Abstract:

In Nigeria, Childhood nutrition and feeding are controlled and influenced by a lot of socio-cultural factors. The timing of initiation of Complementary feeds is a critical determinant of the nutritional status of children under five years of age. This study, therefore, set out to ascertain the Factors associated with the timing of initiation of complementary feeding among Children Aged 4-24 months of age, attending Routine Immunization Clinics in Jos North LGA of Plateau State, Nigeria. This was a descriptive, cross-sectional, facility-based study, using both quantitative and qualitative methods to assess the factors associated with the timing of initiation of complementary feeding among 210 mothers of children aged 4-12months. The FGD showed that mothers relied on past experience and finances to determine the timing of initiation of complementary feed. Although no Socio-demographic variable was found to be statistically associated with the timing of commencement of complementary feeding; more women commenced after 6months of age with tertiary education (68.3%), if the child was female (70.4%) and if the mother was younger age group (76.5%). A larger proportion of the mothers initiated complementary feeding at the time they did, either because they felt the child was not satisfied with taking only breast-milk (37.1%) or because they felt it was the best time to start (36.2%). The most potent influence for the timing of complementary feed commencement was their past experience with other children.

References:

[1] World Health Organization (WHO), 2001, The Global Consultations in Complementary Feeding. (Cited November 18, 2019); Available from: http://www.who.into/nutrition/complementary_feeding/en/.

[2]   Luibia L, Sijin L, Ali M and Ushijima H (2005). Feeding practice of infants and their correlates in urban areas of Beijing, China. Pediatric International.; 45(4) 400-406.

[3] Syed M.A. (2001) Poverty and child mortality in Pakistan. Pakistan Institute of Development Economics, Islamabad. Mumap Technical paper series No 6, available at; http://pide.org.ph/Mimap/report06. (Cited November 18, 2020).

[4]   Solomon S.B (2010). Socio-cultural factors influencing infant feeding practices of mothers attending a clinic in Cape-Coast. Department of sociology and Anthropology, University of Cape-Coast, Ghana. Cited 19^th December 2019.

[5] Mikori A and Orikushaba P. (2012) Nutritional status, Complementary feeding practice and feasible strategies to promote nutrition in wollen, Uganda. African Journal on Nutrition; 25(4): 173-179.

[6] Ogunba B.O. (2006), Maternal Behavior, Feeding Practices, and Under-five nutrition: Implications for child development and care, Journal of Applied Scientific Resources, 2(12), 1132-1136.

[7]  Angio K.M., Ameh D.A., Ibrahim S, and Danbauchi S.S, (2009), Infant Feeding Practice and Nutritional Status of Children in North-Western Nigeria. Asian Journal of Clinical Nutrition; (2), 12-22.

[8]  National Population Commission (2008), National Demographic and Health Survey, MD, USA NPC and ORC macro calverton p.163-174.

[9] National Bureau of Statistics (NBS) and United Nations Children’s Fund (UNICEF). 2017 Multiple Indicator Cluster Survey 2016-17, Survey Findings Report. Abuja, Nigeria: NBS and UNICEF.

[10] Walsh, A., Kearney, L. & Dennis, N. Factors influencing first-time mothers’ introduction of complementary foods: a qualitative exploration. BMC Public Health 15, 939 (2015). https://doi.org/10.1186/s12889-015-2250-z (Cited November 18, 2020).

[11] Abeshu, M. A., Lelisa, A., & Geleta, B. (2016). Complementary Feeding: Review of Recommendations, Feeding Practices, and Adequacy of Homemade Complementary Food Preparations in Developing Countries - Lessons from Ethiopia. Frontiers in nutrition, 3, 41. https://doi.org/10.3389/fnut.2016.00041.

[12] Reda, E. B., Teferra, A. S., & Gebregziabher, M. G. (2019). Time to initiate complementary feeding and associated factors among mothers with children aged 6-24 months in Tahtay Maichew district, northern Ethiopia. BMC research notes, 12(1), 17. https://doi.org/10.1186/s13104-019-4061-2 (Cited November 18, 2019).

[13] Udoh, E. E., & Amodu, O. K. (2016). Complementary feeding practices among mothers and nutritional status of infants in Akpabuyo Area, Cross River State Nigeria. SpringerPlus, 5(1), 2073. https://doi.org/10.1186/s40064-016-3751-7 (Cited November 19, 2020).

[14] Khamis, A.G., Mwanri, A.W., Ntwenya, J.E. et al. (2019) The influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania. BMC Pediatr 19, 518
 (2019). https://doi.org/10.1186/s12887-019-1897-5.

[15] Badake, D, Maina, I., Mboganie, M.A., Muchemi, G., Kihoro, E.M., Chelimo, E., and Mutea, K. (2014) Nutritional Status of Children Under Five Years and Associated factors In Mbeere South District, Kenya. African Crop Science Journal, Vol. 22, (S4):799 - 806 Issn 1021-9730/2014.

[16] Temesgen, H., Yeneabat, T. & Teshome, M., (2018) Dietary diversity and associated factors among children aged 6–23 months in Sinan Woreda, Northwest Ethiopia: a cross-sectional study. BMC Nutr 4, 5. https://doi.org/10.1186/s40795-018-0214-2 (Cited November 18, 2020).

Abstract:

Maternal mortality remains a leading cause of death among women of reproductive age group. This study determined the cost of antenatal care among Health Insurance (HI) enrollees and Out-of-Pocket (OOP) payers accessing maternal healthcare services in a tertiary health institution in Southwest Nigeria. A comparative cross-sectional study was carried out among 380 women (190 HI enrollees and 190 OOP payers) attending antenatal care services in a tertiary health institution in Southwest Nigeria using a systematic random sampling technique. Data was gathered using an interviewer-administered semi-structured questionnaire and analyzed using IBM SPSS version 23. Chi-square and binary logistic regression were used to assess the association between dependent and independent variables and a P-value of <0.05 was taken as significant. The overall mean age of respondents in this study was 33.8 ± 5.0 years (HI Group: 34.1 ± 4.9 years and OOP Group: 33.6 ± 5.0 years). The mean total cost of Antenatal Care (ANC) is lesser for HI enrollees (₦5,095.2 ± 1,753.1 equivalent to $13.3 ± 4.6) as compared with OOP payers (₦15,050.6 ± 5,548.9 equivalent to $39.6 ± 14.6). Predictors and enablers for HI uptake are marital status, family size, level of education, occupation, appropriate and quality HI package, and trust in the HI scheme. It was concluded that the total cost of antenatal care is lower among the Health Insurance enrollees than the Out-of-Pocket payers. Therefore, interventions to increase awareness and designing more enticing HI packages are recommended.

References:

[1] Iyaniwura CA, Yussuf Q. Utilization of Antenatal Care and Delivery Services in Sagamu, SouthWestern Nigeria. Trop J Obstet Gynaecol. 2008; 25 (1): 39-50.

[2] Tellis SB, Rent PD, Dmello MK. Utilization of antenatal care and out of pocket expenditure on delivery care in Dakshina Kannada.. International Journal of Community Medicine and Public Health. 2018; 5(8): 3553-3559. DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20183097.

[3] Kalu-Umeh NN, Sambo MN, Idris SH, Kurfi AM. Costs and Patterns of Financing Maternal Health Care Services in Rural Communities in Northern Nigeria: Evidence for Designing National Fee Exemption Policy. International Journal of MCH and AIDS. 2013; 2(1): 163-172.

[4] Sambo MN, Abdulrazaq GA, Shamang, AF, Ibrahim AA. Household cost of antenatal care and delivery services in a rural community of Kaduna state, Northwest Nigeria. Niger Med Journal. 2013; 54(2): 87-91.

[5] Hitimana R. Lindholm L, Krantz G, Nzayirambah M, Pulkki-Brännström AM. Cost of antenatal care for the health sector and for households in Rwanda. BMC Health Services Research. 2018; 18: 262-670.

[6] NDHS. National Demographic and Health Survey. 2018; 23-27.

[7] Mahiti GR, Mkoka DA, Kiwara AD, Mbekenga CK, Hurtig AK, Goicolea I. Women's perceptions of antenatal, de,livery, and postpartum services in rural Tanzania. Global Health Action. 2015; 8: 1-7. doi:10.3402/gha.v8.28567.

[8] Lincetto O, Mothebesoane-Anoh S, Gomez P, Munjanja S. WHO reproductive health indicators. Opportunity for Africa’s Newborn. 2018. Available at https://www.who.int/pmnch/media/publications/oanfullreport.pdf. (Last accessed January, 2021).

[9] Mbuli MD, Awolu MM, Asangbeng TE., Mbuli IA, Pangmekeh PJ, Shey ND. The Influence of Health Insurance on the Utilization of Maternal Health Care Services in Kumba Health District: A Community-based Assessment. BioRxiv; 2018; 1-18. doi: https://doi.org/10.1101/474130.

[10] Johnson FA, Frempong-Ainguah F, Padmadas SS. Two decades of maternity care fee exemption policies in Ghana: have they benefited the poor?. Health Policy and Planning, 2016; 31: 46–55. doi: 10.1093/heapol/czv017.

[11] FGN. Federal Government of Nigeria. Workshop for Nigerian actors on improving financial access to Maternal, Newborn, Child Health (MNCH) services for the Poor in Nigeria. Technical Report. Tinapa Calaba. 2016; Pg 1-64.

[12] Aregbesola, B. Healthcare in Nigeria: Challenges and recommendations. Sociialprotection.org. 2020. Available online at http://sociialprotection.org/discover/blog/health-care-nigeria-challenges-and-recommendations.

[13] WHO. World Health Organization. Universal Health Coverage. 2020. Available online at http://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc) (Last accessed January, 2021.

[14] Roberts AA, Agboola BC, Oshunniyi L, Roberts OY. Health Insurance and User Fees: A Survey of Health Service Utilization and Payment Methods in Mushin LGA, Lagos, Nigeria. Ann Med Health Sci Res. 2018; 8: 93-99.

[15] Youngji JO, Alland K, Ali H, Mehra S, LeFevre ME, Pak SE, et al. Antenatal care in rural Bangladesh: current state of costs, content and recommendations for effective service delivery. BMC Health Services Research. 2019; 19: 861-872. https://doi.org/10.1186/s12913-019-4696-7.

[16] Borghi J, Bastus S, Belizan M, Carroli G, Hutton G, Fox-Rushby J. 2003. Costs of Publicly Provided Maternity Services in Rosario, Argentina. Salud pública de méxico. 2003; 45(1): 27-34.

[17] Govil D, Purohit N, Gupta SD, Mohanty SK. Out-of-pocket expenditure on prenatal and natal care post Janani Suraksha Yojana: a case from Rajasthan, India. Journal of Health, Population and Nutrition. 2016; 35: 15- 46.

[18] Goli S, Rammohan A, Moradhvaj I: Out-of-pocket expenditure on maternity care for hospital births in Uttar Pradesh, India. Health Economics Review Springer, Heidelberg. 2018; 8(5): 1-16. http://dx.doi.org/10.1186/s13561-018-0189-3.

[19] Pulse Nigeria Article. Cost of Antenatal care in Nigeria. 2019. Available at https://www.pulse.ng/lifestyle/beauty-health/cost-of-antenatal-care-in-nigeria/w9g7f0g. (Last accessed January, 2021).

[20] Ekiti State Government. History of Ekiti State. (2016) Available at http://ekitistate.gov.ng. [Last Accessed on January 2, 2021].

[21] Federal Teaching Hospital Ido-Ekiti. Available at www.fethi.gov.ng. (Last accessed, January, 2021).

[22] WHO. World Health Organization. Social Health Insurance: Sustainable health Financing, Universal Coverage and Social health Insurance. Fact sheet No 320. 2005. Available from: http://www.who.int/ha [Last accessed on February, 2021].

[23] WHO. World Health Organization. Health Systems Financing: The Path to Universal Coverage. Geneva. 2010; 1-50.

[24] Matsubara C, Nguyen TA, Murakami H. Exploring affordability and healthcare-seeking behaviour for delivery and antenatal care among the poor and ethnic minorities in rural Northwestern Vietnam. Global Health Action. 2019; 12: 1-9 DOI: 10.1080/16549716.2018.1556573.

[25] Browne JL, Kayode GA, Arhinful D, Fidder SAJ, Grobbee DE, Klipstein-Grobusch K. Health insurance determines antenatal, delivery and postnatal care utilisation: evidence from the Ghana Demographic and Health Surveillance data. BMJ Open. 2016; 1-9. 6:e008175. doi:10.1136/bmjopen-2015- 008175.

[26] Odhiambo J, Ruhumuriza J, Nkurunziza T, Riviello R, Shrime M, Lin Y, et al. Health Facility Cost of Caesarean Delivery at a Rural District Hospital in Rwanda Using Time-Driven Activity-Based Costing. Maternal and Child Health Journal. 2019. 1-7. https://doi.org/10.1007/s10995-018-2674-z.

[27] Mubyazi GM. Perceived and Real Costs of Antenatal Care Seeking and their Implications For Women’s Access to Intermittent Preventive Treatment of Malaria in Pregnancy in Rural Tanzanian Districts. SM Journal of Public Health and Epidemiology. 2015; 1(2): 1009-1022.

[28] Dalinjong PA, Wang AY, Homer CSE. Has the free maternal health policy eliminated out of pocket payments for maternal health services? Views of women, health providers and insurance managers in Northern Ghana. PLOS ONE. 2018; 13(2): 1-19. https://doi.org/10.1371/journal.pone.0184830.

[29] Dror DM, Hossain SAS, Majumdar A, Pérez Koehlmoos TL, John D, Panda PK. What Factors Affect Voluntary Uptake of Community-Based Health Insurance Schemes in Low- and Middle-Income Countries? A Systematic Review and Meta-Analysis. PLoS ONE. 2016; 11(8): 1-12. e0160479. doi:10.1371/ journal. pone.0160479.

[30] Panda P, Dror IH, KoehlmoosTP, Hossain SAS, John D, Khan JAM, et al. Factors affecting uptake of voluntary and community-based health insurance schemes in low and middle-income countries: a systematic review, 3ie Systematic Review 27. London. International Initiative for Impact Evaluation. 2016. 1-12.

[31] Alasene A, Anangi BT. Uptake of health insurance by the rural poor in Ghana: Determinant and implication for policy. PAMJ. 2018; 31(124): 1-7. 10.11604/pcmj.2018.31.124.16265.

[32] Adebayo EF, Ataguba JE, Uthman OA, Okwundu CI, Lamont KT, Wiysonge CS. Factors
that affect the uptake of community-based health insurance in low income and middle-income countries: a systematic protocol. BMJ Open. 2014; 1-13. doi:10.1136/ bmjopen-2013-004167.

[33] Ndung’u TT. Factors Influencing Uptake of National Health Insurance in the Informal Sector: A Case of Ithanga Division in Murang’a County, Kenya. Master’s degree dissertation. 2015; 1-52. (unpublished).

[34] Nigussie SS. Assessment of Factors Affecting Uptake of Community Based Health Insurance Among Sabata Hawas Woreda Community, Oromiya Region. Addis Ababa, Ethiopia. Master’s Degree Dissertation. 2017; 1-56. (Unpublished Article).

[35] Odeyemi IAO. Community-based health insurance programmes and the national health insurance scheme of Nigeria: challenges to uptake and integration. International Journal for Equity in Health. 2014; 13: 20-28.

Abstract:

Retention on treatment is a critical factor in reducing HIV-related morbidity and mortality, the incidence of new infections, and development of drug resistance among children and adults. This study examined institutional factors affecting retention of HIV patients on treatment, care, and support services at Wuse General Hospital, Abuja. A retrospective cohort study was used to access institutional factors that influence HIV patient retention on treatment. About 4,564 HIV patients were ever enrolled on a treatment programme, and 2,791 patients are currently accessing treatment. A total of 240 clients were recruited for the study, and a pre-tested interviewer-administered semi-structured questionnaire was used for data collection. Data were entered into Stata/MP 15.0 and then exported into SPSS version 23.0 for statistical analysis of the 240 respondents interviewed, the main institutional factor affecting retentions were long waiting time (61.7%), high patient load (46.9%), inadequate space for clinics (48.3%), Poor quality of services (40.8%), difficulty in accessing health facility (32.9%) and inadequate health workers/staff (31.3%). A review of socio-demographic characteristics of respondents and institutional related factors affecting retention in treatment showed an association between marital status (p=0.000), religion (p=0.006), employment status (p=0.009), and institutional related factors affecting retention in care. Retention of HIV patients in treatment and care support services is a major determinant in achieving sustained viral suppression and reduced community HIV transmission. Therefore, strategies to mitigate institutional barriers to treatment retention should be promoted to optimize retention of HIV patients in care.

References:

[1] Mondal, M., and Shitan, M., 2013, Factors affecting the HIV/AIDS epidemic: an ecological analysis of global data. Afr Health Sci, 13(2):301–310.

[2] Health FM, 2010, National guidelines for HIV and AIDS treatment and care in adolescents and adults. Federal Ministry of Health Abuja.

[3] Mberi, M.N., Kuonza, L.R., Dube, N.M., Nattey, C., Manda, S., and Summers, R., 2015, Determinants of loss to follow-up in patients on antiretroviral treatment, South Africa, 2004–2012: a cohort study. BMC Health Serv Res, 15(1):1–11.

[4] WHO. 13-15 September 2011. 2012, Retention in HIV programmes: defining the challenges and identifying solutions: meeting report.

[5] Fuente-Soro, L., López-Varela E., Augusto, O., Bernardo, E.L., Sacoor, C., and Nhacolo, A., 2020, Loss to follow-up and opportunities for re-engagement in HIV care in rural Mozambique: A prospective cohort study. Medicine (Baltimore), 99(20): e20236.

[6] Cohen, M.S., Chen, Y.Q., McCauley, M., Gamble, T., Hosseinipour, M.C., and Kumarasamy, N., 2011, Prevention of HIV-1 Infection with Early Antiretroviral Therapy. N Engl J Med, 365(6):493–505.

[7] Fox MP and Rosen, S., 2010, Patient retention in antiretroviral therapy programs up to three years on treatment in Sub-Saharan Africa, 2007–2009: systematic review. Trop Med Int Health, 15:1–15.

