Scholarly works in Health Promotion and Education

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A cross-sectional study of the knowledge and screening practices of diabetes among adults in a south western Nigerian city
(Pacini Editore SRL, Pisa, Italy, 2021) Osiberu, A. A.; Oluwasanu, M. M.; Omobowale, M.; John Akinola, Y.; Oladepo, O.
Introduction. The control of diabetes depends largely on preventive actions often influenced by knowledge and awareness of the condition, its risk factors, complication, and management. This study assessed the awareness, knowledge, and practices regarding diabetes among adults in two communities in Ibadan, Nigeria. Methods. A community-based cross-sectional study was conducted among five hundred randomly selected non-diabetic respondents, aged 18 to 65 years. Data was collected using the pretested, modified version of the WHO STEPS instrument translated into Yoruba language. Data collected were analysed using descriptive and inferential analysis and the level of significance was set at p < 0.05. Results. Majority of the respondents (89.6%) had previously heard about diabetes. Of these (n = 448), 31.8% were knowledgeable about diabetes and only 28% have ever had their blood glucose level measured by a doctor or other health professionals. Sex and monthly income were statistically associated with respondents’diabetes knowledge while age, religion, monthly income, employment status, marital status, ethnicity and level of education were statistically associated with screening practices (p < 0.05). Monthly income was found to be a significant predictor of the level of knowledge adjusted by sex. Earning N20,000 ($ 52.60) or less had higher odds of being knowledgeable compared to earning no income (OR 0.54, CI 0.35, 0.83). Conclusion. Though Diabetes awareness is high, knowledge gaps and poor screening practices is of concern. This calls for tailored multi-component, community-based, health education interventions.
Acceptability of child adoption as management option for infertility in Nigeria: evidence from focus group discussions
(2009) Oladokun, A.; Arulogun, O.; Oladokun, R.; Morhason-Bello, I. O; Bamgboye, E. A.; Adewole, I. F.; Ojengbede, O. A.
Infertility remains a global health challenge with devastating psycho-social consequences in many African communities. Adoption that may serve as an alternative strategy for the affected couples is not widely practiced. This study was conceptualized to assess the acceptability of child adoption as a management option by Nigerians. Twelve focus group discussions were held involving three communities stratified into inner core, transitory and peripheral, within Ibadan metropolis, South-Western Nigeria from May to July 2008. The participants were purposively selected based on gender and age group. The barriers mentioned were cultural practices, stigmatization, financial implications, and procedural bottle-necks. Measures suggested to curb these negative attitudes were advocacy, community mobilization and enactment of supportive law that will protect all parties involved
Access to Information on Family Planning and Use of Modern Contraceptives Among Married Igbo Women in Southeast, Nigeria
(SAGE, 2019) Oluwasanu, M. M.; John-Akinola, Y. O.; Adeyimika T.; Desmennu, A. T.; Oladunni, O.; Adebowale, A. S.
This study was conducted among married Igbo women in Nigeria who have the lowest median birth interval coupled with a culture of sex preference and low use of modern contraceptives. We examined the relationship between access to information on family planning and sex preference on the use of modern contraceptive (MC). The 2013 Nigeria Demographic and Health Survey data were used. The data of 1,661 women of reproductive age were analyzed in this study. Access to information on family planning was low, and almost half (48.6%) of the women had a score of zero. Controlling for possible confounding variables, the data show that women who have good (odds ratio [OR]¼ 3.92; CI [2.28, 6.75], p <.001) and poor (OR ¼ 2.56; CI [1.85, 3.56], p <.001) access to information on family planning were more likely to use MC than those with no access to information on family planning. Sex preference showed no relationship with the use of MC. Families where husbands want more children than their wives inhibit (OR ¼ 0.62, CI [0.42, 0.90], p <.05) the use of MC compared with those families where husbands and wives fertility desire is the same. Public health programs by government and donors should intensify interventions to increase access to family planning information to promote the use of MC among married Igbo women.
