Scholarly works in Health Promotion and Education
Permanent URI for this collectionhttps://repository.ui.edu.ng/handle/123456789/430
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Item Ensuring health security for Nigerians by 2050: closing the equity gaps in reproductive health(BioMed Central, 2019) Abiona, O.; Oluwasanu, M.; Oladepo, O. O.Background: Reproductive health is a key foundation for strategies to address health security. It constitutes a vital element in the vision to achieve improved health, quality of life and well-being of individuals and families and the realisation of national economic goals. Developing a blue print for health security in reproductive health matters may contribute to closing the equity gaps in Nigeria by the year 2050. Methods: Gaps in reproductive health were identified through situation analysis of selected reproductive health indices. SWOT analysis was also conducted to outline areas of strengths and opportunities, in addition to weaknesses and threats. Key reproductive health indicators were forecasted for 2050. Results: Despite all efforts, gaps still exist in the country’s reproductive health indices including maternal, perinatal, contraceptive, abortion and gynaecological. Most pregnancy-related deaths are linked largely to preventable causes. If unaddressed, these challenges would undermine gains from previous interventions and responses from governmental and non-governmental organizations and pose serious threats to the nation’s health security. Conclusions: The country must be committed to reproductive health agenda that is focused on the International Conference on Population and Development goal in its bid to achieve health security by the year 2050. Due considerations must be accorded to emerging reproductive health issues like men’s reproductive health and their involvement intheir partners’ reproductive health, and the reproductive health needs of the aged, people with disabilities and those in humanitarian settings. Further in achieving health security for Nigerians by the year 2050, the principles underlying the reproductive health policy of the country must be upheld. These include equity, right based approach, gender and age responsiveness, cultural sensitivity and continuum of care amongst others.Item 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.Item Influence of the WHO framework convention on tobacco control on tobacco legislation and policies in sub-Saharan Africa(Springer Nature, 2018) Wisdom, J. P.; Juma, P.; Mwagomba, B.; Ndinda, C.; Mapa-Tassou, C.; Assah, F.; Nkhata,M.; Mohamed, S. F.; Oladimeji, O.; Oladunni, O.; Oluwasanu, M.; Sanni, S.; Jean-Claude, M.; Kyobutung, C"Background: The World Health Organization’s Framework Convention on Tobacco Control, enforced in 2005, was a watershed international treaty that stipulated requirements for signatories to govern the production, sale, distribution, advertisement, and taxation of tobacco to reduce its impact on health. This paper describes the timelines, context, key actors, and strategies in the development and implementation of the treaty and describes how six sub-Saharan countries responded to its call for action on tobacco control. Methods: A multi-country policy review using case study design was conducted in Cameroon, Kenya, Nigeria, Malawi, South Africa, and Togo. All documents related to the WHO Framework Convention on Tobacco Control and individual country implementation of tobacco policies were reviewed, and key informant interviews related to the countries’ development and implementation of tobacco policies were conducted. Results: Multiple stakeholders, including academics and activists, led a concerted effort for more than 10 years to push the WHO treaty forward despite counter-marketing from the tobacco industry. Once the treaty was enacted, Cameroon, Kenya, Nigeria, Malawi, South Africa, and Togo responded in unique ways to implement tobacco policies, with differences associated with the country’s socio-economic context, priorities of country leaders, industry presence, and choice of strategies. All the study countries except Malawi have acceded to and ratified the WHO tobacco treaty and implemented tobacco control policy. Conclusions: The WHO Framework Convention on Tobacco Control provided an unprecedented opportunity for global action against the public health effects of tobacco including non-communicable diseases. Reviewing how six sub-Saharan countries responded to the treaty to mobilize resources and implement tobacco control policies has provided insight for how to utilise international regulations and commitments to accelerate policy impact on the prevention of non-communicable diseases."Item Multi-sectoral action in non-communicable disease prevention policy development in five African countries(Springer Nature, 2018) Juma, P. A.; Mapa-tassou, C.; Mohamed, S. F.; Mwagomba, B. L. M.; Ndinda, C.; Oluwasanu, M.; Jean-Claude, M.; Nkhata, M. J.; Asiki, G.; Kyobutungi, C.Background: The rise of non-communicable diseases (NCDs) in Africa requires a multi-sectoral action (MSA) in their prevention and control. This study aimed to generate evidence on the extent of MSA application in NCD prevention policy development in five sub-Saharan African