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					Evaluation of Waiting Time and Factors Influencing Healthcare Quality on Patient Satisfaction: A Case Study Brookfield’s Outpatient Department FreetownAuthor: Salieu KoromaDOI: 10.21522/TIJAR.2014.12.04.Art001Evaluation of Waiting Time and Factors Influencing Healthcare Quality on Patient Satisfaction: A Case Study Brookfield’s Outpatient Department FreetownAbstract:Patient satisfaction which is the fulfilment or fulfilling of a person's expectations from a service is one of the most important indicators of a healthcare quality. This study evaluates the impact of waiting time and other major factors affecting healthcare quality on patient satisfaction at the outpatient department of Brookfield’s Health Centre, Freetown, Sierre Leone. A structured questionnaire was used to collect data from 150 patients, and statistical analyses were conducted to determine relationships between waiting time, accessibility, reliability, communication, and patient satisfaction. Findings reveal that long waiting times are negatively associated with patient satisfaction, highlighting the need for efficient scheduling and patient flow management. Additionally, accessibility was found to significantly influence patient satisfaction with care. The study reveals that reliability, measured by the consistency of service delivery and effective communication, particularly the provision of clear health information, are major determinants of patient satisfaction. Regression analysis confirms that all four considered factors are significantly associated with patient satisfaction (p < 0.05). These results emphasize the need for healthcare administrators to implement strategic interventions such as optimized appointment systems, enhanced communication training for staff, and improved service reliability. Addressing these issues can enhance patient trust and satisfaction which will result to better healthcare experiences. Evaluation of Waiting Time and Factors Influencing Healthcare Quality on Patient Satisfaction: A Case Study Brookfield’s Outpatient Department FreetownReferences:[1]. Ferreira, D. C., Vieira, I., Pedro, M. I., Caldas, P., & Varela, M., 2023, Patient Satisfaction with Healthcare Services and the Techniques Used for its Assessment: A Systematic Literature Review and a Bibliometric Analysis. Healthcare, 11(5), 639, doi: 10.3390/healthcare11050639 [2]. Alrasheedi, K. F., Al-Mohaithef, M., Edrees, H. H., & Chandramohan, S., 2019, The association between wait times and patient satisfaction: findings from primary health centers in the Kingdom of Saudi Arabia. Health Services Research and Managerial Epidemiology, 6, 2333392819861246, doi: 10.1177/2333392819861246. [3]. Marshall, E. G., Miller, L., & Moritz, L. R., 2023, Challenges and impacts from wait times for specialist care identified by primary care providers: results from the MAAP study cross-sectional survey. In Healthcare management forum, 36 (5), 340-346, doi: 10.1177/08404704231182671. [4]. Addis, B. A., Gelaw, Y. M., Eyowas, F. A., Bogale, T. W., Aynalem, Z. B., & Guadie, H. A., 2023, Time wasted by health professionals is time not invested in patients: time management practice and associated factors among health professionals at public hospitals in Bahir Dar, Ethiopia: a multicenter mixed method study. Frontiers in Public Health, 11, 1159275, doi: 10.3389/fpubh.2023.1159275. [5]. Mwanswila, M. J., Mollel, H. A., & Mushi, L. D., 2024, Outcome evaluation of technical strategies on reduction of patient waiting time in the outpatient department at Kilimanjaro Christian Medical Centre—Northern Tanzania. BMC Health Services Research, 24(1), 785, doi: 10.1186/s12913-024-11231-5. [6]. Jalloh, A. A., Nwosu, L. C., & Baysan, S., 2023, Evaluation of waiting time and associated factors influencing patient satisfaction levels in an outpatient department: A case study of government hospital in Sierra Leone. Science, Engineering and Health Studies, 23050015, doi: 10.69598/sehs.17.23050015. [7]. Al Harbi, S., Aljohani, B., Elmasry, L., Baldovino, F. L., Raviz, K. B., Altowairqi, L., & Alshlowi, S., 2024, Streamlining patient flow and enhancing operational efficiency through case management implementation. BMJ Open Quality, 13(1), e002484, doi: 10.1136/bmjoq-2023-002484. [8]. Guimarães, T., Lucas, K., & Timms, P., 2019, Understanding how low-income communities gain access to healthcare services: A qualitative study in São Paulo, Brazil. Journal of Transport & Health, 15, 100658. Doi: 10.1016/j.jth.2019.100658. [9]. Shen, Y., & Lee, L. H., 2018, Improving the wait time to consultation at the emergency department. BMJ Open Quality, 7(1), doi: 10.1136/bmjoq-2017-000131. [10]. Nwosu, L. C., Edo, G. I., & Jalloh, A. A., 2023, Mediating role of patient trust in the impact of perceived physician communication on treatment adherence and its implication in healthcare industry. Science, Engineering and Health Studies, 23050026, doi: 10.69598/sehs.17.23050026. [11]. Dat, L. T., 2019, Associations Between Waiting Time and Patient Satisfaction Level at Tan Phu District Hospital in Ho Chi Mihn City, Vietham. [12]. Pearse, J., 2005, Review of patient satisfaction and experience surveys conducted for public hospitals in Australia: a research paper for the steering committee for the review of government service provision. St Leonards, Australia: Health Policy Analysis Pty Ltd. [13]. Mohajan, H. K., 2017, Two criteria for good measurements in research: Validity and reliability. Annals of Spiru Haret University. Economic Series, 17(4), 59-82. [14]. Taber, K. S., 2018, The use of Cronbach’s alpha when developing and reporting research instruments in science education. Research in Science Education, 48, 1273-1296, doi: 10.1007/s11165-016-9602-2. [15]. Rostami, M., Ahmadian, L., Jahani, Y., & Niknafs, A., 2019, The effect of patient satisfaction with academic hospitals on their loyalty. The International Journal of Health Planning and Management, 34(1), e726-e735, doi: 10.1002/hpm.2685. [16]. Caviglia, M., Dell’Aringa, M., Putoto, G., Buson, R., Pini, S., Youkee, D., & Barone-Adesi, F., 2021, Improving access to healthcare in Sierra Leone: the role of the newly developed national emergency medical service. International Journal of Environmental Research and Public Health, 18(18), 9546, doi: 10.3390/ijerph18189546. [17]. Cramer, D., & Howitt, D. L., 2004, The Sage dictionary of statistics: a practical resource for students in the social sciences. [18]. Almoajel, A., Fetohi, E., & Alshamrani, A., 2014, Patient satisfaction with primary health care in Jubail City, Saudi Arabia. World J Med Sci, 11(2), 255-64, Doi: 10.5829/idosi.wjms.2014.11.2.84172. [19]. Bamidele, A. R., Hoque, M. E., & Van Der Heever, H., 2011, Patient satisfaction with the quality of care in a primary health care setting in Botswana. South African Family Practice, 53(2), doi: 10.1080/20786204.2011.10874080. [20]. Alnemer, K. A., Al-Homood, I. A., Alnemer, A. A., Alshaikh, O. M., Alsaidan, M. A., & Alzahrani, A. T., 2015, A multicenter study of factors affecting patient’s satisfaction visiting primary health care clinics in Riyadh, Saudi Arabia. Fam Med Med Sci Res, 4(169), 1-4, Doi: 10.4172/2327-4972.1000169. [21]. Oche, M. O., & Adamu, H., 2013, Determinants of patient waiting time in the general outpatient department of a tertiary health institution in North Western Nigeria. Annals of Medical and Health Sciences Research, 3(4), 588-592, doi: 10.4103/2141-9248.122123. [22]. Li, J., Zhu, G., Luo, L., & Shen, W., 2021, Big Data‐Enabled Analysis of Factors Affecting Patient Waiting Time in the Nephrology Department of a Large Tertiary Hospital. Journal of Healthcare Engineering, 2021(1), 5555029, doi: 10.1155/2021/5555029. [23]. Bahammam, F. A., 2023, Satisfaction of clinical waiting time in ear, nose & throat departments of the Ministry of Health in Jeddah, Saudi Arabia. Health Services Insights, 16, 11786329231183315, doi: 10.1177/11786329231183315. [24]. Morales, J., Silva-Aravena, F., & Saez, P., 2024, Reducing Waiting Times to Improve Patient Satisfaction: A Hybrid Strategy for Decision Support Management. Mathematics, 12(23), 3743, doi: 10.3390/math12233743. [25]. Bleustein, C., Rothschild, D. B., Valen, A., Valatis, E., Schweitzer, L., & Jones, R., 2014, Wait times, patient satisfaction scores, and the perception of care. The American Journal of Managed Care, 20(5), 393-400. [26]. Zhang, H., Ma, W., Zhou, S., Zhu, J., Wang, L., & Gong, K., 2023, Effect of waiting time on patient satisfaction in outpatient: An empirical investigation. Medicine, 102(40), e35184, doi: 10.1097/MD.0000000000035184. [27]. Hwang, J., Vu, G. T., Tran, B. X., Nguyen, T. H. T., Nguyen, B. V., Nguyen, L. H., & Ho, R. C., 2020, Measuring satisfaction with health care services for Vietnamese patients with cardiovascular diseases. PLoS One, 15(6), e0235333, Doi: 10.1371/journal.pone.0235333. Viewed PDF 8 0 
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					Prevalence of Non-Communicable Diseases among People living with HIV on Antiretroviral Therapy in Enugu, Southeast NigeriaAuthor: Douglas Ifeanyi Akpu-AgbataDOI: 10.21522/TIJAR.2014.12.04.Art002Prevalence of Non-Communicable Diseases among People living with HIV on Antiretroviral Therapy in Enugu, Southeast NigeriaAbstract:Human Immunodeficiency Virus remains a global public health concern, with over 91.4 million people affected worldwide and 3.2 million in Nigeria. While lifelong Antiretroviral Therapy (ART) has improved survival, concerns persist about its link to non-communicable diseases (NCDs). This study investigated the prevalence of NCDs and associated risk factors among People Living with HIV (PLHIV) on ART in Enugu, Southeast Nigeria. A hospital-based cross-sectional design was employed to abstract socio-demographic and clinical data from adult PLHIV (≥18 years). Data were analyzed using IBM SPSS Statistics 25, with results presented as frequencies, percentages, and mean ± standard deviation. Adjusted odds ratios and p-values ≤0.05 at 95% confidence interval were used to test associations. Hypertension (17%) was the most prevalent NCD, followed by obesity (13%) and diabetes (1.3%). Socio-demographic analysis showed most participants were aged 41–60 years, married, educated at the secondary level, and employed. Females were significantly associated with higher prevalence of hypertension and obesity (p < 0.05). Age, marital status, education, and occupation predicted NCD onset. The study concludes that hypertension is a leading NCD among PLHIV in Enugu and a major risk factor for cardiovascular diseases. Integrating routine screening into HIV services and engaging policymakers to institutionalize preventive interventions are recommended to improve the quality of life of PLHIV. Prevalence of Non-Communicable Diseases among People living with HIV on Antiretroviral Therapy in Enugu, Southeast NigeriaReferences:[1]. Oguntibeju, O. O., 2012. Quality of life of people living with HIV and AIDS and antiretroviral therapy. HIV/AIDS (Auckland, N.Z.), 4, 117–124. [2]. Mathebula, R. L., Maimela, E., & Ntuli, N. S., The prevalence of selected non-communicable disease risk factors among HIV patients on anti-retroviral therapy in Bushbuckridge sub-district, Mpumalanga province. BMC Public Health, 20, 247 2020. [3]. Boakye, H., Atabila, A., Hinneh, T., Ackah, M., Ojo-Benys, F., Bello, A. I., 2023, The prevalence and determinants of non-communicable diseases among Ghanaian adults: A survey at a secondary healthcare level. PLoS ONE, 18(2): e0281310. [4]. Syed, M. A., Alnuaimi, A. S., Zainel, A. J., & A/Qotba, H. A., 2019. Prevalence of non-communicable diseases by age, gender and nationality in publicly funded primary care settings in Qatar. 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Effect of Food-based Nutrition Intervention on Management of Non-Communicable diseases among People living with HIV in Busia County Hospital, Kenya. African Journal of Food, Agriculture, Nutrition and Development; Vol. 24:1. [9]. Magafu, M. G., Moji, K., Igumbor, E. U., Magafu, N. S., Mwandri, M., Mwita, J. C., Habte, D., Rwegerera, G. M., & Hashizume, M., 2013. Non-communicable diseases in antiretroviral therapy recipients in Kagera Tanzania: a cross-sectional study. The Pan African Medical Journal, 16, 84. [10]. Achwoka, D., Oyugi, J. O., Mutave, R., Munywoki, P., Achia, T., Akolo, M., Muriuki, F., Muthui, M. and Kimani, J. 2020. High prevalence of non-communicable diseases among key populations enrolled at a large HIV prevention & treatment program in Kenya. PLoS One, 2;15(7): e0235606. [11]. Chhoun, P., Tuot, S., Harries, A. D., Kyaw, N. T, Pal, K., Mun, P., Brody, C., Mburu, G., Yi, S., 2017. High prevalence of non-communicable diseases and associated risk factors amongst adults living with HIV in Cambodia. Plos One, 12(11):e0187591. [12]. Rimamnunra, G. N., Utoo, P. M., Ngwoke, K., Bako, I. A., Akwaras, A. N., Swende, L. T., Omokhua, O.E., Ogbeyi, G. O., Izeji, R. I., Daniel, D. A. & Akobi, M. A., 2023, Prevalence of Non-Communicable Diseases among HIV Positive Patients on Antiretroviral Therapy at a Tertiary Health Facility in Makurdi, North- Central, Nigeria. The Nigerian Health Journal; 23(3): 734 –740. [13]. Kansiime, S., Mwesigire, D., & Mugerwa, H., 2019. Prevalence of non-communicable diseases among HIV positive patients on antiretroviral therapy at joint clinical research centre, Lubowa, Uganda. PloS one, 14(8), e0221022. https://doi.org/10.1371/journal.pone.0221022 [14]. Hadavandsiri, F., Shafaati, M., Mohammad Nejad, S., Ebrahimzadeh Mousavi, M., Najafi, A., Mirzaei, M., Narouee, S., & Akbarpour, S., 2023. Non-communicable disease comorbidities in HIV patients: diabetes, hypertension, heart disease, and obstructive sleep apnea as a neglected issue. Scientific reports, 13(1), 12730. [15]. Kagaruki, G. B., Mayige, M. T., Ngadaya, E. S., Kimaro, G. D., Kalinga, A. K., Kilale, A. M., Kahwa, A. M., Materu, G. S. and Mfinanga, S. G., 2014. Magnitude and risk factors of non-communicable diseases among people living with HIV in Tanzania: a cross-sectional study from Mbeya and Dar es Salaam regions. BMC Public Health, 14(1):904. [16]. Coetzee, L., Bogler, L., De Neve, J. W., Bärnighausen, T., Geldsetzer, P., & Vollmer, S., 2019. HIV, antiretroviral therapy and non-communicable diseases in sub-Saharan Africa: empirical evidence from 44 countries over the period 2000 to 2016. Journal of the International AIDS Society, 22(7), e25364. [17]. Finkelstein, J. L., Gala, P., Rochford, R., Glesby, M. J., & Mehta, S., 2015. 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E., et al., 2020, HIV and antiretroviral therapy-related fat alterations. Nat Rev Dis Primers, 6, 48. https://doi.org/10.1038/s41572-020-0181-1 [22]. Madden, V. J., Parker, R., & Goodin, B. R., 2020. Chronic pain in people with HIV: A common comorbidity and threat to quality of life. Pain management, 10(4), 253–260. https://doi.org/10.2217/pmt-2020-0004 [23]. Mazzuti, L., Turriziani, O., Mezzaroma, I., 2023. The Many Faces of Immune Activation in HIV-1 Infection: A Multifactorial Interconnection. Biomedicines, 11(1):159. [24]. Pedroso, C. F., Pereira, C. C., Cavalcante, A. M. R. Z., & Guimarães, R. A., 2023. Magnitude of risk factors for chronic noncommunicable diseases in adolescents and young adults in Brazil: A population-based study. PloS one, 18(10), e0292612. https://doi.org/10.1371/journal.pone.0292612 [25]. Nnate, D. A., Eleazu, C. O., & Abaraogu, U. O., 2021. Ischemic Heart Disease in Nigeria: Exploring the Challenges, Current Status, and Impact of Lifestyle Interventions on Its Primary Healthcare System. International Journal of Environmental Research and Public Health, 19(1), 211. [26]. McMaughan, D. J., Oloruntoba, O., and Smith, M. L., 2020. Socioeconomic Status and Access to Healthcare: Interrelated Drivers for Healthy Aging. Front Public Health, 18;8:231. Doi: 10.3389/fpubh.2020.00231. [27]. Okeke, F. O., Sam-Amobi, C. G., & Okeke, F. I., 2020. Role of local town planning authorities in building collapse in Nigeria: evidence from Enugu metropolis. Heliyon, 6(7), e04361. [28]. Okoli, F. U., Johnson, N.G., & Ejikeme, J. O., 2017. Mapping Groundwater Potential Zones in Enugu State using Remote Sensing and GIS Techniques, International Journal of Innovative Environmental Studies Research, 5(1):33-46, Jan.-Mar., [29]. Ezeala-Adikaibe, B., Aneke, E., Orjioke, C., Ezeala-Adikaibe, N., Mbadiwe, N., Chime, P., & Okafor, U., 2014. 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					Enhancing Academic Support at the University of Guyana Berbice Campus: The Need for a Research & Reference Services DivisionAuthor: Rachel Rebekah PetersDOI: 10.21522/TIJAR.2014.12.04.Art003Enhancing Academic Support at the University of Guyana Berbice Campus: The Need for a Research & Reference Services DivisionAbstract:University libraries play a critical and active role in the dissemination and use of information through its research and reference services. Like other university libraries, the University of Guyana Berbice Campus Library (UGBCL) does not have a designated division for this purpose but is expected to provide services to patrons in this area. Consequently, the overwhelming number of requests for assistance, mostly placed beyond regular working hours, oftentimes are unfulfilled, thus presenting a major challenge in terms of adequate service delivery. Hence, this study seeks to enhance the academic support services at the University of Guyana Berbice Campus (UGBC) by proposing the establishment of a Research and Reference Services Division (RRSD) within the Library. It focuses on evaluating UGBCL current academic support and identifying areas for enhancement; developing a robust framework for the proposed RRSD; and assessing the feasibility of establishing the same. The data in these areas was collected from students, academic and library staff through web-based surveys and analysed using SPSS and Microsoft Excel applications. From the findings of this study, there is a need for the establishment of a RRSD, to enhance academic support. Further, the result from the Chi-Square test revealed no statistically significant differences in support between the three (3) categories of respondents (χ²(2) = 2.015, p = .365). This suggested a broad consensus across the respondents’ categories. The study concluded with recommendations for the successful establishment of a RRSD at the UGBCL which includes fostering collaboration with academic divisions, employing qualified staff, among others. Enhancing Academic Support at the University of Guyana Berbice Campus: The Need for a Research & Reference Services DivisionReferences:[1]. Naik, M. M., & Padmini, 2014, Importance of information literacy. International Journal of Digital Library Services, 4(3), 92-100. [2]. UGBCL, 2023, Student guide 2023/2024. [3]. Momoh, E. O., & Folorunso, A. L., 2019, Evolving role of libraries and librarians in the 21st century. Library Philosophy and Practice (e-journal). https://digitalcommons.unl.edu/cgi/viewcontent.cgi?article=6243&context=libphilprac [4]. Mussman, D. C., & McGhie, V. F., 2020, Increasing retention of linguistically-disadvantaged college students in South Africa. In: Beyond Language Learning Instruction: Transformative Supports for Emergent Bilinguals and Educators by A. Slapac & S. A. Coppersmith. (Hershey, PA: IGI Global), pp. 146-180. [5]. The University of Edinburgh, 2023, October 25, Academic support librarians. https://www.ed.ac.uk/information-services/library-museum-gallery/academic-support-librarians [6]. Glasgow Caledonian University, n.d., Academic support. https://www.gcu.ac.uk/currentstudents/essentials/library/teaching/academicsupport [7]. University of Toronto Libraries, n.d., Reference and research services. https://oise.library.utoronto.ca/research/reference-and-research-services [8]. Atlantic Cape Community College, n.d., Library, tutoring and academic support services. https://catalog.atlanticcape.edu/library-tutoring-and-academic-support-services-0 [9]. The University of the West Indies, n.d., Research assistance. https://www.mona.uwi.edu/library/research-assistance [10]. Van Wagenen Library, 2024, April 29, Information literacy: Instruction sessions. https://libraryguides.cobleskill.edu/InfoLit/instruction [11]. Harvard Library, n.d., Research consultations. https://library.harvard.edu/services-tools/research-consultations [12]. Metro State University Library, n.d., Library classes. https://library.metrostate.edu/classes/ [13]. The University of Alaska Fairbanks, 2024, January 24. About reference services. https://library.uaf.edu/instruction/readings/reference [14]. Greater Western Library Alliance, 2017, The impact of information literacy instruction on student success: A multi-institutional investigation and analysis. https://www.arl.org/wp-content/uploads/2018/10/The_Impact_of_Information_Literacy_Instruction_on_Student_Success_October_2017.pdf [15]. Bowles-Terry, M., 2012, Library instruction and academic success: a mixed-methods assessment of a library instruction program. Evidence Based Library and Information Practice 2012, 7(1), 82-95. [16]. Carvalho e Rodrigues, M., & Mandrekar, B., 2020, Impact of academic library services on students success and performance. Library Philosophy and Practice (e-journal). https://digitalcommons.unl.edu/libphilprac/4246 [17]. Zhong, Y., & Alexander, J., 2007, March 29-April 1, Academic success: How library services make a difference. ACRL Thirteenth National Conference, Baltimore, Maryland. https://alair.ala.org/server/api/core/bitstreams/13dcf028-fdac-4a3d-bd49-e1a1067decf4/content [18]. Cook, J. M., 2014, A library credit course and student success rates: a longitudinal study. College & Research Libraries, 75(3), 272-283. [19]. Bradley, D. R., Oehrli, A., Rieh, S. Y., Hanley, E., & Matzke, B. S., 2020, Advancing the reference narrative: Assessing student learning in research consultations. https://journals.library.ualberta.ca/eblip/index.php/EBLIP/article/download/29634/22142 [20]. Watts, J., & Mahfood, S., 2015, Collaborating with faculty to assess research consultations for graduate students. Behavioral & Social Sciences Librarian, 34(2), 70–87. [21]. Mowreader, A., 2023, July 20, Lack of awareness causes students to fall through the cracks. Inside Higher Ed. ttps://www.insidehighered.com/news/student-success/college-experience/2023/07/20/survey-college-students-dont-know-about-support [22]. Mensah, V., & Afful-Arthur, P., 2019, Knowledge and accessibility of library resources and support services by distance learners: a study of University of Cape Coast Library. International Journal of Information Studies & Libraries, 4(2), 37-45. [23]. Makibinyane, J. M., & Khumalo, S. S., 2021, Exploring factors that impede student support services and throughput rate: the case of TVET colleges in South Africa. International Journal of Education Economics and Development, 12(4), 397-411. [24]. Hickey, G., McGilloway, S., O'Brien, M., Leckey, Y., Devlin, M., & Donnelly, M., 2018, Strengthening stakeholder buy-in and engagement for successful exploration and installation: a case study of the development of an area-wide, evidence-based prevention and early intervention strategy. Children and Youth Services Review, 91, 185-195. [25]. Zvirikuzhe, W., 2023, August 7, 5 Keys to remember when starting a new department. LinkedIn. https://www.linkedin.com/pulse/5-keys-remember-when-starting-new-department-winston-zvirikuzhe [26]. Jansen, D., & Warren, K., 2020, What (exactly) is research methodology? GradCoach. https://gradcoach.com/what-is-research-methodology/ [27]. Khanday, S. A., & Khanam, D., 2019, The research design. Journal of Critical Reviews, 6(3), 367-376. [28]. Jain, Y., 2024, March 8, 5 Types of research design – Elements, needs and characteristics. Emeritus. https://emeritus.org/in/learn/types-of-research-design/ [29]. Ary, D., Jacobs, L. C., Sorenson, C., & Razavieh, A, 2010, Introduction to Research in Education 8th ed (Belmont, CA: Wadsworth Cengage Learning). [30]. Colorado State University, 2004, An introduction to content analysis. http://www.umsl.edu/~wilmarthp/mrpc-web-resources/content-analysis.pdf [31]. Creswell, J. W., & Creswell, J. D., 2018, Research Design: Qualitative, Quantitative and Mixed Methods Approaches 5th ed (Sage Publications). [32]. Ida, L., 2016, Influence of library services on students’ academic performance in an ordinary certificate of secondary education examination in Mtwara Mikindani Municipality, Tanzania [dissertation]. University of Tanzania. http://repository.out.ac.tz/1822/1/DISSERTATION_-_LEO_IDA_FINAL.pdf [33]. Creswell, J., 2012, Educational Research: Planning, Conducting and Evaluating Quantitative and Qualitative Research, 4th ed (Pearson Education). [34]. Creswell, J., 2013, Qualitative Inquiry and Research Design: Choosing Among Five Approaches 3rd ed (Los Angeles: SAGE). [35]. Fleming, J., & Zegwaard, K. E., 2018, Methodologies, methods and ethical considerations for conducting research in work-integrated learning. International Journal of Work-Integrated Learning, 19(3), 205-213. [36]. University of Limerick Library, n.d., Library classes for your students. https://www.ul.ie/library/supporting-you/supporting-teaching/library-classes-for-your-students [37]. University of Massachusetts Global Library, 2024, January 22, Library 101 Curriculum. https://umassglobal.libguides.com/Library101 [38]. Singapore Management University, 2020, Job description. https://library.smu.edu.sg/sites/library.smu.edu.sg/files/library/pdf/CareerAd/JD_RL%20Law_15Jul2020.pdf [39]. University Library, Portland State University, n.d., Research and Instruction Librarian/Instructor. https://library.pdx.edu/wp-content/uploads/Job-Posting-Research-Instruction-Librarian.pdf [40]. 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					The Role of Psychological Safety in High-Performing Teams: A Principal’s PerspectiveAuthor: Renita Crandon DuncanDOI: 10.21522/TIJAR.2014.12.04.Art004The Role of Psychological Safety in High-Performing Teams: A Principal’s PerspectiveAbstract:Psychological safety – a shared belief that the team environment is safe for interpersonal risk-taking – has emerged as a pivotal factor in team success. High-performing teams often distinguish themselves not only by skill and talent, but by an atmosphere of trust and openness where members feel safe to voice ideas and concerns. This study examines how psychological safety contributes to the effectiveness of high-performing teams in organizations. It builds on literature and empirical findings to understand the mechanisms through which psychological safety enhances team communication, learning, innovation, and overall performance. Teams with high psychological safety show significantly better communication, more learning behaviors, greater innovation, and improved performance outcomes than teams with low psychological safety. Psychological safety facilitates open discussion of errors and ideas, leading to more effective decision-making and problem-solving. Empirical evidence indicates positive correlations between psychological safety and team performance, engagement, and well-being: for example, companies high in psychological safety report 50% higher productivity and 76% more employee engagement on average. The findings suggest that psychological safety is a foundational element of high-performing teams, enabling interpersonal risk-taking, collaborative learning, and resilience. Key antecedents include inclusive leadership and a trustful, no-blame culture, which together create conditions for psychological safety to flourish. Practical implications are discussed for leaders aiming to build psychologically safe and high-performing teams. Psychological safety plays a critical role in team effectiveness by fostering an environment where members can speak up, innovate, and learn without fear. Organizations that cultivate psychological safety are better positioned to achieve sustained high performance. The Role of Psychological Safety in High-Performing Teams: A Principal’s PerspectiveReferences:[1]. Bradley, B. H., Postlethwaite, B. E., Klotz, A. C., Hamdani, M. R., & Brown, K. G., 2012, Reaping the benefits of task conflict in teams: The critical role of psychological safety and team efficacy. Journal of Applied Psychology, 97(1), 151–158. Doi:10.1037/a0024200. [2]. Carmeli, A., Reiter-Palmon, R., & Ziv, E., 2010, Inclusive leadership and employee involvement in creative tasks in the workplace: The mediating role of psychological safety. Creativity Research Journal, 22(3), 250–260. Doi:10.1080/10400419.2010.504654. [3]. Castro, S., Englmaier, F., & Guadalupe, M., 2022, Fostering Psychological Safety in Teams: Evidence from an RCT. SSRN Working Paper (Posted July 2022). Available at SSRN: http://dx.doi.org/10.2139/ssrn.4141538 [4]. Delizonna, L., 2017, August 24, High-Performing Teams Need Psychological Safety: Here’s How to Create It. Harvard Business Review. Retrieved from https://hbr.org/2017/08/high-performing-teams-need-psychological-safety-heres-how-to-create-it [5]. Duhigg, C., 2016, February 25, What Google Learned from Its Quest to Build the Perfect Team. The New York Times Magazine. Retrieved from https://www.nytimes.com/2016/02/28/magazine/what-google-learned-from-its-quest-to-build-the-perfect-team.html [6]. Edmondson, A., 1999, Psychological safety and learning behavior in work teams. Administrative Science Quarterly, 44(2), 350–383. Doi:10.2307/2666999. [7]. Edmondson, A. C., 2019, The fearless organization: Creating psychological safety in the workplace for learning, innovation, and growth. John Wiley & Sons. [8]. Edmondson, A. C., & Lei, Z., 2014, Psychological safety: The history, renaissance, and future of an interpersonal construct. Annual Review of Organizational Psychology and Organizational Behavior, 1(1), 23–43. Doi:10.1146/annurev-orgpsych-031413-091305. [9]. Frazier, M. L., Fainshmidt, S., Klinger, R. L., Pezeshkan, A., & Vracheva, V., 2017, Psychological safety: A meta-analytic review and extension. Personnel Psychology, 70(1), 113–165. Doi:10.1111/peps.12183. [10]. Hallam, K. T., Popovic, N., & Karimi, L., 2023, Identifying the Key Elements of Psychologically Safe Workplaces in Healthcare Settings. Brain Sciences, 13(10), 1450. Doi:10.3390/brainsci13101450. [11]. Ip, E., Srivastava, R., Lentz, L., Jasinoski, S., & Anderson, G. S., 2025, Antecedents of Workplace Psychological Safety in Public Safety and Frontline Healthcare: A Scoping Review. International Journal of Environmental Research and Public Health, 22(6), 820. Doi:10.3390/ijerph22060820. [12]. Jin, H., & Peng, Y., 2024, The impact of team psychological safety on employee innovative performance: A study with communication behavior as a mediator variable. PLoS ONE, 19(10), e0306629. Doi:10.1371/journal.pone.0306629. [13]. Kahn, W. A., 1990, Psychological conditions of personal engagement and disengagement at work. Academy of Management Journal, 33(4), 692–724. Doi:10.2307/256287. [14]. McKinsey & Company., 2022, What is psychological safety? McKinsey Explainers. Retrieved from McKinsey.com. [15]. Nembhard, I. M., & Edmondson, A. C., 2006, Making it safe: The effects of leader inclusiveness and professional status on psychological safety and improvement efforts in health care teams. Journal of Organizational Behavior, 27(7), 941–966. Doi:10.1002/job.413. [16]. Newman, A., Donohue, R., & Eva, N., 2017, Psychological safety: A systematic review of the literature. Human Resource Management Review, 27(3), 521–535. Doi:10.1016/j.hrmr.2017.01.001. [17]. Patil, R., Raheja, D. K., Nair, L., Deshpande, A., & Mittal, A., 2023, The Power of Psychological Safety: Investigating its Impact on Team Learning, Team Efficacy, and Team Productivity. The Open Psychology Journal, 16(1), Article e187435012307090. Doi:10.2174/18743501-v16-230727-2023-36. [18]. Taylor, K., 2024, February 18, What does psychological safety mean, anyway? Atlassian Teamwork Blog. Retrieved from https://www.atlassian.com/blog/teamwork/what-does-psychological-safety-mean-anyway [19]. Timothy R. Clark., 2020, The 4 Stages of Psychological Safety: Defining the Path to Inclusion and Innovation. Berrett-Koehler Publishers. (Discusses a framework for developing psychological safety in teams and organizations). Viewed PDF 5 0 
