FACULTY OF PUBLIC HEALTH
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Item Effective multisectoral partnerships among government ministries, agencies, and departments for stronger nutrition programming in selected Nigerian southern states: motivations, achievements, challenges and recommendations(Nutrition Society of Nigeria, 2024) Ariyo, O.; Afolabi, W. A.; Ezeogu, A.; Oyetunji, M.; Alarape, K.Background: Efforts to address malnutrition and its consequences in Nigeria has been on for more than 40 years with multi-stakeholders' involvement. Presently, there is limited opportunity for experiential learning to enhance performance. Objective: This paper documented shared experiences, challenges and opportunities in nutrition programming, strategies and framework for better co-ordination and resource mobilization as envisioned by members of seven States Committee on Food and Nutrition (SCFN). Methods: A two-day participatory workshop on strengthening multisectoral nutrition programming across states ministries, departments and agencies including technical and brainstorming sessions, group activities, opinion polls and plenary presentations was conducted. Thirty-two SCFN stakeholders from UNICEF Zone B states (Edo, Ekiti, Lagos, Ogun, Ondo, Osun, Oyo) participated including budget and economic planning, health, agriculture, and academia. Results: Key motivation to promote personnel performance included conducive working environment, government commitment/funding support and performance-based reward. Common achievements included existence of approved State Strategic Action Plan of Food and Nutrition, yearly workplans, regular quarterly meetings, and periodic public nutrition education. Major challenges included poor political will, unfavourable hierarchical structure, inadequate budgetary allocation, weak coordination/collaboration, poor skills/competencies of nutrition desk officers, and dwindling partners' support. Recommendations included mainstreaming nutrition into government political and development agenda, continued sensitization and orientation of policy actors, re-orientation of nutrition desk officers, strengthen collaboration, entrenching the creation of State Council of Nutrition in subsequent nutrition policy review, enhance public awareness and media roles, and institute Nutrition Community of Practice platform. Conclusion: Remarkable progress and surmountable challenges characterise nutrition programming in southern Nigeria. Experience sharing, better coordination, continuous learning and effective stakeholders' engagement are required to enhance nutrition funding, enabling environment, skills and competencies of nutrition actors.Item Housing Quality of Mothers with Under five children: A comparative study of upland and riverine areas of Rivers State.(Scholarzest, 2024) Asiegbu, U. A.; Ariyo, O.Safe housing is fundamental to healthy living. Poor housing quality increases the burden of malnutrition in children globally and nearly half of the children under the age of five die annually due to malnutrition especially in areas with difficult accessibility. This study was designed to compare the housing quality of mothers with under-five children in the upland area with those in the riverine areas of Rivers state. A cross-sectional study involving a multistage stratified random sampling method to select 316 mother/child pairs in six Local Government Areas of Rivers state was adopted. A pretested semi-structured interviewer-administered questionnaire was used. Descriptive and inferential statistics were used to analyse the data. In the upland area about 60% of the households lived in apartments with shared facilities and about a quarter practiced open defecation (25.2%). While more than three-quarter of the households (76.5%) resided in apartments with shared facilities and open defecation was practiced by more than half (56.0%) of the households in the riverine area. Although borehole use was the predominant source of household water supply, the use of public taps was more pronounced in the riverine (21.4%). Bush refuse dumping was predominant in the upland (56.9%) while the ocean (78.9%) was similarly preferred by households in the riverine area. Most mothers lived in apartments where basic facilities were shared and open defecation was high. Efforts should be geared towards providing sanitary facilities to households especially in the riverine communities and sensitisation programmes should be organised to improve hygiene awareness.Item Region, location, and age-specific comparison of nutritional status of in-school adolescent girls (10-19 years) in Nigeria(World Public Health Nutrition Association (WPHNA), 2024) Olumakaiye, M.F.; Nzeagwu, O.C.; Otitoola, O.C.; Ariyo, O.; Abe, J.; Popoola, B.R.; Gbemileke, A.; Akinyotu, E.O.Background: Nutritional status among female adolescents in Nigeria is becoming a major concern because it determines health outcomes and productivity in their adult years. There is a growing recognition of the potential to promote a healthy start to life for the next generation by addressing health and nutritional risks in adolescents. Objective This study assessed the nutritional status of in-school adolescent girls