countries (Kenya, South Africa, Cameroon, Nigeria and Malawi) focusing on policies around the major NCD risk factors. Methods: The broader study applied a multiple case study design to capture rich descriptions of policy contents, processes and actors as well as contextual factors related to the policies around the major NCD risk factors at single- and multi-country levels. Data were collected through document reviews and key informant interviews with decision-makers and implementers in various sectors. Further consultations were conducted with NCD experts on MSA application in NCD prevention policies in the region. For this paper, we report on how MSA was applied in the policy process. Results: The findings revealed some degree of application of MSA in NCD prevention policy development in these countries. However, the level of sector engagement varies across different NCD policies, from passive participation to active engagement, and by country. There was higher engagement of sectors in developing tobacco policies across the countries, followed by alcohol policies. Multi-sectoral action for tobacco and to some extent, alcohol, was enabled through established structures at national levels including inter-ministerial and parliamentary committees. More often coordination was enabled through expert or technical working groups driven by the health sectors. The main barriers to multi-sectoral action included lack of awareness by various sectors about their potential contribution, weak political will, coordination complexity and inadequate resources. Conclusion: MSA is possible in NCD prevention policy development in African countries. However, the findings illustrate various challenges in bringing sectors together to develop policies to address the increasing NCD burden in the region. Stronger coordination mechanisms with clear guidelines for sector engagement are required for effective MSA in NCD prevention. Such a mechanisms should include approaches for capacity building and resource generation to enable multi-sectoral action in NCD policy formulation, implementation and monitoring of outcomes.Item 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.Item Eliminating mother-to-child transmission of the human immunodeficiency virus in sub-Saharan Africa: The journey so far and what remains to be done(Elsevier, 2016) Adetokunboh,O. O.; Oluwasanu, M."This review was carried out to provide a comprehensive overview of efforts toward elimination of mother-to-child transmission (MTCT) of human immune deficiency virus (HIV) with respect to progress challenges, and recommendations in 21 sub-Saharan African priority countries. We reviewed literature published from 2011 to April 2015 using 3 databases; PubMed, Scopus, and Web of Science, as well as the 2014 Global Plan Progress Report. A total of 39 studies were included. Between 2009 and 2013, there was a 43% reduction in new HIV infections, the final MTCT rate was reduced from 28% to 18%, and antiretroviral therapy (ART) coverage increased from 11% to 24%. Challenges included poor adherence to antiretroviral therapy, poor linkage between mother—child pairs and post-natal healthcare services low early infant diagnosis coverage, low pediatric ART coverage, and high unmet needs for contraceptive services. Future recommendations include identification of key barriers, health system strengthening, strengthening community involvement, and international collaboration. There has been significant progress toward eliminating MTCT of HIV, but more effort is still needed.Item 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.Item Knowledge and Practices Relating To Domestic Accident among Mothers of Pre-School Children in Ibadan Southwest Local Government Area, Nigeria(2013) Arulogun,O. S.; Ikolo, O.; Oluwasanu, M.The study assessed the knowledge and practices for domestic accident among 756 mothers of preschool children in Ibadan Southwest Local Government Area, Nigeria. Pretested questionnaire with a 15-point knowledge scale relating to domestic accident prevention was used for data collection. Descriptive statistics and ANOVA were used for data analysis. Mean age of respondents was 28.7±5.8 years and 97.8% had at least primary school education. About 30.3% of mothers place cooking utensils on the floor and 46.0% reported domestic accidents [falls (47.0%), burns (23.5%) and ingestion of kerosene (8.4%)] in their preschool children. Domestic accidents were perceived as not totally preventable (85.3%) and part of children’s development (50.8%). Preventive practices employed included consistent monitoring of preschool children (58.5) and keeping drugs in secured boxes (55.5%). Self responsibility (58.1%), perceived danger (37.0%) and fear of husband’s reaction (32.7%) were main influences for adoption of the preventive behaviour. Although knowledge on the causes and prevention of domestic accidents was high among the respondents, preventive practices need to be strengthened. Educational interventions such as training and public enlightenment aimed at empowering mothers and significant others to be more involved in the prevention of domestic accidents among their preschool children are recommended.Item 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.