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Beyond the Pill: Psychosocial and Behavioural Predictors of ART Non-Adherence Following the Single-Tablet Regimen Transition in Yaoundé, CameroonAuthor: Mbohli Semirnyuy Sharon LumDOI: 10.21522/TIJPH.2013.14.01.Art001
Beyond the Pill: Psychosocial and Behavioural Predictors of ART Non-Adherence Following the Single-Tablet Regimen Transition in Yaoundé, Cameroon
Abstract:
Achieving the UNAIDS 95-95-95 targets depends on optimal adherence to antiretroviral therapy (ART). While Cameroon transitioned to simplified Dolutegravir-based Single-Tablet Regimens (STR), the impact on adherence relative to Multiple-Tablet Regimens (MTR) remains to be elucidated. This hospital-based cross-sectional study among 680 participants at Yaoundé Jamot Hospital quantified adherence using a modified CPCRA 7-day recall and CASE Adherence Index. Results indicated an optimal adherence prevalence of 79.7% (95% CI: 76.4–82.7%) for the 7-day recall and 80.9% for the CASE Index. No significant difference in adherence was observed between STR and MTR users (p = 0.494). Multivariable modified Poisson regression revealed that lack of family support was the strongest predictor of non-adherence (aPR: 1.407, 95% CI: 1.203–1.646; p < 0.001). Other significant factors included depressive symptoms (aPR: 1.257, 95% CI: 1.036–1.525) and risky alcohol consumption (aPR: 1.158, 95% CI: 1.096–1.224). These findings suggest that in the era of simplified regimens, adherence is driven primarily by psychosocial and behavioural determinants rather than physical drug complexity. To bridge the final 20% gap, interventions must prioritize family support systems and mental health screening alongside pharmacological simplification.
Beyond the Pill: Psychosocial and Behavioural Predictors of ART Non-Adherence Following the Single-Tablet Regimen Transition in Yaoundé, Cameroon
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Evaluating the Psychosocial Needs and Reintegration of Returnee Migrants in NigeriaAuthor: Olatunji Joshua AwoleyeDOI: 10.21522/TIJPH.2013.14.01.Art002
Evaluating the Psychosocial Needs and Reintegration of Returnee Migrants in Nigeria
Abstract:
Returnee migrants in Nigeria face complex psychosocial challenges that hinder their reintegration into society. This study evaluated the psychosocial needs and reintegration experiences of returnee migrants across Nigeria. A mixed-method design was used to assess returnees’ psychosocial needs. Quantitative data were collected from 1,316 returnee migrants using a structured, pretested questionnaire with a 5-point Likert scale, selected through multistage sampling across Nigeria’s six geopolitical zones. Qualitative data were obtained through 8 focus group discussions (FGD) with 12 participants each. Quantitative data were analyzed using SPSS version 28.0, while qualitative data were analyzed thematically using QDA Miner. The mean age of respondent was 29.11 ± 6.21. Psychosocial needs assessments revealed limited access to mental health services (36.6%). Most respondents reported weak community belonging (75.7%) and high levels of social isolation (84.7%), while stigma related to returnee status was widely prevalent (85.1%). Psychosocial factors such as Sex, and religion shows a strong independent association with psychosocial needs among returnees. Male respondents have significantly higher odds (AOR= 5.533: p<0.001) of reporting psychosocial needs compared to females. Muslim participants reported lower odds of psychosocial needs (AOR=0.559: p=0.026) compared to Christian respondents. Qualitative findings revealed widespread stigma, broken relationships, and systemic exclusion, particularly affecting women. Returnees emphasized the need for trauma-informed mental health care, sustainable livelihoods, and structural support such as transitional housing. Returnee migrants in Nigeria experience profound psychosocial distress characterized by stigma, economic hardship, and weak community integration. Interventions should focus on reducing stigma, strengthening community acceptance, and integrating psychosocial support.
Evaluating the Psychosocial Needs and Reintegration of Returnee Migrants in Nigeria
References:
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Perceptions of Healthcare Seekers on Universal Health Coverage in Lubero Territory and Butembo City in Democratic Republic of CongoAuthor: Paluku Kahuko-Wa-MithimboDOI: 10.21522/TIJPH.2013.14.01.Art003
Perceptions of Healthcare Seekers on Universal Health Coverage in Lubero Territory and Butembo City in Democratic Republic of Congo
Abstract:
This study aims to contribute to the implementation of universal health coverage in the Democratic Republic of Congo and to assess the implementation of UHC through the level of perception of healthcare seekers. The study is descriptive, cross-sectional, comparative, and correlational. It was conducted from March to August 2025. A survey was carried out using an interview guide submitted to 1, 068 heads of households in nine health zones in Lubero Territory and Butembo City. After data analysis, the findings read as follows: First, expectations regarding the UHC were positive in Lubero (M= 3.50 ± 0.85) and in Butembo (M=3.30 ± 0.82). Second, perceptions in terms of fears were considered negative in Lubero Territory (M= 2.68 ± 0.94) and in Butembo City (M= 2.74 ± 0.86). Third, the expectations of healthcare seekers differ according to place of residence (t =3.75; p=0.000), whereas fears do not (t=-1.01; p=0.310). Fourth, the expectations of healthcare seekers do not differ according to main profession (F=0.500; p=0.776), while fears do (F=5.052; p=0.000). Fifth, perceptions of UHC differ according to marital status (F=3.806; p=0.010) but not according to gender (F=-0.696; p=0.486). Sixth, there was no significant relationship between expectations of UHC and characteristics such as age, level of education, household size, and household income. Indeed, fears about UHC are influenced by educational level (r=0.117; p=0.000), household size (r=-0.125; p=0.000), and household income (r=-0.101; p=0.001).
Perceptions of Healthcare Seekers on Universal Health Coverage in Lubero Territory and Butembo City in Democratic Republic of Congo
References:
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Strengthening Public Health through Prioritization of Village Resilience Components Using the Quadrant of Difficulty-Usefulness ApproachAuthor: SunartoDOI: 10.21522/TIJPH.2013.14.01.Art004
Strengthening Public Health through Prioritization of Village Resilience Components Using the Quadrant of Difficulty-Usefulness Approach
Abstract:
This study aims to evaluate the resilience of Disaster Resilient Villages (Destana) in Magetan Regency, East Java, Indonesia in facing public health crises due to disasters, and to map the priority of village resilience components using the Quadrant of Difficulty and Usefulness (QoDU) approach. This descriptive study took place over eight months in 32 villages, involving 640 respondents consisting of 20 active administrators per village. The evaluation was conducted using the PKD (Village Resilience Assessment) questionnaire which included 32 indicators and 128 questions, filled out through Focus Group Discussions (FGD), while determining the priority of components that had high benefits but were difficult to realize using the QoDU-VR (Quadrant of Difficulty-Usefulness Village Resilience Questionnaire) questionnaire. The results showed that 3 villages (9.4%) were in the primary category, 12 villages (37.5%) were in the middle category, and 17 villages (53.1%) were in the main category, with the district's resilience level at the middle level (score 80.06). The recovery preparedness component scored the lowest (69.94), followed by prevention and mitigation (70.75). Using the QoDU approach, the prevention and mitigation components were prioritized due to their high utility but difficulty in implementation, followed by the post-disaster recovery component. The study also found that disaster-resilient villages in the primary category were not yet fully capable of implementing prevention and mitigation measures, and that the majority of villages did not yet have a post-crisis recovery plan document. The QoDU approach helps establish strategic priorities in building public health resilience. These findings form the basis for strengthening public health through participatory studies based on component and sub-component prioritization strategies in further research.
Strengthening Public Health through Prioritization of Village Resilience Components Using the Quadrant of Difficulty-Usefulness Approach
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[11]. Arifin, S., Wicaksono, S. S., Sumarto, S., Martitah, M., Sulistianingsih, D., 2021, Disaster resilient village-based approach to disaster risk reduction policy in Indonesia: A regulatory analysis, Jamba J. Disaster Risk Stud., 13(1), 1–9, doi: 10.4102/JAMBA.V13I1.1021.
[12]. Bishai, D., Saleh, B. M., Huda, M., Aly, E. M., Hafiz, M., Ardalan, A., 2024, Practical strategies to achieve resilient health systems : results from a scoping review, BMC Health Serv. Res., 24(297), 1–11, doi: https://doi.org/10.1186/s12913-024-10650-8.
[13]. Sunarto, Nugroho, H. S. W., Suparji, Santosa, B. J., 2024, Quadrant of difficulty and usefulness for prioritizing community-based disaster preparedness parameter elements, Rawal Med. J., 49(1), 172–175, doi: 10.5455/rmj.20230918043333.
[14]. Nugroho, H. S. W., et al., 2020, Quadrant of difficulty-usefulness (QODU) as new method in preparing for improvement of e-learning in health college, Risk Manag. Healthc. Policy, 13, 1625–1632, 2020, doi: 10.2147/RMHP.S268814.
[15]. Nkombi, Z., Wentink, G. J., 2022, The role of public participation in disaster risk reduction initiatives: The case of Katlehong township, Jamba J. Disaster Risk Stud., 14(1), 1–12, doi: 10.4102/jamba.v14i1.1203.
[16]. Lin, B., Lee, C., 2025, Enhancing community-based earthquake disaster management : resident preferences and adaptive, Geomatics, Nat. Hazards Risk, 16(1), 1–25, doi: 10.1080/19475705.2025.2450290.
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[18]. Sunarto, Nugroho, H. S. W., Suparji, Rahayu, T. P., Handayani, T. E., Haksama, S., 2024, Participatory Action Research to Realize Disaster Health Crisis Preparedness in the Community, Texila Int. J. Public Heal., 12(4), doi: 10.21522/TIJPH.2013.12.04.Art087.
[19]. Hati, B., 2025, Polymorphic grassroots networks and implications for disaster resilience in popular settlements in Sierra Leone, India and Kenya, Environ. Urban., 37(1), 159–182, doi: 10.1177/09562478251318230.
[20]. Sunarto, Nugroho, H. S. W., Suparji, Hanifah, A. N., Prasetyo, A., 2025, ntegration of Participatory Action Research Approaches in Realizing Disaster Preparedness, Disaster Adv., 18(4), 55–63, 2025, doi: 10.25303/184da055063.