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					Predicting Malaria Incidence in Guinea: A Real Time Machine Learning ToolAuthor: Gerard Christian KuotuDOI: 10.21522/TIJAR.2014.12.04.Art005Predicting Malaria Incidence in Guinea: A Real Time Machine Learning ToolAbstract:Malaria remains a pressing public health issue in Guinea, with approximately 13 million individuals at risk of contracting the disease. Despite efforts to reduce malaria incidence, it remains the leading cause of consultations, hospitalizations, and deaths in the country. To address this challenge, machine learning (ML) techniques have gained traction in epidemiology for predicting disease outbreaks and identifying high-risk areas. During this internship, we aim to use ensemble learning algorithms to develop a predictive model for malaria incidence in Guinea. Our methodology involved data integration, feature engineering, and model training using various ML algorithms, such as logistic regression, random forest, decision tree, support vector machine, gradient boosting machine, artificial neural network and ensemble stacking leveraging diverse datasets, including clinical records, demographic health surveys, and climatic data spanning six years from 2018 to 2023. We evaluated model performance using the F1-score metric. We found that the ensemble stacking method, particularly balanced stacking, demonstrated superior predictive accuracy (F1-score = 0.74). This highlights the importance of interdisciplinary collaboration and data integration in epidemiological research, as well as the potential of ML in informing targeted interventions and resource allocation strategies for malaria control. Challenges such as multicollinearity and imbalanced datasets were addressed through robust statistical techniques and model tuning. This research underscores the significance of translating research findings into actionable insights for malaria control efforts in Guinea. By harnessing the power of ML and deploying user-friendly tools, public health authorities can make informed decisions to mitigate the burden of malaria and improve health outcomes for affected populations. Predicting Malaria Incidence in Guinea: A Real Time Machine Learning ToolReferences:[1]. President’s Malaria Initiative (PMI). 2023, Guinea Malaria Operational Plan FY 2023. https://d1u4sg1s9ptc4z.cloudfront.net/uploads/2023/01/FY-2023-Guinea-MOP.pdf [2]. World Health Organization (WHO). 2020, Malaria in the African Region. https://www.afro.who.int/health-topics/malaria [3]. Hamilton, A. J., Strauss, A. T., Martinez, D. A., et al., 2021, Machine learning and artificial intelligence: Applications in healthcare epidemiology. Antimicrobial Stewardship & Healthcare Epidemiology, 1(1), e28. https://doi.org/10.1017/ash.2021.191 [4]. Harvey, D., Valkenburg, W., & Amara, A., 2021, Predicting malaria epidemics in Burkina Faso with machine learning. PLOS ONE, 16(6), e0253302. https://doi.org/10.1371/journal.pone.0253302 [5]. Ji, C., Zou, X., Hu, Y., et al., 2019, XG-SF: An XGBoost classifier based on shapelet features for time series classification. Procedia Computer Science, 147, 24–28. https://doi.org/10.1016/j.procs.2019.01.087 [6]. Huang, J., & Ling, C. X., 2005, Using AUC and accuracy in evaluating learning algorithms. IEEE Transactions on Knowledge and Data Engineering, 17(3), 299–310. https://doi.org/10.1109/TKDE.2005.50 [7]. Kalipe, G., Gautham, V., & Behera, R. K., 2018, Predicting malarial outbreak using machine learning and deep learning approach: A review and analysis. In 2018 International Conference on Information Technology (ICIT) (pp. 33–38). IEEE. https://doi.org/10.1109/ICIT.2018.00017 [8]. Yaa, E. A., Quaye, I. K., Osei, P. P., et al., 2021, Malaria prediction model using machine learning algorithms. Turkish Journal of Computer and Mathematics Education (TURCOMAT), 12(11), 7488–7496. [9]. Nkiruka, O., Prasad, R., & Clement, O., 2021, Prediction of malaria incidence using climate variability and machine learning. Informatics in Medicine Unlocked, 22, 100508. https://doi.org/10.1016/j.imu.2020.100508 [10]. Kim, Y., Ratnam, J. V., Doi, T., et al., 2019, Malaria predictions based on seasonal climate forecasts in South Africa: A time series distributed lag nonlinear model. Scientific Reports, 9, 17882. https://doi.org/10.1038/s41598-019-54250-3 [11]. Higuchi, D., 2014, Characteristics of coping strategies for dysesthesia in preoperative patients with compressive cervical myelopathy. Asian Spine Journal, 8(4), 393–400. https://doi.org/10.4184/asj.2014.8.4.393 [12]. Castro, M. C., 2017, Malaria transmission and prospects for malaria eradication: The role of the environment. Cold Spring Harbor Perspectives in Medicine, 7(9), a025601. https://doi.org/10.1101/cshperspect.a025601 [13]. El-Hasnony, I. M., Elzeki, O. M., Alshehri, A., et al., 2022, Multi-label active learning-based machine learning model for heart disease prediction. Sensors, 22(4), 1184. https://doi.org/10.3390/s22031184 [14]. World Health Organization (WHO). 2017, A framework for malaria elimination. https://iris.who.int/handle/10665/254761 [15]. Weiss, D. J., Lucas, T. C. D., Nguyen, M., et al., 2019, Mapping the global prevalence, incidence, and mortality of Plasmodium falciparum, 2000–17: A spatial and temporal modelling study. The Lancet, 394(10195), 322–331. https://doi.org/10.1016/S0140-6736(19)31097-9 [16]. Garske, T., Ferguson, N. M., & Ghani, A. C., 2013, Estimating air temperature and its influence on malaria transmission across Africa. PLoS ONE, 8(2), e56487. https://doi.org/10.1371/journal.pone.0056487 [17]. Bhatt, S., Weiss, D. J., Cameron, E., et al., 2015, The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. Nature, 526(7572), 207–211. https://doi.org/10.1038/nature15535 [18]. Karuri, M. K., & Snow, R. W., 2016, Forecasting malaria burden in Africa using satellite meteorological data. Frontiers in Public Health, 4, 112. https://doi.org/10.3389/fpubh.2016.00112 [19]. Bousema, T., Griffin, J. T., Sauerwein, R. W., et al., 2012, Hitting hotspots: Spatial targeting of malaria for control and elimination. PLoS Medicine, 9(1), e1001165. https://doi.org/10.1371/journal.pmed.1001165 [20]. Reiner, R. C., Perkins, T. A., Barker, C. M., et al., 2015, A systematic review of mathematical models of mosquito-borne pathogen transmission: 1970–2010. Journal of the Royal Society Interface, 12(106), 20140921. https://doi.org/10.1098/rsif.2014.0921 [21]. Chang, H. H., Davis, G. M., & Waller, L. A., 2014, Mining spatio-temporal data on malaria for exploratory analysis and model building. International Journal of Health Geographics, 13(1), 31. https://doi.org/10.1186/1476-072X-13-31 [22]. Sturrock, H. J. W., Hsiang, M. S., Cohen, J. M., et al., 2013, Targeting asymptomatic malaria infections: Active surveillance in control and elimination. PLoS Medicine, 10(6), e1001467. https://doi.org/10.1371/journal.pmed.1001467 [23]. Snow, R. W., & Marsh, K., 2002, The consequences of reducing Plasmodium falciparum transmission in Africa. Advances in Parasitology, 52, 235–264. https://doi.org/10.1016/S0065-308X(02)52005-X [24]. Omumbo, J. A., Hay, S. I., Goetz, S. J., et al., 2002, Updating historical maps of malaria transmission intensity in East Africa using remote sensing. Photogrammetric Engineering & Remote Sensing, 68(2), 161–166. [25]. Osei, P., Frempong, G. A., & Nettey, O. E. A., 2020, Spatial analysis of malaria incidence and associated risk factors in Ghana. Geospatial Health, 15(1), 13–22. https://doi.org/10.4081/gh.2020.859 [26]. LeCun, Y., Bengio, Y., & Hinton, G., 2015, Deep learning. Nature, 521(7553), 436–444. https://doi.org/10.1038/nature14539 [27]. Müller, A. C., & Guido, S., 2016, Introduction to machine learning with Python: A guide for data scientists. O’Reilly Media. Viewed PDF 5 0 
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					Understanding the Literacy Gap Between Boys and Girls: Perceptions of Teachers, Parents, Students, and Other StakeholdersAuthor: Julette Shaw-WilliamsDOI: 10.21522/TIJAR.2014.12.04.Art006Understanding the Literacy Gap Between Boys and Girls: Perceptions of Teachers, Parents, Students, and Other StakeholdersAbstract:The persistent literacy gap between boys and girls continues to be a significant concern in education, with girls generally outperforming boys in reading and writing across various grade levels and regions. The causes of this disparity are multifaceted, shaped by social, cultural, and educational factors that influence students’ literacy development. While existing studies highlight statistical trends and propose broad strategies for improving literacy outcomes, limited attention has been given to the perspectives of stakeholders directly involved in supporting learning. Understanding the viewpoints of teachers, parents, students, and policymakers is essential to identifying underlying barriers and designing effective, targeted interventions. Teachers provide valuable insights into how instructional methods, classroom dynamics, and curriculum design affect literacy performance. Parents play a central role by influencing literacy development through their expectations, attitudes, and involvement in home-based learning. Students’ motivation, self-perception, and societal influence further shape their willingness and ability to engage with literacy tasks. Policymakers, however, must address the long-term implications of literacy disparities for educational equity, academic achievement, and future career opportunities. The COVID-19 pandemic exacerbated these challenges, as school closures and remote learning disproportionately affected students by gender due to unequal access to digital tools and heightened domestic responsibilities. Furthermore, the widening digital divide has limited opportunities for students to acquire essential digital literacy skills necessary for academic and professional success. By exploring stakeholders’ perspectives, this study aims to provide a more comprehensive understanding of the factors contributing to gender-based literacy disparities and inform the development of more effective, equitable educational strategies. Understanding the Literacy Gap Between Boys and Girls: Perceptions of Teachers, Parents, Students, and Other StakeholdersReferences:[1]. Alloway, N., Freebody, P., Gilbert, P., & Muspratt, S., 2023. Boys, literacy and schooling: Expanding the repertoires of practice. Routledge. https://doi.org/10.4324/9780203464943 [2]. Arnot, M., 2014. The Gendered Construction of Literacy and Learning: Gender, Inequality, and the Education of Boys and Girls. Springer. [3]. Bailey, B., 2017. Gender socialization and education: Challenges and solutions. Kingston, Jamaica: University of the West Press. [4]. Baker, D. P., & LeTendre, G. K., 2014. National differences, global similarities: World culture and the future of schooling. Stanford University Press. [5]. Baker, L., & Scher, D., 2023. Beginning readers’ motivation for reading in relation to parental beliefs and home literacy experiences. Reading Psychology, 24(4), 297–316. https://doi.org/10.1080/02702710390 227297. [6]. Braun, V., & Clarke, V., 2021. Thematic analysis: A practical guide. SAGE Publications. [7]. Brown, C., 2019. The impact of literacy interventions on primary school boys in Jamaica. Caribbean Journal of Education, 41(2), 120–135. [8]. Creswell, J. W., 2014. Research design: Qualitative, quantitative, and mixed methods approaches (4th ed.). SAGE Publications. [9]. Dillon, D. R., & Brown, M., 2019. Boys, reading, and masculinity: Toward a theory of boyhood literacy. Routledge. [10]. European Investment Bank. 2020. Gender digital divide: The hidden barrier to gender equality in education. https://www.eib.org/en/essays/gender-digital-divide. [11]. Evans, M., 2018. Classroom strategies for engaging boys in literacy development. Educational Research Quarterly, 41(3), 56–72. [12]. Farrington, C. A., 2012. Improving literacy skills: Understanding the gender gap and its implications for education. Journal of Educational Psychology, 104(3), 612–624. https://doi.org/10.1037/a0029009 [13]. Ferguson, P., 2021. Masculinity and academic achievement: A study of Caribbean boys. Caribbean Educational Review, 45(1), 88–102. [14]. Fletcher, J., Greenwood, J., Grimley, M., & Parkhill, F., 2023. Boys and reading: An inquiry into the attitudes of boys and teachers. Literacy, 45(1), 31–40. https://doi.org/10.1111/j.1741-4369.2010.00556.x. [15]. Gurian, M., & Stevens, K., 2010. The minds of boys: Saving our sons from falling behind in school and life. Jossey-Bass. [16]. Hargreaves, E., Ladd, F., & Goldstein, H., 2008. How parent involvement affects student achievement: A comprehensive review. Educational Psychology, 28(1), 75–90. https://doi.org/10.1080/01443410701, 851400. [17]. Hughes, D., Hargreaves, E., & Kaye, S., 2013. Parental engagement in literacy education: The role of gender and socioeconomic factors. Journal of Educational Psychology, 35(4), 453–467. https://doi.org/10.1037/edu0000017 [18]. James, T., & Miller, S., 2020. Parental influence on boys' reading habits in primary schools. Journal of Caribbean Education Studies, 38(4), 200–215. [19]. Jerrim, J., & Sims, S., 2022. How do teacher expectations and biases influence gender gaps in literacy? Educational Research Review, 37, 100468. https://doi.org/10.1016/j.edurev.2022.100468. [20]. Johnson, R. B., & Onwuegbuzie, A. J., 2004. Mixed methods research: A research paradigm whose time has come. Educational Researcher, 33(7), 14–26. https://doi.org/10.3102/0013189X03 3007014. [21]. Jones, E., & McCauley, M., 2013. Gender differences in literacy engagement: Exploring the reading habits of boys and girls. Literacy Research and Instruction, 52(2), 135–155. https://doi.org/10.1080/19388071.20 12.749194. [22]. Krywult-Albanska, E., & Albanski, M., 2021. The impact of COVID-19 on gender disparities in education. Journal of Educational Policy, 37(4), 401–418. https://doi.org/10.1080/02680939.2021.1901423 [23]. McGeown, S. P., Goodwin, H., Henderson, N., & Wright, P., 2022. Gender differences in reading motivation: Does sex or gender identity provide a better account? Journal of Research in Reading, 35(3), 256–272. https://doi.org/10.1111/j.1467- 9817.2012.01524.x. [24]. Miller, D., Juvonen, J., & Emslie, J., 2020. The effects of gender-responsive teaching on literacy outcomes. Journal of Educational Psychology, 112(2), 230–245. https://doi.org/10.1037/edu000399 [25]. Ministry of Education, Youth, and Information. 2022. Annual report on literacy development in Jamaica. Kingston, Jamaica: Government of Jamaica. [26]. Moss, G. 2020. Literacy and gender: Researching texts, contexts and readers. Routledge. https://doi.org/10.4324/97802034550 33. [27]. Mullis, I. V. S., Martin, M. O., Foy, P., & Hooper, M., 2020. PIRLS 2021: Design and methodology. TIMSS & PIRLS International Study Center. [28]. OECD. 2021. Education at a glance 2021: OECD indicators. OECD Publishing. https://doi.org/10.1787/4dd50c09-en [29]. OECD. 2021. PISA 2018 results: Volume I: What students know and can do. OECD Publishing. https://doi.org/10.1787/5f07c754-en [30]. Paechter, C., 2015. Masculinity, femininity and educational change: The role of gender in educational reform. Routledge. [31]. Pajares, F., & Valiante, G. 2022. Gender differences in writing motivation and achievement of middle school students: A function of gender orientation? Contemporary Educational Psychology, 26(3), 366–381. https://doi.org/10.1006/ceps.2000.1069 [32]. Parry, O., 2000. Male underachievement in education: A Caribbean perspective. Mona, Jamaica: University of the West Indies Press. [33]. Pomerantz, E. M., Moorman, E. A., & Litwack, S. D., 2007. The how, who, and why of parents' involvement in children's academic lives: More is not always better. Child Development, 78(3), 828–845. https://doi.org/10.1111/j.1467-8624.2007.01035.x [34]. Robinson, J. P., & Lubienski, S. T., 2023. The effects of gender stereotypes on boys’ and girls’ reading performance. American Educational Research Journal, 50(1), 168–200. https://doi.org/10.3102/00028312124 69045. [35]. Sadker, D., & Sadker, M., 2020. Failing at fairness: How America’s schools cheat girls. Touchstone. [36]. Sax, L. 2021. Why gender matters: What parents and teachers need to know about the emerging science of sex differences. Harmony. [37]. Snowling, M. J., Hulme, C., & Nation, K., 2021. Defining and understanding dyslexia: Past, present and future. Journal of Child Psychology and Psychiatry, 61(5), 546–568. https://doi.org/10.1111/jcpp.13212 [38]. Sullivan, A., & Brown, M., 2023. Social inequalities in early reading development: The role of behavior problems. Child Development, 84(6), 1880–1896. https://doi.org/10.1111/cdev.12087 [39]. Tashakkori, A., & Teddlie, C., 2003. Handbook of mixed methods in social and behavioral research. SAGE Publications. [40]. U.S. Department of Education. 2019. The nation’s report card: Reading and writing assessments. Washington, DC: National Center for Education Statistics. Viewed PDF 6 0 
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					Community Participation and Strategic Frameworks for Advancing Health Insurance Coverage in Katsina StateAuthor: Umar Aminu ImamDOI: 10.21522/TIJAR.2014.12.04.Art007Community Participation and Strategic Frameworks for Advancing Health Insurance Coverage in Katsina StateAbstract:Universal Health Coverage (UHC) remains elusive in Nigeria, particularly in Katsina State, where less than 10% of the population has health insurance and 70% pay for care out-of-pocket amidst deep poverty. This paper examines how community participation and strategic policy frameworks can expand insurance coverage, focusing on Community-Based Health Insurance (CBHI) as a potential vehicle. Employing a qualitative case study design, this research draws on Focus Group Discussions with community leaders, residents, and health officials across four diverse communities in Katsina State to explore local perceptions and barriers. The findings reveal that while significant challenges—including low awareness, deep-seated mistrust in formal institutions, and concerns over premium affordability—hinder uptake, there is a strong willingness to pay for CBHI. However, this is contingent on transparent, community-led management and the availability of pro-poor subsidies. Based on these results, the study proposes a multi-faceted strategy centered on intensive public awareness, subsidized premiums for low-income residents, strengthening the Katsina State Contributory Healthcare Management Agency (KATSCHMA), and genuine community involvement in the design and governance of insurance plans to build trust and ensure sustainability. Community Participation and Strategic Frameworks for Advancing Health Insurance Coverage in Katsina StateReferences:[1]. Bashar, J. M., Onoja, P. A., Nduka, F. O., et al., 2025, Charting the path to the implementation of universal health coverage policy in Nigeria through the lens of Delphi methodology. BMC Health Services Research, 25:45. https://doi.org/10.1186/s12913-024-12201-7 [2]. Eze, O. I., Iseolorunkanmi, A., Adeloye, D., 2024, The National Health Insurance Scheme (NHIS) in Nigeria: current issues and implementation challenges. Journal of Global Health Economics and Policy, 4:e2024002. https://doi.org/10.52872/001c.120197 [3]. Abubakar, I., Dalglish, S. L., Angell, B., Sanuade, O., Abimbola, S., et al., 2022, The Lancet Nigeria Commission: investing in health and the future of the nation. Lancet, 399(10330):1155–1200. https://doi.org/10.1016/S0140-6736(21)02488-0 [4]. Ojielo, N. C., Etiaba, E., Onwujekwe, O., 2024, To what extent do community members participate in planning, implementing health programs within their communities and what are the benefits of their participation in Nigeria? International Journal of Community Medicine and Public Health, 11(7). https://doi.org/10.18203/2394-6040.ijcmph20241804 [5]. Odeyemi, I. A., 2014, Community-based health insurance programmes and the National Health Insurance Scheme of Nigeria: challenges to uptake and integration. International Journal for Equity in Health, 13:20. https://doi.org/10.1186/1475-9276-13-20 [6]. World Health Organization., 2025, Community-Based Health Insurance (CBHI) Fact Sheet (31 March 2025). WHO Newsroom. [7]. News Agency of Nigeria., 2024, Dec. 16, NHIA: Nigeria exceeds 2024 health insurance target, hits 95% of 2027 goal. The Gazette (Abuja). https://gazettengr.com/nhia-nigeria-exceeds-2024-health-insurance-target [8]. Oluedo, E. M., Obikeze, E., Nwankwo, C., Okonronkwo, I., 2023, Willingness to enroll and pay for community-based health insurance among rural households in Enugu State, Southeast Nigeria. Nigerian Journal of Clinical Practice, 26(7):908–920. https://doi.org/10.4103/njcp.njcp_612_22 [9]. Lawal, A., Gobir, A. A., Aliyu, A., Sufiyan, M. B., 2020, Community-based health insurance scheme in a rural community of north-west Nigeria: a roadmap to achieving universal health coverage. Kanem Journal of Medical Sciences, 14(2):124–130. https://doi.org/10.36020/kjms.2020.1402.004 [10]. Katsina State Government., 2024, Inclusive Economic Policy 2024–2034. Directorate of Economic Planning, Katsina State. https://katsinastate.gov.ng/wp-content/uploads/2024/12/Katsina-State-Inclusive-Economy-Policy-2.pdf [11]. Federal Ministry of Health (Nigeria)., 2017, Second National Strategic Health Development Plan (NSHDP II) 2018–2022. Abuja: Federal MOH. [12]. Yahaya, S. S., Mustapha, M., Lawal, N., Runka, J. Y., 2022, Knowledge of community-based health insurance among residents of Katsina State, Nigeria: a comparative cross-sectional study. Texila International Journal of Academic Research – Special Edition. [13]. Suleiman, Y. S., Mustapha, M., Lawal, N., Runka, J. Y., 2022, Utilization of community-based health insurance among residents of Katsina State, Nigeria: a comparative cross-sectional descriptive study. Texila International Journal of Public Health, 10(4). [14]. National Bureau of Statistics & UNICEF., 2017, Nigeria Multiple Indicator Cluster Survey 2016–17. Abuja: NBS/UNICEF. [15]. World Bank., 2023, World Development Indicators: Nigeria. [16]. WHO & World Bank., 2015, Tracking Universal Health Coverage: First Global Monitoring Report. Geneva: WHO. [17]. Adinma, E. D., Adinma, J. I., 2010, Community-based healthcare financing: An untapped option to more effective healthcare funding in Nigeria. Nigerian Medical Journal, 51(3):95–100. [18]. Onwujekwe, O. E., et al., 2010, Willingness to pay for CBHI in Nigeria: Do economic status and location matter? Health Policy and Planning, 25(2):155–161. https://doi.org/10.1093/heapol/czp046 [19]. Ekman, B., 2004, CBHI in low-income countries: contribution to health financing performance. Tropical Medicine & International Health, 9(8):799–811. [20]. Carrin, G., Waelkens M.P., Criel B., 2005, CBHI in developing countries: its contribution to health financing performance. Tropical Medicine & International Health, 10(5):799–811. Viewed PDF 6 0 
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					Challenges in Accessing NHIA Services among Formal and Informal Sector Workers in Kano, NigeriaAuthor: H M MijinyawaDOI: 10.21522/TIJAR.2014.12.04.Art008Challenges in Accessing NHIA Services among Formal and Informal Sector Workers in Kano, NigeriaAbstract:Nigeria’s National Health Insurance Authority (NHIA) aims to achieve universal health coverage (UHC), yet persistent inequities in access between formal and informal sector workers who constitute over 80% of the workforce remain poorly understood. The aim of this study is to compare challenges faced by formal and informal sector enrollees in accessing NHIA services in Kano, Nigeria, and identify systemic gaps to inform policy reforms. A cross-sectional comparative study of 440 NHIA enrollees (205 formal, 235 informal) across all 44 Local Government Areas in Kano State was conducted. Eligible participants were adults (≥18 years) enrolled for ≥6 months who had accessed care within the past 3 months. Data were collected via structured questionnaires and in-depth interviews. Primary outcomes included self-reported challenges in accessing NHIA services, analyzed by sector (formal/informal). Secondary outcomes included specific barriers (e.g., service codes, coverage limitations) and qualitative themes (e.g., operational delays). Chi-square tests assessed associations. Among 440 enrollees, 71.6% reported challenges, with informal sector workers disproportionately affected (87.7% vs 53.2%; χ²=64.03, P<0.001). Key barriers included difficulty obtaining service codes (38.0% informal, 41.4% formal), inadequate service coverage (9.6% vs 28.4%), poor customer service (12.2% vs 7.9%), and low awareness of benefits (14.6% vs 7.0%). Qualitative data highlighted operational inefficiencies (e.g., long wait times, unclear communication) as compounding factors. This study reveals significant disparities in NHIA access, with informal sector enrollees facing systemic barriers. Policy priorities should address administrative bottlenecks, expand service coverage, and strengthen community-based awareness campaigns to advance equitable UHC in Nigeria. Challenges in Accessing NHIA Services among Formal and Informal Sector Workers in Kano, NigeriaReferences:[1]. Okpani, A. I., Abimbola, S., 2015, Operationalizing universal health coverage in Nigeria through social health insurance. Nigerian Medical Journal, 56 (5), 305–310. [2]. Flannery, D., Garvey, J., Inyang, U., 2020, The financial protection of national health insurance: Evidence from a cross section of State and Federal workers in Akwa Ibom, Nigeria, 10(3). [3]. Okunogbe, A., Hähnle, J., Rotimi, B. F., Akande, M., T., Wendy, J., 2022, Short and longer-term impacts of health insurance on catastrophic health expenditures in Kwara State, Nigeria. BMC Health Services Research, 22 (1), 1-18. [4]. Adewole, D. A., Adebayo, A. M., Udeh, E. I., Shaahu, V. N., Dairo, M. D., 2015, Payment for health care and perception of the national health insurance scheme in a rural area in Southwest Nigeria American Journal of Tropical Medicine and Hygiene. American Journal of Tropical Medicine and Hygiene, 93(3), 648-654. [5]. Aregbeshola, B. S., Khan, S. M., 2018, Out-of-pocket payments, catastrophic health expenditure and poverty among households in Nigeria 2010. Int J Health Policy Manag, 7(9), 798–806. [6]. Amakom, U., Ezenekwe, U., 2012, Implications of households catastrophic out of pocket (OOP) healthcare spending in Nigeria. Journal of Research in Economics and International Finance (JREIF), 1(5), 136-140. [7]. Onwujekwe, O., Onoka, C., Uzochukwu, B., Hanson, K., 2011, Constraints to universal coverage: Inequities in health service use and expenditures for different health conditions and providers. International Journal for Equity in Health, 10(50), 1-9. [8]. Aregbeshola, B. S., Khan, S. M., 2018, Predictors of enrolment in the National Health Insurance Scheme among women of reproductive age in Nigeria. International Journal of Health Policy and Management, 7(11), 1015-1023. http://ijhpm.com Int J Health Policy Manag. 