[8] Babatunde, O., Ojo, O.J., Atoyebi, O.A., Ekpo, D.S., Ogundana, A.O., and Olaniyan, T.O., 2015, Seven-year review of retention in HIV care and treatment in federal medical centre Ido-Ekiti. Pan Afr Med J, 22(1).

[9] Amuron, B., Namara, G., Birungi, J., Nabiryo, C., Levin, J., and Grosskurth, H., 2009, Mortality and loss-to-follow-up during the pre-treatment period in an antiretroviral therapy programme under normal health service conditions in Uganda. BMC Public Health, 9(1):290.

[10] Giordano, T.P., Gifford, A.L., White Jr, A.C., Almazor, MES., Rabeneck, L., and Hartman C, 2007, Retention in care: a challenge to survival with HIV infection. Clin Infect Dis, 44(11):1493–1499.

[11] Paracha, S.I., Hafeez, F., Habib, H., Yaqoob, A., Fatima, R., and Saeed, Q., 2019, The extent of loss to follow among patients initiated on antiretroviral treatment, Pakistan 2017-2018: a retrospective cross-sectional study.

[12] Zürcher, K., Mooser, A., Anderegg, N., Tymejczyk, O., Couvillon, M.J., and Nash, D., 2017, Outcomes of HIV‐positive patients lost to follow‐up in African treatment programmes. Trop Med Int Health., 22(4):375–387.

[13] Egger, M., Spycher, B.D., Sidle, J., Weigel, R., Geng, E.H., and Fox, M.P., 2011. Correcting mortality for loss to follow-up: a nomogram applied to antiretroviral treatment programmes in sub-Saharan Africa. PLoS Med.; 8(1): e1000390.

[14] Cornell, M., Lessells, R., Fox, M.P., GARONE, D.B, Giddy, J., and Fenner, L., 1999. Mortality among adults transferred and lost to follow-up from antiretroviral therapy programmes in South Africa: a multicentre cohort study. J Acquir Immune Defic Syndr. 2014;67(2): e67.

[15] Geng, E.H., Odeny, T.A., Lyamuya, R., Nakiwogga-Muwanga. A., Diero, L., and Bwana, M., 2016, Retention in care and patient-reported reasons for undocumented transfer or stopping care among HIV-infected patients on antiretroviral therapy in Eastern Africa: application of a sampling-based approach. Clin Infect Dis. 62(7):935–944.

[16] Brinkhof, M.W., Pujades-Rodriguez, M., and Egger M., 2009, Mortality of patients lost to follow-up in antiretroviral treatment programmes in resource-limited settings: systematic review and meta-analysis. PloS One, 4(6): e5790.

[17] Opio, D., Semitala, F.C., Kakeeto, A., Sendaula E., Okimat, P., and Nakafeero, B., 2019, Loss to follow-up and associated factors among adult people living with HIV at public health facilities in Wakiso district, Uganda: a retrospective cohort study. BMC Health Serv Res; 19(1):628.

[18] Rachlis, B., Bakoyannis, G., Easterbrook, P., Genberg, B., Braithwaite, R.S., and Cohen C.R., 2016, Facility-level factors influencing retention of patients in HIV care in East Africa. PloS One, 11(8): e0159994.

[19] Geng, E.H., Bangsberg, D.R., Musinguzi, N., Emenyonu, N., Bwana, M.B., and Yiannoutsos, C.T.., 2010, Understanding reasons for and outcomes of patients lost to follow-up in antiretroviral therapy programs in Africa through a sampling-based approach. J Acquir Immune Defic Syndr, 53(3):405.

[20] Tuller, D.M., Bangsberg D.R., Senkungu, J., Ware N.C., Emenyonu, N., and Weiser SD., 2010, Transportation costs impede sustained adherence and access to HAART in a clinic population in southwestern Uganda: a qualitative study. AIDS Behav, 14(4):778–784.

[21] Ochieng-Ooko, V., Ochieng, D., Sidle, J.E., Holdsworth, M., Wools-Kaloustian, K., and Siika, A.M., 2010, Influence of gender on loss to follow-up in a large HIV treatment programme in western Kenya. Bull World Health Organ, 88:681–688.

[22] Chan A.K, Mateyu, G., Jahn, A., Schouten, E., Arora, P., Mlotha, W., 2010, Outcome assessment of decentralization of antiretroviral therapy provision in a rural district of Malawi using an integrated primary care model. Trop Med Int Health, 15:90–97.

[23] Dalhatu I, Onotu D, Odafe S, Abiri O, Debem H, Agolory S, Shiraishi RW, Auld AF, Swaminathan M, Dokubo K, Ngige E, Asadu C, Abatta E, Ellerbrock., 2016, Outcomes of Nigeria's HIV/AIDS Treatment Program for Patients Initiated on Antiretroviral Treatment between 2004-2012.

[24] Assefa Y, Worku A, Wouters E, Koole O, Haile Mariam D, Van Damme W. 2012, Simplified tools for measuring retention in care in antiretroviral treatment program in Ethiopia: cohort and current retention in care. PLoS One. 2012;7(6): e38555. doi: 10.1371/journal.pone.0038555.

[25] Chemutai, R.J, Mwaniki, P., Mutai, J.K., Njenga, S., and Kyalo, M.A., 2018, Factors Associated with Retention in Care among HIV Positive Adults Attending Pumwani Comprehensive Care Centre, In Nairobi County, Kenya.

[26] Bekker, L.G., Venter, F., Cohen, K., Goemare, E., Van Cutsem, G., and Boulle, A., 2014, Provision of antiretroviral therapy in South Africa: the nuts and bolts.

[27] Miller, C.M., Ketlhapile, M., Rybasack‐Smith, H., and Rosen, S., 2010, Why are antiretroviral treatment patients lost to follow‐up? A qualitative study from South Africa. Trop Med Int Health; 15:48–54.

[28] Fernandes, C.M., Daya, M.R., Barry. S., and Palmer, N., 1994, Emergency department patients who leave without seeing a physician: the Toronto Hospital experience. Ann Emerg Med, 24(6):1092–1096.

[29] Callaghan, M., Ford, N., and Schneider, H., 2010, A systematic review of task-shifting for HIV treatment and care in Africa. Hum Resour Health; 8(1):8.

[30] Govindasamy, D., Ford, N, and Kranzer, K.., 2012, Risk factors, barriers and facilitators for linkage to antiretroviral therapy care 2012: a systematic review. Aids, 26 16):2059–2067.

[31] Duncombe, C., Rosenblum, S., Hellmann, N., Holmes, C., Wilkinson, L., and Biot, M., 2015, Reframing HIV care: putting people at the centre of antiretroviral delivery. Trop Med Int Health, 20(4):430–447.

[32] Mukumbang, F.C., Mwale, J.C., and Van Wyk, B., 2017, Conceptualising the factors affecting retention in care of patients on antiretroviral treatment in Kabwe District, Zambia, using the ecological framework. AIDS Res Treat.

[33] Mwale, J.C., 2016, Factors affecting retention in care of patients on antiretroviral treatment in the Kabwe district, Zambia.

[34] Kalinjuma, A.V., Glass, T.R., Weisser, M., Myeya, S.J, Kasuga, B., and Kisung’a, Y., 2020, Prospective assessment of loss to follow‐up: incidence and associated factors in a cohort of HIV‐positive adults in rural Tanzania. J Int AIDS Soc, 23(3): e25460.

[35] Larson, B.A., Brennan, A., McNamara, L., Long, L., Rosen, S., and Sanne, I., 2010, Early loss to follow up after enrolment in pre‐ART care at a large public clinic in Johannesburg, South Africa. Trop Med Int Health, 15:43–47.

[36] Francis, J., Geldsetzer, P., Ulenga, N., Sando, D., Lema, I., and Mboggo, E., 2018, The impact of community delivery of antiretroviral therapy on viral
load suppression: findings from a pragmatic randomized non-inferiority trial in Dar es Salaam, Tanzania. In: Journal of the International AIDS Society. John Wiley & Sons Ltd the atrium, southern gate, chichester, PO19 8SQ, W 94–94.

[37] Layer, E.H., Kennedy, C.E., Beckham, S.W., Mbwambo, J.K, Likindikoki, S., Davis, W.W., 2014, Multi-level factors affecting entry into and engagement in the HIV continuum of care in Iringa, Tanzania. PloS One, 9(8): e104961.

Abstract:

Malaria is of public health importance in Zimbabwe. A sharp rise in the number of malaria cases in Binga district was noted during week five in 2013. On further analysis, the Siansundu clinic was found to be in an outbreak situation. The study was conducted to determine factors associated with contracting malaria in Binga District, Matabeleland North, Zimbabwe. An unmatched 1: 1 case-control study was conducted in Siansundu, Binga, among 124 residents. A case was a person who presented with malaria symptoms, a control was a person who was a neighbour of a case and did not suffer from typical malaria symptoms or had a negative RDT result from the 1^st of January 2013. A pre-tested interviewer-administered questionnaire and a checklist were used to collect data. Data were analyzed using Epi Info, where odds ratios and p values were calculated. Risk factors for contracting malaria were: Fetching water at night (OR 2.55, p-value 0.04); Having inadequate mosquito nets per sleeping space (OR 3.596, p-value 0.036); Worshipping and praying outside at night (OR 3.417, p-value 0.0006). Wearing long clothing at night was a protective factor against contracting malaria (OR 0.156, p-value 0.001). The case fatality rate was 0.43%. The district was not prepared for the outbreak and responded late. Educational strategies to address the risk factors for malaria and regular meetings by the emergency preparedness and response team were recommended to prevent future outbreaks and aid outbreak preparedness.

References:

[1] World Health Organisation; Malaria Factsheet;2013 www.who.int.

[2] Centers for Disease Control and Prevention; Malaria, www.cdc.gov.

[3] World Health Organisation; Malaria, International Travel and Health www.who.int.

[4] World Health Organisation; 2010, Guidelines for the Treatment of Malaria; 2^nd Edition, www.who.int.

[5] World Health Organisation, 2010, Centers for Disease Prevention and Control; Technical Guidelines for Integrated Disease Surveillance and Response in the African Region, 2^nd Edition.

[6] World Health Organisation: 10 Facts on Malaria in Africa www.who.int.

[7] Centers for Disease Prevention and Control, 2011, The Global Malaria Epidemic, 2011 www.globalhealth.com.

[8] Ministry of Health and Child Welfare, 2009, Guidelines for Management of Malaria in Zimbabwe

[9] Matabeleland North Province, 2012, Malaria Presentation- Malaria Conference.

[10] Matabeleland North Province, 2013 Week 4, Weekly Disease Surveillance Data.

[11] Sibanda C, Gombe N.T and Hazangue P, 2010, Risk Factors for Contracting Malaria in Siansundu, Binga; (Unpublished).

[12] Ahmed S.M; Haque R and Hossain A, 2009, Knowledge on the Transmission, Prevention and Treatment of Malaria among two Endemic Populations of Bangladesh and their Health-Seeking Behaviour: Malaria Journal, (8)173. https://malariajournal.biomedcentral.com/articles/10.1186/1475-2875-8-173.

[13] Lairez E; 2005, The intersectoral response to the malaria epidemic in Ethiopia, Humanitarian Exchange Magazine; Issue 31 https://odihpn.org/magazine/the-intersectoral-response-to-the-malaria-epidemic-in-ethiopia-in-2003-an-assessment/.

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Abstract:

A minimum of 95% drug adherence is necessary to achieve immunological and virological success in antiretroviral therapy, and to attain this level; patients need to be assisted. The study therefore aimed at comparing the effect of reminder tools on antiretroviral drug adherence among people living with human immunodeficiency virus. The study was a randomised field trial. Questionnaire and adherence assessment forms were administered to two hundred, and twenty-five patients, and information was elicited on socio-demographic history, antiretroviral drug usage, and adherence behaviour. Alarm clocks and counselling were given to one group, stickers, reminder cards, and counselling to the second group, while counselling alone was given to the third group as interventions. Three months later, data were collected from the same patients in order to compare the effect reminder tools had on antiretroviral drug adherence among the patients. Data were entered into Epi Info version 3.5.1 2008 statistical software and analyzed. The optimum adherence levels were 78.7%, 80.0%, and 84.0% at pre-intervention among groups that had alarm clock with counselling, sticker, reminder card with counselling, and those that had counselling alone respectively. The drug side effect was negatively associated with adherence level (p< 0.05), while pill count was not associated with adherence level (p>0.05). At post-intervention, the adherence levels increased by 18.5%, 6.8%, and 1.9%, respectively, among groups that had alarm clock with counselling (p<0.05), sticker, reminder card with counselling (p>0.05), and those that had counselling alone (p>0.05). The alarm clock was more effective than stickers and hand-held cards in improving adherence.

References:

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Abstract:

The coronavirus global pandemic now poses additional peril to the already burdened healthcare systems with inadequate funding in Africa. This paper attempts to present the funding patterns for healthcare in Nigeria, Congo, Tanzania, Egypt, and South Africa. It also explored investor opportunities for lowering OOPs and increasing investor profits. Data were drawn from the WHO, the World Bank, and world charts databases. Government health expenditure was far below what individuals and families pay from out-of-pocket payments (OOPs) for healthcare services except in South Africa, where OOP accounts for only 8%.

Contrary to popular notion, donation funds or foreign aid for healthcare accounts for a lower percentage of total healthcare expenditure in the countries under consideration. Households mostly bore the healthcare expenditure burden (Nigeria’s OOPs of 77%, Congo- 48%, and Egypt- 60%). Averagely, Nigeria and Congo only spent about 3% of their national budget on healthcare. In comparison, Tanzania and Egypt spent an average of 4% and 5% (South Africa-8%) between 2010 and 2017, reflecting low-risk protection for households. Specific aspects for investments through public-private partnerships (PPP) reviewed in this paper should include designing innovative financing models focusing on risk pooling mechanisms to help bridge the funding gap, local production, and manufacture of pharmaceuticals and healthcare equipment at this time, instead of importation. Investors can, therefore, take advantage of the various initiatives outlined in this paper to achieve better health outcomes in Africa.

References:

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Abstract:

Partner Notification Service (PNS) has been a long-standing component of the HIV/AIDS control programs and a keep part of the innovative approaches to achieve epidemic control. Many programs around the world and facilities, especially in Nigeria, have been scaling up the strategy. The study reviewed the activities of Partner Notification Services in the University of Abuja teaching hospital, Abuja, between January 2019 and December 2019. A retrospective cohort analysis of client’s folders, registers, and the electronic medical record was done. A total of 451 clients with HIV infection (194 New Positives and 257 Virally unsuppressed clients) were interviewed. The majority of the clients (86.2%) accepted the offer of Partner Notification Service and elicited 457 partners (1: 1.2 partners), 388 (84.9%) were notified of their risk of exposure to HIV. Of the 323 partners that were reached, 97 (30%) previously knew their HIV-positive status, 62 (19.2%) were newly diagnosed, and 164 (50.8%) tested non-reactive. The total HIV testing yield was 3.8% (207 positives from 5394 HIV test done), Index testing done through Partner Notification Service had the highest yield at 27.4%, then Voluntary testing and counselling at 10.1%, followed TB clinic HTS at a yield of 2.9%. Other testing points had a yield of ≤ 1 %. The study supports many other similar studies in demonstrating the effectiveness of Partner Notification service as a key strategy in achieving epidemic control of HIV/AIDS. It is also effective in the management of scarce resources that currently plagues many developing nations like Nigeria.

References:

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[17] Kariuki, R. M., Rithaa, G. K., Oyugi, E. O., & Gachathi, D. M. (2020). What is the level of uptake of partner notification services in HIV testing in selected health facilities in Gatanga Sub County, Muranga County - Kenya; A retrospective study. BMC Infectious Diseases, 20(1), 1–7. https://doi.org/10.1186/s12879-020-05146-9.

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Abstract:

Anti-retroviral therapy (ART) has decreased the mortality and morbidity of HIV/AIDS. Several medicines are prescribed for disease management; however, adherence to long-term therapy remains poor. Disease severity and health beliefs about medications ultimately influence adherence to treatment. There is a paucity of data with regard to disease severity, health beliefs and medication adherence among HIV patients. The purpose of the study was to investigate the relationship between disease severity, health beliefs, and medication adherence among HIV patients. A cross-sectional descriptive survey was used. Data were collected among 400 HIV-infected patients on ARV who received pretreatment and ongoing adherence counseling and education since 2010 using a self-administered questionnaire. The data were analyzed using Statistical Package for Social Sciences (SPSS). Findings showed that 68.3 % believed that there is a great chance of developing AIDS-related complications if ARV is not taken as directed, while 3.3% do not agree that taking HIV medication as prescribed can prolong life. The majority (95.5%) reported three is no difficulty with the prescribed regimen while 96.7% felt weird like a ‘zombie’ on medication and 95% agreed with the fact that ART medication can prevent the development of AIDS. Medication adherence is a complex, multifaceted issue and patient beliefs about medications contribute significantly, although to adherence. It is important to assess health beliefs for individual patients. When individual beliefs appear likely to undermine adherence, it may be useful to undertake educational interventions to try to modify them.

References:

[1] Sayegh P, Thaler NS, Arentoft A, Kuhn TP, Schonfeld D, Castellon SA, Durvasula RS, Myers HF, Hinkin CH. Medication adherence in HIV-positive African Americans: The roles of age, health beliefs, and sensation seeking. Cogent psychology. 2016 Dec 31;3(1):1137207.

[2] Graham N, Jacobson LP, and Kuo V. Access to Therapy in The Multicenter AIDS Cohort Study, 1989-1992. J Clin Epidemiol. 1994; 47(9): 1003-12.

[3] Smith, S. A Longitudinal Study of Access and Drug Utilization in a Cohort with HIV Disease. Doctoral Dissertation, University of Michigan, 1996.

[4] Spilker B. Methods of Assessing and Improving Patient Compliance in Clinical Trials. IRB. A Review of Human Subjects Research, 1992; 14(3): 1-6.

[5] Geletko SM, Ballard CR, Mathews WC. Health Beliefs and Discontinuation of Zidovudine Therapy. Am J Health-Syst Pharm. 1995; 52: 505-7.

