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Key Barriers Affecting Implementation of Intergrated Management of New-Born and Childhood illnesses among Health workers in Lusaka and Chongwe, ZambiaAuthor: Baleke NgambiDOI: 10.21522/TIJAR.2014.13.01.Art001
Key Barriers Affecting Implementation of Intergrated Management of New-Born and Childhood illnesses among Health workers in Lusaka and Chongwe, Zambia
Abstract:
Zambia adopted the Intergrated Management of Newborn and Childhood Illnesses (IMNCI) strategy in 1995 as a key strategy for addressing the high morbidity and mortality among under-five children. Despite its introduction, implementation of IMNCI has not been optimal as it can be seen from the 2018 Zambia’s health facility assessment, which found that only 56% of health facilities did not meet the programmatic threshold of having at least 60% of health workers managing sick children trained in IMCI, and 20% of sick children were not accessed for cough, diarrhoea and fever and 56% for HIV infection. The purpose of this study was to explore barriers to implementation of the IMNCI strategy among primary healthcare workers at health facility level in Chongwe and Lusaka districts. Data were collected from observation of health workers during assessment of sick under five children, Key Informant Interviews with health workers, National and District Focal-point persons and Health facility assessment. The study revealed Health systems factors such as lack of supervision, training and mentorship, shortage of supplies and equipment, shortage of health workers and inadequate infrastructure; Health workers skills such as poor attitude, Lack of motivation, long duration and difficult steps for IMNCI assessment as barriers to health workers’s adoption of IMNCI during assessment of sick children. Therefore, this study proposes the adoption of a holistic strategy for addressing the non-adherence to IMNCI protocols among health workers that encompasses health systems related factors and health workers skills, attitudes and practice.
Key Barriers Affecting Implementation of Intergrated Management of New-Born and Childhood illnesses among Health workers in Lusaka and Chongwe, Zambia
References:
[1]. WHO Child Health and Development Unit., 2023, Integrated management of childhood illness. https://www.who.int/teams/maternal-newborn-child-adolescent-health-and-ageing/child- health/integrated-management-of-childhood-illness.
[2]. UNICEF, et al., 2021, "Level and trends in child mortality," 2021. https://childmortality.org/wp-content/uploads/2021/12/UNICEF-2021-Child-Mortality-Report.pdf.
[3]. Zambia Statistics Agency, Ministry of Health (MoH) [Zambia], and ICF., 2024, Zambia Demographic and Health Survey 2024: Key Indicators Report. Lusaka, Zambia, and Rockville, Maryland, USA: Zambia Statistics Agency, MoH, and ICF.
[4]. Costello, A., & Sarah, D., et al., 2017, “Towards a Grand Convergence for Child Survival and Health: A strategic review of options for the future building on lessons learnt from IMNCI," WHO, Geneva, 2017.
[5]. Pradhan, N., et al., 2013, "Insight into implementation of facility-based integrated management of childhood illness strategy in a rural district of Sindh, Pakistan," Global Health Action 6: 20086
[6]. Ministry of Health., 2018, Zambia 2018 National Integrated management of Newborn and Childhood Illnesses Health Facility survey report | WHO | Regional Office for Africa., 2018. WHO | Regional Office for Africa. https://www.afro.who.int/publications/zambia-2018-national-integrated-management-newborn-and-childhood-illnesses-health
[7]. United Nations Inter-Agency Group for Child Mortality Estimation (UNIGME)., 2021, ‘Levels & Trends in Child Mortality: Report 2021, Estimates developed by the United Nations Inter-Agency Group for Child Mortality Estimation’, United Nations Children’s Fund, New York.
[8]. Abebe, A., et al., 2019, Assessment of Factors Affecting the Implementation of Integrated Management of Neonatal and Childhood Illness for Treatment of under Five Children by Health Professional in Health Care Facilities in Yifat Cluster in North Shewa Zone, Amhara Region, Ethiopia. International Journal Paediatric. 2019 Dec 14;2019: 9474612. doi: 10.1155/2019/9474612. PMID: 31949443; PMCID: PMC6948312
[9]. Pandya, H., et al., 2018, Health system factors affecting implementation of integrated management of childhood illness (IMCI): qualitative insights from a South African province. Health Policy Plan. 2018 Mar 1;33(2):171-182. doi: 10.1093/heapol/czx154. PMID: 29161375.
[10]. Reñosa, M., et al., 2021, “The staff are not motivated anymore”: Health care worker perspectives on the Integrated Management of Childhood Illness (IMCI) program in the Philippines. BMC Health Services Research 21, 270 (2021). https://doi.org/10.1186/s12913-021-06209-6
[11]. Kiplagat, A., et al., 2014, Factors influencing the implementation of integrated management of childhood illness (IMCI) by healthcare workers at public health centers & dispensaries in Mwanza, Tanzania. BMC Public Health 14, 277 (2014). https://doi.org/10.1186/1471-2458-14-277
[12]. Seid, S., & Sendo, E., 2018, A survey on integrated management of neonatal and childhood illness implementation by nurses in four districts of West Arsi zone of Ethiopia. Paediatric Health, Medicine Therapeutics. 2018; 9:1–7. Epub 2018/02/15. PubMed PMID: 29443325; PubMed Central PMCID: PMCPMC5804021
[13]. Fick, C., 2017, Twenty years of IMCI implementation in South Africa: accelerating impact for the next decade. Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg. SAHR 207-214
[14]. Oladokun, F., et al., 2022, Factors Influencing Implementation of Integrated Management of Childhood Illnesses (IMCI) among Health Care Workers in Selected Primary Health Centres in Ibadan, Nigeria. African Journal of Health Sciences Volume 35, Issue No.5, September - October 2022
[15]. Meno, F., et al., 2019, Factors inhibiting implementation of Integrated Management of Childhood Illnesses (IMCI) in primary health care (PHC) facilities in Mafikeng sub-district. International Journal of Africa Nursing Sciences, Volume 11,2019,100161, ISSN 2214-1391, https://doi.org/10.1016/j.ijans.2019.100161.
[16]. Tshivhase, L., et al., 2020, Challenges facing professional nurses implementing the Integrated Management of Childhood Illness programme in rural primary health care clinics, Limpopo Province, South Africa. South Africa Family Practice (2004). 2020 May 25;62(1): e1-e6. doi: 10.4102/safp. v62i1.5060. PMID: 32501038; PMCID: PMC8378005.
[17]. Vhuromu, E., & Davhana-Maselesele, M., 2010, Experiences of primary health care nurses in implementing integrated management of childhood illnesses strategy at selected clinics of Limpopo Province. Curationis. 2009; 32:60–71. Epub 2010/ 03/17. PubMed PMID: 20225745.
[18]. Alfannah, F., 2020, Do Healthcare Professional View Integrated Management of Childhood Illness Effective? Findings from in-Depth Interviews and Focus Group Discussion in Oman. Research Journal of Medical Sciences. 14. 1-8. 10.36478/rjmsci.2020.1.8.
[19]. Horwood, C., et al., 2009, Experiences of training and implementation of integrated management of childhood illness (IMCI) in South Africa: A qualitative evaluation of the IMCI case management training course. BMC Pediatrics, 9, 62. https://doi.org/10.1186/1471-2431-9-62
[20]. Biswas, A., et al., 2011, Skill of frontline workers implementing integrated management of neonatal and childhood illness: Experience from a district of West Bengal, India. Journal of Tropical Pediatrics, 57(5), 352–356. https://doi.org/10.1093/tropej/fmq106
[21]. Mulaudzi, M., 2015, Adherence to case management guidelines of integrated management of childhood illness (IMCI) by healthcare workers in Tshwane, South Africa. South African Journal of Child Health, vol. 9, no. 3, pp. 89-92.
[22]. Belete, A., et al., 2024, Utilization of the Integrated Management of Newborn and Childhood Illness (IMNCI) protocol and associated factors among health care workers in health centers of South Gondar Zone, Northwest Ethiopia: an institution-based mixed study. Frontiers in Health Services. 4:1364661. doi: 10.3389/frhs.2024.1364661
[23]. Krüger, C., et al., 2017, Adherence to the integrated management of childhood illness guidelines in Namibia, Kenya, Tanzania and Uganda: evidence from the national service provision assessment surveys. BMC Health Services Research 17, 822 (2017). https://doi.org/10.1186/s12913-017-2781-3
[24]. Idindili, B., et al., 2018, Factors influencing implementation of integrated management of childhood illness in Lindi Region, Southern Tanzania. Tanzania Journal of Health Research. 20. 10.4314/thrb.v20i1.7.
[25]. Amachree, D., & Eleke, C., 2022, Adherence and Implementation-related Challenges of Integrated Management of Childhood Illness Guidelines among Nurses at Health Centers in Port Harcourt, Nigeria. International Journal of Medicine and Health Development, 27(3), 244–250. https://doi.org/10.4103/ijmh.IJMH_35_21
[26]. Mupara, L., & Lubbe, C., 2016, Implementation of the Integrated Management of Childhood Illnesses strategy: Challenges and recommendations in Botswana. Global Health Action, 9(1). https://doi.org/10.3402/gha.v9.29417
[27]. Adekanye, R., & Odetola, D., 2020, Challenges facing professional nurses implementing the Integrated Management of Childhood Illness (IMCI) strategy in Vhembe primary health care clinics. South African Family Practice, 40(1), 1-6.
[28]. Gera, T., et al., 2016, Integrated management of childhood illness (IMCI) strategy for children under five. Cochrane Database System Rev. 2016 Jun 22;2016(6):CD010123. doi: 10.1002/14651858.CD010123.pub2. PMID: 27378094; PMCID: PMC4943011.
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Evaluation of Healthcare Service Delivery in Adamawa, Nigeria: A Comparative Analysis of Findings from 3 Patient’s Satisfaction Metrics - Net Promoter Score (NPS), Satisfaction Survey & Quality of Care AssessmentAuthor: Innocent Chinedu UdemezueDOI: 10.21522/TIJAR.2014.13.01.Art002
Evaluation of Healthcare Service Delivery in Adamawa, Nigeria: A Comparative Analysis of Findings from 3 Patient’s Satisfaction Metrics - Net Promoter Score (NPS), Satisfaction Survey & Quality of Care Assessment
Abstract:
Efforts to expand access or reduce healthcare service costs may do little to increase access and utilisation, when quality of care is perceived as unsatisfactory. Strategic use of multiple patients’ experience surveys can help health systems address concerns of dissatisfied clients, improve patient loyalty, and help providers tailor their services to meet patient expectations. The aim of this study is to conduct a comparative assessment of perception of the quality of health service delivered by health facilities in five wards using three client-reported experience measures, namely, patient satisfaction surveys, Net Promoter Score (NPS) studies, and patient overall quality of care assessments. This study adopted the descriptive analytical study using the cross-sectional quantitative method. The overall satisfaction rate, proportion of promoters, and NPS score obtained are 70%, 14.5%, and -40.7, respectively. Findings show overall satisfaction rates of 70% is far higher than the proportion of respondents (14.5%) who were willing to recommend health facilities to friends and families. The distribution of satisfaction rates compared to the proportion of promoters (in parentheses) is as follows: 89.4% (34.2%) in Damare; 86.7% (14.5%) in Imburu; 40.8% (15.4%) in Mbilla; 58.7% (1.2%) in Dumne; and 63.5% (4.3%) in Sabon Pegi. This study has demonstrated the higher reliability of the NPS study over satisfaction surveys, further establishing the complementary value of using at least two metrics over one. The far lesser proportion of promoters compared to satisfied respondents suggests relying on one metric alone provides limited perspectives on clients’ sentiments about the quality of services offered by health facilities.
Evaluation of Healthcare Service Delivery in Adamawa, Nigeria: A Comparative Analysis of Findings from 3 Patient’s Satisfaction Metrics - Net Promoter Score (NPS), Satisfaction Survey & Quality of Care Assessment
References:
[1]. Andaleeb, S., 2001, Service quality perceptions and patient satisfaction: a study of hospitals in a developing country, Social Science and Medicine, Vol.52, pp. 1359- 1370.
[2]. Nuri, N. N., Sarker, M., Ahmed, H. U., Hossain, M. D., Beiersmann, C., and Jahn, A., 2019, Experience and perceived quality of care of patients and their attendants in a specialized mental hospital in Bangladesh. International Journal of Mental Health Systems, 13(1), 46. https://doi.org/10.1186/s13033-019-0303-x
[3]. Turkson, P. K., 2009, Perceived quality of healthcare delivery in a rural district of Ghana. Ghana Medical Journal, 43(2), 65–70. https://doi.org/10.4314/gmj.v43i2.55315
[4]. Ilioudi, S., Lazakidou, A., and Tsironi, M., 2013, Importance of patient satisfaction measurement and electronic surveys: methodology and potential benefits. International Journal of Health Research and Innovation, vol. 1, no. 1, 67-87 ISSN: 2051-5057 (print version), 2051-5065 (online) Scienpress.
[5]. Boscarino, J.A.,1992, The public's perception of quality hospitals II: implications for patient surveys. Hosp Health Serv Adm. Spring;37(1):13-35. PMID: 10116109.
[6]. Chukwuma, J. N., & Obi, F. A., 2025, A political economy analysis of health policymaking in Nigeria: The genesis of the 2014 National Health Act. Health Policy and Planning, 40(4), 459–470. https://doi.org/10.1093/heapol/czaf007
[7]. Oberst, M. T.,1984, Patients’ perceptions of care. Cancer, 53(S10), 2366–2373. https://doi.org/10.1002/cncr.1984.53.s10.2366
[8]. French, K., 1981, Methodological considerations in hospital patient opinion surveys. International Journal Nursing Studies. 1981;18(1):7-32. doi: 10.1016/0020-7489(81)90004-3. PMID: 6906348.
[9]. Kamra, V., Singh, H., and De, K., 2015, Factors affecting patient satisfaction: an exploratory study for quality management in the health-care sector. Total Quality Management & Business Excellence, 27, 1–15. https://doi.org/10.1080/14783363.2015.1057488
[10]. Reerink, I. H. and Sauerborn, R, 1996, Quality of primary health care in developing countries: recent experiences and future directions | International Journal for Quality in Health Care | Oxford Academic. https://academic.oup.com/intqhc/article-abstract/8/2/131/1832376
[11]. Larson, E., Sharma, J., Bohren, M. A., and Tunçalp, Ö., 2019, When the patient is the expert: measuring patient experience and satisfaction with care. Bulletin of the World Health Organization, 97(8), 563–569. https://doi.org/10.2471/BLT.18.225201
[12]. Langseth, P., Langan, P., & Talierco, R., 1995, Service delivery survey (SDS): a management tool. The Economic Development Institute of the World Bank.
[13]. Roder-DeWan, S., Gage, A. D., Hirschhorn, L. R., Twum-Danso, N. A. Y., Liljestrand, J., Asante-Shongwe, K., Rodríguez, V., Yahya, T., and Kruk, M. E., 2019, Expectations of healthcare quality: a cross-sectional study of internet users in 12 low- and middle-income countries. PLoS Medicine, 16(8), e1002879. https://doi.org/10.1371/journal.pmed.1002879
[14]. Adebayo, A. A, and Tukur, A. L., 1999, Adamawa State in maps publication Department of Geography, Federal University of technology Yola, in Co-operate with paraclete publications. A division of paraclete and sons Nigeria. https://www.researchgate.net/figure/Map-of-Adamawa-State-indicating-the-study-area-Source-Adebayo-1999_fig1_328593330
[15]. Baquero, A., 2022, Net promoter score (NPS) and customer satisfaction: relationship and efficient management. Sustainability, 14(4), Article 4. https://doi.org/10.3390/su14042011
[16]. Reichheld, F., 2011, September 20, The ultimate question 2.0 (revised and expanded edition): how net promoter companies thrive in a customer-driven world: Reichheld, Fred, Markey, Rob: 9781422173350: Amazon.com: Books. https://www.amazon.com/Ultimate-Question-Revised-Expanded-Customer-Driven/dp/1422173356
[17]. Daramola O. E., Abu, J. M., and Akande, T. M., 2022, patient preference and reasons for choice of healthcare facilities among enrollees of the national health insurance scheme. a case study of a teaching hospital in North-East Nigeria. Nigerian Medical Practitioner Vol. 81 No. 1-3, 2022 (25-30)
[18]. Hassan, K., Malaika, A., Laiba, N., and Muhammad, K., 2025, December 11, Comparative analysis of patient satisfaction level with radiology services in public and private hospitals of district peshawar. ResearchGate. https://doi.org/10.61919/b4th7d68
[19]. Oredola, A. O. and Odusanya, O. O., 2025, A survey of the perception of the quality of and preference of healthcare services amongst residents of Abeokuta South Local Government, Ogun State, Nigeria. ResearchGate. https://doi.org/10.4103/njcp.njcp_228_16
[20]. Olawoye, O., Ashaye, A., Bekibele, C, Ajuwon, A. J., 2012, A comparative evaluation of patients’ satisfaction with cataract surgical services in a public tertiary and a private secondary eye care facilities in Nigeria. Ann Afr Med 2012; 11:157 62.
[21]. Ogunlade, A. A., Ayandiran, E. O., Olaogun, A. A., Okunola, I., 2017, Perception of emergency nursing care among patients in selected hospitals in Oyo state Nigeria. Int J Caring Sci 2017; 10:971 8.
[22]. Adamu, H., Oche, M. O., 2012, Patient satisfaction with services at a general outpatient clinic of a tertiary hospital in Nigeria. Journal of Advances in Medicine and Medical Research 2012; 4:2181-2202.
[23]. Ujah, I. A. O., Awa, M. J., Meshak, D. J., Garba, R. M., Ajibola, S., Onyekwelu, J., and Lamu, N. M., 2024, Assessment of patients’ satisfaction with healthcare services provided under the Nigeria national health insurance authority. Nigerian Medical Journal: Journal of the Nigeria Medical Association, 65(5), 621. https://doi.org/10.60787/nmj-v65i3.413
[24]. Effiong, F., Dine, R. D., Hassan, I., Olawuyi, D., Isong, I., & Adewole, A., 2025, Coverage and predictors of enrollment in the state-supported health insurance schemes in Nigeria: a quantitative multi-site study. BMC Public Health, 25. https://doi.org/10.1186/s12889-025-23329-4
[25]. Jalei, A. A., Hassan, Y. S. A., Omar, A. I., & Ali, M. A., 2025, Patient satisfaction and health services in two public hospitals in Mogadishu, Somalia: a cross-sectional study. Frontiers in Health Services, 5. https://doi.org/10.3389/frhs.2025.1552322
[26]. Holikatti, P. C., Kar, N., Mishra, A., Shukla, R., Swain, S. P., Kar, S., 2012, A study on patient satisfaction with psychiatric services. Indian J Psychiatry.54(4):327–32. doi: 10.4103/0019-5545.104817
[27]. Abbasi-Moghaddam, M. A., Zarei, E., Bagherzadeh, R., Dargahi, H., Farrokhi, P., 2019, Evaluation of service quality from patients’ viewpoint. BMC Health Serv Res.19:1–7. doi: 10.1186/s12913-019-3998-0
[28]. Khan, H., Awan, M., Noor, L., and Khan, M., 2025, December 11, Comparative analysis of patient satisfaction level with radiology services in public and private hospitals of district Peshawar. ResearchGate. https://doi.org/10.61919/b4th7d68
[29]. Adhikary, G., Shawon, M. S. R., Ali, M. W., Shamsuzzaman, M., Ahmed, S., Shackelford, K. A., et al, 2018, Factors influencing patients’ satisfaction at different levels of health facilities in Bangladesh: results from patient exit interviews. PLoS One. 13(5): e0196643. doi: 10.1371/journal.pone.0196643
[30]. Crow, R., Gage, H., Hampson, S., Hart, J., Kimber, A., Storey, L et al, 2002, The measurement of satisfaction with healthcare: implications for practice from a systematic review of the literature. Health Technol Assess 2002^ (32).
[31]. Khoso, A. R., Akhtar, F., Narejo, A. A., et al, Comparative analysis of service quality between public and private hospitals, using SERVQUAL model: a case study of Peshawar, Pakistan. MEDFARM 11:240-52
[32]. Prakoeswa, C., R., Hidayah, N., Dewi, A., and Purnamasari, I., 2022, Patient satisfaction, perception-expectation gap, and customer satisfaction index in annual survey 2021 at Dr. Soetomo General Academic Hospital, Folia Medica Indonesiana 58(2):178-186. DOI:10.20473/fmi. v58i2.34550
[33]. Akin, O., and Oshineye, A., 2005, Assessment of quality of care in a primary health care setting in Southwest Nigeria. Retrieved December 15, 2025, from https://www.researchgate.net/publication/359817739_Assessment_of_Quality_of_Care_in_a_Primary_Health_Care_Settingin_South_West_Nigeria
[34]. Onwujekwe, A., Etiaba, E., & Oche, A., 2015, Patient satisfaction with health care services: a case study of the federal medical centre, Makurdi, north central Nigeria. International Journal of Medicine and Health Development, 18(1), 39–55. https://doi.org/10.4314/jcm.v18i1.
[35]. Otojareri, K. A., and Adefila Adewale, 2024, Assessment of patient’s satisfaction with health care services from primary healthcare facilities in Chanchanga Local Government, Minna, Niger State. https://www.acquaintpublications.com/article/assessment_of_patients_satisfaction_with_health_care_services_from_primary_healthcare_facilities_in_chanchanga_local_government_minna_niger_state
[36]. Osiya, D. A., Ogaji, D. O., and Onotai, L., 2017, Patients’ satisfaction with healthcare: comparing general practice services in a tertiary and primary healthcare settings. The Nigerian Health Journal, Volume 17 No 1,
[37]. Alismail, A., Schaeffer, B., Oh, A., Hamiduzzaman, S., Daher, N., Song, H.-Y., Furukawa, B., and Tan, L. D., 2020, The use of the net promoter score (NPS) in an outpatient allergy and pulmonary clinic: an innovative look into using tablet-based tool vs traditional survey method. Patient Related Outcome Measures, 11, 137–142. https://doi.org/10.2147/PROM.S248431
[38]. Bitencourt, V. N., Crestani, F., Peuckert, M. Z., Andrades, G. R. H., Krauzer, J. R. M., Cintra, C. de C., Cunha, M. L. da R., Eckert, G. U., Girardi, L., Santos, I. S., and Garcia, P. C. R., 2023, Net Promoter Score (NPS) as a tool to assess parental satisfaction in pediatric intensive care units. Jornal de Pediatria, 99, 296–301. https://doi.org/10.1016/j.jped.2022.11.013
[39]. D’Avila, O. P., Perrone, L. R., Ribeiro, M. C., & Pinto, L. F., 2024, The use of Net Promoter Score for evaluating Primary Health Care: Results from population-based surveys. Ciência & Saúde Coletiva, 29, e01452024. https://doi.org/10.1590/1413-812320242911.01452024EN
[40]. Leslie, H. H., Lee, H.-Y., Blouin, B., Kruk, M. E., and García, P. J., 2022, Evaluating patient-reported outcome measures in Peru: a cross-sectional study of satisfaction and net promoter score using the 2016 EnSuSalud survey. BMJ Quality & Safety, 31(8), 599–608. https://doi.org/10.1136/bmjqs-2021-014095
[41]. Zeithaml, V. A., and Bitner, M. J., 2000, Sservices marketing: integrating customer focus across the firm. 2nd Edition, McGraw-Hill, Boston. https://www.scirp.org/reference/ReferencesPapers?ReferenceID=1808370
[42]. Bancsik, K., Ilea, C. D. N., Daina, M. D., Bancsik, R. S., Uteu, C. L., Bîrsan, S. D., Manole, F., and Daina, L. G., 2023, Comparative analysis of patient satisfaction surveys—a crucial role in raising the standard of healthcare services. Healthcare, 11, 2878. https://doi.org/10.3390/healthcare11212878
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Current Attitudes, Behavior and Cardiovascular Impact of Choice Alcoholic Beverages and Herbs Among Commercial Automobile Drivers in Ibadan, NigeriaAuthor: Adedamope Olajumoke AdediranDOI: 10.21522/TIJAR.2014.13.01.Art003
Current Attitudes, Behavior and Cardiovascular Impact of Choice Alcoholic Beverages and Herbs Among Commercial Automobile Drivers in Ibadan, Nigeria
Abstract:
Alcohol consumption is a major health-risk behavior linked to non-communicable diseases, while herbal beverage use is rising globally. Data on co-consumption of alcohol and herbal drinks among high-risk occupational groups in sub-Saharan Africa are limited. This study examined the prevalence, attitudes, behaviors, and cardiovascular risk associated with alcohol and herbal beverage consumption among commercial automobile drivers in Ibadan, Nigeria. A mixed cross-sectional study with a convergent parallel design was conducted among commercial drivers across local government areas in Ibadan. Quantitative data were collected using structured questionnaires and measurements of blood pressure, pulse rate, and body mass index. Qualitative data were obtained through key informant interviews. Data were analyzed using SPSS v25 and R v4.4.2, with chi-square, t-tests, and ANOVA at p < 0.05. Point prevalence of alcohol consumption was below average. Alcohol consumption was significantly associated with hypertension, while herbal use showed no significant cardiovascular associations. Elevated blood pressure was common, with only 21.9% reporting recent screening. Age, marital status, family structure, and education significantly influenced attitudes and behaviors toward alcohol use. Key informants noted widespread herbal use but limited awareness of health risks. Alcohol consumption is moderately prevalent and associated with hypertension, while herbal beverage use is widespread but unrelated to cardiovascular outcomes. High undiagnosed hypertension emphasize the need for targeted screening, education, and regulation among commercial drivers.
Current Attitudes, Behavior and Cardiovascular Impact of Choice Alcoholic Beverages and Herbs Among Commercial Automobile Drivers in Ibadan, Nigeria
References:
[2]. Adeloye, D., Olawole-Isaac, A., Auta, A., Dewan, M. T., Omoyele, C., Ezeigwe, N., Jacobs, W., et al., 2019, Epidemiology of harmful use of alcohol in Nigeria: A systematic review and meta-analysis. The American Journal of Drug and Alcohol Abuse, 45(5), 438–450. https://doi.org/10.1080/00952990.2019.1628244
[3]. Ajayi, A., & Mazinyo, S., 2020, Socio-economic situation and substance use disorder influences on safety practices among truckers. The Open Transportation Journal, 14, 1–8.
[4]. Akpan, G., & Ikorok, M., 2014, The prevalence of alcohol consumption among commercial drivers in Uyo Local Government Area, Akwa Ibom State, Nigeria. IOSR Journal of Sports and Physical Education, 1(7), 47–51.
[5]. Barnes, A., 2023, Cardiovascular disease risk screening for commercial drivers examined in occupational practice: Implementing evidence-based practice to champion the health of essential workers. Workplace Health & Safety, 71(10), 465–475. https://doi.org/10.1177/21650799231184374
[6]. Boyd, J., Sexton, O., Angus, C., Meier, P., Purshouse, R. C., & Holmes, J., 2022, Causal mechanisms proposed for the alcohol harm paradox: A systematic review. Addiction, 117(1), 33–56. https://doi.org/10.1111/add.15567
[7]. Daramola, A. Y., 2018, Transport operations and sustainable development in the informal economy: The case of commercial motorcycles in Ibadan. Cities, 81, 101–107. https://doi.org/10.1016/j.cities.2018.03.019
[8]. Eagly, A. H., & Chaiken, S., 2007, The advantages of an inclusive definition of attitude. Social Cognition, 25(5), 582–602. https://doi.org/10.1521/soco.2007.25.5.582
[9]. Gaines, L., 2014, Student attitudes towards drinking behaviors (Honors thesis). University of New Hampshire. https://scholars.unh.edu/honors/200
[10]. Griswold, M. G., Fullman, N., Hawley, C., Arian, N., Zimsen, S. R. M., Tymeson, H. D., et al., 2018, Alcohol use and burden for 195 countries and territories, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. The Lancet, 392(10152), 1015–1035. https://doi.org/10.1016/S0140-6736(18)31310-2
[11]. Lasebikan, V. O., Ayinde, O., Odunleye, M., Adeyefa, B., Adepoju, S., & Fakunle, S., 2018, Prevalence of alcohol consumption and alcohol use disorders among outdoor drinkers in public open places in Nigeria. BMC Public Health, 18(1), Article 400. https://doi.org/10.1186/s12889-018-5344-6
[12]. Morojele, N. K., Dumbili, E. W., Obot, I. S., & Parry, C. D. H., 2021, Alcohol consumption, harms and policy developments in sub-Saharan Africa: The case for stronger national and regional responses. Drug and Alcohol Review, 40(3), 402–419. https://doi.org/10.1111/dar.13247
[13]. Okaiyeto, K., & Oguntibeju, O. O., 2021., African herbal medicines: Adverse effects and cytotoxic potentials with different therapeutic applications. International Journal of Environmental Research and Public Health, 18(11), Article 5988. https://doi.org/10.3390/ijerph18115988
[14]. Richardson, W. H., Slone, C. M., & Michels, J. E., 2007, Herbal drugs of abuse: An emerging problem. Emergency Medicine Clinics of North America, 25(2), 435–457. https://doi.org/10.1016/j.emc.2007.02.009
[15]. Roser, M., Ritchie, H., & Spooner, F., 2021, Burden of disease. Our World in Data. https://ourworldindata.org/burden-of-disease
[16]. Spring, B., Moller, A. C., & Coons, M. J., 2012, Multiple health behaviors: Overview and implications. Journal of Public Health, 34(Suppl 1), i3–i10. https://doi.org/10.1093/pubmed/fdr111
[17]. Wahab, B., & Popoola, A., 2018, Climate-induced problems and adaptation strategies of urban farmers in Ibadan. Ethiopian Journal of Environmental Studies & Management, 11(1), 1–12.
[18]. Woo, C. S. J., Lau, J. S. H., & El-Nezami, H., 2012, Herbal medicine. In Advances in botanical research (Vol. 62, pp. 365–384). Elsevier. https://doi.org/10.1016/B978-0-12-394591-4.00009-X
[19]. World Health Organization. 2024a, June 28. Alcohol. https://www.who.int/news-room/fact-sheets/detail/alcohol
[20]. World Health Organization. 2024b, October 4. Determinants of health. https://www.who.int/news-room/questions-and-answers/item/determinants-of-health
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Assessment of Food Hygiene and Safety Knowledge and Practices among Street Food Vendors in Mowe Town of Ogun State, NigeriaAuthor: Modupe Bamidele AdeyemoDOI: 10.21522/TIJAR.2014.13.01.Art004
Assessment of Food Hygiene and Safety Knowledge and Practices among Street Food Vendors in Mowe Town of Ogun State, Nigeria
Abstract:
Street food is a major source of affordable cooked food in developing countries, including Nigeria, yet it remains a significant public health concern due to the risk of food borne illnesses. Poor food handling practices increase the likelihood of contamination with biological, chemical and physical hazards. This study assessed food hygiene and safety knowledge and practices among 103 street food vendors in Mowe town of Ogun State, Nigeria using a cross-sectional descriptive survey involving structured questionnaires and interviews. Most vendors (73.79 %) were females, and over half (54.37 %) were aged 18 to 35 years. Secondary education was the most common qualification (32.04 %), and (42.72 %) were married. The mean food hygiene and safety knowledge/awareness score was 69.42 %, while the mean food hygiene and safety practice score was lower at 54.53 %. Chi-square test (χ²(1) = 0.71, p = 0.398) showed no statistically significant association between knowledge/awareness and food handling practices, although this finding should be interpreted cautiously given the small proportion of respondents with inadequate awareness. The findings suggest that knowledge alone may not consistently translate into safe food handling practices, with implications for more targeted training for vendors and regulators, supported by enabling environments, supervision, compliance monitoring, and regulatory oversight. Strengthened intergovernmental collaboration may also support sustainable improvements in street food safety.