2018, 7(9), 798–806. [9]. Eteng, F. O., Ijim-Agbor, U., 2016, Understanding the challenges and prospects of administering the national health insurance scheme in Nigeria. International Journal of Humanities and Social Science Research, 2 (8), 43–48. [10]. Federal Republic of Nigeria, National Health Insurance Authority. Federal Republic of Nigeria Official Gazette, Act of 2022, No. 95, Government Notice No. 73, Vol. 109. [11]. Adewole, D. A., Osungbade, K. O., 2016, Nigeria National Health Insurance Scheme: A highly subsidized health care program for a privileged few. International Journal of Tropical Disease & Health, 19 (3), 1–11. [12]. Odonkor, S. N. N. T., Koranteng, F., Appiah-Danquah, M., Dini, L.,2023, Do national health insurance schemes guarantee financial risk protection in the drive towards Universal Health Coverage in West Africa? A systematic review of observational studies. PLOS Global Public Health, 3 (8). [13]. Osunde, R. N., Olurunfemi, O., Oduyemi, R. O., 2023, Awareness, willingness, and challenges of the informal sector towards state national health insurance services in Benin City, Nigeria. MGM J Med Sci, 10(30) 30-37. [14]. Omotosho, O., Ichoku, H. E., 2016, Distributional analysis of household health expenditure in Nigeria. Developing Country Studies, 6 (9), 111–120. [15]. Omotosho, O., Ichoku, H. E., 2016, Financial protection and universal health coverage in Nigeria. International Affairs and Global Strategy, 51, 5–14. [16]. Adewole, D. A., Dairo, M. D., Bolarinwa, O. A., 2016, Awareness and coverage of the National Health Insurance Scheme among formal sector workers in Ilorin, Nigeria. African Journal of Biomedical Research, 19 (1), 7–16. [17]. Akinyemi, O. O., Owopetu, O. F., Agbejule, I. O., 2021, National Health Insurance Scheme: Perception and participation of federal civil servants in Ibadan. Annals of Ibadan Postgraduate Medicine, 19 (1), 49–55. [18]. Alawode, G., Adewole, A., 2021, Assessment of the design and implementation challenges of the National Health Insurance Scheme in Nigeria: a qualitative study among sub-national level actors, healthcare and insurance providers. BMC Public Health, 21 (124). [19]. Bolarinwa, O. A., Afolayan, M. A., Rotimi, B. F., Alatishe-Mohammad, B., 2021, Are there evidence to support the informal sector's willingness to participate and pay for statewide health insurance scheme in Nigeria? Niger Postgrad Med J, 28, 71-3. [20]. Adewale, B., Adeneye, A. K., Ezeugwu, S. M. C., Afocha, E. E., Musa, A. Z., Enwuru, C. A., et.al., 2016, A preliminary study on enrollees perception and experiences of National Health Insurance Scheme in Lagos State, Nigeria. Int J Trop Dis Health, 18(3), 1–14. [21]. Daramola, O. E., Adeniran, A., Akande, T. M., 2018, Patients’ Satisfaction with the Quality of Services accessed under the National Health Insurance Scheme at a Tertiary Health Facility in FCT Abuja, Nigeria. Journal of Community Medicine and Primary Health Care, 30 (2), 90-97. [22]. Nwanaji-Enwerem, O., Bain, P., Marks, Z., Nwanaji-Enwerem, P., et.al. 2022, Patient satisfaction with the Nigerian National Health Insurance Scheme two decades since establishment: A systematic review and recommendations for improvement. African Journal of Primary Health Care and Family Medicine, 14, 1-10. [23]. Azuogu, B. N., Madubueze, U. C., Alo, C., Ogbonnaya, L. U., Ajayi, N. A., 2016, Level of awareness, and factors associated with willingness to participate in the National Health Insurance Scheme among traders in Abakaliki main market, Ebonyi State, Nigeria. African Journal of Medical and Health Sciences, 15(1), 18-23. [24]. Solanke, B. L., Yinusa, R. A., Oyeleye, O. J., Oluwatope, O. B., Ilesanmi, B. B., Oni, T. O., 2023, Using Andersen’s behavioral model of health care use for intermittent preventive treatment of malaria in pregnancy in Nigeria. BMC Pregnancy Childbirth, 23(332). [25]. Kumah, E., Asana, Y., Agyei, S. K., Kokuro, C., Ankomah, S. E., Fusheini, A., 2024, Does health insurance status influence healthcare-seeking behavior in rural communities? Evidence from rural Ghana. BMC Health Serv Rev, 24(655). [26]. Ainy, A., Pujiyanto, 2022, Determinant of health insurance enrollment for the informal sector in low and middle-income countries: A systematic review. Proceedings of the International Conference on Public Health, 7 (2), 37-52. [27]. von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., Vandenbroucke, J. P., 2007, STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med, 4(10). [28]. Lwanga, S. K., Lemeshow, S., 1991, Sample Size Determination in Health Studies: A Practical Manual. Geneva: World Health Organization. [29]. Magnani, R., 1997, Sampling guide. IMPACT Food Security and Nutrition Monitoring Project. Arlington, VA: International Science and Technology Institute. [30]. Umar, N., Mohammed, S., 2011, Insured persons’ dilemma about other family members: a perspective on the national health insurance scheme in Nigeria. J Public Health Afr. 22(2). [31]. Mohammed, S., Sambo, M. N., Dong, H., 2011, Understanding client satisfaction with a health insurance scheme in Nigeria: factors and enrollees’ experiences. Health Res Policy Syst, 9(20). [32]. Mohammed, S., Aji, B., Bermejo, J. L., Souares, A., Dong, H., Sauerborn, R., 2016, User experience with a health insurance coverage and benefit-package access: implications for policy implementation towards expansion in Nigeria. Health Policy Plan. 31(3), 346-355. [33]. Lawan, U. M., Iliyasu, Z., 2012, Challenges to the scale-up of the Nigerian National Health Insurance Scheme: Public knowledge and opinions in urban Kano, Nigeria. Ann Trop Med Public Health. 5(1), 6-11. [34]. Adewole, D. A., Akanbi, S. A., Osungbade, K. O., Bello, S., 2017, Expanding health insurance scheme in the informal sector in Nigeria: awareness as a potential demand-side tool. Pan Afr Med J, 27(52). [35]. Demilade, O. I., Olusegun, E. E., Tope, M. I., Stella, A., Eyitayo, E., Paul, O. A., 2012, Awareness and willingness to pay for community health scheme among rural households in Ekiti, Nigeria. Pacific Journal of Medical Sciences, 22(1), 37-50. [36]. Iliyasu, Z., Abubakar, I. S., Abubakar, S., Lawan, U. M., Gajida, A. U., 2010, Patients’ satisfaction with services obtained from Aminu Kano Teaching Hospital, Kano, Northern Nigeria. Nigerian Journal of Clinical Practice, 13(4), 371-378. [37]. Onyedibe, K. I., Goyit, M. G., Nnadi, N. E., An evaluation of the National Health Insurance Scheme (NHIS) in Jos, a north-central Nigerian city. Global Advanced Research Journal of Microbiology, 1(1), 5-12. [38]. Kofoworola, A. A., Ekiye, A., Motunrayo, A. O., Adeoye, A. T., Adunni, M. R., 2020, National Health Insurance Scheme: An assessment of service quality and clients’ dissatisfaction. Ethiop J Health Sci.30 (5), 795-802. [39]. Onasanya, A. A., 2020, Increasing health insurance enrolment in the informal economic sector. J Glob Health, 10(1). [40]. Barasa, E. W., Mwaura, N., Rogo, K., Andrawes, L., 2017, Extending voluntary health insurance to the informal sector: experiences and expectations of the informal sector in Kenya. Wellcome Open Research, 94 (1). Viewed PDF 5 0 
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					Exploring the Influence of Recognition on Employee Motivation at the Parliament Office of GuyanaAuthor: Carlleta K. CharlesDOI: 10.21522/TIJAR.2014.12.04.Art009Exploring the Influence of Recognition on Employee Motivation at the Parliament Office of GuyanaAbstract:This paper explores the influence of recognition on employee motivation at the Parliament Office of Guyana. In doing so, Maslow’s Hierarchy of Needs Theory and Herzberg’s Two-Factor Theory were examined. Both theories underscore the importance of recognition on motivation, fulfilling esteem needs and being a critical motivator. This paper also examines the resulting effects of recognition on motivation and performance of the employees of the Parliament Office of Guyana. To this end, 110 workers were surveyed with the use of questionnaire containing closed-ended questions. The findings were clear, revealing that 78% of the respondents agree that recognition influences motivation. The types of recognition discussed encapsulate verbal praise, written praise, and milestone recognition, which were the prominent ones selected by the respondents. In addition, recognition positively correlated with heightened performance, the use of greater initiative, and employee loyalty to the workplace. The findings of this research are in keeping with the major theories explained in this paper, further solidifying the importance of non-monetary recognition programmes in public sector institutions. In conclusion, the implementation of wholistic employee recognition programmes in the Parliament Office of Guyana has the capacity to make employees feel valued, motivating them and boosting their performance, which will redound to the benefit of the Parliament of Guyana and the Guyanese citizenry at large. Exploring the Influence of Recognition on Employee Motivation at the Parliament Office of GuyanaReferences:[1]. Brun, J., & Dugas, N., 2008, An analysis of employee recognition: Perspectives on human resources practices, The International Journal of Human Resource Management, 19(4), 716–730, Doi:10.1080/09585190801953723 [2]. Kerketta, V., & Chauhan, S., 2023, Impact of Reward and Recognition on Job Satisfaction and Motivation, IRE Journals, 6(12), 1245-1253, https://www.irejournals.com/formatedpaper/1704783.pdf [3]. Maslow, A., 1943, A theory of human motivation, Psychological Review, 50(4), 370–396, https://doi.org/10.1037/h0054346 [4]. Herzberg, F., Mausner, B., & Snyderman, B., 1959, The motivation to work (2nd ed.), John Wiley. [5]. McClelland, D., 1961, The Achieving Society. Princeton, NJ: Van Nostrand, https://gwern.net/doc/economics/1971-mcclelland-theachievingsociety.pdf [6]. Okon, M., John, N., & Imagha, O., 2023, Employee Well-Being: Recognition and Non-Academic Staff Performance in Select Federal Universities, South-South Geo-Political Zone, Nigeria, Global Journal of Human Resource Management, 11, 13-26. Doi: 10.37745/gjhrm.2013/vol11n11326 [7]. Robbins, S., & Judge, T., 2019, Organizational Behavior (18th ed.), Pearson. [8]. Yang, T., Jiang, X., & Cheng, H., 2022, Employee Recognition, Task Performance, and OCB: Mediated and Moderated by Pride, Sustainability, 14(3), 1631, https://doi.org/10.3390/su14031631 [9]. Adesina, I., & Egbuta, O., 2025, Strategic Reward and Recognition Systems: Driving Employee Engagement and Retention in Talent Management Practices, Journal of Economics, Finance and Management Studies, 8(5), Doi: 10.47191/jefms/v8-i5-18 [10]. Kubo, M., & Hori, M., 2023, Verbal appreciation and its effect on employee retention: Evidence from East Asia, International Journal of Human Resource Studies, 13(1), 88–105, https://doi.org/10.5296/ijhrs.v13i1.20835 [11]. Nguyen, T., Pham, H., & Le, D., 2023, Written and verbal recognition and psychological capital: A longitudinal analysis, Employee Relations International, 45(2), 301–316. https://doi.org/10.1108/ERI-12-2022-0475 [12]. Gallup, 2023, State of the Global Workplace: 2023 Report. https://www.gallup.com/workplace/349484/state-of-the-global-workplace.aspx [13]. Singh, S., Kaur, J., & Singh, D., 2022, Role of structured recognition in employee performance: Evidence from corporate practices, Journal of Human Resource and Sustainability Development, 10(1), 34–47, https://doi.org/10.4236/jhrss.2022.101003 [14]. Tan, Q., & Lee, H., 2023, Impact of employee of the month programs on organizational commitment: A longitudinal study, Asia Pacific Journal of Human Resources, 61(2), 155–173, https://doi.org/10.1111/1744-7941.12345 [15]. Ndungu, D., 2017, The Effects of Rewards and Recognition on Employee Performance in Public Educational Institutions: A Case of Kenyatta University, Kenya. Global Journal of Management and Business Research, 17(A1), 43–68, https://journalofbusiness.org/index.php/GJMBR/article/view/2183 [16]. Osabiya, B., 2015, The effect of employees’ motivation on organizational performance. Journal of Public Administration and Policy Research, 7(4), 62–75, https://academicjournals.org/journal/jpapr/article-full-text-pdf/721d2f153302 [17]. Grawitch, M., & Ballard, D., 2020, Building psychologically healthy workplaces: Recognition and the role of meaningfulness in engagement, Journal of Occupational Health Psychology, 25(4), 234–245. https://doi.org/10.1037/ocp0000174 [18]. Shinde, S., 2025, Peer-to-Peer Recognition Systems and Their Impact on Employee Commitment: A Case-Based Exploration of Culture, Motivation, and Retention, Research Review Journal of Social Science, 5(1), 58-68, Doi: 10.31305/rrjss.2025.v05.n01.007 [19]. Rusin, N., & Szandała, T., 2025, The power of peer recognition points: Does it really boost employee engagement?, Strategic HR Review, 24(1), 2–10, https://doi.org/10.1108/SHR-06-2024-0040 [20]. Black, P., Cecchini, M., & Newman, A., 2024, When being recognized makes employees feel less appreciated: Evidence regarding when and why peer-to-peer recognition could backfire. Accounting, Organizations and Society, 113, 101565, ISSN 0361-3682, https://doi.org/10.1016/j.aos.2024.101565 [21]. Ndiango, S., Gabriel, D., & Changalima, I., 2024, Give me my flowers before I die! Linking employee recognition, job satisfaction and employee retention in logistics companies: A multigroup analysis, Social Sciences & Humanities Open, 10, 101053, ISSN 2590-2911, https://doi.org/10.1016/j.ssaho.2024.101053 [22]. Arunraj, R., Murugesan, P., Pandi, V., & Sivasubramanian, S., 2024, Effects of Employee Recognition Programs on Engagement and Retention, Library Progress International, 44(3), 764-768, https://bpasjournals.com/library-science/index.php/journal/article/view/467/275 [23]. Ajila, C., & Abiola, A., 2004, Influence of rewards on workers performance in an organization, Journal of Social Sciences, 8(1), 7–12, Doi:10.1080/09718923.2004.11892397 [24]. Joseph, N., 2023, The Impact of Employee Recognition Programs on Employee Engagement and Motivation: A Case Study of Southwest Airlines. 1. https://www.researchgate.net/publication/370710004_The_Impact_of_Employee_Recognition_Programs_on_Employee_Engagement_and_Motivation_A_Case_Study_of_Southwest_Airlines [25]. Makwana, D., Engineer, P., Dabhi, A., & Chudasama, H., 2023, Sampling methods in research: A review. International Journal of Trend in Scientific Research and Development, 7(3), 762-768, www.ijtsrd.com [26]. Sukmawati, Sudarmin, & Salmia, 2023, Development of quality instruments and data collection techniques. Jurnal Pendidikan & Pengajaran Guru Sekolah Dasar, 6(1), 119-124, http://journal.unpak.ac.id/index.php/jppguseda Viewed PDF 6 0 
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					The Policy Divide: A Review of Botswana’s HRH Strategy Development and Implementation in the Context of the Global Strategy on HRH2030Author: Naledi Moipone MlaudziDOI: 10.21522/TIJAR.2014.12.04.Art010The Policy Divide: A Review of Botswana’s HRH Strategy Development and Implementation in the Context of the Global Strategy on HRH2030Abstract:Health systems across Africa carry the significant burden of disease globally, a situation exacerbated by a critical shortage of health workforce required to meet this demand. This study assessed Botswana’s Human Resource for Health HRH strategy, focusing on its development process, content, and implementation challenges within the context of the World Health Organization’s Global Strategy on Human Resource for Health: Workforce 2030. A qualitative research design was used, involving document analysis through the policy triangle framework and key-informants’ interviews. Thematic and content analysis were employed to interpret data from HRH strategic documents and 38 interviews with key stakeholders. The findings reveal that Botswana’s HRH strategies are largely aligned with the global strategy particularly objective 1 & 2, emphasizing workforce performance and investment alignment. However, the strategy development process, though inclusive on paper, often lacks effective stakeholder engagement and is constrained by limited financial and human resources. These challenges contribute to weak implementation and poor sustainability of HRH initiatives. The study concludes while Botswana has made commendable progress in aligning its HRH efforts with global goals, addressing the systematic barriers, particularly stakeholder representation and resourcing, is critical to achieving long term improvements in health work force planning and implementation. The Policy Divide: A Review of Botswana’s HRH Strategy Development and Implementation in the Context of the Global Strategy on HRH2030References:[1]. World Health Organization. 2016. Global strategy on human resources for health: Workforce 2030. https://www.who.int/publications/i/item/9789241511131 [2]. Afriyie, D. O., Nyoni, J., & Ahmat, A., 2020. The state of strategic health workforce investments in Africa: Evidence from the WHO African Region. BMJ Global Health, 5(3), e002090. https://doi.org/10.1136/bmjgh-2019-002090 [3]. Republic of Botswana. 2020. Human Resources for Health Strategic Plan 2020–2030. Ministry of Health and Wellness. [4]. Walt, G., Shiffman, J., Schneider, H., Murray, S. F., Brugha, R., & Gilson, L., 2008. ‘Doing’ health policy analysis: Methodological and conceptual reflections and challenges. Health Policy and Planning, 23(5), 308–317. https://doi.org/10.1093/heapol/czn024 [5]. Seitio-Kgokgwe, O. S., Gauld, R., Hill, P. C., & Barnett, P., 2016. Analysing the stewardship function in Botswana’s health system: Reflecting on the past, looking to the future. International Journal of Health Policy and Management, 5(12), 705–713. https://doi.org/10.15171/ijhpm.2016.67 [6]. National Development Planning Commission (NDPC). 2024. National monitoring and evaluation policy. Accra, Ghana: Government of Ghana. Retrieved from https://www.ndpc.gov.gh/media/National_ME_Policy_Ghana.pdf [7]. Kaboyakgosi, G., & Marata, K. P., 2013. An analysis of Botswana’s implementation challenges. Pula: Botswana Journal of African Studies, 27(2). https://journals.ub.bw/index.php/pula/article/view/529 [8]. Sisa, E., Naidoo, G., van der Westhuizen, E. J., & Hope, K. R., 2022. Reflections on performance management system of Botswana public service, 1999–2014: An analytical review. Journal of Public Administration and Development Alternatives, 7(3). https://journals.co.za/doi/full/10.55190/TUMZ5318 [9]. Wotela, K., & Metla, N. N., 2021. Challenges of government policy implementation, monitoring and evaluation: Conceptualising research for Botswana Ministry of Youth Empowerment, Sport and Culture Development. Journal of Public Administration and Development Alternatives, 6(2). https://journals.co.za/doi/full/10.55190/QNOH8494 [10]. Phirinyane, M. B., 2009. Human resource management and decentralization in Botswana and South Africa (Doctoral dissertation, University of Birmingham). https://localdemocracy.net/2009/01/01/human-resource-management-and-decentralization-in-botswana-and-south-africa/ [11]. Metla, M., & Wotela, K., 2021. Redesigning a Ministry of Health's organizational structure: Exploring implementation challenges through Botswana's experiences. International Journal of Health Planning and Management, 36(2), 191–207. https://doi.org/10.1002/hpm.2275 [12]. Zambia Ministry of Health. 2017. Challenges of implementing the integrated disease surveillance and response (IDSR) strategy. Lusaka, Zambia: Ministry of Health. [13]. USAID. 2015. Human Resources for Health Effort Index 2015: Namibia, Malawi, and Lesotho. Washington, DC: United States Agency for International Development. [14]. Bourgeault, I. L., Simkin, S., & Chamberland-Rowe, C., 2019. Poor health workforce planning is costly, risky and inequitable. Canadian Medical Association Journal, 191(42), E1147–E1148. https://doi.org/10.1503/cmaj.191241 [15]. Ministry of Health and Social Welfare (MoHSW), Eswatini. 2019. Human Resources for Health Strategic Plan Viewed PDF 4 0 
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					Redefining Entrepreneurial Leadership: Guyanese Women Navigating Structural Bias, Cultural Expectations, and Intersectional Barriers Through Inclusive Innovation and Community EnterpriseAuthor: Candacy GravesandeDOI: 10.21522/TIJAR.2014.12.04.Art011Redefining Entrepreneurial Leadership: Guyanese Women Navigating Structural Bias, Cultural Expectations, and Intersectional Barriers Through Inclusive Innovation and Community EnterpriseAbstract:This study explores how Guyanese women entrepreneurs redefine entrepreneurial leadership by navigating multifaceted challenges rooted in structural bias, cultural expectations, and intersectional barriers. Against a backdrop of significant government investment exceeding $156 billion in women’s empowerment initiatives, this research illuminates the lived realities and leadership strategies of women leading community enterprises and engaging in inclusive innovation across Guyana. Despite robust economic growth and an increasing share of women-owned ventures particularly in agribusiness where women now lead 65% of new ventures these entrepreneurs confront persistent gendered social norms, limited access to finance, and entrenched workplace inequalities. Using a qualitative methodology combining in-depth interviews, focus groups, and case studies, this study documents how Guyanese women leverage inclusive innovation practices and community-oriented business models as mechanisms to overcome systemic obstacles and cultivate sustainable enterprises. Findings reveal how leadership is redefined not only through business acumen but also through relational, culturally grounded approaches that prioritize social cohesion and collective advancement. By centering the perspectives of women navigating intersectional marginalization, this research contributes novel insights to entrepreneurial leadership theory and practice that emphasize inclusivity and community impact. The study offers policy and managerial implications aimed at fostering equitable support systems and amplifying the transformative potential of women-led enterprises in developing economies. This investigation enriches the discourse on gender, intersectionality, and innovation in entrepreneurship and provides a compelling case for reimagining leadership in contexts of social complexity. Redefining Entrepreneurial Leadership: Guyanese Women Navigating Structural Bias, Cultural Expectations, and Intersectional Barriers Through Inclusive Innovation and Community EnterpriseReferences:[1]. Williams, T., 22nd February 2022, "Guyana Chronicle,". https://guyanachronicle.com [2]. Claire Blair Foundation for Women, "HerVenture in Guyana," 2025. https://cherieblairfoundation.org. [3]. Centre for Local Business Development, 2021, "Women's Entrepreneurship Programs,". https://centreguyana.com. [4]. Youth. Challenge International, 2011, "Women's Entrepreneurship in Guyana,". https://ycicanada.wordpress.com. [5]. Bryman, A., 2016, "Social Research Methods," Oxford University Press. [6]. U. N Women, 2024, "Women's health and experience qualitative report Guyana," 2024. https://guyana.un.org. [7]. Braun, V., & Clarke, V., 2006, "Using thematic analysis in psychology," Qualitative Research in Psychology, vol. 3(2), pp. 77-101. [8]. C. f. L. B. Development, "Women's Entrepreneurship programs," 2021. https://centreguyana. [9]. Esnard, T., 2016, Entrpreneurial women in the Caribbean: Critical insights and policy implications, University of the West Indies Press. [10]. W. International, 2023, "WEConnect-Guyana stakeholder ecosystem mapping,". https://we3a.org. [11]. IDB (Inter-American Development Bank), 2025, "Guyana's women entreprenuers:Realising the potential,". https://www.iadb.org. [12]. OECD, 2017, "Inclusive innovation policies: Lessons from international cse studies,". https://www.oecd.org. [13]. Women Entrepreneurs Aspire, 2023. https://we3a.org. [14]. Women Chamber of Commerce and Industry Guyana, 2024, "Annual Report on Women entrepreneurs in Guyana," https://wcciguyana.com. [15]. Global Entrepreneurship Monitor (GEM) Consortium, 2025, "Global entrepreneurship monitor report,". http://gemconsortium.org. [16]. J. &. P. S. Challa, "Influence of leadership styles of women entrepreneurs on their psychological wellbeing," International Journal of Professional Business Review , vol. 8(6), no. e00293, 2023. [17]. Bass, B. M., & Riggio, R. E., 2022, Transformational leadership (4th ed.), Psychology. [18]. Lopez, M., & Rivera, G., 2024, "Emotional intelligence and businesssustainaility: Women entrepreneurs in Latin America," International Journal of Business and Social Science, vol. 15(2), pp. 78 - 93. [19]. World Bank, 2025, "Gender equality and women's economic empowerment," World Bank Publications. [20]. Fernandez, L., & Stewart, J., 2024, "Intersectionality and entrepreneurship: Addressing compunded barriers for women in Latin America and the Caribbean," Journal of Gender and Development, vol. 32(1), pp. 45 - 60. https://doi.org/10.1234/jesc.v12i3.5678 [21]. Martin, T., & Chu, K., 2023, "Digital literacy and entrepreneurial successamong rural woman in Caribbean," Technology an Society, vol. 40(3), pp. 112 - 129. [22]. Thomas, H., & Mitchell, R., 2024, "Socially embedded leadership and community resilience: A Caribbean perspective.," Leadership Quaterly, vol. 35 (2), pp. 145 -163. Viewed PDF 5 0 
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					Reimagining Health Systems for Better Health: Strategic Recommendations for Strengthening Health Workforce in Botswana – A Qualitative StudyAuthor: Naledi Moipone MlaudziDOI: 10.21522/TIJAR.2014.12.04.Art012Reimagining Health Systems for Better Health: Strategic Recommendations for Strengthening Health Workforce in Botswana – A Qualitative StudyReferences:[1]. World Health Organization (WHO). 2016. Global Strategy on Human Resources for Health: Workforce 2030. Retrieved from https://www.who.int [2]. World Health Organization. 2023. 5th Global Forum on Human Resources for Health. [3]. Ikhurionan, O., et al., 2022. Health workforce deficits in LMICs: Challenges and solutions. [4]. Booth, A., et al., 2021. An assessment of human resources for health in Botswana: challenges and strategic priorities. (If used previously in your study). [5]. Bello, M., Bassey, B., & Agupugo, K., 2023. Integrating Telemedicine and AI to Improve Healthcare Access in Rural Communities. International Journal of Life Sciences Research Archive, 4(2), 45–58. Retrieved from https://sciresjournals.com/ijlsra/sites/default/files/IJLSRA-2024-0061.pdf [6]. Lorenzo, F. M. E., Galvez-Tan, J., Icamina, K., & Javier, L., 2007. Nurse migration from a source country perspective: Philippine country case study. Health Services Research, 42(3p2), 1406–1418. https://doi.org/10.1111/j.1475-6773.2007.00716.x [7]. World Health Organization. 2010. Increasing access to health workers in remote and rural areas through improved retention: Global policy recommendations. Geneva: WHO. Retrieved from https://www.who.int/publications/i/item/9789241564014 [8]. Binagwaho, et al., 2013. Human Resources for Health Program in Rwanda. [9]. Olu, O., Mipando, M., Chimwaza, A., & Chisema, A., 2019. Task shifting in Malawi: Achievements and challenges. African Health Monitor, World Health Organization Regional Office for Africa. [10]. India-WHO Collaboration 2020. Strengthening Medical Education. Viewed PDF 4 0 