[6] Conner M, and Norman P. Comparing the Health Belief Model and The Theory of Planned Behavior in Health Screening. In: Social Psychology and Health: European Perspectives”. Eds: Rutter DR and Quine L. Avebury, Brook field, VT 1994.

[7] Morse EV, Simon PM, and Coburn M. Determinants of Subject Compliance within an Experimental Anti-HIV Drug Protocol. Soc. Sci. Med. 1991; 32(10): 1161-7.

[8] Griffith S. A Review of The Factors Associated with Patient Compliance and The Taking of Prescribed Medicines. British Journal of General Practice 1990; 40: 114-6.

[9] Donovan JL, and Blake DR. Patient Non-Compliance: Deviance or Reasoned Decision-Making? Soc Sci Med. 1992; 34(5): 507-13.

[10] Rudd P, Tul V, and Brown K. Hypertension Continuation Adherence: Natural history and role as an indicator condition. Arch Intern Med. 1979; 139-545.

[11] Eldred L, Wu A, and Chaisson RE. Adherence to Antiretroviral Therapy in HIV Disease. 4th Conference on Retroviruses and Opportunistic Infections. Washington DC. Abstract, 1997.

[12] Eraker SA, Kirscht JP, and Becker MH. Understanding and Improving Patient Compliance.
Ann Intern Med. 1984; 100:258-68.

[13] Tseng AL. Compliance Issues in the Treatment of HIV Infection. Am J Health Syst Pharm. 1998; 55:1817-24.

[14] Deeks SG, Smith M, and Holodniy M. HIV-1 Protease Inhibitors: A review for clinicians. JAMA 1997; 277: 145-53.

[15] Swindells S, and Gendelman HE. The New Non-Nucleoside Reverse Transcriptase Inhibitors. Infect Med. 1996; 13:715-9,731.

[16] Ferradini L, Jeannin A, Pinoges L, Izopet J, Odhiambo D, and Mankhambo L. Scaling up of highly active anti-retroviral therapy in a rural district of Malawi: an effectiveness assessment. The Lancet. 2006; 367(9519):1335-42.

[17] Carpenter CCJ, Fischl MA, and Hammer SM. Antiretroviral Therapy for HIV infection. JAMA 1996; 276:146-54.

Abstract:

As the proportions of people living with HIV who do not know their HIV infection status decrease, reaching the last mile of those who are asymptomatic and not in contact with the health care system becomes a critical challenge. This project will use an explanatory sequential mixed-methods study design. It will be conducted in three high-volume health facilities in Matero sub-district 3 of Lusaka district in Zambia over a period of one year. The specific objectives are: to understand the perceived facilitators and barriers to HIV partner testing from the perspective of the health-care provider; to propose interventions necessary for improved HIV case finding; and to reach high risk but hard to reach populations in HIV programs such as middle-aged men and adolescent girls and young women (AGYW). The permission to conduct this study will be obtained from the Lusaka provincial health office before its commencement. Ethical clearance will be sought and obtained from the ERES Converge research ethical committee. The authority to conduct research will be sought from the National Health Research Authority. The expected main findings following the address of the identified challenges are: increased number of recipients of care indexed, increased index contact elicitation ration from 1:1 to at least 1:2, improved rate of contacts tested on time, improved HIV case finding through index testing, and overall, increased HIV index testing positivity rate from below 25% (baseline) to above 40% (at the end of the project).

References:

[1] UNAIDS, Joint United Nations Programme on HIV/AIDS, Global AIDS Update 2018. Miles to go: Closing Gaps; Breaking Barriers; righting injustices. https://www.unaids.org/en/resources/documents/2018/global-aids-update.

[2] Zambia Population-Based HIV Impact Assessment Zamphia 2015–2016.

https://phia.icap.columbia.edu/wp-content/uploads/ZAMBIA-Factsheet.FIN_.pdf.

[3] AVERT, Global information and education on HIV and AIDS, HIV and AIDS in Zambia, 2018. https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/zambia.

[4] M. Katbi, A. Adegboye, A. Adedoyin, F. Yunusa, et al. Effect of clients Strategic Index Case Testing on community-based detection of HIV infections (STRICT study).

https://www.ncbi.nlm.nih.gov/pubmed/term=Effect+of+clients+Strategic+Index+Case+Testing+on+community-based+detection+of+HIV+infections+(STRICT+study).

[5] Partner and Family based Index case testing. A Standard Operating Procedure (SOP). https://static1.squarespace.com/static/5a29b53af9a61e9d04a1cb10/t/5bcf3f4324a69482bb98d34f/1540308814679/Index+Testing+SOP+slides+_v12+October+10+2018.pdf.

[6] Marya Plotkin; Catherine Kahabuka; Alice Christensen; Denice Ochola. Outcomes and Experiences of Men and Women with Partner Notification for HIV Testing in Tanzania: Results from a Mixed Method Study. Open access publication, published online on 31 October 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758678/.

[7] Gari S, Malungo JRS, Martin-Hilber A, Musheke M, Schindler C, Merten S. HIV testing and tolerance to gender based violence: a cross-sectional study in Zambia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749220/.

[8] World Health Organization. HIV status disclosure to sexual partners: rates, barriers, and outcomes for women. Geneva; 2003.

http://apps.who.int/iris/bitstream/10665/42717/1/9241590734.pdf.

[9] Obermeyer C, Osborn M. The utilization of testing and counseling for HIV: a review of the social and behavioural evidence.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994175/.

[10] K. Selvaraj, A. M. V. Kumar, S. Chawla, K. S. Shringarpure, et al. Are partners of HIV-infected people being tested for HIV? A mixed-methods research from Gujarat, India. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5526482/.

[11] Skovdal M, Campbell C, Madanhire C, Mupambireyi Z, Nyamukapa C, Gregson S. Masculinity as a barrier to men's use of HIV services
in Zimbabwe. Global Health. 2011; 7:13. Published 2011 May 15. doi:10.1186/1744-8603-7-13 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107786/.

[12] Obermeyer CM, Osborn M. The utilization of testing and counseling for HIV: a review of the social and behavioral evidence. Am J Public Health. 2007;97(10):1762–1774. doi:10.2105/AJPH.2006.096263 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994175/.

[13] Obermeyer CM, Sankara A, Bastien V, Parsons M. Gender and HIV testing in Burkina Faso: an exploratory study. Soc Sci Med. 2009;69(6):877–884. doi:10.1016/j.socscimed.2009.07.003 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260152/.

[14] Brown LB, Miller WC, Kamanga G, et al. HIV partner notification is effective and feasible in sub-Saharan Africa: opportunities for HIV treatment and prevention. J Acquir Immune Defic Syndr. 2011;56(5):437–442. doi:10.1097/qai.0b013e318202bf7d https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3207356/.

[15] Plotkin M, Kahabuka C, Christensen A, et al. Outcomes and Experiences of Men and Women with Partner Notification for HIV Testing in Tanzania: Results from a Mixed Method Study. AIDS Behav. 2018;22(1):102–116. doi:10.1007/s10461-017-1936-x. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758678/.

Abstract:

The Corona Virus Disease 19 (COVID-19) is the greatest threat to public health in recent times. It has infected over 40 million people globally, having an untoward economic impact on many nations. A global race to find a safe and effective vaccine is ongoing, but controversies exist over the conduct of the vaccine trials among the African population. We assessed the awareness, perceptions of, and willingness to participate in the anticipated COVID-19 vaccine trials among adults in the Federal Capital Territory (FCT), Nigeria. Method: We used a web-based cross-sectional correlational survey and a purposive quota sampling technique to select 478 respondents. Results: 65.2% were aware of the anticipated COVID-19 vaccine trials, 73% had positive perceptions about it, 63.1% expressed fear about it, 46% are not willing to participate in the trials, and 65.2% will not recommend the trials to a family or friend. The correlation between perception and willingness to participate in the trial was positive and low (r=0.043, p<0.667). Sex, age, religion, Area Councils were significantly associated with willingness to participate in the trials. (P-Values 0.001, 0.003, 0.001 and 0.001 respectively). The primary sources of information about the trials include church/mosque, family, healthcare providers, and friends. Conclusion: There is a high level of Awareness of the COVID-19 vaccine trials; perceptions of the trial are positive, but most people are afraid and will neither participate nor recommend the trials to significant others. We recommend a targeted psychosocial intervention to increase participation in the trial and future COVID-19 vaccine uptake.

References:

[1] David J Cennimo, MD, FAAP, FACP, AAHIVS; Michael Stuart Where did the coronavirus outbreak start? - Medscape.

https://www.medscape.com/answers/2500114-197403.

[2] The WHO Just Declared Coronavirus COVID-19 a Pandemic - World Health Organization -https://time.com/5791661/who coronavirus pandemic declaration.

[3] 2009 H1N1 Pandemic (H1N1pdm09 virus) – CDC - https://www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemic.html.

[4] Dr. Anthony Fauci on COVID-19 Pandemic and Public Health Policy - Director of National Institute of Allergy and Infectious Diseases.

[5] NCDC Coronavirus COVID-19 Microsite - https://covid19.ncdc.gov.ng/.

[6] Older Adults and COVID-19 | CDC - https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html.

[7] Nigerian scientists develop. Covid-19 vaccine need human - Uwagbale Edward-Ekpu https://qz.com/africa/1911951/nigerian-scientists-develop-covid-19-vaccine-need-human- trials/.

[8] Coronavirus Vaccine Tracker - The New York Times (2020)

https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html.

[9] Michael S. Diamond and Theodore C. Pierson (2020) - The Challenges of Vaccine Development against a New Virus during a Pandemic - Cell Host Microbe. 2020 May 13; 27(5): 699–703.2020 May 13. DOI: 10.1016/j.chom.2020.04.021 PMCID: PMC7219397 PMID: 32407708.

[10] COVID-19 vaccine – Wikipedia- https://en.wikipedia.org/wiki/COVID-19_vaccine.

[11] Kleinnijenhuis van Crevel R et al, 2015- Innate Immune Recognition of Mycobacterium https://www.researchgate.net/publication/51156793.

[12] De Vrieze, 2020 - Can a century-old TB vaccine steel the immune system- against-new-coronavirus? https://www.sciencemag.org/news/2020/03/-.

[13] Coronavirus Myth busters - World Health Organization https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for- public/myth busters-.

[14] News from the National Library of Medicine – 2020 https://www.nlm.nih.gov/news/2020.html.

[15] Thorp, (2020) - COVID-19 vaccine – Wikipedia https://en.wikipedia.org/wiki/COVID-19_vaccine.

[16] Stevis-Gridneff & Jakes, (2020) - Coronavirus Vaccine Research Gets $8 Billion in Pledges https://www.nytimes.com/2020/05/04/world/europe/eu-coronavirus-vaccine.html.

[17] Blanchfield, (2020) - Blanchfield Army Community Hospital Jobs https://www.indeed.com/q-Blanchfield-Army-Community-Hospital-jobs.html.

[18] Russia registers first COVID-19 vaccine, President Putin 12 Aug 2020 https://www.expresspharma.in/covid19-updates/russia-registers-first-covid-19-vaccine-president-putins-daughter-given-a-shot/.

[19] Russian President Vladimir Putin (2020) https://www.cbsnews.com/news/covid-vaccine-russia-coronavirus-development/.

[20] Mahase, (2020) - Covid-19: US approves emergency use of convalescent BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3327 (Published 25 August 2020 https://www.bmj.com/content/370/bmj.m3327.

[21] Finnan, 2020 - COVID-19 trials at risk after Africa ‘racism’ backlash - SciDev.Net https://www.scidev.net/global/health/news/covid-19-trials-at-risk-after-africa-racism- backlash.html.

[22] African Heath Sciences Vol 5 No 3back up.p65 https://www.ajol.info/index.php/ahs/article/view/7017/1429.

[23] Omeiza Ajayi 12 May 2020. Vanguard Nigeria: COVID-19 - Govt Okays 5 States, FCT for WHO https://allafrica.com/stories/202005120583.html.

[24] Labban L, Thallaj N. & Labban A. (2020) - Assessing the Level of Awareness and Knowledge of COVID-19 Pandemic among Syrians. Archives of Medicine. 12(2) 1-5.

[25] Hadil A., Basingabb F. & Reem A. (2020) - An analytical study on the awareness, attitude and practice during the COVID-19 pandemic in Riyadh, Saudi Arabia. Journal of Infection and Public Health 13 (2020) 1446–1452.

[26] Sun, S., Lin, D. & Operario, D. (2020) - Willingness to Participate in a COVID-19 Vaccine Trial Among Young Adults in China. Journal of infectious disease, 221(8) 1-28.

[27] National Population Estimates - National Bureau of Statistics Source: National Population Commission and National Bureau of Statistics Estimates. POPULATION FORECASTS 2006 - 2016. STATE. 2006. 2007. 2008. 2009. https://nigerianstat.gov.ng/download/474.

[28] Slovin’s Formula Sampling Techniques - https://sciencing.com/slovins-formula-sampling-techniques-5475547.html.

[29] Louay Labban1, Nasser Thallaj1 and Abear Labban (Nov.2020) Assessing_the_Level_of_Awareness_and_Knowled
ge_of_COVID_19_Pandemic_among_Syrians https://www.researchgate.net/publication/342677705.

[30] National Cancer Institute (NCI) | National Institutes of Health (December, 2004) https://www.nih.gov/about-nih/what-we-do/nih-almanac/national-cancer-institute-nci.

[31] Olayinka Victor Ojo, et al. (2020) - Knowledge, Attitude and Willingness of Health Care Workers towards COVID-19 Preventive Measure in a Tertiary Health Institution in North Eastern Part of Nigeria – Central African Journal of Public Health 6(5) DOI: 10.11648/j.cajph.20200605.13 http://article.sciencepublishinggroup.com/pdf/10.11648.j.cajph.20200605.13.

Abstract:

Patients should first be counselled and tested for HIV to benefit from available care and treatment options. The aim of this paper was to find out the level of acceptance of HIV testing among patients who visit the Chest Diseases Clinic of the Korle-Bu Teaching Hospital, Ghana. Information about all adult tuberculosis patients who attended the clinic between January and December 2019 in which patients’ socio-demographic information and tuberculosis treatment history were taken from the TB register, patients who showed initial willingness were referred to a VCT counsellor for HIV counselling before testing was done. Rapid test methods were used, and the results were disclosed. The logistic regression method was used to assess the factors associated with HIV co-infection, willingness, and acceptability. 250 tuberculosis (TB) patients who were among the total of 485 gave their consent and willingly participated in this study. Their median age was 30 years (range, 13–50+), and 56.8% of them were females. 29 patients had tested previously, including 29 HIV positive. 66.0% (165) were willing to be tested.

References:

[1] Guidelines for The Clinical Management of Tb and HIV Co-Infection in Ghana July 2007, TB/HIV Collaboration Disease Control and Prevention Department Ghana Health Service P. O. Box KB 439 Korle Bu, Accra GHANA Email: HTUntp@africaonline.com.gh.

[2] WHO/UNAIDS: UNAIDS/WO policy statement on HIV testing. 2004.

[3] Fylkesnes K, Siziya S. A randomized trial on acceptability of voluntary HIV counseling and testing. Tropical Medicine and International Health 2004; 9:566-72.

[4] Valdiserri et al,1999-2000 Promoting early HIV diagnosis and entry to care, AIDS 13(17):2317-30 DOI: 10.1097/00002030-199912030-00003, PubMed.

[5] UNAIDS: HIV voluntary counseling and testing: a gateway to prevention and care. Five case studies related to mother-to-child transmission of HIV, tuberculosis, young people, and reaching general population groups. UNAIDS Case Study 2002.

[6] https://www.ccmghana.net/index.php/principal-recipients/2018-2020/tuberculosis.

[7] University Research Co., LLC. Integrating home based HIV counseling and testing into TB/HIV collaborative activities using co-infected TB, HIV positive index case: experiences from Swaziland, November 2010.

[8] Sendagire I, Schreuder I, MubiruM, van der Loeff MS, Cobelens F, Konde-Lule J. Low HIV testing rates among tuberculosis patients in Kampala, Uganda. BMC Public Health 2010; 10(1):177, 1-9.

[9] Jerene D, Aschalew E, Bernt L. Acceptability of HIV counseling and testing among tuberculosis
patients in south Ethiopia. BMC International Health and Human Rights 2016;7(4):1-6.

[10] Group TVH-CaTS. Efficacy of voluntary HIV-1 counseling and testing among individuals and couples in: Kenya Tanzania, and Trinidad: a randomized trial. Lancet 2000; 356:103-12.

Abstract:

Modern contraceptive use among couples has been documented to be a highly effective means of improving maternal health by preventing unintended pregnancies and maternal morbidity. Nigeria has a high fertility rate and poor contraceptive usage, marred by social and economic dimensions with other cultural norms, including gender disparity. This paper presents the findings of a cross-sectional quantitative study exploring the adoption and utilization of family planning services among couples in rural-urban communities in Oyo State, Nigeria. Systematic sampling technique was used to select 570 women and men of reproductive age in Rural-urban communities of the Oyo state, using a 54 semi-structured questionnaire which included questions on socio-demographic characteristics, perception, socio-cultural factors, adoption, and utilization of modern contraceptive services. Of the 570 respondents, the mean age of the respondents was 30.3 ±7.8 years. Most (63.3%) of respondents were females, while 36.7% were males. The most common family planning methods respondents and their spouses had heard injectable (21.2%), the male condom (18.6%), and implants (15.1%), IUD (13.4%), and pills (13.2%). Spousal support is 0.438 times more likely to influence utilization of modern family planning method and was statistically significant (β=-0.826, Odd Ratio [OR]=0.438, p<0.05). Similarly, stigmatization is 1.298 times more likely to influence the level of utilization of modern family planning methods (β=0.261, Odd Ratio [OR]=1.298, p<0.05). It is important for government and family planning programmers to focus on programs that address stigmatization and effective spousal communication for improved modern contraceptive uptake.

References:

[1] OECD (2012) NIGERIA-OVERVIEW- West Africa Gateway https://www.oecd.org/swac/publications/Nigeria_e-version_en_light.pdf.

[2] National Population Commission. [Nigeria] and ICF. (2019). Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF.

[3] Apanga, P. A., & Adam, M. A. (2015). Factors influencing the uptake of family planning services in the Talensi District, Ghana. Pan African Medical Journal, 20(1).