Assessment of Food Hygiene and Safety Knowledge and Practices among Street Food Vendors in Mowe Town of Ogun State, Nigeria
References:
[1]. Danikuu, F. M., Baguo, F. B., and Azipala, O., 2015, Hygiene practices among street food vendors in Tamale Metropolis. Journal of Medical and Biomedical Sciences, 4(3): 25-30. doi: http://dx.doi.org/10.4314/jmbs.v4i3.4
[2]. Campbell-Lendrum, D., and Corvalán, C., 2007, Climate change and developing-country cities: implications for environmental health and equity. Journal of Urban Health 84: 109-117.
[3]. Hill, J., McHiza, Z., Puoane, T., and Steyn, N. P., 2019, The development of an evidence-based street food vending model within a socio-ecological framework: A guide for African countries. PloS One 14(10).
[4]. Mensah, P., Yeboah-Manu, D., Owusu-Darko, K., and Ablordey, A., 2002, Street foods in Accra, Ghana: how safe are they? Bulletin of the World Health Organization, 80(7): 546-554.
[5]. Tambekar, D., Jaiswal, V., Dhanorkar, D., Gulhane, P., and Dudhane, M., 2009, Microbial quality and safety of street vended fruit juices: a case study of Amravati city. Internet Journal of Food Safety 10.
[6]. Mwove, J., Imathiu, S., Orina I., and Karanja, P., 2020, Food safety knowledge and practices of street food vendors in selected locations within Kiambu County, Kenya. African Journal of Food Science 14(6):174-185. DOI: 10.5897/AJFS2020.1929
[7]. Omari, R., and Omari, P., 2019, The nutrition, safety and health implications of food hawking in traffic. UNSCN Nutrition, P. 26.
[8]. Alimi, B. A., 2016, Risk factors in street food practices in developing countries: A review. Food Science and Human Wellness 5(3):141-148.
[9]. WHO, 1996, Essential safety requirements for street-vended foods. Geneva, Switzerland: Food Safety Unit, Division of Food and Nutrition, World Health Organization.
[10]. Kaliyaperumal, K., 2004, Guideline for conducting a knowledge, attitude and practice (KAP) study. AECS Illumination, 4(1), 7–9.
[11]. Muyanja, C., Nayiga, L., Brenda, N., and Nasinyama, G., 2011, Practices, knowledge and risk factors of street food vendors in Uganda. Food Control 22(10):1551–1558.
[12]. Okojie, N., 2014, Food Safety and hygienic practices of street food vendors in Owerri, Nigeria.
[13]. Addo-Tham, R., Appiah-Brempong, E., Vampere, H., Acquah-Gyan, E., and Akwasi, A. G., 2020, Knowledge on Food Safety and Food-Handling Practices of Street Food Vendors in Ejisu-Juaben Municipality of Ghana. Advances in Public Health vol. 2020, Article ID 4579573, 7 pages, 2020. https://doi.org/10.1155/2020/4579573
[14]. Okojie, P. W., and Isah, E. C., 2014, Sanitary conditions of food vending sites and food handling practices of street food vendors in Benin city, Nigeria: implication for food hygiene and safety. Journal of Environmental and Public Health. Article ID: 701316, 6 pages.
[15]. Tessema, A. G., Gelaye, K. A., and Chercos, D. H., 2014, Factors affecting food handling Practices among food handlers of Dangila town food and drink establishments, northwest Ethiopia. BMC Public Health 14(1):571.
[16]. Samapundo, S., Climat, R., Xhaferi, R., and Devlieghere, F., 2015, Food safety knowledge, attitudes and practices of street food vendors and consumers in Port-au-Prince, Haiti. Food Control 50:457–466.
[17]. Muinde, O. K., and Kuria, E., 2005, Hygienic and sanitary practices of vendors of street food in Nairobi, Kenya. Africa Journal of Food, Agriculture, Nutrition and Development 5(1).
[18]. Trafialek, J., Drosinos, E. H., and Kolanowski, W., 2017, Evaluation of street food vendors’ hygienic practices using fast observation questionnaire. Food Control 80: 350-359.
[19]. Chukuezi, C. O., 2010, Food safety and hygienic practices of street food vendors in Owerri, Nigeria. Studies in Sociology of Science, 1(1): 50.
[20]. Aluh, F. O., and Aluh, D. O., 2017, Knowledge, attitudes and practices of food hygiene among mobile food vendors in a Nigerian rural settlement. International Journal of Community Medicine and Public Health, [S.l.] 4(11):4025-4030. ISSN 2394-6040.
[21]. Eliku, T., 2016, Hygienic and sanitary practices of street food vendors in the city of Addis Ababa, Ethiopia. Food Science and Quality Management, 6: 32-38.
[22]. Gowri, B., Vasantha-Devi, K. P., and Sivakumar, M., 2011, Microbial Quality, Nutritional Knowledge and Food Hygienic Practices among Street Food Vendors.
[23]. Ansari-Lari, M., Soodbakhsh, S., and Lakzadeh, L., 2016, Knowledge, attitudes and practices of workers on food hygienic practices in meat processing plants in Fars, Iran. Food Control 21:260-263.
[24]. Yusuf, T. A., and Chege, P. M., 2019, Awareness of Food Hygiene Practices and Practices among Street Food Vendors in Nasarawa State, Nigeria. International Journal of Health Science and Research, 9(7):227-233.
[25]. Nyamagwa, G., 2015, Hygienic Practices of the Street Food Vendors and Microbiological Quality and Safety of Selected Cooked Street Foods around Kenyatta University.
[26]. Omemu, A. M., and Aderoju, S. T., 2008, Food safety knowledge and practices of street food vendors in the city of Abeokuta, Nigeria. Food control, 19(4):396-402.
[27]. Clayton, D. A., Griffith, C. J., Price, P., and Peters, A. C., 2002, Food handlers' beliefs and self-reported practices. International journal of environmental health research, 12(1), 25–39. https://doi.org/10.1080/09603120120110031
[28]. Soon, J. M., and Baines, R. N., 2012, Food safety training and evaluation of handwashing intention among fresh produce farm workers. Food Control, 23(2):437-448. https://doi.org/10.1016/j.foodcont.2011.08.012
[29]. Wandolo, M. A., Ndiritu, D., Khayiya, R., and Mugendi, B. W., 2018, Barriers to the Implementation of Food Safety and Hygiene Principles (HACCP) in TVET and University Hospitality Schools in Kenya. International Journal of Scientific Research and Management (IJSRM), 6(07):544-556, EM-2018. https://doi.org/10.18535/ijsrm/v6i7.em05
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Implementing Digital Health Transformation in Zambia: A Case Study of Data Governance and Interoperability (2021–2025)Author: Andrew KashokaDOI: 10.21522/TIJAR.2014.13.01.Art005
Implementing Digital Health Transformation in Zambia: A Case Study of Data Governance and Interoperability (2021–2025)
Abstract:
Digital health systems are central to achieving Universal Health Coverage in low- and middle-income countries, yet many national implementations remain fragmented, donor-driven, and weakly governed. This study examines Zambia’s digital health transformation between 2021 and 2025, with a specific focus on interoperability and health data governance. Using a government-led case study approach, the research evaluated four core national platforms: SmartCare Pro, the National Health Insurance Management Authority system, the Zambia Medicines and Medical Supplies Agency system, and the National Data Warehouse. A convergent mixed-methods design combined system performance logs, interoperability testing, stakeholder surveys, document reviews, and governance compliance audits. Findings demonstrate a 78 percent national data exchange success rate, over 90 percent facility-level compliance with the Data Protection Act, and an average system usability score of 3.7 out of 5. The study shows that the implementation of a national Interoperability Architecture Framework and Health Data Governance Framework significantly improved system integration, accountability, and evidence-based decision-making. The results contribute practical implementation evidence for low- and middle-income countries seeking to transition from fragmented digital health investments to sustainable, government-owned, interoperable health information ecosystems.
Implementing Digital Health Transformation in Zambia: A Case Study of Data Governance and Interoperability (2021–2025)
References:
[1]. World Health Organization. 2020, Global strategy on digital health 2020–2025. Geneva: WHO.
[2]. World Bank. 2021, Digital health investment framework. Washington DC: World Bank.
[3]. Digital Square. 2019, Interoperability and standards in digital health. Washington DC: Digital Square.
[4]. Mehl, G., Labrique, A., 2021, Digital health and the data revolution. Bulletin of the World Health Organization.
[5]. Mutale, W., et al., 2019, Health information systems in sub-Saharan Africa. International Journal of Medical Informatics.
[6]. Jembi Health Systems. 2021, OpenHIE architecture overview. Cape Town: Jembi Health Systems.
[7]. European Commission. 2020, Digital health maturity models. Brussels: European Commission.
[8]. Khatri, V., Brown, C., 2010, Designing data governance. MIS Quarterly Executive.
[9]. Ministry of Health Zambia. 2022, Digital health strategy 2022–2026. Lusaka: Ministry of Health.
[10]. Ministry of Health Zambia. 2023, Interoperability architecture framework. Lusaka: Ministry of Health.
[11]. Ministry of Health Zambia. 2023, Health data governance framework. Lusaka: Ministry of Health.
[12]. Global Digital Health Index. 2022, Country profiles. Washington DC: Global Digital Health Index.
[13]. HL7 International. 2021, FHIR release overview. Ann Arbor: HL7 International.
[14]. OpenHIE Community. 2020, Health information exchange for LMICs. OpenHIE Community.
[15]. Creswell, J. W., Plano Clark, V. L., 2017, Designing and conducting mixed methods research. Thousand Oaks: Sage.
[16]. Davis, F. D., 1989, Perceived usefulness and ease of use. MIS Quarterly.
[17]. Venkatesh, V., Morris, M. G., Davis, G. B., Davis, F. D., 2003, User acceptance of information technology. MIS Quarterly.
[18]. Rogers, E. M., 2003, Diffusion of innovations. New York: Free Press.
[19]. Khoja, S., et al., 2007, eHealth readiness assessment. Journal of Telemedicine and Telecare.
[20]. World Health Organization Regional Office for Africa. 2022, Digital health in the African region. Brazzaville: WHO AFRO.
[21]. Ministry of Health Kenya. 2020, National eHealth strategy. Nairobi: Ministry of Health.
[22]. Mutabazi, J., et al., 2021, Rwanda health information exchange. Health Policy and Technology.
[23]. Digital Square. 2022, Digital public goods in health. Washington DC: Digital Square.
[24]. Barron, P., et al., 2021, Lessons from MomConnect. BMJ Global Health.
[25]. Agyekum, K., et al., 2021, Digital health governance in Ghana. Health Systems & Reform.
[26]. Bangladesh Ministry of Health and Family Welfare. 2021, National digital health architecture. Dhaka: MOHFW.
[27]. India Ministry of Health. 2020, National digital health mission. New Delhi: Ministry of Health.
[28]. Peru Ministry of Health. 2022, eHealth strategy. Lima: Ministry of Health.
[29]. Brazil Ministry of Health. 2021, SUS digital health programme. Brasília: Ministry of Health.
[30]. World Health Organization South-East Asia Regional Office. 2020, DHIS2 integration experiences. New Delhi: WHO SEARO.
[31]. Global Digital Health Forum. 2023, Country case studies. Global Digital Health Forum.
[32]. Shen, Y., et al., 2023, Digital transformation of healthcare systems. Journal of Medical Systems.
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Analysis of Characteristics and Management of Vascular Access in Patient on Hemodialysis at a Private Facility in Botswana: A Retrospective Study Conducted at Sidilega Private HospitalAuthor: Kabongo LDOI: 10.21522/TIJAR.2014.13.01.Art006
Analysis of Characteristics and Management of Vascular Access in Patient on Hemodialysis at a Private Facility in Botswana: A Retrospective Study Conducted at Sidilega Private Hospital
Abstract:
End-stage renal disease (ESRD) imposes a growing global burden, with haemodialysis as the primary therapy and vascular access recognized as its critical “lifeline.” Arteriovenous fistulae (AVFs) provide the best outcomes, whereas central venous catheters (CVCs) carry markedly higher risks of infection, thrombosis, and mortality. In sub-Saharan Africa, late referrals and limited surgical capacity contribute to heavy catheter dependence, yet data from Botswana remain scarce. This retrospective cohort study evaluated 273 haemodialysis patients at Sidilega Private Hospital (Gaborone, Botswana) from February 2022 to February 2024 to describe vascular access patterns, complications, and predictors of adverse outcomes. Demographic, clinical, and procedural variables were collected from dialysis and theatre records and analyzed using descriptive and multivariable statistical methods. The cohort had a mean age of 48.6 years and was 59% male. Hypertension and cardiovascular disease were highly prevalent (each >80%), and 27.4% of patients presented with sepsis on admission. AVFs were created in 72.2% (197/273) of cases; however, 44.2% had prior catheter-based access, demonstrating persistent reliance on temporary access modalities. Complications included stenosis (35.2%), thrombosis (19.0%), and infection (14.7%). Access type emerged as the strongest predictor of complications: compared with AVFs, arteriovenous grafts (AVGs) showed significantly higher odds (OR ≈13.2) and CVCs moderately higher odds (OR ≈6.7) of any complication. Despite the complexity of cases, overall patency at discharge exceeded 95%, and in-hospital mortality was low (2.2%). These findings highlight continued dependence on catheter-based access and reinforce AVFs as the safest modality. Early nephrology referral, structured vascular access programs, and national AVF targets are essential to improve outcomes and align Botswana’s practice with global standards.
Analysis of Characteristics and Management of Vascular Access in Patient on Hemodialysis at a Private Facility in Botswana: A Retrospective Study Conducted at Sidilega Private Hospital
References:
[1]. Somaili, M., Darraj, H., Abusageah, F., Hakami, F., Hakami, K. M., Zogel, B., et al., 2024, Rate of vascular access preparation in hemodialysis patients and associated baseline characteristics in Jazan Region, Saudi Arabia: a multicentre study. Open Medicine (Warsaw), 11, e18742203310950. https://doi.org/10.2174/0118742203310950240827110852
[2]. Halle, M. P., Ashuntantang, G., Kaze, F. F., Takongue, C., Kengne, A. P., et al., 2016, Fatal outcomes among patients on maintenance hemodialysis in sub-Saharan Africa: a 10-year audit from the Douala General Hospital in Cameroon. BMC Nephrology, 17, 165. https://doi.org/10.1186/s12882-016-0377-5
[3]. Baharani, J., Vincent, L., & Vachharajani, T. J., 2023, Long-Term Dialysis Vascular Access in East Africa: Unique Challenges and Novel Solutions. Kidney360, 4(8), 1143-1146. https://doi.org/10.34067/KID.0000000000000211.
[4]. Chang, T. I., Weaver, D. J. Jr., Clark, P. R., Lee, T., Allon, M., et al., 2018, Association of diabetes mellitus with arteriovenous fistula outcomes: a meta-analysis. Journal of Vascular Access, 19(2), 102–109.
[5]. Luma, H. N., Halle, M. P., Eloumou, S. A. F. B., Azingala, F., Kamdem, F., Donfack-Sontsa, O., et al., 2017, Seroprevalence of HIV, hepatitis B and C viruses among hemodialysis patients in two newly opened centers in Cameroon. Pan African Medical Journal, 27, 235. https://doi.org/10.11604/pamj.2017.27.235.13121
[6]. Kazakova, S. V., Baggs, J., Apata, I. W., Yi, S. H., Jernigan, J. A., Nguyen, D., et al., 2020, Vascular access and risk of bloodstream infection among older incident hemodialysis patients. Kidney Medicine, 2(3), 276–285.
[7]. Rha, B., See, I., Dunham, L., et al., 2023, Vital signs: health disparities in hemodialysis-associated Staphylococcus aureus bloodstream infections — United States, 2017–2020. MMWR Morbidity and Mortality Weekly Report, 72(6), 153–159. https://doi.org/10.15585/mmwr.mm7206a3
[8]. Lok, C. E., Huber, T. S., Lee, T., Shenoy, S., Yevzlin, A. S., Rajan, D. K., et al., 2020, KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. American Journal of Kidney Diseases, 75(4 Suppl 2), S1–S164.
[9]. Maguire, N., O'Donnell, M., & O'Kelly, P., 2022, Differential impact of central venous catheters versus arteriovenous fistulae on quality of life among Irish haemodialysis patients. Journal of Vascular Access.
[10]. Almasri, J., Alsawas, M., Mainou, M., Mustafa, R. A., Wang, Z., et al., 2017, Outcomes of vascular access for hemodialysis: a systematic review and meta-analysis. Journal of Vascular Surgery, 65(1), 236–243.
[11]. Weaver, M. L., Holscher, C. M., Sorber, R. A., Lum, Y. W., Reifsnyder, T., 2021, Redo hemodialysis access in elderly patients has acceptable outcomes with similar patency of arteriovenous fistulas as compared to grafts. Annals of Vascular Surgery, 76, 128–133. https://doi.org/10.1016/j.avsg.2021.04.028
[12]. Qian, J. Z., McAdams-DeMarco, M., Ng, D. K., Lau, B., 2020, Arteriovenous fistula placement, maturation, and patency loss in older patients initiating hemodialysis. American Journal of Kidney Diseases, 76(4), 480–489.e1. https://doi.org/10.1053/j.ajkd.2020.02.449
[13]. Trerotola, S. O., 2020, Kinder, gentler, and more important than ever — ESRD dialysis vascular access for older patients. Journal of Vascular and Interventional Radiology, 31(7), 1156–1157. https://doi.org/10.1016/j.jvir.2020.02.033
[14]. Siracuse, J. J., Shah, N. K., Peacock, M. R., Tahhan, G., Kalish, J. A., Rybin, D., et al., 2017, Thirty-day and 90-day hospital readmission after outpatient upper extremity hemodialysis access creation. Journal of Vascular Surgery, 65(5), 1376–1382. https://doi.org/10.1016/j.jvs.2016.11.023
[15]. Ashuntantang, G., Osafo, C., Olowu, W. A., Arogundade, F., Niang, A., Porter, J., et al., 2017. Outcomes in adults and children with end-stage kidney disease requiring dialysis in sub-Saharan Africa: a systematic review. Lancet Global Health, 5(9), e408–e417. https://doi.org/10.1016/S2214-109X(17)30057-8
[16]. Mendelssohn, D. C., Curtis, B., Yeates, K., Langlois, S., MacRae, J. M., Semeniuk, L. M., Camacho, F., McFarlane, P., & STARRT Study investigators, 2011, Suboptimal initiation of dialysis with and without early referral to a nephrologist. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 26(9), 2959–2965. https://doi.org/10.1093/ndt/gfq843
[17]. Diaz-Martinez, L. A., Fisher, G. R., Esparza, D., Bhatt, J. M., D’Arcy, C. E., Apodaca, J., et al., 2019, Recommendations for effective integration of ethics and responsible conduct of research (E/RCR) education into course-based undergraduate research experiences: A meeting report. CBE—Life Sciences Education, 18(2).
[18]. Locham, S., Al-Khafaji, J., Arain, N. A., Kitsios, G. D., & Sidawy, A. N., 2021, Incidence and risk factors of sepsis in hemodialysis patients in the United States. Journal of Vascular Surgery, 73(3), 1016–1021.e3.
[19]. Mathew, A. T., Rosen, L., Pekmezaris, R., Kozikowski, A., Ross, D. W., McGinn, T., Kalantar-Zadeh, K., & Fishbane, S., 2017, Potentially avoidable readmissions in United States hemodialysis patients. Kidney International Reports, 3(2), 343–355. https://doi.org/10.1016/j.ekir.2017.10.014
[20]. Kaze, F. F., Ashuntantang, G., Halle, M. P., & Kengne, A. P., 2014, Outcomes of non-tunneled non-cuffed hemodialysis catheters in patients on chronic hemodialysis in a resource-limited sub-Saharan Africa setting. Therapeutic Apheresis and Dialysis, 18(5), 455–460. https://doi.org/10.1111/1744-9987.12109
[21]. Grant, I. R., Freercks, R. J., Honiball, E. J., & Dube, B., 2021, Analysis of the vascular access service for patients on haemodialysis in Livingstone Hospital. Cardiovascular Journal of Africa, 32(2), 98–101.
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Family Caregiving as a Moral and Spiritual Commitment in Zambia’s Mental Health Care SettingAuthor: Virginia SimasikuDOI: 10.21522/TIJAR.2014.13.01.Art007
Family Caregiving as a Moral and Spiritual Commitment in Zambia’s Mental Health Care Setting
Abstract:
Family caregivers of individuals with chronic psychosis often navigate cultural, social, and emotional challenges while providing care. This study explored the moral and spiritual dimensions of caregiving, focusing on how family, cultural values, and spiritual beliefs shape caregivers’ commitment and coping approaches. Using an interpretive phenomenological design, in-depth interviews were conducted with 30 caregivers, and data were analysed using interpretive phenomenological analysis by Smith et.al (2009) criteria. The results had four superordinate themes; Providing care as a religious duty; Moral duty rooted in kinship and culture; Psychological and emotional strain; Coping through resourcefulness and faith. Findings showed that caregiving is viewed as a moral duty grounded in family and cultural expectations. Caregivers formed their roles as acts of love, loyalty, and responsibility, reinforced by spiritual beliefs that endure perseverance despite stigma, discrimination, and societal opposition. The study highlights that moral commitment serves as both motivation and ethical compass, guiding caregivers through demanding circumstances. However, the findings also showed risks of emotional exhaustion and self-neglect, pointing to the need for institutional and social support. Recognizing caregiving as a moral and culturally informed commitment provides insights for health professionals and policymakers to develop culturally sensitive interventions that support family caregivers’ well-being while strengthening their moral stance.
Family Caregiving as a Moral and Spiritual Commitment in Zambia’s Mental Health Care Setting
References:
[1]. WHO, Comprehensive mental health action plan 2013–2020., 2013, World Health Organization: Geneva.
[2]. Mwape, L., Mweemba, P., and Kasonde, J. M., 2010, Strengthening the health system for mental health in Zambia, Lusaka. Zambia Forum for Health Research, 2010.
[3]. Malhotra, R., & Lim‐Soh, J., 2024, Family caregiving: time-varying contexts of social support, finances, burden, and benefits. Innovation in Aging, 8(Supplement_1), 198. https://doi.org/10.1093/geroni/igae098.0639.
[4]. Marius, S., 2024, Caring for Family Caregivers of the Mentally Ill: A Social Work Perspective. Journal of Social Science and Humanities, 6(7), 105–109. https://doi.org/10.53469/jssh.2024.06(07).23.
[5]. Bekui, B. A. A., Ohene, L. A., Ampomah, M. O., and Aziato, L., 2022, Physical and socioeconomic burden of caregiving on family caregivers of children with cancer at a tertiary hospital in Ghana. Nursing Open, 9(1), e1359. https://doi.org/10.1002/nop2.1359.
[6]. Irshad, S., Batool, I., and Nazim, H., 2022, Relationship between caregiver burden and psychological well-being among the caregivers of cancer patients: Mediating role of resilience. Bulletin of Business and Economics, 13(2), 763–766. https://doi.org/10.61506/01.00391
[7]. Jatoi, H. N., and Majeed, S., 2022, Psychological distress, coping styles and emotional well-being among caregivers of patients with schizophrenia. Journal of Pakistan Psychiatric Society. https://doi.org/10.63050/jpps.19.02.143
[8]. Ofovwe, C. E., and Osasona, S. O., 2022, Burden of caregiving among caregivers of patients with severe mental illnesses in Benin City, Nigeria. African Health Sciences, 22, 657 - 667.
[9]. Setyawati, M. B., Parsons, A. P. J., Laing, B., Lynch, A., Habiburahman, I. L., and Izza, F. N., 2024, The family caregiving; A Rogerian concept analysis of Muslim perspective & Islamic sources. In Heliyon (Vol. 10, Issue 3). Elsevier Ltd. https://doi.org/10.1016/j.heliyon.2024.e25415
[10]. Angelin, R. R., Saravanan, S., James, F. C., and Samuel, R., 2025, Experience of religiosity in caregiving for persons with serious mental illness: a qualitative study using interpretative phenomenological analysis from India. BMJ open, 15(3), e090838. https://doi.org/10.1136/bmjopen-2024-090838
[11]. Sichimba, F., Janlöv, A., and Khalaf, A., 2022, Family caregivers’ perspectives of cultural beliefs and practices towards mental illness in Zambia: an interview-based qualitative study. Scientific Reports, 12, 1-11. https://doi.org/10.1038/s41598-022-25985-7
[12]. Casaleiro, T., Caldeira, S., Cardoso, D., and Apóstolo, J., 2022, Spiritual aspects of the family caregivers' experiences when caring for a community-dwelling adult with severe mental illness: a systematic review of qualitative evidence. Journal of Psychiatric and Mental Health Nursing, 29(7), 1014-1029. https://doi.org/10.1111/jpm.12816.
[13]. Kabelenga, I., 2023, Perceptions of community leaders about normative understandings of good family care of older people in rural and urban Zambia. International Journal of Care and Caring, 7(4), 708-726. https://doi.org/10.1332/239788221x16770625208518
[14]. Kabembo, I. M., 2024, Forgone healthcare for medically vulnerable groups during the pandemic era: Experiences of family caregivers of young adults with substance use disorders in Zambia. Frontiers in Public Health, 12, 1250608. https://doi.org/10.3389/fpubh.2024.1250608
[15]. Mulima, O., 2025, Religion and mental health in Zambia. Working paper, Academia.edu, pp. 1–11. Available at: https://www.academia.edu/126727293/Religion_and_Mental_Health_In_Zambia
[16]. Nqabeni, K., and Davids, R., 2024, We need support: The experiences of family members caring for a relative diagnosed with schizophrenia. Social Work/Maatskaplike Werk, 60(2), 313-338. https://doi.org/10.15270/60-2-1299
[17]. Phillips, R., Durkin, M., Engward, H., Cable, G., and Iancu, M., 2021, The impact of caring for family members with mental illnesses on the caregiver: a scoping review. Health Promotion International, 38, 1–23. https://doi.org/10.1093/heapro/daac049
[18]. Khalaf, A., Nakazwe, K., Halawi, L., and Sichimba, F., 2025, Professional competence and spiritual care provision among Zambian maternal healthcare providers: Through the lens of Watson's Theory of Human Caring. Journal of Holistic Nursing, 8980101251321970. https://doi.org/10.1177/08980101251321970
[19]. Kropf, M., 2024, Spirituality and family caregivers: Ethical considerations on the role as a spiritual guide. Journal for the Study of Spirituality, 14, 156–168. https://doi.org/10.1080/20440243.2024.2392093
[20]. Bunkley, E., Asante, C., Burack, S., Kaufman, L., Miti, S., and Hunleth, J., 2023, A heart for the care: Affect, kin, and care work in a Zambian hospital. Medical Anthropology Quarterly. https://doi.org/10.1111/maq.12837
[21]. Kombo, D. K., Tromp, D. L. A., 2016, Proposal and thesis writing: An introduction. Nairobi: Pauline Publications Africa.
[22]. Creswell, J. W., 2009, Research design: Qualitative, quantitative, and mixed methods approaches. 3rd ed. Thousand Oaks, CA: Sage Publications.
[23]. Wertz, F. J., Charmaz, K., McMullen, L. M., Josselson, R., Anderson, R., and McSpadden, E., 2011, Five ways of doing qualitative analysis: Phenomenological psychology, grounded theory, discourse analysis, narrative research, and intuitive inquiry. New York: Guilford Press.
[24]. Pietkiewicz, I., and Smith, J. A., 2012, A practical guide to using interpretative phenomenological analysis in qualitative research psychology. Psychological Journal, 18(2), 361–369.
[25]. Smith, J. A., and Osborn, M., 2008, Interpretative phenomenological analysis. In: J. A. Smith (ed.), Qualitative psychology: A practical guide to research methods, 2nd ed. (London: Sage Publications), pp. 53–80.
[26]. Muvwimi, T. S., Ngoma, C. M., and Salgado, A. B., 2025, Cultivating self-motivation, lifestyle modification and emotional resilience in elderly patients with multimorbidity: A path to successful self-management. Texila Advanced Journal of Multidisciplinary Health Research, 5(1), Article 018. doi:10.21522/TAJMHR.2016.05.01.Art018.
[27]. Smith, J. A., Flowers, P., and Larkin, M., 2009, Interpretative phenomenological analysis: Theory, method and research (London: Sage Publications Ltd).
[28]. Bhattacherjee, A., 2012, Social Science Research: Principles, Methods, and Practices (University of South Florida). Available from: http://scholarcommons.usf.edu/oa_textbooks/3/
[29]. . Neuman, B., and Fawcett, J., 2011, The Neuman systems model (5th ed.). Upper Saddle River, (NJ): Pearson.
[30]. Silaule, O., Adams, F., and Nkosi, N. G., 2024, Health effects of caregiving and coping with severe mental disorders: A caregivers' experience. S Afr J Psychiatry. 2024;30: a2144. https://doi.org/10.4102/sajpsychiatry.v30i0.2144
[31]. Nkomo, T., and Kekana, M. P., 2025, The realities of caring for a person with a mental disorder in rural and remote Capricorn District of South Africa: A qualitative study. Community Ment Health J;61:531–543. https://doi.org/10.1007/s10597-024-01360-w
[32]. Phillips, A., Durkin, M., Engward, H., Cable, G., and Iancu, M., 2023, The impact of caring for family members with mental illnesses on the caregiver: a scoping review. Health Promot Int;38(3):daac049. https://doi.org/10.1093/heapro/daac049
[33]. Bharti, V., Joseph, J., Malik, Y. K., and Devi, R., 2025, Assessment of mental, spiritual well-being, and religious coping among caregivers of people with mental disorders: A cross-sectional study. Journal of Mental Health and Human Behaviour, 30(1), 56–60. https://doi.org/10.4103/jmhhb.jmhhb_25_25
[34]. Kropf, M., and Schmidhuber, M., 2024, Family caregivers and the ethical relevance of moral identity. Nurs Inq;31(4):e12670. doi:10.1111/nin.12670
[35]. Sarradon-Eck, A., Mathiot, A., Holmes, S. M., Gilbert, E., Capodano, G., and Proux, A., 2023, The moral dimensions of family caregiving for patients with advanced cancer: A qualitative study. European Journal of Cancer Care. https://doi.org/10.1155/2023/6635542
[36]. Verity, F., Turiho, A., Mutamba, B. B., and Cappo, D., 2021, Family care for persons with severe mental illness: Experiences and perspectives of caregivers in Uganda. International Journal of Mental Health Systems, 15(1), 48. https://doi.org/10.1186/s13033-021-00470-2
[37]. . Bahrami, R., and Sadeghi, S., 2025, Spiritual well-being and resilience among family caregivers of people with mental disorders. Mental Health, Religion & Culture, 1–13. https://doi.org/10.1080/13674676.2025.2489083
[38]. Angelin, R. R., Saravanan, S., James, F. C. J., and Samuel, R., 2025, Experience of religiosity in caregiving for persons with serious mental illness: A qualitative study using interpretative phenomenological analysis from India. BMJ Open, 15, e090838. https://doi.org/10.1136/bmjopen-2024-090838
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Infection Prevention and Control Compliance among Healthcare Workers in a Rural Ugandan District: A Facility-Based StudyAuthor: Dominic Savio KakeetoDOI: 10.21522/TIJAR.2014.13.01.Art008
Infection Prevention and Control Compliance among Healthcare Workers in a Rural Ugandan District: A Facility-Based Study
Abstract:
Hospital-acquired infections remain a significant public health challenge, and adherence to standard precautions and infection prevention and control (IPC) measures is essential to minimize transmission. However, compliance in rural health facilities is often inadequate. This study employed an institution-based cross-sectional design conducted over two months in 2021, involving all healthcare workers in 30 lower-level health facilities in Butambala District, Uganda. Inclusion of the entire workforce minimized selection bias and improved representativeness. Data were collected using structured questionnaires and focus group discussions. Chi-square tests, Fisher’s exact tests, and multivariate logistic regression were used to identify factors associated with IPC compliance. Only 10.6% of healthcare workers fully complied with IPC measures. Professional cadre was significantly associated with compliance, with laboratory technicians showing higher adherence (AOR = 2.17, 95% CI [1.14–5.74], p = 0.037). COVID-19 vaccination status was also a significant factor; those who had received the second dose were more likely to comply (AOR = 3.94, 95% CI [1.04–5.74], p = 0.043). Conversely, an inadequate supply of personal protective equipment (PPE) was strongly linked to non-compliance (AOR = 0.012, 95% CI [0.03–0.45], p = 0.002). In conclusion, IPC compliance among healthcare workers in Butambala District was alarmingly low. Professional cadre, vaccination status, and PPE availability were key influencing factors. Strengthening IPC requires targeted interventions to improve PPE supply, enhance training, and promote adherence to national protocols to protect both healthcare workers and patients.