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					Utilization of Long-lasting Insecticide treated Mosquito Nets amongst Households in Upper River Region, The GambiaAuthor: Alieu BahDOI: 10.21522/TIJAR.2014.12.04.Art013Utilization of Long-lasting Insecticide treated Mosquito Nets amongst Households in Upper River Region, The GambiaAbstract:Long Lasting Insecticide-treated bed nets (LLINs) are known to be highly effective in reducing malaria morbidity and mortality. However, there exists availability and usage variations between countries and among households and such may seriously limit the potential impact of nets and cause a negative consequence on malaria transmission. This study examined LLIN ownership and underlying factors that may serve as barriers to utilization amongst households in two districts in Upper River Region. Malaria is the major cause of morbidity and mortality in children and pregnant women. LLINs are an effective option in the prevention of malaria because they serve as a barrier between man and mosquito. However, their utilization among the population is still a problem despite ownership been high. Surveys have shown that the region in which this study was conducted has the lowest utilization rate in The Gambia and the second highest malaria prevalence in the country. The study adapted a structured questionnaire and Focus Group Discussions (FGDs) to better understand the situation of net utilization in the two districts. The study revealed interesting findings: Respondents have clear understanding that LLINs are for the prevention of malaria. Factors such as heat, mesh size of net, texture were very important determinants for a person to use a net. A very important determinant for someone not using a net is the season as a lot of the people belief that mosquitoes are not many during the dry season. Indoor Residual Spraying was one “devil in disguise”. Utilization of Long-lasting Insecticide treated Mosquito Nets amongst Households in Upper River Region, The GambiaReferences:[1]. Organization Who,. High burden to high impact: a targeted malaria response. World Health Organization; 2018. [2]. GBoS, G. B., of S, ICF. The Gambia Demographic and Health Survey 2019-20. 2021 Mar 15 [cited 2023 Mar 6]; Available from: https://dhsprogram.com/publications/publication-FR369-DHS-Final-Reports.cfm [3]. Pryce, J., Richardson, M., Lengeler, C., 2018, Insecticide‐treated nets for preventing malaria. Cochrane Database Syst Rev. Nov 6;2018[11]:CD000363. [4]. Geneva WHO, World Malaria Report 2016. World Health Organization. 2017 [5]. Organization WH. 2015, Global Technical Strategy for Malaria 2016-2030. World Health Organization, 35 p. [6]. Sangaré, L. R., Weiss, N. S., Brentlinger, P. E., Richardson, B. A., Staedke, S. G., Kiwuwa, M. S., et al., 2012, Determinants of use of insecticide treated nets for the prevention of malaria in pregnancy: Jinja, Uganda. PLoS One. 7[6]:e39712. [7]. Lindblade, K. A., Dotson, E., Hawley, W. A., Bayoh, N., Williamson, J., Mount, D., et al., 2005, Evaluation of long-lasting insecticidal nets after 2 years of household use. Tropical Medicine & International Health. 10[11]:1141–50. [8]. Konlan, K. D., Kossi Vivor, N., Gegefe, I., Hayford, L., 2022, Factors associated with ownership and utilization of insecticide treated nets among children under five years in sub-Saharan Africa. BMC Public Health. 22[1]:1–11. [9]. Dagne, G., Deressa, W., 2008, Knowledge and utilization of insecticide treated mosquito nets among freely supplied households in Wonago Woreda, Souther Ethiopia. Ethiopian journal of health development. 22[1]:34–41. [10]. Kanu, N. E., Ajumobi, O., Ajayi, I. O., Nguku, P., Tobin-West, C., Factors influencing the Use of Malaria Prevention Methods Among Women of Reproductive Age in Peri-urban Communities of Port Harcourt City, Nigeria. [11]. Tobin-West, C. I., Kanu, E. N., 2016, Factors influencing the use of malaria prevention methods among women of reproductive age in peri-urban communities of Port harcourt city, Nigeria. Nigerian Postgraduate Medical Journal. 23[1]:6. [12]. Berie, Y., Alemu, K., Belay, A., Gizaw, Z., 2013, Factors affecting utilization of Insecticide treated nets among people living with HIV/AIDs in Bahir Dar city, northwest Ethiopia. [13]. Nnedu, O. N., John-Stewart, G. C., Singa, B. O., Piper, B., Otieno, P. A., Guidry, A., et al., 2012, Prevalence and correlates of insecticide-treated bednet use among HIV-1-infected adults in Kenya. AIDS care. 24[12]:1559–64. [14]. Zerdo, Z., Bastiaens, H., Anthierens, S., Massebo, F., Masne, M., Biresaw, G., et al., 2020, Long-lasting insecticide-treated bed net ownership, utilization and associated factors among school-age children in Dara Mallo and Uba Debretsehay districts, Southern Ethiopia. Malaria Journal. 19:1–13. [15]. Macro, O. R. C., 2006, Central Statistical Agency Addis Ababa, Ethiopia. Central Statistical Agency Addis Ababa, Ethiopia. [16]. Ababa, A., 2003, Federal democratic republic of Ethiopia ministry of health. Ethiopia: Postnatal Care. [17]. Sena, L. D., Deressa, W. A., Ali, A. A., 2013, Predictors of long-lasting insecticide-treated bed net ownership and utilization: evidence from community-based cross-sectional comparative study, Southwest Ethiopia. Malaria Journal. Nov 9;12[1]:406. [18]. Gobena, T., Berhane, Y., Worku, A., 2012, Low long-lasting insecticide nets (LLINs) use among household members for protection against mosquito bite in kersa, Eastern Ethiopia. BMC public health. 12:1–9. [19]. Aderibigbe, S. A., Olatona, F. A., Sogunro, O., Alawode, G., Babatunde, O. A., Onipe. A. I., et al., 2014, Ownership and utilisation of long lasting insecticide treated nets following free distribution campaign in South West Nigeria. The Pan African medical journal. 17. [20]. Utilization of insecticide treated nets among pregnant women in Enugu, South Eastern Nigeria | Nigerian Journal of Clinical Practice [Internet]. [cited 2023 Mar 7]. Available from: https://www.ajol.info/index.php/njcp/article/view/93964 [21]. Axame, W. K., Kweku, M., Amelor, S., Kye-Duodu, G., Agboli, E., Agbemafle, I., et al., 2016, Ownership and Utilization of Long-Lasting Insecticide Treated Nets (LLIN) and Factors Associated to Non-utilization Among Pregnant Women in Ho Municipality of Ghana. Central African Journal of Public Health. 2[1]:35–42. [22]. Tassew, A., Hopkins, R., Deressa, W., 2017, Factors influencing the ownership and utilization of long-lasting insecticidal nets for malaria prevention in Ethiopia. Malaria journal. 16[1]:1–9. [23]. Raghavendra, K., Chourasia, M. K., Swain, D. K., Bhatt, R. M., Uragayala, S., Dutta, G. D. P., et al., 2017, Monitoring of long-lasting insecticidal nets (LLINs) coverage versus utilization: a community-based survey in malaria endemic villages of Central India. Malaria Journal. 2017;16[1]:1–8. [24]. Nuwaha, F., 2002, People’s perception of malaria in Mbarara, Uganda. Tropical Medicine & International Health. 7[5]:462–70. [25]. Smith, J., Firth, J., 2011, Qualitative data analysis: the framework approach. Nurse Researcher. 18[2]. Viewed PDF 5 0 
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					Investigating the Public Health Behavior Related to Street Food Consumption among Lubyayi Residents: Cross-Sectional StudyAuthor: Nshimba Ngoy Kayaya JuiskalydDOI: 10.21522/TIJAR.2014.12.04.Art014Investigating the Public Health Behavior Related to Street Food Consumption among Lubyayi Residents: Cross-Sectional StudyAbstract:Street food consumption is a major public health and social problem confronting urban Residents. Strong public health and social behavior need to be integrated at all community educational levels. The objective of this cross-sectional study is to investigate the public health behavior of street food consumption and identify factors associated with safe food consumption practices. The study provides insight into the perceptions, experiences, and adaptation strategies to Street Food Consumption. A cross-sectional survey of 160 street food Consumers reveals significant awareness of the public health behavior of street food consumption, and factors associated with safe food consumption. The results show an equal gender distribution, with the majority of respondents falling between 25-34 years old, at 31%. Most respondents have a primary or secondary education, at 38%, and Half have a low-income level, at 50%. Most respondents consume street food weekly, 50%. The majority have inadequate food safety knowledge, 63%. 75% have experienced foodborne illnesses. And most of the respondents do not practice proper food handling practices, 63%. The food Taste is the most important factor, 63%. Half of the respondents consider price very important, 50%. Only 38% of respondents prioritize safety. Most respondents do not trust street food vendors, 63%. Most of the respondents do not perceive the street food environment as clean, 63%. Improper waste management is prevalent in 66%. And Most respondents do not have access to clean water, 59%. The findings of this study contribute to the existing body of knowledge on the public health behavior of street food Consumption. Investigating the Public Health Behavior Related to Street Food Consumption among Lubyayi Residents: Cross-Sectional StudyReferences:[1]. FAO, IFAD, UNICEF, WFP, and WHO, 2020, The State of Food Security and Nutrition in the World. Transforming food systems for affordable, healthy diets. Rome, FAO. https://doi.org/10.4060/ca9692en. [2]. World Health Organization, 2018, Food Safety. https://www.who.int/news-room/fact-sheets/detail/food-safety. [3]. Kouamé, G. M., Beugré, G. F. C., & Amani, Y. C., 2021, Street Food around the World: A Review of the Literature. Journal of Service Science and Management, 14, 557-575. https://doi:10.4236/jssm.2021.146035. [4]. Liu, Z., Zhang, G., & Zhang, X., 2020, Food safety knowledge, attitudes, and practices among street food vendors in urban areas. Journal of Food Protection, 83(4), 634-642. https://doi:10.4315/0362-028X.JFP-19-129. [5]. Mwangi, A. M., 2018, Street food vending in urban areas: A review of the literature. Journal of Urban Health, 95(2), 157-166. https://doi:10.1007/s11524-018-0246-6. [6]. Nanyonga, S., 2020, Food safety risks associated with street food consumption in urban areas. Journal of Environmental Health Science & Engineering, 18(2), 637-646. https://doi:10.1007/s40201-020-00534-6 [7]. Schoder, D., 2019, Street food safety: A review of the current situation. Journal of Foodborne Diseases, 36(3), 251-262. [8]. WHO, 2017, WHO's Work on Food Safety. [9]. Grace, D., 2015, Food safety in developing countries: An overview. International Journal of Environmental Research and Public Health, 12(10), 13071-13084. https://doi:10.3390/ijerph121013071 [10]. Rheinländer, T., 2018, Food safety knowledge and practices among street food vendors in a Ghanaian city. Journal of Food Protection, 81(10), 1640-1648. https://doi:10.4315/0362-028X.JFP-18-088 [11]. Soon, J. M., 2018, Food safety training for street food vendors: A systematic review. Journal of Food Protection, 81(5), 796-804. https://doi:10.4315/0362-028X.JFP-17-157 [12]. Ababio, P. F., 2018, Food safety knowledge, attitudes, and practices among food handlers in Ghana. Journal of Food Protection, 81(1), 104-114. https://doi:10.4315/0362-028X.JFP-17-088 [13]. Liu, X., 2020, Food safety risks and control strategies for street food in China. Journal of Foodborne Diseases, 37(1), 53-63. [14]. Martins, J. H., 2019, Street food vendors' knowledge, attitudes, and practices regarding food safety in South Africa. Journal of Food Protection, 82(6), 936-944. https://doi:10.4315/0362-028X.JFP-18-140 [15]. Samapundo, S., 2019, Food safety knowledge, attitudes, and practices among street food vendors in Cambodia. Journal of Food Protection, 82(5), 746-754. https://doi:10.4315/0362-028X.JFP-18-130. [16]. Muyanja, C., 2018, Food safety risks associated with street foods in Kampala, Uganda. Journal of Foodborne Diseases, 35(2), 143-153. [17]. Alimi, B. A., 2018, Food safety knowledge and practices among street food vendors in Nigeria. Journal of Food Protection, 81(8), 1340-1348. https://doi:10.4315/0362-028X.JFP-18-022. [18]. Lee, S. M., 2020, Street food consumption and food safety concerns in Korea. Journal of Foodborne Diseases, 37(2), 123-133. [19]. Nguyen, T. T., 2019, Food safety knowledge and practices among street food vendors in Vietnam. Journal of Food Protection, 82(4), 624-632. https://doi:10.4315/0362-028X.JFP-18-124 [20]. Ortega, D. L., 2019, Food safety and street food consumption in the Philippines. Journal of Foodborne Diseases, 36(1), 31-41. [21]. Kabui, E. W., 2019, Food safety knowledge and practices among street food vendors in Kenya. Journal of Food Protection, 82 [22]. Mensah, P., 2018, Food safety risks associated with street food consumption in Ghana. Journal of Foodborne Diseases, 35(3), 201-211. [23]. Omemu, A. M., 2019, Food safety knowledge and practices among street food vendors in Nigeria. Journal of Food Protection, 82(7), 1080-1088. https://doi:10.4315/0362-028X.JFP-18-156. [24]. Park, S. H., 2020, Street food consumption and food safety concerns in Korea. Journal of Foodborne Diseases, 37(3), 253-263. [25]. Rane, S., 2019, Street food safety: A review of the current situation in India. Journal of Foodborne Diseases, 36(2), 101-111. [26]. Soon, J. M., 2020, Food safety training for street food vendors: A systematic review and meta-analysis. Journal of Food Protection, 83(5), 836-844. https://doi:10.4315/0362-028X.JFP-19-158. [27]. Tumwine, J. K., 2018, Food safety knowledge and practices among street food vendors in Uganda. Journal of Food Protection, 81(9), 1520-1528. https://doi:10.4315/0362-028X.JFP-18-094. [28]. Wu, Y., 2020, Food safety risks and control strategies for street food in China. Journal of Foodborne Diseases, 37(4), 401-411. [29]. Youssef, A. E., 2019, Food safety knowledge and practices among street food vendors in Egypt. Journal of Food Protection, 82(8), 1348-1356. https://doi:10.4315/0362-028X.JFP-18-166. [30]. Zhang, W., 2020, Street food consumption and food safety concerns in China. Journal of Foodborne Diseases, 37(5), 513-523. 31. Lubyayi Health District source 2024. Viewed PDF 6 2 
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					Political Parties, Elections, and Gender Representation: A Comparative Study of Women's Performance in the 2019 Elections in India and NigeriaAuthor: Racheal Modupe OkegbolaDOI: 10.21522/TIJAR.2014.12.04.Art015Political Parties, Elections, and Gender Representation: A Comparative Study of Women's Performance in the 2019 Elections in India and NigeriaAbstract:This study examines women's performance in the 2019 elections in India and Nigeria, within the context of political parties’ values, election dynamics, and gender representation in the two world's male-dominated democracies. Using mixed-methods with SPSS version 2.0 to analyse data from 100 participants, this study analyses the institutional, political, economic, and socio-cultural factors that influence or hinder women's electoral success, despite shared colonial histories and Westminster-style political systems. The results, however, highlight the similarities and differences in representation between the two countries. Both had similar shares of female candidates, 8.9% in India and 8.0% in Nigeria. However, success rates varied: female MP candidates comprised 14.4% of India's House of Representatives but only 3.1% in Nigeria. Voter turnout was similar, with 67.2% of women and 67.0% of men participating in India. Nigeria had lower overall participation, at 36% of the total voters. Also, Indian and Nigerian party inclusion strategies differ; Nigeria relies on patronage and is restricted by religious influence, gender violence, and high nomination fees. India's constitution supports women’s participation amidst male dominance, unlike Nigeria, where the uncertainty about women in politics is higher than in India. Nonetheless, the UN, African Union, ECOWAS, and IDEA found that party elites' control over candidate selection, violence, vote-buying, and logistical issues compromised electoral credibility and inclusivity. Participants recommend legislative or party quotas, along with funding, as essential to improving women's political representation and promoting gender equality. Political Parties, Elections, and Gender Representation: A Comparative Study of Women's Performance in the 2019 Elections in India and NigeriaReferences:[1]. World Bank Demography Report 2022, In the Next Generation Population List, World Bank, Washington, DC. Retrieved July 15, 2024. [2]. Racheal, E., Brule, 2020, Women, Power, and Property: The Paradox of Gender Equity Laws in India. Cambridge University Press, Boston. [3]. Pry, K., 2012, Social and Political Roles of Women in Athens and Sparta. Sabre and Scroll, [4]. Nigeria Independent National Electoral Commission (INEC) 2019, Electoral Act Report. Retrieved from https://www.inecnigeria.org/electionreports 2019 [5]. Inter-Parliamentary Union (IPU), 2019, Gender Quotas Database: Monthly Ranking of Women in the World Parliament. Retrieved from http://www.ipu.org [6]. Inter-Parliamentary Union (IPU), 2019, Gender Quotas Database: Monthly Ranking of Women in the World Parliament. Retrieved from http://www.ipu.org Carnegie International Observer Report. Indian elections 2019-2024: Gender dynamics. Washington: Carnegie Endowment; 2023. [7]. Racheal E. Brule 2020, Women, Power, and Property: The Paradox of Gender Equity Laws in India. Cambridge University Press, [8]. Carnegie International Observer Report, on Nigeria Elections 2019, Washington: Carnegie Endowment; 2023. [9]. Michealina, J., 2018, Review of Lijphart Arendt's Theory of Consociationalism and Power Sharing in Europe. In The Theory of Political Accommodation, (eds) by D. Kuzu and Matt Qvortrup; Cham: Palgrave Macmillan, Journal on Ethno-politics and Minority Issues in Europe, 17(2): pp 77-75. [10]. Awe, B., 2020, Women in Nigeria, In the Journal of African History. Oxford University Research. Retrieved from http://www.idpublications.org [11]. Antonio, Guterres, 2022., Forum Report on Gender Equality and UN Secretary General Remarks at the European Institute for Gender Equality (EIGE); UN-Department of Economic and Social Affairs (UNDESA) Remarks on the Commission on the Status of Women (Accessed: 8 September 2023). [12]. Indian Constitution, Retrieved from Election Commission of India (ECI) 2019 Data Report. Retrieved from https://www.eci.gov.in/candidate-political participation. [13]. Nigeria’s 1999 Constitutional Language Review Conference Report. 2022, Chapter V Section 42 (1) 43 (2). UN Office Abuja, Nigeria [14]. Aina, O., 2012, The review of the 1999 Nigerian Constitution, specifically sections 65, 66, 106, 107, 131, 137, 177, and 187 (Procedures for Party Nominations), was conducted by the members of the Committee of Nigeria. Abuja, Nigeria [15]. Bassey, E. E., 2018, Female representation and objectification in Zulu Sofola's: The Sweet Trap: Critical Perspectives on Female Nigerian Writers. Lagos, Nigeria. [16]. United Nations Development Fund for Women (UNIFEM 2019;2009); Conference Report on Harmonised Approaches to Promoting Gender Equality in a Fragile Environment: Donor Effectiveness, Global Messages and Country Experiences held in Zimbabwe, UNIFEM [17]. Malhotra, I., 2019, India Today: In a Global Dialogue on Federalism. Book Review, Volume I, No. 185. McGill-Queen's University Press. Montreal & Kingston Centres for Federal Studies, India. ISBN 0-77352849, pp. 180-207. [18]. Bolanle, A., 2017, Nigerian Women and the Quest for Gender Integration; Conference Paper, 2-5 http//www.proshareng.com [19]. Sule, B., Adamu, U., and Sambo, U., 2020, The 2019 general election in Nigeria: Examining the issues, challenges, successes and lessons for future general elections. International Journal of Social Sciences Perspectives, 6(2), pp.100-113. [20]. UNIFEM: Nigeria Gender Policy Review Committee Report. 2019, Millennium Development Goals (MDG) Programs Evaluation Session, accessed July 3, 2025. www.millenniumdevelopmentgoals.net.nig [21]. Carnegie International Observer Report on Nigeria Elections 2019, Washington: Carnegie Endowment; 2023. [22]. Salini, S., 2017, "Protection Of Women Under the Indian Constitution". Buddy-Mantra. Archived from the original on 1 October 2023. Retrieved 4 September [23]. Onuoha, F. C., and Ojo, J., 2018, In “Politics Today”: The Practice and Perils of Vote Buying in Nigeria’s Recent Elections. Conflict Trends Journal, 2018, (3), pp.21-29. [24]. INEC Nigeria, 2019, Review of the 2019 Election Assessment in Nigeria. Retrieved from -Annual Report. https://www.nbs.gov.ng/electionreports2019/inec, Abuja, Nigeria. [25]. World Comparative Study Report. 2021, Global data on Women in National Parliaments. Inter-Parliamentary Union (IPU). Retrieved from https://www.ipu.org/2021 [26]. IDEA 2019: Comparing Election Evaluation reports in Nigeria, IDEA-Nigeria, Abuja, Accessed online 2023 www.idea.org [27]. Election Commission of India (ECI), 2019, Election Data Report. Retrieved June 30, 2025, online https://www.eci.gov. [28]. Daron Acemoglu and James A. Robinson, eds. (2012;2023) The Origin of Power-Why Nations Fail, Profile Books Ltd, University of Michigan, ISBN 9781846684302.Internet Archive, https//achieve.org.pdf [29]. Harold D Laswell, 2018, Politics Who Gets What, When, How, ebook 2nd edition, Papamoa Press, ISBN:9781789235573 [30]. United Nations Human Development Annual Index Report 2021, retrieved from Global Impact Index (GII) UN Report. https//www.undp.org pp21-34 [31]. Arend, Lijphart, 1969, Consociational Democracy in World Politics 21 (2): 205-19. http://www.jstor.org/stable/2009820 [32]. Chimamanda, N., 2024, Feminist Manifestos; Dogan Yayinlari, ISBN: 9786256198432,6256198433, World of Book.com; e-book USA. [33]. Garuba Daudu, and Aderemi, Adewale (ed.) (2022/2023) A Study on Inclusive Practices in Political Parties. Westminster Foundation for Democracy (WFD), UK, and NILDS, Abuja, FCT. Viewed PDF 4 0 
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					Exploring the Interconnection between Climate Change and Public Health in Humanitarian Crises- A Case Study of SyriaAuthor: Muhammad ShafiqDOI: 10.21522/TIJAR.2014.12.04.Art016Exploring the Interconnection between Climate Change and Public Health in Humanitarian Crises- A Case Study of SyriaAbstract:The intersection of climate change and public health is increasingly critical in humanitarian settings. Syria exemplifies a complex context where prolonged conflict, environmental degradation, and climate-related shocks converge to severely impact health systems and vulnerable populations. To examine how climate change exacerbates public health challenges during humanitarian crises in Syria, with a focus on systemic vulnerabilities, health outcomes, and potential adaptation strategies. This analysis synthesizes findings from literature, field data, and case studies in Syria to assess the compounded effects of climate change on public health. It applies to a systems-thinking framework to explore health infrastructure, governance, and community-level resilience. Climate change intensifies public health risks by increasing water scarcity, food insecurity, disease outbreaks, and heat-related illnesses. Vulnerable populations, including children, women, and the elderly, face disproportionate health burdens. Conflict-related infrastructure damage and fragmented health systems further hinder effective response. Mental health impacts are profound and under-addressed. Addressing the climate-health-humanitarian nexus in Syria requires integrated strategies that strengthen local health systems, invest in resilient infrastructure, and incorporate climate risk into health planning. Collaborative, multi-sectoral action is essential to mitigate future crises and protect public health in conflict-affected, climate-vulnerable regions. Exploring the Interconnection between Climate Change and Public Health in Humanitarian Crises- A Case Study of SyriaReferences:[1]. Nayna Schwerdtle, N., Bowen, K. J., and McMichael, C., 2020, ‘The health impacts of climate change in humanitarian settings: a call to action’, PLOS Medicine, 17(9), p. e1003269, https://doi.org/10.1371/journal.pmed.1003269. [2]. Meiqari, L., Hoetjes, M., Baxter, L., and Lenglet, A., 2018, ‘Health impact of Syria’s conflict: a review’, International Journal of Public Health, 63(7), pp. 745–753, https://doi.org/10.1007/s00038-018-1102-3. [3]. Ali Mian, N., 2019, ‘Health and health care challenges for older adults in Uganda’, Journal of Aging & Social Policy, 31(3), pp. 234–251, https://doi.org/10.1080/08959420.2018.1534812. [4]. du Cros, P., Heywood, A. E., and MacIntyre, C. R., 2013, ‘Climate change and the elderly: vulnerabilities, risks and responses’, Health Promotion Journal of Australia, 24(3), pp. 159–162, https://doi.org/10.1071/HE13064. [5]. Richmond, M., 2017, ‘Mental health and psychosocial support in conflict: The Syrian crisis’, Journal of Humanitarian Affairs, 1(1), pp. 18–29. [6]. Garry, S., Checchi, F., and Roberts, B., 2018, ‘The impact of conflict on health systems: a case study of Syria’, BMJ Global Health, 3(6), p. e000844, https://doi.org/10.1136/bmjgh-2018-000844. [7]. Haar, R. J., Read, R., and Klonsky, M., 2023, ‘Infrastructure targeting in conflict zones: Health impacts of water system destruction in Syria’, The Lancet Planetary Health, 7(3), pp. e237–e244, https://doi.org/10.1016/S2542-5196(23)00034-1. [8]. Jamal, A., Howard, N., and El-Bouz, M., 2019, ‘Building resilient health systems in fragile settings: Lessons from Syria’, Global Health: Science and Practice, 7(Suppl 1), pp. S47–S60, https://doi.org/10.9745/GHSP-D-18-00406. [9]. Watts, N., et al., 2018, ‘The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come’, The Lancet, 392(10163), pp. 2479–2514, https://doi.org/10.1016/S0140-6736(18)32594-7. [10]. IPCC, 2022, Climate Change 2022: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Sixth Assessment Report, Cambridge University Press, https://www.ipcc.ch/report/ar6/wg2/ [11]. WHO, 2021, Climate Change and Health, World Health Organization, https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health [12]. UNHCR, 2023, Global Trends: Forced Displacement in 2022, UNHCR, The UN Refugee Agency, https://www.unhcr.org/globaltrends2022/ [13]. FAO, 2021, The State of Food Security and Nutrition in the World 2021, Food and Agriculture Organization of the United Nations, https://www.fao.org/3/cb4474en/cb4474en.pdf [14]. Akik, C., et al., 2021, ‘Health system resilience in Lebanon: Responding to the Syrian refugee crisis and economic collapse’, BMJ Global Health, 6(8), e005003, https://doi.org/10.1136/bmjgh-2021-005003. [15]. Ebi, K. L., and Semenza, J. C., 2008, ‘Community-based adaptation to the health impacts of climate change’, American Journal of Preventive Medicine, 35(5), pp. 501–507, https://doi.org/10.1016/j.amepre.2008.08.018. [16]. Burkle, F. M., 2010, ‘Complex humanitarian emergencies: A review of epidemiological and response models’, Public Health, 124(3), pp. 169–173, https://doi.org/10.1016/j.puhe.2009.12.010. [17]. Gleick, P. H., 2014, ‘Water, drought, climate change, and conflict in Syria’, Weather, Climate, and Society, 6(3), pp. 331–340, https://doi.org/10.1175/WCAS-D-13-00059.1. [18]. UNICEF, 2019, Water Under Fire: For Every Child, Water and Sanitation in Complex Emergencies, United Nations Children’s Fund, https://www.unicef.org/media/55896/file/Water-under-fire-2019.pdf [19]. 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A., et al., 2005, ‘Impact of regional climate change on human health’, Nature, 438(7066), pp. 310–317, https://doi.org/10.1038/nature04188. [25]. Black, R., Adger, W. N., and Arnell, N. W., 2011, ‘The effect of environmental change on human migration’, Global Environmental Change, 21(Suppl. 1), pp. S3–S11, https://doi.org/10.1016/j.gloenvcha.2011.10.001. [26]. Watts, N., et al., 2019, ‘The 2019 report of The Lancet Countdown on health and climate change: Ensuring that the health of a child born today is not defined by a changing climate’, The Lancet, 394(10211), pp. 1836–1878, https://doi.org/10.1016/S0140-6736(19)32596-6. Viewed PDF 4 0 
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					Socio-Demographic Predictors of non-communicable Diseases among People Living with HIV on ART in Enugu, Southeast NigeriaAuthor: Douglas Akpu-AgbataDOI: 10.21522/TIJAR.2014.12.04.Art017Socio-Demographic Predictors of non-communicable Diseases among People Living with HIV on ART in Enugu, Southeast NigeriaAbstract:Human Immunodeficiency Virus remains a major global health burden, with millions affected worldwide. Although Antiretroviral Therapy (ART) has reduced HIV-related deaths, its long-term use has been associated with the development of non-communicable diseases (NCDs). This study investigated socio-demographic predictors of NCDs among People Living with HIV (PLHIV) on ART in Enugu, Southeast Nigeria. A hospital-based cross-sectional design was employed to abstract data on socio-demographic characteristics, prevalence, and risk factors among PLHIV aged ≥18 years. Data were analyzed using IBM SPSS Statistics 25, with results presented as frequencies, percentages, and mean ± standard deviation. Logistic regression was applied to generate adjusted odds ratios (AOR) with p-values ≤0.05 at 95% confidence interval. Findings showed that age, marital status, education, and occupation significantly predicted NCD onset. Participants aged 41–60 years were four times more likely to develop hypertension (AOR: 4.47; CI: 3.32–6.18). Being married increased the likelihood of developing any NCD, while secondary education was strongly associated with hypertension (AOR: 4.52; CI: 3.34–5.94) and diabetes (AOR: 2.55; CI: 1.97–3.02). Unemployment also predicted hypertension (AOR: 3.72; CI: 1.32–3.08). Female participants had higher likelihood of hypertension, obesity, and cervical cancer than males. These results highlight the critical role of socio-demographic factors in NCD development among PLHIV on ART. The study underscores the importance of incorporating targeted, context-specific interventions that address socio-economic determinants in HIV care to reduce NCD comorbidities and improve quality of life of affected individuals. Socio-Demographic Predictors of non-communicable Diseases among People Living with HIV on ART in Enugu, Southeast NigeriaReferences:[1]. WHO, 2021, in HIV, Estimated number of people (all ages) living with HIV 2023 [Available from: . [2]. National Agency for the control of AIDS 2011, Update on the HIV/AIDS epidemic response in Nigeria. [3]. Coetzee, L., Bogler, L., De Neve, J-W., Barnighausen, T., Geldsetzer, P., and Vollmer, S., 2019, HIV, antiretroviral therapy and non-communicable diseases in sub-Saharan Africa: empirical evidence from 44 countries over the period 2000 to 2016. J. Int. AIDS Soc. 22(7), e25364. [4]. WHO, Noncommunicable diseases 2017, World Health Organization. [5]. Jadeja, S., Pai, G., Bhat, K., and Sathyanarayana, M. B., 2018, President’s emergency plan for AIDS relief. Syst Rev Pharm., 9(1):6–9. [6]. Bor, J., Herbst, A. J., Newell, M-L., and Barnighausen, T., 2013, Increases in adult life expectancy in rural South Africa: valuing the scale-up of HIV treatment. Science, 3396122:961–965. [7]. Achwoka, D., Oyugi, J. O., Mutave, R., Munywoki, P., Achia, T., Akolo, M., Muriuki, F., Muthui, M., and Kimani, J., 2020, High prevalence of non-communicable diseases among key populations enrolled at a large HIV prevention & treatment program in Kenya. PLoS One, 15(7), e0235606. [8]. Feinstein, M. J., Hsue, P. Y., Benjamin, L. A., Bloomfield, G. S., Currier, J. S., Freiberg, M. S., Grinspoon, S. K., Levin, J., Longenecker, C. T., Post, W. S., and American Heart Association Prevention Science Committee of the Council on Epidemiology and Prevention and Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Stroke Council. 2019. Characteristics, prevention, and management of cardiovascular disease in people living with HIV: a scientific statement from the American Heart Association. Circulation, 140(2), e98-e124. [9]. Seang, K., Javanbakht, M., Lee, S-J., Brookmeyer, R., Pheng, P., Chea, P., Saphonn, V., and Gorbach, P. M., 2022, Differences in prevalence and risk factors of non-communicable diseases between young people living with HIV (YLWH) and young general population in Cambodia. PLoS ONE 17(6), e0269989 [10]. Kansiime, S., Mwesigire, D., & Mugerwa, H., Prevalence of non-communicable diseases among HIV positive patients on antiretroviral therapy at joint clinical research centre, Lubowa, Uganda. PLoS ONE 14(8), e0221022 2019. [11]. Thet, D., and Siritientong, T., 2020, Antiretroviral therapy-associated metabolic complications: Review of the recent studies. HIV/AIDS – Res. Palliative Care 12, 507–524. . [12]. Gausi, B., Otiku, P., Jacob, N., & Oni, T., Patient outcomes in integrated HIV and non-communicable disease models of care: A scoping review. J. Global Health Rep. 5, e2021084 2021. [13]. Okeke, F. O., Sam-Amobi, C. G., & Okeke, F. I., 2020, Role of local town planning authorities in building collapse in Nigeria: evidence from Enugu metropolis. Heliyon, 6(7), e04361. [14]. Ezeala-Adikaibe, B., Aneke, E., Orjioke, C., Ezeala-Adikaibe, N., Mbadiwe, N., Chime, P., & Okafor, U., 2014, Pattern of medical admissions at Enugu state University of Science and Technology Teaching Hospital: a 5-year review. Annals of medical and health sciences research, 4(3), 426–431. [15]. Abugu, J. O., Chukwu, A. M., Onyeso, O. K., et al., 2023, Determinants of the managerial staff’s disposition towards e-payment platforms in public tertiary hospitals in Enugu, Nigeria: a cross-sectional study. BMC Health Serv Res 23, 1240. [16]. Magodoro, I. M., Esterhuizen, T. M., Chivese, T., 2016, A cross-sectional, facility-based study of comorbid non-communicable diseases among adults living with HIV infection in Zimbabwe. BMC Res Notes, 9(1):379. [17]. Achwoka, D., Waruru, A., Chen, T. H., Masamaro, K., Ngugi, E., Kimani, M., Mukui, I., Oyugi, J.O., Mutave, R., Achia, T., Katana, A., Ng'ang'a, L., and De Cock, K. M., 2019, Noncommunicable disease burden among HIV patients in care: a national retrospective longitudinal analysis of HIV-treatment outcomes in Kenya, 2003-2013. BMC Public Health, 3;19(1):372. [18]. Mathebula, R. L., Maimela, E., & Ntuli, N. S., 2020, The prevalence of selected non-communicable disease risk factors among HIV patients on anti-retroviral therapy in Bushbuckridge sub-district, Mpumalanga province. BMC Public Health 20, 247, https://doi.org/10.1186/s12889-019-8134-x. [19]. Anish, T. S., Shahulhameed, S., Vijayakumar, K., Joy, T. M., Sreelakshmi, P. R., Kuriakose, A., 2013, Gender Difference in Blood pressure, Blood Sugar, and Cholesterol in Young Adults with Comparable Routine Physical Exertion. J Family Med Prim Care, 2(2):200-203. doi: 10.4103/2249-4863.117424. [20]. Bogorodskaya, M., Chow, F. C., Triant, V. A., 2013, Stroke in HIV. Canadian Journal of Cardiology, 35(3), 280-287. [21]. Tate, T., Willig, A. L., Willig, J. H., Raper, J. L., Moneyham, L., Kempf, M. C., Saag, M. S., Mugavero, M. J., 2012, HIV infection and obesity: where did all the wasting go? Antivir Ther. 17(7):1281. [22]. Kagaruki, G. B., Mayige, M. T., Ngadaya, E. S., Kimaro, G. D., Kalinga, A. K., Kilale, A. M., Kahwa, A. M., Materu, G. S., and Mfinanga, S. G., 2014, Magnitude and risk factors of non-communicable diseases among people living with HIV in Tanzania: a cross-sectional study from Mbeya and Dar es Salaam regions. BMC Public Health, 14(1):904. [23]. Braithwaite, R. S., Conigliaro, J., McGinnis, K. A., Maisto, S. A., Bryant, K., and Justice, A. C., 2008, Adjusting alcohol quantity for mean consumption and intoxication threshold improves prediction of nonadherence in HIV patients and HIV-negative controls. Alcohol Clin Exp Res., 32(9):1645–51. [24]. Justice, A., Sullivan, L., and Fiellin, D., 2010, Veterans Aging Cohort Study Project Team. HIV/AIDS, comorbidity, and alcohol: can we make a difference? Alcohol Res Health, 33(3):258. [25]. da Silva, C. M., Mendoza-Sassi, R. A., da Mota, L. D., Nader, M. M. and de Martinez, A. M., 2017, Alcohol use disorders among people living with HIV/AIDS in Southern Brazil: prevalence, risk factors and biological markers outcomes. BMC Infect Dis., 17(1):263. Viewed PDF 4 2 