[21]. Fortnam, M., Hailey, P., Witter, S., Balfour, N., 2023, Resilience in interconnected community and formal health (and connected) systems, SSM - Heal. Syst., 3(11), 100027, doi: 10.1016/j.ssmhs.2024.100027.
[22]. Van Assen, M. F., 2021, Training, employe involvement and continuous improvement-the moderating effect of a common improvement method, Prod. Plan. Control, 32(2), 132–144, doi: 10.1080/09537287.2020.1716405.
[23]. Srivastava, P., 2023, Evaluating the Role of Training Programs in Enhancing Employee Skills and Retention, J. Bus. Manag., 25(8), 66–71, doi: 10.9790/487X-2508016671.
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Malaria Epidemiology and Control among Under-Five Children in Northeastern NigeriaAuthor: Mohammed Bala AminuDOI: 10.21522/TIJPH.2013.14.01.Art005
Malaria Epidemiology and Control among Under-Five Children in Northeastern Nigeria
Abstract:
In Nigeria, malaria continues to be a leading cause of morbidity and mortality among children under five, with disproportionate effects in areas affected by violence. The findings and discussion of a doctoral thesis conducted in the Jere Local Government Area (LGA), Borno State, are presented in this study as a publication-ready synthesis. Multistage cluster sampling was used to gather data from 235 families with children under 5 through a community-based cross-sectional study. Sociodemographic traits, malaria episodes, preventive measures, treatment-seeking behavior, and surveillance performance were all evaluated using structured questionnaires that were modified from WHO and DHS assessments. To assess community outreach and reporting completeness, facility-based surveillance records were examined. SPSS version 26 was used to perform logistic regression analysis, chi-square tests, and descriptive statistics. Over 95% of households reported at least one malaria episode in the six months prior, indicating a persistently high malaria burden. Insecticide-treated nets (ITNs) and indoor residual spraying (IRS) were reported to have high preventive coverage; however, symptom-based evaluation was a major component of diagnostic confirmation. Despite widespread community awareness of government and non-governmental organization efforts, surveillance outreach and home visits by medical professionals were scarce. There was no statistically significant correlation found between the incidence of malaria and the age of caregivers. The results show a dichotomy between persistent hyperendemic transmission and high knowledge and reported preventative coverage. Achieving significant reductions in the malaria burden among children under five in conflict-affected areas requires bolstering community-based case detection, expanding surveillance reach, and strengthening diagnostic confirmation.
Malaria Epidemiology and Control among Under-Five Children in Northeastern Nigeria
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[13]. Tusting, L. S., Willey, B., Lucas, H., Thompson, J., Kafy, H. T., Smith, R., & Lindsay, S. W., 2019, Socioeconomic development as an intervention against malaria: A systematic review and meta-analysis. PLoS Medicine, 16(3), e1002820.
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[17]. Gething, P. W., Elyazar, I. R. F., Moyes, C. L., Smith, D. L., Battle, K. E., Guerra, C. A., Patil, A. P., Tatem, A. J., Howes, R. E., Myers, M. F., George, D. B., Horby, P., Wertheim, H. F. L., Price, R. N., Mueller, I., Baird, J. K., & Hay, S. I., 2012, A long-neglected world malaria map. Nature, 465(7296), 342–345.
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Associations between Wildfire Smoke Exposure and Chronic Cardiovascular and Respiratory Conditions in Selected Provinces in Canada: A Retrospective Ecological StudyAuthor: Chukwubuikem Cornelius OkaforDOI: 10.21522/TIJPH.2013.14.01.Art006
Associations between Wildfire Smoke Exposure and Chronic Cardiovascular and Respiratory Conditions in Selected Provinces in Canada: A Retrospective Ecological Study
Abstract:
Wildfire smoke (PM2.5) has been recognized as an environmental risk factor with severe adverse health outcomes. Exposure to PM 2.5 can lead to severe cardiovascular and respiratory health conditions. The study aims to assess and examine the ecological associations between wildfire smoke exposure and the burden of chronic cardiovascular and respiratory conditions in Canada from 2010 to 2023, by integrating health outcome data with wildfire activity and air quality indicators across provinces. The study used a retrospective study design to collect secondary data from the Canadian Chronic Disease Surveillance System (CCDSS) for health outcomes (acute myocardial infarction, asthma, chronic obstructive pulmonary disease (COPD), heart failure, stroke) across the selected provinces, from the Canadian Wildland Fire Information System (CWFIS), for wildfire perimeters and their causes, and from the National Air Pollution Surveillance Program (NAPS), for air quality using PM 2.5 concentration as a proxy for air pollution exposure. The correlation between average PM₂.₅ concentrations and incidence rates was weakly negative (r = –0.106, p = 0.238), and the wide confidence interval (95% CI: –0.6357 to 0.1593). Similarly, the correlation between high-risk air quality days (HRD) and incidence rates was also weak and negative (r = –0.042, p = 0.643), again failing to reach statistical significance. The findings indicate that wildfire smoke exposure, though an important environmental health concern, was not a statistically significant predictor of chronic cardiovascular and respiratory disease incidence across the studied provinces. This does not negate the potential health risks of wildfire smoke.
Associations between Wildfire Smoke Exposure and Chronic Cardiovascular and Respiratory Conditions in Selected Provinces in Canada: A Retrospective Ecological Study
References:
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[5]. Seinfeld, J. H., & Pandis, S. N., 1998, Atmospheric chemistry and physics: From air pollution to climate change (2nd ed.). John Wiley & Sons.
[6]. Liu, J. C., Pereira, G., Uhl, S. A., Bravo, M. A., & Bell, M. L., 2015, A systematic review of the physical health impacts from non-occupational exposure to wildfire smoke. Environmental Research, 136, 120–132. https://doi.org/10.1016/j.envres.2014.10.015.
[7]. Brook, R. D., Rajagopalan, S., Pope, C. A., Brook, J. R., Bhatnagar, A., Diez-Roux, A. V., et al., 2010, Particulate matter air pollution and cardiovascular disease: An update to the scientific statement from the American Heart Association. Circulation, 121(21), 2331–2378. https://doi.org/10.1161/CIR.0b013e3181dbece.
[8]. Jones, C. G., Rappold, A. G., Vargo, J., Cascio, W. E., Kharrazi, M., McNally, B., et al., 2020, Out-of-hospital cardiac arrests and wildfire-related particulate matter during 2015–2017 California wildfires. Journal of the American Heart Association, 9(8), e014125. https://doi.org/10.1161/JAHA.119.014125
[9]. Jain, P., Barber, Q. E., Taylor, S. W., Whitman, E., Castellanos Acuna, D., Boulanger, Y., et al., 2024, Drivers and impacts of the record-breaking 2023 wildfire season in Canada. Nature Communications, 15, 6764. https://doi.org/10.1038/s41467-024-51154-7
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[15]. Black, C., Gerriets, J. E., Fontaine, J. H., Harper, R. W., Kenyon, N. J., Tablin, F., et al., 2017, Early life wildfire smoke exposure is associated with immune dysregulation and lung function decrements in adolescence. American Journal of Respiratory Cell and Molecular Biology, 56(5), 657–666. https://doi.org/10.1165/rcmb.2016-0380OC.
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[18]. Yu, M., Zhang, S., Ning, H., Li, Z., & Zhang, K., 2024, Assessing the 2023 Canadian wildfire smoke impact in the Northeastern US: Air quality, exposure, and environmental justice. Science of the Total Environment, 926, 171853. https://doi.org/10.1016/j.scitotenv.2024.171853
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From Ward to Policy: Nurses’ Views on Breastmilk Donation and Banking in Selected Hospitals in Bono Region, GhanaAuthor: Bennin Juabie DouriDOI: 10.21522/TIJPH.2013.14.01.Art007
From Ward to Policy: Nurses’ Views on Breastmilk Donation and Banking in Selected Hospitals in Bono Region, Ghana
Abstract:
Breast milk donation and banking provide lifesaving nutrition for preterm and vulnerable infants. However, the success of such programs depends largely on the knowledge, perceptions, and acceptability among frontline health professionals. This study assessed nurses’ views on breast milk donation and banking in Bono regional hospitals, Ghana. A cross-sectional descriptive study was conducted among nurses across three selected referral hospitals in the Bono region of Ghana. Data were collected using structured questionnaires covering knowledge, perceptions, and acceptability of breast milk donation and banking. Four hundred and twenty-two (422) nurses were randomly selected for data collection. Descriptive and inferential statistics were used to analyze responses, with associations tested between socio-demographic factors and acceptability. Nurses demonstrated moderate knowledge of breast milk donation, with notable gaps in conceptual understanding and safety protocols. Perception toward breastmilk donation and banking were neutral, with recognition of donor milk’s role in improving neonatal survival, though concerns about affordability and disease transmission persisted. Acceptability was high, with many nurses expressing willingness to donate or encourage donation. Age, workplace, and religion significantly influenced acceptance levels. The study concludes that while nurses in Bono regional hospitals show readiness to support breast milk donation and banking, targeted education, cultural and religious engagement, clear safety and financing frameworks are needed to address existing concerns.
From Ward to Policy: Nurses’ Views on Breastmilk Donation and Banking in Selected Hospitals in Bono Region, Ghana
References:
[1]. Adjei, B., Adu-Kofi, I. M., Alpan, C., Ababio, N., Dsaue, N. A., 2025, Acceptance and perception of human milk banking: A review. International Journal of Multidisciplinary Research, 7(2), 1-10.
[2]. Iloh, K. K., Osuorah, C. D. I., Ndu, I. K., Asinobi, I. N., Obumneme-Anyim, I. N., Ezeudu, C. E., et al., 2018, Perception of donor breast milk and determinants of its acceptability among mothers in a developing community: A cross-sectional multi-center study in south-east Nigeria. International Breastfeeding Journal, 13(1), 1-13.
[3]. Mampane, T., Wolvaardt, J. E., 2024, The acceptability of a donor human milk bank and donated human milk among mothers in Limpopo Province, South Africa. Maternal and Child Nutrition, 20(3).
[4]. Appiah, P. K., Amu, H., Osei, E., Konlan, K. D., Mumuni, I. H., Verner, O. N., et al., 2021, Breastfeeding and weaning practices among mothers in Ghana: A population-based cross-sectional study. PLoS ONE, 16(11), 1-19. Available at: https://doi.org/10.1371/journal.pone.0259442
[5]. Namuddu, M. G., Kiguli, J., Nakibuuka, V., Nantale, R., Mukunya, D., 2023, Acceptability of donated breast milk among pregnant women in selected hospitals in central Uganda: A cross-sectional study. International Breastfeeding Journal, 18(1), 1-11.