[4] Guttmacher Institute Fact Sheet. (2015) Abortion in Nigeria.

[5] WHO. (2018). Family Planning/contraception fact sheet. Retrieved Feb.26, 2019, from: https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception.

[6] Macro, I. C. F., & National Population Commission. (2009). Nigeria demographic and health survey 2008. Abuja, Nigeria: National Population Commission and ICF Macro.

[7] National Bureau of Statistics (Nigeria). (2012). Annual Abstract of Statistics, 2012. National Bureau of Statistics Federal Republic of Nigeria [Online].

[8] Adeyemi A., Olugbenga-Bello A.I., Adeoye O., Salawu M., Aderinoye A., Agbaje M. (2016) Contraceptive Prevalence and determinants among women of reproductive age group in Ogbomoso, Oyo State, Nigeria. Open Access J Contracept. 2016; 7:33-41 https://doi.org/10.2147/OAJC.S94826.

[9] Akokuwebe, M.E. and Ojo, O. A., (2016). Factors Influencing Acceptability of Family Planning among Women in Rural Communities in Ife Central Local Government Area, Osun State, Nigeria. Ibadan Journal of the Social Sciences, 14 (2),250-261.

[10] Thomas, O. (2020). City Population - statistics, maps & charts. Retrieved 09 25, 2020, from Oyo State in Nigeria: https://www.citypopulation.de/php/nigeria-admin.php?adm1id=NGA031.

[11] Manpower Nigeria. (2020). Kajola local government area (L/G.A): Oyo state. Retrieved September 26, 2020 from Manpower Nigeria: https://www.manpower.com.ng/places/lga/687/kajola.

[12] Esike C.O.U., Anozie O.B., Ani M., Ekwedigwe K., Onyebuchi A.K., Ezeonu P.O., et al. (2017) Barriers to family planning acceptance in Abakaliki, Nigeria. Tropical Journal of Obstetrics & Gynaecology, 34:212-7.

[13] Etokidem, A. J., Ndifon, W., Etowa, J., & Asuquo, E. F. (2017). Family planning practices of rural community dwellers in cross river state, Nigeria. Nigerian Journal of clinical practice, 20(6), 707-715. https://www.guttmacher.org/fact-sheet/abortion-nigeria.

[14] Islam, A. Z. (2018). Factors affecting modern contraceptive use among fecund young women in Bangladesh: does couples’ joint participation in household decision-making matter? Reproductive health, 15(1), 1-9.

[15] Donta B., Nair S., Saggurti N., Ghule M., Battala M., Dasgupta A., Gajanan V., Silverman J. and Raj A. (2016) The Importance of Husbands’ Engagement in Family Planning Discussion to Promote Contraception Use for Birth Spacing in Rural India. Asia-Pacific Population Journal. 31 (2) 5-20.

[16] Duru C. B., Nnebue C.C., Iwu A.C., Oluoha R.U., Ndukwu E.U., Nwaigbo E. (2018). Utilization of Family Planning Services among Women of Reproductive Age in Urban and Rural Communities of Imo State, Nigeria: A Comparative Study. Afrimedic Journal, 6(1): 11-26.

[17] Johnson O.E (2017). Determinants of Modern Contraceptive Uptake among Nigerian Women: Evidence from the National Demographic and Health Survey. African Journal of Reproductive Health. 21[3]: 89-95.

[18] Jayalakshmi A*, Kirani, A. **, Prabhakar P K** and Pushpanjali, S.** (2002) A Study of Male Involvement in Family Planning. Health and Population Perspectives and Issues 25 (3): 113 - 123, https://www.researchgate.net/publication/265183365 8:2582-6.

[19] Mutombo N. and Bakibinga P. (2014). The effect of joint contraceptive decisions on the use of Injectables, Long-Acting and Permanent Methods (ILAPMs) among married female (15–49) contraceptive users in Zambia: a cross-sectional study. Reproductive Health. 11:51 http://www.reproductive-health-journal.com/content/11/1/51.

[20] Blackstone, S. R., & Iwelunmor, J. (2017). Determinants of contraceptive use among Nigerian couples: evidence from the 2013 Demographic and Health Survey. Contraception and reproductive medicine, 2(1), 1-8.

[21] Omololu Adegbola, Fatimah Murtazha, Habeebu-Adeyemi, (2016). The influence of male partners on contraceptive usage in sub-Saharan Africa-Lagos experience. Vol. 13, Issue 3, Pg. 112-116. doI: 10.4103/2468-6859.185247 http://www.jcsjournal.org/article.asp?issn=24686859;year=2016;volume=13;issue=3;spage=112;epage=116;aulast=Adegbola.

[22] Jain, A., Ismail, H., Tobey, E., & Erulkar, A. (2019). Stigma as a barrier to family planning use among married Youth in Ethiopia. Journal of biosocial science, 51(4), 505-519.

Abstract:

The tuberculosis prevalence survey conducted in 2018-2019 has given the new estimation of TB prevalence (117,000) in Nepal. Out of the estimated burden, about 32,000 people were diagnosed and registered in the National Tuberculosis Programme for treatment in 2019. More than half of the projected tuberculosis cases are still missing in the country, which is a major challenge for achieving the END TB targets by 2035. The study aims to identify the challenges of carrying out the National Tuberculosis Prevalence Survey (NTPS) and recommend possible ways to mitigate the encounters in the future study. All tuberculosis prevalence survey reports were obtained from the World Health Organization as grey literature and analyzed the methods that they used to carry out the survey, challenges they faced while conducting the surveys, and programme implications after the surveys. The studies used a cross-sectional population-based random sampling method to select the clusters using the proportional population to size (PPS) method to select primary and secondary sampling units. Multiple challenges existed to conduct the survey in the country. The logistical and transportation of sputum, equipment, and human resources in different geographical terrain, the low positive rate in culture method and less priority given for health-seeking behavior and TB risk factors in the survey. There are several challenges for conducting a nationwide survey. However, they can be resolved by developing alternatives and communicating the plan in advance. The survey always provides the ground to improve and expand the scope of strategies and interventions, which leads to achieving the desired goals in the programme.

References:

[1] World Health Organisation, (2019), Global Tuberculosis Report.

[2] Ministry of Health and Population, National Tuberculosis Control Centre, (2020), Annual Progress Report.

[3] Onuka O, et al., 2018, Effectiveness of Contact Tracing of Index Tuberculosis Cases in Nigeria. Adv Infect Dis. 2018;08(04):173–99.

[4] Amo-Adjei J, 2016., Individual, household and community level factors associated with keeping tuberculosis status secret in Ghana. BMC Public Health [Internet]. 2016;16(1):1–9 http://dx.doi.org/10.1186/s12889-016-3842.

[5] Ministry for Health (2016), Report of the first national tuberculosis prevalence survey in Mongolia 2014-2015.

[6] Ministry of Health and Sports (2019), 4 th National TB Prevalence Survey 2017/2018, Myanmar, short version, version 1 as of Aug 2019.

[7] Ministry of Health and Family Welfare (2016), National Tuberculosis Prevalence Survey Bangladesh 2015-2016.

[8] Ministry of Health (2015), Indonesia Tuberculosis Prevalence Survey Indonesia 2013-14.

[9] Floyd K, et.al, Prevalence survey update. Available from:

http://www.stoptb.org/countries/tbteam/assets/documents/MeetingDocs6/12PrevalenceSurvey_EpiAssessments_TBsurveillanceassessments.pdf.

[10] King NR, et.al, 2006, Kingdom of Cambodia Ministry of Health Report of. 2006;(September).

[11] Ministry of Health (2012), report second Tuberculosis N, Program C. Report Second National Tuberculosis Prevalence Survey, 2011.

[12] Ministry of National Health Services Regulation and Services (2010/11), Prevalence of Pulmonary Tuberculosis among Adult Population of Pakistan.

[13] Ministry of Health (2017), National Tuberculosis Prevalence Survey 2016 Philippines.

[14] Disease Control Bureau of the Ministry of Health (2010), Report on the 5th National Tuberculosis Epidemiological Survey in China.

[15] Ministry of Health (2006), determining the Tuberculosis Burden in Eritrea-new methodological approach, 2005.

[16] World Health Organisation, Country Office Report (2009), Report of the Bangladesh Nationwide Tuberculosis Disease-cum -infection prevalence survey (2007-2009).

[17] Ministry of Health, Vietnam National Tuberculosis Programme (2008), Draft Report National Tb Prevalence Survey 2006–7.

[18] Ministry of Health (2005), Indonesia Tuberculosis Prevalence Survey in Indonesia 2004.

[19] Kapata N, et al. (2016), The Prevalence of Tuberculosis in Zambia: Results from the First National TB Prevalence 2013–4.

[20] Federal Democratic Republic of Ethiopia, Ministry of Health (2011), First Ethiopian National Population Based Tuberculosis Prevalence Survey, Ababa A.

[21] Ministry of Health (2018), Kenya National Tuberculosis Prevalence Survey.

[22] Ministry of Health (2006), determining the Tuberculosis Burden in Eritrea-new methodological approach, 2005.

[23] Republic of Zimbabwe Ministry of Health and Child Care (2014), the Zimbabwe National Population based Tuberculosis Prevalence Survey Report.

[24] Ministry of Health and Social Welfare (2014), the Gambian Survey of Tuberculosis Prevalence (GAMSTEP).

[25] The United Republic of Tanzania, Ministry of Health and Social Welfare (2013), the first National Tuberculosis Prevalence Survey in the United Republic of Tanzania final report;32(C):120.

[26] Bradshaw MJ, et, al. (2020), Neurologic Manifestations of Systemic Rheumatologic Diseases. Current Clinical Neurology. p. 321–42.

[27] Ministry of Health and Social Services (2019), Namibia Tuberculosis Disease Prevalence Survey report.

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Abstract:

Infection prevention and control is an important topic in the delivery of quality health care because it aims at protecting the patient, the health worker, and the general public. The main objective of the study was to determine health workers’ compliance with Infection Prevention and Control policy guidelines during health care delivery. A cross-sectional design using a quantitative method was used to carry out this study in which 143 health workers at the La General Hospital were selected using a stratified sampling method. The data collected using a structured questionnaire was statistically analyzed using chi-square test and logistic regression to establish an association between the dependent and independent variables using a significance level of p<0.05 at 95% Confidence Interval. The results indicated that knowledge of Infection Prevention and Control among health workers was high as 97% had adequate knowledge, with 64% of this proportion having excellent knowledge. Additionally, the availability of infection prevention resources to health workers always was 31.4%; non-compliance due to time constraints at work was 66.4%, and compliance with Infection Prevention and Control guidelines was 30.7%. Time constraint at work was significantly associated with health workers’ compliance with Infection Prevention and Control (p = 0.001). The paper suggests that regular in-service training on Infection Prevention and Control must be continued to improve the standards of health delivery practice. Management is encouraged to improve the availability of Infection Prevention resources to health workers and to duly regulate staff workload in order to reduce time constraints and prevent burnout.

References:

[1] Gracia-Zapata, M. R., Silva e Souza, A. C., Guimaraes, J. V., Tipple, A. F. V., Prado, M. A., Gracia-Zapata, M. T. A., 2010, Standard precautions: knowledge and practice among nursing and medical students in a teaching hospital in Brazil. International Journal of Infection Control, 6(1). DOI: https://doi.org/10.3396/ijic.v6i1.4075.

[2] Jackson, C., Lowton, K., and Griffiths, P., 2014, Infection Prevention as a ‘Show’: A Qualitative Study of Nurses’ Infection Prevention Behaviors. International Journal of Nursing Studies, 51(3), 400-408.

[3] WHO, 2010, The burden of health care associated infections World-wide Geneva, Switzerland: WHO http://www.who.int/gpsc/country_work/burden_hcai/en/.

[4] Public Health England, 2014, Health care associated infections (HCAI): guidance, data and analysis. Accessed on 14/5/2018. www.gov.uk/government/collections/.

[5] National collaborating centre for women’s and children’s health (UK), 2008, Surgical Site Infection: Prevention and Treatment of Surgical Site Infection. (London, U.K.: National Institute of Clinical Excellence (NICE)). https://www.ncbi.nih.gov/books/NBK53731/.

[6] Abou El-Enein, N. Y., & El-Mahdy, H. M., 2011, Standard precautions: a knowledge, attitude and practice study among nurses in the dialysis unit in a University Hospital in Alexandria, Egypt. Journal of Egypt Public Health Association, 86, 3-10.

[7] WHO, 2016, Health care associated infections fact sheet Accessed on 14/5/2018 http://tinyurl.com/d2qwn9m.

[8] Malliarou, M., Sarafis, P., Zyga, S. & Constantinidis, T., 2013, The importance of nurse hand hygiene. International Journal of Caring Sciences, 6(3), 327-331.

[9] Ministry of Health, Ghana, (National Policy and Guidelines for Infection Prevention and Control in Health Care Settings in Ghana, 2015), Accessed on 15/12/2017. http://www.ghanahealthservice.org/downloads/National_Policy_and_Guidelines%20_for_Infection_Prevention_and_Control_in_Health_Care_Settings_2015.pdf.

[10] Hayeh, P. A., 2012, Infection Prevention and Control Practices Among Health Workers at Ridge Regional Hospital. (Master’s Thesis) University of Ghana. http://197.255.68.203/handle/123456789/5874 and http://ugspace.ug.edu.gh/handle.

[11] Enemark, U., Newman, M., Asante, F., & Fenny, A., 2016, Healthcare Associated Infections in Ghana. Accessed on 20/2/2018. Available at http://drp.dfcentre.com/project/healthcare-associated-infections-ghana and http://haiproject.org.

[12] Myjoyonline, 2017, Third time lucky: man shares harrowing experience after losing 2 babies at KATH Accessed on 13/6/2018. Available at https://www.myjoyonline.com/.

[13] Njovu, E., 2016, Factors affecting compliance to Infection Prevention and Control guidelines by Nurses at St. Dominic Mission Hospital, Ndola Copperbelt, Zambia. Texila International Journal, 2(2), 1-10.

[14] Maosa, E. K., 2012, Factors influencing hospital infection prevention and control practices among medical staff in Kisii Level Five Hospital, Kisii County, Kenya. (Master’s Thesis), The University of Nairobi, Kenya.

http://erepository.uonbi.ac.ke/handle.

[15] Yakob, E., Lamaro, T., & Henok, A., 2015, knowledge, attitude and practice towards infection Control measures among Mizan- Aman General Hospital Workers, South West Ethiopia. Journal of Community Medicine and Health Education, 5(5), 370. Doi: 10.4172/2161 -0711.1000370.

[16] Chipfuwa, T., Manwere, A., & Shayamano, P., 2014, Barriers to infection prevention and control (IPC) practice among nurses at Bindura Provincial Hospital, Zimbabwe. IOSR Journal of nursing and health science, 3(1), 69-73.

[17] Suchitra, J. B., & Lakshmi Devi, N., 2007, Impact of education on knowledge, attitudes and practices among various categories of health care workers on nosocomial infections. India Journal of Medical Microbiology.25(3), 181-187.

[18] Ward, D., 2011, The role of education in the prevention and control of infection: A review of the literature Nurse Education Today. 31(1), 9-17.

[19] Warren, D., & Kollef, M., 2005, Prevention of Hospital Infection. Microbes and Infection. 7(2), 267-273.

[20] Raka, L., 2010, prevention and control of hospital-related infections in low- and middle-income Countries. The Open Infectious Disease Journal. 4(1), 125 – 131.

[21] Mukwato, K. P., Ngoma, C. M., & Maimbolwa, M., 2007, compliance with infection prevention guidelines by health care workers at Roland Ross General Hospital Mufulira District. Medical Journal of Zambia, 35(3), 110-116.

[22] Delaune, S. C., & Ladner, P. K., 2010, Fundamentals of nursing standards and practice (4th ed.) (Clifton Park, NY: USA Cengage Learning).

[23] Canadian Committee on Antibiotic Resistance, 2007, Infection Prevention and Control Best Practices for Long Term Care, Home and Community Care including Health Care Offices and Ambulatory Clinics. Accessed on 10/3/2018. www.ccar-ccra.org.

[24] Harbarth, S., Sudre, P., Dharan, S., Cadenas, M. & Pittet, D., 1999, Outbreak of Enterobacter Clocae Related to Understaffing, overcrowding and Poor Hygiene Practices. Infection Control and Hospital Epidemilogy, 20(9), 598-603.

[25] Ward, D. J., 2012, Attitudes towards infection prevention and control: an interview study with nursing students and nurse mentors. PubMed Journal, 21(4):301-6. Doi: 10.1136/bmjqs-2011-000360 PMID:22328459.

[26] Israel, G. D. (1992). Determining sample size. University of Florida Cooperative Extension Service http://www.sciepub.com.

Abstract:

Young females usually migrate from the Northern part of Ghana to the South to engage in head porting business. However, the high cost of rent in urban areas and the poor environmental conditions of poor urbanites have exposed head porters to bad conditions with varying implications on health and well-being. This study examines the health-related conditions of female head porters in Kumasi through stakeholders’ opinions. The study used quantitative methods in eliciting information from female head-porters in Asokore Mampong, Kumasi. In all, 100 respondents; comprising relatives of female head porters and other opinion leaders such as the Assembly member, Imam, Pastor, Teachers from Northern Ghana, were interviewed through self-administered questionnaires. Data were analyzed using a statistical package for the social sciences (SPSS) and excel. Economic reasons remain topical for the migration of females from the north to the south to engage in head porting. While many of these migrants do not return home, leading to the emergence of migrant settlements in Kumasi, others return to support their families with their earnings. Stakeholders argued that skills development and creating of entrepreneurial ventures are necessary to reduce the north-south migratory patterns. The migration of females from the north to the south in search of greener pastures is likely to continue as a result of opportunity gaps. However, worsening conditions of living may deteriorate the health conditions of some of the migrants. Stakeholders recommend a new wave of solutions with focus on skills development, job creation, and entrepreneurial training as solutions.

References:

[1] ILO. (2004). World employment report 2004-05. Employment, productivity, and poverty reduction (includes CD-ROM). Retrieved from http://www.ilo.org/global/publications/ilo-bookstore/order- online/books/WCMS_PUBL_9221148130_EN/lang--en/index.htm.