Advocacy for diabetes & other non-communicable diseases
(Nigerian Medical Association, 2014) Chinenye, S.; Onyemelukwe, G. C.; Johnson, T. O.; Oputa, R. N.; Oluwasanu, M.; Ogbera, A. O.
Analysis of alcohol policy in Nigeria: multi-sectoral action and the integration of the WHO “best-buy” interventions
(Springer Nature, 2019) Abiona, O.; Oluwasanu, M.; Oladepo, O. O.
Background: Harmful alcohol use is a modifiable risk factor contributing to the increasing burden of non-communicable diseases and deaths and the implementation of policies focused on primary prevention is pivotal to address this challenge. Policies with actions targeting the harmful use of alcohol have been developed in Nigeria. This study is an in-depth analysis of alcohol-related policies in Nigeria and the utilization of WHO Best Buy interventions (BBIs) and multi-sectoral action (MSA) in the formulation of these policies. Methods: A descriptive case study design and the Walt and Gilson framework of policy analysis was utilized for the research. Components of the study included a scoping review consisting of electronic search of Google and three online databases (Google Scholar, Science Direct and PubMed) to identify articles and policy documents with no language and date restrictions. Government institution provided documents which were not online. Thirteen policy documents, reports or articles relevant to the policy formulation process were identified. Other components of the study included interviews with 44 key informants (Bureaucrats and Policy Makers) using a pretested guide. The qualitative data were coded and analyzed using thematic analysis. Results: Findings revealed that policy actions to address harmful alcohol use are proposed in the 2007 Federal Road Safety Act, the Non-communicable Diseases Prevention and Control Policy and the Strategic Plan of Action. Only one of the best buy interventions, (restricted access to alcohol) is proposed in these policies. Multi-sectoral action for the formulation of alcohol-related policy was low and several relevant sectors with critical roles in policy implementation were not involved in the formulation process. Overall, alcohol currently has no holistic, health-sector led policy document to regulate the marketing, promotion of alcohol and accessibility. A major barrier is the low government budgetary allocation to support the process. Conclusions: Nigeria has few alcohol-related policies with weak multi-sectoral action. Funding constraint remains a major threat to the implementation and enforcement of proposed policy actions.
Analysis of alcohol policy in Nigeria: multi-sectoral action and the integration of the WHO “best-buy” interventions
(Springer Nature, 2019) Adebayo, A. M.; Oluwasola, T. A. O.; Oluwasanu, M. M.; Fawole, A. O .
Background: Harmful alcohol use is a modifiable risk factor contributing to the increasing burden of non-communicable diseases and deaths and the implementation of policies focused on primary prevention is pivotal to address this challenge. Policies with actions targeting the harmful use of alcohol have been developed in Nigeria. This study is an in-depth analysis of alcohol-related policies in Nigeria and the utilization of WHO Best Buy interventions (BBIs) and multi-sectoral action (MSA) in the formulation of these policies. Methods: A descriptive case study design and the Walt and Gilson framework of policy analysis was utilized for the research. Components of the study included a scoping review consisting of electronic search of Google and three online databases (Google Scholar, Science Direct and PubMed) to identify articles and policy documents with no language and date restrictions. Government institution provided documents which were not online. Thirteen policy documents, reports or articles relevant to the policy formulation process were identified. Other components of the study included interviews with 44 key informants (Bureaucrats and Policy Makers) using a pretested guide. The qualitative data were coded and analyzed using thematic analysis. Results: Findings revealed that policy actions to address harmful alcohol use are proposed in the 2007 Federal Road Safety Act, the Non-communicable Diseases Prevention and Control Policy and the Strategic Plan of Action. Only one of the best buy interventions, (restricted access to alcohol) is proposed in these policies. Multi-sectoral action for the formulation of alcohol-related policy was low and several relevant sectors with critical roles in policy implementation were not involved in the formulation process. Overall, alcohol currently has no holistic, health-sector led policy document to regulate the marketing, promotion of alcohol and accessibility. A major barrier is the low government budgetary allocation to support the process. Conclusions: Nigeria has few alcohol-related policies with weak multi-sectoral action. Funding constraint remains a major threat to the implementation and enforcement of proposed policy actions.
