Health Promotion & Education
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Item Assessment of design and challenges in the implementation of state supported health insurance scheme in a South West State, Nigeria.(College of Medicine, University of Ibadan, 2019) Adewole, D. A.; Dipeolu, I. O.Background: Poor health indices in most low and middle-income countries are due to inadequate access to available health care. In Nigeria, the National Health Insurance Scheme (NHIS) devolved to State Supported Health Insurance Programme (SSHIP), a new approach aimed at improving access to health care and achieving Universal Health Coverage (UHC). Currently, not much is known about the design of SSHIP, anticipated challenges associated with its implementation, and plans to mitigate and appropriately address them. To elicit useful information about these (anticipated) challenges, the study was carried out among stakeholders who were directly involved in the design of the scheme in Oyo State, Nigeria. Findings will help to identify likely gaps needed to be addressed at the early stage of the scheme. This will contribute to efforts in implementing a sustainable health insurance scheme in the state. Methods: This is a descriptive cross-sectional study. To allow the researchers achieve the study objectives, a purposive sampling technique was employed in selecting all the 12-man Steering Committee members in the State Health Insurance Scheme for interviews. A validated In-Depth Interview (IDI) guide was used to collect qualitative data from the target population. Transcripts from the data were analysed using the thematic approach with the aid of ATLAS Ti software package version 7. Ethical approval was obtained from the Oyo State Ministry of Health Research Ethics Committee, Ibadan Nigeria. Consent was also sought and obtained from individual study participants. Results: The concept and design of the SSHIP are fundamentally the same as any other social health insurance scheme like the NHIS, however, certain differences exist. In Oyo State, the SSHIP is made compulsory, it is supported by the organised trade unions, and policies (and benefits packages) are stratified based on the financial ability of individuals to subscribe to different premium platforms. Certain features of the scheme such as enrolment, premium determination and collection methods, and the absence of government funding support are likely areas of challenges that may militate against its sustainability. Stakeholders need to address these appropriately. Likewise, awareness and understanding the basic design of the scheme among potential beneficiaries will go a long way in the efforts to implement and sustain a successful scheme. Conclusions: Findings in this study are suggestive that the State SSHIP enjoys good support from stakeholders in Oyo State. However, identified likely areas in the design of the scheme that could become. a challenge to the scheme need to be appropriately addressed to ensure its successful implementation and sustainability. We accept as a limitation to more robust information the inability to interview certain key stakeholders such as the State Chairman of the Nigerian Labour Congress and some of the potential beneficiaries of the scheme.Item Nigerian rural mothers’ knowledge of routine childhood immunisations and attitudes about use of reminder text messages for promoting timely completion.(Palgrave Macmillan, 2019) Oladepo, O.; Dipeolu, I. O.; Oladunni, O.Mothers’ poor knowledge and attitudes about routine immunization impede childhood immunization completion. This study assessed mothers’ knowledge in rural communities about routine immunization and acceptability of mobile phone reminder text messages as an intervention for improving uptake and timely completion of routine immunization. The study adopted a descriptive cross-sectional design among 3440 consenting mothers of infants in six randomly selected Nigerian states and in the Federal Capital Territory (FCT). We used a Focus Group Discussion guide and validated questionnaire to collect data; we analysed data using a thematic approach and descriptive statistics. Respondents’ ages were 26.7 ± 5.5 years. Knowledge of routine immunization was poor; attitudinal disposition was positive. Most (90.5%) indicated willingness to accept reminder text messages for routine immunization and 91.5% opined that mobile phones can be effective in providing such information. Mothers’ willingness to accept the use of SMS reminder text messages for promoting routine immunization completion requires well-designed and culture sensitive persuasive messages.Item Involvement of pastors’ wives in educating nursing mothers on childcare practices in Ibadan North Local Government Area, Nigeria.