[2] Shamsu-Deen, Z., & Adadow, Y. (2019). Health-seeking behaviour among migrant female head porters in the City of Accra, Ghana. Ghana Journal of Development Studies, 16(2), 138-156–156. https://doi.org/10.4314/gjds.v16i2.7.

[3] Tufeiru, A. (2014). The Nexus of Female Capital and North-South Labor Migration in Ghana: A Potential Remedy from Microfinance. Journal of Developing Societies 30(1), 91–114. https://doi.org/10.1177/0169796X13504680.

[4] Owusu-Ansah, J. K., & Addai, M. (2016). Coping with life in a squatter settlement: The case of migrant women in Kumasi, Ghana. Journal of Science and Technology, 33(3). https://webapps.knust.edu.gh/just/index.php?journal=just&page=article&op=view&path%5B%5d=1426.

[5] Owusu, A. (2012). The Living Conditions of Female Head Porters in the Kumasi Metropolis, Ghana. Retrieved July 31, 2017, from Research Gate website: https://www.researchgate.net.

[6] Opare, J. A. (2003). Kayayei: The women head porters of southern Ghana. Journal of Social Development in Africa, 18(2). https://doi.org/10.4314/jsda.v18i2.23825.

[7] Hashim, I. (2007). Independent Child Migration and Education in Ghana. Development and Change, 38(5), 911–931. https://doi.org/10.1111/j.14677660.2007.00439.x.

[8] Kwankye, S. O., Anarfi, J. K., Tagoe, C. A., & Castaldo, A. (2007). Coping Strategies of Independent Child Migrants from Northern Ghana to Southern Cities (Available):/publication/237502608_Coping_Strategies_of_Independent_Child_Migrants_from_Northern_Ghana_to_Southern_Cities.

[9] Otieku, E., Ackah, C. G., & Forkuor, D. (2017). Motivations, income determinants, and livelihood vulnerability of female teenage head porters in Kasoa, Ghana. International Journal of Social Economics, 44(12), 2396–2408. https://doi.org/10.1108/IJSE-10-2016-0286.

[10] Nyarko, S. H., & Tahiru, A. M. (2018). Harsh Working Conditions and Poor Eating Habits: Health-Related Concerns of Female Head Porters (Kayayei) in the Mallam Atta Market, Accra, Ghana. BioMed Research International, 2018, 1–7. https://doi.org/10.1155/2018/6201837.

[11] Agarwal, S., Attah, M., Apt, N., Grieco, M., Kwakye, E. A., & Turner, J. (1997). Bearing the weight: The kayayoo, Ghana’s working girl child. International Social Work, 40(3), 245–263. https://doi.org/10.1177/002087289704000302.

[12] Azumah, F. D. & Onzaberrugu J. N. (2018). The Lifestyle of female head porters: the single mother and her coping strategies at Aboabo, Kumasi. International Journal of Innovation Education and Research 6(2).

[13] Owusu, L. & Yeboah, T. (2018). Living conditions and social determinants of healthcare inequalities affecting female migrants in Ghana. GeoJournal.

[14] Boateng, S., Amoako, P., Poku, A. A., Baabereyir, A., & Gyasi, R. M. (2017). Migrant female head porters’ enrolment in and utilization and renewal of the National Health Insurance Scheme in Kumasi, Ghana.

[15] Bessey, F. O. (2015). The Woes of the Returnee Female Migrant: Case of Kayayei from Northern Ghana. Developing Country Studies, 5(6), 168–172. Retrieved from

http://www.iiste.org/Journals/index.php/DCS/article/view/2098.

[16] Shamsu–Deen, Z. (2013). Migration and Health Nexus: A Case of Female Porters (Kayayei) in Accra, Ghana. Research on Humanities and Social Sciences, 3(3), 103–109.

http://www.iiste.org/Journals/index.php/RHSS/article/view/4936.

[17] Owusu, G., Agyei-Mensah, S. and Lund, R. (2008). Slums of hope and slums of despair: Mobility and livelihoods in Nima, Accra, Norsk Geografisk Tidsskrift, 62:180-190.

[18] Boakye-Yiadom, L., & Mckay, A. (2006). Migration between Ghana’s Rural and Urban Areas: The Impact on Migrants Welfare (PDF Download Available). Retrieved August 3, 2017, from Research Gate website: https://www.researchgate.net/publication/228393018_Migration_between_Ghana’s_Rural_and_Urban_Areas_The_Impact_on_Migrants_Welfare.

[19] Awumbila, M., & Ardayfio-Schandorf, E. (2008). Gendered poverty, migration and livelihood strategies of female porters in Accra, Ghana. Norwegian Journal of Geography, 62(3), 171–179. https://doi.org/10.1080/00291950802335772.

[20] Yeboah, M. (2008). Gender and livelihoods: Mapping the economic strategies of porters in Accra, Ghana. Retrieved July 31, 2017, from http://pqdtopen.proquest.com/doc/304446957.html?FMT=ABS.

[21] Wilson, A., & Mittelmark, M. B. (2013). Resources for Adjusting Well to Work Migration: Women from Northern Ghana Working in Head Porterage in Greater Accra. Africa Today, 59(4), 24–38. Retrieved from https://muse.jhu.edu/article/511476.

[22] Wilson, A. (2012). Resources for Thriving among Female porters in Accra. A Qualitative study of Migrants from Northern Ghana to Greater Accra Region. A Salutogenic Approach. Retrieved from https://bora.uib.no/handle/1956/5879.

[23] Jenkins, E. K., Slemon, A., Haines-saah, R. J., & Oliffe, J. (2018). A Guide to Multisite Qualitative Analysis. Qualitative Health Research, 28(12), 1969–1977.
https://doi.org/10.1177/1049732318786703.

[24] Guest, B. G., Macqueen, K. M., & Namey, E. E. (2014). Integrating Qualitative and Quantitative Data. In Applied Thematic Analysis (pp. 187–216). Thousand Oaks: SAGE Publications, Inc.

[25] Guest, B. G., Namey, E. E., & Mitchell, M. L. (2017). Sampling in Qualitative Research. In Collecting Qualitative Data: A Field Manual for Applied Research (pp. 41–74). 55 City Road: SAGE Publications, Ltd.

Abstract:

Preeclampsia (PE) is the leading cause of maternal and perinatal morbidity/mortality. A study in Lusaka estimated Preeclampsia/Eclampsia prevalence at 18.9%. The aim of the study was to determine the health system and maternal predictors of preeclampsia among pregnant women attending public health facilities (HF) in Lusaka, Zambia. This is a 12months retrospective cohort study. Records of 770 pregnant women during antenatal care between January to December 2020 from five HFs in Lusaka were reviewed and classified into with or without PE. The risk factors for PE were abstracted from the records. Descriptive analysis and inferential statistics were determined. The respondents were aged 18-40years with mean age of 27.09 years and SD±5.1. Age 25- 32 years accounted for 344 (45%), Married 250 (82%), 346 (45%) had secondary school education and 293 (38%) had parity of 2. Significant differences were observed in the administration of magnesium sulphate and oxygen for severe preeclampsia (p = 0.001) and anti-hypertensive for eclampsia (p < 0.05). Knowledge gaps in the diagnosis and management of pre-eclampsia were identified. Multivariate analysis revealed woman’s age (aOR= 0.326, 95% CI: 0.0024-0.8231), education aOR= 0.128, 95% CI: 0.00121-0.0323) and a good nutritional diet aOR= 0.109, 95% CI: 0.0393-0.4639) were independent predator of PE. Predictors of PE amongst pregnant women were having preeclampsia in the previous pregnancy, having parity of three or more, and knowledge gaps in the diagnosis and management of PE were found. We recommend refresher training on detection and management of PE among health workers attending to pregnant women.

References:

[1] Vousden N, Lawley E, Seed PT, et al. Incidence of eclampsia and related complications across 10 low- and middle-resource geographical regions: Secondary analysis of a cluster randomized controlled trial. PLoS Med. 2019; 16(3): e1002775. https://doi.org/10.1371/journal.pmed.1002775.

[2] World Health Organization. (2015) Trends in maternal mortality: 1990 to 2015. Estimates by WHO, UNICEF, UNFPA, The World Bank, and the United Nations Population Division. Geneva: World Health Organization; 2015 [cited 2019 Mar 6]. Available from: http://apps.who.int/iris/bitstream/10665/194254/1/9789241565141_eng.pdf? ua=1.

[3] Say L, Chou D, Gemmill A, et al. (2014) Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014; 2(6): e323–33.

[4] World Health Organization. (2011) WHO recommendations for Prevention and treatment of preeclampsia and eclampsia. Geneva: World Health Organization. 2011.

[5] Ness R B and Roberts J M (1996) Heterogeneous causes constituting the single syndrome of preeclampsia: a hypothesis and its implications, AmJ Obstet Gynecol Nov; 175(5):1365-70.

[6] Ramanathan J and Kelly B (2003) Pre-eclampsia: fluids, drugs, and anesthetic management, Anesthesiol Clin North Am, 2003 Mar; 21(1):145-63.

[7] Duley L (2009). The Global Impact of Pre-eclampsia and Eclampsia. Semin Perinatol. Jun. 2009; 33(3):130–7. http://dspace.unza.zm:8080/xmlui/handle/123456789/3145?show=full.

[8] Abalos E, Cuesta C, Grosso AL, Chou D, Say L. (2013) Global and regional estimates of preeclampsia and eclampsia: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2013; 170(1):1–7.

[9] Chowa PE, Lin C, Goma F, (2011) Prevalence of Hypertension Among Women of Child.

[10] Chisoko CE. (2013) Preeclampsia: maternal and fetal outcomes according to symptomatology and proteinuria at University Teaching Hospital, Lusaka. University of Zambia. 2013.

[11] Ministry of Community Development, Mother and Child Health and Ministry of Health. Zambia National Emergency Obstetric and Newborn (EmONC) Needs Assessment 2014-15, Preliminary report, October 22 2015, Lusaka, Zambia.

[12] Mareg, M, Molla, A. Berhanu, M, Z, Hagos, B. Determinants of Preeclampsia among Pregnant Mothers Attending Antenatal Care (ANC) and Delivery Service in Gedeo Zone, Southern Ethiopia: Case Control-Study. International journal of women’s health. 2020: 567—575.

[13] Samar E. Case-control study of risk factors associated with preeclampsia in the Gaza strip. J Med Sci. 2015; 6(9):229–233.

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[15] Ennazhiyil SV, Valsan SM, Rajeev AV, Srinivasan C, Kunnath RP. The socio-demographic determinants of gestational diabetes mellitus among postnatal women from Palakkad district, Kerala: comparative study. Int J Community Med Public Health. 2019; 6(6):2449.

[16] Tessema A G, Tekeste A, Ayele A T (2015) Preeclampsia and associated factors among pregnant women attending antenatal care in Dessie referral hospital, Northeast Ethiopia: a hospital-based study, BMC Pregnancy and Childbirth (2015) 15:73.

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[21] Ramesh, K. Ghandi, S, Rao, V (2014) Socio-Demographic and Other Risk Factors of Preeclampsia at a Tertiary Care Hospital, Karnataka: Case Control Study. Journal of clinical and diagnostic research8 (9): JC01–JC04.

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[25] Kahsey, H.B, Gashe, F, Ayele, W.M (2018) Risk factors for hypertensive disorders of pregnancy among mothers in Tigray region, Ethiopia: matched case-control study. Springer link journal.

[26] El-Moselhy EA, Khalifa HO, Soliman M, Mohammad KI, Abd El-Aal HM. Risk factors and impacts of pre-eclampsia: an epidemiological study among pregnant mothers in Cairo Egypt. Journal of American Science. 2011; 7(5):311–23.

[27] Brantsæter AL, Haugen M, Samuelsenet SO, Torjusen H, Trogstad L, Alexander J. A dietary pattern characterized by high intake of vegetables, fruits, and vegetable oils is associated with reduced risk of preeclampsia in nulliparous pregnant Norwegian women. J Nutr. 2009; 139(6):1162–8.

[28] Endeshaw M, Ambaw F, Aragaw A, Ayalew A. Effect of maternal nutrition and dietary habits on preeclampsia: a case-control study. International Journal of Clinical Medicine. 5(21):1405.

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Abstract:

This study on assessment of progress in capacity building of HIV/AIDS supply chain workforce in Nigeria included research objectives, questions, and hypothesis. A pre-tested self-completion structured questionnaire was administered to participants (422) with a response rate of 396 (93.8%). The reliability statistics showed the questionnaire is less reliable (α = 0.237). Notable progress includes donor agencies interventions contributing considerably to capacity building of government personnel and adequate capacity at the national level 396 (100.0), the institutionalization of capacity development at all levels through National Product Supply Chain Management Programme, Procurement and Supply Management Technical Working Groups, and Logistics Management Coordinating Unit 292 (73.7) and demonstrable capacity in key supply chain functions 259 (65.4). The study revealed substantial progress in capacity building of the HIV/AIDS supply chain workforce, evident with the institutionalization of capacity building and demonstrable capacity in the key supply chain functions. More so, master trainers from the government are not always part of the facilitators and involved in capacity building, needs assessment does not always precede capacity building, the inadequate pool of master trainers, fellowship training program is not recognized, and pre-service training has not been institutionalized. Chi-square statistics revealed that the extent of progress in capacity building is a significant factor of HIV/AIDS supply chain workforce capacity (p<0.05). There is a need to develop manuals, policies, and procedures to ensure sustained progress in capacity building, needs assessment precedes capacity building, more training conducted to ensure an adequate pool of master trainers in the public sector and their participation in future capacity building interventions.

References:

[1] IOM (Institute of Medicine), 2011, Preparing for the Future of HIV/ AIDS in Africa: A Shared Responsibility. Washington, DC: The National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK209740/.

[2] WHO Drug Action Program, 1998, (http://www.who.int/medicinedocs/collect/medicinedocs/pdf/s2237e/s2237e.pdf).

[3] WHO, 2007, Everybody’s business: Strengthening health systems to improve health outcomes: WHO’s framework for action, WHO Document Production Services, Geneva, Switzerland, https://www.who.int/healthsystems/strategy/everybodys_business.pdf.

[4] Frenk, J., 2010, The Global Health System: Strengthening National Health Systems as the Next Step for Global Progress. PLoS Med, 7(1): e1000089, https://doi.org/10.1371/journal.pmed.1000089.

[5] United States Agency for International Development (USAID), 2015a, USAID’s vision for health systems strengthening. Washington, DC, USA, https://www.usaid.gov/sites/default/files/documents/1864/HSS-Vision.pdf.

[6] Adeloye, D., David, R. A., Olaogun, A. A., Auta, A., Adesokan, A., Gadanya, M., Opele, J. K., Owagbemi, O., and Iseolorunkanmi, A., 2017, Health workforce and governance: the crisis in Nigeria, Human Resources for Health, 15:32, https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-017-0205-4.

[7] WHO, 2016, Nigeria. In: Global Health Workforce Alliance. Geneva, Switzerland, https://www.who.int/workforcealliance/countries/nga/en/.

[8] Dal Poz, M. R., Gupta, N., Quain, E. and Soucat, A. L. B., 2009, Handbook on monitoring and evaluation of human resources for health. Geneva, WHO Press, https://www.who.int/hrh/resources/handbook/en/

[9] WHO, 2010, Growing threat from counterfeit medicines. Bulletin, 88(4):241-320, https://www.who.int/bulletin/volumes/88/4/10-020410/en/

[10] Hyder, A. A, Bloom, G., Leach, M., Syed, S. B., Peters, D. H. and Future Health Systems: Innovations for Equity, 2007, “Exploring health systems research and its influence on policy processes in low- income countries”. BMC Public Health, 7:309, https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-7-309.

[11] David, P. and Bennet, S., 2012, “Better Guidance Is Welcome, but without Blinders”. PLoS Med. 9 (3): e1001188, https://doi.org/10.1371/journal.pmed.1001188.

[12] Bennet, S., Agyepong, I. A., Sheikh, K., Hanson, K., Ssengooba, F. and Gilson, L., 2011, “Building the Field of Health Policy and Systems Research: An Agenda for Action”. PLoS Medicine. 8 (8): e1001081.doi:10.1371/journal.pmed.1001081, https://pubmed.ncbi.nlm.nih.gov/21918641/.

[13] Campbell, J., Cometto, G., Rasanathan, K., Kelley, E., Syed, S., Zurn, P., De Bernis, L., Matthews, Z., Benton, D., Frank, O. and Nove, A., 2015, Improving the resilience and workforce of health systems for women’s, children’s, and adolescents’ health. BMJ, 351:h4148, https://pubmed.ncbi.nlm.nih.gov/26371216/.

[14] Aondoakaa, S.C. and Agbakwuru, P.C., 2012, An Assessment of land Suitability for Rice Cultivation in Dobi, Gwagwalada Area Council, FCT, Nigeria. Ethiopian Journal of Environmental Studies and Management, 5(4):559-566, https://dx.doi.org/10.4314/ejesm.v5i4.S2.

[15] Ebele, F.U., Aregbosola, B.G., Hasstrup, D.T. and Adams, E., 2014, The Effect of Climate Change on Agricultural Production among Farmers in Kwali Area Council of Federal Capital Territory of Nigeria. Advances in Social Sciences Research Journal, 1(2):13-26, https://doi.org/10.14738/assrj.12.58.

[16] Cochran, W.G., 1977, Sampling Techniques. 3rd Edition, John Wiley & Sons, New York, https://archive.org/details/Cochran1977SamplingTechniques_201703.

[17] Itiola, A. J., and Agu, K. A., 2018, Country ownership and sustainability of Nigeria’s HIV/AIDS Supply Chain System: qualitative perceptions of progress, challenges and prospects. Journal of Pharmaceutical Policy and Practice, 11:21, https://joppp.biomedcentral.com/articles/10.1186/s40545-018-0148-8.

[18] Goldberg, J. and Bryant, M., 2012, Country ownership and capacity building: the next buzzwords in health systems strengthening or a truly
new approach to development? BMC Public Health, 12:531-539, https://pubmed.ncbi.nlm.nih.gov/22818046/.

[19] Machagge, M., Matoyo, D. and Alenga, I., 2014, Supply chain management curriculum integration in pre-service training in Tanzania. Journal of Pharmaceutical Policy and Practice, 7(Suppl 1): P14, https://joppp.biomedcentral.com/articles/10.1186/2052-3211-7-S1-P14.