Analysis of tobacco control policies in Nigeria: historical development and application of multi-sectoral action
(Springer Nature, 2018) Oladepo, O.; Oluwasanu, M.; Abiona, O.
Background: Tobacco use is a major risk factor for non-communicable diseases and policy formulation on tobacco is expected to engrain international guidelines. This paper describes the historical development of tobacco control policies in Nigeria, the use of multi-sectoral action in their formulation and extent to which they align with the World Health Organisation “best buy” interventions. Methods: We adopted a descriptive case study methodology guided by the Walt and Gilson Policy Analysis Framework. Data collection comprised of document review (N = 18) identified through search of government websites and electronic databases with no date restriction and key informant interviews (N = 44) with stakeholders in public and private sectors. Data was integrated and analyzed using content analysis. Ethical approval was granted by the University of Ibadan and University College Hospital Ethics Review Committee. Results: Although the agenda for development of a national tobacco control policy dates back to the 1950s, a comprehensive Framework Convention for Tobacco Control (FCTC) compliant policy was only developed in 2015, 10 years after Nigeria signed the FCTC. Lack of funding and conflict of interest (of protecting citizens from harmful effect of tobacco viz. a viz. the economic gains from the industry) are the major barriers that slowed the policy process. Current tobacco –related policies developed by the Federal Ministry of Health were formulated through strong multi-sectoral engagement and covering all the four WHO “best buy” interventions. Other policies had limited multi-sectoral engagement and “best buy” strategies. The tobacco industry was involved in the development of the Standards for Tobacco Control of 2014 contrary to the long-standing WHO guideline against engagement of the industry in policy formulation. Conclusions: Nigeria has a comprehensive national policy for tobacco control which was formulated a decade after ratification of the FCTC due to constraints of funding and conflict of interest. Not all the tobacco control policies in Nigeria engrain the principles of multi sectorality and best buy strategies in their formulation. There is an urgent need to address these neglected areas that may hamper tobacco control efforts in Nigeria.
Antiretroviral Treatment and Resistance Patterns in HIV-Infected Children
(Springer, 2015) Adetokunboh, O.; Atibioke, O.; Balogun, T.; Oluwasanu, M.
Paediatric HIV-infected patients have higher risk of developing resistance to antiretroviral drugs, and from public health perspective, drug resistance remains a limiting factor for effective management of HIV infection in children. We reviewed the current evidences available on the antiretroviral treatment and resistance patterns in HIV-infected children. Prevalence of HIV drug resistance varied among the three main classes of antiretroviral drugs, namely nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors and protease inhibitors in both treatment naïve and treatment-experienced children in different countries. Most of the patients with extensive triple-class drug resistant mutations were found to be considerably exposed to the three main classes of antiretroviral agents. Identification of genetic factors linked with susceptibility to perinatal transmission of HIV may be key in understanding the development of resistance due to waning antiviral effectiveness. Children who were less likely to achieve viral re-suppression were more likely to have resistance mutations. Newer drugs such as etravirine can be used as alternatives in case of resistance to efavirenz while newly developed diagnostic method such as next-generation sequencing is a platform for improving quality of detections especially minor variant drug resistance mutations.
Attitude of health care workers to the involvement of alternative healthcare providers in the home management of childhood malaria
(Baywood Publishing Co., inc, 2005) Falade, C. O.; Osowole, O. S.; Adeniyi, J. D.; Oladepo, O.; Oduola, A. M. J.