Infection Prevention and Control Compliance among Healthcare Workers in a Rural Ugandan District: A Facility-Based Study
References:
[1]. Chipfuwa, T., Manwere, A., & Shayamano, G., 2014, The role of infection prevention and control (IPC) in clinical governance: A comparison of infection control strategies in a selected teaching hospital in Zimbabwe. Annals of Medical and Health Sciences Research, 4(5), 664-670.
[2]. Ndejjo, R., Musinguzi, G., Yu, X., Buregyeya, E., Musoke, D., Wang, J. S., ... & Makumbi, F. E., 2015, Occupational health hazards among healthcare workers in Kampala, Uganda. Journal of Environmental and Public Health, 2015.
[3]. Monegro, J. I., Muppidi, V., & Regunath, K., 2020, Hospital-Acquired Infections. Stat Pearls. Stat Pearls Publishing.
[4]. Sydnor, E., & Perl, T. M., 2011. Hospital epidemiology and infection control in acute-care settings. Clinical Microbiology Reviews, 24(1), 141-173.
[5]. WHO, 2015. Report on the Burden of Endemic Health Care-Associated Infection Worldwide: Clean Care is Safer Care.
[6]. Tariku, G. H., Eshetu, H. E., and Abdella, A. A., 2017, Compliance with Standard Precautions and Associated Factors among Healthcare Workers in Gondar University Comprehensive Specialized Hospital, Northwest Ethiopia. Journal of Environmental and Public Health, 2017;8. https://doi.org/10.1155/2017/2050635
[7]. Kaye, K. S., 2014, Infection control in healthcare facilities: A confluence of three emerging challenges. Infection Control & Hospital Epidemiology, 35(4), 367-370
[8]. Nejad, B. S., Allegranzi, B., Syed, S. B., Ellisc, B., and Pittetd, D., 2011, Health-care-associated infection in Africa: a systematic review. Bulletin of the World Health Organization, 89(10), 757–765
[9]. Reda, A. A., Fisseha, S., Mengistie, B., and Vandeweerd, J.M., 2010. Standard precautions: occupational exposure and behaviour of health care workers in Ethiopia. 5(12).
[10]. Valim, M. D. L. A., 2016, The influence of occupational risks on hand hygiene practices among healthcare professionals. International Journal of Infection Control, 12(3).
[11]. Ilesanmi, O., & Afolabi, A., 2020, COVID-19: Knowledge, Attitude, Risk Perception, and Communication Practices of Healthcare Workers in a Tertiary Health Institution in Southwestern Nigeria. Journal of Multidisciplinary Healthcare, 13, 1407-1414.
[12]. Wang, D., Hu, B., HU, C., Zhu, F., Liu, X., Zhang, J., Wang, B., et al., 2020, Clinical Characterstics of 138 Hospitalized Pateints with 2019 Novel CoronoVirus-infected Pneumonia. JAMA, 323(11): 1061-1069.
[13]. Ong, M. S., et al., 2013, Communication interventions to improve adherence to infection control precautions: a randomized crossover trial. BMC Infectious Diseases 72, 1–9.
[14]. Ilesanmi, O. S., Afolabi, A. A., Akande, A., Raji, T., & Mohammed, A., 2021, Infection prevention and control during COVID-19 pandemic: realities from health care workers in a north central state in Nigeria. Epidemiology and infection, 149, e15. https://doi.org/10.1017/S0950268821000017
[15]. Chughtai, A. A., Seale, H., Islam, M. S., Owais, M., Macintyre, C. R., 2020, Policies on the use of respiratory protection for hospital health workers to protect from coronavirus disease (COVID-19). Int J Nurs Stud 105():103567.
[16]. Li, L., Xv, Q., and Yang, J., 2020, COVID-19: the need for continuous medical education and training. The Lancet Respiratory Medicine 8, e23. https://doi:10.1016/S2213-2600 (20):30125-9
[17]. Fernandes, A. H., Murphy, M., Creedon, S., Bhuachalla, C., O’Brien, D., Gould, D., 2019, Patient involvement in the implementation of infection prevention and control guidelines and associated interventions: a scoping review. BMJ Open, 9(3), Doi: 10.1136/bmjopen-2018-025824
[18]. World Health Organization, 2016, Guidelines on Core Components of Infection Prevention and Control Programmes at the National and Acute Health Care Facility Level. [Online] Available from: https://www.who.int/gpsc/core-components.pdf [Accessed on 13/06/2021]
[19]. World Health Organization. 2017, Infection prevention and control in health care. WHO Guidelines.
[20]. Bartman, I., Boulet, J. R., Qin, S., and Bowmer, M.I., 2020, Canadians studying medicine abroad and their journey to secure postgraduate training in Canada or the United States. Canadian Medical Education Journal, 11(3), p.e13.
[21]. Nofal, M., Subih, M., & Al-Kalaldeh, M., 2017, Factors influencing compliance to the infection control precautions among nurses and physicians in Jordan: A cross-sectional study. Journal of infection prevention, 18(4), 182–188. https://doi.org/10.1177/1757177417693676
[22]. Komuhangi, G., 2019, Compliance with Standard Precautions of Infection Control in the Management of Labour by Health Care Workers at Mulago Hospital, Uganda. International Journal of Medical Science and Health Research. 3(2); 2581-3366
[23]. Opollo, M. S., Otim, T. C., Kizito, W., Thekkur, P., Kumar, A. M. V., Kitutu, F. E., Kisame, R., Zolfo, M., 2021, Infection Prevention and Control at Lira University Hospital, Uganda: More Needs to Be Done. Trop. Med. Infect. Dis. 6, 69. https://doi.org/10.3390/tropicalmed6020069
[24]. Wasswa, P., Nalwadda, C. K., Buregyeya, E., et al., 2015,.Implementation of infection control in health facilities in Arua district, Uganda: a cross-sectional study. BMC Infect Dis 15, 268 https://doi.org/10.1186/s12879-015-0999-4
[25]. Chitimwango, P. C., 2017, Attitudes and Practices of Nurses in Infection Prevention and Control Within a Tertiary Hospital in Zambia.
[26]. Azene, Z. N., Merid, M. W., Muluneh, A. G., Geberu, D. M., Kassa, G. M, Yenit, M. K, et al., 2020, Adherence towards COVID-19 mitigation measures and its associated factors among Gondar City residents: A community-based cross-sectional study. PLoS ONE, 15(12): https://doi.org/10.1371/journal.pone.0244265
[27]. Zhou, Q., Lai, X., Zhang, X., and Tan, L., 2020, Compliance measurement and observed influencing factors of hand hygiene based on COVID-19 guidelines in China. American Journal of Infection Control, https://doi.org/10.1016/j.ajic.2020.06.003
[28]. Cochrane, 2021. Factors that influence whether healthcare workers follow infection prevention and control guidelines for respiratory infectious diseases. Accessed on 11th June 2021 at https://www.cochrane.org/news/factors-influence-whether-healthcare-workers-follow-infection-prevention-and-control-guidelines
[29]. Haile, T. G., Engeda, E. H., & Abdo, A. A., 2017, Compliance with Standard Precautions and Associated Factors among Healthcare Workers in Gondar University Comprehensive Specialized Hospital, Northwest Ethiopia. Journal of Environmental and Public Health, 9(7) https://doi.org/10.1155/2017/2050635
[30]. Ireye, F., Ejiyere, H., Aigbiremolen, A. O., Famiyesin, O. E., Rowland-Udoh, E. A., Ogeyemhe, C. O., Okudo, I., and Onimisi, A. B., 2019, Knowledge, Attitude and Infection Prevention and Control Practices Regarding Lassa Fever among Healthcare Workers in Edo State, Nigeria. 8(1): 21-27 https://doi:10.5923/j.ijpt.20190801.03
[31]. Eljedi, A., and Dalo, S., 2014, Compliance with the National Palestinian Infection Prevention and Control Protocol at Governmental Paediatric Hospitals in Gaza Governorates. 14 (3)
[32]. Russell, D., Dowding, D. W., McDonald, M. V., Adams, V., Rosati, R. J., Larson, E. L., et al., 2018, Factors for compliance with infection control practices in home healthcare: findings from a survey of nurses' knowledge and attitudes toward infection control. Am J Infect Control. 46(11):1211–1217. https://doi:10.1016/j.ajic.2018.05.005
[33]. Desta, M., Ayenew, T., Sitotaw, N., Tegegne, N., Dires, M., Getie, M., 2018, Knowledge, practice and associated factors of infection prevention among healthcare workers in Debre Markos referral hospital. Northwest Ethiopia BMC Health Serv Res. 18(1):1–10. https://doi:10.1186/s12913-017-2770-6
[34]. AlJohani, A., Karuppiah, K., Al Mutairi, A., 2021, Narrative review of infection control knowledge and attitude among healthcare workers. J Epidemiol Glob Health.11(1):20
[35]. Albano, L., Matuozzo, A., Marinelli, P., Di Giuseppe, G., 2014, Knowledge, attitudes and behaviour of hospital health-care workers regarding influenza A/H1N1: a cross-sectional survey. BMC Infect Dis. 14(1):1–7. https://doi:10.1186/1471-2334-14-208
[36]. Romanelli, F., Bird, E., & Ryan, M., 2009. Learning styles: a review of theory, application, and best practices. American journal of pharmaceutical education, 73(1), 9. https://doi.org/10.5688/aj730109
[37]. Schmitz, A., Maiolino, P., Maggiali, M., Natale, L., Cannata, G., and Metta, G., 2011. Methods and technologies for the implementation of large-scale robot tactile sensors. IEEE Transactions on Robotics, 27(3), pp.389-400.
[38]. Bedoya, G., Dolinger, A., Rogo, K., Mwaura, N., Wafula, F., Coarasa, J., Das, J., et al., 2017, Observations of Infection Prevention and Control Practices in Primary Health Care, Kenya. Bulletin of the World Health Organization, 95, 503-516. https://doi.org/10.2471/BLT.16.179499
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Analysis of the Risks of Transmission of Ebola Virus Disease within the Population in Beni Health Zone 2025Author: Douglas Kambale AsifiweDOI: 10.21522/TIJAR.2014.13.01.Art009
Analysis of the Risks of Transmission of Ebola Virus Disease within the Population in Beni Health Zone 2025
Abstract:
During the West African epidemic between 2013 and 2016, the largest known to date, chains of transmission reached urban centers for the first time, causing more cases and deaths than in all previous epidemics combined. To prevent such animal to human transmission, current research efforts are focused on identifying animal reservoirs of the virus. This study is of the descriptive correlational type because we evaluated the relationship between the knowledge, attitude and practice of households on the risks of Ebola Virus Disease transmission and the quantitative approach was used. Quantitative data were collected by face-to-face interview based on a questionnaire submitted to households and the supervision of the investigators was continuous to ensure the smooth running of the study in 4 health areas constituting the Ebola Virus Disease foci (Malepe Health Area, Kasabinyole Health Area, Ngongolio Health Area and Kanzulinzuli Health Area). The results of the study specify that the risks of transmission of Ebola Virus Disease by the population in Beni Health Zone are linked to the following socio-demographic and economic factors: the level of education of the respondent and the dangers of eating smoked meat (Kh2=41.239a; dll=3 and pv=0.000<0.05); and prevention and practice against Ebola Virus Disease (OR: 0.485[0.245 ; 0.959] and (pv=: 0.038<0.05). Strict adherence to good prevention practices will help avoid the risks of Ebola Virus Disease transmission in Beni Health Zone.
Analysis of the Risks of Transmission of Ebola Virus Disease within the Population in Beni Health Zone 2025
References:
[1]. Martines, R. B., Ng, D. L., Greer, P. W., Rollin, P. E., Zaki, S. R., 2015, Tissue and cellular tropism, pathology and pathogenesis of Ebola and Marburg viruses. The Journal of Pathology, 235(2), pp. 153-174, https://pathsocjournals.onlinelibrary.wiley.com/doi/full/10.1002/path.4456
[2]. Goldstein, T., Anthony S. J., Gbakima, A., Bird, B. H., Bangura, J., Tremeau-Bravard, A., et al., 2018, The discovery of Bombali virus adds further support for bats as hosts of ebolaviruses. Nature Microbiology. 3(10), p. 1084‑1089, https://pubmed.ncbi.nlm.nih.gov/30150734/, Nat Microbiol.2018 Oct;3(10): 1084-1089.doi: 10.1038/s41564-018-0227-2. Epub 2018 Aug 27.
[3]. Caron, A., Bourgarel, M., Cappelle, J., Liégeois, F., De Nys H. M., Roger, F., 2018, Ebola Virus Maintenance: If Not (Only) Bats, What Else? Viruses. 10 (10), p. 549, https://pubmed.ncbi.nlm.nih.gov/30304789/, Viruses.2018 Oct 9;10(10):549. doi: 10.3390/v10100549.
[4]. CDC, 2019, Ebola Virus Disease Distribution Map: Cases of Ebola Virus Disease in Africa Since 1976, https://www.cdc.gov/vhf/ebola/history/distribution-map.html
[5]. Eric Delaporte, Abdoulaye, 2018, EboHealth: Ebola: un modèle « One Health » pour comprendre et prévenir les risques d’émergence (IRD/CERFIG/CIRAD), https://shsebola.hypotheses.org/ebohealth, https://www.google.com/search?q=EboHealth%2C+2018%2C&oq=EboHealth%2C+2018%2C&gs_lcrp=EgZjaHJvbWUyBggAEEUYOdIBCDQwODRqMGo3qAIAsAIA&sourceid=chrome&ie=UTF-8
[6]. Nene, M., 2020, The response to Ebola Virus Disease (EVD) in Eastern DR Congo, p. 2, https://www.elrha.org/docs/document/2020-rapport-elhra.pdf?file_url=document/s7ikmv661t4k90oah9sunctq0o/2xktvczx8s- uxmiiscans66lrua/original?content-type=application%2Fpdf&name=2020-rapport-elhra.pdf
[7]. WHO, 2020, Integrated and multidisciplinary analyses in epidemics, https://www.unicef.org/drcongo/rapports/revue-analyses-integrees-90-premiers-jours-epidemie-ebola-equateur
[8]. WHO, 2018, “How is EVD transmitted?”, Slides 11–13, https://cdn.peaceopstraining.org/course_promos/ebola_awareness/evd_awareness_english.pdf
[9]. Augustin, M. N., & Mbeva, J. B. K., 2021. Knowledge, attitudes, and behaviors of healthcare professionals at the start of an Ebola virus epidemic. Infectious Diseases Now, 51(1), 50-54.
[10]. WHO, 2023, Ebola (Virus Disease), https://sante.gouv.fr/soins-et-maladies/maladies/maladies-vectorielles-et-zoonoses/ebola/article/maladie-a-virus-ebola
[11]. Public Health Agency of Canada, 2025, Ebola Disease:Prevention and Risks, https://www.canada.ca/fr/sante-publique/services/maladies/maladie-virus-ebola/pour-professionnels-sante-maladie-virus-ebola.html
[12]. BCZS Beni, 2025, PAO (Operational Action Plan), p. 3-18.
[13]. The Structure of a Scientific Article (IMRAD), https://mgtfe.be/guide-de-redaction/8-plan-de-redaction-du-tfe/8-1-le-plan-imrad-imred/
[14]. DPS NK, 2024, National Health Information System (SNIS)/Annual Report, https://www.fbp-rdc.org/data/zone/pIAYIpy4hiH#section-quantit
[15]. AFRAC INSTITUTE, 2020, Thesis writing, www.afracinstitute.org
[16]. BCZS Beni, 2024, National Health Information System
[17]. Douglas ASIFIWE, 2025, Perceptions and Prevention Practices of the Population in Beni Health Zone. Doctoral Dissertation (PhD) in Public Health, Texila American University (Zambia)-Central University of Nicaragua.
[18]. Bavon MUPENDA, 2017, Training on Planning, Monitoring and Evaluation, and Operational Research.
[19]. Johns Hopkins University, 2021, Knowledge, Attitudes, and Practices (KAP) Survey on Ebola Prevention in Côte d'Ivoire, https://onehealthbehaviors.org/wp-content/uploads/2022/07/Rapport_Etude-Ebola_e%CC%81f_V2.pdf
[20]. Frédéric Le Marcis, Almudena Mari-Saez, 2021, Final report : Study of the resurgence of Ebola Virus Disease in the Nzérékoré region: Ebola 2021: the resurgence and the communities, https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2021-10/010082904.pdf
[21]. Charles K., 2019, Perceptions of Healthcare Workers Regarding the Ebola Virus Disease Response in the Butembo Health Zone, Official University of Ruwenzori, Butembo, https://www.memoireonline.com/07/21/11998/Perception-du-personnel-soignant-face--la-riposte-de-la-maladie--virus-ebola-dans-la-zone-de.html/
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Silent Struggles: Menstrual Hygiene Challenges Faced by Female University Students in UgandaAuthor: Josephine NamyaloDOI: 10.21522/TIJAR.2014.13.01.Art010
Silent Struggles: Menstrual Hygiene Challenges Faced by Female University Students in Uganda
Abstract:
Menstruating individuals face barriers in managing their periods safely and with dignity, especially in low-and middle–income countries like Uganda. Menstrual health interventions have focused on schoolgirls, assuming university students have fewer challenges. However, female university students in Uganda face significant challenges. Thus, the objective of this study was to explore challenges faced by female university students in Central and Southwestern Uganda through a socio-ecological perspective. A phenomenological design was used. A sample of 88 participants was purposively selected using a two-stage stratified sampling technique. Four focus group discussions and 16 key informant interviews were conducted to collect data. Interviews were transcribed and analysed thematically using NVivo 12 software. These were complemented by structured observations of WASH facilities. The socio-ecological model (SEM) is a public health framework that describes how health is impacted at multiple levels including individual, interpersonal, community, organizational and policy levels. Key themes were identified, and challenges contributing to menstrual hygiene were categorized as per the SEM. The findings showed that female students experienced physical pains and missed classes hindering their education. Also, linking menstruation to sorcery led to fears related with disposal of menstrual absorbents and inadequate WASH infrastructure, which contributed to poor menstrual hygiene management reflecting systemic failures at universities. Many female students had knowledge gaps about menstrual hygiene management based on biases of cultural taboos and practices. They lacked confidence in managing their menstruation while at university, highlighting the need for universities to establish programs and policies that promote their well-being and academic success.
Silent Struggles: Menstrual Hygiene Challenges Faced by Female University Students in Uganda
References:
[1]. Ahmed, T., Hasan, M. K., Aunto, T. K., Ahmed, T., and Zahid, D., 2025, Menstrual hygiene knowledge and practices among adolescent schoolgirls in flood-affected rural Bangladesh. Reproductive Health, 22(1), p.87.
[2]. Jaafar, H., Ismail, S. Y., and Azzeri, A., 2023, Period poverty: a neglected public health issue. Korean journal of family medicine, 44(4), p.183.
[3]. Ishimwe Bazakare, M. L., Ngabo Rwabufigiri, B., and Munyanshongore, C., 2024, Knowledge and practice toward menstrual hygiene management and associated factors among visual impaired adolescent girls: a case of two selected institutions in Rwanda. Therapeutic Advances in Reproductive Health, 18, p.26334941241303518.
[4]. Ssemata, A. S., Ndekezi, D., Kansiime, C., Bakanoma, R., Tanton, C., Nelson, K. A., Hytti, L., Neema, S., Torondel, B., Seeley, J., and Weiss, H. A., 2023, Understanding the social and physical menstrual health environment of secondary schools in Uganda: A qualitative methods study. PLOS global public health, 3(11), p.e0002665.
[5]. Ministry of Education and Sports. Menstrual health guidelines for schools and education institutions in Uganda, 2023. https://www.education.go.ug/wp-content/uploads/2025/05/final-guidelines-for-printing-2024.pdf
[6]. Report of the Auditor General. value for money audit report on government of uganda’s efforts,through ministry of education and sports (moes), to support the management of menstrual health and hygiene in primary and secondary schools, December 2024. https://www.oag.go.ug/reports/2486
[7]. Rossouw, L., and Ross, H., 2021, Understanding period poverty: socio-economic inequalities in menstrual hygiene management in eight low-and middle-income countries. International journal of environmental research and public health, 18(5), p.2571.
[8]. Nassozi, P., Kebirungi, H., Opit, E., Muweesi, C., Taddeo Kaahwa, Y., Sserwadda, L., Kaweesi, M., Kuteesa Mugenyi, D., Mutebi, A., Isabirye, C., and Tomusange, R., 2024, Assessment of female students' perception on access and utilization of water and sanitation facilities for menstruation management in higher education institutions in Uganda. Sexuality, Gender & Policy, 7(4), pp.332-347.
[9]. Ameade, E. P., & Garti, H. A., 2016, Relationship between Female University Students' Knowledge on Menstruation and Their Menstrual Hygiene Practices: A Study in Tamale, Ghana. Advances in preventive medicine, 2016, 1056235. https://doi.org/10.1155/2016/1056235
[10]. Golden, S. D. and Earp, J. A. L., 2012, Social ecological approaches to individuals and their contexts: twenty years of health education & behavior health promotion interventions. Health education & behavior, 39(3), pp.364-372.
[11]. Sharma, A., McCall-Hosenfeld, J. S., and Cuffee, Y., 2022, Systematic review of menstrual health and hygiene in Nepal employing a social ecological model. Reproductive health, 19(1), p.154.
[12]. Dibaba, D. B., Alemu, B. M. and Debela, S. A., 2024, Impact of water, sanitation, and hygiene (WASH) interventions on gender-specific school attendance and learning outcomes: A systematic review and meta-analysis protocol. PLoS One, 19(8), p.e0308144.
[13]. Yin, R. K., 2009, Case study research: Design and methods (Vol. 5). sage.
[14]. Bronfenbrenner, U., 1979, The ecology of human development: Experiments by nature and design (Vol. 352). Harvard university press.
[15]. Munro, A. K., Hunter, E. C., Hossain, S. Z. and Keep, M., 2021, A systematic review of the menstrual experiences of university students and the impacts on their education: a global perspective. PloS one, 16(9), p.e0257333.
[16]. Suleman, A., Krishna, S., Krishnakumar, D., Nemoto, K., Nguyễn, M. L. T., and Mehta, S. D., 2024, A pilot survey of students’ menstrual attitudes, experiences, and needs on an urban university campus. Women's Health, 20, p.17455057241254713.
[17]. Ezebialu, I. U., Ezenyeaku, C. C., and Umeobika, J. C., 2021, Prevalence of dysmenorrhea and its contribution to school absenteeism among Nigerian undergraduate students. Annals of Health Research, 7(1), pp.59-66.
[18]. Ogwal, J. O., Ojuka, E., Migisha, R., Namayanja, R., Okello, S., Omolo, R. O., Muyambi, V., Enyang, J. J., Obeny, A., Ogwang, R., and Angulo, C., 2025, Menstrual disorder and associated factors among medical students in Uganda: a cross-sectional study. Discover Medicine, 2(1), p.305.
[19]. Esan, D. T., Tola, Y. O., Akingbade, O., Ariyo, S. A., Ogunniyi, B. I., and Agbana, R. D., 2023, Knowledge and Practice of Menstrual Hygiene among Female Undergraduates at a Private Tertiary Institution in Nigeria. Pacific Rim International Journal of Nursing Research, 27(4), pp.798-810.
[20]. Hassan, S., Ghandour, R., Bakri, L., Shwiki, S., Safi, S., Abuzaid, R., and Zeidan, H., 2023, Menstrual health and hygiene among young Palestinian female university students in the West Bank: a cross-sectional study. BMJ open, 13(3), p.e069222.
[21]. Hadımlı, A., Akan, A., Kardeş, G., Akkurt, B., and Saydam, B. K., 2024, Determination of menstrual hygiene management and genital hygiene behaviors of students: A university example from Turkey. Revista da Escola de Enfermagem da USP, 58, p.e20240113.
[22]. Adane, Y., Ambelu, A., Azage, M., and Mekonnen, Y., 2024, Assessment of the barriers towards menstrual hygiene management: evidence from a qualitative study among school communities: lessons from Bahir Dar city in northwest Ethiopia. Frontiers in Reproductive Health, 6, p.1445862.
[23]. Appiah-Brempong, E., Harris, M. J., Newton, S., and Gulis, G., 2018, Examining school-based hygiene facilities: a quantitative assessment in a Ghanaian municipality. BMC public health, 18(1), p.581.
[24]. Winter, S. C., Johnson, L., and Dzombo, M. N., 2023, Sanitation-related violence against women in informal settlements in Kenya: a quantitative analysis. Frontiers in public health, 11, p.1191101.
[25]. Fielding-Miller, R., Shabalala, F., Masuku, S., and Raj, A., 2021, Epidemiology of campus sexual assault among university women in Eswatini. Journal of interpersonal violence, 36(21-22), pp.NP11238-NP11263.
[26]. Ikogho, D. E., and Onoharigho, F. D., 2025, Menstrual waste management practices among female students in Niger delta development commission hostels in educational institutions in Niger delta, Nigeria. BMC women's health, 25(1), p.60.
[27]. Edet, O. B., Bassey, P. E., Esienumoh, E. E., and Ndep, A. O., 2021, Attitudes, Beliefs and Perception of Menstruation Related Socio Cultural Practices and Menstrual Hygiene Management among In School Adolescent Girls in Cross River State, Nigeria. African Journal of Biomedical Research, 24(3), pp.363-369.
[28]. Namuwonge, F., Kizito, S., Ssentumbwe, V., Namatovu, P., Namuli, F., Tutlam, N. T., Nabunya, P., and Ssewamala, F. M., 2025, Culture, self-esteem and menstrual hygiene management among adolescent girls in Uganda: the impact of economic and family strengthening. BMC Women's Health, 25(1), p.230.
[29]. Castro, S., and Czura, K., 2025, Cultural taboos and misinformation about menstrual health management in rural Bangladesh. World Development, 188, p.106871.
[30]. Morley, M., Cava, I., Glass, N., Salwitz, E., Hughes-Wegner, A. T., and DeMaria, A. L., 2025, Addressing Period Poverty: Evaluating a Free Period Product Program in a University Setting. Health Promotion Practice, p.15248399241311590.
[31]. Rawat, M., Novorita, A., Frank, J., Burgett, S., Cromer, R., Ruple, A., and DeMaria, A. L., 2023, “Sometimes I just forget them”: capturing experiences of women about free menstrual products in a US based public university campus. BMC Women's Health, 23(1), p.351.
[32]. Government of Uganda, Uganda issues Tax Amendment Acts for 2025, Kampala, Uganda, 2025.
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Patients’ Assessed Quality of Healthcare and Satisfaction with Health Services in Selected Facilities in Cross River State, NigeriaAuthor: Ekpenyong, Janet DavidDOI: 10.21522/TIJAR.2014.13.01.Art011
Patients’ Assessed Quality of Healthcare and Satisfaction with Health Services in Selected Facilities in Cross River State, Nigeria
Abstract:
In recent years, patients have become more knowledgeable about their healthcare options and are increasingly advocating for improved quality of care and treatment. The extent to which their expectations are met during clinical encounters significantly influences their cooperation with healthcare providers. This, in turn, results in fewer complaints, improved patient retention, increased patronage, and a greater likelihood of referrals. A descriptive cross-sectional study design was employed, and a multistage sampling technique was used to recruit 416 patients admitted across selected primary, secondary, and private healthcare facilities in Cross River State, Nigeria. Data were analysed with SPSS Version 23, employing both descriptive and inferential statistical techniques, with chi-square tests used to examine the study hypotheses. Findings revealed that while 300(72.1%) perceived the overall quality of healthcare delivery to be poor. Additionally, 225(54.1%) assessed the level of patient engagement and communication during healthcare provision as low. In contrast, a large majority 387(93%) expressed high levels of satisfaction with the quality of care received. Perceived quality of care was significantly associated with sociodemographic factors such as sex (p = 0.012), marital status (p = 0.024), religion (p = 0.035), tertiary education (p = 0.008), income level (p = 0.002), and type of healthcare services received (p = 0.001). Targeted Interventions to improve healthcare delivery, patient engagement, and communication are recommended to enhance overall service quality.
Patients’ Assessed Quality of Healthcare and Satisfaction with Health Services in Selected Facilities in Cross River State, Nigeria
References:
[1]. Borowska, M., Religioni, U., Augustynowicz, A., 2022, Patients’ opinions on the quality of services in hospital wards in Poland. International Journal of Environmental Research and Public Health. 20(1):412.
[2]. Ozor, O., Etiaba, E., Onwujekwe, O., 2024, Strengthening the effectiveness of community health system: Assessing the factors that enhance or constrain the delivery of health services within communities in Nigeria. Health Research Policy and Systems. 22(1):124.
[3]. Akinyinka, M. R, Oluwole, E. O, Odusanya, O. O., 2019, Community perception of quality of health care received and client satisfaction in Lagos, Nigeria. Journal of community medicine and primary health care. 31(2):47-65.
[4]. Larson, E., Sharma, J., Bohren, M. A., Tunçalp, Ö., 2019, When the patient is the expert: measuring patient experience and satisfaction with care. Bulletin of the World Health Organization.97(8):563.
[5]. Umoke, M. U., Prince, C. I., Nwimo, I. O., Nwalieji, C. A., Onwe, R. N., Emmanuel Ifeanyi, N., 2020, Patients’ satisfaction with quality of care in general hospitals in Ebonyi State, Nigeria, using SERVQUAL theory. SAGE open medicine. 8:2050312120945129.
[6]. Sinyiza, F. W., Kaseka, P. U., Chisale, M. R. O., Chimbatata, C. S., Mbakaya, B. C., Kamudumuli, P. S., 2022, Patient satisfaction with health care at a tertiary hospital in Northern Malawi: results from a triangulated cross-sectional study. BMC Health Services Research. 22(1):695.
[7]. Etim, J. J., Nja, G. M., Ejemot-Nwadiaro, R. I., 2023, Patient-assessed quality of care and level of satisfaction in healthcare facilities in Cross River State, Nigeria. medRxiv.
[8]. Adongo, A. A., Azumah, F. D., Nachinaab, J. O., 2021, A comparative study of quality of health care services of public and private hospitals in Ghana. Journal of Public Health. 1-7.
[9]. Mahmoud, A. B., Ekwere, T., Fuxman, L., Meero, A. A., 2019, Assessing patients’ perception of health care service quality offered by COHSASA-accredited hospitals in Nigeria. Sage Open. (2):2158244019852480.
[10]. Odumodu, I. J., Olufunlayo, T. F., Ogunnowo, B. E., Kalu, M. E., 2020, Satisfaction with services among attendees of physiotherapy outpatient clinics in tertiary hospitals in Lagos State. Journal of Patient Experience. 7(4):468-78.
[11]. Oleribe, O. O., Momoh, J., Uzochukwu, B. S., Mbofana, F., Adebiyi, A., Barbera, T, 2019, Identifying key challenges facing healthcare systems in Africa and potential solutions. International journal of general medicine. 395-403.
[12]. Onah, C. K., Azuogu, B. N., Ochie, C. N., Akpa, C. O., Okeke, K. C., Okpunwa, A. O., 2022, Physician emigration from Nigeria and the associated factors: the implications to safeguarding the Nigeria health system. Human Resources for Health. 20(1):85.
[13]. Akunne, M. O., Okonta, M. J., Ukwe, C. V., Heise, T. L, Ekwunife, O. I., 2019, Satisfaction of Nigerian patients with health services: a protocol for a systematic review. Systematic Reviews. 8:1-6.
[14]. Umoke, M. U., Prince, C. I., Eyo, N., Ugwu, A., Agu, M. N., Chukwu, O. J., 2020, Sociodemographic determinants of Patients’ satisfaction with the quality of care in the general hospitals in Ebonyi State, Nigeria. Global Journal of Health Science. 12(11):7.