in Nigeria and made comparisons across regions, locations, and age groups. Methods A multistage stratified random sampling procedure was used to select participants from three geopolitical zones in Nigeria for this descriptive cross-sectional study of 2261 inschool adolescent girls aged 10 -19 years. Body mass index-for-age (BMI), waist-hip-ratio (WHR), and waist-height-ratio (WHtR) were calculated from weight, height, hip, waist, and mid-upper arm circumferences measurements. Results The mean age was 14.9 years (± 1.78 years), the mean body weight was 47.8 kg (± 9.02 kg), compared to a calculated mean ideal weight of 54.5 kg (± 9.05 kg). Using BMI, 9.8% of these adolescent girls were underweight, 7% were either overweight or obese, 47.9% were at risk judging from WHR, 10% had abdominal obesity present using WHtR, 35.7% were malnourished, and 11.8% were obese using MUAC. South East girls were eleven times more likely to have a high BMI (OR=11.341, 95%CI=6.059-21.225) and three times more likely to have a high WHtR (OR=2.870, 95%CI=1.954-4.213) than other regions. The likelihood of being overweight/obese was higher among urban than peri-urban girls; BMI (OR=1.008, 95%CI=0.728-1.395) and MUACoverweight (OR=1.280, 95%CI=0.988-1.657). Older girls, 14- 16yrs; WHtR (OR = 1.426, 95%CI = 0.970-2.097) and 17 -19yrs (OR = 1.024, 95%CI = 0.617- 1.699) were likely to be overweight/obese compared to 10 -13yrs (OR=3.878, 95%CI=2.385- 6.305). Girls 14 -16 were three times and 17-19 were six times more likely to have higher MUAC overweight (OR = 3.878, 95%CI = 2.385-6.305) and (OR=6.371, 95%CI=3.854-10.865), respectively than those at 10-13 years. Conclusions These findings underscore the significant disparities in the nutritional status of adolescent girls across regions, locations, and age ranges in Nigeria. This highlights the urgent need for targeted, region-specific nutrition-sensitive intervention programmes among adolescent girls, potentially leading to improved public health outcomes in Nigeria.Item Nutritional status of school children in South-west Nigeria: Inferences from a national homegrown school feeding programme(Makerere University Medical School, 2024) Obembe, T. A.; Bosede, A. O.; Ariyo, O.; Adeniji, F. I. P.; Olaoye, A.; Adebayo, A. M.Background: The School Feeding Programme if properly executed has the capacity to improve the nutritional status of the school children. Objective: To assess the nutritional status of school children in Ondo State Nigeria given that the National Home-Grown School Feeding Programme (NHGSFP) has been operational in the state for over five years. Methods: This was a descriptive cross-sectional study. Results: A total of 234 subjects from public schools and 227 subjects from private schools were enrolled in the study. Their mean age was 8.23 ± 1.92 years. Wasting, overweight, obesity, underweight, and stunting were noted in 19.4%, 11.4%, 0.4%, 5.0%, and 20.7% of the children, respectively. The prevalence of stunting (30.3%) and wasting (23.9%) was more among subjects from the public schools. A significant association was found between Weight-for-Age Z-score, Height-for-Age Z-score, and BMI-for-Age Z-score and the children’s school type (p < 0.005). Conclusion: Majority of the children showed normal growth, the rest were in both extremes of malnutrition, the subjects from private schools seem to present better nutritional status, although there is no baseline data to ratify this finding. A further study on this subject using the current finding as a baseline data is recommended. Keywords: School children; Nutritional assessment; Stunting; Underweight; Wasting; School feeding programme.Item Barriers and facilitators of early initiation of breastfeeding Practice In Imo State: findings from the perception of Mothers and Health Workers(Nutrition Society of Nigeria, 2023) Chima-Onumajuru, A. P.; Ariyo, O.; Kawu, A.; Samuel, F. O.; Owolabi, A. J.Background and Objectives: Despite the well-known benets of breastfeeding, many barriers hinder its early initiation, and several facilitators promote it. Understanding these barriers and facilitators is crucial to promote optimal practice. Objectives: This research explored the determinants of early initiation of breastfeeding (EIBF), highlighting the factors that affect the decision-making process of mothers and healthcare providers in Imo state, Nigeria. Methods: This cross-sectional study involved purposive sampling of 66 mother-child pairs and 10 health workers across four primary healthcare centres in Imo state. Semi-structured individual interviews and focus group discussions were used to explore the determinants of the practice of early initiation of breastfeeding. Qualitative data (transcripts) were analysed using the QDAMiner Lite software. Thematic analysis involving organizing, and summarizing qualitative data was adopted and codes were used to classify text excerpts into their appropriate categories. Results: Summarily, mothers and health workers pointed out the following positive determinants: baby crying; educating the mothers on EIBF; support from midwives; training of health workers; health workers' knowledge of EIBF. They also pointed out the following barriers: