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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.
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[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
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[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.
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[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
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[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
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[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
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[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.
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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
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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
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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:
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[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.
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[10]. Ministry of Health Zambia. 2023, Interoperability architecture framework. Lusaka: Ministry of Health.
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[12]. Global Digital Health Index. 2022, Country profiles. Washington DC: Global Digital Health Index.
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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
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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
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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
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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
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[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.
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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
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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
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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
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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
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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
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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
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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.
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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.
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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.
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[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.
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[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.
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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
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[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
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[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
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[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
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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
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[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
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[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.
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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.
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[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.
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[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.
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[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.
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[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.
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[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.
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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.
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[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
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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.
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[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.
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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
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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
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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
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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
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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
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