[15]. Osakede, U. A., 2021, Public health spending and health outcome in Nigeria: the role of governance. International Journal of Development Issues. 20(1):95-112.
[16]. Modibbo, H., Inuwa, N., 2020, Health outcomes and economic growth nexus: Evidence from Nigeria. Journal of Business and Economic Options. 3(2):46-55.
[17]. Gishu, T., Weldetsadik, A. Y., Tekleab, A. M., 2019, Patients’ perception of quality of nursing care; a tertiary center experience from Ethiopia. BMC nursing. 218:1-6.
[18]. Abbasi-Moghaddam, M. A., Zarei, E., Bagherzadeh, R., Dargahi, H., Farrokhi, P., 2019, Evaluation of service quality from patients’ viewpoint. BMC health services research. 19:1-7.
[19]. Nji, E., Oko, J., Out, F., Enyievi, P., Adie, A., Obeagu, E., 2024, Dietary Pattern and Nutritional Status of in-School Adolescents of Selected Secondary Schools in Yala Local Government Area of Cross River State, Nigeria. Elite Journal of Public Health. 2(6):1-17.
[20]. Fagbamigbe, A. F., Idemudia, E. S., 2015, Assessment of quality of antenatal care services in Nigeria: evidence from a population-based survey. Reproductive health. 2015;12:1-9.
[21]. Kruk, M. E., Leslie, H. H., Verguet, S., Mbaruku, G. M., Adanu, R. M., Langer, A., 2016, Quality of basic maternal care functions in health facilities of five African countries: an analysis of national health system surveys. The lancet global health. 4(11):e845-e55.
[22]. Leslie, H. H., Sun, Z., Kruk, M. E., 2017, Association between infrastructure and observed quality of care in 4 healthcare services: a cross-sectional study of 4,300 facilities in 8 countries. PLoS medicine. 14(12):e1002464.
[23]. Ukonu, M. O., Nwachukwu, C. A., Mgboji, O. A., 2020, Evaluation of Doctor-patient communication outcomes in two public hospitals in Enugu and Ebonyi States, Nigeria. African Population Studies. 34(1).
[24]. Onyechi, N., Babalola, Y., 2020, Doctor-Patient Communication: Percep-tion of Doctors’ Communication Skills among Patients in Selected Hospitals in Ibadan Nigeria. Journal of Management and Social Sciences. 9(2).
[25]. Ogaji, D. S, Giles, S., Daker-White, G., Bower, P., 2016, Findings and predictors of patient-reported experience of primary health care in Nigeria. Journal of patient experience. 3(3):69-80.
[26]. Al-Worafi, Y. M., 2023, Patient Engagement in Healthcare in Developing Countries. Handbook of Medical and Health Sciences in Developing Countries: Education, Practice, and Research: Springer. p. 1-16.
[27]. Ezeaka, N. B., Ochuba, C. C., Bartholomew, C. E., 2025, Addressing healthcare inequalities in Nigeria: A communication perspective on advocacy and policy implications. Journal of Advanced Research and Multidisciplinary Studies. 5(1):1-11.
[28]. Adebayo, C. T., 2021, Physician-patient interactions in Nigeria: A critical-cultural perspective on the role of power. Journal of Intercultural Communication Research. 50(1):21-40.
[29]. Manulik, S., Karniej, P., Rosińczuk, J., 2018, The influence of socio-demographic characteristics on respondents’ perceptions of healthcare service quality. Journal of Education, Health and Sport. 8(12):708-24.
[30]. Asamrew, N., Endris, A. A., Tadesse, M., 2020, Level of patient satisfaction with inpatient services and its determinants: a study of a specialized hospital in Ethiopia. Journal of environmental and public health. 1:2473469.
[31]. Shagaya, Y. J., 2015, Assessment of student’s satisfaction and quality of patient care under the Nigerian Tertiary Institutions Social Health Insurance Programme (TISHIP). Assessment. 7(6):20-31.
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The Impact of Corporate Governance on Women's Financial Inclusion and Economic Empowerment in Selected Ethiopian Private Commercial Banks located in Addis AbabaAuthor: Meti Leta GonfaDOI: 10.21522/TIJAR.2014.13.01.Art012
The Impact of Corporate Governance on Women's Financial Inclusion and Economic Empowerment in Selected Ethiopian Private Commercial Banks located in Addis Ababa
Abstract:
This study examined the effect of corporate governance on women's financial inclusion and economic empowerment in Addis Ababa's private commercial banks. Utilizing a mixed-methods approach and both primary and secondary data, the research employed descriptive and inferential statistics like Pearson correlation and regression to analyze the relationships between variables. The findings revealed several challenges. There was a notable lack of saving promotion for women through various media, despite banks’ general efforts to boost savings. While banks discussed women's credit policies, women's participation in decision-making and accountability for financial inclusion plans were major issues. The study also found that despite a well-organized female workforce, there was a shortage of influential female leadership, knowledgeable staff for complex tasks, and sufficient training to bridge skill gaps. Additionally, while relevant digital financial service information was provided, it often lacked timeliness, completeness, and user-friendliness. Customer relations were also found to be deficient, with a failure to properly address customer feedback, arrange meetings, and recognize or award female customers. Ultimately, the study concluded that initiatives focused on increasing savings, improving access to credit, boosting female labor force participation, and enhancing digital financial services have a significant positive impact on women's financial inclusion and economic empowerment.
The Impact of Corporate Governance on Women's Financial Inclusion and Economic Empowerment in Selected Ethiopian Private Commercial Banks located in Addis Ababa
References:
[1]. Al-Mamun, A., Wahab, E. A. A., Mazumder, M. N. H., Su, Z., 2025, Board characteristics and performance of Islamic banks in Malaysia. Journal of Islamic Finance, https://www.researchgate.net/publication/348921358_Board_Characteristics_and_Islamic_Bank_Performance#fullTextFileContent , doi; 10.35313/ijabr.v3i1.123.
[2]. Aldana, U., Boyd, R., 2025, Empowerment and microfinance: Evidence from Latin America. International Journal of Development. https://www.researchgate.net/publication/348921358_Board_Characteristics_and_Islamic_Bank_Performance#fullTextFileContent.
[3]. Alla, M., 2025, Corporate Governance, https://www.researchgate.net/publication/319983192_Corporate_Governance, DOI: 10.5772/intechopen.69704
[4]. Ayatakshi-Endow, S., Steele, M., 2025, Financial behavior and empowerment. Journal of Economic Psychology, https://www.sciencedirect.com/journal/journal-of-economic-psychology.
[5]. Barrett, M., 2025, Women’s empowerment and gender relations. Gender & Society, https://journals.sagepub.com/home/gas
[6]. Bateman, M., 2025, The role of microfinance in development. Development Policy Review. https://onlinelibrary.wiley.com/journal/14677679
[7]. Belai, G., 2025, Economic Policy and Development Strategy in Ethiopia. Addis Ababa University Press, https://libcat.aau.edu.et/cgi-bin/koha/opac-detail.pl?biblionumber=284953.
[8]. Bhattacherjee, A., 2025, Social science research: Principles, methods, and practices. Textbooks in Social Sciences, https://digitalcommons.usf.edu/cgi/viewcontent.cgi?article=1002&context=oa_textbooks
[9]. Bruno, Alessandro., 2025, Corporate governance in the banking sector. Journal of Banking Regulation, https://link.springer.com/journal/41261.
[10]. Bozkurt, O., et al., 2025, Gender and finance: A global perspective. International Journal of Finance, https://www.researchgate.net/publication/386169182_Gendered_Social_Norms_and_Financial_Inclusion_in_Turkey.
[11]. Brownbridge, M., Harvey, C., 2025, Banking in Africa: The impact of financial sector reform since independence. African Economic Research Consortium, https://aercafrica.org/publication/journal/.
[12]. Bruhn, M., Love, I., 2025, Gender, financial inclusion and economic development. Journal of Development Economics, https://www.sciencedirect.com/journal/journal-of-development-economics.
[13]. Burak, A., 2025, Corporate governance in emerging markets. Emerging Markets Review, https://www.sciencedirect.com/journal/emerging-markets-review.
[14]. Cadbury, A., 2025, Corporate Governance Handbook. Oxford University Press, https://corp.oup.com/.
[15]. Churchill, N., Iacobucci, D., 2025, Marketing Research: Methodological Foundations. Cengage Learning, https://www.cengage.com/.
[16]. Claessens, S., 2025, Corporate governance and development. Global Corporate Governance Forum, https://www.ifc.org/en/insights-reports/2000/discussion-papers.
[17]. Claessens, S., 2025, Corporate governance and regulation. Journal of Finance and Management, https://www.researchgate.net/publication/23550136_Corporate_Governance_and_Regulation_Can_There_be_too_Much_of_a_Good_Thing.
[18]. Coleman, S., 2025, Financial literacy and women's economic empowerment. Journal of Consumer Affairs, https://onlinelibrary.wiley.com/journal/17456606.
[19]. Creswell, J. W., 2025, Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. SAGE Publications, https://www.sagepub.com/.
[20]. Davis, J., Schoorman, D., Donaldson, L., 1997, Toward a stewardship theory of Management Team. Academy of Management Team Review, 22(1):20–47, doi: 10.5465/amr.1997.9707180258.
[21]. De Andrés-Alonso, P., Santamaría-Mariscal, M., 2025, Corporate governance mechanisms and firm performance. European Management Journal, https://www.sciencedirect.com/journal/european-management-journal.
[22]. Donalds, T., Preston, J., 2025, The stakeholder theory of the corporation. Academy of Management Review, https://journals.aom.org/journal/amr.
[23]. Donaldson, L., Davis, J. H., 2025, Stewardship theory or agency theory. Australian Journal of Management, https://journals.sagepub.com/home/aum.
[24]. Duvendack, M., et al., 2025, Systematic review: The impact of microfinance. Journal of Development Effectiveness, https://www.tandfonline.com/toc/rjde20/current.
[25]. Gregory, H. J., Simms, M. E., 2025, Corporate governance: What it is and why it matters. McKinsey Quarterly, https://www.mckinsey.com/quarterly/overview.
[26]. Holloway, K., et al., 2025, Women's economic empowerment and financial inclusion. International Development Review, https://www.findevgateway.org/paper/2017/03/womens-economic-empowerment-through-financial-inclusion-review-existing-evidence-and.
[27]. Jayachandran, S., 2015, The roots of gender inequality in developing countries. Annual Review of Economics, 7(1):63–88, doi: 10.1146/annurev-economics-080614-115404.
[28]. Jensen, M. C., Meckling, W. H., 1976, Theory of the firm: Managerial behavior, agency costs, and ownership structure. Journal of Financial Economics, 3(4):305–360, doi: 10.1016/0304-405X(76)90026-X.
[29]. John, K., Senbet, L. W., 2025, Corporate governance and board impactness. Journal of Banking and Finance, https://www.sciencedirect.com/journal/journal-of-banking-and-finance.
[30]. Kefyalew, G., Dagnachew, B., 2025, Corporate governance and its impacts on financial performance of banks evidence from selected private commercial banks in Ethiopia. Ethiopian Journal of Business, https://academicjournals.org/journal/JEIF/article-abstract/15F0F6F64964.
[31]. Nathan, R., et al., 2025, Financial inclusion of women in developing countries. Journal of Financial Services Research, https://link.springer.com/journal/10693.
[32]. Sanjaya, W., Nursechafia, I., 2025, Corporate governance in Indonesia. Indonesian Management Review, https://ssek.com/blog/corporate-governance-in-indonesia-management-of-a-company/.
[33]. Trivelli, C., de los Rios, C., 2025, Women and financial inclusion in Latin America. Latin American Research Review, https://china.elgaronline.com/edcollchap/book/9781789903874/book-part-9781789903874-27.pdf.
[34]. Winter, S. G., 2025, On Coase, competence, and the corporation. Journal of Institutional Economics, https://www.cambridge.org/core/journals/journal-of-institutional-economics.
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Determinants of Mother-to-Child Transmission of Human Immunodeficiency Virus among Clients Enrolled in a Prevention of Mother-to-Child Transmission of HIV Program in Plateau State, NigeriaAuthor: Kefas I. B.DOI: 10.21522/TIJAR.2014.13.01.Art013
Determinants of Mother-to-Child Transmission of Human Immunodeficiency Virus among Clients Enrolled in a Prevention of Mother-to-Child Transmission of HIV Program in Plateau State, Nigeria
Abstract:
Maternal-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) accounts for the majority of new pediatric HIV infections. Preventing MTCT of HIV (PMTCT) remains a critical intervention for ensuring that women and children survive and have a high quality of life. This study reflects on the determinants of MTCT in Plateau State. A retrospective analysis of mother-infant pairs enrolled in the PMTCT program across 29 HIV treatment sites in Plateau State between 2017 and 2021 was carried out. Data were extracted from facility registers and Electronic Medical Record (EMR). HIV-positive mothers and infants’ pairs who met inclusion criteria were enrolled. HIV MTCT predictors were ascertained using a logistic regression model at a 5% level of statistical significance. Data from 3,430 mother-infant pairs were analyzed. EID PCR-positive results were found in 0.8% of infants at six weeks and 1.2% at 18 months. Predictors at six to eight weeks included maternal gravidity (OR= 0.13, 95% CI 0.018:0.927, p<0.05), point of entry (PoE) into the PMTC program (OR= 10.9, 95% CI 4.7:25.4, p<0.001), and high viral load count among mothers (OR= 3.4, 95% CI 1.40:8.71, p<0.05). Predictors at 18 months were gravidity (OR = 0.19.95% CL 0.05:0.84, p = 0.05), and PMTCT program PoE (OR= 12.5, 95% CI 5.51:28.20, p < 0.001). This study identifies key determinants in mother-to-child HIV transmission in Plateau State, including PMTCT entry of point, gravidity, and high maternal viral load, underscoring the need for targeted interventions focusing on enhancing healthcare accessibility.
Determinants of Mother-to-Child Transmission of Human Immunodeficiency Virus among Clients Enrolled in a Prevention of Mother-to-Child Transmission of HIV Program in Plateau State, Nigeria
References:
[1]. Ozim, C. O., Mahendran, R., Amalan, M., Puthussery, S., 2023, Prevalence of human immunodeficiency virus (HIV) among pregnant women in Nigeria: a systematic review and meta-analysis. BMJ Open. British Medical Journal Publishing Group. 13:e050164. https://doi.org/10.1136/BMJOPEN-2021-050164
[2]. Okusanya, B., Nweke, C., Gerald, L. B., Pettygrove, S., Taren, D., Ehiri, J., 2022, Are prevention of mother-to-child HIV transmission service providers acquainted with national guideline recommendations? A cross-sectional study of primary health care centers in Lagos, Nigeria. BMC Health Serv Res. BMC Health Serv Res. 2022;22. https://doi.org/10.1186/S12913-022-08152-6
[3]. UNAIDS, 2023, The path that ends AIDS: UNAIDS Global AIDS Update 2023 | UNAIDS. Available from: https://www.unaids.org/en/resources/documents/2023/global-aids-update-2023
[4]. UNAIDS, 2024, Global HIV & AIDS statistics — Fact sheet | UNAIDS [cited 2024 Feb 27]. Available from: https://www.unaids.org/en/resources/fact-sheet
[5]. UNAIDS, 2022, Full report — In Danger: UNAIDS Global AIDS Update 2022 | UNAIDS. 2022 [cited 2024 Feb 27]. Available from: https://www.unaids.org/en/resources/documents/2022/in-danger-global-aids-update
[6]. Chevalier, J. M., Hansen, M. A., Coskun, E., Sy, K. T. L., Drakes, J., Dowling, S., et al., 2024, Cost-effectiveness of intervention combinations toward the elimination of vertical transmission of HIV in limited-resource settings: a mathematical modeling study. Lancet Glob Health. Elsevier; 2024;12:e457–66. https://doi.org/10.1016/S2214-109X(23)00588-0
[7]. Boakye, D. S., Adjorlolo, S., 2023, Achieving the UNAIDS 95-95-95 treatment target by 2025 in Ghana: a myth or a reality? Glob Health Action. Taylor and Francis Ltd.; 2023;16. https://doi.org/10.1080/16549716.2023.2271708
[8]. Dapar, M. P., Joseph, B. N., Okunlola, R. C., Mutihir, J., Chingle, M. P., Banwat, M. E., 2021, Pregnancy and Birth Outcomes Among Women on Antiretroviral Therapy: A Long-term Retrospective Analysis of Data from a Major Tertiary Hospital in North Central Nigeria. International Journal of Maternal and Child Health and AIDS. Global Health and Education Projects, Inc. 10:183. https://doi.org/10.21106/IJMA.511
[9]. Van de Perre, P., Goga, A., Ngandu, N., Nagot, N., Moodley, D., King, R., et al., 2021, Eliminating postnatal HIV transmission in high incidence areas: need for complementary biomedical interventions. The Lancet. Elsevier B.V.; 2021;397:1316–24. https://doi.org/10.1016/S0140-6736(21)00570-5
[10]. Ligami, C., 2023, Mentor mothers stopping vertical transmission in Kenya. Lancet HIV [Internet]. 2023 Jul 1 [cited 2024 Feb 27];10(7):e430–1. Available from: http://www.thelancet.com/article/S2352301823001480/fulltext
[11]. Frescura, L., Godfrey-Faussett, P., Ali Feizzadeh, A., El-Sadr, W., Syarif, O., Ghys, P. D., et al., 2022, Achieving the 95 95 95 targets for all: A pathway to ending AIDS. PLoS One [Internet]. 2022 Aug 1 [cited 2024 Feb 27];17(8). Available from: https://pubmed.ncbi.nlm.nih.gov/35925943/
[12]. Adelekan, B., Harry-Erin, B., Okposo, M., Aliyu, A., Ndembi, N., Dakum, P., et al., 2022, Final HIV status outcome for HIV-exposed infants at 18 months of age in nine states and the Federal Capital Territory, Nigeria. PLoS One [Internet]. 2022 Feb 1 [cited 2025 Jan 23];17(2):e0263921. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8843197/
[13]. Federal Ministry of Health, 2020, National Guidelines for HIV Prevention, Treatment and Care (2020). Natl Aids Sti’S Control Program [Internet]. 2020 [cited 2024 Feb 9];250. Available from: http://apps.who.int/medicinedocs/documents/s23252en/s23252en.pdf
[14]. Federal Ministry of Health, N., 2015, National Guidelines on PMTCT of HIV 2015. 2010th ed. 2015
[15]. UGOCHUKWU, E. F., ONUBOGU, C. U., EDOKWE, E. S., EKWOCHI, U., OKEKE, K. N., UMEADI, E. N., et al, 2021, A Review and Analysis of Outcomes from Prevention of Mother-to-Child Transmission of HIV Infant Follow-up Services at a Pediatric Infectious Diseases Unit of a Major Tertiary Hospital in Nigeria: 2007-2020. Int J MCH AIDS [Internet]. 2021 Dec 15 [cited 2024 Feb 27];10(2):269–79. Available from: https://pubmed.ncbi.nlm.nih.gov/34938595/
[16]. National Clinical Mentors- NASCP, 2024, [Internet]. [cited 2024 Aug 19]. Available from: https://career.nascp.gov.ng/jobs/national-clinical-mentors-ln18plwdvpno1kjn
[17]. US CDC N, 2023, US CDC launches AP3 program to expand HIV treatment coverage among pediatrics, adolescents, and pregnant women - U.S. Embassy and Consulate in Nigeria [Internet]. 2023 [cited 2024 Feb 27]. Available from: https://ng.usembassy.gov/us-cdc-launches-ap3-program-to-expand-hiv-treatment-coverage-among-pediatrics-adolescents-and-pregnant-women/
[18]. UNAIDS, 2023, The Global Alliance to end AIDS in children | UNAIDS [Internet]. 2023 [cited 2024 Feb 27]. Available from: https://www.unaids.org/en/topic/alliance-children
[19]. Charles, A., Tinuade, O., Jonah, M., Mercy, I., Ifechi, A., Christian, I., et al., 2016, HIV Prevalence among Pregnant Women Clients Attending Antenatal Clinic at the Faith Alive Foundation and PMTCT Centre, Jos Plateau State. World J AIDS [Internet]. 2016 Apr 22 [cited 2024 Mar 18];6(2):59–64. Available from: http://www.scirp.org/journal/PaperInformation.aspx?PaperID=67194
[20]. Sagay, A., Ebonyi, A., Meloni, S., Musa, J., Oguche, S., Ekwempu, C., et al, 2015, Mother-to-Child Transmission Outcomes of HIV-Exposed Infants Followed Up in Jos North-Central Nigeria. Curr HIV Res [Internet]. 2015 May 13 [cited 2024 Aug 19];13(3):193–200. Available from: https://pubmed.ncbi.nlm.nih.gov/25986370/
[21]. Government PS, 2024, Welcome! Home| Plateau State Government Website [Internet]. [cited 2024 Mar 18]. Available from: https://www.plateaustate.gov.ng/
[22]. Commission NP, 2024, Plateau (State, Nigeria) - Population Statistics, Charts, Map and Location [Internet]. [cited 2024 Mar 18]. Available from: https://citypopulation.de/en/nigeria/admin/NGA032__plateau/
[23]. Oyeledun, B., Ajibola, A., Fatunsin, E., 2024, Improving HIV Testing Coverage and Linkage to Antiretroviral Therapy Through a Community-Based PMTCT Intervention in Traditional Birth Atten-dants’ Managed Care Centers in Lagos State.
[24]. Oleribe, O. O., Enenche, E., Udofia, D., Ekom, E., Osita-Oleribe, P. I., Kim, J. U., et al., 2018, Assessment of the effectiveness of PMTCT program in eight service delivery points in North Central Nigeria. HIV AIDS (Auckl) [Internet]. 2018 [cited 2024 Feb 27];10:253. Available from:/pmc/articles/PMC6251355/
[25]. Alachew, Ashagrea, M., 2018, Determinants of Mother to Child Transmission of HIV Among Infants Born from HIV Positive Women in North Wollo Zone, North East Ethiopia: 2018, Case Control Study Desie health science college, Ethiopia. [cited 2024 Feb 27]; Available from: www.annexpublishers.com
[26]. Ditekemena, J., Matendo, R., Colebunders, R., Koole, O., Bielen, G., Nkuna, M., et al., 2015, Health Outcomes of Infants in a PMTCT Program in Kinshasa. J Int Assoc Provid AIDS Care [Internet]. 2015 Sep 22 [cited 2024 Feb 27];14(5):449–54. Available from: https://pubmed.ncbi.nlm.nih.gov/24639467/
[27]. Zoakah, A. I., 2014, Coverage and Uptake of PMTCT Services in Primary Health Care Centers in Plateau State, Nigeria [Internet]. 2014 [cited 2024 Feb 27]. Available from: https://www.academia.edu/72070844/Coverage_and_Uptake_of_PMTCT_Services_in_Primary_Health_Care_Centres_in_Plateau_State_Nigeria
[28]. Astawesegn, F. H., Stulz, V., Conroy, E., Mannan, H., 2022, Trends and effects of antiretroviral therapy coverage during pregnancy on mother-to-child transmission of HIV in Sub-Saharan Africa. Evidence from panel data analysis. BMC Infect Dis [Internet]. 2022 Dec 1 [cited 2024 Mar 19];22(1):1–13. Available from: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07119-6
[29]. Nduati, E. W., Hassan, A. S., Knight, M. G., Muema, D. M., Jahangir, M. N., Mwaringa, S. L., et al, 2015, Outcomes of prevention of mother to child transmission of the human immunodeficiency virus-1 in rural Kenya - A cohort study Infectious Disease epidemiology. BMC Public Health [Internet]. 2015 Oct 3 [cited 2024 Mar 20];15(1):1–12. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-2355-4
[30]. Federal Ministry of Health Nigeria, 2015, National Operational Plan for the Elimination of Mother to Child Transmission (eMTCT) of HIV in Nigeria 2015–2016 [Internet]. 2015 [cited 2024 Feb 27]. Available from: https://www.researchgate.net/publication/281102376_National_Operational_Plan_for_the_Elimination_of_Mother_to_Child_Transmission_eMTCT_of_HIV_in_Nigeria_2015-2016
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Climate Change and Malaria: Impact, Vulnerability, and Adaptation Pathways in Homa Bay County, KenyaAuthor: Jacob Bulimo KhaoyaDOI: 10.21522/TIJAR.2014.13.01.Art014
Climate Change and Malaria: Impact, Vulnerability, and Adaptation Pathways in Homa Bay County, Kenya
Abstract:
This paper presents the relationship between climate change (temperature, rainfall, humidity) and incidence of malaria in Homabay County, Kenya. Climate change impacts, household exposure, sensitivity, and adaptive capacity were analysed to inform policy. The study combined ecological time-series analysis, household surveys, and key informant interviews. It analysed climate and morbidity data from 2010-2024, supplemented with primary data from 401 households and insights from 19 stakeholders. Standardized questionnaires and in-depth interviews guided data collection. The ARDL models assessed short and long-run climate effects on malaria, logistic regression examined determinants of household vulnerability, and thematic analysis generated qualitative insights. The findings showed malaria cases averaged 23,082 per month (SD = 13,402), mean temperature 23.3°C (SD = 1), rainfall 117.7 mm (SD = 67), and humidity 74%. The long-run model showed a significant baseline incidence and a highly significant first-month lag (IRR ≈ 1.92). Similarly, short-run results confirmed strong persistence, with first differenced lag significant (IRR ≈ 1.82). The household survey showed an overall moderate vulnerability to malaria (median 0.35), driven by high exposure, moderate sensitivity and adaptive capacity. Sensitivity linked to older household-head, low education, poor housing, and climate-dependent livelihoods significantly increased odds of malaria by 52%. Exposure had a positive effect on malaria incidence (OR ≈ 1.29) while stronger adaptive capacity lowered malaria risk. The study concluded that climate change has a significant impact on malaria in Homa Bay County. It highlights the need for real-time climate-health early warning systems by integrating meteorological data into IDSR for timely outbreak detection.
Climate Change and Malaria: Impact, Vulnerability, and Adaptation Pathways in Homa Bay County, Kenya
References:
[1]. WHO, 2020, Urgent health challenges for the next decade. https://www.who.int/news-room/photo-story/detail/urgent-health-challenges-for-the-next-decade.
[2]. Too., S. K., Chaudhary, P., Rajwant. K., Randhawa., Gobindgarh, M., Distt, Fatehgarh, S., 2021, Knowledge about Impact of Global Warming on Health. https://www.researchgate.net/doi/10.13140/RG.2.2.27847.98722.
[3]. WHO, 2025, Malaria. https://www.who.int/news-room/fact-sheets/detail/malaria.
[4]. WHO, 2023, Climate change. https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health.
[5]. Coates, S., Yeshaneh, W., Davis, M., Andersen, L., 2020, The effects of climate change on human health in Africa, a dermatologic perspective: a report from the International Society of Dermatology Climate Change Committee. Int J Dermatol.
[6]. RCRC., 2021, Climate Change Impacts on Health and Livelihoods; Kenya Assessment. https://www.climatecentre.org/wp-content/uploads/RCRC_IFRC-Country-assessments-KENYA.pdf.
[7]. Scott, A. A., Misiani, H., Okoth, J., Jordan, A., Gohlke, J., Ouma G., 2017, Temperature and heat in informal settlements in Nairobi. PLoS One, 12(11), e0187300.
[8]. Le, P., Kumar, P., Ruiz, M., Mbogo, C., Muturi, J., 2029, Predicting the direct and indirect impacts of climate change on malaria in coastal Kenya. PLOS One, 6(14), e0211258.
[9]. GoK., 2021, Homa Bay County Climate Change Policy. https://repository.kippra.or.ke/handle/123456789/3551.
[10]. GoK., 2025, Homa Bay County Annual Development Plan. https://repository.kippra.or.ke/handle/123456789/5296.
[11]. Sarmah, H. K., Hazarika, B. B., 2012, Importance of the Size of Sample and Its Determination in the Context of Data Related to the Schools of Greater Guwahati. Bulletin of the Gauhati University Mathematics Association, 12, 55-76. https://www.scirp.org/reference/referencespapers?
[12]. Alemu, A., Lemma, B., Bekele, T., Geshere, G., Simma, E. A., Deressa, C. T., 2024, Malaria burden and associated risk factors among malaria suspected patients attending health facilities in Kaffa zone, Southwest Ethiopia. Malar J, 23(1), 397.
[13]. Kipruto, E., Oluoch, O. A., Anyona, D., Mutua, E., 2017, Effect of climatic variability on malaria trends in Baringo County, Kenya. ResearchGate, https://www.researchgate.net/publication/317300603
[14]. Mordecai, E. A., Ryan, S. J., Caldwell, J. M., Shah, M. M., LaBeaud, A. D., 2020, Climate change could shift disease burden from malaria to arboviruses in Africa. Lancet Planet Health, 4(9), e416–23.
[15]. Norin, T., Malte, H., Clark, T. D., 2014, Aerobic scope does not predict the performance of a tropical eurythermal fish at elevated temperatures. J Exp Biol, 217(2), 244–51.
[16]. Ayanlade, A., Oluwaranti, A., Ayanlade, O. S., Borderon, M., Sterly, H., Sakdapolrak, P., 2022, Extreme climate events in sub-Saharan Africa: A call for improving agricultural technology transfer to enhance adaptive capacity. Clim Serv, 1(27), 100311.
[17]. Nosrat, C., Altamirano, J., Anyamba, A., Caldwell, J. M., Damoah, R., Mutuku, F., 2021, Impact of recent climate extremes on mosquito-borne disease transmission in Kenya. PLoS Negl Trop Dis, 15(3), e0009182.
[18]. van der Deure, T., Nogués‐Bravo, D., Njotto, L. L., Stensgaard, A., 2025, Climate Change Favors African Malaria Vector Mosquitoes. Glob Change Biol, 31(11), e70610.
[19]. Hu, M., Zhang, D., Pei, Q., 2025, Climate change and human resilience: Behavioral and mental responses in Eurasia over the last millennium. Prog Phys Geogr Earth Environ, 10(49).
[20]. Lokoel, G., O’Meara, W. P., 2025, Climate change, development, and resilience: a warning from Turkana, Kenya. Lancet Planet Health, 9(8), 101286.
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Socio-Cultural and Economic Barriers to Facility-Based Delivery: Perspectives of Men and Community Gatekeepers in Nasarawa StateAuthor: Abraham Ajigasokoa AhmaduDOI: 10.21522/TIJAR.2014.13.01.Art015
Socio-Cultural and Economic Barriers to Facility-Based Delivery: Perspectives of Men and Community Gatekeepers in Nasarawa State
Abstract:
This study examined the socio-cultural and economic barriers influencing the uptake of facility-based delivery in Nasarawa State, Nigeria, from the perspectives of men and community gatekeepers, while proposing policy recommendations for strengthening male engagement and traditional birth attendant (TBA) collaboration. A mixed-methods cross-sectional design was employed, combining quantitative data from 443 married men across Akwanga, Keffi, and Lafia LGAs, alongside qualitative insights from 12 FGDs, 21 KIIs, and 46 IDIs with male decision-makers, TBAs, elders, and health workers. Quantitative data were analyzed using descriptive statistics, chi-square tests, and logistic regression (p < 0.05). Qualitative data were thematically coded to explore cultural norms, economic barriers, gendered decision-making, and perceptions of health facilities. Economic constraints, including financial hardship (61.2%), transport limitations (57.8%), and long distances to facilities (54.9%), were the most frequently cited barriers. Socio-cultural beliefs that childbirth is a strictly female domain, community reliance on TBAs (48.5%), and the influence of elders significantly reduced support for facility delivery. Mistrust of healthcare workers, perceived disrespect, and fear of hidden charges also discouraged facility utilization. Qualitative narratives highlighted that TBAs were preferred due to cultural alignment, affordability, flexible payment systems, and emotional support. Facility-based delivery in Nasarawa State is constrained by intersecting socio-cultural, economic, and health-system barriers. Strengthening male involvement, improving community, facility trust, addressing transport and affordability constraints, and integrating TBAs into supervised referral frameworks are vital. A context-specific Health Belief Model (HBM) is proposed to guide interventions.