delayed breast milk ow; lack of knowledge on the subject matter; mother and mother-in-law inuence; mother's health status; mother's personal belief; no support from midwives; delivery via cesarean section; no record of EIBF; lack of training; and poor motivation. Conclusions: The results show how vital the understanding of the concept and benets of EIBF facilitates its practice from the perspective of mothers and health workers. Continuous investments to train health workers who in turn teach mothers should be prioritized.Item Effect of counselling and text message reminder on the uptake and adherence of iron and folic acid supplements among pregnant women attending antenatal clinic in Gwagwalada, Abuja(Nutrition Society of Nigeria, 2023) Uwatt, E.; Ariyo, O.; Oloyede, J.; Ezekannagha, O.; Owolabi, A. J.; Brai, B. I. C.; Abubakar, S. M.Background and Objectives: Innovative strategies are required to mitigate poor compliance to iron-folic acid supplementation and associated high burden of anaemia in Nigeria. Objectives: This study was designed to assess how counselling and text message reminders could improve the uptake and adherence to iron-folic acid supplements among Nigerian pregnant women. Methods: The study used a quasi-experimental design with a simple random sampling of 153 respondents equally allocated into three groups; counselling ( A), counselling and text message reminders (B), and control (C). Adherence to the supplements was assessed using pill count and the 8-item Morisky adherence questionnaire. Parametric and nonparametric analyses were utilized to evaluate survey results across the two interventions. Results: Age of respondents (years) was 31.23±5.05, 31.97±5.63 and 26.63±6.25 for Groups A, B and C, respectively. Self-report adherence was 71.96±13.62, 68.02±11.56, and 65.19±11.84 in group B, A and C, respectively. Folic acid adherence was 91.62±7.98, 89.61±8.62, and 88.57±14.10; while iron adherence was 91.29±8.03, 89.36±8.86 and 88.55±14.00 in group B, C and A, respectively. Group A was 2.6 times more likely to have poor folic acid adherence, 4.0 times more likely to have poor iron adherence and 1.6 times more likely to have poor self-report adherence compared to group B. Conclusion: Counselling and text message reminders are more effective than antenatal counselling alone in improving uptake and adherence to iron-folic acid supplements among Nigerian pregnant women. Efforts to prevent iron deciency anaemia among Nigeria women should incorporate counselling and text message reminders to enhance adherence to uptake and adherence to iron-folic acid supplements.Item Assessment of barriers and promoters for the adoption of Orange-fleshed sweet Potato in Kano State, Nigeria(Nutrition Society of Nigeria, 2023) Ibrahim, D.; Abubakar, S. M.; Brai, B. I. C.; Ariyo, O.; Ajieroh, V.; Owolabi, A. J.Background and Objectives: Vitamin A deciency (VAD) slows recovery from illnesses and increases the severity of infections like measles and diarrhoeal disease. Vitamin A deciency affects about 30% of children less than 5 years of age in Nigeria. The use of β- carotene biofortied Orange-eshed sweet potato (OFSP) has been recognised as one of the effective, food-based, and nutrition-sensitive agricultural approaches to improve vitamin A intakes. However, the adoption of this biofortied crop merits further study. This research assessed knowledge, attitude and adoption of OFSP among farmers in Kano State. Methods: Data were collected using questionnaire and focus group discussions (FGDs) from 125 respondents from farmers and consumers, in-depth interview was done with stakeholders in ministry of Health and Agriculture, eHealth and CIP, these were selected through purposive and simple random sampling. Mean, frequencies and percentages of data collected were analysed using SPSS (version 22). Results: The questionnaire result shows that OFSP acceptance was <30%, Choice preference showed that majority of farmers and consumers valued the WFSP more than the OFSP. The FGD's result indicates that the factors for promotion of adoption of OFSP include; availability of market niche, affordability, access to OFSP vines, pleasant taste and texture, sensitization on OFSP benets, resistance to pest, improve shelf life and promotion of local vines production system while barriers are the counteracts of the above mentioned. Conclusion: The level of adoption of OFSP in Kano State appeared low (<30%) among the respondents. This calls for efforts in addressing the barriers for the adoption of OFSP.Item Awareness, Perception and Constraints to Consumption of Pro-Vitamin A Cassava Foods among Women of Reproductive Age in Ikire, Nigeria(Faculty of Agriculture, University of Nigeria, Nsukka, 2023) Ariyo, O.; Oladejo, E. O.; Atojoko, M. A.Pro-vitamin A cassava was introduced to Nigeria since 2011; however, the consumption remains low. Increased consumption of pro-vitamin A cassava foods can complement other vitamin A deficiency control initiatives. The study was designed to assess the awareness, perception and constraints to consumption of provitamin A cassava foods among women of reproductive age in rural and urban areas of Ikire, Nigeria. The cross-sectional study involved 200 