[20] Matovu, J. K. B., Rhoda, K. W., Susan M., Olico O., William, B. and David S., 2013, Strengthening health workforce capacity through work-based training; BMC International Health and Human Rights, 13:8, https://bmcinthealthhumrights.biomedcentral.com/articles/10.1186/1472-698X-13-8.

[21] Windisch, R., Waiswa, P., Neuhann, F., Scheibe, F. and Savigny, D., 2011, Scaling up antiretroviral therapy in Uganda: using supply chain management to appraise health systems strengthening. Globalization and Health, 7:25, https://europepmc.org/article/PMC/3161852.

[22] Adekola, A. and Adelanwa, A., 2014, Developing the SCM workforce in Nigeria through contextualized pre-service education and continued professional development. Journal of Pharmaceutical Policy and Practice, 7(Suppl 1): O22, https://joppp.biomedcentral.com/articles/10.1186/2052-3211-7-S1-O22.

[23] Mazibuko, G. N., Sagwa, E., Kagoya, H. R., Kibuule, D., Rennie, T., Mavere, T., Ghoneim, R., Mabirizi, D., Naikaku, E., Niaz, Q. and Lates, J., 2014, Incorporating pharmaceutical supply management modules in the pre-service curriculum of the BPharm program, of the University of Namibia, School of Pharmacy, Journal of Pharmaceutical Policy and Practice, 7(Suppl 1): P12, http://www.joppp.org/supplements/7/S1.

Abstract:

Cervical cancer is preventable using vaccines given to adolescents in three doses. The affordability of these vaccines and people’s willingness to pay (WTP) could affect the uptake of the vaccines, especially in developing countries. The study aimed to determine the willingness to pay for the vaccines and identify the factors associated with different levels of WTP among the participants. A cross-sectional study of 377 female teachers in the Enugu metropolis was undertaken between July and October 2017. A structured pre-tested interviewer-administered questionnaire was utilized for the collection of data. Willingness to pay was determined by the contingent valuation method utilizing the bidding game technique to estimate the maximum amount each participant would pay for the three doses of the HPV vaccine. Data were analyzed using SPSS version 20. The average monthly income of the participants was 152.18 USD (₦56307.91), with a range of 5.41-2162.16 USD (₦2,000 – 800,000). A considerable proportion (74.3%) of the respondents was willing to pay out of pocket for the vaccine. The average maximum willingness to pay for the three doses of the bivalent vaccine was 15USD, far below 63USD, which was the lowest cost for the three doses of the vaccine in Nigeria. Small family size (P<0.05) and high husband’s monthly income (P<0.05) were significantly associated with increased willingness to pay for cervical cancer vaccine by the participants. In conclusion, the willingness to pay for the cervical cancer vaccine among the participants was high but at a lower average cost than it currently goes for in Nigeria.

References:

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[2] Griffiths M., 2002, Screening for cervical cancer in developing countries. [Internet]. World Health Organization, http://screening.iarc.fr/doc/cervical_cancer_screening_in_dev_countries.pdf.

[3] Monsonego J., 2007, Prévention du cancer du col utérin (II): vaccination HPV prophylactique, connaissances actuelles, modalités pratiques et nouveaux enjeux. Presse Med [Internet], 36(4):640–66, http://www.ncbi.nlm.nih.gov/pubmed/17350792.

[4] PhRMA, 2016, A Decade of Innovation in Cancer:2006-2016 [Internet], www.phrma.org.

[5] Harper DM, Franco EL, Wheeler C, Ferris DG, Jenkins D, Schuind A, et al., 2004, Efficacy of a bivalent L1 virus-like particle vaccine in prevention of infection with human papillomavirus types 16 and 18 in young women: a randomised controlled trial. Lancet [Internet], 364(9447):1757–65, http://www.ncbi.nlm.nih.gov/pubmed/15541448.

[6] Villa LL, Ault KA, Giuliano AR, Costa RLR, Petta CA, Andrade RP, et al. 2006, Immunologic responses following administration of a vaccine targeting human papillomavirus Types 6, 11, 16, and 18. Vaccine [Internet], 24(27–28):5571–83, http://www.ncbi.nlm.nih.gov/pubmed/16753240.

[7] Harper DM, Franco EL, Wheeler CM, Moscicki A-B, Romanowski B, Roteli-Martins CM, et al., 2017 Sustained efficacy up to 4·5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: follow-up from a randomised control trial. www.thelancet.com [Internet]. https://pdfs.semanticscholar.org/ead8/931b56deb09d4b7087c9808d2b85b8b69b83.pdf.

[8] Villa LL., 2008, Introduction of HPV prophylactic vaccines: a new challenge for Public Health in the 21st century. Rev Bras Epidemiol [Internet], 11(3):516–516, http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1415-790X2008000300019&lng=en&nrm=iso&tlng=en.

[9] Cutts F, Franceschi S, Goldie S, Castellsague X, de Sanjose S, Garnett G, et al., 2007, Human papillomavirus and HPV vaccines: a review. Bull World Health Organ [Internet], 85(9), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2636411/pdf/06-038414.pdf.

[10] Saxenian H, Cornejo S, Thorien K, Hecht R, Schwalbe N., 2011, An Analysis of How the GAVI Alliance and Low- And Middle-Income Countries Can Share Costs of New Vaccines. Health Aff [Internet], 30(6):1122–33, http://www.ncbi.nlm.nih.gov/pubmed/21653966.

[11] Graham JE, Mishra A., 2011, Global challenges of implementing human papillomavirus vaccines. Int J Equity Health [Internet], 10(1):27, http://www.scopus.com/inward/record.url?eid=2-s2.0-79959680444&partnerID=tZOtx3y1.

[12] Ngorsuraches S, Nawanukool K, Petcharamanee K, Poopantrakool U., 2015, Parents’ preferences and willingness-to-pay for human papilloma virus vaccines in Thailand. J Pharm Policy Pract [Internet], http://dx.doi.org/10.1186/s40545-015-0040-8.

[13] Umeh IB, Nduka SO, Ekwunife OI, Goldie S, O’Shea M, Campos N, et al., 2016, Mothers’ willingness to pay for HPV vaccines in Anambra state, Nigeria: a cross sectional contingent valuation study. Cost Eff Resour Alloc [Internet], 14(1):8, http://resource-allocation.biomedcentral.com/articles/10.1186/s12962-016-0057-0.

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[18] Hoyos D, Mariel P., 2010, Contingent valuation: past, present and future, 07:329–43.

[19] Alder S, Gustafsson S, Perinetti C, Mints M, Sundström K, Andersson S., 2015, Mothers’ acceptance of human papillomavirus (HPV) vaccination for daughters in a country with a high prevalence of HPV. Oncol Rep [Internet]., 33(5):2521–8, http://www.ncbi.nlm.nih.gov/pubmed/25738832.

[20] Ugwu E, Obi S, Ezechukwu P, Okafor I, Ugwu A., 2013, Acceptability of human papilloma virus vaccine and cervical cancer screening among female health-care workers in Enugu, Southeast Nigeria. Niger J Clin Pract [Internet], 16(2):249, http://www.njcponline.com/text.asp?2013/16/2/249/110141.

[21] Holman DM, Benard V, Roland KB, Watson M, Liddon N, Stokley S., 2014, Barriers to human papillomavirus vaccination among US adolescents: a
systematic review of the literature. JAMA Pediatr [Internet], 168(1):76–82, http://www.ncbi.nlm.nih.gov/pubmed/24276343.

[22] Ezenwa BN, Balogun MR, Okafor IP., 2013, Mothers’ human papilloma virus knowledge and willingness to vaccinate their adolescent daughters in Lagos, Nigeria. Int J Womens Health [Internet], 5:371–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23874123.

[23] Iliyasu Z, Abubakar IS, Aliyu MH, Galadanci HS., 2010, Cervical cancer risk perception and predictors of human papilloma virus vaccine acceptance among female university students in northern Nigeria. J Obstet Gynaecol (Lahore) [Internet], 30(8):857–62.

http://www.tandfonline.com/doi/full/10.3109/01443615.2010.511724.

[24] Kruiroongroj S, Thavorncharoensap M., 2014, Knowledge, Acceptance, and Willingness to Pay for Human Papilloma Virus (HPV) Vaccination among Female Parents in Thailand, 15:5469–74.

[25] Cerda AA, García LY, Gaete FI, Pizarro TH., 2013, Willingness to pay for human papillomavirus vaccine in Metropolitan Santiago, Chile. Rev Med Chil [Internet], 141(2):167–72, https://pubmed.ncbi.nlm.nih.gov/23732488/.

[26] Kannan MM, Kingston R, Num SK, Chin NS, Yong J, Lui Y, et al., 2015, Health Professional Students’ Willingness to Pay for Human Papillomavirus Vaccination and Factors Influencing Their Decision in Malaysia. Virus Disease, https://doi.org/10.1016/j.jval.2015.09.1274.

Abstract:

The National Health Management Information System (NHMIS) was designed to provide timely and reliable health service delivery information. The efficiency and effectiveness of health service delivery is assessed by the availability of quality, complete and timely data. The NHMIS Policy review was initiated by a consortium of relevant stake holders led by the Department of Planning, Research and Statistics (DPRS) of the federal ministry of health (FMOH) and the National Primary Health Care Development Agency (NPHCDA). The Emphasis of the NHMIS Is to strengthen the Health Information System-HIS in the country and promote the use of quality information for evidence-based decision-making at the community, LGA, and national levels. In spite of substantial investments, the health sector in Nigeria has made slow progress in improving its health indices. Thus the Nigeria State Health Investment Project(NSHIP), through support from WHO, introduced the Performance-based financing –PBF currently rolled out in three states- Adamawa, Nasarawa, and the Ondo States to deliver a result-based approach to improve quantity and quality of health services especially in the area of maternal health. Health centers receive funds directly based on the number of essential services they delivered and the improved quality of care. This encouraged health centers to focus on delivering results, and the new funds enabled them to improve their services. This study compared data reported using the NHMIS and declared validated on the PBF declaration forms in funding health facilities in Nasarawa state for quarter 1 (Jan.- Mar.)2018 and quarter 2 (Apr. – June) 2018.

References:

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[6] Nyamtema A.S, 2010, Bridging the gaps in the Health Management Information System in the context of a changing health sector. BMC Medical Informatics & Decision Making,10(1),36 https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/1472-6947-10-36.

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[11] Nshimyiryo A, Kirk CM, Sauer SM, Ntawuyirusha E, Muhire A, Sayinzoga F, et al.,2020, Health management information system (HMIS) data verification: A case study in four districts in Rwanda, 15(7), https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0235823.

[12] Ouedraogo M, Kurji J, Abebe L, Labonté R, Morankar S, Bedru KH, et al., 2019, A quality assessment of Health Management Information System (HMIS) data maternal and child health in Jimma Zone, Ethiopia, 14(3), https://pubmed.ncbi.nlm.nih.gov/30856239/.

[13] O’Hagan R, Marx MA, Finnegan KE, Naphini P, Ng’ambi K, Laija K, et al., 2017, National Assessment of Data Quality and Associated Systems-Level Factors in Malawi. Global Health: Science and Practice.;5(3), https://pubmed.ncbi.nlm.nih.gov/28963173/.

[14] Venkateswaran M, Mørkrid K, Abu Khader K, Awwad T, Friberg IK, Ghanem B, et al., 2018, Comparing individual-level clinical data from antenatal records with routine health information systems indicators for antenatal care in the West Bank: A cross-sectional study,13, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0207813.

[15] Kum Ghabowen Iwimbong, 2015, Comparing Data Reported using the National Health Management Information System and data Declared/Validated on the PBF Declaration forms in
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[16] Kumar, M., Gotz, D., Nutley, T., & Smith, J. B. (2017). Research gaps in routine health information system design barriers to data quality and use in low- and middle-income countries: A literature review. The International Journal of Health Planning and Management, 33(1), 1–9. https://doi.org/10.1002/hpm.

[17] Maduekwe, N. I., Banjo, O. O., & Sangodapo, M. O. (2017). The Nigerian Civil registration and vital statistics system: Contexts, institutions, operation. Social Indicators Research, 134(2), 651–674. https://doi.org/10.1007/s11205-016-1448-5.

[18] Upadhaya, N., Jordans, M. J. D., Abdulmalik, J., Ahuja, S., Alem, A., Hanlon, C., et all., Gureje, O. (2016). Information systems for mental health in six low- and middle-income countries: Cross country situation analysis. International Journal of Mental Health Systems, 10, 60. https://doi.org/10. 1186/s13033-016-0094-2.

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[20] Smith, Peter C, Karanikolos, Marina & Cylus, Jonathan. (‎2018)‎, European Observatory on Health Systems and Policies, Evolution of health system performance assessment: the roles of international comparisons and international institutions. Eurohealth, 24 (‎2)‎, 15 - 18. World Health Organization. Regional Office for Europe. https://apps.who.int/iris/handle/10665/332564.

Abstract:

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Abstract:

The economic barriers to the retention of HIV patient on treatment is a challenge to optimal viral suppression. This study examined economic factors related to retention such as employment status, food insecurity and cost of transportation to health facility that may influence retention at Wuse General Hospital, Abuja. A retrospective cohort study design was used to access economic factors that influence the retention of HIV patients on treatment. A total of 240 clients were recruited, and a pre-tested interviewer-administered semi-structured questionnaire was used for data collection. Data were entered into Stata/MP 15.0 and then exported into SPSS version 23.0 for statistical analysis. Of the 240 respondents interviewed. The findings revealed that there is an association between socio-demographic and employment status and retention in care. The results show that younger ages (20-49), being males (64.1%) and unemployed (72.3%), are more likely to be associated with retention (p<0.047). The association between socio-economic characteristics of respondents and cost of travelling to facility (p=0.016) and rural of place residence (p=0.000) was statistically significant, respectively. This study also reveals that the cost of transportation less than N200 has significant relationships with retention in at the study site (p=0.016). To address the challenges related to travel distance to health facility and high transport cost, patients should be continually encouraged to access treatment at their nearest clinic of their choice. Linking unemployed HIV patients to economic empowerment programmes will help improve their economic status.

References:

[1] Global HIV & AIDS statistics — 2020 fact sheet. https://www.unaids.org/en/resources/fact-sheet.

[2] Global HIV and AIDS statistics. Avert. 2015. https://www.avert.org/global-hiv-and-aids-statistics.

[3] NAISS, 2018, Results and Implications for Nigeria’s HIV Program. IHP. 2019. https://www.internationalhealthpolicies.org/blogs/the-2018-nigeria-hiv-aids-indicator-and-impact-survey-naiss-results-and-implications-for-nigerias-hiv-program/.

[4] Janssen, S., Wieten, R.W., Stolp S., Cremers, A.L., Rossatanga, E.G., and Klipstein-Grobusch, K., 2015, Factors associated with retention to care in an HIV clinic in Gabon, Central Africa. PLoS One, 10(10): e0140746.

[5] Taylor, B.S., Garduño, L.S., Reyes, E.V., Valiño, R., Rojas, R., and Donastorg, Y., 2011, HIV care for geographically mobile populations. Mt Sinai J Med J Transl Pers Med, 78(3):342–351.

[6] Weiser, S., Wolfe, W., Bangsberg, D., Thior, I., Gilbert, P., and Makhema, J., 200, Barriers to antiretroviral adherence for patients living with HIV infection and AIDS in Botswana. JAIDS-HAGERSTOWN MD, 34(3):281–288.

[7] Tuller, D.M., Bangsberg, D.R., Senkungu, J., Ware, N.C., Emenyonu, N., and Weiser, S.D., 2010, Transportation costs impede sustained adherence and access to HAART in a clinic population in southwestern Uganda: a qualitative study. AIDS Behav, 14(4):778–784.

[8] Olupot-Olupot, P., Katawera, A., Cooper, C., Small, W., Anema, A. and Mills, E., 2008, Adherence to antiretroviral therapy among a conflict-affected population in Northeastern Uganda: a qualitative study. Aids, 22(14):1882–1884.

[9] Senkomago, V., Guwatudde, D., Breda M., and Khoshnood, K., 2011, Barriers to antiretroviral adherence in HIV-positive patients receiving free medication in Kayunga, Uganda. AIDS Care, 23(10):1246–1253.

[10] Lankowski, A.J., Siedner MJ, Bangsberg D.R., and Tsai A.C.., 2014, Impact of geographic and transportation-related barriers on HIV outcomes in sub-Saharan Africa: a systematic review. AIDS Behav, 18(7):1199–1223.

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Abstract:

Maternal mortality is currently high and remains one of the most important public health problems in developing countries. This study determined the cost of vaginal and caesarean section deliveries among Health Insurance (HI) enrollees and Out-of-Pocket (OOP) payers. A comparative cross-sectional study was carried out among 380 women {(133 vaginal and 57 caesarean section deliveries among each of HI enrollees and OOP payers)} who accessed delivery services in a tertiary health institution in Southwest Nigeria using a systematic random sampling technique. Data was gathered using an interviewer-administered semi-structured questionnaire and analyzed using IBM SPSS version 23. P-value <0.05 was taken as significant. The overall mean age of respondents in this study was 36.5 ± 4.7years among the vaginal delivery respondents and 35.8 ± 3.6 years among caesarean section delivery respondents. The mean total cost of vaginal delivery for HI enrollees {₦14,238.5 ± 4,809.0 ($34.5 ± 12.7)} is lesser than for OOP payers {₦37,928.5 ± 19,813.0 ($99.8 ± 52.1)}. Furthermore, the mean total cost of caesarean section delivery for HI enrollees {₦14,238.5 ± 4,809.0 ($34.5 ± 12.7)} is lesser than for OOP payers (₦37,928.5 ± 19,813.0 ($99.8 ± 52.1}. 94.1% of the non-insurance enrollees were willing to join Health Insurance Scheme. It was concluded that the total cost of vaginal and caesarean section deliveries is lower among the Health Insurance enrollees than the Out-of-Pocket payers. Therefore, intervention to increase awareness on health insurance is recommended.