Socio-Cultural and Economic Barriers to Facility-Based Delivery: Perspectives of Men and Community Gatekeepers in Nasarawa State
References:
[1]. World Health Organization (WHO), 2023, Trends in Maternal Mortality 2000–2020. Geneva.
[2]. National Population Commission (Nigeria) and ICF, 2019. Nigeria Demographic and Health Survey 2018, Abuja, Nigeria, and Rockville, Maryland, USA.
[3]. Alkema, L., Chou, D., Hogan, D., et al., 2016, Global, regional, and national levels and trends in maternal mortality. Lancet, 387(10017):462–474.
[4]. Bohren, M. A., Hunter, E. C., Munthe-Kaas, H. M., Souza, J. P., Vogel, J. P., Gülmezoglu, A. M., 2014, Facilitators and barriers to facility-based delivery in low- and middle-income countries: A qualitative evidence synthesis. Reproductive Health, 11, 71, https://doi.org/10.1186/1742-4755-11-71
[5]. Gabrysch, S., Campbell, O. M. R., 2009, Still too far to walk: Literature review of the determinants of delivery service use. BMC Pregnancy and Childbirth, 9, 34, https://doi.org/10.1186/1471-2393-9-34
[6]. Montagu, D., Sudhinaraset, M., Diamond-Smith, N., Campbell, O., Gabrysch, S., Freedman, L., et al., 2017, Where women go to deliver: Understanding the changing landscape of childbirth in Africa and Asia. Health Policy and Planning, 32(8), 1146–1152, https://doi.org/10.1093/heapol/czx060
[7]. Doctor, H. V., Findley, S. E., Ager, A., Cometto, G., Afenyadu, G. Y., Adamu, F., et al., 2013, Using community-based research to shape the design and delivery of maternal health services in Northern Nigeria. Reproductive Health Matters, 21(41), 20–28, https://doi.org/10.1016/S0968-8080(13)41695-0
[8]. Adamu, Y. M., Salihu, H. M., 2002, Barriers to the use of antenatal and obstetric care services in rural Kano, Nigeria. Journal of Obstetrics and Gynaecology, 22(6), 600–603, https://doi.org/10.1080/0144361021000020349
[9]. Byrne, A., Morgan, A., 2011, How the integration of traditional birth attendants with formal health systems can increase skilled birth attendance. Tropical Doctor, 41(4), 199–200, https://doi.org/10.1258/td.2011.110062
[10]. Sibley, L. M., Sipe, T. A., 2006, Transition to skilled birth attendance: Is there a future role for trained traditional birth attendants? Journal of Midwifery & Women’s Health, 51(4), 259–265, https://doi.org/10.1016/j.jmwh.2006.02.002
[11]. Akeju, D. O., Oladapo, O. T., Vidler, M., Akinmade, A. A., Sawchuck, D., Qureshi, R., et al., 2016, Determinants of health facility utilisation during childbirth in Northwest Nigeria: A cross-sectional survey. BMJ Open, 6(12), e010593, https://doi.org/10.1136/bmjopen-2015-010593
[12]. Thaddeus, S., Maine, D., 1994, Too far to walk: Maternal mortality in context. Social Science & Medicine, 38(8), 1091–1110, https://doi.org/10.1016/0277-9536(94)90226-7
[13]. Okeke, E. N., Umeh, C. A., 2009, Health-seeking behavior for maternal complications in Nigeria. Afr J Reprod Health, 13(1):123–137.
[14]. Bohren, M. A., Vogel, J. P., Hunter, E. C., Lutsiv, O., Makh, S. K., Souza, J. P., et al., 2015, The mistreatment of women during childbirth in health facilities globally: A mixed-methods systematic review. PLoS Medicine, 12(6), e1001847, https://doi.org/10.1371/journal.pmed.1001847
[15]. Pacagnella, R. C., Cecatti, J. G., Osis, M. J. D., Souza, J. P., 2012, The role of delays in severe maternal morbidity and mortality: Expanding the conceptual framework. Reproductive Health Matters, 20(39), 155–163, https://doi.org/10.1016/S0968-8080(12)39601-8
[16]. Al-Taiar, A., Clark, A., Longenecker, J. C., Whitty, C. J., 2010, Physical access and utilization of basic emergency obstetric care in Yemen. Int J Gynaecol Obstet, 109(3):230–235.
[17]. Mullany, B. C., 2006, Barriers to and attitudes towards promoting husbands’ involvement in maternal health in Kathmandu, Nepal. Social Science & Medicine, 62(11), 2798–2809, https://doi.org/10.1016/j.socscimed.2005.11.013
[18]. Audet, C. M., Chire, Y. M., Vaz, L. M. E., Bechtel, R., Carlson-Bremer, D., Wester, C. W., et al., 2016, Barriers to male involvement in antenatal care in rural Mozambique. BMC Pregnancy and Childbirth, 16, 66, https://doi.org/10.1186/s12884-016-0841-1
[19]. Comrie-Thomson, L., Tokhi, M., Ampt, F., Portela, A., Chersich, M., Luchters, S., 2015, Challenging gender inequity through male involvement in maternal and newborn health: Critical assessment of an emerging evidence base. Culture, Health & Sexuality, 17(sup2), 177–189, https://doi.org/10.1080/13691058.2015.1053412
[20]. Ganle, J. K., Dery, I., 2015, ‘What men don’t know can hurt women’: Perspectives on men’s involvement in maternal healthcare in Ghana. Reproductive Health, 12, 93, https://doi.org/10.1186/s12978-015-0083-y
[21]. Moyer, C. A., Adongo, P. B., Aborigo, R. A., Hodgson, A., Engmann, C. M., 2014, ‘They treat you like you are not a human being’: Maltreatment during labour and delivery in rural northern Ghana. Midwifery, 30(2), 262–268, https://doi.org/10.1016/j.midw.2013.05.006
[22]. Bohren, M. A., Hunter, E. C., et al., 2014, Misconduct in maternity care. Reprod Health, 11(1):1–17.
[23]. Oladapo, O. T., Osiberu, M. O., 2008, Do women like antenatal care? Niger J Med, 17(1):32–36.
[24]. Kujawski, S. A., Freedman, L. P., Ramsey, K., Moyo, W., Moyo, P., Kruk, M. E., et al., 2015, Community and health system factors associated with facility delivery in rural Tanzania: A multilevel analysis. Social Science & Medicine, 147, 190–199, https://doi.org/10.1016/j.socscimed.2015.11.010
[25]. Freedman, L. P., Kruk, M. E., 2014, Disrespect and abuse of women in childbirth: Challenging the global quality and accountability agendas. Reproductive Health Matters, 22(44), 1–8, https://doi.org/10.1016/S0968-8080(14)44812-2
[26]. Abuya, T., Warren, C. E., Miller, N., Njuki, R., Ndwiga, C., Maranga, A., et al., 2015, Exploring the prevalence of disrespect and abuse during childbirth in Kenya. BMC Pregnancy and Childbirth, 15, 224, https://doi.org/10.1186/s12884-015-0645-6
[27]. Rosenstock, I, M., 1974, Historical origins of the health belief model. Health Educ Monogr, 2:328–335.
[28]. Becker, M, H., 1974, The Health Belief Model and Personal Health Behavior.
[29]. Champion, V. L., Skinner, C. S., 2008, The Health Belief Model. In: Glanz K et al., eds. Health Behavior and Health Education. 4th ed.
[30]. Creswell, J. W., Plano Clark, V. L., 2017, Designing and Conducting Mixed Methods Research. 3rd ed.
[31]. Tashakkori, A., Teddlie, C., 2010, Handbook of Mixed Methods in Social & Behavioral Research.
[32]. Fetters, M. D., Curry, L. A., Creswell, J. W., 2013, Achieving integration in mixed methods designs. Health Serv Res, 48(6):2134–2156.
[33]. Nasarawa State Ministry of Health., 2023, Annual Health Report.
[34]. NPC Nigeria. 2022 Subnational Health Facility Assessment.
[35]. Babalola, S., Fatusi, A., 2009, Determinants of use of maternal health services in Nigeria—Looking beyond individual and household factors. BMC Pregnancy and Childbirth, 9, 43, https://doi.org/10.1186/1471-2393-9-43
[36]. Izugbara, C. O., Ezeh, A. C., 2010, Women, religion and the use of maternity services in Islamic northern Nigeria. Development in Practice, 20(4–5), 551–560, https://doi.org/10.1080/09614521003763190
[37]. Cochran, W. G., 1977, Sampling Techniques. 3rd ed.
[38]. Guest, G., Bunce, A., Johnson, L., 2006, How many interviews are enough? Field Methods,18(1):59–82.
[39]. Kwankye, S. O, Augustt, E., 2017, Maternal health-seeking behaviour in Ghana. Afr Popul Stud, 31(1):3544–3559.
[40]. Ochako, R., Fotso, J. C., Ikamari, L., Khasakhala, A., 2016, Utilization of maternal health services among young women in Kenya: Insights from the Kenya Demographic and Health Survey, 2003. BMC Pregnancy and Childbirth, 16, 150, https://doi.org/10.1186/s12884-016-0930-5
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Feasibility of Establishing Community-Based Health Insurance (CBHI) Scheme: A Comparative Analysis of Existence of CBHI Preconditions, and Capacity and Willingness to Pay in 5 Locations in Adamawa, NigeriaAuthor: Innocent Chinedu UdemezueDOI: 10.21522/TIJAR.2014.13.01.Art016
Feasibility of Establishing Community-Based Health Insurance (CBHI) Scheme: A Comparative Analysis of Existence of CBHI Preconditions, and Capacity and Willingness to Pay in 5 Locations in Adamawa, Nigeria
Feasibility of Establishing Community-Based Health Insurance (CBHI) Scheme: A Comparative Analysis of Existence of CBHI Preconditions, and Capacity and Willingness to Pay in 5 Locations in Adamawa, Nigeria
References:
[1]. Bloom, D. E., Khoury, A., and Subbaraman, R., 2018, The promise and peril of universal health care. Science (New York, N.Y.), 361(6404), eaat9644. https://doi.org/10.1126/science.aat9644
[2]. Woldemichael, A., Gurara, D., and Shimeles, A. A., 2019, The impact of community-based health insurance schemes on out-of-pocket healthcare spending: evidence from Rwanda. IMF Working Papers, 2019(038).
[3]. Banerjee, A., Hanna, R., Olken, B. A., and Sverdlin Lisker, D., 2024, Social Protection in the Developing World. Journal of Economic Literature, 62(4), 1349–1421.
[4]. Monitoring, Evaluation, Accountability, and Learning (MEAL) Plan 2024 to 2028: Adamawa State Social Protection Policy. October, 2023. https://www.google.com/search?q=adamawa+social+p
[5]. Umaru, W., Hassan, M., Veino, B., and Bawuro, M., 2024, Assessment of Prevalence Rate of Maternal Mortality in Adamawa State, Nigeria. ResearchGate. https://doi.org/10.47001/IRJIET/2024.804010
[6]. Okafor, M., 2025, Nigeria maternal mortality: The world’s worst country to give birth. June 2, https://www.bbc.com/news/articles/c5yk8ek86kdo
[7]. NDHS, 2023/24. Federal Ministry of Health and Social Welfare (FMoHSW), National Population Commission (NPC), and ICF (2024).
[8]. Nwanze, L., Siuliman, A., and Ibrahim, N., 2023, Factors associated with infant mortality in Nigeria: a scoping review. PloS One, 18(11).
[9]. Ijeoma, U. N., Unaogu, N. N., Onyeka, T. I., Nwatu, C. B., Onyekonwu, C. L., Onwuekwe, I. O., Ugwumba, F., Nwutobo, R. C., and Nwachukwu, C. V., 2019, Health-related quality of life in people with chronic diseases managed in a low-resource setting – a study from South East Nigeria. Nigerian Journal of Clinical Practice, 22(9), 1180.
[10]. Usman, M., 2025, October, 25, Nigeria targets 44m citizens under health insurance coverage by 2030 — Pate. The ICIR – Latest News, Politics, Governance, Elections, Investigation, Factcheck, Covid-19. October 25, 2025. Accessed October 30, 2025. https://www.icirnigeria.org/nigeria-targets-44m-citizens-under-health-insurance-coverage-by-2030-pate/
[11]. Ogbuoji, O., and Yamey, G., 2019, How many child deaths can be averted in Nigeria? Assessing state-level prospects of achieving 2030 sustainable development goals for neonatal and under-five mortality. Gates Open Research, 3, 1460.
[12]. Nigeria Health Watch, 2025, January 29, Assessing the impact of the USAID funding freeze on Nigeria’s health sector. Nigeria Health Watch. https://articles.nigeriahealthwatch.com/assessing-the-
[13]. National Health Insurance Authority (NHIA), 2025, December, Financial access to healthcare for all Nigerians: status of health insurance enrolment coverage by states as of Q3 2025. https://www.nhia.gov.ng/
[14]. Pillah, P., 2025, Evaluation of the performance and challenges of the national health insurance scheme (NHIS) in Nigeria. Retrieved November 22, 2025, from https://www.researchgate.net/publication/369230792_
[15]. Namyalo, P. K., Mutatina, B., Byakika, S., Walimbwa, A., Kato, R., and Basaza, R. K., 2023, The feasibility analysis of integrating community-based health insurance schemes into the national health insurance scheme in Uganda. PLOS ONE, 18(4), e0284246.
[16]. Chemouni, B., 2018, The political path to universal health coverage: Power, ideas and community-based health insurance in Rwanda. World Development, 106, 87–98. https://doi.org/10.1016/j.worlddev.2018.01.023
[17]. Getahun, G. K., Kinfe, K., & Minwuyelet, Z., 2023, The role of community-based health insurance on healthcare-seeking behaviour of households in Addis Ababa, Ethiopia. Preventive Medicine Reports, 34, 102234.
[18]. Kakama, A. A., Namyalo, P. K., and Basaza, R. K., 2020, Feasibility and desirability of scaling up Community-based Health Insurance (CBHI) in rural communities in Uganda: Lessons from Kisiizi Hospital CBHI scheme. BMC Health Services Research, 20(1), 662.
[19]. World Health Organisation (WHO), 2025, March, Community based health insurance, Retrieved January 1, 2026, from https://www.who.int/news-room/fact-sheets/detail/community-based-health-insurance-CBHI
[20]. Health Policy Project. 2011, Community-based health insurance brief: Nigeria. chrome-extension://efaidhttps://www.healthpolicyproject.com/pubs/97_communitybasedhealthinsurance.pdf
[21]. International Labour Organization (ILO), 2005, Health micro-insurance schemes: feasibility study guide Volume 1: https://www.ilo.org/wcmsp5/groups/public/@asia/@ro-bangkok/@ilo-
[22]. Bolarinwa, O. A., Ameh, S., Ochimana, C., Oluwasanu, A. O., Okello, S., Mohamed, S. F., Muhihi, A., & Danaei, G., 2021, Willingness and ability to pay for healthcare insurance: A cross-sectional study of Seven Communities in East and West Africa (SevenCEWA). PLOS Global Public Health, 1(11), e0000057.
[23]. Mbagwu, G., 2018, Factors influencing membership of farmers in cooperative societies in Abia state, Nigeria. Scientific Papers Series Management, Economic Engineering in Agriculture and Rural Development, 18(1), 2018 PRINT ISSN 2284-7995, E-ISSN 2285-3952.
[24]. Danjuma, I. G., 2020, Appraising the influence of socio-economic characteristic of members on their level participation in cooperative society in Adamawa state, Nigeria. International Journal of Scientific and Research Publications, 10(4), April 2020. ISSN 2250-3153.
[25]. Nosratnejad, S., Rashidian, A., Dror, D. M., 2016, Systematic review of willingness to pay for health insurance in low- and middle-income countries. PLoS One. 2016;11(6):1–14.
[26]. Babatunde, O., and Akande, T., 2012, Willingness to pay for community health insurance and its determinants among household heads in rural communities in north-central Nigeria. IrsshCom. 2012; 2 (2): 133–42.
[27]. Kibret, G. D., Leshargie, C. T., Wagnew, F., Alebel, A., 2019, Willingness to join community-based health insurance and its determinants in the East Gojjam Zone, Northwest Ethiopia. BMC Res Notes [Internet]. 2019;12(1):1–5.
[28]. Shepperd, D. S., Benjamin, E. R., 1988, User fees and health financing in developing countries: mobilising financial resources for health. In: DE BeU and MR Reich (eds) Health, Nutrition and Economic Crises: Approaches to Policy in the Third World. Mass., USA: Auburn House, 1988.
[29]. Ujah, I. A. O., Awa, M. J., Meshak, D. J., Garba, R. M., Ajibola, S., Onyekwelu, J., & Lamu, N. M., 2024, Assessment of patients’ satisfaction with healthcare services provided under the Nigeria National Health Insurance Authority. Nigerian Medical Journal: Journal of the Nigeria Medical Association, 65(5), 621.
[30]. Effiong, F., Dine, R. D., Hassan, I., Olawuyi, D., Isong, I., & Adewole, A., 2025, Coverage and predictors of enrollment in the state-supported health insurance schemes in Nigeria: A quantitative multi-site study. BMC Public Health, 25. https://doi.org/10.1186/s12889-025-23329-4
[31]. De Allegri, M., Sanon, M., Sauerborn, R., "To enrol or not to enrol? A qualitative investigation of demand for health insurance in rural West Africa. Soc Sci Med. 2006;62(6):1520–7.
[32]. Abebe, Y., & Belayneh, F., 2023, Determinants of willingness to pay for community-based health insurance scheme among households in rural community of southern Ethiopia. BMC Health Services Research, 23(1), 1365.
[33]. Magge, H., Cabral, H. J., Kazis, L. E., Sommers, B. D., 2013, Prevalence and predictors of underinsurance among low-income adults. Journal of General Internal Medicine. 2013;28(9):1136–1142.
[34]. Bamidele, J. O., Adebimpe, W. O. 2012, Awareness, attitude and willingness of artisans in Osun State, Southwestern Nigeria, to participate in community-based health insurance. J Community Med Prim Health Care. 24:1–10.
[35]. Anderson, I. E., Adeniji, F. O., 2019, Willingness to pay for social health insurance by the self-employed in Port Harcourt, Rivers State: A Contingent Valuation Approach. Asian J Adv Res Rep. 7:1–15.
[36]. Garedew, M. G., Sinkie, S. O., Handalo, D. M., Salgedo, W. B., Yitebarek Kehali, K., Kebene, F. G., Waldemarium, T. D., & Mengesha, M. A., 2020, Willingness to join and pay for community-based health insurance among rural households of selected districts of Jimma Zone, Southwest Ethiopia.
[37]. CHECOD, 2017, Highlights of feasibility study for community-based health insurance scheme | Center For Health Economics Development. Retrieved July 13, 2025, from https://blog.checod.org/highlights
[38]. Sampieri, H., and Collado, F., 2014, Metodología de la Investigación. McGraw-Hill Interamericana Editores, S.A. DE C.V, Ciudad de México.
[39]. Giannouchos, T. V., Ukert, B., Vozikis, A., Steletou, E., and Souliotis, K., 2021, Informal out-of-pocket payment experience and individuals’ willingness to pay for healthcare services in Greece. Health Policy, 125(6), 693–700.
[40]. Adebayo, E. F., Uthman, O. A., Wiysonge, C. S., Stern, E. A., Lamont, K. T., & Ataguba, J. E., 2015, A systematic review of factors that affect uptake of community-based health insurance in low-income and middle-income countries. BMC Health Services Research, 15(1), 543.
[41]. Russell, S., 1996, Ability to pay for health care: concepts and evidence. Health Policy and Planning, 11(3), 219–237.
[42]. Magaria, B. R., Shauri, N. E., & Masanyiwa, Z. S., 2023, Household’s ability to afford health insurance packages in Tanzania. Open Journal of Social Sciences, 11(4), 59–73. https://doi.org/10.4236/jss.2023.114005
[43]. Onwujekwe, O., Uzochukwu, B., and Kirigia, J., 2011, Basis for effective community-based health insurance schemes: Investigating inequities in catastrophic out-of-pocket health expenditures, affordability and altruism. African Journal of Health Economics, 1(1), Article 1.
[44]. Anbari, Z., Mohammad, N., Mohammad, A., and Ebrazeh, A., 2014, Health Expenditure and Catastrophic Costs for Inpatient- and Outpatient Care in Iran—PMC.
[45]. Banerjee, A., Duflo, E., Hornbeck, R., 2018, How much do existing borrowers value microfinance? evidence from an experiment on bundling microcredit and insurance. Economica. Oct;85(340):671-700.
[46]. Adebayo, A. A, and Tukur, A. L., 1999, Adamawa State in maps publication Department of Geography, Federal University of technology Yola, in Co-operate with paraclete publications. A division of paraclete and sons Nigeria. https://www.researchgate.net/figure/Map-of-Adamawa-State-indicating-the-study-area-Source-Adebayo-1999_fig1_328593330
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Food Safety Emergency Response in Africa: Institutional and Contextual Analyses from Eight CountriesAuthor: Modupe Bamidele AdeyemoDOI: 10.21522/TIJAR.2014.13.01.Art017
Food Safety Emergency Response in Africa: Institutional and Contextual Analyses from Eight Countries
Abstract:
Foodborne diseases remain a public health and socioeconomic development challenge in Africa, where fragmented systems limit preparedness and response. This study examined the institutional and contextual dimensions of food safety emergency preparedness and response across eight African countries: Nigeria, Egypt, Ghana, Kenya, Ethiopia, Uganda, Cameroon, and South Africa. A mixed-methods design was used, combining structured questionnaires and key informant interviews with stakeholders from regulatory agencies, public health institutions, academia, food businesses, development partners, and the general public. Thematic analysis, supported by a triangulation of survey findings, interviews, and a regional desk review, enabled cross country comparison of system functionality. Benchmarking was conducted against three major frameworks: FAO/WHO Food Safety Emergency Management (FSEM), the WHO Joint External Evaluation (JEE) tool, and Ghana's Food Safety Emergency Response Plan (FoSERP). Findings revealed recurring gaps across most countries including fragmented governance, poor coordination, under-resourced surveillance, uneven laboratory capacity, limited training, inadequate financing, compliance and communication, and One Health integration. Although some strengths were identified in selected countries (Ghana and Egypt), these were insufficient to offset systemic weaknesses. The benchmarking exercise highlighted significant gaps between existing global guidance and operational reality. Overall, the results underscore the need for integrated governance structures, institutionalized rapid risk assessment and incident management processes, and sustained investment in laboratory networks, workforce development, and proactive risk communication. Strengthening these foundational elements is essential for building resilient and responsive food safety emergency systems across Africa.
Food Safety Emergency Response in Africa: Institutional and Contextual Analyses from Eight Countries
References:
[1]. World Health Organization (WHO), 2015b, WHO estimates of the global burden of foodborne diseases: foodborne disease burden epidemiology reference group 2007– 2015. Geneva.
[2]. WHO-AFRO, 2024, Status of National Food Safety Systems in the African Region. WHO Regional Office for Africa.
[3]. Granada, L., et al., 2021, Food Safety in Sub-Saharan Africa: Systems, Gaps, and Opportunities. Global Food Security, 28, 100462.
[4]. Nauta, M. J., et al., 2018, A Risk-Based Approach to Improving Food Safety in Developing Countries. International Journal of Food Microbiology, 285, 44–52.
[5]. WHO, 2012, Developing a Food Safety Strategy for Africa. World Health Organization.
[6]. Smith, R. D., et al., 2019, Food Safety Governance in Low-Income Contexts: Lessons from the South African Listeriosis Outbreak. Journal of Public Health Policy, 40(3), 331–347.
[7]. Newfood Magazine, 2018, South Africa’s Listeriosis Outbreak: What Went Wrong? Retrieved from https://www.newfoodmagazine.com
[8]. EFSA, 2020, The European Union Summary Report on Trends and Sources of Zoonoses. European Food Safety Authority.
[9]. FDA, 2023, Emergency Operations Center: Capabilities and Responses. U.S. Food and Drug Administration.
[10]. FAO & WHO, 2022, INFOSAN Activity Report 2020/2021. Food and Agriculture Organization & World Health Organization.
[11]. Fasominu, O., et al., 2022, Assessing Nigeria’s Capacity for Food Safety Emergency Preparedness: A JEE-based Review. African Health Review, 14(2), 55–69.
[12]. Resnik, D. B., 2018, Food Safety and the Ethics of Regulations. Food Ethics, 3(2), 79–95.
[13]. WHO, 2022, Global Strategy for Food Safety 2022–2030. World Health Organization.
[14]. Ghana FDA, 2019, National Food Safety Emergency Response Plan (FoSERP). Ghana Food and Drugs Authority.
[15]. FAO & WHO, 2019b, Food Safety Emergency Preparedness and Response. FAO & WHO.
[16]. PACA, 2017, Aflatoxin Control in Africa: Scaling Up Action. Partnership for Aflatoxin Control in Africa.
[17]. WHO, 2016, International Health Regulations: Joint External Evaluation Tool. World Health Organization.
[18]. Renn, O., 2008, Risk Governance: Coping with Uncertainty in a Complex World. Earthscan.
[19]. Scott, W. R., 2014, Institutions and Organizations: Ideas, Interests, and Identities (4th ed.), SAGE Publications.
[20]. von Bertalanffy, L., 1968, General System Theory: Foundations, Development, Applications. George Braziller.
[21]. Etikan, I., Musa, S. A., & Alkassim, R. S., 2016, Comparison of convenience sampling and purposive sampling. American Journal of Theoretical and Applied Statistics, 5(1), 1–4.
[22]. Worldometer, 2025, Population by country. Retrieved July 9, 2025, from https://www.worldometers.info/world-population/population-by-country/
[23]. Raosoft Inc., 2004, Sample size calculator. http://www.raosoft.com/samplesize.html
[24]. European Food Safety Authority (EFSA), 2015, The principles and methods behind EFSA’s Guidance on Uncertainty in Scientific Assessment. EFSA Journal, 13(1), 1–35. https://doi.org/10.2903/j.efsa.2015.1058
[25]. World Health Organization (WHO), 2008, Foodborne disease outbreaks: Guidelines for investigation and control. Geneva: World Health Organization.
[26]. World Health Organization (WHO), 2015a, Risk communication in food safety: Handbook. Geneva: World Health Organization.
[27]. Patton, M. Q., 2015, Qualitative Research & Evaluation Methods (4th ed.). SAGE Publications.
[28]. Braun, V., & Clarke, V., 2006, Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.
[29]. Adeyemo, M. B., & Jeff-Agboola, Y. A., 2025, Desk review of food safety emergency response in eight African countries: Policy evaluation, response mechanisms, and infrastructure gaps. Texila International Journal of Public Health, 13(3), Article 4. https://doi.org/10.21522/TIJPH.2013.13.03.Art004
[30]. FAO & WHO, 2019a, Strengthening National Food Control Systems: Guidelines to Assess Capacity Building Needs. Food and Agriculture Organization & World Health Organization.
[31]. Federal Ministry of Health (FMoH), 2014, National Policy on Food Safety and its Implementation Strategy (Nigeria). https://faolex.fao.org/docs/pdf/nig151436.pdf
[32]. Egyptian Parliament, 2017, Law No. 1/2017 on the establishment of the National Food Safety Authority. https://example.gov.eg/law1-2017
[33]. World Health Organization, 2017, Joint External Evaluation of IHR core capacities of the Republic of Kenya: mission report. 27 February to 3 March 2017, World Health Organization. https://iris.who.int/handle/10665/258694 License: CC BY-NC-SA 3.0 IGO
[34]. Abera, W., 2024, Overview of food safety and FBD surveillance in Ethiopia [PowerPoint presentation]. https://cdn.who.int/media/docs/default-source/foodborne-diseases/webinar-ranking-food-safety-presentation-abera.pdf?sfvrsn=fcdfbac6_3
[35]. Sodjinou, V. D., Ayelo, P. A., Douba, A., & Ouendo, D. E., 2022, Main challenges of the detection in the context of global health security: systematic review of Joint External Evaluation (JEE) reports. The Pan African medical journal, 42, 243. https://doi.org/10.11604/pamj.2022.42.243.26563
[36]. Haughey, S. A., Chevallier, O. P., McVey, C., & Elliott, C. T., 2021, Laboratory investigations into the cause of multiple serious and fatal food poisoning incidents in Uganda during 2019. Food Control, 121, 107648. https://doi.org/10.1016/j.foodcont.2020.107648
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A Clinical Perspective on Adult Cerebral Atrophy in Chronic Alcohol Use: Considering the Role of Neurotropic TORCH-Related Viruses (CMV, HSV-1, and Rubella)Author: Jean-Paul Mukeba TshitendeDOI: 10.21522/TIJAR.2014.13.01.Art018
A Clinical Perspective on Adult Cerebral Atrophy in Chronic Alcohol Use: Considering the Role of Neurotropic TORCH-Related Viruses (CMV, HSV-1, and Rubella)
Abstract:
Chronic alcohol use is a well-recognized cause of cerebral atrophy and ventricular enlargement in adults. Neurotropic viral infections, including cytomegalovirus (CMV), herpes simplex virus type 1 (HSV-1), and rubella virus—pathogens traditionally grouped within the TORCH framework—may also contribute to central nervous system injury, particularly in states of immune dysfunction. This descriptive observational study draws on routine clinical observations of eight adults aged 42–65 years with long-standing alcohol use who presented with neurological symptoms at a district-level hospital with referral access to tertiary care. Non-contrast computed tomography imaging demonstrated diffuse cerebral atrophy with proportional ventricular enlargement consistent with hydrocephalus ex vacuo rather than true hydrocephalus. Clinical history and available serological data suggested prior exposure to CMV, HSV-1, and/or rubella in several patients, without evidence of acute viral encephalitis. Integrating these observations with a narrative review of the literature, this article explores plausible mechanisms through which alcohol-related neurotoxicity, immune dysregulation, and latent or prior neurotropic viral exposure may interact to accelerating neuronal injury, with particular vulnerability of temporal lobe structures. These mechanisms are discussed as hypothesized associations rather than proven causal relationships. Recognition of these interactions is clinically relevant for practitioners evaluating alcohol-exposed adults with cerebral atrophy and ventricular enlargement, especially in resource-limited settings where advanced neuroimaging and molecular viral diagnostics are not readily available.
A Clinical Perspective on Adult Cerebral Atrophy in Chronic Alcohol Use: Considering the Role of Neurotropic TORCH-Related Viruses (CMV, HSV-1, and Rubella)
References:
[1]. Harper, C., 2009, The neuropathology of alcohol-related brain damage. Alcohol and Alcoholism, 44(2), 136–140.
[2]. Oscar-Berman, M., and Marinković, K., 2007, Alcohol: Effects on neurobehavioral functions and the brain. Neuropsychology Review, 17(3), 239–257.
[3]. Sullivan, E. V., Rosenbloom, M. J., Serventi, K. L., and Pfefferbaum, A., 2000, Effects of alcohol dependence on volumes of the brain. Neuropsychology, 14(3), 341–350.
[4]. Griffin, D. E., 2014, Viral encephalomyelitis. In J. E. Bennett, R. Dolin, and M. J. Blaser (Eds.), Mandell, Douglas, and Bennett’s principles and practice of infectious diseases (8th ed.). Elsevier.
[5]. Cheeran, M. C. J., Lokensgard, J. R., and Schleiss, M. R., 2009, Neuropathogenesis of congenital cytomegalovirus infection: Disease mechanisms and prospects for intervention. Clinical Microbiology Reviews, 22(1), 99–126.
[6]. Whitley, R. J., and Kimberlin, D. W., 2005, Herpes simplex encephalitis: Children and adolescents. Seminars in Pediatric Infectious Diseases, 16(1), 17–23.
[7]. Bradshaw, M. J., and Venkatesan, A., 2016, Herpes simplex virus-1 encephalitis in adults: Pathophysiology, diagnosis, and management. Neurotherapeutics, 13(3), 493–508.
[8]. Thomas, E., Mahadevan, A., and Taly, A. B., 2018, Viral encephalitis: An overview. Annals of Indian Academy of Neurology, 21(4), 282–291.