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					Effectiveness of a Theory-Based Health Education on Intention to Delay Next Pregnancy using Long-Acting Contraceptives (LARC) Among Women Attending Antenatal Clinics in Katsina State, NigeriaAuthor: Shaima’u KABIR AbbaDOI: 10.21522/TIJAR.2014.12.04.Art018Effectiveness of a Theory-Based Health Education on Intention to Delay Next Pregnancy using Long-Acting Contraceptives (LARC) Among Women Attending Antenatal Clinics in Katsina State, NigeriaAbstract:Pregnancies conceived after a short interval within less than 2 years of deliver are associated with increase health risks for both mothers and the child. A large number of women in developing countries would like to delay or stop childbearing but are not using any method of contraception due to limited choice of methods A randomized controlled trial was conducted involving 685 women attending selected antenatal clinics across Katsina State, Nigeria to determine effectiveness of a theory-based health education intervention on women’s intention to delay next pregnancy using Long-Acting Reversible Contraceptives (LARC). Data was collected at baseline and six months post-intervention using a validated questionnaire. Data was analyzed using SPSS version 26. Descriptive analysis was performed first to explore the baseline characteristics of the respondents as well as to explore their socio-demographic and reproductive and obstetric history. Findings reveal significant improvements in intention to utilize LARCs post-intervention, suggesting that theory-driven education can effectively bridge the gap between knowledge and practice in contraceptive uptake. Limitations include potential self-reporting bias and loss to follow-up which might affect generalizability. However, the large sample size, rigorous methodology, and strong statistical significance enhance the reliability of the findings. Effectiveness of a Theory-Based Health Education on Intention to Delay Next Pregnancy using Long-Acting Contraceptives (LARC) Among Women Attending Antenatal Clinics in Katsina State, NigeriaReferences:[1]. Bolarinwa, O. A., Nwagbara, U. I., Saeed, B. Q., Mashige, K. P., & Aboagye, R. G., 2021, Prevalence and determinants of long-acting reversible contraceptive use among women in Sub-Saharan Africa. BMC Women's Health, 21(1), 1-9. [2]. Luo, Z., Gao, L., Anguzu, R., et al., 2018, Long-acting reversible contraceptive use in the post-abortion period among women seeking abortion in mainland China: intentions and barriers. Reprod Health, 15, 85. https://doi.org/10.1186/s12978-018-0543-2 [3]. Teferi, S. M., Seyoum, K., Ejigu, N., Geta, G., Wedajo, L. F., & Alemu, S. S., 2024, Delayed time to pregnancy and associated factors among pregnant women attending antenatal care in bale zone administrative towns health facilities: multi-center cross-sectional study. BMC pregnancy and childbirth, 24(1), 531. https://doi.org/10.1186/s12884-024-06709-3 [4]. NDHS. 2018, Nigeria Demographic and Health Survey. National Population Commission & ICF. [5]. MICS. 2021, Multiple Indicator Cluster Survey 2021. National Bureau of Statistics. [6]. Parks, C., & Peipert, J. F., 2016, Eliminating health disparities in unintended pregnancy with long-acting reversible contraception (LARC). American journal of obstetrics and gynecology, 214(6), 681-688. [7]. Harney, C., Dude, A., & Haider, S., 2017, Factors associated with short interpregnancy interval in women who plan postpartum LARC: a retrospective study. Contraception, 95(3), 245-250. [8]. United Nations Department of Economic and Social Affairs, Population Division. 2015, Trends in Contraceptive use worldwide. (ST/ESA/SER.A/349). UNDFPA, Geneva [9]. barra-Nava, I., Choudhry, V., & Agardh, A., 2020, Desire to delay the first childbirth among young, married women in India: a cross-sectional study based on national survey data. BMC public health, 20(1), 350. https://doi.org/10.1186/s12889-020-8402-9 [10]. Carol S. W., Erik B. L., Richard S. L., Diana, L.V., & Cynthia, H. C., 2015, How do pregnancy intentions affect contraceptive choices when cost is not a factor? A study of privately insured women, Contraception,92(5), 501-507. https://doi.org/10.1016/j.contraception.2015.05.007 [11]. Jennifer S. B., Warren, M., Kusunoki, Y., Hayford S. R., & Karen, B. G., 2019, Relationship Dynamics and Changing Desire for Pregnancy Among Young Women. Perspectives on Sexual and Reproductive Health, 51(3), 143-152. https://doi.org/10.1363/psrh.12119 Viewed PDF 3 0 
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					The Impact of Information Technology on Hospital Management SystemsAuthor: Vincent DavidDOI: 10.21522/TIJAR.2014.12.04.Art019The Impact of Information Technology on Hospital Management SystemsAbstract:This study examines the significant contribution of IT to improving hospital information system management. They are mainly aimed at assessing how IT applications in hospitals, including Electronic Health Records (EHR), Clinical Decision Support Systems (CDSS), and telemedicine, enhance processes, communication, and patient outcomes. Using quantitative data sources involving performance measurement data, together with qualitative data collected through interviews and observation forms, forms the basis of the research. This study demonstrated its strengths by gathering data from various hospitals using a stratified random sample, enabling a comprehensive comparison of various healthcare facilities. Some of the findings highlighted are the fact that integration has a positive overall impact on the working of the business, reduces office responsibilities, and increases positive effects on patients. Electronic health records simplify patient data entry, allowing for better album handling and more accurate records. CDSS assists the clinician in making the right choices, which in turn helps to improve the quality of care. The Impact of Information Technology on Hospital Management SystemsReferences:[1]. Argaw, S. T., Troncoso-Pastoriza, J. R., Lacey, D., Florin, M.-V., Calcavecchia, F., Anderson, D., Burleson, W., Vogel, J.-M., O’Leary, C., Eshaya-Chauvin, B., & Flahault, A., 2020. Cybersecurity of Hospitals: discussing the challenges and working towards mitigating the risks. BMC Medical Informatics and Decision Making, 20(1). https://doi.org/10.1186/s12911-020-01161-7 [2]. Chen, H., Li, L., & Chen, Y., 2020. Explore success factors that impact artificial intelligence adoption on telecom industry in China. Journal of Management Analytics, 8(1), 1–33. https://doi.org/10.1080/23270012.2020.1852895 [3]. Ratna Dewi, & Evita Isretno Israhadi, 2021. Legal Aspects of BPJS as National Health Insurance. https://doi.org/10.4108/eai.6-3-2021.2306412 [4]. Ulker-Demirel, E., & Ciftci, G., 2020. A systematic literature review of the theory of planned behavior in tourism, leisure and hospitality management research. Journal of Hospitality and Tourism Management, 43, 209–219. https://doi.org/10.1016/j.jhtm.2020.04.003 [5]. Umar, R. M., Apikoglu-Rabus, S., & Yumuk, P. F., 2020. Significance of a clinical pharmacist-led comprehensive medication management program for hospitalized oncology patients. International Journal of Clinical Pharmacy, 42(2), 652–661. https://doi.org/10.1007/s11096-020-00992-8 [6]. Uslu, B. Ç., Okay, E., & Dursun, E., 2020. Analysis of factors affecting IoT-based smart hospital design. Journal of Cloud Computing, 9(1). https://doi.org/10.1186/s13677-020-00215-5 [7]. Wu, J., Nadarajah, R., Nakao, Y. M., Nakao, K., Wilkinson, C., Cowan, J. C., A. John Camm, & Gale, C. P., 2023. Temporal trends of cause-specific mortality after diagnosis of atrial fibrillation. European Heart Journal. https://doi.org/10.1093/eurheartj/ehad571 [8]. Stoumpos, S., et al., 2023. Digital transformation in healthcare: leveraging EHR for patient-centered care. Journal of Health Informatics, 29(2), 123–135. Doi: 10.1016/j.jhi.2023.02.005. [9]. Marques, G., & Ferreira, C. R., 2021. Telemedicine during COVID-19: Applications, challenges, and future directions. Telehealth Journal, 27(4), 245–259. Doi: 10.1016/j.tele.2021.06.011. [10]. Miandoab, P., et al., 2023. Overcoming interoperability challenges in electronic health records systems. Journal of Medical Informatics, 35(1), 55–68. DOI: 10.1097/JMI.0000000000000623. [11]. Nguyen, T., et al., 2023. Clinical Decision Support Systems for improving patient safety: A systematic review. Clinical Decision Support Journal, 14(3), 201–214. DOI: 10.1177/20552076231101972. [12]. Kwon, H., et al., 2022. Smart hospital services and their impact on operational workflows. Healthcare Management Review, 47(1), 12–23. Doi: 10.1097/HMR.0000000000000309. [13]. Yazici, A., 2020. RFID applications in hospital environments: Enhancing patient safety and efficiency. Health Information Science Journal, 16(2), 89–102. Doi: 10.1108/HISJ-08-2020-0045. [14]. Mantas, J., et al., 2021. Informatics in healthcare: patient data management and continuity of care. International Journal of Medical Informatics, 151, 104467. Doi: 10.1016/j.ijmedinf.2021.104467. [15]. Monteiro, A., et al., 2023. The role of IoMT and wearable devices in real-time patient monitoring. Healthcare Technology Journal, 41(3), 321–338. Doi: 10.1080/17538157.2023.1810124. [16]. Khanra, S., et al., 2020. Big data analytics in healthcare: A systematic literature review. Health Policy and Technology, 9(1), 16–27. Doi: 10.1016/j.hlpt.2020.09.003. [17]. Haghi Kashani, M., et al., 2021. Internet of Things in healthcare applications: Opportunities and challenges. Journal of Medical Systems, 45(10), 112–125. Doi: 10.1007/s10916-021-01785-3. [18]. Yaqoob, I., et al., 2021. Training and support for IT adoption in healthcare organizations. Healthcare IT Management, 18(2), 50–61. Doi: 10.1057/hit.2021.004. [19]. Braithwaite, J., et al., 2020. Cultural resistance to health IT adoption: Insights and strategies. Organizational Change in Healthcare Journal, 14(2), 99–114. Doi: 10.1002/ochj.2020.002. [20]. Selvaraj, S., & Sundaravaradhan, S., 2020. Challenges in IoT interoperability for healthcare. Health Services Research Journal, 55(3), 389–401. Doi: 10.1111/1475-6773.13382. Viewed PDF 3 0 
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					Effects of Institutions on Entrepreneurship Development in Developing EconomiesAuthor: Ayorinde A EzekielDOI: 10.21522/TIJAR.2014.12.04.Art020Effects of Institutions on Entrepreneurship Development in Developing EconomiesAbstract:This study is galvanized by an accelerating disturbing debate in the circle of researchers relating to the effect of institutional influences on entrepreneurship development in the emerging economies. This study investigates the effect of combined formal and informal institutional factors on entrepreneurship development in developing economies. To accomplish the stated objectives, the empirical work of this study engaged secondary data-sets that covered 20 developing countries spanning between 1996-2022 and analyzed the data using the following estimation techniques: Panel Ordinary Least Square (POLS), Feasible Generalized Least Square (FGLS), Fixed Effect (FE), and Random Effect (RE) approach. The results of the study revealed that a unit increase in each employed institution has positive or negative effect on entrepreneurship development in emerging economies. The study recommends among other things that; deepening the developments of money deposit and micro-financial institutions to facilities credit to various individuals or organizations that embrace self-employment as well as the identification by the governments of the emerging economies of those economic factors that can make GDP growth to promote self-employment in their various countries. This study therefore concludes that institutional influences have varying positively and negatively impact on entrepreneurship development in emerging economies. Effects of Institutions on Entrepreneurship Development in Developing EconomiesReferences:[1]. Abdullah, A., Tojo, T., & David, U., 2024, Female entrepreneurship in the start-up ecosystem of Saudi Arabia, Journal of Enterprising Communities: People and Places in the Global Economy, 18(5). [2]. Abdullah, A., Tojo, T., & David, U., 2022, The influence of institutions on early-stage entrepreneurial activity: a comparison between men and women in Saudi Arabia, Journal of Entrepreneurship in Emerging Economies, 15(5). [3]. Abidin, N. Z., Saraih, U. N., & Rashid, I. M. A., 2022, The effect of foreign direct investment on wage in Malaysian manufacturing sector: New Evidence Using ARDL. Management & Accounting Review, 21(2) Journal of Entrepreneurship in Emerging Economies, 15(5). [4]. Amao-Taiwo, B., Shittu, A., & Yinusa, O., 2023, Higher education student entrepreneurship support services: Implications for the development of entrepreneurial skills, Covenant Journal of Entrepreneurship, 7(1), 42-51. [5]. Bernatzki, T., Busse, M., & Hoekstra, R., 2022, Promoting Rwanda’s business environment: Impact of reforms and drivers of change. Development Policy Review, 40(2), 578. [6]. Bakkar, Y., Durst, S., & Gerstlberger, W., 2021, The impact of institutional dimensions on entrepreneurial intentions of students—International evidence, Journal of Risk and Financial Management 14: 174. https://doi.org/10.3390/jrfm14040174 [7]. Bullough, A., Guelich, U., Manolova, T. S., & Schjoedt, L., 2022, “Women’s entrepreneurship and culture: gender role expectations and identities, societal culture, and the entrepreneurial environment”, Small Business Economics, 58(2), 985-996. [8]. Chaves, V. J. C., Ribes, G. G., & Moya, C. I., 2024, Effect of the economic, social and technological factors on sustainable entrepreneurship over time, Journal of Business Research, 173, 114457. [9]. Choi, J., Dutz, M. A., & Usman, Z., 2020, The future of work in Africa: Harnessing the potential of digital technologies for all. World Bank Publications. [10]. Dao, T. B. T., Khuc, V. Q., Dong, M. C., & Cao, T. L., 2023, How does foreign direct investment drive employment growth in Vietnam’s formal economy? Economies, 11(11), 266. https://doi.org/10.3390/economies11110266 [11]. Dianez-Gonzalez, J. P., Camelo-Ordaz, C., 2019, The influence of the structure of social networks on academic spin-offs’ entrepreneurial orientation, Industrial Marketing Management, 80, 84-98. [12]. Drummond, C., McGrath, H., O’Toole, T., 2018, The impact of social media on resource mobilization in entrepreneurial firms, Industrial Marketing Management, 70, 68-89. [13]. Ejiogu, A., Okechukwu, O., Ejiogu, C., Owusu, A., & Adeola, O., 2022, 'Determinants of informal entrepreneurship in Africa', International Journal of Entrepreneurship and Small Business 45(1), 35-61. https://doi.org/10.1504/IJESB.2022.120552 [14]. Ejiogu, A., Ejiogu, C., & Ambituuni, A., 2018, “The dark side of transparency: Does the Nigeria extractive industries transparency initiative help or hinder accountability and corruption control?” The British Accounting-review, available at: https://doi.org/10.1016/j.bar.2018.10.00 [15]. Franzke, S., Wu, J., Froese, F. J., & Chan, Z.X., 2022, “Female entrepreneurship in Asia: a critical review and future directions”, Asian Business and Management, 21(3), 343-372. [16]. Gloria, L. O. M., Juan, C. R. A., & Katherine, Y. L. M., 2022, Culture as an obstacle for entrepreneurship, Journal of Innovation and Entrepreneurship, 11:46. [17]. Hechevarría, D., Bullough, A., Brush, C., & Edelman, L., 2019, “High-growth women’s entrepreneurship: fueling social and economic development”, Journal of Small Business Management, 57(1), 5-13. [18]. Horne, R., 2024, Employment and social trends by region. World Employment and Social Outlook, 2024(1), 37-60 [19]. Huatao, P., Bingbing, L., & Yang, L., 2022, How social network influences the growth of entrepreneurial enterprises: Perspective on organizational and personal network, SAGE Journals. [20]. Inegbedion D. O., & Oghojafor B. E. A., 2021, Entrepreneurship education and elimination of unemployment among graduates and non-graduates of tertiary institutions in Nigeria. Journal of Women Empowerment and Studies, 01(02), 6-16 [21]. Kara, A., & Dheer, R. J., 2023, The relationship between culture and entrepreneurship: the role of trust, International Entrepreneurship Management Journal, 19, 1803-1833. [22]. Kusa, R., Duda, J., & Suder, M., 2021, Explaining SME performance with fsQCA: The role of entrepreneurial orientation, entrepreneur motivation, and opportunity perception. Journal of Innovation & Knowledge, 6(4), 234–245. https://doi.org/10.1016/j.jik.2021.06.001 [23]. Li, T., 2024, The joint effects of formal and informal institutions on entrepreneurial startups: a global perspective, International Studies of Management & Organization, 54(4). [24]. Miyajima, M. K., 2023, The Link between Social Grant and Employment in South Africa. International Monetary Fund. Selected issues papers 2023(039). http://doi.org/10.5089/979400243493.018 [25]. Mollel, E. S., Chachage, B., & Pasape, L., 2024, A framework for enhancing entrepreneurship development in higher learning institutions (HLIs) in Tanzania, International Journal for Multidisciplinary Research, 6(3), E-ISSN: 2582-2160. [26]. Mojishola, E., 2024, Effect of Corruption on Entrepreneurial Development in Nigeria. Journal of Policy and Development Studies, 17(2), 79-91. [27]. Mozumdar, L., Materia, V.C., Hagelaar, G., Islam, M. A., Velde, G.V.D., & Omta, S.W.F., 2022, “Contextuality of entrepreneurial orientation and business performance: the case of women entrepreneurs in Bangladesh”, Journal of Entrepreneurship and Innovation in Emerging Economies, 8(1), 94-120. [28]. North, D. C., 1990, Institutions, institutional change and economic performance. Cambridge. Cambridge University Press. [29]. Ogunsanwo, O. F., & Olowo, S. O., 2020, Role of Bank of Industry on small scale entrepreneurial development in Nigeria. American International Journal of Business Management, 3(3), 19-24. [30]. Pau, S. P., Irene, C., & Alicia, M. T., 2022, Institutional factors affecting entrepreneurship: A QCA analysis, European Research on Management and Business Economics. [31]. Sindakis, S., & Showkat, G., 2024, The digital revolution in India: bridging the gap in rural technology adoption. Journal of Innovation and Entrepreneurship, 13(1), 29. [32]. Sobhan, N., & Hassan, A., 2023, The effect of institutional environment on entrepreneurship in emerging economies: female entrepreneurs in Bangladesh, Journal of Entrepreneurship in Emerging Economies, Emerald Publishing Limited 2053-4604. https://doi.org/10.1108/JEEE-01--0028 [33]. Shanji, X., & Taeyoung, P., 2023, The roles of big businesses and institutions in entrepreneurship: A cross-country panel, Journal of Innovation & Knowledge, 9. [34]. Spyromitros, E., & Panagiotidis, M., 2022, The impact of corruption on economic growth in developing countries and a comparative analysis of corruption measurement indicators. Cogent Economics & Finance, 10(1), 2129368. [35]. Wanli, D., & Juan, W., 2023, The effect of entrepreneurship education on the entrepreneurial intention of different college students: Gender, household registration, school type, and poverty status, PLoS ONE 18(7): e0288825. [36]. Welter, F., 2020, “Contexts and gender–looking back and thinking forward”, International Journal of Gender and Entrepreneurship, 12(1), 27-38. [37]. World Bank, 2020, Doing business: Institutional quality and economic performance in Africa. Washington, DC: World Bank. [38]. Williams, C. C., Adom, K., & Horodnic, I. A., 2020, “Determinants of the level of informalization of enterprises: Some evidence from Accra, Ghana”, Journal of Developmental Entrepreneurship, 25(1), 2050004. [39]. Yoon, H., Kim, N., Buisson, B., & Phillips, F., 2018, “A cross-national study of knowledge, government intervention, and innovative nascent entrepreneurship”, Journal of Business Research 84: 243-252. Viewed PDF 2 0 
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					Pedagogy in a Pandemic: A Case Study of Blended Learning Challenges at a Technical University in BotswanaAuthor: Boitshoko .E. OtlhomileDOI: 10.21522/TIJAR.2014.12.04.Art021Pedagogy in a Pandemic: A Case Study of Blended Learning Challenges at a Technical University in BotswanaAbstract:This paper explores the challenges encountered by students and teaching staff members during the implementation of blended learning at the Botswana International University of Science and Technology (BIUST) amid the Covid-19 pandemic. A mixed-methods research approach was adopted, guided by a descriptive case study design. The population of the study were BIUST staff and students. A total of 73 students and 53 teaching staff members were purposively selected to participate in the study. The research employed Diffusion of Innovation (DoI) theory and Social Constructivist theory. Structured surveys, semi-structured interviews, open-ended questionnaires, and document analysis were used to collect data. The use of triangulation methods strengthened the reliability and validity of the research findings. The findings indicated that participants faced numerous challenges, such as unreliable internet connections, increased workload for teaching staff members, a lack of digital literacy skills among students and teaching staff members, students’ low engagement in the virtual learning environment, and inadequate training programs on blended learning. The participants recognised blended learning's value, but multiple obstacles made it difficult to implement it effectively during the pandemic. The study concluded that BIUST needed to develop stronger preparedness through investing in technological infrastructure, inclusive planning, and ongoing professional development on the application of digital tools for students and staff members. Pedagogy in a Pandemic: A Case Study of Blended Learning Challenges at a Technical University in BotswanaReferences:[1]. Dhawan, S., 2020, “Online Learning: A Panacea in the Time of COVID-19 Crisis,” Journal of Educational Technology Systems, 49(1), pp. 5–22, Doi:10.1177/0047239520934018. [2]. Desale, T., Kokande, M., Patil, D., Dhage, S., and Wagh, S., 2024, “ERP System for College Examination,” International Journal of Advanced Research in Computer and Communication Engineering (IJARCCE), 13(4), Doi:10.17148/ijarcce.2024.134150. [3]. Bond, M., Bedenlier, S., Marín, V. I., and Händel, M., 2021, “Emergency remote teaching in higher education: mapping the first global online semester,” International Journal of Educational Technology in Higher Education, 18, Doi:10.1186/s41239-021-00282-x. [4]. Rasheed, R. A., Kamsin, A., and Abdullah, N. A., 2020, “Challenges in the online component of blended learning: A systematic review,” Computers & Education, 144, Doi:10.1016/j.compedu.2019.103701. [5]. Mabuza, D. C., and Thwala, L. N., 2025, “Barriers to Effective Blended Learning for Consumer Science in Eswatini’s Rural High Schools,” East African Journal of Education Studies, 8(1), pp. 408–429, Doi:10.37284/eajes.8.1.2721. [6]. Singun, A. J., 2025, “Unveiling the barriers to digital transformation in higher education institutions: a systematic literature review,” Discover Education, Doi:10.1007/s44217-025-00430-9. [7]. Woldegiorgis, E. T., 2025, “Challenges of integrating technology in East African higher education systems in the post-pandemic era: emerging academic cultures,” Technology, Pedagogy and Education, pp. 1–19, Doi:10.1080/1475939X.2025.2520589. [8]. Abera, M., Bimenyimana, P. C., Abebe, S. M., Byungura, J. C., Ndikumana, R., and Jemal, M. W., 2025, “Challenges of Implementing E-Learning in African Universities: Experiences from Ethiopia and Rwanda,” Education Policy Analysis Archives, 33, Doi:10.14507/epaa.33.8772. [9]. Ghansah, B., 2025, “From crisis to opportunity: the digital evolution of higher education in Africa amidst the COVID-19 pandemic,” Discover Education, 4(1), Doi:10.1007/s44217-025-00527-1. [10]. Panday, A., Ray, T., Jalandharachari, A. S., and Gopinath, G., 2025, “Insights into blended learning research: a thorough bibliometric study,” Discover Education, 4(5), Doi:10.1007/s44217-025-00439-0. [11]. Price, E., and Winchester, T., 2025, “Designing for diversity: a scoping review of equity in higher education’s blended learning practices,” Australian Educational Researcher, Doi:10.1007/s13384-025-00859-9. [12]. Merola, R. H., 2025, “Online learning’s potential to improve access and quality in higher education in Mexico: Perspectives of higher education stakeholders,” Journal of Education and e-Learning Research, 12(1), pp. 94–103, Doi:10.20448/jeelr.v12i1.6448. [13]. Fernández, A., Gómez, B., Binjaku, K., and Meçe, E. K., 2023, “Digital transformation initiatives in higher education institutions: A multivocal literature review,” Education and Information Technologies, 28(10), pp. 12351–12382, Doi:10.1007/s10639-022-11544-0. [14]. Akram, U., Rakos, L., Petrosani, U. D., Solomon, R. A., and Fülöp, M. T., 2020, “The role of universities’ sustainability, teachers’ wellbeing, and attitudes toward e-learning during COVID-19,” [15]. Ndibalema, P., 2025, “Digital literacy gaps in promoting 21st century skills among students in higher education institutions in Sub-Saharan Africa: a systematic review,” Cogent Education, Doi:10.1080/2331186X.2025.2452085. [16]. Sha, L., Wang, X., and Liu, T., 2025, “Understanding college students’ acceptance of machine translation in foreign language learning: an integrated model of UTAUT and task-technology fit,” Humanities and Social Sciences Communications, 12(1), Doi:10.1057/s41599-025-04888-8. [17]. Sun, X., et al., 2025, “Application and effectiveness of blended learning in medical imaging via the technology acceptance model,” BMC Medical Education, 25(1), Doi:10.1186/s12909-025-07293-6. [18]. Musa, A. I., Ezra, G. S., and Monsurat, M. F., 2015, “Information and Knowledge Management Perceived Attributes of Diffusion of Innovation Theory as a Theoretical Framework for understanding the Non-Use of Digital Library Services,” Information and Knowledge Management, 5(9), https://www.iiste.org [19]. Menzli, L. J., Smirani, L. K., Boulahia, J. A., and Hadjouni, M., 2022, “Investigation of open educational resources adoption in higher education using Rogers’ diffusion of innovation theory,” Heliyon, 8(7), Doi:10.1016/j.heliyon.2022.e09885. [20]. Kottara, C., Asonitou, S., and Kavalieraki-Foka, D., 2025, “A Conceptual Framework for Student Retention in an Advanced Financial Accounting Course: Traditional vs. Blended Learning Environments,” Trends in Higher Education, 4(3), p. 30, Doi:10.3390/higheredu4030030. [21]. Sha, L., Wang, X., and Liu, T., 2025, “Understanding college students’ acceptance of machine translation in foreign language learning: an integrated model of UTAUT and task-technology fit,” Humanities and Social Sciences Communications, 12(1), Doi:10.1057/s41599-025-04888-8. Viewed PDF 15 1 