women aged 15-49 years (100 each), selected using a three-stage sampling procedure. Data were collected using an interviewer-administered questionnaire including awareness, perception, and constraints to biofortified cassava products consumption. Data were analyzed using frequencies, percentages and Chi square test at p < 0.05. Age of respondents was 31.50±9.30 years and 27.00±9.80 years among rural and urban respondents, respectively. More respondents from rural (22%) than urban areas (2%) had no formal education. More respondents from urban than rural had ever heard (55%; 53%), seen (49%; 43%), tasted (40%; 29%), were aware of the benefits (36%; 9%), and had ever consumed (20%; 16%) biofortified cassava foods, respectively. Acceptability of colour (29%; 24%), taste (27%; 20%), aroma/flavour (26%; 20%), and texture (26%; 18%) was higher in rural than urban areas, respectively. Only 12% and 2% of urban and rural respondents considered pro-vitamin A cassava foods affordable. Rural/urban variation exists in awareness and perception of pro-vitamin A cassava foods, however, knowledge of their benefits and perceived affordability remain major constraints in both areas. A multi-faceted approach to promote nutrition education and policy support for increased affordability are recommended.Item Knowledge and attitude of infant feeding among health workers in private health facilities in Ibadan, Oyo State, Nigeria(Borno State chapters of the Nigerian Medical Association (NMA), 2023) Ariyo, O.; Olaniyi, B. O.; Onojade, O. D.; Oladipo, F. S.Background: Knowledge and attitude of health workers affect caregivers’ infant feeding practices. However, information on the knowledge and attitudes of health workers in private hospitals is lacking. This study was designed to assess the infant feeding knowledge, attitude, and personal experiences of health workers in private hospitals in Ibadan, Nigeria. This cross-sectional study involved sampling of 108 consenting health workers of registered private health facilities offering ante-natal care services in Ibadan North communities of Oyo State, Nigeria. Data were collected using a semi-structured questionnaire including the socio-demographic characteristics, knowledge, and attitude of infant feeding practices. Knowledge was assessed using a 19-point scale categorized as good (≥13) and poor (<13). Attitude was assessed using a 65-point scale, categorized as good (≥33) and poor (<33). Data were analysed using descriptive statistics at p<0.05. Eighty five percent of the health workers were female, 51.9% were aged 21-30 years, 48.1% were married, and 25.9% were degree holders. Only 47.2% had attended infant feeding training recently, 57.0% had good knowledge and 53.0% had good attitude. Only 30.6% knew early initiation of breastfeeding, and 30.6% knew continued breastfeeding up 24 months and beyond. Just 49.1% considered breastfeeding in public non-embarrassing, and 33.3% agreed that infants less than six months should not be given water. There is evidence of limited knowledge and poor attitude towards the recommended infant feeding practices among the health workers in private health facilities in Ibadan. Periodic training on infant feeding for health workers in private health facilities is hereby recommended.Item Access to nutritioninformation, dietary diversity and shortfall food groups among Nigerian In-school adolescents(Medical and Dental Consultants’ Association of Nigeria, 2023) Ariyo, O.; Oladipo, F. S.; Alimi, E. J.; Atojoko, M. A.Background: Healthy dietary behaviour is essential for adolescents to promote psychosocial development and cognitive performance and prevent nutrition-related chronic diseases. Yet, the prevalence of micronutrient malnutrition remains high among Nigerian adolescents. Objective: To assess access to nutrition information, dietary diversity, and shortfall food groups among in-school adolescents in Mokola, Ibadan, Oyo, Nigeria. Methods: This descriptive, cross-sectional study involved 360 in-school adolescents selected using a multistage sampling technique. The data, which included sociodemographic characteristics, access to nutrition information and dietary intake, were obtained using a semi-structured, interviewer-administered questionnaire. Dietary intake was assessed using a 24-hour recall approach to determining dietary diversity using Food and Agriculture Organisation (FAO)’s Minimum Dietary Diversity for Women procedure. Results: The mean age of the respondents was 15.5±2.3 years, and 58.1% were females. Only 5.4% had access to information on healthy eating. The minimum dietary diversity score during the previous 24 hours was 5.41±1.3, and only 46.5% of the respondents met the minimum dietary diversity for women. Shortfall food groups included nuts and seeds (4.1%), dairy foods (6.1%), pulses (7.2%), fruits (10.3%), other vegetables (10.3%), and eggs (15.3%). Conclusion: Poor access to nutrition information and low dietary diversity were observed among in-school adolescents in Mokola, Ibadan, Nigeria. Policymakers should strengthen the educational system to promote active learning of healthy eating and improve access to the varieties of foods and snacks made from the shortfall food groups.