[9]. Szabo, G., and Saha, B., 2015, Alcohol’s effect on host defense. Alcohol Research: Current Reviews, 37(2), 159–170.
[10]. Crews, F. T., Lawrimore, C. J., Walter, T. J., and Coleman, L. G., 2017, The role of neuroimmune signaling in alcoholism. Neuropharmacology, 122, 56–73.
[11]. Pfefferbaum, A., and Sullivan, E. V., 2005, Disruption of brain white matter microstructure by excessive alcohol consumption. Neuropsychopharmacology, 30, 423–432.
[12]. Zahr, N. M., and Sullivan, E. V., 2008, Perspectives on fronto-fugal circuitry from human imaging of alcohol use disorders. Neuropharmacology, 56, 194–205.
[13]. Mailles, A., and Stahl, J.-P., 2009, Infectious encephalitis in adults. The Lancet Neurology, 8(12), 1149–1161.
[14]. Cinque, P., Marenzi, R., and Ceresa, D.,1998, Cytomegalovirus infections of the nervous system. Clinical Infectious Diseases, 26(6), 1409–1415. https://doi.org/10.1086/516282
[15]. Lokensgard, J. R., Cheeran, M. C., Hu, S., and Gekker, G., 2016, Chronic neuroinflammation following CMV infection. Journal of Neurovirology, 22, 720–732.
[16]. De Chiara, G., Piacentini, R., Fabiani, M., Mastrodonato, A., Marcocci, M. E., Limongi, D., Napoletani, G., Protto, V., Coluccio, P., Celestino, I., Li Puma, D. D., Grassi, C., and Palamara, A. T., 2019, Recurrent herpes simplex virus-1 infection induces hallmarks of neurodegeneration and cognitive deficits in mice. PLoS Pathogens, 15(3), e1007617. https://doi.org/10.1371/journal.ppat.1007617
[17]. Itzhaki, R. F., Lathe, R., Balin, B. J., Ballard, C., Barnett, F. C., Beach, T., Biglan, O., and Bloom, S. L., 2016, Microbes and Alzheimer’s disease. Journal of Alzheimer’s Disease, 51(4), 979–984.
[18]. Itzhaki, R. F., 2018, Herpes simplex virus type 1 and Alzheimer’s disease. Journal of Alzheimer’s Disease, 64, S53–S63.
[19]. Molina, P. E., Happel, K. I., Zhang, P., Kolls, J. K., and Nelson, S., 2010, Alcohol abuse and the immune system. Alcohol Research & Health, 33(1–2), 97–108.
[20]. Barr, T., and Helms, C., 2016, Opposing effects of alcohol on the immune system. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 65, 242–251.
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Exploring the Effect of STEM Teaching Methods on Grade 9 Mathematics Students’ Conceptual Understanding and Performance Compared to Traditional Instruction at a Non-Traditional High School in Halfway Tree in St. AndrewAuthor: Mark A. LewisDOI: 10.21522/TIJAR.2014.13.01.Art019
Exploring the Effect of STEM Teaching Methods on Grade 9 Mathematics Students’ Conceptual Understanding and Performance Compared to Traditional Instruction at a Non-Traditional High School in Halfway Tree in St. Andrew
Abstract:
The ongoing dependence on conventional, lecture-centric mathematics teaching in Jamaican secondary schools has been linked to low levels of student engagement, restricted conceptual comprehension, and inadequate problem-solving results, especially in non-traditional high school environments. To address this issue, the present study sought to evaluate the efficacy of STEM-oriented teaching strategies in enhancing Grade 9 students' conceptual grasp and performance in mathematics, in contrast to traditional teaching methods. A mixed-methods research framework was utilized, involving 58 Grade 9 students from a non-traditional high school located in Half Way Tree, St. Andrew. During a five-day instructional timeframe, students participated in both STEM-integrated lessons—incorporating visual tools such as charts, graphs, and diagrams—and standard lecture-based instruction. Data collection was conducted through weekly mathematics evaluations and structured student surveys. Quantitative data were analyzed employing regression analysis and one-sample t-tests. The results indicated that STEM-based instruction had a statistically significant positive impact on student engagement, class participation, and understanding of mathematical concepts. Regression analysis revealed a moderate positive correlation between STEM variables and instructional effectiveness, while t-test outcomes confirmed significant differences favoring STEM instruction (p < 0.05). Despite facing challenges related to insufficient teacher training and resource limitations, the study concludes that STEM-focused teaching approaches are more effective than traditional methods in improving mathematical learning outcomes. The findings advocate for the incorporation of STEM pedagogy in mathematics education, particularly in under-resourced and non-traditional school settings.
Exploring the Effect of STEM Teaching Methods on Grade 9 Mathematics Students’ Conceptual Understanding and Performance Compared to Traditional Instruction at a Non-Traditional High School in Halfway Tree in St. Andrew
References:
[1]. Eshaq, H. A., 2024, The effect of using STEM education on students’ mathematics achievement. Every, E., Ball, L., & van Driel, J.
[2]. Ortiz-Revilla, J., Greca, I. M., & Arriassecq, I., 2022, A theoretical framework for integrated STEM education. Science & Education, 31(2), 383-404.
[3]. Felder, R. M., & Brent, R., 2024, Teaching and learning STEM: A practical guide. John Wiley & Sons.
[4]. Sevimli, E., & Ünal, E., 2022, Is the STEM Approach Useful in Teaching Mathematics?
[5]. Foust, C., 2017, Traditional versus Non-Traditional School Management: an Exploratory Analysis of the Impact on High School Students' Academic Achievement.
[6]. Sirajudin, N., & Suratno, J., 2021, Developing creativity through STEM education.
[7]. Jawad, L. F., Majeed, B. H., & AL Rikabi, H. T. S., 2021, The Impact of Teaching by Using STEM Approach in The Development of Creative Thinking and Mathematical Achievement Among the Students of The Fourth Scientific Class.
[8]. Dare, E. A., Keratithamkul, K., Hiwatig, B. M., & Li, F., 2021, Beyond content: The role of STEM disciplines, real-world problems, 21st century skills, and STEM careers within science teachers’ conceptions of integrated STEM education.
[9]. Rahman, N. A., Rosli, R., Rambely, A. S., & Halim, L., 2021, Mathematics Teachers' Practices of STEM Education.
[10]. Holmes, K., Mackenzie, E., Berger, N., & Walker, M., 2021, Linking K-12 STEM pedagogy to local contexts
[11]. Nagaraj, B. K., Kalaivani, A., Begum, S., Akila, S., & Sachdev, H. K., 2023, The emerging role of artificial intelligence in STEM higher education.
[12]. Kandaga, T., Dahlan, T., Gardenia, N., & Saputra, J., 2021, A Lesson Study to Foster Prospective Teachers’ Disposition in STEM Education.
[13]. Huang, Y. C., 2021, Comparison and contrast of Piaget and Vygotsky’s Theories.
[14]. Polanin, J. R., Austin, M., Taylor, J. A., Steingut, R. R., Rodgers, M. A., & Williams, R., 2024, Effects of the 5E Instructional Model: A Systematic Review and Meta-Analysis.
[15]. Mayombe, C., 2024, Promoting youths' skills acquisition through experiential learning theory in vocational education and training in South Africa
[16]. Taherdoost, H., 2022, What are the different research approaches? Comprehensive review of qualitative, quantitative, and mixed-method research, their applications, types, and limitations.
[17]. Noor, S., Tajik, O., and Golzar, J., 2022, Simple random sampling. International Journal of Education & Language Studies, 1(2), pp.78-82
[18]. Hasan, N., Rana, R. U., Chowdhury, S., Dola, A. J., and Rony, M. K. K., 2021, Ethical considerations in research.
[19]. Liu, X., 2022, December. Multivariate Linear Regression Method Based on SPSS Analysis of the Influencing Factors of Urban Residents’ Exhibition Support.
[20]. Ali, P., and Younas, A., 2021, Understanding and interpreting regression analysis.
[21]. Introduction to Linear Regression Analysis, Fifth Edition. Douglas C. Montgomery, Elizabeth A., Peck, G. Geoffrey Vining, John Wiley & Sons, Inc. Published 2012 by John Wiley & Sons, Inc.
[22]. Skiera, B., Reiner, J., and Albers, S., 2021, Regression analysis.
[23]. Chicco, D., Warrens, M. J., and Jurman, G., 2021, The coefficient of determination, R-squared is more informative than SMAPE, MAE, MAPE, MSE, and RMSE in regression analysis evaluation.
[24]. Afifah, S., Mudzakir, A., and Nandiyanto, A. B. D., 2022, How to calculate a paired sample t-test using SPSS software: From step-by-step processing for users to the practical examples in the analysis of the effect of the application of anti-fire bamboo teaching materials on student learning outcomes.
[25]. Elsayed, A. M. A., 2022, SPSS.
[26]. Bakirci, H., Kirici, M. G., and Kara, Y., 2022, The Effectiveness of STEM-Supported Inquiry-Based Learning Approach on Conceptual Understanding of 7th Graders: Force and Energy Unit.
[27]. Diana, N., 2021, March. Analysis of teachers’ difficulties in implementing the STEM approach in learning: A literature review.
[28]. Syafril, S., Rahayu, T., Al-Munawwarah, S. F., Satar, I., Halim, L. B., Yaumas, N. E., and Pahrudin, A., 2021, February. Mini review: Improving teachers’ quality in STEM-based science teaching-learning in secondary school.
[29]. Hamad, S., Tairab, H., Wardat, Y., Rabbani, L., AlArabi, K., Yousif, M., Abu-Al-Aish, A., and Stoica, G., 2022, Understanding science teachers’ implementations of integrated STEM
[30]. Bal, A. P., and Bedir S. G., 2021, Examining teachers' views on STEM education.
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Assessing Community Members’ Knowledge about AEFI, Awareness about AEFI Reporting and Their Vaccine Safety Perception in Oyo State NigeriaAuthor: Olayiwola, O. S.DOI: 10.21522/TIJAR.2014.13.01.Art020
Assessing Community Members’ Knowledge about AEFI, Awareness about AEFI Reporting and Their Vaccine Safety Perception in Oyo State Nigeria
Abstract:
Immunization as a cost-efficient has proven to be a successful public health initiatives, as it prevents more than 2.5 million child fatalities yearly. Worry about the possibility of adverse events after vaccination (AEFI) may lead to low vaccination rates, a reduction in vaccine confidence, or return of vaccine preventable diseases. This study aim to understand the community level knowledge about AEFI, their awareness about AEFI reporting and perception about vaccine safety. This study is a descriptive cross-sectional study that was carried out among 422 vaccine recipients in Oyo State that have at least received a dose of vaccine in the last 10 years. Semi- structured questionnare was used for data collection. The data was analyzed using SPSS24 and the descriptive statistical tools used are frequency, mean and standard deviation. The mean knowledge score out of 10 was 6.61± 2.34 and more than half (56.2%) of the respondents have good knowledge about the concept of AEFI. The mean awareness scores out of 10 was 4.75±1.48 and only few (3.3%) of respondents have good awareness about AEFI reporting. The majority (95.7%) of study respondents perceived vaccines as safe and effective against vaccine preventable diseases, however more than half (52.9%) of the respondents perceived that many HWs administer vaccines in a harmful manner. This study demonstrated community members’ suboptimal awareness about reporting system for AEFI, as well as having perception that vaccines though safe and effective, their administration were in a harmful manner.
Assessing Community Members’ Knowledge about AEFI, Awareness about AEFI Reporting and Their Vaccine Safety Perception in Oyo State Nigeria
References:
[1] World Health Organization, 2022, Child mortality (under 5 years). https://www.who.int/news-room/fact-sheets/detail/levels-and-trends-in-child-under-5-mortality-in-2020
[11] World Health Organization., 2021, Adverse events following immunization (AEFI). www.who.int
[12] Jegede, A. S., 2007, What led to the Nigerian boycott of the polio vaccination campaign? PLoS Med. 4(3), 0417-0422. https://doi.org/10.1371/journal.pmed.0040073
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The Impact of Alcohol and Herbal Consumption on the Cardiovascular Health Status of Commercial Automobile Drivers in IbadanAuthor: Adedamope Olajumoke AdediranDOI: 10.21522/TIJAR.2014.13.01.Art021
The Impact of Alcohol and Herbal Consumption on the Cardiovascular Health Status of Commercial Automobile Drivers in Ibadan
Abstract:
Cardiovascular diseases are a group of non-communicable diseases with a rising burden in Nigeria. Commercial automobile driving is an occupation with associated risks that may worsen the burden among the population concerned. A cross-sectional survey of 1713 automobile drivers across Ibadan showed a predominantly male population with more than half in the 36–49 years age bracket, and 74.6% with at least secondary level of education. 44.7% of them have been working for 5-10 years, mostly working for 9-16 hours a day (96.3%) and 6-7 days in a week (96.2%). The long hours of work, prevalence of alcohol consumption (44.4%), and prevalence of herbal consumption (87.7%) may have contributed to the difference in the proportion of the population with previously diagnosed hypertension (2.3%) and the proportion observed to be hypertensive during the study (13.3%). A significant association between alcohol consumption and the prevalence of hypertension, pedal oedema and other diagnosed chronic illnesses were also observed. In contrast, no significant association was noted between herbal consumption and the parameters of the cardiovascular health status observed. It is concluded that although the prevalence of hypertension in this population was lower than previously reported in mixed community samples, the significant association between alcohol use and elevated blood pressure underscores the vulnerability of this occupational group.
The Impact of Alcohol and Herbal Consumption on the Cardiovascular Health Status of Commercial Automobile Drivers in Ibadan
References:
[1]. Gheorghe, A., Griffiths, U., Murphy, A., Legido-Quigley, H., Lamptey, P., & Perel, P., 2018, The economic burden of cardiovascular disease and hypertension in low- and middle-income countries: A systematic review. BMC Public Health, 18(1), 975. https://doi.org/10.1186/s12889-018-5806-x
[2]. Akinpeloye, O., Onoja, A., & Alabi, A., 2025, Determinants of Hypertension Among Transport Workers in Ibadan, Nigeria: A Structural Equation Modeling Approach. Cureus. https://doi.org/10.7759/cureus.96458
[3]. Adeyanju, O. Z., Nkwocha, C. R., & Opurum, G. C., 2024, Life style, health seeking behaviour and nutritional status of commercial vehicle drivers in Port Harcourt, Nigeria. World Nutrition, 15(1), 2–9. https://doi.org/10.26596/wn.20241512-9
[4]. Barnes, A., 2023, Cardiovascular Disease Risk Screening for Commercial Drivers Examined in Occupational Practice: Implementing Evidence-Based Practice to Champion the Health of Essential Workers. Workplace Health & Safety, 71(10), 465–475. https://doi.org/10.1177/21650799231184374
[5]. 5. Piano, M. R., 2016, Alcohol’s effect on the Cardiovascular System. Alcohol Research: Current Reviews, 38(2), 219–241.
[6]. 6. Anderson, B. O., Berdzuli, N., Ilbawi, A., Kestel, D., Kluge, H. P., Krech, R., Mikkelsen, B., Neufeld, M., Poznyak, V., Rekve, D., Slama, S., Tello, J., & Ferreira-Borges, C., 2023, Health and cancer risks associated with low levels of alcohol consumption. The Lancet Public Health, 8(1), e6–e7. https://doi.org/10.1016/S2468-2667(22)00317-6
[7]. Biddinger, K. J., Emdin, C. A., Haas, M. E., Wang, M., Hindy, G., Ellinor, P. T., Kathiresan, S., Khera, A. V., & Aragam, K. G., 2022, Association of Habitual Alcohol Intake With Risk of Cardiovascular Disease. JAMA Network Open, 5(3), e223849. https://doi.org/10.1001/jamanetworkopen.2022.3849
[8]. Wilsnack, R. W., Wilsnack, S. C., Kristjanson, A. F., Vogeltanz‐Holm, N. D., & Gmel, G., 2009, Gender and alcohol consumption: Patterns from the multinational GENACIS project. Addiction, 104(9), 1487–1500. https://doi.org/10.1111/j.1360-0443.2009.02696.x
[9]. Owolabi, T., Alabi, T. A., & Busari-Akinbode, S. A., 2021, Changing times and women on the wheels: A qualitative investigation of the experiences of female commercial drivers in Lagos State, Nigeria. Journal of Enterprising Communities: People and Places in the Global Economy. http://dx.doi.org/10.1108/JEC-07-2021-0105
[10]. Greaves, L., Poole, N., & Brabete, A. C., 2022, Sex, Gender, and Alcohol Use: Implications for Women and Low-Risk Drinking Guidelines. International Journal of Environmental Research and Public Health, 19(8), 4523. https://doi.org/10.3390/ijerph19084523
[11]. Abiona, T. C., Aloba, O. O., & Fatoye, F. O., 2006, Pattern of alcohol consumption among commercial road transport workers in a semi-urban community in South Western Nigeria. East African Medical Journal, 83(9), 494–499.
[12]. Lv, Y., Cao, X., Yu, K., Pu, J., Tang, Z., Wei, N., Wang, J., Liu, F., & Li, S., 2024, Gender differences in all-cause and cardiovascular mortality among US adults: From NHANES 2005–2018. Frontiers in Cardiovascular Medicine, 11, 1283132. https://doi.org/10.3389/fcvm.2024.1283132
[13]. Rethemiotaki, I., 2024, Global prevalence of cardiovascular diseases by gender and age during 2010–2019. Archives of Medical Science – Atherosclerotic Diseases, 8(1), 196–205. https://doi.org/10.5114/amsad/176654
[14]. Atanasovska, A., 2023, Risk factors for cardiovascular diseases in professional drivers. Archives of Public Health, 15(1), 16–32. https://doi.org/doi.org/10.3889/aph.2023.%25206091
[15]. Jones, D. W., Ferdinand, K. C., Taler, S. J., Johnson, H. M., Shimbo, D., Abdalla, M., Altieri, M. M., Bansal, N., Bello, N. A., Bress, A. P., Carter, J., Cohen, J. B., Collins, K. J., Commodore-Mensah, Y., Davis, L. L., Egan, B., Khan, S. S., Lloyd-Jones, D. M., Melnyk, B. M., … Williamson, J. D., 2025, 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 152(11). https://doi.org/10.1161/CIR.0000000000001356
[16]. Posadzki, P., Watson, L. K., & Ernst, E., 2013, Adverse effects of herbal medicines: An overview of systematic reviews. Clinical Medicine, 13(1), 7–12. https://doi.org/10.7861/clinmedicine.13-1-7
[17]. Richardson, W. H., Slone, C. M., & Michels, J. E., 2007, Herbal Drugs of Abuse: An Emerging Problem. Emergency Medicine Clinics of North America, 25(2), 435–457. https://doi.org/10.1016/j.emc.2007.02.009
[18]. Okaiyeto, K., & Oguntibeju, O. O., 2021, African Herbal Medicines: Adverse Effects and Cytotoxic Potentials with Different Therapeutic Applications. International Journal of Environmental Research and Public Health, 18(11), 5988. https://doi.org/10.3390/ijerph18115988
[19]. Woo, C. S. J., Lau, J. S. H., & El-Nezami, H., 2012, Herbal Medicine. In Advances in Botanical Research (Vol. 62, pp. 365–384). Elsevier. https://doi.org/10.1016/B978-0-12-394591-4.00009-X
[20]. Gavanji, S., 2022, Cardiotoxicity Effects of Herbal Medicine, A Review Article. Biology, Medicine, & Natural Product Chemistry, 12(1), 89–96. https://doi.org/10.14421/biomedich.2023.121.89-96
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Factors Associated to the Resurgence of Ebola Virus Disease within the Population in Beni Health Zone 2025Author: Douglas Kambale AsifiweDOI: 10.21522/TIJAR.2014.13.01.Art022
Factors Associated to the Resurgence of Ebola Virus Disease within the Population in Beni Health Zone 2025
Abstract:
The second largest Ebola outbreak recorded worldwide was reported on August 1, 2018, and declared over on June 25, 2020. A total of 3470 cases were reported, including 3317 confirmed and 153 probable cases. There were 2287 deaths, including 2134 among confirmed cases and 153 among probable cases. The epidemic lasted two years, and the ongoing conflict made its management particularly challenging. Despite progress, the epidemic continues to resurface in neighboring countries, provinces, and health zones within the Beni Health Zone. Our study is descriptive and correlational, with a quantitative approach, as we described the relationship between household knowledge, attitudes, and practices regarding Ebola. Investigators, under close supervision, collected data through direct interviews for the quantitative data, based on a questionnaire administered to households. The results of the analysis confirm that the factors associated with the resurgence of Ebola virus disease (EVD) in the population of Beni Health Zone are linked to the following sociodemographic factors: the respondent's sex : OR: 6.367 [1.664; 24.364] and (p=0.007<0.05); OR: 2.770 [1.190; 6.448]; and the level of education: OR: 3.798 [1.597; 54.902] and (p=0.013<0.05). The application of best prevention practices will help prevent the resurgence of EVD in Beni Health Zone.
Factors Associated to the Resurgence of Ebola Virus Disease within the Population in Beni Health Zone 2025
References:
[1]. WHO, 2023, Ebola (Virus Disease), https://sante.gouv.fr/soins-et-maladies/maladies/maladies-vectorielles-et-zoonoses/ebola/article/maladie-a-virus-ebola
[2]. WHO, 2021b, Global Outbreak Alert and Response Network, https://www.afro.who.int/fr/countries/uganda/news/louganda-declare-une-epidemie-de-maladie-virus-ebola
[3]. Jean-Bosco Kahindo Mbeva, 2022, Management of the Twelfth Ebola Virus Disease Outbreak - Perceptions of Stakeholders in North Kivu Province, Democratic Republic of Congo - International Journal of Innovation and Applied Studies ISSN 2028-9324 Vol. 36 No. 4 Jul. 2022, pp. 1090-1102 © 2022, Innovative Space of Scientific Research Journals, http://www.ijias.issr-journals.org
[4]. Unicef, CASS, 2020, Integrated and Multidisciplinary Epidemic Analysis, https://www.unicef.org/drcongo/rapports/revue-analyses-integrees-90-premiers-jours-epidemie-ebola-equateur
[5]. Nene, M., 2020, The response to Ebola Virus Disease (EVD) in Eastern DR Congo, p. 2, https://www.elrha.org/docs/document/2020-rapport-elhra.pdf?file_url=document/s7ikmv661t4k90oah9sunctq0o/2xktvczx8s-uxmiiscans66lrua/original?content-type=application%2Fpdf&name=2020-rapport-elhra.pdf
[6]. La Libre Belgique, 2021, “Guinea: Four deaths due to Ebola, the first since 2016”, https://www.la-croix.com/Ebola-Guinee-annonce-premiers-deces-2016-2021-02-14-1301140582
[7]. WHO, 2018, “How is EVD transmitted?”, Slides 11–13, https://cdn.peaceopstraining.org/course_promos/ebola_awareness/evd_awareness_english.pdf
[8]. WHO, 2021, Global Outbreak Alert and Response Network, https://www.who.int/fr/emergencies/disease-outbreak-news/item/2021-DON351
[9]. Judson, S. D., Fischer, R., Judson, A., Munster, V. J., 2016, Ecological Contexts of Index Cases and Spillover Events of Different Ebolaviruses. PLOS Pathogens. 12(8), p. e1005780, https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1005780
[10]. JHPIEGO, 2016, Everything you need to know about the Ebola Virus, https://fr.scribd.com/document/750476528/Jhpiego-Tout-Savoir-Sur-Le-Virus-Ebola
[11]. BCZS Beni, 2025, PAO (Operational Action Plan), p. 2-18.
[12]. Larousse Pocket Dictionary, 2011, P. 802, https://library.au.int/fr/dictionnaire-larousse-de-poche-edition-2011
[13]. Le Robert, 2025, Dictionnaire, https://www.amazon.fr/Dictionnaire-Robert-illustr%C3%A9-dictionnaire-ligne/dp/2321019999
[15]. BCZS Beni, 2024, National Health Information System.
[16]. AFRAC INSTITUTE, 2020, Thesis writing, www.afracinstitute.org
[17]. DPS NK, 2024, National Health Information System (SNIS)/Annual Report, https://www.fbp-rdc.org/data/zone/pIAYIpy4hiH#section-quantit
[18]. Douglas Asifiwe, 2025, Perceptions and practices of Ebola Virus Disease prevention within the population in the Beni health Zone, Doctoral/PhD Thesis in Public Health, Texila American University (Zambia) - Central University of Nicaragua.
[19]. Bavon Mupenda, 2017, Training on Planning, Monitoring and Evaluation, and Operational Research.
[20]. Frédéric Le Marcis, Almudena Mari-Saez, 2021, Final report, Study of the resurgence of Ebola Virus Disease in the Nzérékoré region: Ebola 2021 - The resurgence and the communities, https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2021-10/010082904.pdf
[21]. WHO, 2021, A new Ebola outbreak has been declared in Guinea. February 14, 2021, www.afro.who.int/fr/news/une-nouvelle-epidemie-debola-declaree-en-guinee
[22]. CASS, 2020, Perceptions of Ebola Virus Disease risks among women and their involvement in the Ebola response, https://drive.google.com/drive/folders/1Btk11rD7Rs5tea4hx1yeJIQaEhKUAc0c?usp=sharing
[23]. WHO, 2021, Emergency preparedness and response, Ebola virus disease, Democratic Republic of the Congo, February 10, 2021, www.who.int/csr/don/10-february-2021-ebola-drc/fr/
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An Evaluation of the Challenges Faced by Women in Attaining Strategic Management PositionsAuthor: Khanyisile Patience Dlamini ShabanguDOI: 10.21522/TIJAR.2014.13.01.Art023
An Evaluation of the Challenges Faced by Women in Attaining Strategic Management Positions
Abstract:
This study investigates the challenges women face in reaching strategic management roles within the tech industry, focusing on perceptions from Eswatini Government Enterprises, higher learning institutions, and corporate leaders. The research employs a mixed-methods approach, combining qualitative and quantitative data to provide a comprehensive analysis of organizational, individual, cultural, and empowerment challenges. It utilizes qualitative methods for deeper insights and quantitative methods for broader data representation. Online surveys assessed female leaders' perspectives. Data was gathered from both secondary sources and primary sources through semi-structured interviews and questionnaires. A total of 40 female participants were randomly selected to ensure diverse perspectives. The research revealed that while women possess the potential for executive roles, societal stereotypes and the balancing act of reproductive and professional responsibilities hinder their progress. Female managers tend to adopt transformational leadership styles, emphasizing the need for supportive organizational structures to facilitate their growth. It is recommended that women must overcome fears of failure and seek support through female networks to bolster confidence in leadership roles; Company Leadership, shift management practices to foster inclusivity and self-esteem among diverse employee groups; Policy Makers, revise female empowerment frameworks and establish forums for women to share experiences and successes; and Future Research, explore the evolving challenges faced by women in tech management to promote greater inclusion. Promoting gender diversity in the tech industry is crucial for innovation and progress. An inclusive environment allows diverse perspectives to thrive, ultimately benefiting the entire sector.
An Evaluation of the Challenges Faced by Women in Attaining Strategic Management Positions
References:
[1]. United Nations, 1995, "Report on the Fourth World Conference on Women," United Nations, New York.
[2]. Masami, H. B., and Addullahi, M., 2023, "Women Participation in Governance: Prospects and Challenges," Yogyakarta - Indonesia.
[3]. Babic, A., and Hanseg, I., 2021, The Glass Ceilling for Women Managers: Antecedents and Consequences for Work - Family Interface and Well-Being at Work. Frontiers in Psychology, 12(618250).
[4]. Chanda, T. C., and Ngulube, L., 2024, Women in Leadership: Examining Barriers to Women's Advancement in Leadership Positions. Asian Journal of Advanced Research, 18(6), 273-290, May 2024.
[5]. Johnson, E., 2024, Influence in Gender Sterotypes in Hiring Decisions. Journal of Advanced Sociology, 5(1), 14 - 24.
[6]. Susilowati, N. E., Fratiwi N. J., and Barus C. S. A., 2024, Balancing Act: Navigating Work and Life - A Compelling Bobliographic Exploration Among Women, but does Everyone Consider It. Women: Education and Social Welfare, 1(1), 1-11.
[7]. Coursera Staff, 2024, What are Leadership Skills, and Why Are They Important. Coursera.
[8]. Leis, M., and Wormington, S., 2024, 12 Essential Qualities of Effective Leadership. Center for Creative Leadership.
[9]. Voltage Control, 2024, Achieving SuccessTogether: Shared Vision in Leadership. Voltage Control.
[10]. Indeed Editorial Team, 2024, 8 Qualities of Strong Leadership and How to Become a Strong Leader. Indeed Career Guide.
[11]. Laundry, L., 2019, Why Emotional Intelligence is Imprtant in Leadership. Harvard Business School.
[12]. Williams, J., and Shaw, H., 2019, Situational Leadership. Practice Supervisor Development Programme.
[13]. Hersey, P., Situational Leadership. Leadership Success.
[14]. John, H., 2024, "Situational Leadership: Getting the Best from a Coaching Approach," AOEC, 19 July 2024.
[15]. Health, V., 2025, Situational Leadership, Relevant The, Relevant Then. The Center for Leadership Studies, https://situational.com/situational-leadership/?utm_source=google&utm_medium=ppc&utm_campaign=Situational%20Leadership&utm_term=situational%20leadership%20style&gad_source=1&gclid=CjwKCAiAlPu9BhAjEiwA5NDSAyV6X72T4OXtW0_oZqSL1ag1ZwkUvkkL92wTp9hH7FZhjWzDqMR
[16]. Sacavem, A., Martinez, L. F., Cunha, J. V. d., and Abreu, A. M., 2017, Charismatic Leadership: A Study on Delivery Styles, Mood and Performance. Journal of Leadership Studies, 11(3). 21 - 38.
[17]. Saharia, N. M., and Thangjam, T., 2025, 9 Most Popular Leadership Styles to Lead Effectively. Vantage Circle.
[18]. Shonk, K., 2025, Charismatic Leadership: Weighing the Pros and Cons. Program on Negotiation at Harvard Law School
[19]. Shabhazi, H., and Korejan, M., 2016, An Analysis of the Transformational Leadership. Journal of Fundamental and Applied Sciences, 8(2), 452.
[20]. Bass, B. M., and Bass, R., 2008, The Bass Handbook of Leadership: Theory, Research, and Managerial Applications. New York: Free Press.
[21]. Rowe, W. G., and Guerrero, L., 2011, Cases in Leadership, Thousand Oaks: California: Sage.
[22]. Hassnain, A. M. U., 2023, Impact of Autocratic and Democratic Leadership Styles on Employees' Performance and Motivation. Journal of Administrative and Business Studies, 8(3).
[23]. Zahidi, S., 2024, Global Dender Gap 2024: Insight Report. World Economic Forum.
[24]. Lara, S., and Baird, M., 2024, The Impact of Changes in Labor Market Conditions on Women Hired into Leadership Roles. LinkedIn Economic Graph, 04.
[25]. Hupfer, S., Muzumder, S., and Crossan, G., 2022, Women in Tech are Cracking the Industry's Glass Ceiling, Achieving Double Digit Gains in Leadership Roles. Deloitte Insight.
[26]. Becker, G., 2020, 2020 Women in US Technology Leadershiop Report. Silicon Valley.
[27]. Creswell, J., and Creswell, J. D., 2018, In Research Design: Qualitative, Quantitative and Mixed Methods Approaches, 5th ed., 213 - 246.
[28]. Rashid, Y., Rashid, A., Waseem, A., Warraich M. A., and Sabir S. S., 2019, Case Study Method: A Step-by-Step Guide for Business Researchers. International Journal for Qualitative Methods. SAGE.
[29]. Halkias, D., Neubert, M., and Harkiolakis, N., 2023, Multiple Case Study Date Analysis for Doctoral Researchers in Managment and Leadership. Social Science Research Network.
[30]. Ikart, E. M., 2023, Emotional Intelliegence: Why It Matters in Change Leadership and Innovation in the 21st Century Style of Work. International Journal of Innovation.
