Browsing by Author "Akindele, A. O."

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    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.
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    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.