[6]. Zamahlubi, H. T., Naidoo, K. L., Khan, F., Masekela, R., 2024, Knowledge, attitudes and awareness regarding donor breast milk: A cross-sectional study of mothers in a high HIV-prevalent area. South African Journal of Clinical Nutrition, 37(1), 1-8. Available at: https://doi.org/10.1080/16070658.2023.2189347
[7]. National Institute for Health and Care Excellence (NICE), 2021, Quick reference guide: Donor breast milk banks-The operation of donor breast milk bank services. NICE Clinical Guideline, February 1-15.
[8]. Pinto, M., Moehlecke Iser, B., Molon Fernandes, T., Oliveira Schuelter, P., Ferreira D’Agostini, M., 2020, Contributing and limiting factors for human milk donation. Journal of Health Sciences, 22(2), 177-182.
[9]. Chagwena, D. T., Mugariri, F., Sithole, B., Mataga, S. F., Danda, R., Matsungo, T. M., et al., 2020, Acceptability of donor breastmilk banking among health workers: A cross-sectional survey in Zimbabwean urban settings. International Breastfeeding Journal, 15(1), 1-11.
[10]. Ramli, N., Ibrahim, N. R., Hans, V. R., 2021, Human milk banks-The benefits and issues in an Islamic setting. East Journal of Medicine, 15(4), 163-167.
[11]. Tende, F. K., Nwameme, A. U., Tabong, P. T. N., 2023, Acceptability of breast milk donor banking: A qualitative study among health workers in Greater Accra Regional Hospital, Ghana. PLOS Global Public Health, 3(8), 1-17. Available at: https://doi.org/10.1371/journal.pgph.0001870
[12]. Obeng, C., Jackson, F., Amissah-Essel, S., Siah-Asamoah, C., Perry, C. A., Gonzalez Casanova, L., et al., 2023, Women’s perspectives on human milk banking in Ghana: Results from a cross-sectional study. Frontiers in Public Health, 11. Available at: https://doi.org/10.3389/fpubh.2023.xxxxxx
[13]. Mpayo, L. L., Msuya, M. A., Moshiro, R., Cosmas, I. L., Kimaryo, Y., 2024, Awareness and acceptability of donor human milk banking among women in Dar es Salaam, Tanzania: A cross-sectional study. Journal of African Neonatal, 4, 77-83.
[14]. UNICEF, 2010, Implementation guidance: Making EHS an integral part of process design. UNICEF Publication, 135-149.
[15]. Dalinjong, P. A., Wang, A. Y., Homer, C. S. E., 2018, The implementation of the free maternal health policy in rural Northern Ghana: Synthesised results and lessons learnt. BMC Research Notes, 11, Article 276.
[16]. Nanjundeswaraswamy, T. S., Divakar, S., 2021, Determination of sample size and sampling methods in applied research. Proceedings in Engineering Sciences, 3(1), 25-32.
[17]. Abdul Hamid, S. B., Haris, S. N., Hui, J. C., 2022, Breastfeeding knowledge, attitude and practices and its association with food insecurity during COVID-19. Environment and Public Health Journal, 7(21), 153-164. Available at: https://doi.org/10.21834/ebpj.v7i21.3686
[18]. Masi, A. C., Stewart, C. J., 2024, Role of breastfeeding in disease prevention. Microbial Biotechnology, 17(7), 1-10.
[19]. World Health Organization (WHO), 2003, Global strategy for infant and young child feeding. Fifty-Fourth World Health Assembly Document, 1-8.
[20]. Ogundare, E. O., Dedeke, I. O. F., Babatola, A. O., Adeniyi, A. T., Ajite, A. B., Lawal, O. A., et al., 2023, Human milk banking acceptability among pregnant and nursing mothers in Southwest Nigeria. Journal of Public Health Research, 12(3).
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Knowledge and Utilization of Health Insurance following the Rollout of the State Contributory Health and Basic Healthcare Provision Fund in Kaduna State, NigeriaAuthor: Muazu HabibuDOI: 10.21522/TIJPH.2013.14.01.Art008
Knowledge and Utilization of Health Insurance following the Rollout of the State Contributory Health and Basic Healthcare Provision Fund in Kaduna State, Nigeria
Abstract:
The availability of information to the public plays a fundamental role in creating awareness, building trust and improving utilization of health insurance schemes. Knowledge of health insurance is often limited, and results in low utilization rates of services among vulnerable groups or those in informal sectors. This study examines the knowledge and utilization of health insurance schemes in Kaduna State, using z-test of difference of two proportions at 5% level of significance for 1944 respondents. Statistical analysis (chi-square tests and Z-test of proportions) using Stata 16.0 revealed that 86.1% of respondents have heard of the general term ‘Health Insurance”. Knowledge declined significantly for specific schemes (KADCHMA: 67.0% and BHCPF: 59.2%). The State Contributory Health Scheme (KADCHMA) shows the highest mean utilization of services at 1,167.08 enrollees, National Health Insurance at 458.23 enrollees, private health insurance at 219.90 enrollees, BHCPF 179.61 at enrollees and Tertiary institutions Social Insurance scheme at 0.33. Despite the successes recorded, less than half of the population (49.6%) understands the operationality of the schemes, 29.3% only heard of the schemes with no understanding of their functionality, and 9.8% only heard of the schemes indicating low knowledge. The average percentage of the catchment population covered under all the schemes is extremely low, averaging 15.97% per facility. Addressing these issues requires multi-stakeholders’ engagement to create awareness and mobilize citizens to understand and enrolled into the health insurance schemes.
Knowledge and Utilization of Health Insurance following the Rollout of the State Contributory Health and Basic Healthcare Provision Fund in Kaduna State, Nigeria
References:
[1]. Lawan, U. M., Iliyasu, Z., Daso, A. M., 2012, Challenges to the scale-up of the Nigerian National Health Insurance Scheme: Public knowledge and opinions in urban Kano, Nigeria. Ann Trop Med Public Health. Available from: http://www.atmph.org/text.asp?2012/5/1/34/92878. Accessed on 12/10/2025.
[2]. Abiba, L., Janine, H., and Jeroen, S., 2012, Effects of Knowledge, Acceptance and use of Contraceptives on Household Wealth in 26 African Countries. Available at: http://www.ru.nl/nice/workingpapers. Accessed 22/10/2025.
[3]. Mimmie, C. N., Pranee, L., and Mary, C., 2013, Contraception Knowledge and Attitudes: Truths and Myths among African Australian Teenage Mothers in Greater Melbourne, Australia. Available at: University of Roehampton Online Library. Accessed 12/10/2025.
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Vision Assessment of Drivers of Passenger Service Vehicles Operating across Bushenyi-Ishaka MunicipalityAuthor: Okaali Simon DanielDOI: 10.21522/TIJPH.2013.14.01.Art009
Vision Assessment of Drivers of Passenger Service Vehicles Operating across Bushenyi-Ishaka Municipality
Abstract:
The main purpose of the study is to establish the vision of the drivers of Passenger Service Vehicles operating across Bushenyi – Ishaka municipality in Uganda. A cross-sectional descriptive study with both quantitative and qualitative techniques was used. Semi structured questionnaires were administered to 392 participants and the data was analysed at three (3) different levels; Univariate, to find out the proportion of respondents with reduced vision for driving, Bivariate, to assess the effect of individual factors on accident involvement & Multivariate, to assess for the effect of the potential confounding variables. Participants underwent eye examinations comprising visual acuity, colour vision test using Ishihara Pseudo-Isochromatic plates, confrontational visual fields, external and internal Ocular eye health examinations. 87% of the drivers of Passenger Service Vehicles met the visual requirement for driving (visual acuity greater than 6/9 in both eyes) while 13% had inadequate vision for driving (visual acuity less than 6/9 in both eyes). The commonest cause of reduced vision was refractive error (71%) and the factors associated with it according to the respondents were the family history of blindness, old age and accidents (trauma). Poor visual acuity was significantly associated with road traffic accidents (P-0.004). This study implies that the number of operators of passenger service vehicles in Bushenyi District with visual acuity less than 6/9 for driving is high and the level of awareness and utilization of eye care services by the drivers of Passenger Service Vehicles in Bushenyi is low.
Vision Assessment of Drivers of Passenger Service Vehicles Operating across Bushenyi-Ishaka Municipality
References:
[1]. Bushenyi District Records Department, 2012, Annual Report (unpublished).
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[12]. Sali, G., 2003, Vision assessment of public service vehicle drivers operating in and from Kampala., Dissertation, Makerere University, Kampala.
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Healthcare Providers' Perceptions of Universal Health Coverage in Lubero and Butembo, DR-CongoAuthor: Paluku Kahuko-Wa-MithimboDOI: 10.21522/TIJPH.2013.14.01.Art010
Healthcare Providers' Perceptions of Universal Health Coverage in Lubero and Butembo, DR-Congo
Abstract:
The target of this investigation is to contribute to the implementation of universal health coverage in the Democratic Republic of Congo. As a descriptive, cross-sectional, comparative, and correlational study, it was conducted from March to August 2025. Data collection consisted of a survey questionnaire administered to 920 healthcare providers in both the Lubero Territory and Butembo City. Regarding increased frequency and use of services, expectations on UHC are positive (M=3.75[3.68; 3.81] ± 0.05), increasing rate of income recovery (M=3.39[3.31; 3.46] ± 1.15) and protecting of household finances (M=3.38[3.32; 3.45] ± 1.07). Healthcare providers fear delays in patient bill payments (M=2.42 [2.35; 2.50] ± 1.13) and disruption of input stocks (M=2.55 [2.47; 2.63] ± 1.23). Expectations of healthcare providers vary by residence (t = 7.06; p = 0.000), whereas fears do not (t = 0.00; p = 0.999). Expectations of healthcare providers vary depending on each one’s main job (F = 3.536; p = 0.001). The same is observed for fears (F=3.390; p=0.001). Perceptions vary by marital status (F=2.832; p=0.037) but not by gender (F=-0.074; p=0.918). Expectations of healthcare providers of UHC are influenced by the level of education (r=0.094; p=0.004) and depend on household income (r=-0.079; p=0.016).