The attitudes of 193 healthcare workers (Nurses (35.7%), auxiliary nurses' (35.7%), followed by community health officers (26.4%) in 55 primary and secondary healthcare facilities to home management of malaria were evaluated in four local government areas in Southwestern Nigeria. Results showed that mothers and patent medicine sellers were perceived as offering useful services in home management of malaria by giving first aid and selling antimalaria drugs, respectively. Although 79% of respondents expressed the opinion that mothers are the most appropriate to give first line management to children suffering from malaria, 56% were also of the view that such children should receive definitive treatment in a formal health care facility. Furthermore, 45% of the respondents felt that only formal healthcare workers should treat children who have malaria irrespective of the location of the treatment because mothers, patent medicine sellers, and traditional healers have not been formally trained. Healthcare workers were willing to train mothers and patent medicine sellers on effective management of childhood malaria, but were not favorably disposed toward collaboration with traditional healers in the home management of malaria. There is an urgent need for formal healthcare workers to seek better understanding of traditional healers' practices as well as their cooperation for improved home management of childhood malaria among indigenous groups.
Audiometric assessment in patients with carcinoma of the larynx
(2000-12) Osowole, O. S.; Nwaorgu, O. G. B.
Audiometric assessment was carried out on twelve patients with advanced carcinoma of the larynx who were on admission on the Ear, Nose and Throat Ward of the University College Hospital, Ibadan, Nigeria between October 1995 and June 1996. The sharp dropping curve was the most common type of audiograph observed. Fifty percent of the patients had very sharp dropping curve at 200Hz, 33.3% had mild dropping curve at 4000Hz and 8000Hz while 16.7% had a flat curve within the social adequacy range. Implications of this in the treatment and rehabilitation of such patients is discussed.
AWARENESS, ATTITUDE AND PRACTICES OF PRE-MARITAL GENOTYPE TEST AMONG UN-MARRIED STUDENTS OF THE POLYTECHNIC, IBADAN, NIGERIA
(2014-04) OTEVWOYERE, V. E.
Sickle Cell Anaemia (SCA) is one of the major causes of morbidity and mortality and a strategic way of reducing the problem is to educate the public and create more awareness on its causes and prevention. There is need for adequate information on awareness and attitude of young adults in tertiary institutions to undertake Pre-marital Genotype Test (PGT).Therefore, this study was aimed at determining the awareness, attitude, and practices of PGT among unmarried students of The Polytechnic, Ibadan. A cross sectional survey was conducted among 382 students who were randomly selected from the four halls of residence in The Polytechnic Ibadan, using a multistage sampling technique. A semi-structured questionnaire which included information on socio-demographic characteristics, awareness about SCA and PGT, 40- point attitude scale relating to PGT, practice of PGT and intention to undertake the test was administered on the respondents. Scores of < 20 and ≥ 20 were classified as negative and positive respectively. Descriptive statistics and Chi-square test were used to analyse the data with level of significance set at 5%. The mean age of respondents was 21.6 ± 3.1 years, 56.6% were females, 68.6% were Christians and 35.5% were in their first year of the National Diploma (ND) course. Respondents’ awareness of SCA and PGT were 89.0% and 92.3% respectively. Major sources of information on SCA and PGT were television (67.9% and 59.8%), friends (54.9% and 50.6%), parents (44.1% and 59.8%) and health workers (47.4% and 50.3%) for both sexes. More than half of the respondents (58.4%) knew their Haemoglobin (Hb) genotype. Of those that claimed to know their Haemoglobin (Hb) genotype, 37.3%, 17.1%, 3.1% and 0.9% were AA, AS, SS and AC respectively. Parents were the major decision makers for respective Hb genotype testing. Of those that knew their Hb genotype, 18.2% and 26.2% of males and females respectively had informed their partners of the result. In respect to respondent’s attitude to PGT, 54.0% had positive and 46.0% had negative attitude. Less than quarter (23.4%) of the respondents would not marry anyone with SCA, 58.4% agreed that it should not be a hindrance to marriage, while 55.4% affirmed their right to know their partner’s genotype before marriage and 37.3% reported that their partner’s genotype result would affect their selection of spouse. Furthermore, majority (85.3%) knew the importance of PGT. About 35.0% of those who did not know their Hb genotype intend to undertake the test before marriage. There was significant relationship between respondent’s awareness about SCA and awareness about genotype testing (p= 0.001). Awareness and practice in respect to sickle cell anaemia and pre-marital genotype test among respondents were high. Partner’s result affects the decision of respondents especially those with positive attitude towards premarital genotype test as critical factor. More awareness programmes should be created by the stakeholders during fresher’s orientation programme by educating the students on premarital genotype test and the consequences of actions guiding their choice of partner.