[31]. Goleman, D., and Chemiss, C., 2024, Optimal - How to Sustain Personal and Organizational Excellence Every Day, Harper Collins.
[32]. Bekirogullari, Z., 2019, Employees Empowerment and Engagement in Attaining Personal and Organizational Goals. The European Journal of Social and Behavioral Sciences.
[33]. Dixon-Fyle, S., Dolan, K., Hunt, D. V., and Prince S., 2020, Diversity Wins: How Inclusion Matters. McKinsey & Company.
[34]. We are Tech Women, 2023, Why Women Leaders in Tech are Important.
[35]. Tabassum, N., and Nayak, B. S., 2021, Gender Stereotypes and Theor Impact on Women's Career Progressions from a Managerial Perspective. SAGE Journal, 10(2), 192 - 208.
[36]. Deborah, F.M., and Tomei M., 2022, Transforming Enterprises Through Diversity and Inclusion. International Labour Organization, Geneva.
[37]. Melnyk, J., 2023, We Need More Women in Tech Leadership - and This is How Companies Can Help. https://wearetechwomen.com/are-women-in-tech-under-more-pressure-to-show-up-at-work-2/
[38]. Awad, N., Hennessy, A., and Morse, C., K., 2021, Learning from Women Who've Made It to the Top in Tech. BCG.
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Harnessing Technology in Talent Acquisition: Opportunities, Challenges, and the Imperative for Ethical InnovationAuthor: Usha RudradatDOI: 10.21522/TIJAR.2014.13.01.Art024
Harnessing Technology in Talent Acquisition: Opportunities, Challenges, and the Imperative for Ethical Innovation
Abstract:
As technology continues to transform human resource (HR) functions, its role in talent acquisition has become increasingly critical. This paper explores how technology enhances recruitment by streamlining processes, increasing candidate reach, and reducing costs, while also addressing emerging challenges. Attracting Millennials, the largest and fastest-growing workforce segment, requires modern strategies such as personalized outreach, social media engagement, and a compelling Employee Value Proposition. Digital tools like video interviews, gamified assessments, and mobile-friendly platforms facilitate efficient screening and diverse candidate pools. Additionally, onboarding platforms integrate automation, socialization, and digital training, improving new hire experience and engagement. However, with these advancements comes the risk of algorithmic bias, which may reinforce pre-existing inequalities if not properly monitored. Studies show that algorithmic models can disadvantage certain groups, such as women or minorities, by relying on biased historical data. Case studies, including those involving Google job ads and judicial risk assessments, illustrate these concerns. To mitigate such risks, organizations are encouraged to audit algorithms and balance automated processes with human judgment. This paper concludes that while technology can revolutionize talent acquisition, it must be used responsibly. Leveraged correctly, it enables organizations to attract, assess, and retain top talent efficiently. However, companies must continuously evaluate these tools to ensure fairness, inclusivity, and alignment with organizational goals.
Harnessing Technology in Talent Acquisition: Opportunities, Challenges, and the Imperative for Ethical Innovation
References:
[1]. Angwin, J., Larson, J., Mattu, S., & Kirchner, L., 2016, Machine bias. ProPublica, https://www.propublica.org/article/machine-bias-risk-assessments-in-criminal-sentencing
[2]. Barocas, S., & Selbst, A. D., 2016, Big data's disparate impact. California Law Review, 104, 671–732, https://ssrn.com/abstract=2477899
[3]. Bersin, J., 2016, HR technology disruptions for 2017: Nine trends reinventing the HR software market. Deloitte, https://www2.deloitte.com/content/dam/Deloitte/us/Documents/human-capital/us-hc-disruptions.pdf
[4]. Breaugh, J., 2016, Talent acquisition: A guide to understanding and managing the recruitment process. The SHRM Foundation, https://www.shrm.org/hr-today/trends-and-forecasting/special-reports-and-expert-views/Documents/Talent-Acquisition-Recruitment.pdf
[5]. Cain Miller, C., 2015, When algorithms discriminate. The New York Times, https://www.nytimes.com/2015/07/10/upshot/when-algorithms-discriminate.html
[6]. Datta, A., Tschantz, M., & Datta, A., 2015, Automated experiments on ad privacy settings. Proceedings on Privacy Enhancing Technologies, 92–112, http://www.andrew.cmu.edu/user/danupam/dtd-pets15.pdf
[7]. Dumoulin, N., 2017, A leap of faith, a leap onto technology. Human Capital, 20(11), 42–44.
[8]. Emma, 2020, Measuring and Evaluating Recruitment Results. TalentVis, https://talentvis.com/en/news-and-insights/Measuring-and-Evaluating-Recruitment-Results%C2%A0
[9]. Ferrazzi, K., 2015, Technology can save onboarding from itself. Harvard Business Review Digital Articles, 2–5, Business Source Complete, Ipswich, MA.
[10]. Kopoulos, A., 2017, Employee onboarding best practices: A technology perspective. Alaska Business Monthly, 33(4), 70–71, Business Source Complete, Ipswich, MA.
[11]. Mann, G., & O'Neil, C., 2016, Hiring algorithms are not neutral. Harvard Business Review, https://hbr.org/2016/12/hiring-algorithms-are-not-neutral
[12]. Maurer, R., 2017, Machine learning can help HR overcome human failings. SHRM, https://www.shrm.org/resourcesandtools/hr-topics/talent-acquisition/pages/machine-learning-hr-human-failings.aspx
[13]. New-hire onboarding portals provide a warmer welcome, 2015, HR Magazine, December 2015/January 2016.
[14]. Phillips-Wren, G., Doran, R., & Merrill, K., 2016, Creating a value proposition with a social media strategy for talent acquisition. Journal of Decision Systems, https://doi.org/10.1080/12460125.2016.1187398
[15]. Pulakos, E., & Kantrowitz, T., 2017, Choosing effective talent assessments to strengthen your organization. SHRM.
[16]. Rickheim, M., 2011, Capturing the minds and hearts of millennials. Profiles in Diversity Journal, 13(6), 76.
[17]. Robb, D., 2015, New-hire onboarding portals provide a warmer welcome. HR Magazine, 60(10), 58–60, Business Source Complete, Ipswich, MA.
[18]. Roepe, L. R., 2017, Millenialize your workforce. HR Magazine, 62(3), 44–48.
[19]. Stephan, M., Brown, D., & Erickson, R., 2017, Talent acquisition: Enter the cognitive recruiter. Deloitte, https://dupress.deloitte.com/dup-us-en/focus/human-capital-trends/2017/predictive-hiring-talent-acquisition.html
[20]. Tandon, N., 2017, Re-energising HR and re-vitalising organisations. Willis Towers Watson, https://www.willistowerswatson.com/en/insights/2017/09/Re-energising-HR-andre-vitalising-organisations
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Digital Finance in Fragile Settings: Structural Predictors of Mobile Money Retention in North Kivu, Democratic Republic of CongoAuthor: Rodrigue KALUMENDODOI: 10.21522/TIJAR.2014.13.01.Art025
Digital Finance in Fragile Settings: Structural Predictors of Mobile Money Retention in North Kivu, Democratic Republic of Congo
Abstract:
This study investigated the factors influencing the continuous usage of mobile money services in the cities of Butembo and Beni, North Kivu (DRC), using a structural equation modelling approach via SmartPLS. The findings reveal that Trust, Subjective Norms, and Perceived Cost significantly affect users’ continued use of mobile money platforms, while Customer Experience and Perceived Quality do not show a direct effect. The results highlight Continuous Usage as a central mechanism that strongly predicts both Behavioural Intention and User Engagement, reinforcing its role as a critical bridge between initial perceptions and long-term behaviour. From a managerial standpoint, building trust, leveraging social influence, and reducing transaction costs are key strategies for increasing adoption and retention. Theoretically, the study confirms the relevance of trust- and norm-based models in digital finance usage within low-infrastructure contexts. The paper concludes with a call for future research to explore longitudinal patterns, qualitative dimensions of service perception, and contextual moderators such as digital literacy and income level.
Digital Finance in Fragile Settings: Structural Predictors of Mobile Money Retention in North Kivu, Democratic Republic of Congo
References:
[1]. Shaikh, A. A., Glavee-Geo, R., Karjaluoto, H., & Hinson, R. E., 2023, ‘Mobile money as a driver of digital financial inclusion’, Technol. Forecast. Soc. Change, vol. 186, p. 122158, Doi: 10.1016/j.techfore.2022.122158.
[2]. Kim, M., Zoo, H., Lee, H., & Kang, J., 2018, ‘Mobile financial services, financial inclusion, and development: A systematic review of academic literature’, Electron. J. Inf. Syst. Dev. Ctries., 84(5), p. e12044, Doi: 10.1002/isd2.12044.
[3]. Donovan, K., 2012, ‘Mobile Money for Financial Inclusion’, in Information and Communications for Development 2012, The World Bank, pp. 61–73. Doi: 10.1596/9780821389911_ch04.
[4]. Adelaja, A. O., Umeorah, S. C., Abikoye, B. E., & Nezianya, M. C., 2024, ‘Advancing financial inclusion through fintech: Solutions for unbanked and underbanked populations’, World J. Adv. Res. Rev., 23(2), pp. 427–438, Doi: 10.30574/wjarr.2024.23.2.2379.
[5]. Jack, W., & Suri, T., 2011, ‘Mobile Money: The Economics of M-PESA’, National Bureau of Economic Research, Cambridge, MA, w16721, Jan. 2011. Doi: 10.3386/w16721.
[6]. Demirgüç-Kunt, A., Klapper, L., Singer, D., & Ansar, S., 2022, The Global Findex Database 2021: Financial Inclusion, Digital Payments, and Resilience in the Age of COVID-19. The World Bank. Doi: 10.1596/978-1-4648-1897-4.
[7]. Jack, W., Ray, A., and Suri, T., 2013, ‘Transaction Networks: Evidence from Mobile Money in Kenya’, Am. Econ. Rev., 103(3), pp. 356–361, Doi: 10.1257/aer.103.3.356.
[8]. Kemp, S., 2024, ‘Digital 2024: The Democratic Republic of the Congo’, DataReportal – Global Digital Insights. Accessed: Dec. 01, 2024. [Online]. Available: https://datareportal.com/reports/digital-2024-democratic-republic-of-the-congo
[9]. Kemp, S., ‘Digital 2023: Global Overview Report — DataReportal – Global Digital Insights’. Accessed: Dec. 01, 2024. [Online]. Available: https://datareportal.com/reports/digital-2023-global-overview-report?utm_source=DataReportal&utm_medium=Country_Article_Hyperlink&utm_campaign=Digital_2023&utm_term=Democratic_Republic_Of_The_Congo&utm_content=Global_Overview_Link
[10]. Ngunza, K., 2024, ‘Democratic Republic of the Congo - United States Department of State:023 Investment Climate Statements: Democratic Republic of the Congo’, www.state.gov. Accessed: Dec. 01, 2024. [Online]. Available: https://www.state.gov/reports/2023-investment-climate-statements/democratic-republic-of-the-congo/
[11]. International Monetary Fund. African Dept.,2019, ‘Democratic Republic of the Congo: Selected Issues in: IMF Staff Country Reports Volume 2019 Issue 286 (2019)’. Accessed: Dec. 01, 2024. [Online]. Available: https://www.elibrary.imf.org/view/journals/002/2019/286/article-A004-en.xml
[12]. Kalumendo, R., Kapakazi, K., Kisumano, G. M., Bwambale, L., & Mitume, B., 2023, ‘Factors Influencing the Continuous Usage of Mobile Banking Services in Butembo, Democratic Republic of Congo’, TEXILA Int. J. Manag., 9(2), pp. 46–54, Doi: 10.21522/TIJMG.2015.09.02.Art005.
[13]. Kalumendo, R., 2023,‘The Benefits of Technological Developments on Businesses: A Survey Conducted among SMEs in Beni, Democratic Republic of Congo’, https://doi.org/10.21522/TIJAR.2014.SE.22.01.Art012
[14]. Kalumendo, R., 2022, ‘Barriers to SME Computerization in Developing Countries: Evidence from SMEs in North Kivu, Democratic Republic of Congo’, Texila Int. J. Manag., 8(2), pp. 163–169, Doi: 10.21522/TIJMG.2015.08.02.Art013.
[15]. Kalumendo, R., 2022, ‘Predictive Factors of IT Systems Adoption by SME Employees in Developing Countries: Evidence from SME Employees in North Kivu, DRC’, Texila Int. J. Acad. Res., 9(4), pp. 28–36, Doi: 10.21522/TIJAR.2014.09.04.Art003.
[16]. Ozili, P. K., 2018, ‘Impact of digital finance on financial inclusion and stability’, Borsa Istanb. Rev., 18(4), pp. 329–340, Doi: 10.1016/j.bir.2017.12.003.
[17]. Nelly Tochi Nwosu, and Oluwatosin Ilori, 2024, ‘Behavioral finance and financial inclusion: A conceptual review and framework development’, World J. Adv. Res. Rev., 22(3), pp. 204–212, Doi: 10.30574/wjarr.2024.22.3.1726.
[18]. World Bank, 2024, ‘Financial inclusion is a key enabler to reducing poverty and boosting prosperity’, World Bank. Accessed: Dec. 05, 2024. [Online]. Available: https://www.worldbank.org/en/topic/financialinclusion/overview
[19]. Bansal, S., 2014, ‘Perspective of Technology in Achieving Financial Inclusion in Rural India’, Procedia Econ. Finance, vol. 11, pp. 472–480, Doi: 10.1016/S2212-5671(14)00213-5.
[20]. Ozili, P. K., 2022, ‘Digital Financial Inclusion’, in Big Data: A Game Changer for Insurance Industry, K. Sood, R. K. Dhanaraj, B. Balusamy, S. Grima, and R. Uma Maheshwari, Eds, Emerald Publishing Limited, pp. 229–238. Doi: 10.1108/978-1-80262-605-620221015.
[21]. Ahmad, A. H., Green, C. J., Jiang, F., & Murinde, V., 2023, ‘Mobile money, ICT, financial inclusion and growth: How different is Africa?’, Econ. Model., vol. 121, p. 106220, Doi: 10.1016/j.econmod.2023.106220.
[22]. Avom, D., Bangaké, C., and Ndoya, H., 2023, ‘Do financial innovations improve financial inclusion? Evidence from mobile money adoption in Africa’, Technol. Forecast. Soc. Change, vol. 190, p. 122451, Doi: 10.1016/j.techfore.2023.122451.
[23]. Warsame, M. H., and Abdalla, Y. A., 2024, ‘Impact of mobile financial services on financial inclusion: empirical insights from Kenya’, Int. Rev. Econ., vol. 71, no. 3, pp. 633–666, Doi: 10.1007/s12232-024-00456-9.
[24]. Lu, B., Wang, Z., and Zhang, S., 2021, ‘Platform-based mechanisms, institutional trust, and continuous use intention: The moderating role of perceived effectiveness of sharing economy institutional mechanisms’, Inf. Manage., 58(7), p. 103504, Doi: 10.1016/j.im.2021.103504.
[25]. Mcknight, D. H., Carter, M., Thatcher, J. B., and Clay, P. F., 2011, ‘Trust in a specific technology: An investigation of its components and measures’, ACM Trans. Manag. Inf. Syst., 2(2), pp. 1–25, Doi: 10.1145/1985347.1985353.
[26]. Arora, P., and Banerji, R., 2024, ‘The impact of digital banking service quality on customer loyalty: An interplay between customer experience and customer satisfaction’, Asian Econ. Financ. Rev., 14(9), pp. 712–733, Doi: 10.55493/5002.v14i9.5199.
[27]. Phan Tan, L., & Le, T. H., 2024, ‘The Influence of Perceived Price and Quality of Delivery on Online Repeat Purchase Intention: The Evidence from Vietnamese Purchasers’, Cogent Bus. Manag.,10(1), p. 2173838, Doi: 10.1080/23311975.2023.2173838.
[28]. Dodds, W. B., Monroe, K. B., and Grewal, D., 1991, ‘Effects of Price, Brand, and Store Information on Buyers’ Product Evaluations’, J. Mark. Res., 28(3), pp. 307–319, Doi: 10.1177/002224379102800305.
[29]. DeLone, W. H., & McLean, E. R., 2003, Model of Information Systems Success: A Ten-Year Update’, J. Manag. Inf. Syst., vol. 19, no. 4, pp. 9–30, doi: 10.1080/07421222.2003.11045748.
[30]. Song, Y., Gui, L., Wang, H., and Yang, Y., 2023, ‘Determinants of Continuous Usage Intention in Community Group Buying Platform in China: Based on the Information System Success Model and the Expanded Technology Acceptance Model’, Behav. Sci., 13(11), p. 941, Doi: 10.3390/bs13110941.
[31]. Bhattacherjee, A., 2001, ‘Understanding Information Systems Continuance: An Expectation-Confirmation Model’, MIS Q., vol. 25, no. 3, p. 351, Doi: 10.2307/3250921.
[32]. O’Brien, H. L., and Toms, E. G., 2008, ‘What is user engagement? A conceptual framework for defining user engagement with technology’, J. Am. Soc. Inf. Sci. Technol., 59(6), pp. 938–955, Doi: 10.1002/asi.20801.
[33]. Venkatesh, V., Thong, J. Y., & Xu, X., 2012, ‘Consumer Acceptance and Use of Information Technology: Extending the Unified Theory of Acceptance and Use of Technology’, MIS Q., 36(1), p. 157, Doi: 10.2307/41410412.
[34]. Davis, F. D., 1989, ‘Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology’, MIS Q., 13(3), p. 319, Doi: 10.2307/249008.
[35]. Hair, J. F., Hult, G. T. M., Ringle, C. M., and Sarstedt, M., 2017, A primer on partial least squares structural equation modeling (PLS-SEM), Second edition. Los Angeles London New Delhi Singapore Washington DC Melbourne: SAGE.
[36]. Hair, J. F., lliam Black, Babin, B. J., and Anderson, R. E., 2010, Eds, Multivariate data analysis: a global perspective, 7. ed., Global ed. Upper Saddle River, NJ Munich: Pearson.
[37]. F. Hair Jr, J., Sarstedt, M., Hopkins, L., & G. Kuppelwieser, V.,2014, ‘Partial least squares structural equation modeling (PLS-SEM): An emerging tool in business research’, Eur. Bus. Rev., 26(2), pp. 106–121, Doi: 10.1108/EBR-10-2013-0128.
[38]. Preacher, K. J., and Hayes, A. F., 2008, ‘Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models’, Behav. Res. Methods, 40(3), pp. 879–891, Doi: 10.3758/BRM.40.3.879.
[39]. Hair, J. F., Ringle, C. M., Gudergan, S. P., Fischer, A., Nitzl, C., and Menictas, C., 2018, ‘Partial least squares structural equation modeling-based discrete choice modeling: an illustration in modeling retailer choice’, Bus. Res., 12(1), pp. 115–142, doi: 10.1007/s40685-018-0072-4.
[40]. Taber, K. S., 2018, ‘The Use of Cronbach’s Alpha When Developing and Reporting Research Instruments in Science Education’, Res. Sci. Educ., 48(6), pp. 1273–1296,, Doi: 10.1007/s11165-016-9602-2.
[41]. Fornell, C., and Larcker, D. F., 1981, ‘Evaluating Structural Equation Models with Unobservable Variables and Measurement Error’, J. Mark. Res.,18(1), p. 39, Doi: 10.2307/3151312.
[42]. Chin, W. W., 1988, ‘The Partial Least Squares Approach to Structural Equation Modeling’, in Modern Methods for Business Research, New York: Psychology Press, 1988. Doi: 10.4324/9781410604385.
[43]. Cohen, J., 2009, Statistical power analysis for the behavioral sciences, 2. ed., Reprint. New York, NY: Psychology Press.
[44]. Sharma, P. N., Shmueli, G., Sarstedt, M., Danks, N., and Ray, S., 2021, ‘Prediction‐Oriented Model Selection in Partial Least Squares Path Modeling’, Decis. Sci.,52(3), pp. 567–607, Doi: 10.1111/deci.12329.
[45]. Mcknight, D. H., Carter, M., Thatcher, J. B., and Clay, P. F., 2011, ‘Trust in a specific technology: An investigation of its components and measures’, ACM Trans. Manag. Inf. Syst.,2(2), pp. 1–25, Doi: 10.1145/1985347.1985353.
[46]. Lu, Y., Yang, S., Chau, P. Y. K., and Cao, Y., 2011, ‘Dynamics between the trust transfer process and intention to use mobile payment services: A cross-environment perspective’, Inf. Manage., 48(8), pp. 393–403, Doi: 10.1016/j.im.2011.09.006.
[47]. Dodds, W. B., Monroe, K. B., and Grewal, D., 1981, ‘Effects of Price, Brand, and Store Information on Buyers’ Product Evaluations’, J. Mark. Res., 28(3), p. 307, Doi: 10.2307/3172866.
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Hybrid Strategic Leadership: Integrating Spiritual and Market Logics for Sustained Success in Megachurches: A Systematic Literature ReviewAuthor: Oscar MumbaDOI: 10.21522/TIJAR.2014.13.01.Art026
Hybrid Strategic Leadership: Integrating Spiritual and Market Logics for Sustained Success in Megachurches: A Systematic Literature Review
Abstract:
Megachurches, acting as highly visible, resource-intensive Faith-Based Organizations (FBOs), inherently operate under a profound institutional contradiction: the tension between their core, non-commercial spiritual mandate (Spiritual Logic) and the massive operational, administrative, and financial demands characteristic of any large-scale enterprise (Market Logic). When this internal conflict is poorly managed, organizational instability or mission failure frequently follows. An exhaustive review of the extant academic literature reveals a critical theoretical vacuum: the absence of a unified, dedicated leadership model specifically engineered to navigate the unique complexity and intense public scrutiny faced by these large-scale hybrid religious institutions. To overcome this theoretical limitation, this study utilizes a rigorous Systematic Literature Review (SLR) methodology. This process comprehensively maps and synthesizes existing theoretical and empirical research on institutional logics and strategic management within the megachurch ecosystem. The robust evidence synthesized dictates the necessity of the Hybrid Strategic Leadership (HSL) model as the essential executive capability for achieving sustained organizational success. HSL is defined as the dynamic strategic capacity required to both intentionally decouple and synergistically blend spiritual functions (e.g., mission clarity and pastoral care) with market imperatives (e.g., efficiency, professionalization, and growth). The resultant HSL framework offers a crucial, actionable strategic blueprint for senior megachurch leaders, securing both long-term spiritual authenticity and material operational vitality.
Hybrid Strategic Leadership: Integrating Spiritual and Market Logics for Sustained Success in Megachurches: A Systematic Literature Review
References:
[1]. Besharov, M. L., & Smith, W. K., 2014. The paradox of embeddedness: A dialectic of meaning, management, and markets. Organization Science, 25(2), 380–398.
[2]. D'Aunno, T., Sutton, R. I., Price, R. H., 2000, The professional construction of organizational change: A dialectical analysis. Administrative Science Quarterly, 45(4), 844–876.
[3]. Allen, P., 2015, Authentic spiritual leadership: The mega church corporate model of the new millennium. Author House.
[4]. Andrews, S. M., 2023, Strategic leadership, change, and growth in not-for-profit, membership-based, value-driven organizations. Journal of Organizational Change Management, 46(6), N/A.
[5]. Bianchi, M., Roy, M. J., & Teasdale, S. (2022). Towards a multi-level understanding of the edited strategies employed in managing hybridity: A systematic review. Sustainability, 15(1), 177.
[6]. Browning, D., 2010, Hybrid Church: The Fusion of Intimacy and Impact. John Wiley & Sons.
[7]. Burton, O., Brister, J., 2012, Organizational hybridization: A business model to integrate best practices of for-profit and non-profit organizations. Journal of Biblical Integration in Business, 15(1), N/A.
[8]. Chaves, M., 2017, American Religion: Contemporary Trends. Princeton University Press.
[9]. Chen, L., et al., 2019, Bifocal leadership: Navigating dual missions in hybrid organizations. Academy of Management Journal, 62(4), 1001-1025.
[10]. Grassl, W., 2011, Hybrid forms of business: The logic of gift in the commercial world. Journal of Business Ethics, 100(Suppl 1), 109-123.
[11]. Gronn, P., 2011, Hybrid configurations of leadership. In: A. Bryman, D. Collinson, K. Grint, B. Jackson, M. Uhl-Bien (Eds.), The Sage handbook of leadership, 437-454. SAGE.
[12]. Hestad, D., Tàbara, J. D., Thornton, T. F., 2021, The three logics of sustainability-oriented hybrid organisations: A multi-disciplinary review. Sustainability Science, 16(2), 647-661.
[13]. Johnson, A. B., 2020, Mission drift and fiscal health: A study of faith-based organizations. Journal of Religious Management, 45(2), 112-135.
[14]. Meyer, J. W., & Rowan, B., 1977, Institutionalized organizations: Formal structure as myth and ceremony. American Journal of Sociology, 83(2), 340-363.
[15]. DiMaggio, P. J., & Powell, W. W., 1983, The iron cage revisited: Institutional isomorphism and collective rationality in organizational fields. American Sociological Review, 48(2), 147-160.
[16]. Oyo, C., Musinguzi, D., & Owino, P., 2025. Contract-covenant governance model: A theoretical framework for integrated faith-based institutional governance in Catholic organizations. East African Scholars Multidisciplinary Bulletin, 8(04), 69–82.
[17]. Pache, A. C., Santos, F., 2013, Inside the hybrid organization: Selective coupling as a response to competing institutional logics. Academy of Management Journal, 56(4), 972-1001.
[18]. Pruisken, I., Coronel, J., 2014, Megachurches: Managerization in the Religious Field? In: W. Faulstich (Ed.), Religion im Wandel: Die Renaissance des Religiösen in der Gesellschaft, 53–79. Springer VS.
[19]. Hannan, M. T., & Freeman, J., 1977, The population ecology of organizations. American Journal of Sociology, 82(5), 929-964.
[20]. Smith, J., 2018, The paradox of the sacred and the secular: Institutional logics in non-profit management. Non-Profit Quarterly, 25(1), 45-58.
[21]. Smith, S. R., 2010, Hybridization and nonprofit organizations: The governance challenge. Policy and Society, 29(3), 219-229.
[22]. Thornton, P. H., & Ocasio, W., 1999, Institutional logics and the historical contingency of power in organizations: The emergence of the early retirement program at General Motors, 1974-1994. American Journal of Sociology, 105(3), 801-843.
[23]. Tagirov, M. R., 2025, Ways to balance spiritual values and economic efficiency. Economics and Management: Problems, Solutions, 5(13), 14–21.
[24]. Greenwood, R., & Oliver, C., 1991, Organizational effectiveness and human services sector: An application of the population ecology model. Administrative Science Quarterly, 36(2), 273-299.
[25]. Yi, P. T. T., 2023, Faith-based investing, stewardship, and sustainability: A comparative analysis. Erasmus Law Review, 16, 114.
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A Comparative Analysis of Use of Machine Learning Algorithms for Customer Churn Prediction at Supermarkets in Lagos NigeriaAuthor: Temiye OluwaseunDOI: 10.21522/TIJAR.2014.13.01.Art027
A Comparative Analysis of Use of Machine Learning Algorithms for Customer Churn Prediction at Supermarkets in Lagos Nigeria
Abstract:
The retail industry needs customer churn prediction to create successful customer retention strategies. The identification of churn customers in Nigerian supermarkets relies on conventional manual survey methods which take up time and generate limited predictive results. The research investigated customer behavior through transaction data analysis to predict churn while identifying the most effective supervised machine learning models for customer churn risk assessment. The study used transaction data from multiple supermarkets based in Lagos, Nigerian. Retrospective data from Plenty Africa, a digital loyalty platform, was used for this comparative analysis. The research employed predictive modeling methods to study customer characteristics and shopping patterns which helped detect patterns that lead to customer loss. The model performance was evaluated through conventional assessment metrics which led to a comparison for determining which approach performed better. The research showed that machine learning methods succeed in predicting customer departure through supermarket data collection which enables businesses to develop effective customer retention strategies. The research also shows how supermarkets can enhance their operational performance by using data-driven churn prediction systems which generate better results than human-based methods in retail operations.
A Comparative Analysis of Use of Machine Learning Algorithms for Customer Churn Prediction at Supermarkets in Lagos Nigeria
References:
[1]. Hadden, J., Tiwari, A., Roy, R., & Ruta, D., 2007, Computer-assisted customer churn management: State-of-the-art and future trends. Computers & Operations Research, 34(10), 2902–2917.
[2]. Kim, H. S., & Yoon, C. H., 2004, Determinants of subscriber churn and customer loyalty in the Korean mobile telephony market. Telecommunications Policy, 28(9–10), 751–765.
[3]. Verbeke, W., Dejaeger, K., Martens, D., Hur, J., & Baesens, B., 2012, New insights into churn prediction in the telecommunication sector: A profit-driven data mining approach. European Journal of Operational Research, 218(1), 211–229. https://doi.org/10.1016/j.ejor.2011.09.031
[4]. Huang, Y., & Kechadi, T., 2013, An effective hybrid learning system for telecommunication churn prediction. Expert Systems with Applications, 40(14), 5635–5647.
[5]. Jian, C., Gao, J., & Ao, Y., 2016, A new sampling method for classifying imbalanced data based on support vector machine ensemble. Neurocomputing, 193, 115–122.
[6]. Pendharkar, P., 2009, Misclassification cost-minimizing fitness functions for genetic algorithm-based artificial neural network classifiers. Journal of the Operational Research Society, 60(8), 1123–1134.
[7]. Chawla, V., Lyngdoh, T., Guda, S., & Purani, K., 2020, Systematic review of determinants of sales performance: Verbeke et al.’s 2011 classification extended. Journal of Business & Industrial Marketing, 35(8), 1359–1383.
[8]. Dölarslan, E. S., 2014, Assessing the effects of satisfaction and value on customer loyalty behaviors in service environments: High-speed railway in Turkey as a case study. Management Research Review, 37(8), 706–727.
[9]. Gómez, B., Arranz, A., & Cillán, J., 2006, The role of loyalty programs in behavioral and affective loyalty. Journal of Consumer Marketing, 23(7), 387–396.
[10]. Hofman-Kohlmeyer, M., 2016, Customer loyalty programs as a tool of customer retention: A literature review. In CBU International Conference Proceedings (Vol. 4, p. 199).
[11]. Meyer-Waarden, L., 2008, The influence of loyalty programme membership on customer purchase behavior. European Journal of Marketing, 42(1/2), 87–114.
[12]. Sucki, O., 2019, Predicting customer churn with machine learning methods: Case study of private insurance customer data (Master’s thesis). Lappeenranta–Lahti University of Technology.
[13]. Chen, K., Hu, Y. H., & Hsieh, Y. C., 2015, Predicting customer churn from valuable B2B customers in the logistic industry: A case study. Information Systems and E-Business Management, 13(3), 475–494.
[14]. Voulodimos, A., Doulamis, N., Doulamis, A., & Protopapadakis, E., 2018, Deep learning for computer vision: A brief review. Computational Intelligence and Neuroscience, 2018, Article 7068349.
[15]. Grossi, E., & Buscema, M., 2007, Introduction to artificial neural networks. European Journal of Gastroenterology & Hepatology, 19(12), 1046–1054.
[16]. Jhaveri, S., Khedkar, I., Kantharia, Y., & Jaswal, S., 2019, Success prediction using random forest, CatBoost, XGBoost, and AdaBoost for Kickstarter campaigns. In Proceedings of the 3rd International Conference on Computing Methodologies and Communication (ICCMC 2019) (pp. 1170–1173).
[17]. Coussement, K., & Van den Poel, D., 2008, Improving customer attrition prediction by integrating emotions from client/company interaction emails and evaluating multiple classifiers. Expert Systems with Applications, 36(3), 6127–6134.
[18]. Freed, M., & Lee, J., 2015, Krylov iterative methods for support vector machines to classify galaxy morphologies. Journal of Data Analysis and Information Processing, 3(3), 72–86.
[19]. Singh, H., & Samalia, H. V., 2014, A business intelligence perspective for churn management. Procedia – Social and Behavioral Sciences, 109, 51–56.