Healthcare Providers' Perceptions of Universal Health Coverage in Lubero and Butembo, DR-Congo
References:
[1]. Alkodaymi, S. M., Abou Shaar, B., Ashraf Fawzy, N., Alhabbbash, R., Senjab, A., & Rawan AlSaoudm, R., 2020, Knowledge, perception, and attitudes of Universal Health Coverage policies among Alfaisal University students in Saudi Arabia. Journal of education and health promotion. https://pmc.ncbi.nlm.nih.gov/articles/PMC7871921/
[2]. Bukele Kekemb, T., & Mbuyi, Y., 2022, Determinants of the Universal Health Coverage Process in the Democratic Republic of Congo: An Econometric Approach Using the PLS Algorithm International Journal of Multidisciplinary and Current Research, Vol.10 (July/Aug 2022 issue), pp. 332-343.
[3]. Care, et al., 2017, Health for All: Why Universal Health Coverage Is Important ?. https://www.cordaid.org/en/wp-content/uploads/sites/11/2017/12/Cordaid_Health_HealthForAll-Why-is-Universal-Health-Coverage-important-FR-LR.pdf
[4]. Etcheberry, J., 2015, Knowledge and Perceptions of DCEM4 Students from Île-de-France on Complementary Universal Health Coverage and Its Beneficiaries. [Doctoral Theses, Paris Diderot University – Paris 7]. http://www.bichat-larib.com/publications.documents/4995_ETCHEBERRY_these.pdf
[5]. Faye, M. F., 2021, Universal Health Coverage in Senegal: Impact Evaluation and Analysis of Health Financing Policies. [Doctoral Thesis, Cheikh Anta Diop University of Dakar]. https://theses.hal.science/tel-03690782/
[6]. Ifeagwu, S. C., Nakaboga Kikonyogo, R., Nakkazi, S., Beinomugisha, J., Ojiambo Wandera, S., Kiwanuka, S. N., King, R., Tine Van Bortel, T. V., Brayne, C., Parkes-Ratanshi, R., 2024, Sickness has no time: Awareness and perceptions of health care workers on universal health coverage in Uganda. Plos one 19(7). https://doi.org/10.1371/journal. pone.0306922
[7]. Ismail, S., 2016, Economic Evaluation of Health Insurance Reform in Tunisia. [Doctoral Theses. PARIS-DAUPHINE UNIVERSITY]. https://theses.hal.science/tel-01300569/
[8]. Kabinda, J., Mitashi, P., & Chengem, F., 2017, Universal Health Coverage (UHC): How to Finance the Inclusion of the Informal Sector in the Democratic Republic of Congo (DRC)? https://aenweb.blob.core.windows.net/aenweb/files/files/Policy_brief_1.pdf
[9]. Maeda, A., Araujo, E., Cashin, C., Harris, J., Ikegami, N., Michael, R., & Reich, 2015, Universal Health Coverage for Inclusive Sustainable Development. http://dx.doi.org/10.1596/978-1-4648-0592-9
[10]. Mataria, A., 2018, Basic Health Coverage: Review of International Experiences.
[11]. Mbeva, K. J-B., Ndeba, M. P., Nguemeleu, T. E., Mahamba, N., Nyavanda, K. L., & Syayipuma, K. J-R., 2023, Challenges and Issues of Universal Health Coverage in the Democratic Republic of Congo: An Interpretative Critical Literature Review. International Journal of Innovation and Scientific Research, (66)1, pp. 42-56. http://www.ijisr.issr-journals.org/
[12]. Mugo, M., 2022, Health Insurance and Health Status in Kenya: Toward Universal Health Coverage. http://publication.aercafricalibrary.org/bitstream/handle/123456789/3390/HC-002.pdf?sequence=1&isAllowed=y
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[14]. OECD, 2021, Population with Health Coverage, in Health at a Glance 2021: OECD Indicators, Éditions OCDE, Paris. https://doi.org/10.1787/d9136695-fr
[15]. WHO., 2013, World Health Report 2013: Research for Universal Health Coverage. https://apps.who.int/iris/bitstream/handle/10665/85764/9789240691193_fre.pdf
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[20]. Sanoussi, Y., et., Ametoglo, M., 2019, Extent and Determinants of Catastrophic Health Expenditures: The Case of Togolese Households. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3440106
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[22]. Taverne, B., Laborde-Balen, G., Rassoul Top, B., Sow, K., & Coumé, M., 2023, Perceptions and Use of Universal Health Coverage (Plan Sésame) by Elderly People in Dakar (Senegal), and Its Impact on Health Expenditures Related to Diabetes and Hypertension. Médecine Tropicale Et Santé Internationale. 10.48327/mtsi.v3i3.2023.320
[23]. Inter-Parliamentary Union, & WHO., 2022, The Path to Universal Health Coverage. https://apps.who.int/iris/bitstream/handle/10665/365283/9789240061408-fre.pdf?sequence=1
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[25]. OMS & Groupe de la Banque mondiale. 2014, Universal Health Coverage: Tracking Progress at the National and Global Levels. https://iris.who.int/bitstream/handle/10665/112823/WHO_HIS_HIA_14.1_fre.pdf
[26]. The Global Fund, 2016, Audit Report on Global Fund Grants to the Republic of Uganda. https://www.theglobalfund.org/media/2820/oig_gf-oig-16-005_report_fr.pdf
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Assessing the Mental Health Challenges and Experiences of Returnee Migrants in NigeriaAuthor: Olatunji Joshua AwoleyeDOI: 10.21522/TIJPH.2013.14.01.Art011
Assessing the Mental Health Challenges and Experiences of Returnee Migrants in Nigeria
Abstract:
Returnee migrants in Nigeria often experience severe psychological distress due to traumatic migration experiences and reintegration challenges. This study assesses the mental health challenges and experiences of returnee migrant in Nigeria. This study adopted a quantitative cross-sectional design to examine mental health challenges and psychosocial experiences among returnee migrants across Nigeria’s six geopolitical zones. A sample size of 1,316 was determined using Cochran’s formula, with participants selected through multi-stage sampling and snowballing techniques. Data was collected via pretested interviewer-administered questionnaires and analyzed using SPSS 28. The mean age of the respondents was 29±6.212 years. The results revealed that the main reasons for migration were the pursuit of better living conditions (43.2%), followed by torture (38.6%), while torture (24.1%) and labour exploitation (22.3%) were the leading reasons for return. Findings revealed a high prevalence of mental health status, with over 80% reporting trouble sleeping, anxiety, and loss of interest in activities. Regression analysis on factors associated with mental health status among returnee migrants confirmed that sex and religion remained significant predictors of mental health status. Female returnees were about five times more likely to report poor mental health than males (AOR = 5.499, p < 0.001). Also. Religion showed a protective effect, with Christianity associated with lower odds of poor mental health (AOR= 0.119:P<0.001) compared to Islam. The findings underscore the urgent need for trauma-informed, community-based, and government-supported mental health interventions for returnee migrants in Nigeria.
Assessing the Mental Health Challenges and Experiences of Returnee Migrants in Nigeria
References:
[1]. International Organization for Migration, 2019, Migration in Nigeria: A Country Profile 2019. International Organization for Migration, https://publications.iom.int/system/files/pdf/iom_reintegration_handbook.pdf
[2]. International Organization for Migration, 2022, World Migration Report 2022: Migration and Migrants – A Global Overview. International Organization for Migration, https://worldmigrationreport.iom.int.
[3]. World Health Organization, 2022, Mental Health: Strengthening Our Response. World Health Organization, https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response.
[4]. World Health Organization, 2017, Depression and Other Common Mental Disorders: Global Health Estimates. World Health Organization, Geneva, Switzerland, https://apps.who.int/iris/handle/10665/254610.
[5]. Wada, Y. H., Rajwani, L., Anyam, E., Karikari, E., Njikizana, M., Srour, L., et al., 2021, Mental health in Nigeria: A neglected issue in public health. Public Health in Practice, 2, https://doi.org/10.1016/j.puhip.2021.100166.
[6]. Moullan, Y., Jusot, F., 2014, Why is the “healthy immigrant effect” different between European countries? European Journal of Public Health, 24(Suppl. 1), 80–86, https://doi.org/10.1093/eurpub/cku112.
[7]. Blair, A. H., Schneeberg, A., 2014, Changes in the “healthy migrant effect” in Canada: Are recent immigrants healthier than they were a decade ago? Journal of Immigrant and Minority Health, 16(1), 136–142, https://doi.org/10.1007/s10903-013-9813-9.
[8]. Wapmuk, S., 2019, International migration, Nigerian returnee migrants, and challenges of reintegration. Journal of African Studies and Development, 9, 158–180.
[9]. Biswas, J., Gangadhar, B. N., Keshavan, M., 2016, Cross-cultural variations in psychiatrists’ perception of mental illness: A tool for teaching culture in psychiatry. Asian Journal of Psychiatry, 23, 1–7, https://doi.org/10.1016/j.ajp.2016.05.011.
[10]. Sanderson, S., 2019, Returnees struggle to adjust to life in Nigeria. InfoMigrants, https://www.infomigrants.net.
[11]. International Organization for Migration, 2020, Returnees and health workers join hands to improve psychosocial well-being in Nigeria. International Organization for Migration, https://www.iom.int.
[12]. Kunnuji, M., Onitolo, E., Grant, C., 2024, Addressing the humanitarian needs of forced rural-to-city migrants in north-west Nigeria with a focus on mental health vulnerability. Social Science in Action, https://www.socialscienceinaction.org.
[13]. Akinlua, J. T., Meakin, R., Umar, A. M., Freemantle, N., 2015, Current prevalence pattern of hypertension in Nigeria: A systematic review. PLOS ONE, 10(10), https://doi.org/10.1371/journal.pone.0140021.
[14]. Yamane, Y., 1967, Mathematical formulae for sample size determination. Open Journal of Statistics, 12, 291–302.
[15]. International Organization for Migration, 2023, IOM Nigeria Annual Report 2023. International Organization for Migration.
[16]. Atem, D. M., 2020, Unthinkable journeys: Sub-Saharan Africa involuntary youth migration. Journal of Economic Development Studies, 8(3), https://doi.org/10.15640/jeds.v8n3a5.
[17]. Sumata, C., 2021, A framework for understanding migration from Sub-Saharan Africa: Transnational and global perspectives. In Handbook of Culture and Migration, 162–167, https://doi.org/10.4337/9781789903461.00022.