(College of Medicine, University of Ibadan, 2019) Oyewole, O. E.; Akpamu, U.; Dipeolu, I. O.Poor childcare practices among nursing mothers have been implicated as one of the factors influencing high child morbidity and mortality in many developing countries including Nigeria. Many health promotion and education approaches have been used in previous studies to improve childcare practices but very few have considered the inherent potentials of using faith-based strategy as one of the acceptable means of health promotion in many developing countries. This descriptive cross-sectional study was aimed at investigating the involvement of Pastors’ wives as change agents in educating nursing mothers on childcare practices in Ibadan North Local Government Area. Multi-stage sampling technique was used to select pastors’ wives from all the registered churches in the Local Government Area. A pre-tested interviewer-administered questionnaire was used for data collection. Data were analysed using descriptive and inferential statistics. One hundred and twenty-eight (N=128) pastors’ wives with age of 46.1±9.3 years were interviewed. Overall, 9.4% had never taught or preached on childcare practices or other health-related matters to mothers/women in the church before. Analysis showed that 42.2%, 26.6% and 31.3% of Pastor’s wives had good, fair and poor level of basic communication techniques, respectively. Age and educational status of Pastors’ wives significantly affect the level of communication between Pastors’ wives and mothers in the church (p<0.05). Involvement of Pastors’ wives with the mothers on childcare practices was through counselling (90.6%), teaching (53.1%), preaching (29.7%) and phone calls (18.8%). Counselling was the most preferred method (68.0%) of communication. This study establishes the fact that Pastors’ wives and nursing mothers have been communicating health matters through counselling, which can be used as an opportunity for improving child care through faith-based setting.Item Attitude and Willingness of Infertile Persons Towards the uptake of Assisted Reproductive Technology in Ibadan, Nigeria.(Annals of Ibadan Postgraduate Medicine, 2019) Akande, S. O.; Dipeolu, I. O.; Ajuwon, A. JIntroduction: In most developing countries the joy of every married man and woman is to procreate and raise children of their own. However, this desire does not always find fulfilment among some couples because of primary or secondary infertility. The majority who experience this condition live in developing countries where fertility services including Assisted Reproductive Technologies (ARTs) are not always available. This study, therefore, investigated the attitude and willingness of infertile persons to uptake ARTs. Methods: The study was a descriptive cross-sectional survey; a three-stage multi-stage sampling technique was adopted to select 202 married persons receiving fertility services at a gynaecological clinic in Ibadan, Nigeria. A validated interviewer-administered semi-structured questionnaire was used for data collection. Data were analysed using SPSS with descriptive and inferential statistics with the level of the significant set at <0.05. Results: Respondents’ age was 34.3 years (SD ± 6.5); 88.6% were female; 55.5% had tertiary education; 54.5% reported a history of primary infertility. The negative attitude towards ARTs was observed among many of the respondents; however, some were willing to use ART services. In vitro fertilization (IVF) was the most preferred method; only 15.0% were optimistic of non-complications. The cost was the most mentioned barrier to use of ART. Positive association existed between attitude and willingness to use ART. Females are three times more likely than males to have a positive attitude toward the uptake of ART. Conclusion: Public enlightenment and advocacy are recommended to influence negative attitude towards ARTs.Item Blueprint for health literacy: Population education, community health innovation(The College of Medicine, University of Ibadan, 2019) Oyewole, O. E.; Dipeolu, I. O.; Ajuwon, G. A.; Odetola, T. DIntroduction: The WHO submits that improving peoples’ access to health information and enhancing their capacity to use it effectively are forms of health empowerment. Health literacy involves the acquisition of skills that are essential to effectively search for and obtain, process and interpret and use basic health information available. With the current national data on literacy rate in Nigeria, the future looks bleak for health literacy if appropriate and adequate measures are not put in place to address the problems. A functional health care system relies on efficient health literacy programme as the bedrock of health security. The goal of health literacy review is to establish the gaps and important roles of health literacy in the quest to enhancing health security. Methods: This was an exploratory study design, using an empirical study guide that was developed from the set objectives. Appropriate search engine tools including Google scholar and desk review of documents and journal articles were used as a source of information. Information harvested were analysed thematically based on the themes from the objectives. Findings: Factors influencing health literacy were identified and suggestions to address the observed gaps were highlighted. These include development and dissemination of health information that is accurate, accessible, and actionable, using all appropriate health promotion and education approaches. Increase in research funding, and evaluation of interventions are equally required. Conclusion: The review has revealed the health status will improve when health literacy is fostered. Statutorily, all aspect