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					Investigating Barriers to Pre-Exposure Prophylaxis Uptake to Prevent HIV Among General Population of Sub-Saharan Africa Countries- A Systematic ReviewAuthor: Zanele Patience SimelaneDOI: 10.21522/TIJAR.2014.12.04.Art022Investigating Barriers to Pre-Exposure Prophylaxis Uptake to Prevent HIV Among General Population of Sub-Saharan Africa Countries- A Systematic ReviewAbstract:Sub-Saharan Africa is one of the regions were the prevalence of HIV is high. Many strategies have been introduced to fight HIV in these countries including Pre-exposure prophylaxis (PrEP). The uptake of PrEP has been low in these countries thus this review aims to investigate the barriers to PrEP uptake among the general population of Sub-Saharan Africa countries. A systematic review was conducted and the research studies that were used were selected from google scholar and PubMed databases. Twelve (12) studies were analyzed to determine the barriers to Pre-exposure prophylaxis uptake among the general population of Sub-Saharan Africa countries. Majority of the studies revealed that barriers to Pre-exposure prophylaxis were stigma, fear of side effects, lack of knowledge, pill burden, lack of transport to the health facility, distance from the facility, attitude of health care workers and stock out of medications. There is need to increase PrEP awareness in these countries so to reduce the level of stigma attached to PrEP and improve access to health facilities. Investigating Barriers to Pre-Exposure Prophylaxis Uptake to Prevent HIV Among General Population of Sub-Saharan Africa Countries- A Systematic ReviewReferences:[1]. United Nations Programme on HIV/AIDS (AIDS)., 2024, Global HIV and AIDS Statistics. http://unaids.org/en/resources/fact-shets. [2]. Elizabeth Glaser Pediatric AIDS Foundation (EGPAF)., 2025, Adolescents and HIV. http://pedaids.org/adolescents-and-hiv. [3]. HIV and AIDS in East and Southern Africa Regional Awareness Overview., Avert. 2019, http://www.avert.org/professionals/hiv-around-world-sub-saharan-africa/overvew [4]. World Health Organisation. 2025, Pre-Exposure Prophylaxis PrEP, Global HIV Programme. WHO. Geneva. http://www.who.int/teams/global-hiv. [5]. Center for Disease Control (CDC)., 2024, Preventing HIV with PrEP. http://www.cdc.gov/hiv/prevention/prep/html. [6]. Global HIV/AIDS Organizations., 2025, Pre- Exposure Prophylaxis, HIV org. http://www.hiv.gov-basics/hiv-prevention/using-hiv-medication [7]. Center for Disease Control (CDC)., 2024, Morbidity and Mortality Weekly Reports Progress Towards UNAIDS Global HIV Pre-exposure Prophylaxis Targets: CDC-supported Oral Pre-Exposure Prophylaxis-37 Countries 2017-2023. http://www.cdc.gov/mmusr/volumes/73/wr/mm7347a3.htm [8]. Admassu, A., Nostlinger, C., & Hensen, B., 2024, Barrier to PrEP use and adherence among adolescent girls and young women in Eastern, Southern and Western Africa. BMC Women’s Health. NO: 665.ISSN:14726874. [9]. Muhunuza, R., Ssemata, A. S., Kakande, A., Ahmend, N., Atujura, M., & Mangxilana, N., 2021, Exploring Perceived Barriers and facilitators of PrEP Uptake among in Uganda, Zimbabwe and South Africa. Volume 50.1729-1742. [10]. Ashipala, D. O., 2024, Exploring Factors hindering the Uptake of HIV Pre-Exposure Prophylaxis by potential users in Namibia. 2024. S Afr J hv. Med. 2024:25(1) 91561. http://doi.org/10.4102/sajhiumed.v25il.1561 [11]. Nicholus, S. C., Matewere, M., Bula, A., Tsidya, M., Hosseinnipour, M. C., Matoga, M., & Mipando, N., 2025, http://doi.org/10.1371/journal.pgph.0004006 [12]. Gombe, M. M., Cakourous, B. E., Ncube, G., Zwangobani, N., Mareke, P., Mkwambs, A., Prescott, M. A., Bhalasara, T., Murwira, M., Mangwiro, A., & Prust, M. L., 2020, Key Barriers and Enablers Associated with PrEP Uptake and Continuation of Oral PrEP in Public Sector Zimbabwe: Qualitative Perspective of General Population Clients at High Risk. PLOS One. 2020. Jan13; 15(11): e0227632. http://doi10:1371. Journal.prone.0227632. PMID: 31931514. [13]. Gibson, J., Ezema, A. U., Orero, W., Were, I., Osasogie, O., Mbulto, P. O., & Hirschhorn, L. R, 2021. Facilitators and Barriers to HIV Pre-Exposure Prophylaxis Uptake through a Community-based Intervention Stratergy among Adolescent girls and young women in Semi-Sub-country. Volume:21. Article number: 1284(20210. http://10.1186/512889-021-11335-1 [14]. Zotova, N., Shongo, A., Lelo, P., Mbonze, N., Koba, D., Ntangu, P., Shi, Q., Adedimeji, A., Anastos, K., Yatobeina, M., Patel, V., & Ross, J., 2024, Low Retention on PrEP and Barriers to PrEP use among Key Population in Kinshasa, DRC: A mixed method study. http://doi.org/10.1101/2024.12.18.24318849. [15]. Stoebenau, K., Muchaga, G., Ahmad, S. S., Bwalya, C., Muvale, M., Toussant, S., Maambo, C., Peter, C. J., Baumhart, C., Mwango, I. k., Lavoie, M. C., & Claassen, C. W., 2024, Barriers and Facilitators to Uptake and persistence on PrEP among Key Population in Southern Province in Zambia: A Thematic analysis. June: 17; 24(1). http://doi:10.1186/s12889-024-19152-y. PMID: 3886691. [16]. Barnighausen, K., Matse, S., Hughey, A. B., Hettema, A., Barnighausen, T. W., & Machon, S. A., 2020, “We know this will be haard at the beginning, but better in long-term: Understand PrEP uptake in the general population in Eswatini. AIDS Care. http://doi:101080/09540121.2019.1653437. PMID: 31437021. [17]. Chebet, J. J., Machon, S. A., Tarumbiswa, T., Hlalele, H., Maphonga, C., Mandora, E., Ernst, K., Alaofe, H., Baerninhausen, T., Ehin, J. E., Geldsetzer, P., & Nichler, M., 2023, Motivation for Pre-Exposure Prophylaxis Uptake and Decline in an HIV-Hyperendemic Setting: Finding from a Qualitative Implementation Study in Lesotho. AIDS Res.Ther.2023. Jul6; 20(1):43. http://doi:10.1186/512981.023.00535. PMID: 37415180. [18]. Muwonge, T. R., Nsubuya, R., Brown, C., Nakyanzi, A., Bagaya, M., Bambia, M. et al., 2020, Knowledge and Barrier of PrEP Among Diverse Groups of potential PrEP uses in Central Uganda. PLOS one.15 (10): e0241399. http://doi.org/101371/journal.pone.024/399 [19]. Sila, J., Larsen, A., KInuthia, J., Owin, G., Abuna, F., Kohler, P., John-Stewart, G., & Pinty, J., 2020, High Awareness, Yet Low Uptake, Pre-Exposure Prophylaxis Among Adolescent Girls and Young Women with Family Planning Clinics in Kenya. AIDS Patient Care STDS.2020 Aug: 34(8):336-343. http://10.1089.apc.2020.0037.PMID: 32757980. [20]. Tietelman, A. M., Hong-van, T., Flores, D., Bannon, J., Brawne, B. M., Davis, A., Gurgerty, P., & Koblin. B., 2021, Individual, Social, and Structural Factors Influencing PrEP Uptake Among CSgender Women: A theory-informed elicitation study. AIDS Care.2021 March 9:34(3):273-283. http://doi:10.1080/09540121.2021.1894319 [21]. Crook, N., Singer, R. B., Smith, A., Donenberg, S. Mathews, A. K., Patil, C. L., Haider, S., & Johnson, A., 2022, Barriers to PrEP Uptake among Black Female Adolescent and Emerging Adults.Science direct. http://doi.org/10.1016/j.pmedr.2022.102062 [22]. Samo, R. N., Jamali, M. S., Mahmood, S. F., Umar, R., Mustafa, K., & Muhamand, S. J., 2025, Understanding Barriers to HIV Pre-Exposure Prophylaxis Initiation Among Men who have Sex with Men in Sindh, Pakistan. International Journal of STD and AIDS. Jul; 36(8):649-654. http://doi.10.1177/09564624251344419. PMID: 40396384. Viewed PDF 3 0 
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					Drug-Abuse and Prevention Strategies Among Secondary-School Athletes Participating in Football and Athletics in Port-Loko District, Northwest Region, Sierra LeoneAuthor: Sorie Habibson KamaraDOI: 10.21522/TIJAR.2014.12.04.Art023Drug-Abuse and Prevention Strategies Among Secondary-School Athletes Participating in Football and Athletics in Port-Loko District, Northwest Region, Sierra LeoneAbstract:This study investigates the prevalence of drug abuse among secondary schools’ athletes participating in football and athletics within the Port-Loko District, North-west-region of Sierra Leone. Rising concerns about the impact of drug use on athletic performance, health, and academic success necessitated a comprehensive analysis of the factors contributing to substance abuse in this demographic through a mixed methods approach, including surveys/questionnaire, interviews and focus group-discussions with athletes, coaches, sport masters and parents. The research identified key trends in drug consumption, motivation behind usage, and the socio-economic factors influencing these behaviors. The population of the study included 400 pupils athletes in selected secondary-schools within Port-Loko District formed the population and sample size 200 was done by simple random sampling and purposive sampling. Data was collected with instruments like questionnaires, interviews and focus-group-discussions. Data was analyzed using the IB-SPSS software version 25 and results translated into tables and charts. Findings revealed that considerable proportion of athletes are exposed to various substances, predominantly stimulants, and performance-enhancing drugs, often driven by the pressures to excel in sports and the absence of adequate knowledge regarding the risks associated with drug use. The research underscores the critical role of peer-influence, accessibility of drug, and the need for improved educational resources. In response to these findings, the research proposes targeted prevention strategies tailored to the unique-environment of secondary-school sports. Recommendations include the implementation of comprehensive drug-education-program, increase involvement of stakeholders and parents in sports education, and the establishment of support system that encourage healthy-life-style choices among youth-athletes. Drug-Abuse and Prevention Strategies Among Secondary-School Athletes Participating in Football and Athletics in Port-Loko District, Northwest Region, Sierra LeoneReferences:[1]. Adams, R., & Green, T., 2024, The impact of drug abuse on academic performance among student athletes. Journal of Sports Medicine. [2]. Amiek, B., 1978, Abuse of chemical substances. South Africa. [3]. Arif, Hughes, Khant & Shafique., 1992, methodology of collecting data UNESCO publications. [4]. Awake magazine, 1996, National house hold survey on drug abuse, page 74-75. America [5]. Bai, A., Jalloh, M., & Sesay, M., 2022, Peer Influence and Drug Abuse Among Student Athletes in Sierra Leone. Journal of Adolescent Health, 70(3), 456-463. [6]. Bangs, B., 2001, Drug and related problems in Sierra Leone. Pamphlet. Freetown. Private printing press. [7]. Bangura, N. A., 1998, Drug use, misuse in Sierra Leone. Pamphlet. Private printing press. [8]. Beck, 1987, Effects of drugs to students. Press conference release. Freetown. [9]. Brima, 1999, World Tobacco Day. Ministry of Health and sanitation. Sierra Leone. [10]. Browne, J., & Smith, L., 2022, Peer influence and drug use in adolescent athletes. International Journal of Adolescent Health. [11]. Fofana, A., & Kamara, S., 2024, Drug Policy and Its Impact on Student Athletes in Sierra Leone. International Journal of Drug Policy, 102, 103-110. [12]. Johnson, M., & Lee, A., 2022, Cannabis use among student athletes: A growing concern. Sports Health Review. [13]. Johnson, R., & Lee, T., 2022, Alcohol Use Among Adolescent Athletes: A Review of the Literature. Substance Use & Misuse, 57(5), 678-689. [14]. Kanu, A., Koroma, M., & Sesay, J., 2024, Methods of Drug Abuse Among Student Athletes: A Qualitative Study. African Journal of Sports Medicine, 12(1), 34-42. [15]. Kanu, F., Osei, A., & Thompson, R., 2024, Drug abuse prevention strategies in secondary schools: A case study in Sierra Leone. African Journal of Public Health. [16]. Koroma, M., Jalloh, M., & Fofana, A., 2025, Prevention Strategies for Drug Abuse Among Student Athletes: A Comprehensive Review. Journal of Substance Abuse Treatment, 120, 45-52. [17]. Miller, S., & Johnson, P., 2022, The role of education in preventing drug abuse among athletes. Journal of Health Education. [18]. Nguyen, T., Smith, J., & Browne, L., 2023, Peer support systems in sports: A preventive measure against drug abuse. Journal of Youth Sports. [19]. Osei, A., & Kanu, F., 2024, Parental involvement in drug abuse prevention among student athletes. Journal of Family Studies. [20]. Smith, J., Thompson, R., & Lee, A., 2021, Performance-enhancing drugs in youth sports: A review of the literature. Journal of Sports Science. [21]. Smith, L., Thompson, R., & Kamara, S., 2021, Types of Drugs Abused by Student Athletes: A Systematic Review. Sports Medicine, 51(4), 789-802. [22]. Thompson, R., 2023, The perceived benefits of drug use among student athletes. Journal of Sports Psychology. [23]. Thompson, R., Jalloh, M., & Bai, A., 2023, The Perception of Success in Drug Use Among Student Athletes. Journal of Youth Studies, 26(2), 123-135. [24]. Williams, D., & Green, T., 2023, Health consequences of drug abuse in adolescent athletes. Journal of Adolescent Health. Viewed PDF 4 0 
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					Uptake and Satisfaction with NHIA: A Study of Formal and Informal Sector Employees in Kano, NigeriaAuthor: HM MijinyawaDOI: 10.21522/TIJAR.2014.12.04.Art024Uptake and Satisfaction with NHIA: A Study of Formal and Informal Sector Employees in Kano, NigeriaAbstract:Universal health coverage (UHC) is a global imperative, yet Nigeria’s National Health Insurance Authority (NHIA) continues to reflect deep inequalities, particularly between formal and informal sector workers. This cross-sectional comparative study surveyed 440 NHIA enrollees (205 formal, 235 informal) from all 44 Local Government Areas in Kano State, Nigeria, to assess NHIA uptake, satisfaction, and service utilization. Participants were adults enrolled for ≥6 months and had accessed NHIA-accredited outpatient services in the preceding three months. Socio-demographic characteristics, enrollment pathways, satisfaction across financial and service domains, and key predictors of satisfaction and continued enrollment were analyzed. Formal sector workers reported higher NHIA awareness (87.3% vs. 83.0%), longer enrollment duration (≥7 years: 27.6% vs. 5.6%; p<0.001), and greater satisfaction across financial indicators including co-payments (81.4% vs. 31.1%; p<0.001) and co-contributions (71.7% vs. 28.5%; p<0.001). While 98.5% of formal and 98.3% of informal respondents desired to continue enrollment, informal enrollees were significantly more likely to report neutrality on key satisfaction metrics. Notably, informal respondents were more likely to believe that NHIA improved their health (66.8% vs. 36.1%; p<0.001). Qualitative data highlighted affordability, trust, and family coverage as motivators, but also underscored persistent awareness and access barriers for informal workers. While satisfaction with NHIA services is high overall, structural disparities persist between sectors. Formal workers benefit from embedded payroll systems and employer facilitation, whereas informal enrollees face awareness, affordability, and access barriers. Targeted reforms such as simplified enrollment, premium subsidies, and expanded community outreach are essential to achieve equitable UHC in Nigeria. Uptake and Satisfaction with NHIA: A Study of Formal and Informal Sector Employees in Kano, NigeriaReferences:[1]. Habib, S., Hamid, S., Khowaja, A., 2016, The role of micro health insurance in providing financial risk protection in developing countries- A systematic review. [2]. Omotosho, O., Ichoku, H., 2016, Financial Protection and Universal Health Coverage. International affairs and global health strategy. (51) 5-14. [3]. Flannery, D., Garvey, J., Inyang, U., 2020, The financial protection of national health insurance: Evidence from a cross section of State and Federal workers in Akwa Ibom, Nigeria. [4]. Okunogbe, A., Hähnle, J., Rotimi, B. F., Akande, M., T., Wendy, J., Short and longer-term impacts of health insurance on catastrophic health expenditures in Kwara State, Nigeria. BMC Health Services Research.22 (1-18). [5]. Amakom, U., Ezenekwe, U., 2012, Implications of households catastrophic out of pocket (OOP) healthcare spending in Nigeria. Journal of Research in Economics and International Finance (JREIF) [6]. Aregbeshola, B. S., Khan, S. M., 2018, Out-of-pocket payments, catastrophic health expenditure and poverty among households in Nigeria 2010. Int J Health Policy Manag. 7(9):798–806. doi:10.15171/ijhpm. [7]. Adewole, D. A., Osungbade, K. O., 2016, Nigeria’s National Health Insurance Scheme: A Highly Subsidized Health Care Program for a Privileged Few [8]. Aregbeshola, B. S., Khan, S. M., 2018, Predictors of enrolment in the National Health Insurance Scheme among women of reproductive age in Nigeria. International Journal of Health Policy and Management. 7(11), 1015-1023. [9]. Onwujekwe, O., Onoka, C., Uzochukwu, B., Hanson, K., Constraints to universal coverage: Inequities in health service use and expenditures for different health conditions and providers. 10 (1-9). [10]. Onoka, C. A., Onwujekwe, O. E., Uzochukwu, B., Uguru, N., Anochie, C., Ewelukwa O., 2012, Variations in Incidence Out of Pocket Spending for Illness amongst Households of Different Socio-Economic Groups: An Investigation Using Expenditure Diaries. [11]. Omotosho, O., Ichoku, H. E., Distributional Analysis of Household Health Expenditure in Nigeria. Developing country issues. 9 (111-120). [12]. Akinyemi, O. O., Owopetu, O. F., Agbejule, I. O., National health insurance scheme: perception and participation of federal civil servants in Ibadan. [13]. Ibeneme, G. C., Ugochukwu, C., Nwosu, A.O., Fortwengel, G., Oko, C. C., Okpua, N., 2024, National Health Insurance Scheme Enrolees. Satisfaction with Quality of Care and Willingness to Retain Membership in a tertiary hospital in Nigeria: Implications for Community-Based Health Insurance uptake. 1-13. [14]. Daramola, O. E., Adeniran, A., Akande, T. M., 2018, Patients’ Satisfaction with the Quality of Services accessed under the National Health Insurance Scheme at a Tertiary Health Facility in FCT Abuja, Nigeria. Journal of Community Medicine and Primary Health Care. 30 (2) 90-97. [15]. Osunde, N. R., Olorunfemi, O., Oduyemi, R. O., 2023, Awareness, willingness, and challenges of the informal sector toward state National Health Insurance Services in Benin City, Nigeria. MGM J Med Sci. (10)30-7. [16]. Osahon, E., Achieving Universal Health Coverage in Nigeria: Moving Beyond Annual Celebrations to Concrete Address of the Challenges. [17]. Bolarinwa, O. A., Afolayan, M. A., Rotimi, B. F., Alatishe-Mohammad, B., 2021, Are there evidence to support the informal sector's willingness to participate and pay for statewide health insurance scheme in Nigeria? Niger Postgrad Med J. 28(71-3). [18]. Nwanaji-Enwerem, O., Bain, P., Marks, Z., Nwanaji-Enwerem, P., et.al., 2022, Patient satisfaction with the Nigerian National Health Insurance Scheme two decades since establishment: A systematic review and recommendations for improvement. African Journal of Primary Health Care and Family Medicine. 14 (1-10). [19]. Onoka, C. A., Hanson, K., Hanefeld, J., Uzochukuwu, B. S., 2015, Towards universal coverage: A policy analysis of the development of the National Health Insurance Scheme in Nigeria. 30 (9) 1105- 1117. [20]. Adewole, D. A., Adebayo, A. M., Udeh, E. I., Shaahu, V. N., Dairo, M. D., 2015, Payment for health care and perception of the national health insurance scheme in a rural area in Southwest Nigeria American Journal of Tropical Medicine and Hygiene. 93 (648-654). [21]. Ebelechukwu, L. O., Chikosolu, Y. O., Chima, T. I., Clara, C. O., Chukwunweike, A. O., 2021, Health care payment practice, perception and awareness of national health insurance scheme by market women in Enugu Metropolis South-East Nigeria. 10.11604/pamj.2021.40.127.26775. [22]. Olamuyiwa, T. E., Adeniji, F. O., 2021, Patient's Satisfaction with Quality of Care at a National Health Insurance Clinic at a Tertiary Center, South-South Nigeria. J Patient Exp.16; 8:2374373520981471. doi: 10.1177/2374373520981471. PMID: 34179352; PMCID: PMC8205399. [23]. Uguru, N., Ogu, U., Uguru, C., et al., 2024, Is the national health insurance scheme a pathway to sustained access to medicines in Nigeria? BMC Health Serv Res. https://doi.org/10.1186/s12913-024-10827-1 [24]. Alawode, G., Adewole, A., 2021, Assessment of the design and implementation challenges of the National Health Insurance Scheme in Nigeria: a qualitative study among sub-national level actors, healthcare and insurance providers. BMC Public health. 21. 10.1186/s12889-020-10133-5 [25]. Iliyasu, Z., Abubakar, I. S., Abubakar, S., Lawan, U. M., & Gajida, A. U., 2010, Patients’ satisfaction with services obtained from Aminu Kano Teaching Hospital, Kano, Northern Nigeria. Nigerian Journal of Clinical Practice. 13(4), 371-378 [26]. Barasa, E. W., Mwaura, N., Rogo, K., and Andrawes, L., 2017, Extending voluntary health insurance to the informal sector: experiences and expectations of the informal sector in Kenya [version 1; referees: 3 approved] Welcome Open Research 2017, :94 (doi:2 10.12688/wellcomeopenres.12656.1 Viewed PDF 5 0 
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					Indian Bharatiya Janata Party (BJP) & Parliamentary Elections 2014-2024: Evaluating Strategies and the Gender GapAuthor: Racheal Modupe OkegbolaDOI: 10.21522/TIJAR.2014.12.04.Art025Indian Bharatiya Janata Party (BJP) & Parliamentary Elections 2014-2024: Evaluating Strategies and the Gender GapAbstract:This study analyses the ratio of male to female party candidates in India and how the Bharatiya Janata Party (BJP)'s strategies from 2014 to 2024 have marginalised women, making elections a crucial turning point. Scholars have shown that women often lose elections due to party decisions and strict criteria, reinforcing male dominance. Despite promises and women casting 67.40% of the votes, female politicians remain underrepresented: the Sabha parliamentary body comprises 469 elected men out of the 543 elected members, as determined by the First-Past-the-Post system. Since independence, the INC party and the BJP have focused on Hindutva ideology, promoting a male-dominated, Hindu cultural identity. Methodically, the study reviewed relevant literature, including the Election Commission of India, the Constitution, articles, BJP websites, and campaign reports, to evaluate the BJP's winning strategies and the "Seva” group's efforts to garner women’s votes. It also examined literature on factors contributing to the gender gap, under the BJP’s nomination patterns, which are often aligned with class-caste clusters, geographical, and religious divisions. While, India’s deeply rooted male-dominated tradition has discouraged many women from pursuing careers in politics. The result portrays the BJP as India's most male-dominated ruling party, urging the government and political parties to promote women candidates and achieve the UN's goal of having one-third of all electoral positions allotted to women. It recommends establishing inclusive media platforms among women's elites to achieve electoral equality, adopting a bottom-up approach. Indian Bharatiya Janata Party (BJP) & Parliamentary Elections 2014-2024: Evaluating Strategies and the Gender GapReferences:[1]. Royal Institute of International Affairs, 2022, India: The world's largest democracy. London: Chatham House. [2]. Royal Institute of International Affairs, 2022, India: The world's largest democracy. London: Chatham House. [3]. Sridharan, E., 2014, India's Constitutional Watershed Vote Report: Behind Modi's victory. Journal of Democracy; 25(4): 20-33. [4]. Sridharan, E., 2014, India's Constitutional Watershed Vote Report: Behind Modi's victory. Journal of Democracy; 25(4): 20-33. [5]. Milan, V., Smogard, D., 2014, A New Era in Indian Politics? Washington: Carnegie Endowment for International Peace; 2014. [6]. Hosken, F., 1981, Women's Suffrage Movements: A global perspective. American Historical Review. 1981;86(3):515-532. [7]. Khaitan, T., 2020, The Path to Women's Suffrage: International comparisons. Oxford: Oxford University Press. [8]. Ute S., 2001, Women's suffrage in the Middle East. Middle Eastern Studies, 37(2), 234-251. [9]. Gandhi, M., 2021, The Representation of People's Acts and Indian Democracy. Political Studies India. 19(2):156-178. [10]. Kaushik, P., 2019, Caste, Constitution and Electoral Politics in India. Indian Political Science Review. 41(3):234-256. [11]. Jafar, M., 2020, The Persistence of Caste in Indian Electoral Politics. South Asian Politics. 28(4):412-435. [12]. Kofi, A., 2021, Religion and politics in Secular Democracies: India and the United States compared. Comparative Politics. 53(2):189-210. [13]. Malhotra, I., 2019, The Assassination of Mahatma Gandhi and its Impact on Indian politics. Historical Studies. 87(4):567-589. [14]. Praveen, K., 2024, Gender Representation in Indian parliament: A critical analysis. Indian J Gender Studies. 31(1):45-67. [15]. Krutika, P., Saaliq, S., Rising, D., 2024, Modi claims victory in India's election, but drop in support forces him to rely on coalition partners. AP News. India. [16]. Sanjay, K., 2020, Verdict 2019: The expanded support base of the Bharatiya Janata Party. Asian Journal of Comp Polit. 2020; 5(1):45-62. [17]. Suhas, P., 2017, Hindu nationalism and Indian democracy. Political Studies Review. 2017;15(3):345-367. [18]. Kofi, A., 2021, Electoral laws and delimitation in India. Indian Law Review, 45(2), 234-256. [19]. Sanjay,2023, Comparative Electoral Systems Study., ECI and INEC: A comparative analysis. Electoral Studies. 78:112-128. [20]. Sanjay, R., 2019, BJP's Ethical Standards and Governance, 2019-2024. Indian Political Analysis. 27(4):445-467. [21]. Sanjay, K., 2015, The Modi Wave: BJP's 2014 Electoral Victory. South Asian Politics. 23(2):189-210. [22]. Kumar, S., 2009, Women's loyalty and Hindutva ideology in BJP politics. Gender Politics India. 17(3):234-251. [23]. Sanjay, R., 2015, Divided we govern: Coalition politics in India. London: C Hurst & Co Publishers Ltd. [24]. Zoya, H. A., 2024, The Unified Opposition must take on the BJP in 2024: The Wire News, June 15, 2024. [25]. UN-Indian Gender Policy Review, 2020, Placing the 2019 BJP victory in comparative and historical context. India Review. 2020;19(2):136-152. [26]. Dipanita, M., 2021, Report on voter turnout across years in the Lok Sabha. Ashoka University: Department of Political Science. [27]. Dyson, T. A., 2018, Population history of India: From the first modern people to the present day. Oxford, Oxford University Press. [28]. Indian National Statistical Organisation, 2024, Electoral Participation by Gender, 2024. New Delhi: Statistical Bureau Office. [29]. Inter-Parliamentary Union (IPU), 2021, Women's Representation in Politics: Global Rankings. Geneva, IPU. [30]. Parihart, L. D., 2011, Women and politics in India: “Electoral Participation patterns”. Electoral Studies India. 29(3):345-367. [31]. Parihart, L. D., 2021, Women and law: From impoverishment to empowerment. Lucknow: Eastern Book Company. [32]. Ludden, D., 2013, India and South Asia: A Short History. One World Publications. [33]. Praveen, K., 2024, BJP Seva strategy and women's mobilisation. Indian Politics Today. 42(3): PP, 234-251. [34]. Anirvan, C., 2021, India in Modern Perspective. Cambridge: Harvard University Centre for International Affairs. [35]. Carnegie International Observer Report, 2019, Indian elections: Gender dynamics. Washington: Carnegie Endowment. [36]. Human Development Report, 2023, Global Gender Gap Report 2022-2023. Geneva: UNDP. [37]. Doherty, I., 2004, Coalition of best practices. Washington, DC: National Democratic Institute. [38]. IEC Conference Report in developing democracies. Political Studies Quarterly. 41(2):234-256. [39]. Egwu, S., 2015, National gender policy and women's political participation. Policy Studies India. 33(4):399-415. [40]. Omotoso, F., 2016, Transnational democracy and feminist perspectives. Gender Politics International. 24(3) pp,145-16. Viewed PDF 4 0 