[18]. Cattaneo, C., Magli, F., Franceschetti, L., 2022, Commentary on: “Tortures alleged by migrants in Italy: compatibility and other medicolegal challenges”. International Journal of Legal Medicine, 136(2), 391–392, https://doi.org/10.1007/s00414-021-02744-3.
[19]. Esposito, M., Salerno, M., Chisari, M. G., Sessa, F., Rapisarda, V., Pomara, C., 2024, Analysis of the health conditions of migrants and asylum seekers in reception centers: From scene investigation to the evaluation of signs of torture. Forensic Science International, 365, https://doi.org/10.1016/j.forsciint.2024.112288.
[20]. Leichtle, N., 2025, Not a semester hero. Migration and Society, 8, 1–16, https://doi.org/10.3167/arms.2025.0122of5.
[21]. Tessitore, F., Parola, A., Margherita, G., 2023, Mental health risk and protective factors of Nigerian male asylum seekers hosted in Southern Italy: A culturally sensitive quantitative investigation. Journal of Racial and Ethnic Health Disparities, 10(2), 730–742, https://doi.org/10.1007/s40615-022-01260-3.
[22]. Adusei, A. B., Ayiku, R. N. B., Amarteyfio, K. A. N. A., Bondzie, E. P. K., Adjei-Banuah, N. Y., Abdul-Samed, A. B., et al., 2025, Disparities in the access and provision of mental health services as part of primary health care: A case study of Ga-South District in the Greater Accra Region. Frontiers in Public Health, 13, https://doi.org/10.3389/fpubh.2025.1537955.
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Determinants for Pre-exposure Prophylaxis Discontinuation among Perceived Low Risk Populations in Homa Bay and Kisii Counties, KenyaAuthor: Muchele Polycarp MuseeDOI: 10.21522/TIJPH.2013.14.01.Art012
Determinants for Pre-exposure Prophylaxis Discontinuation among Perceived Low Risk Populations in Homa Bay and Kisii Counties, Kenya
Abstract:
Pre-exposure prophylaxis (PrEP) effectively prevents HIV, but early discontinuation—especially among those perceiving low risk—reduces its impact. This study explored socio-demographic and contextual factors influencing PrEP discontinuation and assessed healthcare worker engagement in Homa Bay and Kisii counties, Kenya. Using a correlational design, 293 individuals who stopped PrEP within three months were selected via stratified random sampling from LVCT Vukisha95-supported facilities. Data, collected through structured questionnaires and linked to program records, were analyzed using descriptive statistics, chi-square tests, and multivariable logistic regression to identify factors associated with discontinuation. Most participants were female (71.7%), aged 20–34 years, and from Homa Bay (68.3%). County of residence predicted discontinuation, with Kisii residents less likely to stop PrEP than Homa Bay residents (aOR = 0.09; 95% CI: 0.04–0.19; p < 0.001). Formal employment was associated with increased odds of discontinuation (aOR = 2.80; 95% CI: 1.24–6.45; p = 0.014). Individuals aged 25–29 (aOR = 0.26; p = 0.041) and 45–49 (aOR = 0.16; p = 0.038) were less likely to discontinue PrEP than adolescents 15–19 years. Education had a marginal effect, while sex, marital status, income, and HIV risk category were not significant. About 40% cited reasons differing from records, and only 15% consulted healthcare workers before stopping PrEP. PrEP discontinuation driven by perceived low HIV risk is influenced more by contextual and socioeconomic factors than actual risk, highlighting the need for personalized risk assessment, better documentation, and proactive healthcare worker engagement in high-burden areas.
Determinants for Pre-exposure Prophylaxis Discontinuation among Perceived Low Risk Populations in Homa Bay and Kisii Counties, Kenya
References:
[1]. World Health Organization, 2023, HIV statistics, globally and by WHO regions, 2023, Global HIV, Hepatitis and Sexually Transmitted Infections Programs. https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/strategicinformation/hiv-data-and-statistics.
[2]. Blumenthal, J., Jain, S., Mulvihill, E., Sun, S., Marvin, H., Ellorin, E., Graber, S., Haubrich, R., Morris Sheldon, 2019, Perceived Versus Calculated HIV Risk: Implications for Pre-exposure Prophylaxis Uptake in a Randomized Trial of Men Who Have Sex With Men. J Acquir Immune Defic Synd, 80(2): e23–e29, doi: 10.1097/QAI.0000000000001888.
[3]. Whitfield, T. H., John, S. A., Rendhina, A. J., Grov, C., Parsons T Jeffrey, 2018, Why I quit pre-exposure prophylaxis (PrEP)? A mixed-method study exploring reasons for PrEP discontinuation and potential re-initiation among gay and bisexual men. AIDS Behaviour, 2018 Nov;22(11):3566-3575, doi: 10.1007/s10461-018-2045-1.
[4]. Tailor, J., Rodrigues, J., Meade, J., Segal, K., Mwakyosi Lilian Benjamin, 2022, Correlations between oral Pre-Exposure Prophylaxis (PrEP) initiations and policies that enable the use of PrEP to address HIV globally. PLOS Glob Public Health, 2022 Dec 7;2(12):e0001202, doi: 10.1371/journal.pgph.0001202.
[5]. Zhang, J., Li, C., Xu, J., Hu, Z., Rutstein, S. E., & Tucker, J. D., Ong, J. J., Jiang, Y., Geng, W., Wright, S. T., Cohen, M, S., Shang, H., Tang Weiming, 2022, Discontinuation, suboptimal adherence, and reinitiation of oral HIV pre-exposure prophylaxis: a global systematic review and meta-analysis. Lancet HIV 2022 Apr;9(4):e254-e268, doi: 10.1016/S2352-3018(22)00030-3.
[6]. Stankevitz, K., Grant, H., Lloyd, J., Gomez, G. B., Kripke, K., Torjesen, K., Terris-Prestholt Fern, 2020, Oral preexposure prophylaxis continuation,measurementa and reporting. AIDS, 2020 Oct 1;34(12):1801-1811, doi: 10.1097/QAD.0000000000002598.
[7]. Marcus, J. L., Hurley, L. B., Hare, C. B., Nguyen, D. P., Phengrasamy, T., Silverberg, M. J., Stoltey, JE,. Volk Johnathan E, 2017, Preexposure Prophylaxis for HIV Prevention in a Large Integrated Health Care System: Adherence, Renal Safety, and Discontinuation. Pub Med Central, 540-546, doi: 10.1097/QAI.0000000000001129.
[8]. Marcus, J. L., Hurley, L. B., Ngoyen, D. P., Silverberge, M. J., Volk Johnathan E, 2017, Redefining Human Immunodeficiency Virus (HIV) Preexposure Prophylaxis Failures. Clinical Infectious Diseases, 1768 – 1769, doi: 10.1093/cid/cix593.
[9]. Mathews, L. T., Atukunda, E. C., Owembabazi, M., Kalyebera, K. P., Psaros, C., Chitneni, P., Hendrix, C.W., Marzinke, M.A., Anderson, P.L., Ischunwa, O.O., Hurwitz, K.E., Bennett, K., Muyindike, W., Bangsberg, D.R., Haberer, E.J., Marrazzo, J.M., Bwana Mwebesa Bosco, 2023, High PrEP uptake and objective longitudinal adherence among HIV-exposed women with personal or partner plans for pregnancy in rural Uganda: A cohort study. Plos Medicine, February 16, 2023, https://doi.org/10.1371/journal.pmed.1004088
[10]. Mirembe, B. G., Donnel, D., Krows, M., Zwane, Z., Bukusi, E., Panchia, R., Louw, C., Mwelase, N., Selepe, P., Senne, M., Naidoo, L., Chihana, R., Kasaro, M., Nuwagabo-Biribonwoha, H., Kotze, P., Gill, K., MacDonald, P., Vantteerden, A., Bosman, S., Jaggernath, M., Preez, P., Ward, A., Peters, R. P. H, Elany-Moretiwe, S., Peacock, S., Johnson, R., wang, G., Gandhi, M., Velloza, J., Heffron, R., Celum Connie, 2024, High recent PrEP adherence with point-of-care urine tenofovir testing and adherence counselling among young African women: results from the INSIGHT cohort. J Int AIDS Society, 2024 Dec;27(12):e26389, Doi: 10.1002/jia2.26389.
[11]. Ogolla, M., Nyabiage, O. L., Musingila, P., Gachau, S., Odero, T. M., June, E. O., Ochanda, B., Appolonia, A., Katiku, E., Joseph, R., Ogolla, C., Otieno, L., Odhiambo, R., Truong Hong-Ha M, 2023, Uptake and continuation of HIV pre-exposure prophylaxis among women of reproductive age in two health facilities in Kisumu County, Kenya. Journal for International AIDS Society, 023 Mar;26(3):e26069, doi: 10.1002/jia2.26069.
[12]. Tapsoba, J. d., Cover, J., Obong`o, C., Brandy, M., Cressey, T. R., Mori, K., Okomo, G., Kariithi, E., Obanda, R., Oluoch-Madiang, D., Chen, Y.Q., Drain, P., Duerr Anne, 2022, Continued attendance in a PrEP program despite low adherence and non-protective drug levels among adolescent girls and young women in Kenya: Results from a prospective cohort study. Plos Medicine, September 12, 2022, https://doi.org/10.1371/journal.pmed.1004097
[13]. Anyasi, H., Idemudia, A., Badru, T., Onyegbule, S., Isang, E., Sanwo, O., Pandey, S. R., Chiegil, R., Bateganya, M., Schartz, K., Njuguna, N., Persaud, N., Plotkin, M., Iyortim, I., Khamofu Hadiza, 2024, Discontinuation of HIV oral pre-exposure prophylaxis: findings from programmatic surveillance within two general population HIV programs in Nigeria. BMC Public Health. 2024 May 16;24(1):1325, doi: 10.1186/s12889-024-18808-z.
[14]. Ongolly, F. K., Dolla, A., Irungu, E. M., Odoyo, J., Wamoni, E., Peebles, K., Mugwanya, K., Mugo, N. R., Bukusi, E. A., Morton, J., Baeten, J. M., O`Malley Gabrielle, 2022, “I just decided to stop:” Understanding PrEP discontinuation among individuals initiating PrEP in HIV care centers in Kenya. J Acquir Immune Defic Syndr, 2021 May 1;87(1):e150-e158, doi: 10.1097/QAI.0000000000002625.
