FACULTY OF PUBLIC HEALTH
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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 Effects of a multi-level intervention on the pattern of physical activity among in-school adolescents in Oyo state Nigeria: a cluster randomised trial(Springer Nature, 2017) Oluwasanu,M. M.; Oladepo, O. O.Background: Physical inactivity contributes to the global burden of non-communicable diseases. The pattern of physical activity in adulthood are often established during adolescence and sedentary behaviours in the early years could influence the development of diseases later in life. Studies on physical activity in Nigeria have focused largely on individual behaviours and the effects of school-based interventions have not been well investigated. The aim of the proposed study is to identify factors influencing; and evaluate the effects of a multi-level intervention on the physical activity behaviours of in-school adolescents in Oyo state, Nigeria. Methods: The study will adopt a cluster randomised controlled trial design and schools will serve as the unit of randomisation. The sample size is 1000 in-school adolescents aged 10–19 years. The study will be guided by the socio-ecological model and theory of reasoned action and baseline data will be obtained through a mixed methods approach comprising a cross sectional survey to document the self-reported physical activity levels coupled with objectively measured physical activity levels using pedometers for a subset of the sample. Other measurements including weight, height, waist and hip circumferences, fitness level using the 20-m shuttle run test (20-mSRT) and blood pressure will be obtained. The schools’ built environment and policy support for physical activity will be assessed using structured questionnaires coupled with key informant interviews and focus group discussions with the school authorities. Baseline findings will guide the design and implementation of a 12-week multi-level intervention. The primary outcome measures are self–reported and 7-day objectively measured physical activity. Other secondary outcome measures are body-mass-index for age, waist-to-hip ratio, cardioresiratory fitness and blood pressure. The association between behavioural factors and physical activity levels will be assessed. Follow-up measurements will be taken immediately after the intervention and 3-months post intervention. Discussion: Physical activity behaviours of adolescents in Nigeria are influenced by multiple factors. There is an urgent need for effective school-based interventions with a potential to improve the physical activity behaviours of adolescents in Nigeria and other low and middle income countries.Item Nigerian antimalarial ethnomedicine 2: Ethnobotanica surveys of herbal remedies used in the treatment of febrile illnesses in the middle belt of Nigeria(2002) Ajaiyeoba, E. O.; Osowole, O. S.; Oduola, O .O.; Ashidi, J. S.; Akinboye, D. O.; Gbotosho, G. O.; Falade, C. O.; Ogundahunsi, O. A. T.; Fawole, O. I.; Bolaji, O. M.; Falade, M. O.; Oladepo, O. O.; Itiola, O. A.; Oduola, A. M. J.An ethnobotanical survey was conducted among residents of Gboko (urban) and Katsina Ala ( rural) local government areas in Benue state located in the middle belt of Nigeria. The Katsina-Ala and Gboko communities belong to the Tiv ethnic group. Documentation of the use of herbs as alternative in the treatment of fevers and identification of potential phytomedicines against malaria was done. Semi-structured questionnaires and focus group discussion guides were used to obtain information on description of febrile illness and utilization of herbal remedies for prevention and treatment. A total of 499 respondents comprising of mothers, fathers, community leaders/elders, herbs sellers and traditional healers were interviewed in the study. In the study, 9 types of febrile illnesses were proffered. The five most common type of febrile illnesses described were malaria (37.3%), yellow (28.8%), typhoid (27.3%), high fever (3.4%) and ordinary fever (0.5%). Perceived causes of febrile illness included mosquito bites, contamination of water and food, among others. Headache, general weakness, yellow coloration of eyes/uririe, elevated body temperature and diarrhoea, were the most common symptoms associated with febrile illnesses outlined by the respondents. Furthermore, malaria (81.5%) and high fever (57%) were reported to be common during the rainy season while typhoid (52%) is common during the dry season. Yellow fever was said to be non-dependent on season. Respondents believed children were more at risk of malaria compared with the other types of febrile illnesses mentioned. The respondents indicated that herbal recipes were effective treatment for Febrile illness. From the 105 recipes compiled, Azadirachto indica, Ficus thonningii, Annona senegalensis and Cymbopogon citratus were the most frequent herbs mentioned. Leaf (60.4%), was the most common part of plants used while boiling (92.5%), was frequently mentioned as method of herbal remedy preparation. The main route of administration of remedies mentioned was oral administration (97.9%). The study confirms the potential contribution of Phytomedicine to management of febrile illnesses, including malaria in the Tiv ethnomedicine.