of health care needs to subscribe to the philosophy of health literacy.Item Facilitating professional mobile learning communities with instant messaging(Elsevier, 2019) Pimmer, C.; Brühlmann, F.; Odetola, T. D.; Dipeolu, O.; Oluwasola, D. O.; Ajuwon, A. JAlthough Mobile Instant Messaging (MIM) is a massive communication phenomenon and its educational use can be seen as a genuine form of mobile learning, it has been studied to a limited extent to date. The present study examined the use of MIM to engage young professionals in mobile learning communities during their school-to-work transition. This transition is one of the most central but also challenging developmental phases marked by the experience of knowledge gaps and a lack of belonging. To assess knowledge and socio-professional learning effects associated with the use of MIM, this study adopted a quasi-experimental, survey-based approach with an intervention and control condition (n=114) in the setting of an international research project. In the intervention condition, newly graduated nurses from Nigeria participated in WhatsApp groups in which moderators shared knowledge and stimulated professional discussions over a period of 6 months. Data were collected via online surveys and knowledge tests. The findings show that participants in the moderated WhatsApp groups had significantly higher knowledge and exhibited fewer feelings of professional isolation compared with the control group, which was not subject of any treatment. The effects were even more pronounced when controlling for active contributions (writing vs reading messages), which also amounted to significantly higher levels of professional identification. In addition, across intervention and control groups, the self-reported general active use of WhatsApp (outside of the intervention) was positively associated with the measures of professional social capital maintained with school connections, professional identity, (lower) professional isolation, job satisfaction, and the perceived transfer of school knowledge to work practice. Whereas knowledge and socio-professional effects can be triggered through moderated WhatsApp interventions yet the general (and thus informal) use of WhatsApp is associated with socio-professional connectedness. The findings are of particular relevance in the developing context under investigation, which is marked by a lack of alternative support structures.Item Theory-practice gap: The experience of Nigerian nursing students.(Unisa Press (University of South Africa Press), 2018) Odetola, T. D.; Oluwasola, O.; Pimmer, C.; Dipeolu, I. O.; Akande, S. O.; Olaleye, O. S.; Gröhbiel, U.; Ajuwon, A. J.The “disconnect” between the body of knowledge acquired in classroom settings and the application of this knowledge in clinical practice is one of the main reasons for professional fear, anxiety and feelings of incompetence among freshly graduated nurses. While the phenomenon of the theory-to-practice gap has been researched quite extensively in high income country settings much less is known about nursing students’ experiences in a developing country context. To rectify this shortcoming, the qualitative study investigated the experiences of nursing students in their attempt to apply what they learn in classrooms in clinical learning contexts in seven sites in Nigeria. Thematic content analysis was used to analyse data gained from eight focus group discussions (n = 80) with the students. The findings reveal a multifaceted theory-practice gap which plays out along four tensions: (1) procedural, i.e. the difference between practices from education institutions and the ones enacted in clinical wards – and contradictions that emerge even within one clinical setting; (2) political, i.e. conflicts that arise between students and clinical staff, especially personnel with a lower qualification profile than the degree that students pursue; (3) material, i.e. the disconnect between contemporary instruments and equipment available in schools and the lack thereof in clinical settings; and (4) temporal, i.e. restricted opportunities for supervised practice owing to time constraints in clinical settings in which education tends to be undervalued. Many of these aspects are linked to and aggravated by infrastructural limitations, which are typical for the setting of a developing country. Nursing students need to be prepared regarding how to deal with the identified procedural, political, material and temporal tensions before and while being immersed in clinical practice, and, in so doing, they need to be supported by educationally better qualified clinical staff.Item Instant messaging and nursing students' clinical learning experience.