[20]. Dingli, A., Marmara, V., & Fournier, N. S., 2017, Comparison of deep learning algorithms to predict customer churn within a local retail industry. International Journal of Machine Learning and Computing, 7(5), 128–132.
[21]. Anjum, A., Usman, S., Zeb, A., Afridi, I., Shah, P. M., Anwar, Z., Raza, B., Malik, A., & Malik, S., 2017, Optimizing coverage of churn prediction in the telecommunication industry. International Journal of Advanced Computer Science and Applications, 8(6), 145–153.
[22]. Xiahou, X., & Harada, Y., 2022, B2C e-commerce customer churn prediction based on K-means and support vector machine. Theoretical and Applied Electronic Commerce Research, 17(2), 458–475.
[23]. Amatare, S. A., & Ojo, A. K., 2020, Predicting customer churn in the telecommunication industry using convolutional neural network model. IOSR Journal of Computer Engineering, 22(3), 1–7.
[24]. Seymen, O. F., Dogan, O., & Hiziroglu, A., 2021, Customer churn prediction using deep learning. In Advances in Intelligent Systems and Computing (Vol. 1383, pp. 520–529).
[25]. Martínez, A., Schmuck, C., Pereverzyev, S., Pirker, C., & Haltmeier, M., 2020, A machine learning framework for customer purchase prediction in the non-contractual setting. European Journal of Operational Research, 281(3), 588–596.
[26]. Sabbeh, S. F., 2018, Machine-learning techniques for customer retention: A comparative study. International Journal of Advanced Computer Science and Applications, 9(2), 273–281.
[27]. Bentejac, C., Csörgő, A., & Martínez-Muñoz, G., 2019, A comparative analysis of XGBoost. Artificial Intelligence Review, 52(2), 1937–1967.
[28]. Lai, S. B. S., Shahri, N. H. N. B. M., Mohamad, M. B., Rahman, H. A. B. A., & Rambli, A. B., 2021, Comparing the performance of AdaBoost, XGBoost, and logistic regression for imbalanced data. Mathematics and Statistics, 9(3), 379–385. https://doi.org/10.13189/ms.2021.090320
[29]. Tsai, C. F., & Lu, Y. H., 2009, Customer churn prediction by hybrid neural networks. Expert Systems with Applications, 36(10), 12547–12553.
[30]. Cenggoro, T. W., Wirastari, R. A., Rudianto, E., Mohadi, M. I., Ratj, D., & Pardamean, B., 2021, Deep learning as a vector embedding model for customer churn. Procedia Computer Science, 179, 624–631.
[31]. Kiangala, S. K., & Wang, Z., 2021, An effective adaptive customization framework for small manufacturing plants using extreme gradient boosting and random forest ensemble learning algorithms in an Industry 4.0 environment. Machine Learning with Applications, 4, 100024.
[32]. Xiahou, X., & Harada, Y., 2022, Customer churn prediction using AdaBoost classifier and BP neural network techniques in the e-commerce industry. American Journal of Industrial and Business Management, 12(3), 277–293.
[33]. Fang, K., Jiang, Y., & Song, M., 2016, Customer profitability forecasting using big data analytics: A case study of the insurance industry. Computers & Industrial Engineering, 101, 554–564.
[34]. Raosoft, Inc. 2004, Sample size calculator. http://www.raosoft.com/samplesize.html
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Vascular Access for Hemodialysis in Sub-Saharan Africa: Patterns, Complications, and Gaps in Evidence – A Narrative ReviewAuthor: Kabongo LDOI: 10.21522/TIJAR.2014.13.01.Art028
Vascular Access for Hemodialysis in Sub-Saharan Africa: Patterns, Complications, and Gaps in Evidence – A Narrative Review
Abstract:
Vascular access is a critical determinant of outcomes in hemodialysis, with arteriovenous fistulas (AVFs) offering superior patency and lower complication rates compared with arteriovenous grafts (AVGs) and central venous catheters (CVCs). Despite strong international recommendations favoring AVFs, catheter dependence remains disproportionately high in sub-Saharan Africa. This narrative review synthesizes current evidence on patterns of vascular access use, associated complications, and management strategies in sub-Saharan Africa, with a focus on identifying gaps relevant to low- and middle-income settings. A narrative review of published literature was conducted, focusing on epidemiology, patient outcomes, complication profiles, and access management strategies related to hemodialysis vascular access globally and within sub-Saharan Africa. Available evidence demonstrates marked regional disparities in vascular access utilization. While high-income countries report increasing AVF prevalence, most African dialysis centers remain heavily reliant on catheters, largely due to late nephrology referral, limited surgical capacity, and health system constraints. Catheter use is consistently associated with higher rates of infection, thrombosis, hospitalization, and mortality. Data on AVF maturation, patency, and long-term outcomes in Africa remain sparse, and reported complication rates appear higher than in high-income settings. There is a substantial evidence gap regarding vascular access outcomes in sub-Saharan Africa. Context-specific data are urgently needed to guide policy, improve access planning, and reduce catheter dependence. This review underscores the importance of regionally grounded research to inform quality improvement and align practice with global standards.
Vascular Access for Hemodialysis in Sub-Saharan Africa: Patterns, Complications, and Gaps in Evidence – A Narrative Review
References:
[1]. Packer, D., & Kaufman, J. S., 2020, Catheter First: The Reality of Incident Hemodialysis Patients in the United States. Kidney medicine, 2(3), 242–244. https://doi.org/10.1016/j.xkme.2020.04.004
[2]. Ghimire, Anukul, & Tennankore, Karthik, & Vitale, George, 2024, Unused Hemodialysis Acid Concentrate is Dollars and Dialysate Down the Drain: An Opinion Piece. Canadian Journal of Kidney Health and Disease. 11. 10.1177/20543581241308631.
[3]. Grant, E., Johnson, L., Prodromidis, A., & Giannoudis, P. V., 2021, The Impact of Peer Support on Patient Outcomes in Adults With Physical Health Conditions: A Scoping Review. Cureus, 13(8), e17442. https://doi.org/10.7759/cureus.17442
[4]. Atilola, O., 2015, Mental health service utilization in sub-Saharan Africa: is public mental health literacy the problem? Setting the perspectives right. Global Health Promotion. 23(2):30-37. doi:10.1177/1757975914567179
[5]. Zainol, Zuraidah, & Osman, Juliana, & Upsi, Rosmini, 2019, The Effect of Financial Knowledge and Financial Attitudes on Financial Behavior among University Students. International Journal of Academic Research in Business and Social Sciences. 9. 10.6007/IJARBSS/v9-i8/6205.
[6]. Ravani, P., Palmer, S. C., Oliver, M. J., Quinn, R. R., MacRae, J. M., Tai, D. J., Pannu, N. I., Thomas, C., Hemmelgarn, B. R., Craig, J. C., Manns, B., Tonelli, M., Strippoli, G. F., & James, M. T., 2013, Associations between hemodialysis access type and clinical outcomes: a systematic review. Journal of the American Society of Nephrology: JASN, 24(3), 465–473. https://doi.org/10.1681/ASN.2012070643
[7]. Venegas-Ramírez, J., Hernández-Fuentes, G. A., Palomares, C. S., Diaz-Martinez, J., Navarro-Cuellar, J. I., Calvo-Soto, P., Duran, C., Tapia-Vargas, R., Espíritu-Mojarro, A. C., Figueroa-Gutiérrez, A., Guzmán-Esquivel, J., Antonio-Flores, D., Meza-Robles, C., & Delgado-Enciso, I., 2025, Vascular Access Type and Survival Outcomes in Hemodialysis Patients: A Seven-Year Cohort Study. Medicina (Kaunas, Lithuania), 61(4), 584. https://doi.org/10.3390/medicina61040584
[8]. Allon, M., 2019, Quantification of Complications of Tunneled Hemodialysis Catheters. American journal of kidney diseases : the official journal of the National Kidney Foundation, 73(4), 462–464. https://doi.org/10.1053/j.ajkd.2018.12.032
[9]. Siqueira, J. F., Jr, & Rôças, I. N., 2022, Present status and future directions: Microbiology of endodontic infections. International endodontic journal, 55 Suppl 3, 512–530. https://doi.org/10.1111/iej.13677
[10]. Stanifer, J. W., Jing, B., Tolan, S., Helmke, N., Mukerjee, R., Naicker, S., & Patel, U. D., 2014. The epidemiology of chronic kidney disease in sub-Saharan Africa: A systematic review and meta-analysis. The Lancet Global Health, 2(3), e174–e181. https://doi.org/10.1016/S2214-109X(14)70002-6
[11]. Chan, M., Mok, C., & Hawley, C., 2025, The epidemiology of haemodialysis catheter infections in Australia. The Medical Journal of Australia, 223(5), 231-236. www.mja.com.au.
[12]. Pisoni, R. L., Zepel, L., Port, F. K., & Robinson, B. M., 2015, Trends in US Vascular Access Use, Patient Preferences, and Related Practices: An Update From the US DOPPS Practice Monitor With International Comparisons. American journal of kidney diseases : the official journal of the National Kidney Foundation, 65(6), 905–915. https://doi.org/10.1053/j.ajkd.2014.12.014
[13]. Laura, A., Diaz-Martinez, Ginger, R., Fisher, David Esparza, Jay, M., Bhatt, Christina, E., D’Arcy, Jennifer Apodaca, Sara Brownell, Lisa Corwin, William, B., Davis, Kevin, W., Floyd, Patrick, J., Killion, Jaclyn Madden, Patricia Marsteller, Teresa Mayfield-Meyer, Kelly, K., McDonald, Martina Rosenberg, Mark, A., Yarborough, & Jeffrey, T. O., 2019, Recommendations for Effective Integration of Ethics and Responsible Conduct of Research (E/RCR) Education into Course-Based Undergraduate Research Experiences: A Meeting Report, CBE—Life Sciences Education, 18:2
[14]. Maguire, N., O'Donnell, M., & O'Kelly, P., 2022, Differential impact of central venous catheters versus arteriovenous fistulae on quality of life among Irish haemodialysis patients. Journal of Vascular Access.
[15]. Maduell, Francisco & Ojeda, Raquel & Arias, Mart & Rossi, Florencia & Fontseré, Néstor & Vera, Manel & Rico, Naira & Gonzalez, Leonardo & Piñeiro, Gastón & Jimenez Hernandez, Mario & Rodas, Lida & Bedini, Jose, 2016, Eight-Year Experience with Nocturnal, Every-Other-Day, Online Haemodiafiltration. Nephron. 133. 10.1159/000446970.
[16]. Roy-Chaudhury, P., Lee, T. C., & Munda, R., 2013, Predicting dialysis vascular access blood flow and diameter: too much, too little, or just right. Kidney international, 84(6), 1076–1078. https://doi.org/10.1038/ki.2013.307
[17]. Dember, L. M., Beck, G. J., Allon, M., Arnold, H., Delmez, J. A., Dixon, B. S., Greenberg, A., Hammes, M., Larive, B., Newman, L., Trerotola, S., Wong, V., Bian, K., Bridgewater, B., Canaud, B., Feldman, H., Greene, T., Ikizler, T. A., Levin, N., … Rocco, M. V., 2004, Effect of angioplasty and stenting on primary patency of arteriovenous fistulas for hemodialysis: A randomized trial. JAMA, 292(1), 30–39.
[18]. Moist, L. M., Allon M.,Trerotola J. F., Brouwer M., Daly P. O., Dellagiustina J. K., Dember J. E., Astor B. C., & Glickman M. H., 2006, Risk equation determining unsuccessful cannulation events and nonfunctional fistulae at initiation of dialysis. Journal of the American Society of Nephrology 17, no. 11: 3204-3210.
[19]. Sanders, M. S., Wrobleski, S. K., Cheema, F., & Allon, M., 2014, Surgical management of dialysis access-associated steal syndrome. Journal of Vascular Surgery, 60(6), 1598-1603; discussion 1603-1604. doi.org
[20]. Tessitore, L., & Bedogna, V., 2017, A prospective 1-year study of a monitoring protocol for detecting vascular access dysfunction. Nephrology Dialysis Transplantation, 32(suppl_2), ii139–ii139.
[21]. Yahav, D., Paul, M., Guyatt, G., Leibovici, L., & Gafter-Gvili, A., 2019, Seven Versus 14 Days of Antibiotic Therapy for Uncomplicated Gram-negative Bacteremia: A Noninferiority Randomized Controlled Trial. Clinical Infectious Diseases, 69(10), 1691–1698. doi.org
[22]. Weijmer, M. C., Vervloet, M. G., & ter Wee, P. M., 2004, Compared to tunnelled cuffed haemodialysis catheters, temporary untunnelled catheters are associated with more complications already within 2 weeks of use. Nephrology Dialysis Transplantation, 19(3), 670–677. https://doi.org/10.1093/ndt/gfg581
[23]. Lok, C. E., Huber, T. S., Lee, T., Shenoy, S., Yevzlin, A. S., Abreo, K., Allon, M., Asif, A., Astor, B. C., Glickman, M. H., Graham, J., Moist, L. M., Rajan, D. K., Roberts, C., Vachharajani, T. J., Valentini, R. P., & National Kidney Foundation 2020, KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. American journal of kidney diseases : the official journal of the National Kidney Foundation, 75(4 Suppl 2), S1–S164. https://doi.org/10.1053/j.ajkd.2019.12.001
[24]. Almasri, J., Alsawas, M., Mainou, M., Mustafa, R. A., Wang, Z., Woo, K., Cull, D. L., & Murad, M. H., 2016, Outcomes of vascular access for hemodialysis: A systematic review and meta-analysis. Journal of vascular surgery, 64(1), 236–243. https://doi.org/10.1016/j.jvs.2016.01.053
[25]. Schmidli, J., Widmer, M. K., Basile, C., de Donato, G., Gallieni, M., Gibbons, C. P., Haage, P., Hamilton, G., Hedin, U., Kamper, L., Lazarides, M. K., Lindsey, B., Mestres, G., Pegoraro, M., Roy, J., Setacci, C., Shemesh, D., Tordoir, J. H. M., van Loon, M., Esvs Guidelines Committee, … Roca-Tey, R., 2018, Editor's Choice - Vascular Access: 2018 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 55(6), 757–818. https://doi.org/10.1016/j.ejvs.2018.02.001
[26]. Baharani, J., Vincent, L., & Vachharajani, T. J., 2023, Long-Term Dialysis Vascular Access in East Africa: Unique Challenges and Novel Solutions. Kidney 360, 4(8), 1143-1146. https://doi.org/10.34067/KID.0000000000000211.
[27]. Bamgboye,E. L., 2016, Hemodialysis: Management problems in developing countries, withNigeriaasasurrogate. KidneyInternationalSupplements. 6(2),92–95. https://doi.org/10.1016/j.kisu.2016.01.009
[28]. Allon, M., 2019, Quantification of Complications of Tunneled Hemodialysis Catheters. American journal of kidney diseases : the official journal of the National Kidney Foundation, 73(4), 462–464. https://doi.org/10.1053/j.ajkd.2018.12.032
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Challenges Associated with Implementation of Solar Energy in GhanaAuthor: Abdul Samad IssahaqueDOI: 10.21522/TIJAR.2014.13.01.Art029
Challenges Associated with Implementation of Solar Energy in Ghana
Abstract:
This study investigates the challenges hindering the adoption of solar energy in Ghana, with the aim of improving understanding of the barriers to sustainable solar energy use. Most research in this area has concentrated primarily on economic, technical, and environmental factors, neglecting the sociocultural and psychological dimensions influencing solar energy adoption. This study therefore aims to bridge this knowledge gap by examining the cultural, psychological, and behavioral challenges affecting solar energy implementation in Ghana. The study adopted a cross-sectional research design which enabled the study to provide valuable insights into the prevailing issues influencing solar energy implementation across selected cities including Accra which is the capital city of Ghana. A stratified random sampling technique and a purposive sampling technique was used to select the desired sample size of 200. Descriptive statistics such as mean, median, standard deviation, and frequency distributions were used to summarize the data. The analysis also used Statistical Package for the Social Sciences (SPSS) due to its robust statistical and visualization capabilities. The findings reveal that although the initial cost of solar installations poses a significant obstacle, long-term benefits such as lower electricity expenses and positive environmental impacts are widely recognised. The research highlights a strong link between public perception and the willingness to adopt solar energy. Favorable attitudes and greater awareness correspond to higher adoption rates, while negative perceptions discourage uptake. This demonstrates the crucial role of public education and perception management in promoting solar energy integration. Key challenges identified include high upfront costs, limited information, technological difficulties, insufficient government support, cultural resistance, and inconsistent energy supply. Addressing these barriers requires comprehensive strategies that incorporate financial incentives (such as subsidies and tax reductions), awareness campaigns, enhanced government involvement, infrastructure improvements, and community engagement initiatives. Overall, the study underscores that improving public awareness and perception, alongside targeted policy measures, can create an enabling environment for widespread solar energy adoption. These insights offer valuable guidance for policymakers and researchers aiming to advance renewable energy development in Ghana and beyond.
Challenges Associated with Implementation of Solar Energy in Ghana
References:
[1]. Ibrahim, I. D., Hamam, Y., Alayli, Y., et al., 2021, A Review on Africa Energy Supply through Renewable Energy Production: Nigeria, Cameroon, Ghana and South Africa as a Case Study. Energy Strategy Reviews, 38, Article ID: 100740. https://doi.org/10.1007/s40095-021-00427-8
[2]. Adom, P. K., 2019, Energy indices: A risk factor or not in the financial sector. Energy Strategy Reviews, 24(July 2018), 14–26. https://doi.org/10.1016/j.esr.2019.01.005
[3]. Begay, S., & Hammond, D. 2022. Solar Energy Implementation Strategies on Picuris Pueblo. 2022.
[4]. Braun, V., and Clarke, V., 2006, Using thematic analysis in psychology. Qualitative research in psychology, 3(2), pp.77-101.
[5]. Broström, T., & Svanström, K., 2011, Solar energy and cultural-heritage values. In World Renewable Energy Conference, Linköping, May 2011 (pp. 2034-2040). Linköping University Electronic Press.
[6]. Abdelrazik, M. K., Abdelaziz, S. E., Hassan, M. F., & Hatem, T. M., 2022, Climate action: Prospects of solar energy in Africa. Energy Reports, 8, 11363–11377. https://doi.org/10.1016/j.egyr.2022.08.252
[7]. Bryman, A., 2016, Social research methods. Oxford university press.
[8]. Creswell, J. W., and Creswell, J. D., 2017, Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.
[9]. Das, S. S., Behera, S. R., Behera, D. D., & Patnaik, S., 2021, Consumer’s Perception in Adoption of Clean Energy Products in Areas of South Odisha. Current Journal of Applied Science and Technology, May, 7–12. https://doi.org/10.9734/cjast/2021/v40i831334
[10]. Denzin, N. K., and Lincoln, Y. S., 2018, The Sage Handbook of Qualitative Research. 5th Edition, Sage, London.
[11]. Elangovan, M., Babu, P. D., & Balaji, T., 2021, Study of Solar Energy and Future Needs. International Research Journal on Advanced Science Hub, 3(Special Issue 9S), 23–28. https://doi.org/10.47392/irjash.2021.244
[12]. Flick, U., 2018, Triangulation in data collection. The SAGE handbook of qualitative data collection, pp.527-544.
[13]. Gielen, D., Boshell, F., Saygin, D., Bazilian, M. D., Wagner, N., & Gorini, R., 2019, The role of renewable energy in the global energy transformation. Energy Strategy Reviews, 24(January), 38–50. https://doi.org/10.1016/j.esr.2019.01.006
[14]. Hakemzadeh, M., Sopian, K., Venkatraman, B., & Arjunan, T. V., 2023, Global Energy Model and International Solar Energy Policies. Solar Thermal Conversion Technologies for Industrial Process Heating, May 2022, 315–341. https://doi.org/10.1201/9781003263326-16
[15]. Johnson, C., & Dignard-Bailey, L., 2008, Implementation strategies for solar communities. Open House International, 33(3), 26–37. https://doi.org/10.1108/ohi-03-2008-b0004
[16]. Kabir, E., Kumar, P., Kumar, S., Adelodun, A. A., & Kim, K. H., 2018, Solar energy: Potential and future prospects. Renewable and Sustainable Energy Reviews, 82(August 2017), 894–900. https://doi.org/10.1016/j.rser.2017.09.094
[17]. Kuamoah, C., 2020, Renewable Energy Deployment in Ghana: The Hype, Hope and Reality. https://doi.org/10.1177/0975087819898581
[18]. Lee, J., & Shepley, M. M. C., 2020, Benefits of solar photovoltaic systems for low-income families in social housing of Korea: Renewable energy applications as solutions to energy poverty. Journal of Building Engineering, 28(July 2019), 101016. https://doi.org/10.1016/j.jobe.2019.101016
[19]. Lin, B., & Kaewkhunok, S., 2021, The role of socio-Culture in the solar power adoption: The inability to reach government policies of marginalized groups. Renewable and Sustainable Energy Reviews, 144(March), 111035. https://doi.org/10.1016/j.rser.2021.111035
[20]. Loy, N., Rachmawati, I., & Karolus, M. L., 2023, Solar energy technology: Knowledge, awareness, and acceptance of solar energy in Ngada, East Nusa Tenggara, Indonesia. International Journal of Sustainable Development & World Policy, 12(1), 1–10. https://doi.org/10.18488/26.v12i1.3296
[21]. Mahama, M., Sarfo, N., Derkyi, A., & Nwabue, C. M., 2020, Challenges of renewable energy development and deployment in Ghana: perspectives from developers. 0123456789(Zahedi 2010).
[22]. Maqbool, R., Akubo, S. A., Rashid, Y., Ashfaq, S., & Saiba, M. R., 2023, Solar energy and the circular economy policies for sustainable management. Solar Energy Harvesting, Conversion, and Storage: Materials, Technologies, and Applications, 363–376.
[23]. Masson, V., Bonhomme, M., Salagnac, J. L., Briottet, X., & Lemonsu, A., 2014, Solar panels reduce both global warming and urban heat island. Frontiers in Environmental Science, 2(JUN), 1–10. https://doi.org/10.3389/fenvs.2014.00014
[24]. Mehdi, H., Reza, B. H., & Mehdi, C., 2018, Journal of Research and Rural Planning. Journal of Research and Rural Planning, 6(4), 223–241.
[25]. Mensah, K., Boahen, S., & Amoabeng, K. O., 2017, Renewable Energy Situation in Ghana: Review and Recommendations for Ghana’s Energy Crisis Gic 2017-Eas001 Renewable Energy Situation in Ghana: Review and Recommendations for Ghana’ S Energy Crises. May.
[26]. NIEMANN, J., Raluca BAIDOC, R., Adrian PISLA, A., 2011, Change Management Aspects in Solar Energy Implementation Lorand KACSO-VIDREAN1. Available online at www.sciencedirect.com
[27]. Nuñez-Jimenez, A., Mehta, P., & Griego, D., 2023, Let it grow: How community solar policy can increase PV adoption in cities. Energy Policy, 175(February). https://doi.org/10.1016/j.enpol.2023.113477
[28]. Ojong, N., 2021. Solar home systems in south asia: Examining adoption, energy consumption, and social practices. Sustainability (Switzerland), 13(14), 21–24. https://doi.org/10.3390/su13147754
[29]. Opoku, O. A., Sampson, E., Okudzeto, H., Health, D., & Anak, J. A., 2022, Exploring Challenges and Prospects of Solar Energy Entrepreneurship of Accra Metropolis in Ghana. February. https://doi.org/10.52218/ijbtob.v2i1.181
[30]. Merk, C., Pönitzsch, G., Kniebes, C., Rehdanz, K., & Schmidt, U., 2014, Exploring public perception of solar radiation management (No. 1892). Kiel Working Paper.
[31]. Policies, A. F., & Introduction, I., 2014, Building a Better Solar Energy. 221–247.
[32]. Policies, R. E., & Kant, K., 2023, Renewable Energy Policies and Their Effectiveness in Promoting Solar Energy Adoption in India. Turkish Online Journal of Qualitative Inquiry, 11(2), 664–669. https://doi.org/10.52783/tojqi.v11i2.9987
[33]. Ponce, P., Pérez, C., Fayek, A. R., & Molina, A., 2022, Solar Energy Implementation in Manufacturing Industry Using Multi-Criteria Decision-Making Fuzzy TOPSIS and S4 Framework. Energies, 15(23). https://doi.org/10.3390/en15238838
[34]. Purohit, I., Sharma, A. K., & Purohit, P., 2023, Information Technology Interventions in the Implementation of Grid-Connected Rooftop Solar Projects in India. April, 1–21.
[35]. Rai, V., & Beck, A. L., 2015, Public perceptions and information gaps in solar energy in Texas. Environmental Research Letters, 10(7). https://doi.org/10.1088/1748-9326/10/7/074011
[36]. Rivera, N. M., Spiller, E., & Ruiz-Tagle, J. C., 2022, The Health Benefits of Solar Power Generation Evidence from Chile. SSRN Electronic Journal, 1–76. https://doi.org/10.2139/ssrn.4246580
[37]. Rukh Shakeel, S., & Rajala, A., 2022. Transforming Energy Marketing Practices for Enhanced Solar PV Adoption. Human Factors, Business Management and Society, 56, 107–115. https://doi.org/10.54941/ahfe1002258
[38]. Sharan, A. M., 1996, Solar tracking system Support system for solar panels. 9–12.
[39]. Sharma, N., & R, O. K. 2020. Socio-Economic benefits of solar water pumps. 7(12), 1077–1083.
[40]. Shams, S., Danish, M. S. S., & Sabory, N. R., 2020, Solar Energy Market and Policy Instrument Analysis to Support Sustainable Development. Sustainability Outreach in Developing Countries, 113–132. https://doi.org/10.1007/978-981-15-7179-4_8
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Adverse Drug Reaction Assessment in the Paediatric Population: A Non-Interventional Pharmacovigilance StudyAuthor: Krishna Priyanka GiddaDOI: 10.21522/TIJAR.2014.13.01.Art030
Adverse Drug Reaction Assessment in the Paediatric Population: A Non-Interventional Pharmacovigilance Study
Abstract:
Adverse drug reactions (ADRs) in children are under-reported due to limited clinical trials, off-label prescribing, and lack of caregiver awareness. Pharmacovigilance is essential to evaluate and prevent drug-related harm in paediatric populations. The objective is to identify adverse drug reactions in paediatric patients using the WHO-UMC causality assessment scale and document the pattern and severity of adverse events (AEs). Non-interventional observational study was conducted in 140 paediatric subjects (< 13 years). Clinical history, anthropometrics, and adverse events were documented. Causality was assessed using the WHO-UMC ADR Probability Scale. Descriptive statistics were applied. The mean age of subjects was 7.42 ± 2.94 years; 72.86% were male. All subjects had no significant medical history. The mean ADR probability score was 0.43 ± 1.46, indicating doubtful causality. A total of 53 AEs were identified: nausea (16.35%), gastritis (8.81%), drowsiness (2.52%), rash (2.52%), abdominal pain (1.89%), stomach pain (0.63%), and swollen eyes (0.63%). All AEs were mild in intensity. It was Concluded that ADR incidence in the study population was low and predominantly mild. Causality scores indicate minimal association with drug therapy. Strengthening paediatric pharmacovigilance programs remains essential to ensure medication safety.
Adverse Drug Reaction Assessment in the Paediatric Population: A Non-Interventional Pharmacovigilance Study
References:
[1]. Kearns, G. L., Abdel-Rahman, S. M., Alander, S. W., Blowey, D. L., Leeder, J. S., Kauffman, R. E., 2003, Differences in absorption, distribution, metabolism and excretion of xenobiotics between the paediatric and adult populations, Dev Pharmacol Ther, 27(2):119–32.
[2]. Rodríguez-Monguí, E., Glorion, M. S., Saad, L. R., 2013, Factors and Mechanisms for Pharmacokinetic Differences between Pediatric Population and Adults. Pharm Res., 30(5):1253–67.
[3]. Hodel, K. V. S., Fiuza, B. S. D., Conceição, R. S., Aleluia, A. C. M., Pitanga, T. N., Fonseca, L. M. D. S., Valente, C. O., Minafra-Rezende, C. S., & Machado, B. A. S., 2024, Pharmacovigilance in vaccines: Importance, main aspects, perspectives, and challenges—A narrative review. Pharmaceuticals, 17(6), 807.
[4]. Khan, Z., Ahmed, A., & Ilyas, U., 2024, The crucial role of pharmacovigilance in managing infectious diseases in lower and middle-income countries. Therapeutic Advances in Drug Safety, 15, 20420986241251593.
[5]. Fermont, I., 2019, Pharmacovigilance strategy: opportunities for cross-national learning. Israel Journal of Health Policy Research, 8(1), 54.
[6]. Singh, J., Singh, H., Rohilla, R., Kumar, R., & Gautam, C. S., 2018, Lack of awareness of pharmacovigilance among young health-care professionals in India: An issue requiring urgent intervention. International Journal of Applied and Basic Medical Research, 8(3), 158–163.
[7]. Tripathy, R., Das, S., Das, P., Mohakud, N. K., & Das, M., 2021, Adverse drug reactions in the pediatric population: Findings from the Adverse Drug Reaction Monitoring Center of a teaching hospital in Odisha (2015–2020). Cureus, 13(11), 1-7.
[8]. Kurma, V. R., Manchu, T., Amancharla, M. K., Manchu, K., & Kandula, P. K., 2019, Pattern of adverse drug reactions in paediatric patients reported to adverse drug reaction monitoring centre in a tertiary care hospital. International Journal of Contemporary Pediatrics, 6(4), 1557–1562.
[9]. Cotrim, H., Granja, C., Carvalho, A. S., Cotrim, C., & Martins, R., 2021, Children’s understanding of informed assents in research studies. Healthcare, 9(7), 871.
[10]. Behera, S. K., Das, S., Xavier, A. S., Selvarajan, S., Anandabaskar, N., 2019, Indian Council of Medical Research's National Ethical Guidelines for biomedical and health research involving human participants: The way forward from 2006 to 2017. Perspect Clin Res. 10(3):108-114.
[11]. Wang, H., Li, S., Yang, S., 2022, Clinical profiles of adverse drug reactions in hospitalized children with chronic underlying diseases: a multicenter prospective study. Pediatr Drugs. 24(2):147–158.
[12]. Choi, Y., Lee, J., Choi, H., 2017, Clinical profiles of adverse drug reactions in hospitalized children with complex chronic conditions: data from Seoul National University Children’s Hospital. BMC Pharmacol Toxicol, 12(2): 1-17.
[13]. Gupta, S., Zaki, S. A., Masavkar, S., Shanbag, P., 2023, Causality, Severity, and Avoidability of Adverse Drug Reactions in Hospitalized Children: A Prospective Cohort Study. Cureus. 15(1): 1-9.
[14]. S. G. S. Rajeshreddy, V., Patil, L. V., 2003, Causality assessment and the severity of the adverse drug reactions in a tertiary-care hospital: a pharmacovigilance study. Int J Basic Clin Pharmacol, 6(12): 2800-2803.
[15]. Pimpalkhute, S. A., Jaiswal, K. M., Sontakke, S. D., Bajait, C. S., Gaikwad, A., 2015, Assessment of adverse drug reactions in hospitalized pediatric patients in a tertiary care hospital. Indian J Pharmacol, 47(5):512-516.
[16]. Morales-Ramírez, J. O., García-Cortés, L. V., 2021, Frequency, pattern and severity of adverse drug reactions in hospitalized children: a prospective observational study. BMC Pediatr, 21:232.
[17]. Zhdanova, O. A., Batishcheva, G. A., Perova, N. N., Mubarakshina, O. A., Cherenkova, O. V., Neyno, E. D., 2024, Analysis of spontaneous reports of adverse drug reactions in children of different ages. Pharmateca, 31(3):89–95.
[18]. Darawadi, B., Parameshwar, H., Sahil, R., Jithan, A. V., 2022, Pharmacovigilance in paediatric population. Int J Allied Med Sci Clin Res, 10(3):332–334.
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