Breast cancer in adolescents and young adults less than 40Years of age in Nigeria: a retrospective analysis
(Hindawi Limited, 2022) Ntekim, A.; Oluwasanu, M.; Odukoya, O.
Background. Breast cancer among adolescents and young adult (AYA) females aged 15-39 years is associated with different patterns of aggressiveness, as well as psychosocial and economic issues. At present, the burden of breast cancer among this age group is unknown in Nigeria. There is a need to determine the proportion of AYA with breast cancer in Nigeria. This will inform the development of breast cancer care programs appropriate for this age group. Objective. The objective of this study was to highlight the burden of breast cancer with an emphasis on AYAs in Nigeria and its implications. Methods. A retrospective review of data from cancer registries in Nigeria between 2009 and 2016 was carried out. Results. Among AYA females in Nigeria, breast cancer was by far the most common cancer, constituting 50% of all cancers and 51% (2798 of 5469) of all breast cancer cases. IA third (30.8%) of breast cancer cases in all centers studied were AYAs. Conclusion. The high proportion of AYA with breast cancer is an important feature suggesting that urgent actions are required to ensure early detection and improve breast cancer care among this age group.
Case management of childhood fever by traditional healers in Southwest Nigeria: Identification of training and collaborative needs
(Baywood Publishing Co., inc, 2008) Fawole, O. I.; Akinboye, D. O.; Falade, C. O.; Arulogun, O. S.; Adeniyi, J. D.
Traditional healers play an important role in the provision of healthcare in many communities in Africa. This study aimed to improve home management of malaria in children by assessing the healer's knowledge and practice. A semi-structured questionnaire interview of 127 traditional healers selected by proportionate sampling technique from two rural and two urban local government areas (LGAs) of southwestern Nigeria was followed by a training program. Malaria ranked first (87%) among the illnesses managed by the healers. Diagnosis of fever was often (72%) based on client history, physical examination (24.4%), consulting oracles (18.9%), and interpretation of dreams (3.1%). Treatment of malaria was with boiled herbs ("agbo"; 72%), ground herbs ("agunmu"; 14%), and incisions and scarifications (3%). Forty-one (32.5%) healers had referred febrile children to a health facility. Younger healers and those who had at least a secondary education were more likely to refer patients (p < 0.05 in both cases). Thirty-six healers (28.4%) had previous formal training on management of fevers, most of whom were the younger (p < 0.(5), educated healers (p> 0.05), with fewer years of practice (p> 0.05). Research into traditional herbs (48%), better acknowledgment by government (23.6%); and collaboration with other health sectors were suggestions to improve practice. Traditional healers, especially the older, less-educated, and long-practicing healers, urgently require formal training and collaboration with other healthcare providers to improve knowledge and promote early referral of children with fever.
Causes and remedies for low research productivity among postgraduate scholars and early career researchers on non-communicable diseases in Nigeria
(Springer, 2019) Oluwasanu, M. M.; Atara, N.; Balogun, W.; Awolude, O.; Olayinka Kotila, O.; Aniagwu, T.; Adejumo, P.; Oyedele, O. O.; Ogun, M.; Arinola, G.; Babalola, C. P.; Olopade, C. S.; Olopade, O.; Ojengbede, O.