[15]. Pillay, D., Stankevitz, K., Lanham, M., Ridgeway, K., Murire, M., Briedenhann, E., jenkins, S., Subedar, H., Hoke, T., Mullick Saiqa, 2020, Factors influencing uptake, continuation, and discontinuation of oral PrEP among clients at sex worker and MSM facilities in South Africa. PLOS One, April 30, 2020, https://doi.org/10.1371/journal.pone.0228620
[16]. Dzenga, T., Moyo, E., Moyo, P., Kamangu, J., Dzinamarira Tafadzwa, 2023, Factors influencing the retention of clients in oral pre-exposure prophylaxis (PrEP) care at 3 months after initiation in the Omusati region of Namibia. International Journal of Africa Nursing Sciences, Volume 19, 2023, 100623, https://doi.org/10.1016/j.ijans.2023.100623.
[17]. Garofoli, M., Siguier, M., Robineau, O., Valette, M., Phung, B., Bachelard, A., Rioux, C., Gac, S.L., Digumber, M., Pialoux, G., Ghosn, J., Champenois Karen, 2024, Incidence and factors associated with PrEP discontinuation in France. Journal of Antimicrobial Chemotherapy, 2024 Jul 1;79(7):1555-1563, doi: 10.1093/jac/dkae133.
[18]. Churu, M., Kulemba, K., Kapesa, A., Kajura, A., Wilfred, D., Basinda, N., Kaluvya, S., Mageda Kihulya Pastory, 2023, Factors associated with adherence to oral HIV pre-exposure prophylaxis among female sexworkers in the Mara Region, Tanzania A 2022 cross-sectional study. Medicine (Baltimore) 2023 Sep 8;102(36):e34824, doi: 10.1097/MD.0000000000034824.
[19]. Herns, S., Panwala, R., Pfeil, A., Sardinho, M., Rossi, V., Blumenthal, J., & Hill Lucus, 2023, Predictors of PrEP retention in at risk patients seen at a HIV primary care clinic in San Diego. International Journal of STD and AIDS, 785–790, 2023 Oct;34(11):785-790, doi: 10.1177/09564624231179276.
[20]. Qu, D., Zhong, X., Xiao, G., Dai, J., Liang, H., Huang Ailong, 2018, Adherence to pre-exposure prophylaxis among men who have sex. International Journal of Infectious Diseases, 2018 Oct:75:52-59, doi: 10.1016/j.ijid.2018.08.006. Epub 2018 Aug 17.
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Epidemiology, Surveillance, and Control of Malaria Among Under-Five School Children in Jere Local Government, Borno State, NigeriaAuthor: Mohammed Bala AminuDOI: 10.21522/TIJPH.2013.14.01.Art013
Epidemiology, Surveillance, and Control of Malaria Among Under-Five School Children in Jere Local Government, Borno State, Nigeria
Abstract:
In Nigeria, malaria is a major source of illness and mortality, disproportionately affecting children under five. This study examines the prevalence, monitoring, and management of malaria among school-age children under five in Borno State, Nigeria's Jere Local Government Area, from 2012 to 2019. Structured questionnaires, key informant interviews, and medical facility records were used to gather data for this descriptive cross-sectional study. The results showed a consistently high prevalence of malaria in children under five, which was exacerbated by environmental risk factors, insufficient access to healthcare, and displacement. Low coverage, insecurity, and poor compliance hampered the use of malaria control measures, including indoor residual spraying (IRS), seasonal malaria chemoprevention (SMC), and long-lasting insecticidal nets (LLINs). Due to rising treatment expenses, decreased production, and poorer educational outcomes for afflicted children, the condition had a substantial negative influence on households' socioeconomic well-being. To reduce the disease burden among susceptible groups in conflict-affected areas, it is advised to integrate community-based awareness initiatives, enhance intervention coverage, and fortify malaria surveillance systems.
Epidemiology, Surveillance, and Control of Malaria Among Under-Five School Children in Jere Local Government, Borno State, Nigeria
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Stratified Evaluation of Quality Management Practices in HIV Rapid Testing Laboratories: Evidence from the South Region of CameroonAuthor: Abanda Emmanuel ChafahDOI: 10.21522/TIJPH.2013.14.01.Art014
Stratified Evaluation of Quality Management Practices in HIV Rapid Testing Laboratories: Evidence from the South Region of Cameroon
Abstract:
Ensuring high-quality HIV rapid testing is critical to accurate diagnosis and effective treatment, especially in resource-limited settings like Cameroon. This study conducted a stratified evaluation of quality management systems (QMS) in HIV rapid testing laboratories across the South Region of Cameroon using the WHO Stepwise Process for Improving the Quality of HIV Rapid Testing (SPI-RRT) tool. The objective was to assess adherence to quality standards across facility types and support levels, and to identify critical gaps in implementation. A total of 99 laboratories were audited between 2022 and 2024, stratified by ownership (government, private, faith-based, and community-based organizations) and PEPFAR support. Results showed that PEPFAR-supported laboratories had significantly higher mean SPI-RRT scores (59) compared to non-supported sites (14), p < 0.001. Community-based organizations demonstrated the highest compliance (28 ± 21), followed by faith-based (25 ± 23), private (25 ± 17), and government-owned facilities (14 ± 21). Notably, only 12% of laboratories reached SPI-RRT Level 3 or 4, indicating limited readiness for certification. The lowest-scoring elements included quality control, document management, and corrective actions, highlighting systemic weaknesses in QMS implementation. District-level disparities were also evident, with Sangmelima and Kribi outperforming other districts in readiness scores. These findings provide essential insights into quality assurance challenges in decentralized HIV testing programs and underscore the need for targeted interventions, including technical mentorship, continuous quality improvement, and enhanced supervision to improve diagnostic reliability.
Stratified Evaluation of Quality Management Practices in HIV Rapid Testing Laboratories: Evidence from the South Region of Cameroon
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[10]. Yapa, H. M., Dhlomo-Mphatswe, W., Moshabela, M., De Neve, J.-W., Herbst, C., et al., 2020, “A Continuous Quality Improvement Intervention to Improve Antenatal HIV Care Testing in Rural South Africa: Evaluation of Implementation in a Real-World Setting,” Int. J. Health Policy Manag., 11(5), pp. 610–628. https://doi.org/10.34172/ijhpm.2020.178
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[16]. Drain, P. K., Dorward, J., Bender, A., Lillis, L., Marinucci, F., Sacks, J., Bershteyn, A., et al., 2019, “Point-of-Care HIV Viral Load Testing: An Essential Tool for a Sustainable Global HIV/AIDS Response,” Clin. Microbiol. Rev., 32(3), pp. e00097-18. https://doi.org/10.1128/CMR.00097-18
[17]. Holtzman, C. W., Godfrey, C., Ismail, L., Raizes, E., Ake, J. A., Tefera, F., Okutoyi, S., and Siberry, G. K., 2022, “PEPFAR’s Role in Protecting and Leveraging HIV Services in the COVID-19 Response in Africa,” Curr. HIV/AIDS Rep., 19(1), pp. 26–36. https://doi.org/10.1007/s11904-021-00587-6
[18]. Lewis, C. C., Mettert, K. D., Dorsey, C. N., Martinez, R. G., Weiner, B. J., Nolen, E., Stanick, C., Halko, H., and Powell, B. J., 2018, “An Updated Protocol for a Systematic Review of Implementation-Related Measures,” Syst. Rev., 7(1), p. 66. https://doi.org/10.1186/s13643-018-0728-3
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[20]. Maruta, T., Motebang, D., Mathabo, L., Rotz, P. J., Wanyoike, J., and Peter, T., 2012, “Impact of Mentorship on WHO-AFRO Strengthening Laboratory Quality Improvement Process Towards Accreditation (SLIPTA),” Afr. J. Lab. Med., 1(1), p. 6. https://doi.org/10.4102/ajlm.v1i1.6
[21]. Endalamaw, A., Khatri, R. B., Mengistu, T. S., Erku, D., Wolka, E., Zewdie, A., and Assefa, Y., 2024, “A Scoping Review of Continuous Quality Improvement in Healthcare System: Conceptualization, Models and Tools, Barriers and Facilitators, and Impact,” BMC Health Serv. Res., 24, p. 487. https://doi.org/10.1186/s12913-024-10828-0
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Policy Recommendations from The Gambia on Improving the Maternal Health System in Sub-Saharan AfricaAuthor: Joy MichaelDOI: 10.21522/TIJPH.2013.14.01.Art015
Policy Recommendations from The Gambia on Improving the Maternal Health System in Sub-Saharan Africa
Abstract:
The Gambia is ranked as one of the countries with the highest maternal death rate and the country has made great strides in improving maternal health through community-based interventions during the last ten years. The aim of this study is to assess policy recommendations from The Gambia on improving the maternal health system in sub-Saharan Africa. The specific objectives of this study were to; (i) determine the socio-demographic information of the respondents in the study area; (ii) determine policy and government interventions on maternal health; (iii) assess donor programs and interventions targeting on maternal health; (iv) determine external donor programs and interventions on maternal health; (v) determine representative of the community on maternal health. A retrospective quasi-experimental design with a well-structured questionnaire was used to obtain information from 217 participants across the major administrative regions of The Gambia, and the data were analysed using descriptive statistics. The results showed that the majority (64.8%) of respondents confirmed the existence of government policies to improve maternal health service quality, 52.9% were aware of interventions for maternal health in the study area, and UNICEF was the highest external donor (58.8%). Representatives of the community showed that 41.7% of the group of community representatives were community mobilizers/facilitators, the majority utilised services at hospitals (79.5%), and hospital-based service utilisation was primarily guided by the availability of good services and supplies (61.0%). Given that high maternal mortality rates persist in Sub-Saharan Africa, The Gambia's approach highlights the significance of inclusive, creative, and context-specific solutions.