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					Investigate the Effects of Climate Change on the Agriculture Production of Kazumba Lulu Rural Communities: Cross-Sectional StudyAuthor: Nshimba Ngoy Kayaya JuiskalydDOI: 10.21522/TIJAR.2014.12.04.Art026Investigate the Effects of Climate Change on the Agriculture Production of Kazumba Lulu Rural Communities: Cross-Sectional StudyAbstract:Climate change represents significant challenges to agricultural production, food security, and livelihoods in rural Communities. This article investigates the effects of climate change on agricultural production in rural Communities and identifies effective adaptation strategies. The study provides insights into the perceptions, experiences, and adaptation strategies of rural Communities in the context of climate change. This study examines the impact of climate change on agricultural production in rural communities, with a focus on the adoption of multiple crop cultivation and adaptation strategies. A cross-sectional survey of 200 household heads of farmers reveals significant insights into the impacts of climate change and the adaptive measures employed by rural farmers. The results show that: - 84% of respondents perceive climate change as a significant threat to agricultural production. - Changes in rain availability affect 30% of respondents, while crop yields and water availability are impacted by 25% and 27.5%, respectively. Food security is also affected, with 17.5% of respondents reporting changes in their food security. - Crop diversification was the most common adaptation strategy (48%), followed by Climate-smart agriculture 5% and irrigation management (2%). 45% of respondents have limited access to climate information, and Insufficient resources. The findings of this study contribute to the existing body of knowledge on climate change and its impact on agriculture. The study provides recommendations for policymakers, practitioners, and researchers to support climate-resilient agriculture development in rural communities. The study's results have implications for food security, sustainable livelihoods, and poverty in rural communities. Investigate the Effects of Climate Change on the Agriculture Production of Kazumba Lulu Rural Communities: Cross-Sectional StudyReferences:[1]. IPCC, 2013, Climate change 2013: The physical science basis. Cambridge University Press. https://doi.org/10.1017/CBO9781107415324 [2]. Lobell, D. B., & Burke, M. B., 2010, Atlas of US climate change impacts. Environmental Defense Fund. https://doi.org/10.1016/j.agrformet.2010.07.008 [3]. Schlenker, W., & Roberts, M. J., 2009, Nonlinear temperature effects indicate severe damages to US crop yields under climate change. Proceedings of the National Academy of Sciences, 106(37), 15594-15598. https://doi.org/10.1073/pnas.0906865106 [4]. Thornton, P. K., & Herrero, M., 2015, Climate change and livestock systems. Agricultural Systems, 137, 1-12. https://doi.org/10.1016/j.agsy.2015.03.006 [5]. Altieri, M. A., & Koohafkan, P., 2008, Enduring farms: Climate change, smallholders and traditional farming communities. Food and Agriculture Organization of the United Nations. ISBN: 978-983-2729-55-6 [6]. FAO, 2017, The future of food and agriculture: Trends and challenges. Food and Agriculture Organization of the United Nations. ISBN 978-92-5-109551-5 [7]. IFAD, 2014, The impact of climate change on rural poverty. International Fund for Agricultural Development. https://ioe.ifad.org/documents/d/new-ifad.org/climate-change-building-smallholder-resilience_e-pdf [8]. World Bank, 2015, Climate-smart agriculture: A call to action. World Bank Group. http://documents.worldbank.org/curated/en/992021468197391264 [9]. Ahmed, S., & Stepp, J. R., 2013, Climate change and food security in rural communities. Journal of Food Security, 5(2), 1-12. https://doi.org/10.12691/jfs-5-2-1 [10]. Bhattacharya, S., & Das, S., 2015, Climate change and its impact on agriculture in India. Journal of Agricultural Economics, 66(2), 1-12. DOI: https://doi.org/10.1111/1477-9552.12083 [11]. Kumar, P., & Singh, R. K., 2014, Climate-resilient agriculture in rural India. Agricultural Systems, 127, 1-12. DOI: https://doi.org/10.1016/j.agsy.2014.03.004 [12]. Mandal, S., & Bhattacharya, S., 2015, Climate change and its impact on rural livelihoods. Journal of Rural Development, 34(2), 1-12. https://doi.org/10.25175/jrd/2015/v34/i2/71845 [13]. Singh, R. K., & Singh, A. K., 2015, Climate-resilient agriculture in rural India. Journal of Agricultural Science, 153(2), 1-12. https://doi.org/10.1017/S0021859614000714 [14]. CGIAR, 2015, Climate-smart agriculture: A research report. CGIAR Research Program on Climate Change, Agriculture and Food Security. https://www.cgiar.org/research/program-platform/climate-change-agriculture-and-food-security/ [15]. FAO, 2015, The impact of climate change on agriculture. Food and Agriculture Organization of the United Nations. https://www.fao.org/geospatial/our-work/what-we-do/climate-change-impact-on-agriculture-production/en/ [16]. Lobell, D. B., & Gourdji, S. M., 2015, Climate change and food security. Environmental Research Letters, 10(10), 1-12. https://doi.org/10.1088/1748-9326/10/10/104003 [17]. Schlenker, W., & Roberts, M. J., 2009, Nonlinear temperature effects indicate severe damages to US crop yields under climate change. Proceedings of the National Academy of Sciences, 106(37), 15594-15598. https://doi.org/10.1073/pnas.0906865106 [18]. Thornton, P. K., & Herrero, M., 2015, Climate change and livestock systems. Agricultural Systems, 137, 1-12. DOI: 10.1016/j.agsy.2015.03.006. [19]. Altieri, M. A., & Nicholls, C. I., 2013, Climate change and smallholder farmers. https://doi.org/10.1007/s10584-013-0909-y [20]. IFAD, 2015, Climate-smart agriculture: A policy brief. International Fund for Agricultural Development. ISBN 978-92-9072-282-3. [21]. Kurukulasuriya, Pradeep H.; Rosenthal, Shane J., Climate change and agriculture: a review of impacts and adaptations (English). Environment department papers; no. 91. Climate change series, Washington, DC; World Bank. http://documents.worldbank.org/curated/en/757601468332407727 [22]. Ahmed, S., & Stepp, J. R., 2013, Climate change and food security in rural communities. Journal of Food Security, 5(2), 1-12. https://doi.org/10.12952/journal.elementa.000092 [23]. Bhattacharya, S., & Das, S., 2015, Climate change and its impact on agriculture in India. Journal of Agricultural Economics, 66(2), 1-12. DOI: 10.1111/1477-9552.12083 [24]. Kumar, P., & Singh, R. K., 2014, Climate-resilient agriculture in rural India. Agricultural Systems, 127, 1-12. https://doi.org/10.1016/j.agsy.2014.03.004 [25]. Mandal, S., & Bhattacharya, S., 2015, Climate change and its impact on rural livelihoods. Journal of Rural Development, 34(2), 1-12. DOI: 10.25175/jrd/2015/v34/i2/71845 [26]. IPCC, 2014, Climate change, Impacts, vulnerability, and adaptation. Cambridge University Press. DOI: 10.1017/CBO9781107415379 [27]. Lobell, D. B., & Burke, M. B., 2010, Atlas of US climate change impacts. Environmental Defense Fund. doi: 10.1016/j.agrformet.2010.07.008 [28]. Prajapati, Harshad & Yadav, Khushboo & Hanamasagar, Yamuna & Kumar, Margam & Khan, Tanzeel & Belagalla, Ningaraj & Thomas, Vimala & Jabeen, Afshan & G., Gomadhi & Malathi, G., 2024, Impact of Climate Change on Global Agriculture: Challenges and Adaptation. International Journal of Environment and Climate Change. 14. 372-379. 10.9734/ijecc/2024/v14i44123. [29]. Reuters, 2015, Climate change and food security. https://www.reuters.com/article/business/environment/over-consumption-climate-change-threaten-food-security-water-supply-fao-idUSKBN0N522W/ [30]. The Guardian, 2015, Climate change and agriculture. https://www.theguardian.com/environment/2022/nov/03/big-agriculture-climate-crisis-cop27 [31]. The New York Times, 2015, Climate change and food security https://www.nytimes.com/by/Christopher-flavelle [32]. USDA, 2015, Climate change and agriculture. https://www.ers.usda.gov/amber-waves/2015/November/climate-change-water-scarcity-and-adaptation [33]. European Commission, 2015, Climate change and agriculture. https://commission.europa.eu/publications/annual-activity-report-2015_en#details [34]. Paris Agreement, 2015, Article 2. https://unfccc.int/files/meetings/paris_nov2015/application/PDF/paris_agreement_english_pdf [35]. United Nations Framework Convention on Climate Change, 1992, Article 2. https://unfccc.int/resource/docs/convkp/conveng.pdf [36]. Kazumba Lulu Community Farmers' Network Source, 2024. Viewed PDF 5 2 
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					Experiences and Perceptions of Parents toward Health Care Delivery at Neonatal Intensive Care Unit in Tamale Government Hospitals: A Qualitative InquiryAuthor: Ahmad Sukerazu AlhassanDOI: 10.21522/TIJAR.2014.12.04.Art027Experiences and Perceptions of Parents toward Health Care Delivery at Neonatal Intensive Care Unit in Tamale Government Hospitals: A Qualitative InquiryAbstract:Neonatal Intensive Care Unit admission is usually unexpected and can be stressful to the parents causing strenuous psychosocial effects. Parents of infants admitted to the Neonatal Intensive Care Units often reported suffering stress, depression, and feelings of powerlessness. This study explored the experiences of parents on health care delivery at Neonatal Intensive Care Units. A qualitative study was conducted using phenomenology design and data were collected from nine mothers taking care of their infants at the Neonatal Intensive Care Units of two government hospitals in Tamale. Face-to-face in-dept interviews were conducted employing a semi-structured interview guide. The interviews were audio taped, and thematic analysis was performed to analyse the interview transcripts. Three themes were generated from data analysis and organized in line with the theoretical framework adopted in this study. Although participants are willing to cooperate in the health care delivery system, many of them are not comfortable with the behaviour of some staffs in the facilities. The study found that logistics to render health care was woefully inadequate. Inadequate environmental hygiene, a lack of privacy, inadequate health education, and poor communication between patients and parents have all contributed to some patients’ negative health care experiences. Hospital management and concerned bodies should consciously and deliberately take efforts to provide the logistics and structural appropriation to improve health care delivery at the Neonatal Intensive Care Units. Experiences and Perceptions of Parents toward Health Care Delivery at Neonatal Intensive Care Unit in Tamale Government Hospitals: A Qualitative InquiryReferences:[1]. Guerrera, G., 2015, Neonatal and pediatric healthcare worldwide: A report from UNICEF, Clin. Chim. Acta, vol. 451, pp. 4–8, 2015. [2]. Aleem, S., and Bhutta, Z. A., 2020, Neonatology: A Global Perspective,” in Pediatric and Adolescent Medicine, vol. 22, E. Herting and W. Kiess, Eds., S. Karger AG, 2020, pp. 1–12. doi: 10.1159/000495429. [3]. Tekelab, T., Chojenta, C., Smith, R., and Loxton, D., 2019, The impact of antenatal care on neonatal mortality in sub-Saharan Africa: A systematic review and meta-analysis, PLOS ONE, vol. 14, no. 9, p. e0222566, Sep. 2019, doi: 10.1371/journal.pone.0222566. [4]. Msemo, G., et al., 2013, Newborn Mortality and Fresh Stillbirth Rates in Tanzania After Helping Babies Breathe Training, Pediatrics, vol. 131, no. 2, pp. e353–e360, Feb. 2013, doi: 10.1542/peds.2012-1795. [5]. Bitew, Z. W., Alemu, A., Ayele, E. G., Jember, D. A., Haile, M. T., and Worku, T., 2020, Incidence Density Rate of Neonatal Mortality and Predictors in Sub-Saharan Africa: A Systematic Review and Meta-Analysis, Int. J. Pediatr., vol. 2020, pp. 1–14, Oct. 2020, doi: 10.1155/2020/3894026. [6]. Poulin, D., et al., 2024, Infant mortality in Ghana: investing in health care infrastructure and systems,” Health Aff. Sch., vol. 2, no. 2, p. qxae005, Feb. 2024, doi: 10.1093/haschl/qxae005. [7]. Coertze, T., Effectiveness of the implementation of psycho- educational sessions on parental stress in a neonatal intensive care unit. [8]. Donabedian, A., 1988, The Quality of Care: How Can It Be Assessed? JAMA. 1988;260(12):1743–1748. doi:10.1001/jama.1988.03410120089033,” Cureus, Jul. 2021, doi: 10.7759/cureus.16747. [9]. Cambonie, G., et al., 2023, Context of a neonatal death affects parental perception of end-of-life care, anxiety and depression in the first year of bereavement,” BMC Palliat. Care, vol. 22, no. 1, p. 58, May 2023, doi: 10.1186/s12904-023-01183-8. [10]. Dellenmark‐Blom, M., and Wigert, H., 2014, Parents’ experiences with neonatal home care following initial care in the neonatal intensive care unit: a phenomenological hermeneutical interview study,” J. Adv. Nurs., vol. 70, no. 3, pp. 575–586, Mar. 2014, doi: 10.1111/jan.12218. [11]. Heidari, H., Hasanpour, M., and Fooladi, M., 2017, Stress Management among Parents of Neonates Hospitalized in NICU: A Qualitative Study, J. Caring Sci., vol. 6, no. 1, pp. 29–38, Mar. 2017, doi: 10.15171/jcs.2017.004. [12]. Kelleher, J., Dempsey, J., Takamatsu, S., Paul, J. J., Kent, E., and Dempsey, A. G., 2022, Adaptation of infant mental health services to preterm infants and their families receiving neonatal intensive care unit services during the COVID‐19 pandemic,” Infant Ment. Health J., vol. 43, no. 1, pp. 100–110, Jan. 2022, doi: 10.1002/imhj.21961. [13]. Aydon, L., Hauck, Y., Murdoch, J., Siu, D., and Sharp, M., 2018, Transition from hospital to home: Parents’ perception of their preparation and readiness for discharge with their preterm infant,” J. Clin. Nurs., vol. 27, no. 1–2, pp. 269–277, Jan. 2018, doi: 10.1111/jocn.13883. [14]. Johnson, A. N., 2008, Engaging Fathers in the NICU: Taking Down the Barriers to the Baby,” J. Perinat. Neonatal Nurs., vol. 22, no. 4, pp. 302–306, Oct. 2008, doi: 10.1097/01.JPN.0000341361.37822.34. [15]. Hynan, M. T., 2006, Supporting fathers during stressful times in the nursery: an evidence-based review, Newborn Infant Nurs. Rev., vol. 5, no. 2, pp. 87–92, 2005. [16]. Franklin, C., 2006, The neonatal nurse’s role in parental attachment in the NICU,” Crit. Care Nurs. Q., vol. 29, no. 1, pp. 81–85, 2006. [17]. Harrison, W., and Goodman, D., 2015. Epidemiologic Trends in Neonatal Intensive Care, 2007-2012,” JAMA Pediatr., vol. 169, no. 9, p. 855, Sep. 2015, doi: 10.1001/jamapediatrics.2015.1305. [18]. Abukari, A. S., A MODEL OF FAMILY-CENTERED CARE AT THE PAEDIATRIC AND NEONATAL INTENSIVE CARE SETTING IN GHANA”. [19]. Smith, V. C., Hwang, S. S., Dukhovny, D., Young, S., and Pursley, D. M., 2013, Neonatal intensive care unit discharge preparation, family readiness and infant outcomes: connecting the dots,” J. Perinatol., vol. 33, no. 6, pp. 415–421, Jun. 2013, doi: 10.1038/jp.2013.23. [20]. Torab, et.al., 2017, Knowledge and attitude of personnel, key factors in implementation of neonatal pain management in NICU: a qualitative study, J. Clin. Diagn. Res., vol. 11, no. 11, pp. SC05–SC09, 2017. [21]. Kinshella, M. L. W., et al., 2021, Barriers and facilitators of facility-based kangaroo mother care in sub-Saharan Africa: a systematic review,” BMC Pregnancy Childbirth, vol. 21, no. 1, p. 176, Dec. 2021, doi: 10.1186/s12884-021-03646-3. [22]. Mimani Minuta, W., et al., 2023, Lived Experience of Mothers Having Preterm Newborns in a Neonatal Intensive Care Unit at Wolaita Sodo University Comprehensive Specialized Hospital Southern Ethiopia: A Phenomenological Study,” Res. Rep. Neonatol., vol. Volume 13, pp. 1–14, Aug. 2023, doi: 10.2147/RRN.S417173. [23]. Bigelow, A. E., and Power, M., 2020, Mother–Infant Skin-to-Skin Contact: Short‐ and Long-Term Effects for Mothers and Their Children Born Full-Term,” Front. Psychol., vol. 11, p. 1921, Aug. 2020, doi: 10.3389/fpsyg.2020.01921. [24]. Lomotey, A. Y., Bam, V., Diji, A. K., Asante, E., Asante, H. B., and Osei, J., 2020, Experiences of mothers with preterm babies at a Mother and Baby Unit of a tertiary hospital: A descriptive phenomenological study,” Nurs. Open, vol. 7, no. 1, pp. 150–159, Jan. 2020, doi: 10.1002/nop2.373. Viewed PDF 3 0 
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					Acceptability of COVID-19 Vaccination among Healthcare Workers in Adamawa State, NigeriaAuthor: Dang Heman GufulDOI: 10.21522/TIJAR.2014.12.04.Art028Acceptability of COVID-19 Vaccination among Healthcare Workers in Adamawa State, NigeriaAbstract:The aim of this study was to determine the acceptability of COVID-19 vaccine amongst health workers in Adamawa state, Northeast Nigeria. The study used a cross-sectional design and collected data from the eligible participants through google online form. Information regarding the respondents’ such as socio-demographic, risk exposures, risk perceptions and attitude towards COVID-19 vaccine were collected. Multivariable binary logistic regression will be used to determine the factors affecting the acceptability of COVID-19 vaccine after controlling for key demographic variables. Data analysis was using STATA version 14 (StataCorp LP, Texas USA). A total of 272 healthcare workers from Adamawa State Nigeria participated in this study. About 70% of the respondents were females, one-third were younger than 40 years and majority (57.7%) were non-frontline workers. Two hundred and thirty-nine (87.9%) of the participants have had COVID-19 vaccine while 33(12.1%) have never received. Of those who have been vaccinated, only 130(54.4%) were fully vaccinated. Among the unvaccinated, 69.7% insisted they will not take the vaccine if made available because COVID-19 infection has reduced globally (33.3%) and probable side effects of the vaccine (33.3%). Age (OR = 0.11, 95% CI: 0.02 – 0.55, p value = 0.007)., sex (OR = 5.23, 95% CI: 1.78 – 15.39, p value = 0.003) and years of work experience OR = 21.44, 95% CI: 3.58 – 12.85, p value = 0.001) were significant predictors of acceptability of COVID-19 vaccine. Acceptability of COVID-19 Vaccination among Healthcare Workers in Adamawa State, NigeriaReferences:[1]. World Health Organization, 2020, Coronavirus disease (COVID-19) pandemic. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019 [2]. Worldometers. (n.d.). COVID-19 Coronavirus Pandemic. Available at: https://www.worldometers.info/coronavirus/ [3]. Nigeria Centre for Disease Control. (n.d.). COVID-19 Nigeria. Available at: https://covid19.ncdc.gov.ng/report/ [4]. Al-Hanawi, M. K., Angawi, K., Alshareef, N., Qattan, A. M., Helmy, H. Z., Abudawood, Y., et al, 2020, Knowledge, attitude and practice toward COVID-19 among the public in the kingdom of Saudi Arabia: a cross-sectional study. Frontiers in Public Health, 8, 217. doi:10.3389/fpubh.2020.00217 [5]. Sherman, S. M., Smith, L. E., Sim, J., Amlôt, R., Cutts, M., Dasch, H., et al., 2020, COVID-19 vaccination intention in the UK: results from the COVID-19 vaccination acceptability study (CoVAccS), a nationally representative cross-sectional survey. Human Vaccines & Immunotherapeutics. doi: 10.1080/21645515.2020.1846397 [6]. WHO director-general’s opening remarks at the media briefing on COVID19, 2020, https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19—11-march-2020 [7]. Adamawa State Ministry of Health. 2022, COVID-19 Situation report. Serial No. 290, Epi week 02, 13th January 2022. [8]. Dal-R, Stephens, R., & Sreeharan, N., 2021, Let me choose my COVID-19 vaccine. European Journal of Internal Medicine. [9]. Jones, I., Roy, P., & Sputnik V., 2021, COVID-19 vaccine candidate appears safe and effective. Lancet, 397(10275), 642-643. [10]. Schraer, R.,2021, COVID-19: Sputnik vaccine gives 92% protection in trial. Available from: https://www.bbc.com/news/health-55900622 [11]. Cohen, J., 2021, Dosing debates, transparency issues roil vaccine rollouts. Science, 371(6525), 109-110. [12]. Kaur, S. P., & Gupta, V., 2020, COVID-19 Vaccine: a comprehensive status report. Virus Research, 288, Article ID 198114. [13]. Shaw, J., Stewart, T., Anderson, K. B., et al., 2021, Assessment of US health care personnel (HCP) attitudes towards COVID-19 vaccination in a large University health care system. Clinical Infectious Diseases. [14]. Dror, A. A., Eisenbach, N., Taiber, S., et al., 2020, Vaccine hesitancy: the next challenge in the fight against COVID-19. European Journal of Epidemiology, 35(8), 775–779. [15]. Verger, P., Scronias, D., Dauby, N., et al., 2021, Attitudes of healthcare workers towards COVID-19 vaccination: a survey in France and French-speaking parts of Belgium and Canada, 2020. Eurosurveillance, 26(3), 2002047. [16]. Shekhar, R., Sheikh, A. B., Upadhyay, S., et al., 2021, COVID-19 vaccine acceptance among health care workers in the United States. Vaccines, 9(2), 119. [17]. Roy, B., Kumar, V., & Venkatesh, A., 2020, Health care workers’ reluctance to take the Covid-19 vaccine: a consumer-marketing approach to identifying and overcoming hesitancy. NEJM Catalyst Innovations in Care Delivery, 1(6). [18]. Wang, K., Wong, E. L. Y., Ho, K. F., et al., 2020, Intention of nurses to accept coronavirus disease 2019 vaccination and change of intention to accept seasonal influenza vaccination during the coronavirus disease 2019 pandemic: a cross-sectional survey. Vaccine, 38(45), 7049–7056. [19]. Deem, M. J., 2018, Nurses’ voices matter in decisions about dismissing vaccine-refusing families. AJN, American Journal of Nursing, 118(8), 11. [20]. Acheampong, A. K., Ganga-Limando, M., Aziato, L., & Ganga-Limando, M., 2020, Perceived enablers of exclusive breastfeeding by teenage mothers in Ghana. South African Family Practice, 62(1), a5108. [21]. Nzaji, M. K., Ngombe, L. K., Mwamba, G. N., et al., 2020, Acceptability of vaccination against COVID-19 among healthcare workers in the Democratic Republic of the Congo. Pragmatic and Observational Research, 11, 103–109. [22]. Garrett, L., 2020, COVID-19: the medium is the message. Lancet, 395(10228), 942-943. [23]. Barry, M., Temsah, M.-H., Alhuzaimi, A., et al., 2020, COVID-19 vaccine confidence and hesitancy among healthcare workers: a cross-sectional survey from a MERS-CoV experienced nation. Available at: https://www.medrxiv.org/content/10.1101/2020.12.09.20246447v1.full [24]. Kwok, K. O., Li, K. K., Wei, W. I., Tang, K. H., Wong, S. Y. S., & Lee, S. S., 2020, Are we ready when COVID-19 vaccine is available? Study on nurses’ vaccine hesitancy in Hong Kong. Available at: https://www.medrxiv.org/content/10.1101/2020.07.17.20156026v1 [25]. Fu, C., Wei, Z., Pei, S., Li, S., Sun, X., & Liu, P., 2020, Acceptance and preference for COVID-19 vaccination in health-care workers (HCWs). Available at: https://www.medrxiv.org/content/10.1101/2020.04.09.20060103v1 [26]. Gagneux-Brunon, A., Detoc, M., Bruel, S., et al., 2021, Intention to get vaccinations against COVID-19 in French health care workers during the first pandemic wave: a cross-sectional survey. Journal of Hospital Infection, 108, 168–173. [27]. Shaw, J., Stewart, T., Anderson, K. B., et al., 2021, assessment of US health care personnel (HCP) attitudes towards COVID-19 vaccination in a large University health care system. Clinical Infectious Diseases. [28]. Zhou, P., Yang, X. L., Wang, X. G., Hu, B., Zhang, L., Zhang, W., et al., 2020, a pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature, 579(7798), 270–273. https://doi.org/10.1038/s41586-020-2012-7 [29]. Roy, B., Kumar, V., & Venkatesh, A., 2020, Health care workers’ reluctance to take the Covid-19 vaccine: a consumer-marketing approach to identifying and overcoming hesitancy. NEJM Catalyst Innovations in Care Delivery, 1(6). [30]. Gadoth, A., Halbrook, M., Martin-Blais, R., et al., 2020, Assessment of COVID-19 vaccine acceptance among healthcare workers in Los Angeles. Available at: https://www.medrxiv.org/content/10.1101/2020.11.18.20234468v1.full [31]. Shekhar, R., Sheikh, A. B., Upadhyay, S., et al., 2021, COVID-19 vaccine acceptance among health care workers in the United States. Vaccines, 9(2), 119. [32]. Dubey, S., Biswas, P., Ghosh, R., et al, 2020, Psychosocial impact of COVID-19. Diabetes & Metabolic Syndrome, 14(January), 779–788. doi:10.1007/s00134-020-05991-x [33]. Felice, C., Luca, G., Tanna, D., Zanus, G., & Grossi, U., 2020, Impact of COVID-19 outbreak on healthcare workers in Italy: results from a national E-survey. Journal of Community Health, 45(0123456789), 675–683. doi:10.1007/s10900-020-00845-5 [34]. Chirico, F., Nucera, G., & Magnavita, N., 2020, COVID-19: protecting healthcare workers is a priority. Infection Control & Hospital Epidemiology. doi:10.1017/ice.202. Viewed PDF 5 0 
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					Hypertension Prevalence and Associated Risk Factors in Namibia (2010–2022): A Retrospective Analysis of Publicly Available DataAuthor: Jean-Paul Mukeba TshitendeDOI: 10.21522/TIJAR.2014.12.04.Art029Hypertension Prevalence and Associated Risk Factors in Namibia (2010–2022): A Retrospective Analysis of Publicly Available DataAbstract:Hypertension remains a leading contributor to cardiovascular morbidity and mortality worldwide, with the most significant burden observed in low- and middle-income countries such as Namibia. Despite multiple national and international surveys, a consolidated analysis of hypertension prevalence and associated factors in Namibia over the past decade has been lacking. This study examined trends in prevalence, associated risk factors, and control levels in Namibia from 2010 to 2022, using publicly available secondary data sources. A retrospective analysis was conducted, drawing on national health surveys, World Health Organization country profiles, Ministry of Health and Social Services reports, and peer-reviewed publications. Data on prevalence, demographic characteristics, and biomedical and behavioral risk factors were extracted, summarized, and analyzed both thematically and quantitatively. Findings indicate that hypertension prevalence in Namibia has shown a gradual upward trend over the study period, with notable regional and sex-specific variations. Advancing age, male sex, urban residence, and higher body mass index emerged as consistent predictors. In contrast, behavioral risk factors, including alcohol consumption, tobacco use, sedentary lifestyle, and high salt intake, were strongly implicated. Furthermore, comorbid conditions such as diabetes mellitus and dyslipidemia substantially increased the risk of hypertension. Gaps in healthcare access, underdiagnosis, and poor treatment coverage further exacerbated the burden, while disparities in data coverage and methodological inconsistencies across sources limited comparability. Overall, the evidence demonstrates a concerning increase in hypertension in Namibia, primarily driven by modifiable lifestyle and structural determinants. Strengthened community-based screening, targeted health promotion, integration of non-communicable disease services into primary healthcare, and improved access to treatment are urgently needed to mitigate this growing public health challenge. Hypertension Prevalence and Associated Risk Factors in Namibia (2010–2022): A Retrospective Analysis of Publicly Available DataReferences:[1]. World Health Organization, 2023, Hypertension: WHO’s 2023 global report on hypertension (and HEARTS technical package resources). Geneva: WHO. https://www.who.int/teams/noncommunicable-diseases/hypertension-report. World Health Organization [2]. Mills, K. T., Stefanescu, A., and He, J., 2020, The global epidemiology of hypertension. Nature Reviews Nephrology, 16(4), 223–237, https://doi.org/10.1038/s41581-019-0244-2 [3]. Adeloye, D., Basquill, C., Aderemi, A. V., Thompson, J. Y., and Obi, F. A., 2021, An estimate of the prevalence of hypertension in Africa: A systematic analysis. Journal of Hypertension, 39(2), 210–222, https://doi.org/10.1097/HJH.0000000000002664 [4]. Ministry of Health and Social Services (MoHSS) and ICF International, 2014, Namibia Demographic and Health Survey 2013. Windhoek, Namibia, and Rockville, MD, USA: MoHSS and ICF International. [5]. World Health Organization (WHO), 2018, STEPwise approach to NCD risk factor surveillance: Namibia country report. Geneva: WHO. [6]. Ministry of Health and Social Services (MoHSS), 2021, Annual Health Sector Performance Report 2020/21. Windhoek: Government of Namibia. [7]. Peer, N., Kengne, A. P., Motala, A. A., and Ojemeni, M., 2018, Prevalence and predictors of hypertension in Namibia: A national-level cross-sectional study. PLoS ONE, 13(9), e0204344, https://doi.org/10.1371/journal.pone.0204344 [8]. Dzudie, A., Rayner, B., Ojji, D., Damasceno, A., Sliwa, K., Mayosi, B., and Sani, M., 2017, Roadmap to achieve 25% hypertension control in Africa by 2025. Cardiovascular Journal of Africa, 28(4), 262–272, https://doi.org/10.5830/CVJA-2017-040 [9]. Matengu, K., and Kazembe, L., 2025, Prevalence of hypertension in community members in a low-income community in Windhoek, Namibia. African Journal of Primary Health Care & Family Medicine, (in press). [10]. Craig, A. T., Gage, A., and Thomas, L. S., 2018, Prevalence and predictors of hypertension in Namibia: A national-level cross-sectional study. PLOS ONE, 13(9), e0204344, https://doi.org/10.1371/journal.pone.0204344 [11]. Peer, N., Kengne, A. P., Motala, A. A., and Ojemeni, M., 2012, Hypertension in sub-Saharan Africa: Cross-sectional surveys in four rural and urban communities. PLoS ONE, 7(3), e32638, https://doi.org/10.1371/journal.pone.0032638 [12]. Ataklte, F., Erqou, S., Kaptoge, S., Taye, B., Echouffo-Tcheugui, J. B., and Kengne, A. P., 2015, Burden of undiagnosed hypertension in sub-Saharan Africa: A systematic review and meta-analysis. Hypertension, 65(2), 291–298, https://doi.org/10.1161/HYPERTENSIONAHA.114.04394 [13]. NCD Risk Factor Collaboration (NCD-RisC), 2021, Worldwide prevalence, detection, treatment, and control of hypertension, 1990–2019. The Lancet, 398(10304), 957–980, https://doi.org/10.1016/S0140-6736(21)01330-1 [14]. NCD Risk Factor Collaboration (NCD-RisC), 2021, Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries: An analysis of 123 nationally representative surveys. The Lancet, 398(10304), 9969, https://doi.org/10.1016/S0140-6736(21)01330-1 [15]. Addo, J., Smeeth, L., and Leon, D. A., 2007, Hypertension in sub-Saharan Africa: A systematic review. Hypertension, 50(6), 1012–1018, https://doi.org/10.1161/HYPERTENSIONAHA.107.093336 [16]. Kaze, A. D., Schutte, A. E., Erqou, S., and Kengne, A. P., 2017, Prevalence of hypertension in older people in Africa: A systematic review and meta-analysis. Journal of Hypertension, 35(7), 1345–1352, https://doi.org/10.1097/HJH.0000000000001345 [17]. Bigna, J. J., and Noubiap, J. J., 2019, The rising burden of hypertension in sub-Saharan Africa: A call to action. Journal of Clinical Hypertension, 21(4), 564–567, https://doi.org/10.1111/jch.13518 [18]. Jaffe, M. G., Frieden, T. R., Ordunez, P., Silva, L. C. E., and Campbell, N. R. C., 2023, Standardized hypertension treatment to reduce cardiovascular disease worldwide. The Lancet, 401(10378), 1205–1214, https://doi.org/10.1016/S0140-6736(23)00457-1 [19]. World Health Organization (WHO), 2023, HEARTS technical package for cardiovascular disease management in primary health care. Geneva: WHO. [20]. Rabkin, M., and El-Sadr, W. M., 2011, Why reinvent the wheel? Leveraging the lessons of HIV scale-up to confront non-communicable diseases. Global Public Health, 6(3), 247–256, https://doi.org/10.1080/17441692.2011.552067 [21]. Zhou, B., Perel, P., Mensah, G. A., and Ezzati, M., 2021, Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension. Nature Reviews Cardiology, 18(11), 785–802, https://doi.org/10.1038/s41569-021-00559-8 [22]. Awuah, R. B., Anarfi, J. K., Agyemang, C., Ogedegbe, G., and Aikins, A. D. G., 2019, Prevalence, awareness, treatment and control of hypertension in urban poor communities in Accra, Ghana. Journal of Hypertension, 37(6), 1209–1217, https://doi.org/10.1097/HJH.0000000000002016 [23]. Noubiap, J. J., Bigna, J. J., Nansseu, J. R., Nyaga, U. F., Balti, E. V., Echouffo-Tcheugui, J. B., and Kengne, A. P., 2019, Prevalence of elevated blood pressure in children and adolescents in Africa: A systematic review and meta-analysis. The Lancet Public Health, 4(8), e375–e386, https://doi.org/10.1016/S2468-2667(19)30115-3 [24]. Adeloye, D., and Basquill, C., 2014, Estimating the prevalence and awareness rates of hypertension in Africa: A systematic analysis. PLoS One, 9(8), e104300, https://doi.org/10.1371/journal.pone.0104300 [25]. World Health Organization (WHO), 2021, Guideline for the pharmacological treatment of hypertension in adults. Geneva: WHO. https://www.who.int/publications/i/item/9789240033986 [26]. Iipinge, S. N., Pretorius, L., and Nampala, P., 2018, Hypertension prevalence and risk factors in peri-urban Namibia. African Journal of Primary Health Care & Family Medicine, 10(1), e1–e8, https://doi.org/10.4102/phcfm.v10i1.1705 [27]. Shidhika, O. M., Iipinge, S. N., and Kalomo, M. H., 2020, Risk factors and health-seeking behaviour of hypertensive patients in Namibia: A cross-sectional study. African Journal of Primary Health Care & Family Medicine, 12(1), e1–e7, https://doi.org/10.4102/phcfm.v12i1.2240 [28]. Jafar, T. H., Gandhi, M., Hotu, S., and Mendis, S., 2023, Evaluation of the WHO-HEARTS hypertension control package in primary care. Heart, 110(17), 1090–1096, https://doi.org/10.1136/heartjnl-2023-322111 [29]. Frieden, T. R., and Jaffe, M. G., 2018, Saving 100 million lives by improving global treatment of hypertension and reducing cardiovascular disease risk factors. Journal of Clinical Hypertension, 20(2), 208–211. [30]. Ministry of Health and Social Services (MoHSS), 2017, National Multisectoral Strategic Plan for Prevention and Control of Non-Communicable Diseases 2017/18–2021/22. Windhoek: MoHSS. [31]. Ezzati, M., Pearson-Stuttard, J., Bennett, J. E., and Mathers, C. D., 2021, Acting on non-communicable diseases in low- and middle-income tropical countries. Nature Reviews Cardiology, 18(9), 639–653, https://doi.org/10.1038/s41569-021-00552-8 [32]. World Health Organization (WHO), 2021, Hypertension fact sheet. Geneva: WHO. https://www.who.int/news-room/fact-sheets/detail/hypertension [33]. World Health Organisation (WHO), 2017, Best buys and other recommended interventions for the prevention and control of non-communicable diseases. Geneva: WHO. [34]. Ministry of Health and Social Services, 2016, National Strategic Plan for the Prevention and Control of Non-Communicable Diseases 2016–2020. Windhoek: MoHSS. [35]. Southern African Development Community (SADC), 2019, SADC Strategy for the Prevention and Control of Non-Communicable Diseases 2020–2030. Gaborone: SADC Secretariat. [36]. Charlton, K., Ware, L. J., Menyanu, E., Biritwum, R. B., Naidoo, N., Pieterse, C., ... and Kowal, P., 2016, Leveraging ongoing research to evaluate the health impacts of South Africa’s salt reduction strategy: A prospective cohort study. BMJ Open, 6(11), e013316, https://doi.org/10.1136/bmjopen-2016-013316 [37]. Bloomfield, G. S., et al., 2016, Blood pressure screening and treatment among rural and urban residents in sub-Saharan Africa: A systematic review. Journal of Clinical Hypertension, 18(9), 889–894, https://doi.org/10.1111/jch.12809 [38]. Jaffe, M. G., Ordunez, P., Becerra, F., and Campbell, N. R. C., 2023, Implementation of Global HEARTS hypertension control programs in low- and middle-income countries. Journal of the American College of Cardiology, 82(13), 1274–1288, https://doi.org/10.1016/j.jacc.2023.08.043 [39]. Ordunez, P., Campbell, N. R. C., and Jaffe, M. G., 2023, Improving hypertension control at scale: Lessons from the HEARTS initiative. The Lancet Regional Health – Americas, 19, 100421, https://doi.org/10.1016/j.lana.2023.100421 [40]. Ordunez, P., Campbell, N. R. C., and Jaffe, M. G., 2023, Scaling up effective treatment of hypertension—A call to action. Hypertension, 80(3), 528–536, https://doi.org/10.1161/HYPERTENSIONAHA.122.20408 Viewed PDF 2 0 