Objective: The aim of the descriptive, cross sectional, questionnaire-based study reported here was to explore the causes of low productivity in non-communicable diseases research among postgraduate scholars and early career researchers in Nigeria and identify measures that could facilitate increased research output. Results: The 89 respondents were masters-level, doctoral scholars and resident doctors who attended a workshop. Majorities of the respondents (over 70%) either agreed or strongly agreed that factors contributing to poor non-communicable diseases research productivity include a dearth of in-country researchers with specialized skills, inability of Nigerian researchers to work in multidisciplinary teams, poor funding for health research, sub-optimal infrastructural facilities, and limited use of research findings by policy makers. Almost all the respondents (over 90%) agreed that potential strategies to facilitate non-communicable diseases research output would include increased funding for research, institutionalization of a sustainable, structured capacity building program for early career researchers, establishment of Regional Centers for Research Excellence, and increased use of research evidence to guide government policy actions and programs.
Cervical cancer and human papillomavirus vaccine knowledge, utilisation, prevention educational interventions and policy response in Nigeria: a scoping review
(SAGE Publishing, 2022) John-Akinola, Y. O.; Ndikom, C. M.; Oluwasanu, M. M.; Adebisi, T.; Odukoya, O.
Purpose: This review evaluated the knowledge, utilisation, prevention education, and policy response across the six geopolitical regions of Nigeria to inform national efforts for the prevention and control of cervical cancer. Methods: A keyword-based systematic search was conducted in PubMed/MEDLINE (NCBI), Google Scholar, and AJOL electronic databases, including a manual scan of papers, journals and websites to identify relevant peer-reviewed studies. Articles were screened and assessed for eligibility. Results: Many (158) articles were downloaded and after duplicates were removed, 110 articles were included in the final analysis. These were made up of qualitative, quantitative (cross-sectional), intervention and policy studies. Studies have generally reported poor knowledge and awareness of cervical cancer screening but those carried out in urban areas demonstrated a slightly higher level of awareness of Human Papilloma Virus (HPV) vaccine, HPV vaccination uptake and utilization of cervical cancer preventive services than the rural studies. The studies did not show strong government support or policies in relation to cervical cancer control. Conclusion: Knowledge and uptake of cervical cancer preventive services across diverse groups in Nigeria remain poor. These could be linked to socio-cultural factors, the lack of an organised cervical cancer screening programme and low financial resource pool for cervical cancer prevention. Therefore, it is necessary to increase government, donor prioritisation and political support in order to ensure increased investment and commitment to cervical cancer elimination in Nigeria.
Community based distribution agents’ approach to provision of family planning information and services in five Nigerian States: A mirage or a reality?
(African Online Scientific Information Systems (AOSIS), 2011-01-11) Fayemi, M.; Momoh, G.; Oduola, O.; Delano, G.; Ladipo, O.; Adebola, O.
Background: Reducing maternal mortality in Nigeria has received continuous attention both nationally and internationally. Objectives: This article highlights the outcome of an intervention which sought to address maternal mortality reduction through increasing contraceptive uptake in 10 rural local government areas (LGAs)in five Nigerian states. Method: The community based distribution (CBD) approach was used in the implementation of a three year intervention that targeted 10 LGAs. Two hundred and fifty community members were trained as community based distribution agents (CBDA) to provide information on reproductive health, provide non-prescriptive family planning (FP) commodities, treat minor aliment and make referrals to primary health centres within the communities. Results: Final evaluation revealed an increase in the proportion of community members who had utilised FP commodities at all, from 28% at baseline to 49%, and an increase in the proportion of current contraceptive users from 16% at baseline to 37%. An average of 50% increase in clientele patronage was also observed in the 10 LGAs’ primary health care centres. Most (96%) of the interviewed CBDA agents reported that a drug-revolving system was in place to ensure that drugs and commodities were available. On-the-spot assessment of the service forms revealed that 86% of them had their activities regularly recorded in their worksheets. Some of the challenges faced by CBDA were discrimination and misconception of community members about family planning (38%), inadequate financial support (14%), and transportation problems (8%). Conclusion: This study has demonstrated that the CBD approach played a critical role in enhancing access to Reproductive Health and Family Planning information and services in the project communities.
