in collaboration with the Federal and State Ministries of Health and the Pharmacy Council of Nigeria, trained PMVs in six states to deliver injectable contraceptive services. Outcome evaluation demonstrated increased client uptake of injectable contraceptive services; however, there is limited information on how and why the intervention influenced outcomes. This study was conducted to elucidate the processes and mechanism through which the previous intervention influenced women’s utilisation of injectable contraceptive services. Methods: The study utilised a mixed methods, convergent parallel design guided by the UK Medical Research Council framework. Quantitative data were obtained from 140 trained PMVs and 145 of their clients in three states and 27 in-depth interviews were conducted among relevant stakeholders. The quantitative data were analysed descriptively, while the qualitative data were analysed thematically. Results: The results revealed that even after the completion of the PMV study which had a time-bound government waiver for injectable contraceptive service provision by PMVs, they continued to stock and provide injectables in response to the needs of their clients contrary to the current legislation which prohibits this. The causal mechanism that influenced women’s utilisation of injectable contraceptives were the initial training that the PMV received; the favourable regulatory environment as demonstrated in the approval provided by government for PMVs to provide injectable contraceptives for the duration of the study; and the satisfaction and the confidence the female clients had developed in the ability of the PMVs to serve them. However, there were gaps with regards to the consistent supply of quality injectable contraceptive commodities and in PMVs use of job aids. Referral and linkages to government or private-owned facilities were also sub-optimal. Conclusion: PMVs continue to play important roles in family planning service provision; this underscores the need to formalize and scale-up this intervention to aid their integral roles coupled with multi-faceted initiatives to enhance the quality of their services.
Psychiatric morbidity among pregnant and non pregnant women in Ibadan, Nigeria
(Taylor & Francis Group, 2023) Bello, O. O.; Bella-Awusah, T. T.; Adebayo, A. M.; John-Akinola, Y. O.; Ndikom, C. M.; Ilori, T.; Cadmus E. O.; Omokhodion F.
A comparative cross-sectional study was conducted among 991 pregnant and 674 non-pregnant women of reproductive age attending healthcare facilities in Ibadan, Nigeria using the General Health Questionnaire-12 (GHQ), and WHO self-reporting questionnaire (SRQ). Logistic regression analysis was conducted to identify predictors of psychiatric morbidity at p <0.05. A significantly higher proportion of pregnant women experienced psychological distress on the GHQ (51.8%) and psychiatric morbidity on SRQ (33.3%) compared with 28.6% and 18.2% of non-pregnant women, respectively. Predictors of psychiatric morbidity among pregnant women were the type of facility, poor satisfaction and communication with partners, the experience of violence in the home, previous abortions, and previous history of depression. Psychiatric morbidity among non-pregnant women was predicted by younger age, previous history of depression, poor satisfaction and communication with partners. There is a need for early identification of psychiatric morbidity among women of reproductive age, to ensure early interventions and prevent long-term disability.
Quality of implementation of the school health program in a rural district of Oyo State, Nigeria: a public-private comparison
(Springer Verlag GmnH, 2019) Adebayo, A. M.; Sekoni, O. O.; Uchendu, O. C.; Ojifinni, O. O.; Akindele, A. O.; Adediran, O. S.
Background There is abundant evidence that the first and only School Health Policy (SHPo) in Nigeria was adopted in 2006, but no study has since evaluated the quality of implementation (QoI) in government and privately funded schools. This study was conducted to evaluate the QoI of the School Health Program (SHP) in public and private primary schools of a rural Local Government Area in Oyo State using the SHPo framework as a guide. Subjects and methods A comparative-descriptive cross-sectional design was chosen. A two-stage sampling technique was used to select 46 primary schools in a rural area: 30 public and 16 private. An observational checklist was used to assess the five domains of the SHP, namely: School Health Services (SHS), Skills Based Health Education (SBHE), School Feeding Services (SFS), Healthful School Environment (HSE) and School, Home and Community Relationship (SHCR), as listed in the Nigerian SHPo framework. QoI was assessed by exploring the availability, suitability and functionality of basic provisions for SHP implementation. Results The majority of schools (90% public; 87.5%private) had first-aid boxes, but they had no contents in 23.3%of public and 68.8% of private schools. In only one private school was evidence of periodic medical inspection. A school meal service was present in 93.3%of public and 18.8%of private schools. Only one private school practiced medical screening. Some had gendersensitive toilets (81.3% private; 33.3% public). None of the schools had evidence of pre-employment medical and routine screening for non-communicable diseases for staff. Overall, around 50% of schools had poor QoI of the SHP (63.3% public; 25.0% private). Conclusion QoI of the SHP in selected rural public and private primary schools was generally poor, but with better quality in private than public schools.
