Scholarly works in Health Promotion and Education
Permanent URI for this collectionhttps://repository.ui.edu.ng/handle/123456789/430
Browse
15 results
Search Results
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 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.Item Prevalence and factors Associated with alcohol Use in selected urban communities in Ibadan, Nigeria(SAGE Publications, 2023) Aremu,T.; Anibijuwon, I. B.; John‑Akinola, Y. O.; Oluwasanu, M.; Oladepo O.Nigeria is ranked high among African countries in the consumption of alcohol and the national adult per capita consumption was estimated at 12.3litres. Harmful alcohol use is the sixth leading cause of disability and deaths in Nigeria. This study assessed the prevalence and factors associated with alcohol use in selected urban communities in Ibadan, Nigeria. This community-based cross sectional study was conducted among 500 respondents in two selected urban communities in Ibadan, Nigeria. The World Health Organization STEPS tool was used to collect data on socio-demographic characteristics of respondents and the history of alcohol use. Alcohol users were categorized into ever consumed, current consumers, consumers within last 12 months, and frequent consumers within 30 days (low, medium, and high consumers).Chi-square analysis was used to identify factors associated with the different categories of alcohol consumption. The mean age of the respondents was 35.36_12.24 years. Almost one third of the participants (29.0%) reported they had ever consumed alcohol and (13.6%) had consumed alcohol within 30 days prior to the study. Factors significantly associated with the ever-use of alcohol were gender (p¼0.000), and income (p¼0.000). Current use of alcohol had a statistically significant relationship with male gender (p¼0.000). The prevalence of high alcohol use is low in the sample of urban communities studied, and factors influencing include sex, marital status, level of education, income. These results should inform policy decisions to address the alcohol use in urban communities in Southwest Nigeria.Item The global role, impact, and limitations of Community Health Workers (CHWs) in breast cancer screening: a scoping review and recommendations to promote health equity for all(Taylor & Francis Group, 2021) Hand, T.; Rosseau, N. A.; Stiles, C. E.; Sheih, T.; Ghandakly, E.; Oluwasanu, M.; Olopade, O. I.Introduction: Innovative interventions are needed to address the growing burden of breast cancer globally, especially among vulnerable patient populations. Given the success of Community Health Workers (CHWs) in addressing communicable diseases and non-commu-nicable diseases, this scoping review will investigate the roles and impacts of CHWs in breast cancer screening programs. This paper also seeks to determine the effectiveness and feasi-bility of these programs, with particular attention paid to differences between CHW-led interventions in low- and middle-income countries (LMICs) and high-income countries (HICs). Methods: A scoping review was performed using six databases with dates ranging from 1978 to 2019. Comprehensive definitions and search terms were established for ‘Community Health Workers’ and ‘breast cancer screening’, and studies were extracted using the World Bank definition of LMIC. Screening and data extraction were protocolized using multiple independent reviewers. Chi-square test of independence was used for statistical analysis of the incidence of themes in HICs and LMICs. Results: Of the 1,551 papers screened, 33 were included based on inclusion and exclusion criteria. Study locations included the United States (n=27), Bangladesh (n=1), Peru (n=1), Malawi (n=2), Rwanda (n=1), and South Africa (n=1). Three primary roles for CHWs in breast cancer screening were identified: education (n=30), direct assistance or performance of breast cancer screening (n=7), and navigational services (n=6). In these roles, CHWs improved rates of breast cancer screening (n=23) and overall community member knowledge (n=21). Two studies performed cost-analyses of CHW-led interventions. Conclusion: This review extends our understanding of CHW effectiveness to breast cancer screening. It illustrates how CHW involvement in screening programs can have a significant impact in LMICs and HICs, and highlights the three CHW roles of education, direct perfor-mance of screening, and navigational services that emerge as useful pillars around which governments and NGOs can design effective programs in this area.Item Implementing oncology clinical trials in Nigeria: A model for Capacity building.(Springer Nature, 2020) Ntekim, A.; Ibraheem, A.; Sofoluwe, A.; Adepoju, T.; Oluwasanu, M.; Aniagwu, M.; Awolude, O.; Balogun,W.; Kotila, K.; Adejumo, P.; Babalola, C. P.; Arinola, G.; Ojengbede, O.; Olopade, C. O.; Olopade, O. I.Background: There is both higher mortality and morbidity from cancer in low and medium income countries (LMICs) compared with high income countries (HICs). Clinical trial activities and development of more effective and less toxic therapies have led to signi¦ cant improvements in morbidity and mortality from cancer in HICs. Unfortunately, clinical trials remain low in LMICs due to poor infrastructure and paucity of experienced personnel to execute clinical trials. There is an urgent need to build local capacity for evidence based treatment for cancer patients in LMICs. Methods: We conducted a survey at facilities in four Teaching Hospitals in South West Nigeria using a checklist of information on various aspects of clinical trial activities. The gaps identi¦ ed were addressed using resources sourced in partnership with investigators at HIC institutions. Results: De¦ cits in infrastructure were in areas of patient care such as availability of oncology pharmacists, standard laboratories and diagnostic facilities, clinical equipment maintenance and regular calibrations, trained personnel for clinical trial activities, investigational products handling and disposals and lack of standard operating procedures for clinical activities. There were two GCP trained personnel, two study coordinators and one research pharmacist across the four sites. Interventions were instituted to address the observed de¦ cits in all four sites which are now well positioned to undertake clinical trials in oncology. Training on all aspects of clinical trial was also provided. Conclusions: Partnerships with institutions in HICs can successfully identify, address, and improve de¦ cits in infrastructure for clinical trial in LMICs. The HICs should lead in providing funds, mentorship and training for LMIC institutions to improve and expand clinical trials in LMIC countries.Item Global disparities in breast cancer outcomes: new perspectives, widening inequities, unanswered questions(Elsevier, 2020) Oluwasanu, M.; Olopade, O. L.Item 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.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.