(Elsevier, 2018) Pimmer, C.; Brühlmann, F.; Odetola, T. D.; Dipeolu, O.; Gröhbiel, U.; Ajuwon, A. J.Background: Although learning in clinical settings is a key element of nursing education, for many learners these are challenging developmental contexts often marked by isolation and a lack of belongingness. Despite the massive appropriation of mobile instant messaging (MIM) platforms and the connective properties attendant to them, very little is known about their role in and impact on nursing students' clinical learning experiences. Approach and Methods: To address this gap, the study, which was part of a multinational research project on the use of mobile social media in health professions education in developing countries, examined the use of the instant messaging platform WhatsApp by nursing students during placements and potential associations with socio-professional indicators. The survey involved a total number of 196 nursing students from 5 schools in Oyo State, Nigeria. Results: The findings suggest that students used WhatsApp relatively frequently and they perceived that this platform strongly enhanced their communication with other students and nurses. WhatsApp use during placements was positively associated with students' maintained social capital with peer students, the development of a professional identity, placement satisfaction and with reduced feelings of isolation from professional communities. The determinants that influenced WhatsApp use during placements were perceived usefulness and perceived ease of use. No associations were found between WhatsApp use during placement and age, attitude, subjective norms and placement duration. Conclusion: This study is one of the first of its kind that points to the relevance of mobile instant messaging as part of nursing students' (inter)personal learning environments in clinical settings and, particularly, in the development setting under investigation. Further research is needed to corroborate these findings, to enhance the understanding of the impact mechanisms, and to evaluate a more systematic use of MIM in clinical learning contexts.Item Influence of internet exposure on sexual behaviour of young persons in an urban District of Southwest Nigeria(AFENET, 2016) Arulogun, O. S.; Arinze, I.; Dipeolu, I. O.Introduction: The proportion of young people exposed to pornographic materials through the internet in Nigeria is increasing. However, the influence of the exposure on their sexual behaviour has not been fully explored. This study therefore explored the effects of internet exposure on the sexual behaviour of young persons in Ibadan North Local Government Area of southwest Nigeria. Methods: A survey of 413 young persons was done using a pretested self-administered questionnaire which included questions on internet exposure and its influence on behaviour. Data were analysed using descriptive statistics, Chi-square test and logistic regression. Results: Mean age of males was 21.7 ± 3.4 years while that of females was 20.9 ± 3.2 years. Forty-nine percent of the respondents used the internet for the first time between the ages of 15-19 years. Main source of information about the internet was friends (63.3%) and 99.3% accessed the internet from cybercafé. Seventy-two percent had ever stumbled on pornographic sites. Reactions included glancing through before closing (45.2%), closure of the sites (38.5%), and minimizing page to view later (12.5%). Post-exposure influence on behaviour included engagement in oral sex (48.3%), body tattoo (18.3%), having multiple sexual partners (11.6%) and homosexuality (5.0%). More males (95% CI OR =1.245-6.465) and frequent users (95% CI OR =1.168-3.497) were likely to report a change in sexual behaviour. Conclusion: Internet use was common among the young persons. Interventions aimed at reducing exposure to sexual content on internet targeting young persons especially the males and cybercafé operators are advocated.Item Influence of internet exposure on sexual behaviour of young persons in an urban District of Southwest Nigeria(AFENET, 2016) Arulogun, O. S.; Arinze, I.; Dipeolu, I. O.Introduction: The proportion of young people exposed to pornographic materials through the internet in Nigeria is increasing. However, the influence of the exposure on their sexual behaviour has not been fully explored. This study therefore explored the effects of internet exposure on the sexual behaviour of young persons in Ibadan North Local Government Area of southwest Nigeria. Methods: A survey of 413 young persons was done using a pretested self-administered questionnaire which included questions on internet exposure and its influence on behaviour. Data were analysed using descriptive statistics, Chi-square test and logistic regression. Results: Mean age of males was 21.7 ± 3.4 years while that of females was 20.9 ± 3.2 years. Forty-nine percent of the respondents used the internet for the first time between the ages of 15-19 years. Main source of information about the internet was friends (63.3%) and 99.3% accessed the internet from cybercafé. Seventy-two percent had ever stumbled on pornographic sites. Reactions included glancing through before closing (45.2%), closure of the sites (38.5%), and minimizing page to view later (12.5%). Post-exposure influence on behaviour included engagement in oral sex (48.3%), body tattoo (18.3%), having multiple sexual partners (11.6%) and homosexuality (5.0%). More males (95% CI OR =1.245-6.465) and frequent users (95% CI OR =1.168-3.497) were likely to report a change in sexual behaviour. Conclusion: Internet use was common among the young persons. Interventions aimed at reducing exposure to sexual content on internet targeting young persons especially the males and cybercafé operators are advocated.