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Abstract:

This study aimed to bridge the gap between cancer and environmental causes, push for improved prevention, early screening, and better surveillance on indicators of poor health linked to cancer. The objective assessed knowledge, attitude, and practice among Moi University College of Health Sciences finalist undergraduate students on environmental carcinogens in Eldoret, Kenya. The study site was MTRH, with a cross-sectional study design. The study population was the adult finalist undergraduate students in the College of Health Sciences at MTRH. Inclusion criteria: adult finalist undergraduate students in the College of Health Sciences willing to share information and consenting to participate. Sample Size was determined after the census of all the participants and meeting inclusion criteria. Mixed sampling was used. Data collection tools were a pre-validated structured questionnaire, observation checklist, and secondary data. Data collection was done using Google forms. Data were cleaned and checked for completeness. Statistical analysis and cross-tabulation for variables were done using SPSS version 26. Data Presentation was through tables, graphs, and prose formats. The results of the study were as follows: There were 40 males and 22 females, ratio-1.82:1. Modal age was 22years (19.67%). Prior to joining the university, 61.29% had encountered cancer cases. 36% agreed that they were not aware of predisposing factors, while 32% and 12% agreed that tobacco users and factory workers were predisposed, respectively. 28 respondents used plastic containers, 1.61% used tobacco, and 21 took alcohol. 92% were never screened for cancer, though 17 females and 26 males did self-examination at least once a month.

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Abstract:

References:

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Abstract:

Objective: The aim of the study was to determine the prevalence of Gender-based violence and pregnancy outcomes in pregnant women attending antenatal care clinics in two selected primary health care centres at Abuja FCT, Nigeria. Methodology: The descriptive and analytical cross-sectional research design and a convenience sampling method were used. A pretested semi-structured questionnaire with a Cronbach’s alpha value of 0.77 was administered with the interviewer-administered data collection technique to collect data. The study population were pregnant women who attended antenatal clinic at the Primary Health Care Centres at Karu and Jikwoyi in Abuja-FCT; the sample size was 384 pregnant women between the ages of 15-44 years. Raw data generated from the completed questionnaire was analysed for simple frequency, percentage, and Chi-square analysis using the SPSS version 16. Results: Prevalence of GBV among the participants was 59.6%, 99.4% accounted for emotional abuse, physical abuse at 28.5%, and sexual abuse at 13.6%. The findings indicate that GBV single cases of emotional abuse was 66.7%, physical abuse was 0.4%, combined cases of emotional and physical violence were 19.3%, emotional combined with sexual was 4.8%, while the case of multiple violence of emotional, physical and sexual was 8.8%. Overall, husbands were the perpetrators of the abuse and accounted for emotional abuse at 96.9%, physical at 89.2%, and sexual abuse at 100.0%. Conclusion: The effect of physical abuse on pregnant outcome among pregnant women in their previous pregnancies was that 27.6% had a miscarriage, while 6.9% had preterm delivery.

References:

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[2] Okada, M. M., Hoga, L. A. K., Borges, A. L. V, Albuquerque, R. S., & Belli, M. A (2015). Domestic violence against pregnant women. Acta Paul Enferm. 28(3),270-4 http://dx.doi.org/10.1590/1982- 0194201500045.

[3] Chaves, K, Eastwood, J., Ogbo, F. A., Hendry, A., Jalaludin, B., Khanlari, S., and Page, A. Itimate partner violence identified through routine antenatal screening and maternal and perinatal health outcomes. BMC Pregnancy and Childbirth (2019) 19:357 https://doi.org/10.1186/s12884-019-2527-9.

[4] Puccia, M. I. R., Mamede, M. V. and deSoula, L. (2018). Intimate partner violence and postpartum women in Sao Paulo, Brazil. Journal of Human Growth and Development 28(2). http://dx.doi.org/10.7322/jhgd/147218.

[5] Izguirre, A and Calvete, E. (2014). Intimate partner violence during pregnancy: women’s narrative about their mothering experiences. Psychosocial Intervention, 23, 209-215.

[6] Gurung, S & Acharya, J. (2015). Factor Influencing Gender-Based Violence among Pregnant Women Attending Antenatal Clinic in PHC of Syangja District, Nepal. Makara Journal of Health Research, 2015, 19(3): 99-103. Doi: 10.7454/msk. v19i3.5640.

[7] Ramalingappa, P., Sowmya, K.P., & Akhila, M.P. (2017). Factor affecting intimate partner violence among Pregnant Women in a Tertiary care centre NJOG, 12(2), 52- 57.

[8] Malan, M., Spedding, M. F., & Sorsdahl, K (2018). The prevalence and predictors of intimate partner violence among pregnant women attending a midwife and obstetrics unit in the Western Cape. Global Mental Health, retrieved from https://www/cambrigdeorg/core on 06/06/2019. DOI:10.1017/gmh.2018.9

[9] Lencha, B., Ameya, G., Baresa, G., Minda, Z., & Ganfure, G. (2019). Intimate partner violence and its associated factors among pregnant women in Bale Zone, Southeast Ethiopia: A cross-sectional study. PloS one, 14(5), e0214962.

[10] Zheng, B., Zhu, X., Hu, Z., Zhou, W., Yu, Y., Yin, S., & Xu, H (2020). The prevalence of domestic violence and its correlation with family factors: A cross-sectional study among pregnant women in urban communities of Hengyang City, China BMC Public Health (2020) 20,620 https://doi.org/10.1186/s12889-020-08683-9.

[11] Olagbuji, B., Ezeanochie, M., Ande, A., & Ekaete, E. (2010). Trends and determinants of pregnancy-related domestive violence in a referral centre in southern Nigeria. International journal of gynecology& obstretics 108,101-103.

[12] Arulogun, O. S., & Jidda, K. A. (2011). Experiences of violence among pregnant women attending antenatal clinics in selected hospitals in Abuja, Nigeria. Sierra Leone Journal of Biomedical Research, 3(1), 43-48.

[13] Adesina, O., Oyugbo, I. & Olubukola, A. (2011). Prevalence and pattern of violence in pregnancy in Ibadan, South-west, Nigeria. Journal of Obstetrics and Gynaecology, 31 (3), 232-236.

[14] Orpin, B. J., Papadopoulos, C., & Puthussery, S. (2013). The prevalence of domestic violence among pregnant women in Nigeria: a systemic review. Trauma, Violence & Abuse, 21 (1),3-15. https://doi.org/10.1177/1524838017731570.

[15] Onoh, R. C., Umeora, O. U. J., Ezeonu, P. O., Onyebuchi, A. K., Lawani, O. L., & Agwu, U. M. (2013). Prevalence, pattern and consequences of intimate partner violence during pregnancy at Abakaliki Southeast Nigeria. Annals of Medical and Health Sciences Research, 3(4), 484-491.

[16] Iliyasu, Z., Abubakar, I. S., Galadanci, S. H., Hayatu, Z., & Aliyu, M. H. (2013). Prevalence and risk factors for domestic violence among pregnant women in Northern Nigeria. Journal of Interpersonal Violence, 28(4), 868–883. Doi: 10.1177/0886260512455872.

[17] Ashimi, A. O., & Amole, T.G. (2015). Prevalence and predictors for domestic violence among pregnant women in a rural community Northwest, Nigeria. Nigeria Medical Journal: Journal of the Nigeria Medical Association, 56(2), 118-121.

[18] Ishfaq, K., Malik, R., & Hussain, S. (2018). Contributing Factors of Domestic Violence against Women: A Study of Dar-Ul-Aman, District Multan, Pakistan. Pakistan Journal of Criminology, 10(4), 30-41.

[19] Ezeudu, C.C., Akpa, O., Waziri, N. E., Oladimeji, A., Adedire, E., Saude, I., Nguku, P., Nsubuga, P., & Fawole, O. I (2019). Prevalence and correlates of intimate partner violence, before and during pregnancy among attendees of maternal and child health services, Enugu, Nigeria: mixed-method approach, January 2015. PAMJ Supplement Vol 32(1), 14 10.11604/pamj.supp.2019.32.113289.

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Abstract:

Diarrhoeal diseases are a public health concern and constitute about 5% of all main causes of out-patient department visits in the city of Bulawayo. We conducted a dataset analysis of diarrhoeal diseases to determine how the trends have varied over the years. A descriptive cross-sectional study based on an electronic database for diarrhoeal diseases (2007-2012) was conducted. Data was collected using compilation forms and checklists, then analysed using Microsoft Excel. Three key informants were interviewed. The formula, (Mean + 1.5SD), was used to calculate thresholds for bloody diarrhoea. There were more watery than bloody diarrhoeal cases throughout the review period, with 2008 having the highest number of such cases under 5. In Northern Suburbs, there was a general decrease in both types of diarrhoea cases in both age groups (<5 and >5)  whilst in Emakhandeni; there was an increase in bloody diarrhoea incidence after 2009. The incidence rate for bloody diarrhoea was higher for females throughout. There was an increase in the number of stool specimens collected for examination between 2008 and 2012. Overall, there was a decrease in the incidence of diarrhoea in Bulawayo city, partly due to regular anti-diarrhoeal campaigns. Following the study, the following measures were implemented: Health education to improve hygienic practices; advocacy for improved water and sanitation in Cowdray Park; rotavirus vaccination for under-fives; maintenance of all records on diarrhoea and up to date thresholds in all clinics for use in monitoring diarrhoea.

References:

[1] World Health Organisation, 2017, Diarrhoeal Disease Factsheet http://www.who.int.

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[5] World Health Organisation, 2004, Zimbabwe Country Profile of Environmental Burden of Disease.http://www.who.int/entity/quantifying_ehimpacts/national/country/countryprofile/zimbabwe.pdf.

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[7] Annual Reports City of Bulawayo Health Services Department; 2006-2011.

[8] Banda S: Personal Communication, Health Information Office; City of Bulawayo Health Services Department.

[9] Zimbabwe National Statistics Agency: 2010-2011, Zimbabwe Demographic and Health Survey. https://dhsprogram.com/pubs/pdf/FR254/FR254.pdf.

[10] Prüss-Ustün A, Wolf J, Bartram J, Clasen T, Cumming O, Freeman MC, Gordon B, Hunter PR, Medlicott K, Johnston R, 2019, Burden of disease from inadequate water, sanitation and hygiene for selected adverse health outcomes: An updated analysis with a focus on low- and middle-income countries. Int J Hyg Environ Health. 222(5):765-777. https://pubmed.ncbi.nlm.nih.gov/31088724/.

[11] Null C, Stewart CP, Pickering AJ, Dentz HN, Arnold BF, Arnold CD, Benjamin-Chung J, Clasen T, Dewey KG, Fernald LCH, Hubbard AE, Kariger P, Lin A, Luby SP, Mertens A, Njenga SM, Nyambane G, Ram PK, Colford JM Jr, 2018, Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Kenya, a cluster-randomised controlled trial. Lancet Glob Health. Mar;6(3): e316-e329. https://pubmed.ncbi.nlm.nih.gov/29396219/.

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[16] Mahmud I, Das S, Khan SH, Faruque ASG, Ahmed T, 2020, Gender disparity in care-seeking behaviours and treatment outcomes for dehydrating diarrhoea among under-5 children admitted to a diarrhoeal disease hospital in Bangladesh: an analysis of hospital-based surveillance data. BMJ Open. 3;10(9). https://pubmed.ncbi.nlm.nih.gov/32883737/.

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[18] Arvelo W, Blum LS, Nahar N, von Seidlein L, Nahar L, Pack RP, Brooks AW, Pach A, Breiman RF, Luby SP, Ram PK, 2011, Community perceptions of bloody diarrhoea in an urban slum in South Asia: implications for introduction of a Shigella vaccine. Epidemiol Infect, 139(4):599-605 https://pubmed.ncbi.nlm.nih.gov/20546637/.

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Undernutrition and Diarrhea Prevalence in an Urban Slum in Indonesia: Focus on Water, Sanitation, and Hygiene. Am J Trop Med Hyg, 100(3):727-732. https://pubmed.ncbi.nlm.nih.gov/30693865/.

Abstract:

Integrated development generally refers to integrated implementation of quality interventions within or across sectors aimed at stimulating development. Funders/donors, policymakers, and programme managers are key stakeholder groups that determine the success of integrated development interventions. A shared convergence in their perspectives enables joint plans and actions. Our objectives were to determine the perspectives of integrated development, among selected stakeholder groups in Nigeria, and to discuss implications for practice. This was a quantitative survey. We used a multi-stage random sampling technique to select a representative sample of 301 key stakeholders in Nigeria. We analysed the data using SPSS. Almost half (49.5%) of these respondents were senior level stakeholders and 46.5% of them had over 10 years of experience. Respondents’ perspectives of the meaning of integrated development varied. Respondents mostly (69.8%) felt that ID meant multi-sectoral interventions. Perspectives also varied by stakeholder type, sector and characteristics. Enhancing collaborations and strengthening human capacity was the predominant benefit among funders/donors (70.4%) while the most predominantly expressed benefit among the policy makers (78.9%) and programme managers (78.3%) was that ID yields more impactful and sustainable interventions. These findings clearly show that nuanced communication of integrated development is needed to achieve consensus and programme success.

References:

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Abstract:

Pharmaceutical interventions are being investigated as possible treatment options for COVID-19. Antimalarial drugs-Hydroxychloroquine and chloroquine are also being investigated in clinical trials due to their antiviral effects though their efficacy in the treatment of COVID-19 is largely inconclusive. This study assessed the knowledge, perception, and practice of prescribing these drugs in the treatment of COVID-19 by practicing medical doctors in Nigeria. The survey was conducted online using Google forms sent via a link on WhatsApp^© and Facebook^© through the authors’ contacts to medical doctors in the six geo-political zones of Nigeria from April-May 2020. Ethical issues were addressed by ensuring the anonymity of respondents, voluntary participation, and non-incentivized. Descriptive statistics were used to determine the mean and frequencies of data generated using SPSS version 22. Responses were obtained from 145 medical doctors with mean age of 37.78±6.47 years and 10.9±5.58 years of practice experience. All the respondents knew that the virus affects the lungs. Over 48% of the doctors believed in the efficacy of the antimalarial drugs, and more than half of them thought it would be more effective for mild disease presentation. About 46.8% of respondents agreed to prescribe the drug to COVID-19 patients, and most based their decisions on case reports, recommendations of NCDC or WHO. However, 75.9% believed a randomized control trial should be conducted to determine the efficacy and safety of the drugs. Practicing doctors in Nigeria are knowledgeable on COVID-19, and their perceptions and decision to prescribe antimalarial drugs are largely dependent on clinical trial outcomes.

References:

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Abstract:

The study carried out an assessment of the perceptions of health professionals in Nigeria on the awareness messaging on COVID-19 directed at the public using the SMS (Short Message Service) Technology. The researcher focused on health professionals in the metropolitan areas of Nigeria as the respondents. A structured questionnaire titled “health professionals’ perception on awareness of messaging on COVID-19” was used to collect data from the respondents. The mode of data collection was a questionnaire survey administered online. The findings suggest that health professionals who participated in the survey have a very positive perception of the usefulness and appropriateness, coverage, and impact of the COVID-19 broadcast messages from the Nigerian Centre for Disease Control (NCDC); their responses show that the short messages were sent to Nigerians from different backgrounds and locations to inform the populace about the outbreak of COVID-19, prevention, knowledge about early symptoms, how to reduce the spread of COVID-19 in case of infection and what to do in case of emergency. Additionally, the research outcomes show that SMS broadcast was the leading channel of information dissemination and reception for COVID-19 response as against the traditional channel of information dissemination on radio, TV, and others. These findings have highlighted the importance and value of digital health services such as SMS technology in responding to health emergencies.

References:

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[8] Canada Taiwo, R. (2010). The thumb tribe’: Creativity and social change through SMS in Nigeria. California Linguistic Notes, XXXV (1).

[9] Kang, J., & Maity, M. (2012). Texting among the bottom of the pyramid: Facilitators and barriers to SMS use among the low-income mobile users in Asia. LIRNE asia. International Development Research Centre, Canada, and UK aid, Department for International Development, UK.

[10] Taylor, A. S., & Vincent, J. (2005). An SMS history: in Hamill, L., & Lasen, A. (Eds.), Mobile world: Past, present and future (Ch.4, pp. 75 – 92). London: Springer.

[11] Ling, R. (2005). The socio-linguistics of SMS: An analysis of SMS use by a random sample of Norwegians. In Ling, R. & Pedersen, P. (Eds.), Mobile communications: Renegotiation of the social sphere (pp. 335 – 349). London: Springer.

[12] Tomita, D. K. (2009). Text messaging and implications for its use in education. TCC 2009 Proceedings, 184 – 193.

[13] Sulaiman, A., &Zolait, A. H. S. (2012). Adoption of short messaging service (SMS) in Malaysia. IGI Global. DOI: 10.4018/978-4666-1752-0.ch004.

[14] Grinter, R.E. and Eldridge, M. 2003. wan2tlk: Everyday text messaging. In Proceedings ofthe ACM Conference on Human Factors in Computing (CHI). Ft. Lauderdale, FL (Apr. 5–10).441–448.

[15] Tossell, C. C., Kortum, P., Shepard, C., Barg-Walkow, L., Rahmati, and Zhong, L. (2012). To longitudinal study of emoticon use in text messaging from smartphones. Computers in Human Behavior, 28(2): 659-663.

[16] National Bureau of Statistics (NBS), Active Voice and Internet Per State, Porting and Tariff Information Q4 2020, Date Access: 22/02/2021. https://nigerianstat.gov.ng/download/1240.

[17] Taiwo, Rotimi (2012): Language and Mobile Telecommunication in Nigeria: SMS as a Digital Lingual-Cultural Expression. Ile-Ife: Obafemi Awolowo University Press.

[18] Sudip Bhattacharya, Amarjeet Singh, and Roy Rillera Marzo (2019). Delivering emoji/icon-based universal health education messages through smartphones. AIMS Public Health. 2019; 6(3): 242–247. Published online 2019 Jul 22. doi: 10.3934/publichealth.2019.3.242. Available online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6779603/.

[19] Federal Ministry of Health (FMoH), COVID19 Health Service Uptake (Dashboard), Date of Access: 22/04/2021. https://msdat.fmohconnect.gov.ng/covid19_health_service_uptake/index.html.