Regional differences in adolescent childbearing in Nigeria
(Institute for Population and Social Research, Mahidol University, Thailand, 2016) Adebowale, A. S.; Fagbamigbe, A. F.; Adebayo, A. M.
Nigeria’s total fertility rate (TFR) and adolescent first birth rate are among the highest worldwide, but variation exists by region. Unfortunately, data to monitor the level of adolescent first births is still scarce in Nigeria. This study examines regional differences in the level of adolescent first birth among women ages 20-49 years (n=23,801) in Nigeria. Data were analyzed using Chi-square and Cox proportional hazard models (α=0.05). Mean age at first birth was lower in the regions of higher TFR, among less educated and poorer women. In the South East, as for other regions in Nigeria, the mean children ever born was 6.13±2.8, 5.18±2.8, 4.1±2.4 and 2.97±1.9 for women who had their first birth at ages <15, 15-19, 20-24 and ≥25 respectively. The adolescent first birth was highest in the North West (74.8%, TFR=6.7) and lowest in the South West (32.1%, TFR=4.6). The hazard-ratio of beginning first birth was 1.58 (CI=1.46-1.70), 2.87 (CI=2.68-3.07), 3.43 (CI=3.23-3.67) and 1.74 (CI=1.61-1.88) higher in the North Central, North East, North West and South South, respectively, than the South West. Regional differences exist in adolescent first birth in Nigeria and TFR was higher in the regions where adolescent first birth was prevalent. Improving women’s education, particularly in the core northern regions, can raise the age at first birth in Nigeria.
Tuberculosis treatment outcomes and associated factors in two states in Nigeria
(John Wiley & Sons Ltd (Wiley-Blackwell), 2029) Adebayo, A. M.; Adeniyi , B. O.; Oluwasanu, M.; Abiodun, H.; Ajuwon, G.; Ogbuji, Q. C.; Adewole, D.; Osho, A. J.; Olukolade, R.; Ladipo, D. A.; Ajuwon, A.
Objective: To determine the treatment success rate among TB patients and associated factors in Anambra and Oyo, the two states with the largest burden of tuberculosis in Nigeria. Methods: A health facility record review for 2016 was conducted in the two states (Anambra and Oyo). A checklist was used to extract relevant information from the records kept in each of selected DOTS facilities to determine TB treatment success rates. Treatment success rate was defined as the proportion of new smear-positive TB cases registered under DOTS in a given year that successfully completed treatment, whether with bacteriologic evidence of success (“cured”) or without (“treatment completed”). Treatment success rate was classified into good (≥85%) and poor (<85%) success rates using the 85% national target for TB treatment outcome. Data were analysed using descriptive statistics and Chi square at p<0.05. Results: There were 1281 TB treatment enrollees in 2016 in Anambra and 3809 in Oyo (total=4835). An overall treatment success rate of 75.8% was achieved (Anambra-57.5%; Oyo-82.0%). The percentage cure rates were 61.5% for Anambra and 85.2% for Oyo. Overall, only 28.6% of the facilities in both states (Anambra-0.0%; Oyo-60.0%) had a good treatment success rate. More facilities in Anambra (100.0%) than Oyo (40.0%) had a poor treatment success rate (p<0.001), as did more private/FBO (100.0%) than public health facilities (60.0%) (p=0.009). All tertiary facilities had a poor treatment success rate followed by 87.5% of secondary health facilities and 56.5% of primary healthcare facilities (p=0.035). Conclusion: Treatment success and cure rates in Anambra state were below the 85.0% of the recommended target set by the WHO. Geographical location, and level/tier and type of facility were factors associated with this. Interventions are recommended to address these problems.