Community gate keepers' awareness and perception of prevention of mother-to-child transmission of HIV services in Ibadan, Nigeria
(2007) Arulogun, O. S.; Adewole, I. F.; Olayinka-Alli, L.; Adesina, A. O.
Each year, around half a million children aged under 15 become infected with HIV and more than 90% are the result of mother-to-child transrnission. Services to prevent mother-to-child HIV transmission (PMTCT) are therefore important entry points for HIV AIDS Prevention, treatment and care services for women, their children and families. The study aimed at identifying level of awareness and knowledge of PMTCT services that can be utilized in improving access. The methodology consisted of 20 individual in-depth interviews spread over Adabeji, Adeoyo/Agbadagbudu, Jakiru/Onipasan and Eleta communities, in Ibadan among household heads, religious and community based leaders. Key factors identified were low knowledge of mother to child transmission, lack of knowledge of the PMTCT services, inadequate community sensitization, inadequate health care facilities. The success of PMTCT programmes demands a shift towards a more community-based approach which calls for strong advocacy, enlightenment and community mobilization for improved awareness and utilization of PMTCT services
Community-directed interventions for priority health problems in Africa: results of a multicountry study
(2010) Ajuwon, A. J.
Objective: To deterrnine the extent to which the community-directed approach used in onchocerciasis control in Africa could effectively and efficiently provide integrated delivery of other health interventions. Methods: A three-year experirnental study was undertaken in 35 health districts from 2005 to 2007 in seven research sites in Carneroon, Nigeria and Uganda. Four trial districts and one comparison district were randomly selected in each site. All districts had established ivermectin treatment programmes, and in the trial districts four other established interventions - vitamin A supplementation, use of insecticide-treated nets, home management of malaria and short-course, directly-observed treatment for tuberculosis patients - were progressively incorporated into a community-directed intervention (CDI) process. At the end of each of the three study years, we performed quantitative evaluations of intervention coverage and provider costs, as well as qualitative assessments of the CDI process. Findings with the CDI strategy, significantly higher coverage was achieved than with other delivery approaches for all interventions except for Short-course, directly-observed treatment. The coverage of malaria interventions more than doubled. The district-level costs of delivering all five interventions were lower in the CDI districts, but no cost difference was found at the first-line health facility level. Process evaluation showed that: (i) participatory processes were important; (ii) recurrent problerns with the supply of intervention materials were a major constraint to implementation; (iii) the communities and community implementers were deeply committed to the CDI process; (iv) community implementers were more motivated by intangible incentives than by external financial incentives. Conclusion The CDI strategy, which builds upon the core principles of primary health care, is an effective and efficient model for integrated delivery of appropriate health interventions at the community level in Africa.
Comparison of blood pressure in deaf secondary school children and their hearing counterparts: association between noise and blood pressure
(2006-12) Nwaorgu, O. G. B.; Arulogun, O. S
Background and Objective: High blood pressure has been known to be one of the problems that could develop as a result of exposure to noise. Consequently, those who are hearing impaired are thought to be immune to this. This study assessed the relationship between noise exposure and blood pressure. Methodology: This is a comparative prospective study involving participants (consisting of the hearing and the hearing impaired) drawn from a school environment that is situated close to a major highway and railway and evaluating the impact of noise on their blood pressure. Results: The study population consisted of 299 secondary school students. The noise sensitive group comprised 220 participants with normal hearing while the noise-insensitive group comprised 79 hearing impaired from the same school. More participants 6 (85.7%) from the noise insensitive group were found to have significantly higher blood pressure than their hearing counterparts 1 (14.3%). In addition, majority of the participants (63.1 %) irrespective of their level of noise sensitivity were underweight. Conclusion: This study finds liaise exposure alone not sufficient to bring about an increase in blood pressure of the studied population. This not withstanding we advocate for policy measures aimed at controlling the source of environmental noise around educational institution which will aid in reducing the adverse effects of noise on the school children.
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.