[20] The United Nations Department of Global Communications (2020). Civil Society Survey on Misinformation about COVID-19. Available online at https://www.un.org/en/civil-society/civil-society-survey-covid-19.

[21] Krejcie, R.V., & Morgan, D.W., (1970). Determining Sample Size for Research Activities. Educational and Psychological Measurement.

[22] World Health Organization, Geneva: The 2018 Update, Global Health Workforce Statistics. (http://www.who.int/hrh/statistics/hwfstats/).

[23] Isreal A. Ademiluyi, Sunday O. Aluko-Arowolo (2009). Infrastructural Distribution of Healthcare Services in Nigeria: An overview. Journal of
Geography and Regional Planning Vol. 2(5), pp. 104-110, May 2009. Available online at https://academicjournals.org/journal/JGRP/article-full-text-pdf/046164D1629 ISSN 2070-1845.

[24]  Loubet, P., Czeschan, C., Sintes, M. et al. Use of short message service in at-home COVID-19 patient management. BMC Med 18, 391 (2020). https://doi.org/10.1186/s12916-020-01863-9.

Abstract:

Glycemic control remains a major cornerstone in the management of diabetes mellitus. Despite consistent studies, the incidence of both short-and long-term complications of diabetes had been quite alarming. This study employed a descriptive design. A total enumeration of 185 diabetic women of reproductive age constituted the sample size. A self-structured questionnaire with 40 items divided into five sections and a checklist for recording glycemic control were used for data collection. The data analysis involves the use of Statistical Package for Social Sciences (SPSS) version 23. Results were presented as frequencies, mean and standard deviation, and regression analysis. The findings from the study revealed that 112 (67.1%) of the women had normal glycemic status while 55 (32.9%) had high status. Furthermore, it revealed a significant negative correlation between educational qualification and glycemic control (r = -.161, p= 0.049). The study revealed a slight significant correlation between diet and glycemic control (r = -.148, p=0.052). Other practices did not share a significant correlation with glycemic control. The study concluded that an appreciable percentage of the respondents had high glycemic control status, education and diet had a significant partial correlation with glycemic control. Most of the women had good practice of diet, exercise, medication, and self-monitoring of blood glucose as shown in their health records. However, a sharp contrast exists between their record of glycemic control, which was good, and the current level, which revealed no significant correlations between self-management practices and glycemic control. Hence, the need for more patient education on self-management practices.

References:

[1] Witkowski A, et al. (2011). Effects of renal sympathetic denervation on blood pressure, sleep apnea course, and glycemic control in patients with resistant hypertension and sleep apnea. Hypertension; 58:559–65.

[2] Al-Goblan, A. S., Al-Alfi, M. A., & Khan, M. Z. (2014). Mechanism linking diabetes mellitus and obesity. Diabetes Metab Syndrome.

[3] World Health Organization (WHO) (2018). World health statistics 2017: Monitoring health World Health Day (2016). Beat Diabetes. Global Report on Diabetes. License: CC BY-NC-SA 3.0 IGO.https://www.who.int/about/who-weare/publishing-policies/copyright.

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[7] Oluyombo, R., Ayodele, P. O., Akinwusi, O. O., Okunola, A., Arogundade, F. A., Sanusi, A. A. & Onayade A. (2013). A Community Study of the Prevalence, Risk Factors, and Pattern of chronic kidney disease in Osun State, southwest Nigeria. West African journal of medicine.2013;32(2):85-92.

[8] Center for Disease Control and Prevention, National Diabetes Statistics Report, 2014 & 2015 (US Department of Health and Human Services, Center for Disease Control and Prevention, Atlanta, 2014).

[9] De-Graft, A. A., Owusu-Dabo, E., Agyemang, C. (2013) Diabetes in Ghana: a review of research on prevalence, experiences, and healthcare. Available from https://www.researchgate.net/

[10] Stuckey, H. L., Mullan-Jensen, C. B., & Reach, G. (2014) personal accounts of the negative and adaptive psychosocial experiences of people with diabetes in the second Diabetes Attitudes, Wishes and Needs (DAWN2) study. Diabetes Care; 37, 2466–74. type 2 diabetes mellitus: present and future perspectives. Nature reviews.

[11] Gurmu, Y., Gela, & Aga, (2018) Factors associated with self-care practice among adult diabetes patients in West Shoa Zone, Oromia Regional State, Ethiopia BMC Health Serv Res. 18, 732 (2018). https://doi.org/10.1186/s12913-018-3448-4.

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of self-care practice and its associated factors among diabetic patients in Urban are of Urmia, Northwest of Iran” Journal of Research in Health Science 11, 1-4.

Abstract:

Antiretroviral therapy (ART) has decreased the mortality and morbidity of HIV/AIDS, and high adherence to ART (>95%) is necessary for a good therapeutic outcome. Non-adherence can lead to drug-resistant HIV caused by failure to achieve maximal viral suppression. Little is known about adherence to ART and its determinants among ethnically diverse and economically disadvantaged patients. The purpose of the study was to identify the level of adherence and describe factors that influence ART adherence among ethnically diverse and economically disadvantaged patients. This is with a view to providing information that could help health care providers understand patient motivations for discontinuing their antiretroviral treatment and helping patients collaboratively develop treatment regimens that facilitate adherence and optimize the outcomes of HIV/AIDS therapy. A cross-sectional descriptive survey was used. Data were collected among 400 HIV-infected patients on ARV who received pretreatment and ongoing adherence counseling and education since 2010 using a self-administered questionnaire. The data were analyzed using Statistical Package for Social Sciences (SPSS). Findings showed that the self-reported adherence to the specific timing for taking the medications (medication schedule) was significantly low (8.3%). The major factors for non-adherence to medication reported in this study were being busy at work or school, forgetfulness, fasting and travelling away from home. Also, employment status was associated with poor adherence, which may be corroborated by the major reason for non-adherence (busy at work or school). This study is one of the first steps in the exploration of the relationship of factors responsible and medication adherence among HIV patients. This study used three different measures of medication adherence. These are patients’ knowledge of the benefits of taking the drugs, adherence to a medication schedule, and the number of prescribed doses of medications missed. Health care providers must identify possible barriers to adherence at the earliest and provide appropriate solutions. These factors should be considered when designing and implementing adherence interventions.

References:

[1] Achappa B, Madi D, Bhaskaran U, Ramapuram JT, Rao S, Mahalingam S. Adherence to Antiretroviral Therapy Among People Living with HIV. N Am J Med Sci. 2013 Mar;5(3):220-3. doi: 10.4103/1947-2714.109196. PMID: 23626959; PMCID: PMC3632027.

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[3] Vrijens B, De Geest S, Hughes DA, Przemyslaw K, Demonceau J, Ruppar T, Dobbels F, Fargher E, Morrison V, Lewek P, Matyjaszczyk M. A new taxonomy for describing and defining adherence to medications. British journal of clinical pharmacology. 2012 May;73(5):691-705.

[4] Fong OW, Ho CF, Fung LY, et al. Determinants of adherence to highly active antiretroviral therapy (HAART) in Chinese HIV/AIDS patients. HIV Med 2003;4: 133-8.

[5] National AIDS Council. The Zambia HIV/AIDS Strategic Framework, 2 2021. Lusaka: Zambia Ministry of Health; 2016.

[6] Gupta M, Das SC. Determinants contributing for poor adherence to antiretroviral therapy: A hospital record-based study in Balasore, Odisha. J Family Med Prim Care. 2019 May;8(5):1720-1724. doi: 10.4103/jfmpc.jfmpc_40_19. PMID: 31198743; PMCID: PMC6559074.

[7] Mhaskar R, Alandikar V, Emmanuel P, Djulbegovic B, Patel S, Patel A. Adherence to antiretroviral therapy in India: A systematic review and analysis. Indian J Commun Med. 2013;38(2):74–82. https://doi.org/10.4103/0970-0218.112435.

[8] Amelia J, Poquette DJ, Moore BG, Erin E, Morgan IG, Steven PW. Prospective memory and antiretroviral medication non-adherence in HIV: An analysis of ongoing task delay length using the memory for intentions screening test. J Int Neuropsychol Soc. 2013; 19:155–161. https://doi.org/10.1017/S1355617712001051.

[9] Gast A, Mathes T. Medication adherence influencing factors an (updated) overview of systematic reviews. Systematic reviews. 2019 Dec;8(1):1-7.

[10] Schäfer C. Patientencompliance. Springer Fachmedien Wiesbaden; 2017.

[11] Peltzer K, Preez NF, Ramlagan S, Fomundam H, Anderson J, Chanetsa L. Antiretrovirals and the use of traditional, complementary and alternative medicine by HIV patients in Kwazulu-Natal, South Africa: A longitudinal study. Afr J Tradit Complement Altern Med. 2011;8(4):337–345. https://doi.org/10.4314/ajtcam.v8i4.l.

[12] Kagee A, Remien RH, Berkman A, Hoffman S, Campos L, Swartz L. Structural barriers to ART adherence in Southern Africa: Challenges and potential ways forward. Global Public Health. 2011;6(1):83–97. https://doi.org/10.1080/17441691003796387.

[13] Masci JR. Outpatient management of HIV infection. 4th ed. Boka Raton, FL: CRC Press; 2011.

[14] Coetzee B, Kagee A, Vermeulen N. Structural barriers to adherence to antiretroviral therapy in a resource-constrained setting: The perspectives of health care providers. AIDS Care. 2011;23(2):146–151. https://doi.org/10.1080/09540121.2010.498874.

[15] Ogbochi M, Naomi NM, Jerry WL, Peter CG, Gisele M. Determinants of antiretroviral therapy adherence among women in Southern Malawi: Healthcare providers’ perspectives. AIDS Res Treatment. 2014. https://doi.org/10.1155/2014/489370.

[16] Young S, Wheeler A, McCoy S, Weiser SD. A review of the role of food insecurity in adherence to care and treatment among adult and paediatric populations living with HIV and AIDS. AIDS Behav. 2014;18(5):505–515. https://doi.org/10.1007/s10461-013-0547-4.

[17] Oku AO, Owoaje ET, Ige OK, Oyo-ita A. Prevalence and determinants of adherence to HAART amongst PLHIV in a tertiary health facility in south-south Nigeria. BMC Infect Dis. 2013; 13:401.

[18] Basti BD, Mahesh V, Bant DD, Bathija GV. Factors affecting antiretroviral treatment adherence among people living with human immunodeficiency virus/acquired immunodeficiency syndrome: A prospective study. J Family Med Prim Care. 2017 Jul-Sep;6(3):482-486. doi: 10.4103/2249-4863.222014. PMID: 29416993; PMCID: PMC5787940.

[19] Ingersoll KS, Cohen J. The impact of medication regimen factors on adherence to chronic treatment: A review of literature. J Behav Med 2008; 31:213-24.

[20] Agu KA, Ochei UM, Oparah AC, and Onoh OU. Treatment outcomes in patients receiving combination ARV therapy in Central hospital, Benin City, Nigeria. Trop. J. Pharm. Res. 2010; 9: 1-10.

[21] Schneider J, Kaplan SH, Greenfield S, Li W, Wilson IB. Better physician-patient relationships are associated with higher reported adherence to antiretroviral therapy in patients with HIV infection. Journal of General Internal Medicine. 2004; 19(11):1096-1103.

[22] Ammassari A, Trotta MP, Murri R, Castelli F, Narciso P, Noto P, Vecchiet J, Monforte AD, Wu AW, and Antinori A. Correlates and predictors of
adherence to highly active antiretroviral therapy: overview of published literature. Journal of Acquired Immune Deficiency Syndromes 2002; 31(3): S123-127.

[23] Murphy RL, Kivel NM, Zala C, Ochoa C, Tharnish P, Matthew J, et al. Antiviral activity and tolerability of amdoxovir with zidovudine in a randomized double-blind placebo-controlled study in HIV-1 infected individuals. Antivir Ther. 2010; 15:185–92.

[24] Möbius U, Lubach-Ruitman M, Castro-Frenzel B, Stoll M, Esser S, Voigt E, Christensen S, Rump JA, Fätkenheuer G, Behrens GM, Schmidt RE. Switching to atazanavir improves metabolic disorders in antiretroviral-experienced patients with severe hyperlipidemia. J Acquir Immune Defic Syndr. 2005 1;39(2):174-80. PMID: 15905733.

[25] Desai M, Iyer G, Dikshit RK. Antiretroviral drugs: critical issues and recent advances. Indian J Pharmacol. 2012;44(3):288-298. doi:10.4103/0253-7613.96296.

[26] Johnson MO, Charlebois E, Morin SF, Catz SL, Goldstein RB, Remien RH, Rotheram-Borus MJ, Mickalian JD, Kittel L, Samimy-Muzaffar F, Lightfoot MA. Perceived adverse effects of antiretroviral therapy. Journal of pain and symptom management. 2005 1;29(2):193-205.

[27] World Health Organization. Rapid advice: Antiretroviral therapy for HIV infection in adults and adolescents. [Accessed on 2021 June]. Available from: http://www.who.int/hiv/pub/arv/rapid_advice_art.pdf.

[28] De Maat MM, De Boer A, Koks CH, Mulder JW, Meenhorst PL, van Gorp EC, Mairuhu AT, Huitema AD, Beijnen JH. Evaluation of clinical pharmacist interventions on drug interactions in outpatient pharmaceutical HIV‐care. Journal of clinical pharmacy and therapeutics. 2004, 29(2):121-30.

Abstract:

Medicine’s availability, understanding their administration and radiational use are critical in drug therapeutic outcomes. Advancement in science has led to understanding of the etiology of several disease conditions, yet challenges remain due to patients’ non-adherence to prescribed treatment (14). The purpose of this study was to assess patient’s knowledge and understanding of their TB medications and their awareness of lifestyle modifications to adapt for post TB living. The study also assessed common factors affecting TB patients. A descriptive cross-sectional study was carried out. The study population consisted of 250 diagnosed TB patients attending the Clinic who were systematically selected. An Interviewer administered questionnaire with REDCAP was used to collect data, organized using Excel spreadsheet software and analysed using Statistical Package for Social Sciences (SPSS). Logistic regression was used to establish significance. Results: 63.2% (n=158) were males and 36.8% (n=92) were females with a 100% response rate. 62.8% (n=157) have pulmonary TB, 35.2% (n=88) Extra PTB whiles 2.0% (n=5) MDR-TB. 9.2% (n=23) of patients are aware that TB could reduce their sexual function. Only 20.4% (n=51) knew their medications and 2.7% (n=18) aware of lifestyle changes to adapt post treatment for an improved Quality of Life. 86.4% (n=216) out of the 250 patients received immediate care. Logistic regression showed that Odds ratio at 95% confident interval of the potential predictors were insignificant except age and marital status. Since less than 50% knew their medicines and lifestyle changes to adapt pharmacists and prescribers need to improve on patient education and counselling.

References:

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[5] Sharma P, Goyal RK, Nandave M. A Review: Prevention, Treatment, and Management of Tuberculosis through Combinational Approaches of Different Indian Systems of Medicine. Vol. 70, Drug research. NLM (Medline); 2020. p. 65–70.

[6] Bonsu F, Addo KK, Alebachew Z, Gyapong J, Badu-Peprah A, Gockah R, et al. National population-based tuberculosis prevalence survey in Ghana, 2013. Vol. 24, International Journal of Tuberculosis and Lung Disease. International Union Against Tuberculosis and Lung Disease (The Union); 2020. p. 321–8.

[7] A Trial of Early Antiretrovirals and Isoniazid Preventive Therapy in Africa. N Engl J Med. 2015 Aug 27;373(9):808–22.

[8] Yeong C, Byrne AL, Cho JG, Sintchenko V, Crighton T, Marais BJ. Use of GeneXpert MTB/RIF on a single pooled sputum specimen to exclude pulmonary tuberculosis among hospital inpatients placed in respiratory isolation. Int J Infect Dis. 2020 Mar 1; 92:175–80.

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[10] Ghana Ministry of Health. The National Tuberculosis Health Sector Strategic Plan for Ghana: 2015-2020. Minist Heal. 2015;1–132.

[11] An exploration of the causes of tuberculosis stigma in an urban district in Ghana | Request PDF [Internet]. [cited 2021 Feb 28]. Available from: https://www.researchgate.net/publication/23180777_An_exploration_of_the_causes_of_tuberculosis_stigma_in_an_urban_district_in_Ghana.

[12] Dodor EA. The feelings and experiences of patients with tuberculosis in the Sekondi-Takoradi Metropolitan district: implications for TB control efforts. Ghana Med J [Internet]. 2012 [cited 2021 Feb 28];46(4):211–8. Available from: /pmc/articles/PMC3645176/.

[13] Evenson W. Occupational Exposure to Mycobacterium tuberculosis Legal Issues in Workers’ Compensation.

[14] Adherence to long therapies: Evidence for action. Geneva, Switzerland (WHO,2003).

[15] Alam AY, Qureshi AA, Adil MM, Ali H. Comparative study of knowledge, attitude and practices among antenatal care facilities utilizing and non-utilizing women. J Pak Med Assoc. 2005; 55:53–6.

[16] Nhamoyebonde S, Leslie A. Biological Differences Between the Sexes and Susceptibility to Tuberculosis. 2014 [cited 2021 Feb 28]; Available from: https://academic.oup.com/jid/article/209/suppl_3/S100/2192832.

[17] Self-Study Modules on Tuberculosis, 6-9 Module 6 Managing Tuberculosis Patients and Improving Adherence Module 6-Managing Tuberculosis Patients and Improving Adherence 2.

[18] Chapter 5: Treatment for Latent Tuberculosis Infection Chapter 5 Treatment for Latent Tuberculosis Infection.

[19] Tuberculosis (TB) - Treatment - NHS [Internet]. [cited 2021 Feb 28]. Available from: https://www.nhs.uk/conditions/tuberculosis-tb/treatment/.

[20] Senanayake MGB, Wickramasinghe SI, Samaraweera S, De Silva P, Edirippulige S. Examining the social status, risk factors and lifestyle changes of tuberculosis patients in Sri Lanka during the treatment period: a cross-sectional study. Multidiscip Respir Med [Internet]. 2018 Dec 1 [cited 2021 Feb 28]; 13(1):9. Available from: https://mrmjournal.biomedcentral.com/articles/10.1186/s40248-018-0121-z.

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http://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-016-2136-x.

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