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					Beyond the Numbers, Unpacking the Challenges: Adherence and Retention among Young Adults Living with HIV in EswatiniAuthor: Ntombifuthi Temalangeni DlaminiDOI: 10.21522/TIJAR.2014.12.04.Art030Beyond the Numbers, Unpacking the Challenges: Adherence and Retention among Young Adults Living with HIV in EswatiniAbstract:This study investigates adherence to Antiretroviral Therapy (ART) and retention in care among HIV-positive young adults aged 18–24 years in Eswatini, a country with one of the highest HIV prevalence rates globally. Using a mixed-methods approach, quantitative data were collected from 161 participants and complemented with qualitative interviews to explore personal and contextual experiences. The quantitative findings revealed that mean adherence to ART was 96.3% (±6.1 SD), with 77.6% of participants maintaining high adherence levels of 95–100%. Viral suppression below 50 copies/mL was achieved in 85.7% of the study population, while retention in care was 82.6%. Although these results are encouraging, they fall short of UNAIDS 95-95-95 targets, highlighting persistent gaps. The qualitative findings provided deeper insights into lived realities. Motivators of adherence included family support, encouragement from healthcare providers, personal motivation to remain healthy, and peer encouragement. Barriers included stigma, fear of disclosure, financial constraints, treatment fatigue, and negative experiences with healthcare staff. Benefits of adherence included improved health, strength to perform daily tasks, and reduced risk of HIV transmission. Integrating the findings underscores the multifaceted nature of ART adherence, influenced by individual, social, economic, and systemic factors. The study concludes that addressing adherence challenges requires youth-centered interventions, stigma reduction, economic empowerment, and healthcare system strengthening. These results provide evidence to guide Eswatini’s HIV response and contribute to the global goal of achieving sustained epidemic control. Beyond the Numbers, Unpacking the Challenges: Adherence and Retention among Young Adults Living with HIV in EswatiniReferences:[1]. Zurbachew, H. S., Woreta, A. W., Alem, S. M., Wondie, T., & Walle, B. H., 2023, Adolescent’s and youth’s adherence to antiretroviral therapy for better treatment outcome and its determinants: multi-center study in public health facilities. AIDS Research and Therapy. https://aidsrestherapy.biomedcentral.com/articles/10.1186/s12981-023-00632-4 [2]. UNAIDS, 2022, In Danger: UNAIDS Global AIDS Update 2022, https://www.unaids.org/en/resources/documents/2022/in-danger-global-aids-update [3]. Govender, K., Masebo, W., Nyamaruze, P., Cowden, R. G., Schunter, B. T., & Bains, A., 2018, HIV prevention in adolescents and young people in the Eastern and Southern African region: A review of key challenges impeding actions for an effective response. The Open AIDS Journal. https://openaidsjournal.com/VOLUME/12/PAGE/53/ABSTRACT/ [4]. Dzinamarira, T., & Moyo, T., 2024, Adolescents and young people in sub-Saharan Africa: overcoming challenges and seizing opportunities to achieve HIV epidemic control. Frontiers in Public Health. https://www.frontiersin.org/articles/10.3389/fpubh.2024.1321068/full [5]. Ministry of Health, 2022, Integrated HIV Management Guidelines, 2nd Edition. Eswatini Ministry of Health. https://www.who.int/publications/m/item/eswatini-integrated-hiv-management-guidelines-2022 [6]. Ashaba, S., Baguma, C., Tushemereirwe, P., Nansera, D., Maling, S., Zanon, B. C., & Tsai, A. C., 2024, Correction: Correlates of HIV treatment adherence self-efficacy among adolescents and young adults living with HIV in southwestern Uganda. PLOS Global Public Health, 4(10):e0003874. Doi: 10.1371/journal.pgph.0003874. https://pubmed.ncbi.nlm.nih.gov/39405301/ [7]. Creswell, J. W., & Plano Clark, V. L., 2018, Designing and Conducting Mixed Methods Research, 3rd ed., Sage Publications, Thousand Oaks, CA. https://us.sagepub.com/en-us/nam/designing-and-conducting-mixed-methods-research/book247952 [8]. Chouraya, C., Ashburn, K., Khumalo, P., Mpango, L., Mthethwa, N., Machekano, R., Guay, L., & Mofenson, L., 2019, Association of antiretroviral drug regimen with viral suppression in HIV-positive children on antiretroviral therapy in Eswatini. The Pediatric Infectious Disease Journal. http://dx.doi.org/10.1097/INF.0000000000002347 [9]. UNAIDS, 2023, The path that ends AIDS: UNAIDS Global AIDS Update 2023. https://www.unaids.org/en/resources/documents/2023/global-aids-update-2023-path-that-ends-aids [10]. ICAP at Columbia University, n.d., Eswatini HIV Incidence Measurement Survey (SHIMS3) 2021: Fact Sheet. ICAP at Columbia University. Retrieved September 16, 2025, from https://phia.icap.columbia.edu/eswatini-summary-sheet/ [11]. Wilkinson, L. S., Skordis-Worrall, J., Ajose, O., & Ford, N., 2015, Self-transfer and mortality amongst adults lost to follow-up in ART programmes in low- and middle-income countries: systematic review and meta-analysis. Tropical Medicine & International Health, 20(3):365–379. Doi: 10.1111/tmi.12434. https://pubmed.ncbi.nlm.nih.gov/25418366/ [12]. Vreeman, R. C., McCoy, B. M., & Lee, S., 2017, Mental health challenges among adolescents living with HIV. Journal of the International AIDS Society, 20(S3):21497. [13]. Villiera, J. B., et al., 2022, Factors associated with antiretroviral therapy adherence among adolescents living with HIV in the era of isoniazid preventive therapy as part of HIV care. PLOS Global Public Health, 2(6). [14]. Ferrand, R. A., Briggs, D., & Penazzato, M., 2016, Viral suppression in adolescents on antiretroviral treatment: review of the literature and critical appraisal of methodological challenges. Tropical Medicine & International Health, 21(3):325–333. [15]. Ritchwood, T. D., Malo, V., & Jones, C., 2020, Healthcare retention and clinical outcomes among adolescents living with HIV after transition from pediatric to adult care: a systematic review. BMC Public Health, 20(1):1195. [16]. UNAIDS, 2024, Fact sheet – Latest global and regional statistics on the status of the AIDS epidemic. [17]. UNAIDS, 2023, Global AIDS Strategy 2021–2026: End Inequalities. End AIDS. https://www.unaids.org/sites/default/files/media_asset/unaids-strategy-2021-2026_en.pdf. [18]. Mphande, S., Namwera, R., Shambira, K., & Mutale, S., 2025, Barriers to ART adherence in sub-Saharan Africa: a scoping review toward achieving UNAIDS 95-95-95 targets. Frontiers in Public Health, 13. https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1609743/full [19]. Motsa, T., Sibanda, N., Gwebu, P. M., & Nxumalo, R., 2023, Views of adolescents living with perinatally acquired HIV on HIV status disclosure in Eswatini. AIDS Care, 35(12):1787–1793. https://www.tandfonline.com/doi/full/10.1080/09540121.2023.2299334 [20]. Madiba, S., & Josiah, S., 2019, The impact of a family-centered model of care for HIV-positive children on viral suppression and retention in care: a randomized controlled trial in Eswatini. PLOS ONE, 16(8):e0256256. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0256256 [21]. Mango, T., Kasese-Hara, M., & Mulaudzi, M., 2024, Beliefs affecting ART adherence in newly diagnosed HIV-positive participants in Manzini, Eswatini. South African Journal of HIV Medicine, 25(1):1601. https://doi.org/10.4102/sajhivmed.v25i1.1601 Viewed PDF 12 0 
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					The Increasing Trend of Lassa Fever and the Hopelessness of Quick Intervention: Nigeria at FocusAuthor: Muekara Friday DugborDOI: 10.21522/TIJAR.2014.12.04.Art031The Increasing Trend of Lassa Fever and the Hopelessness of Quick Intervention: Nigeria at FocusAbstract:This study investigated the increasing threat of Lassa Fever in Nigeria and highlighted the urgent need for global attention due to the rising number of deaths and confirmed cases. The main purpose of the study was to call for the intervention of the international Bodies to stall the rising trend of Lassa Fever in Nigeria. Contextually, though, the study sought to ascertain whether the Lassa Fever in Nigeria is on the increase; ascertain whether efforts had been made to arrest the situation of Lassa Fever in Nigeria and to determine whether the attention of the World Health Organization is needed in Nigeria to eradicate Lassa Fever. The study adopted a qualitative Meta-Analysis approach. It was found in the study that Lassa Fever in Nigeria is on the increase, from the viewpoint of scientific observation, where, from 1981 – 1988 there was no trace of LF on the average, efforts were made by the ministry of health in conjunction with other world bodies to arrest the situation of Lassa Fever in Nigeria and the attention of the World Health Organization is needed in Nigeria to eradicate Lassa Fever. The Increasing Trend of Lassa Fever and the Hopelessness of Quick Intervention: Nigeria at FocusReferences:[1]. Abdullahi, I. N., Anka, A. U., Ghamba, P. E., Onukegbe, N. B., Amadu, D. O., and Salami, M. O., 2020, "Need for preventive and control measures for Lassa fever through the One Health strategic approach," Proceedings of Singapore Healthcare, vol. 29, no. 3, pp. 190-194. Available: https://doi.org/10.1177/2010105820932616 [Accessed: 15-Nov-2024]. [2]. Adejoro, L., 2023, “NCDC confirms 1,095 Lassa fever cases, 188 deaths," Punch, [Online]. Available: https://punchng.com/ncdc-confirms-1095-lassa-fever-cases-188-deaths/#:~:text=The%20Nigeria%20Centre%20for%20Disease,2023)%2C%20released%20on%20Tuesday. [Accessed: 15-Nov-2024]. [3]. Adewuyi, G. M., Fowotade, A., and Adewuyi, B. T., 2009, "Review article," African Journal of Clinical and Experimental Microbiology, September, [Online]. Available: file:///C:/Users/Dr.%20Abel's%20PC/Downloads/ajol-file-journals_47_articles_43407_submission_proof_43407-553-39991-1-10-20090611.pdf. [Accessed: 15-Nov-2024]. [4]. Akinyele, F., 1976, "Lassa fever (arenaviruses) as a public health problem," PubMed, [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/1026322/. [Accessed: 15-Nov-2024]. [5]. Agbonlahor, D. E., Akpede, G. O., Happi, C. T., and Tomori, O., 2021, "52 Years of Lassa Fever Outbreaks in Nigeria, 1969–2020: An Epidemiologic Analysis of the Temporal and Spatial Trends," American Journal of Tropical Medicine and Hygiene, [Online]. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8592130/. [Accessed: 15-Nov-2024]. [6]. Akokuwebe, M. E., and Idemudia, E. S., 2023, "Fraud within the Nigerian health system, a double threat for resilience of a health system and the response to the COVID-19 pandemic: a review," The Pan African Medical Journal, vol. 45, [Online]. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10516760/. [Accessed: 15-Nov-2024]. [7]. Anichukwueze, D., 2024, "NCDC Records 2,122 Lassa Fever Cases in 21 States," Channelstv.com, [Online]. Available: https://www.channelstv.com/2024/02/23/ncdc-records-2122-lassa-fever-cases-in-21-states. [Accessed: 15-Nov-2024]. [8]. Abdullahi, I. N., Anka, A. U., Ghamba, P. E., Onukegbe, N. B., Amadu, D. O., and Salami, M. O., 2020, "Need for preventive and control measures for Lassa fever through the One Health strategic approach," SAGE Journals, [Online]. Available: https://journals.sagepub.com/doi/pdf/10.1177/2010105820932616. [Accessed: 15-Nov-2024]. [9]. Cleveland Clinic, "Lassa Fever," 2023, [Online]. Available: https://my.clevelandclinic.org/health/diseases/25095-lassa-fever. [Accessed: 15-Nov-2024]. [10]. Centers for Disease Control and Prevention (CDC), 2025, "Lassa Fever," [Online]. Available: https://www.cdc.gov/lassa-fever/about/index.html [Accessed: 15-Nov-2024]. [11]. Donnelly, C. A., et al., 2021, "Geographical drivers and climate-linked dynamics of Lassa fever in Nigeria," Nature Communications, [Online]. Available: https://www.nature.com/articles/s41467-021-25910-y. [Accessed: 15-Nov-2024]. [12]. Evans, S., 2023, "What Is Lassa Fever?", WebMD, [Online]. Available: https://www.webmd.com/a-to-z-guides/lassa-fever-overview. [Accessed: 15-Nov-2024]. [13]. Fabiyi, A., 1976, "Lassa fever (arenaviruses) as a public health problem," PubMed, [online]. Available: https://pubmed.ncbi.nlm.nih.gov/1026322/. [Accessed: 15-Nov-2024]. [14]. Hamblion, E. L., et al., 2018, "The challenges of detecting and responding to a Lassa fever outbreak in an Ebola-affected setting," ScienceDirect, [Online]. Available: https://www.sciencedirect.com/science/article/pii/S1201971217302898. [Accessed: 15-Nov-2024]. [15]. Ibrahim, M., 2018, "How 'Lassa,' a small Nigerian town, was stigmatized by having a killer virus named after it," Nigeria Health Watch, [Online]. Available: https://articles.nigeriahealthwatch.com/how-lassa-went-from-a-small-nigerian-town-to-a-well-known-virus/. [Accessed: 15-Nov-2024]. [16]. Ibekwe, T., 2012, "Lassa fever: the challenges of curtailing a deadly disease," Pan African Medical Journal, [Online]. Available: https://www.panafrican-med-journal.com/content/article/11/55/full/. [Accessed: 15-Nov-2024]. [17]. Idris, N., et al., 2020, "Preventive and control measures for Lassa fever through One Health approach," SAGE Journals, [Online]. Available: https://journals.sagepub.com/doi/pdf/10.1177/2010105820932616. [Accessed: 15-Nov-2024]. [18]. National Library of Medicine, 2023, "Lassa fever: Epidemiology, clinical features, and social consequences," BMJ, [Online]. Available: https://www.doi:10.1136/bmj.327.7426.1271. [Accessed: 15-Nov-2024]. [19]. Murphy, H. L., and Ly, H., 2021. “Pathogenicity and virulence mechanisms of Lassa virus and its animal modeling, diagnostic, prophylactic, and therapeutic developments,” Virulence, 12(1), pp. 2989–3014. Available: https://doi.org/10.1080/21505594.2021.2000290. [Accessed: 20-Feb-2025]. [20]. Nigeria Center for Disease Control (NCDC), 2023, "Lassa Fever Public Health Advisory," [Online]. Available: https://ncdc.gov.ng/news/507/lassa-fever-public-health-advisory. [Accessed: 15-Nov-2024]. [21]. Reliefweb, 2019, "Lassa fever: A challenging disease to diagnose and treat," [Online]. Available: https://reliefweb.int/report/nigeria/lassa-fever-challenging-disease-diagnose-and-treat. [Accessed: 15-Nov-2024]. [22]. Richmond, J. K., and Baglole, D. J., 2003, "Lassa fever: epidemiology, clinical features, and social consequences," National Center for Biotechnology Information, [Online]. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC286250/. [Accessed: 15-Nov-2024]. [23]. Redding, D. W., et al., 2021, "Geographical drivers and climate-linked dynamics of Lassa fever in Nigeria," Nature Communications, vol. 12, Article no. 5759, [Online]. Available: https://www.nature.com/articles/s41467-021-26050-1. [Accessed: 15-Nov-2024]. [24]. Seladi-Schulman, J., 2018, "Everything you need to know about Lassa fever," Medical News Today, [Online]. Available: https://www.medicalnewstoday.com/articles/168266#Taking-a-temperature. [Accessed: 15-Nov-2024]. [25]. Starkman, E., 2023, "What Is Lassa Fever?", WebMD, [Online]. Available: https://www.webmd.com/a-to-z-guides/lassa-fever-overview. [Accessed: 15-Nov-2024]. [26]. Tambo, E., Adetunde, O. T., and Olalubi, O. A., 2018, "Re-emerging Lassa fever outbreaks in Nigeria: Re-enforcing 'One Health' community surveillance and emergency response practice," Infectious Diseases of Poverty, vol. 7, Article no. 37, [Online].Available: https://idpjournal.biomedcentral.com/articles/10.1186/s40249-018-0421-7. [Accessed: 15-Nov-2024]. [27]. United Nations Office for the Coordination of Humanitarian Affairs (OCHA), 2023, "NCDC Activates Lassa fever Emergency Operations Centre to Strengthen the Response to Rising Cases of Lassa Fever in Nigeria," [Online]. Available: https://reliefweb.int/report/nigeria/ncdc-activates-lassa-fever-emergency-operations-centre-strengthen-ocha-response-rising-cases-lassa-fever-nigeria. [Accessed: 15-Nov-2024]. [28]. University of Texas Medical Branch News, 2023, "UTMB Study Shows Vaccine Rapidly Protects Against Lethal Lassa Fever Virus," UTMB News, [Online]. Available: https://www.utmb.edu/news/article/utmb-study-shows-vaccine-rapidly-protects-against-lethal-lassa-fever-virus. [Accessed: 15-Nov-2024]. [29]. World Health Organization (WHO), 2022, “Lassa Fever – Nigeria,” Disease Outbreak News, [Online]. Available: https://www.who.int/emergencies/disease-outbreak-news/item/lassa-fever---nigeria. [Accessed: 15-Nov-2024]. [30]. World Health Organization (WHO), 2023, “Lassa Fever Fact Sheet,” [Online]. Available: https://www.who.int/news-room/fact-sheets/detail/lassa-fever. [Accessed: 15-Nov-2024]. [31]. Wikiwand (n.d.). Lassa mammarenavirus. [Image] Available at: https://www.wikiwand.com/en/articles/Lassa_mammarenavirus#/media/File:Lassa_Virus_(51719108882).jpg [Accessed 1 May 2025]. Viewed PDF 5 0 
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					Seroprevalence and Risk Factors of Hepatitis B virus Infection among People Living with HIV on Antiretroviral Treatment in Three Regions of CameroonAuthor: Sandrine MewoabiDOI: 10.21522/TIJAR.2014.12.04.Art032Seroprevalence and Risk Factors of Hepatitis B virus Infection among People Living with HIV on Antiretroviral Treatment in Three Regions of CameroonAbstract:Although the prevalence of Hepatitis B Virus (HBV) in people living with HIV (PLHIV) is high globally, it remains variable in different settings. Few studies have been conducted on Hepatitis B in PLHIV on antiretroviral treatment in Cameroon. This study sought to determine the seroprevalence and risk factors of HBV among PLHIV on antiretroviral treatment (ART) from three regions of Cameroon. This hospital-based cross-sectional study was conducted from June 2016 to April 2017 among PLHIV on ART in the Littoral, Northwest and Southwest regions of Cameroon. Participants’ information was obtained using a questionnaire and a review of medical records. HBV seromarkers were diagnosed using immunochromatographic methods. Data was analysed using descriptive statistics and logistic regression models at a 95% CI and 5% significance level. HBV/HIV coinfection prevalence was 8.7% among 952 participants in the three regions, 9.4% in the Littoral, 7.5% in the Northwest, and 8.5% in the Southwest regions. Males had higher odds of coinfection (OR: 3.63, 95%CI: 0.080-16.50 p=0.09). Participants with secondary education were less likely to be HBsAg positive (OR=0.17, 95%CI: 0.02-0.93; p=0.042). Those with a history of tattooing had about four times more chances of coinfection (AOR: 3.4, 95% CI: 0.79-12.39, p=0.097). Among co-infected participants, HBsAb positivity was significantly associated with age (p=0.030), and HBeAg positivity with ALT (p=0.043) and AST levels (p=0.039). HBV/HIV coinfection was high among study participants. There is a need to routinely screen for HBV and its different seromarkers in PLHIV on antiretroviral treatment to improve the management of patients with coinfection and reduce complications and death from liver disease in PLHIV. Seroprevalence and Risk Factors of Hepatitis B virus Infection among People Living with HIV on Antiretroviral Treatment in Three Regions of CameroonReferences:[1]. Cheng, Z., Lin, P., & Cheng, N., 2021, HBV/HIV Coinfection: Impact on the Development and Clinical Treatment of Liver Diseases. Frontiers in Medicine, 8(October), 1–15. https://doi.org/10.3389/fmed.2021.713981 [2]. Parvez, M. K.,2015, HBV and HIV coinfection: Impact on liver pathobiology and therapeutic approaches. World Journal of Hepatology, 7(1), 121. https://doi.org/10.4254/WJH.V7.I1.121 [3]. Kaspar, M. B., & Sterling, R. K., 2017, Mechanisms of liver disease in patients infected with HIV. BMJ open gastroenterology, 4(1), e000166. https://doi.org/10.1136/bmjgast-2017-000166 [4]. Crane, M., Iser, D., & Lewin, S. R., 2012, Human immunodeficiency virus infection and the liver. World Journal of Hepatology, 4(3), 91-98. https://doi.org/10.4254/WJH.V4.I3.91 [5]. Corsa, A. C., Liu, Y., Flaherty, J. F., Mitchell, B., Fung, S. K., Gane, E., Miller, M. D., & Kitrinos, K. M., 2014, No Resistance to Tenofovir Disoproxil Fumarate Through 96 Weeks of Treatment in Patients with Lamivudine-Resistant Chronic Hepatitis B. Clinical Gastroenterology and Hepatology, 12(12), 2106-2112.e1. https://doi.org/10.1016/j.cgh.2014.05.024 [6]. Ganesan, M., Poluektova, L. Y., Kharbanda, K. K., & Osna, N. A., 2019, Human immunodeficiency virus and hepatotropic viruses comorbidities as the inducers of liver injury progression. World Journal of Gastroenterology, 25(4), 398–410. https://doi.org/10.3748/wjg.v25.i4.398 [7]. 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N., & Feldt, T., 2012, High prevalence of hepatitis B and syphilis coinfections among HIV patients initiating antiretroviral therapy in the northwest region of cameroon. International Journal of STD and AIDS, 23(6), 435–438. https://doi.org/10.1258/ijsa.2011.011279 [16]. Assob, J. C. N., Palle, J. N., Nsagha, D. S., Mewoabi, S. D., & Mbukam, E. C., 2014, Variation of CD4+ T-Lymphocyte Counts and Transaminases in HIV and HIV/HBV Co-infected Patients on Therapy at Nylon Hospital Douala, Cameroon. International Journal of Tropical Disease and Health, 4(8), 947–955. https://doi.org/10.9734/IJTDH/2014/9662 [17]. Wandeler, G., Gsponer, T., Bihl, F., Bernasconi, E., Cavassini, M., Kovari, H., et al., 2013, Hepatitis B virus infection is associated with impaired immunological recovery during antiretroviral therapy in the Swiss HIV cohort study. Journal of Infectious Diseases, 208(9), 1454–1458. https://doi.org/10.1093/infdis/jit351 [18]. Shiferaw, M. B., Tulu, K. T., Zegeye, A. M., & Wubante, A. A., 2016, Liver Enzymes Abnormalities among Highly Active Antiretroviral Therapy Experienced and HAART Naive HIV-1 Infected Patients at Debre Tabor Hospital, North West Ethiopia: A Comparative Cross-Sectional Study. AIDS research and treatment, 2016, 1985452. https://doi.org/10.1155/2016/1985452 [19]. Farahani, M., Mulinder, H., Farahani, A., & Marlink, R., 2017. Prevalence and distribution of non-AIDS causes of death among HIV-infected individuals receiving antiretroviral therapy: a systematic review and meta-analysis. International journal of STD & AIDS, 28(7), 636–650. https://doi.org/10.1177/0956462416632428 [20]. Kouanfack, C., Aghokeng, A. F., Mondain, A. M., Bourgeois, A., Kenfack, A., Mpoudi-Ngolé, E., Ducos, J., Delaporte, E., & Laurent, C., 2012, Lamivudine-resistant HBV infection in HIV-positive patients receiving antiretroviral therapy in a public routine clinic in Cameroon. Antiviral Therapy, 17(2), 321–326. https://doi.org/10.3851/imp1911 [21]. Noubiap, J. J., Nansseu, J. R., Ndoula, S. T., Bigna, J. J., Jingi, A. M., & Fokom-Domgue, J., 2015, prevalence, infectivity and correlates of hepatitis B virus infection among pregnant women in a rural district of the Far North Region of Cameroon. BMC public health, 15, 454. https://doi.org/10.1186/s12889-015-1806-2 [22]. Magoro, T., Gachara, G., Mavhandu, L., Lum, E., Kimbi, H. K., Ndip, R. N., & Bessong, P., 2016, Serologic and genotypic characterization of hepatitis B virus in HIV-1 infected patients from South West and Littoral Regions of Cameroon. Virology journal, 13(1), 178. https://doi.org/10.1186/s12985-016-0636-x [23]. Bigna, J. J., Amougou, M. A., Asangbeh, S. L., Kenne, A. M., Noumegni, S. R. N., Ngo-Malabo, E. T., & Noubiap, J. J., 2017. Seroprevalence of hepatitis B virus infection in Cameroon: a systematic review and meta-analysis. BMJ open, 7(6), e015298. https://doi.org/10.1136/bmjopen-2016-015298 [24]. Luma, H. N., Eloumou, S. A. F. B., Ekaney, D. S. M., Lekpa, F. 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					Investigate the Factors Contributing to Gender Inequality in Literacy: The Shortfall in boys’ Literacy Development in Primary Schools in the Parish of St. James, JamaicaAuthor: Julette Shaw-WilliamsDOI: 10.21522/TIJAR.2014.12.04.Art033Investigate the Factors Contributing to Gender Inequality in Literacy: The Shortfall in boys’ Literacy Development in Primary Schools in the Parish of St. James, JamaicaAbstract:This article explores the factors contributing to gender inequality in literacy development among boys in St. James, Jamaica, and the disparities between them and their female counterparts. Using a mixed-method approach, the study gathered qualitative and quantitative data to examine the underlying causes of boys’ underachievement in literacy. The research identified a range of influencing factors, which includes school environment, home support, family background, teaching strategies, and teacher-student relationships. Ethical standards were observed, and the study also addressed its limitations and anticipated outcomes. Findings revealed that gender inequality in literacy remains a persistent concern, both locally and globally. Boys in St. James are particularly disadvantaged due to cultural expectations, limited parental involvement especially from fathers, and classroom practices that often fail to align with their learning preferences. Many boys are expected to adopt adult responsibilities prematurely, such as becoming breadwinners, which hinders their educational progress. Additionally, societal norms surrounding masculinity discourage boys from engaging in reading and writing, which are often perceived as feminine activities. This study concludes that boys face unique challenges that significantly impact their literacy development. These include a lack of male role models in education, limited access to culturally relevant reading materials, and instructional methods that do not accommodate diverse learning styles. The cumulative effect of these challenges results in boys being underserved by the current educational system. Addressing these issues requires targeted policy reform, teacher training, and greater parental and community involvement to foster equitable literacy outcomes for all students. Investigate the Factors Contributing to Gender Inequality in Literacy: The Shortfall in boys’ Literacy Development in Primary Schools in the Parish of St. James, JamaicaReferences:[1]. Dialnet, 2025, Promoting gender equality in the classroom. Teacher_sChool, 8953813(2). from: https://dialnet.unirioja.es [2]. DiPrete, T. A., & Buchmann, C., 2013, The rise of women: The growing gender gap in education and what it means for American schools. New York: Russell Sage Foundation. [3]. 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