Policy Recommendations from The Gambia on Improving the Maternal Health System in Sub-Saharan Africa
References:
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Assessment of the Influence of Adolescent-Youth Friendly Health Services on HIV-related quality of life (AYLHIV) in Taraba State, NigeriaAuthor: Dadi Aisha NantimDOI: 10.21522/TIJPH.2013.14.01.Art016
Assessment of the Influence of Adolescent-Youth Friendly Health Services on HIV-related quality of life (AYLHIV) in Taraba State, Nigeria
Abstract:
Adolescents and youth living with HIV (AYLHIV) face unique challenges impacting their mental, emotional, and social well-being. In Nigeria, where youth-friendly healthcare services are evolving, the true influence of Adolescent and Youth-Friendly Health Services (AYFHS) on HIV-related quality of life (HRQoL) remains unclear. This study assessed the impact of AYFHS on the HRQoL of AYLHIV in Taraba State, Nigeria. Informed consent was obtained from all participants. A cross-sectional comparative study was conducted among 386 AYLHIV aged 10–24 years, comprising 193 AYFHS attendees and 193 non-attendees using a multistage sampling method. Data were collected via a structured, interviewer-administered questionnaire covering Anti-retro-viral therapy (ART) adherence, stigma, resilience, and overall quality of life. Analyses were performed using SPSS version 27, with t-tests and multiple regressions applied to determine group differences. Findings revealed that AYFHS attendees had significantly better ART adherence (78% vs. 62%), higher resilience (81% vs. 54%), and greater confidence in managing HIV in AYLHIV attendees. The AYLHIV attendees were also more hopeful about the future and less likely to feel ashamed of their status. Enhanced social support, peer- engagement, and provider friendliness were key contributing factors. Non-attendees reported greater emotional distress and lower treatment confidence. These results demonstrate that AYFHS attendees significantly improve HIV-related quality of life among adolescents. In conclusion, expanding youth-friendly models maybe essential for improving treatment outcomes and addressing psycho-social needs, contributing to Nigeria’s progress toward achieving UNAIDS 95-95-95 goals.
Assessment of the Influence of Adolescent-Youth Friendly Health Services on HIV-related quality of life (AYLHIV) in Taraba State, Nigeria
References:
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[3]. Bekker, L.-G., Johnson, L., Wallace, M., & Hosek, S., 2015, Building our youth for the future. Journal of the International AIDS Society, 18(2Suppl 1), 20027. https://doi.org/10.7448/IAS.18.2.20027
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[6]. Mark, D., Armstrong, A., Andrade, C., Penazzato, M., Hatane, L., Taing, L., & Bekker, L.-G., 2021, Adolescent HIV treatment in the era of Universal Health Coverage: Lessons from South Africa and beyond. Journal of the International AIDS Society, 24(Suppl 2), e25652. https://doi.org/10.1002/jia2.25652
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[13]. Busza, J., Besana, G. V. R., Mapunda, P., &Oliveras Rodriguez, M. L., 2020, Meeting the needs of adolescents living with HIV through differentiated care: Lessons from the Zvandiriprogramme in Zimbabwe. Journal of the International AIDS Society, 23(S5), e25552. https://doi.org/10.1002/jia2.25552
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[15]. O’Brien, K. K., Tynan, A. M., Nixon, S. A., & Glazier, R. H., 2020, Effectiveness of aerobic exercise for adults living with HIV: Systematic review and meta-analysis using the Cochrane Collaboration protocol. BMC Infectious Diseases, 20(1), 73.https://doi.org/10.1186/s12879-020-4779-1
[16]. Denison, J. A., Banda, H., Dennis, A. C., Packer, C., Nyambe, N., Stalter, R. M., Mwansa, J. K., & McCarraher, D. R., 2020, “The sky is the limit”: Adhering to antiretroviral therapy and HIV self-management from the perspectives of adolescents living with HIV and their caregivers. Journal of the International AIDS Society, 23(3), e25470. https://doi.org/10.1002/jia2.25470
[17]. Pantelic, M., Boyes, M., Cluver, L., & Thabeng, M., 2020, ‘They Say HIV is a Punishment from God or from Ancestors’: Cross-Cultural Adaptation and Psychometric Assessment of an HIV Stigma Scale for South African Adolescents Living with HIV (ALHIV-SS). Child Indicators Research, 13(1), 149–170. https://doi.org/10.1007/s12187-019-09660-0
[18]. Willis, N., Milanzi, A., Mawodzeke, M., Dziwa, C., Armstrong, A., Yekeye, I., Keatinge, J., & Cowan, F. M., 2020, Effectiveness of community adolescent treatment supporters (CATS) interventions in improving linkage and retention in care, adherence to ART and psychosocial well-being: A randomised trial among adolescents living with HIV in rural Zimbabwe. BMC Public Health, 20, 117. https://doi.org/10.1186/s12889-019-7995-4
[19]. Mburu, G., Ram, M., Skovdal, M., Bitira, D., Hodgson, I., Mwai, G. W., & Seeley, J., 2020, Supportive social relationships and improved health-related quality of life among adolescents living with HIV in sub-Saharan Africa: A structural equation modelling analysis. AIDS Care, 32(1), 6-15. https://doi.org/10.1080/09540121.2020.1739203
[20]. de Terte, I., Becker, L. A., & Marks, D. F., 2020, Resilience and quality of life among people living with HIV: A systematic review of quantitative studies. Journal of Health Psychology, 25(6), 709-723.https://doi.org/10.1177/1359105317718053
[21]. Shah, S. K., Celum, C., Baeten, J. M., Bukusi, E., & Pintye, J., 2021, Resilience among adolescents living with HIV: A review of global literature. AIDS Care, 33(6), 713-720. https://doi.org/10.1080/09540121.2020.1742864
[22]. Mark, D., Armstrong, A., Andrade, C., Penazzato, M., Hatane, L., Taing, L., & Bekker, L.-G., 2021, Adolescent HIV treatment in the era of Universal Health Coverage: Lessons from South Africa and beyond. Journal of the International AIDS Society, 24(2), e25652.https://doi.org/10.1002/jia2.25652
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Evaluating the Prevalence of Non-Communicable Diseases Among HIV Positive Individuals in Chingola District, ZambiaAuthor: Judith MusondaDOI: 10.21522/TIJPH.2013.14.01.Art017
Evaluating the Prevalence of Non-Communicable Diseases Among HIV Positive Individuals in Chingola District, Zambia
Abstract:
The study was aimed at evaluating the prevalence of non-communicable diseases among HIV positive individuals in Chingola District, Zambia. The widespread success of antiretroviral therapy (ART) has caused HIV to change from an acute to a chronic illness. Although the life expectancy of people living with HIV (PLHIV) has increased dramatically as a result of this advancement, new health issues have also emerged, most notably the increased prevalence of non-communicable diseases (NCDs) in this population. HIV-positive people are increasingly being diagnosed with noncommunicable diseases (NCDs), including diabetes, hypertension, cardiovascular disease, and chronic respiratory conditions. The study was carried out in Zambia's Copperbelt Province's Chingola District. Purposively, five of the district's largest antiretroviral therapy (ART) clinics were chosen based on patient volume and accessibility. Between January and May of 2025, a descriptive cross-sectional study was carried out involving 500 participants. The results show that most prevalent non-communicable disease among the 500 HIV-positive people was hypertension, which affected 268 participants i.e. 53.58% of the sample. The analysis identified predictors of non-communicable diseases (NCDs) include age which had the odds of having an NCD increased by 5% for every year, indicating that age was a significant factor (OR = 1.05, 95% CI: 1.03–1.08, p < 0.001). The study concludes that there is a significant burden of non-communicable diseases (NCDs) among people living with HIV (PLHIV) in the district.
Evaluating the Prevalence of Non-Communicable Diseases Among HIV Positive Individuals in Chingola District, Zambia
References:
[2] World Health Organization, Country Disease Outlook - Zambia. Date of access: 20/05/2025 https://www.afro.who.int/sites/default/files/2023-08/Zambia.pdf
[4] UNAIDS, Global AIDS Update 2023. Date of access: 20/05/2025 https://www.unaids.org/en/resources/documents/2023/global-aids-update
[5] Nduka, C. U., Stranges, S., Sarki, A. M., Kimani, P. K., & Uthman, O. A., 2020, Evidence of increased risk of non-communicable diseases in HIV-positive populations in sub-Saharan Africa: A systematic review and meta-analysis. PLOS ONE, 15(8), e0237420. https://doi.org/10.1371/journal.pone.0237420
[6] Rabkin, M., Nishtar, S., & Besada, D., 2018, Integrated care for chronic conditions: the global challenge to achieve health equity. Health Affairs, 37(3), 408–412. https://doi.org/10.1377/hlthaff.2017.1393
[11] World Health Organization, 2021, Noncommunicable diseases: Key facts. Date of access: 2/06/2025 https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
[13] Chanda-Kapata, P., Klinkenberg, E., Maddox, N., & Kapata, N, 2016, Health seeking behaviour among individuals with presumptive tuberculosis in Zambia. PLOS ONE, 11(3), e0149336. https://doi.org/10.1371/journal.pone.0149336
[15] Moyo-Chilufya, M., Maluleke, K., Kgarosi, K., Muyoyeta, M., Hongoro, C., & Musekiwa, A., 2023, The burden of non‑communicable diseases among people living with HIV in Sub‑Saharan Africa: A systematic review and meta‑analysis. eClinicalMedicine, 65, 102255. https://doi.org/10.1016/j.eclinm.2023.102255
[16] Nduka, C. U., Stranges, S., Sarki, A. M., Kimani, P. K., & Uthman, O. A., 2017, Evidence of increased cardiometabolic risk in HIV-positive individuals receiving antiretroviral therapy: A systematic review and meta-analysis. PLOS ONE, 12(4), e0173936. https://doi.org/10.1371/journal.pone.0173936
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Phenomenological and Clinical Insights into Near-Death Experiences: A Retrospective Analysis in Aseer Province Population, Saudi ArabiaAuthor: Om Prakash PalanivelDOI: 10.21522/TIJPH.2013.14.01.Art018
Phenomenological and Clinical Insights into Near-Death Experiences: A Retrospective Analysis in Aseer Province Population, Saudi Arabia
Abstract:
Near death experience (NDE) reported as supernatural and emotional feelings with episodes involving a special state of consciousness, including several special elements and these experiences typically occur with often grouped contents commonly observed in life-threatening conditions. Participants were provided with an Arabic version of the Near-Death Experience (NDE) scale via mail and social media platforms, along with a contact number for inquiries. NDE scale scores, used to assess the depth of the near-death experience, were considered indicative of an NDE if they were 7 or greater. A total of 14 participants of both sex aged between 18 and 56 years, with a mean age of 37.1 years (SD = 12.4). with a gender dispersion of 57.1% (8 males) and 42.9% (6 females). The most commonly reported incidence of near-death experiences was “sudden understanding of everything” (93.0%), “time speeding up” (85.7%), and “feeling happy” (85.7%). Conversely, the incidence reported least frequently was “visions of the future” at 28.6% and “racing thoughts” at 21.4%. No statistically significant variation in the frequency of responses across the 12 of NDE elements. The elements most frequently reported exhibited narrow confidence intervals with elevated lower bounds: “sudden understanding of everything” (93.0%, 95% CI [77.9%, 100.0%]), “time speeding up” (85.7%, 95% CI [66.4%, 100.0%]), and “feeling happy” (85.7%, 95% CI [66.4%, 100.0]). This study shows that Near-Death Experiences (NDEs) involve sensory, emotional, cognitive, and spiritual elements, with altered consciousness and neural links, showing no gender differences.
Phenomenological and Clinical Insights into Near-Death Experiences: A Retrospective Analysis in Aseer Province Population, Saudi Arabia
References:
[1]. Long, J., 2014, Near-death experience: Evidence for their reality. Mo Med, 111(5):372–380.
[2]. van Lommel, P., 2014, Getting comfortable with near-death experiences: Dutch prospective research on near-death experiences during cardiac arrest. Mo Med, 111(2):126–131.
[3]. Parnia, S., Waller, D. G., Yeates, R., Fenwick, P., 2001, A qualitative and quantitative study of the incidence, features and aetiology of near-death experiences in cardiac arrest survivors. Resuscitation, 48(2):149–156.
[4]. Greyson, B., 2003, Incidence and correlates of near-death experiences in a cardiac care unit. Gen Hosp Psychiatry, 25(4):269–276.
[5]. Parnia, S., Spearpoint, K., de Vos, G., Fenwick, P., Goldberg, D., Yang, J., et al., 2014, AWARE- Awareness during resuscitation- A prospective study. Resuscitation, 85(12):1799–1805.
[6]. Moody, R. A., 2013, Getting comfortable with death & near-death experiences: An essay in medicine & philosophy. Mo Med, 110(5):368–371.
[7]. Horstmann, G., 2015, The surprise-attention link: A review. Ann N Y Acad Sci, 1339:106–115.
[8]. Ring, K., 1982, Precognitive and prophetic visions in near-death experiences. Anabiosis, 2:47–74.
[9]. Ring, K., 1988, Prophetic visions in 1988: A critical reappraisal. J Near-Death Stud, 7(1):4–18.
[10]. Shaw, N. A., 2024, The role of cerebral hypercarbia in the induction of the near-death experience. J Nerv Syst Physiol Phenom, 1(1):1–32.
[11]. Martial, C., Rousseau, A. F., Dams, L., Massart, Q., Choquer, L., Cassol, H., et al., 2024, Phenomenological memory characteristics and impact of near-death experience in critically ill survivors: Observations at discharge and after a 1-year follow-up. Int J Clin Health Psychol, 24(3):100478.
[12]. Schmied, I., Knoblauch, H., Schnettler, B., 1999, Todesnäheerfahrungen in Ost- und Westdeutschland—eine empirische Untersuchung. In: Knoblauch, H., Soeffner, H. G., eds. Todesnähe: Interdisziplinäre Zugänge zu einem außergewöhnlichen Phänomen. Konstanz: Universitätsverlag Konstanz: 217–250.
[13]. Morse, M., 1996, Parting visions: A new scientific paradigm. In: Bailey, L. W., Yates, J., eds. The near-death experience: A reader. New York and London: Routledge: 299–318.
[14]. Greyson, B., 1983, The near-death experience scale: Construction, reliability, and validity. J Nerv Ment Dis, 171(6):369–375.
[15]. Rousseau, A. F., Dams, L., Massart, Q., Choquer, L., Cassol, H., Laureys, S., et al., 2023, Incidence of near-death experiences in patients surviving a prolonged critical illness and their long-term impact: A prospective observational study. Crit Care, 27(1):76.
[16]. King, R. A., 2021, The irrelevance of time in near-death experiences (NDEs). Academia Letters, Article 2427.
[17]. Romand, R., Ehret, G., 2023, Neuro-functional modeling of near-death experiences in contexts of altered states of consciousness. Front Psychol, 13:846159.
[18]. Kopel, J., 2019, Near-death experiences in medicine. Proc (Bayl Univ Med Cent), 32(1):163–164.
[19]. Blanke, O., 2004, Out of body experiences and their neural basis. BMJ, 329(7480):1414–1415.
[20]. Greyson, B., 2003, Incidence and correlates of near-death experiences in a cardiac care unit. Gen Hosp Psychiatry, 25(4):269–276.
[21]. Schwaninger, J., Eisenberg, P. R., Schechtman, K. B., Weiss, A. N., 2002, A prospective analysis of near-death experiences in cardiac arrest patients. J Near-Death Stud, 20:215–232.
[22]. Hashemi, A., Oroojan, A. A., Rassouli, M., Ashrafizadeh, H., 2023, Explanation of near-death experiences: A systematic analysis of case reports and qualitative research. Front Psychol, 14:1048929.
[23]. Athappilly, G., Greyson, B., Stevenson, I., 2006, Do prevailing societal models influence reports of near-death experiences? J Nerv Ment Dis, 194(3):218–222.
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Safety Climate and Practices in University Laboratories: Evidence from a Ghanaian Case StudyAuthor: James Kojo PrahDOI: 10.21522/TIJPH.2013.14.01.Art019
Safety Climate and Practices in University Laboratories: Evidence from a Ghanaian Case Study
Abstract:
Academic laboratories in developing countries face numerous occupational health and safety (OHS) challenges due to limited resources, diverse hazards, and often underdeveloped safety systems. This study was conducted to evaluate the safety climate, occupational health and safety (OHS) knowledge, attitudes, and practices of laboratory workers in academic laboratories at the University of Cape Coast, Ghana. This cross-sectional study used the Nordic Safety Climate Questionnaire (NOSACQ-50), a standard questionnaire, direct workplace observations, and a decision matrix risk assessment to identify and evaluate hazards. The study was conducted in academic laboratories across three colleges at the University of Cape Coast, Ghana. The study included 104 laboratory staff members with at least one year of work experience in laboratory settings. Participants demonstrated high knowledge of OHS (mean score: 12.94 ± 2.76) and awareness (12.42 ± 2.39), but poor safety practices (12.06 ± 4.48) and inconsistent use of personal protective equipment (PPE). The overall safety climate score was low (2.45 ± 0.71), with management's safety commitment and justice rated poorly. Observations revealed inadequate PPE availability, lack of ergonomic infrastructure, and absence of incident reporting systems. High-risk hazards, including chemical inhalation, musculoskeletal injuries, and chemical splashes, were identified with risk scores of 20 each. The findings reveal significant gaps between OHS knowledge and safety practices in academic laboratories. These gaps highlight the need for improved resource allocation, stronger management engagement, enhanced safety training, and the establishment of dedicated OHS units to foster safer working environments and promote a robust safety culture in academic institutions.
Safety Climate and Practices in University Laboratories: Evidence from a Ghanaian Case Study
References:
[2]. Mearns, K. J., & Flin, R., 1999, Assessing the state of organizational safety—culture or climate? Curr. Psychol, 18(1), 5–17, https://doi.org/10.1007/s12144-999-1013-3
[3]. Probst, T. M., Goldenhar, L. M., Byrd, J. L., & Betit, E., 2019, The Safety Climate Assessment Tool (S-CAT): A rubric-based approach to measuring construction safety climate. J. Saf. Res, 69, 43-51, ISSN 0022-4375, https://doi.org/10.1016/j.jsr.2019.02.004
[4]. Health and Safety Executive (HSE), 2011, Measuring the safety climate in organizations. Available from chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://books.hse.gov.uk/gempdf/Measuring_the_Safety_Climate_in_Organisations.pdf
[5]. Loh, M. Y., Dollard, M. F., McLinton, S. S., & Brough, P., 2024, Translating psychosocial safety climate (PSC) into real-world practice: two PSC intervention case studies. JOH, 66 (1): uiae051, https://doi.org/10.1093/joccuh/uiae051
[6]. Kines, P., Lappalainen, J., Mikkelsen, K. L., Olsen, E., Pousette, A., Tharaldsen, J., Tómasson, K., & Törner, M., 2011, Nordic Safety Climate Questionnaire (NOSACQ-50): A new tool for diagnosing occupational safety climate. Int. J. Ind. Ergon, 41(6): 634–646, https://doi.org/10.1016/j.ergon.2011.08.004
[7]. Minister, A., 2015, Unsafe science. NFPA J, Available at http://www.nfpa.org/ newsandpublications/nfpa-journal/ 2015/september-october2015/ features/unsafe-science
[8]. Singh, K., 2009, Laboratory‐Acquired Infections. Clin. Infect. Dis, 49(1) : 142–147, https://doi.org/10.1086/599104
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Clinical Study of Dickkopf-Related Protein 1 and its Relation with Biomarkers of Bone Resorption in Patients with Metabolic SyndromeAuthor: Entedhar R. SarhatDOI: 10.21522/TIJPH.2013.14.01.Art020
Clinical Study of Dickkopf-Related Protein 1 and its Relation with Biomarkers of Bone Resorption in Patients with Metabolic Syndrome
Abstract:
Metabolic syndrome (MetS) is a global health concern, with potential complications affecting bone health. Dickkopf-1 (DKK1) may serve as a marker for MetS progression, particularly when analyzed alongside other bone metabolism markers such as Bone Gamma Osteocalcin (BGP-OST), calcitonin, and intact parathyroid hormone (I-PTH). To evaluate the correlations between DKK1 levels and bone metabolism markers (BGP-OST, calcitonin, and I-PTH) in patients with MetS, this case-control study included 88 participants (60 MetS patients and 28 healthy controls). Based on data distribution, biomarker levels were analyzed using one-way ANOVA or Kruskal-Wallis H tests. Correlations were assessed using Spearman’s test, with p < 0.05 considered statistically significant. The diagnostic utility of DKK1 was evaluated using ROC curve analysis. No significant differences were observed between MetS patients and controls for DKK1, I-PTH, or calcitonin levels, whereas BGP-OST levels were significantly higher in MetS patients (p < 0.05). In MetS patients, DKK1 showed a significant negative correlation with calcitonin, while BGP-OST had a significant positive correlation with calcitonin. DKK1 demonstrated diagnostic potential with an AUC of 0.758 and a 4.11 ng/mL cut-off value. DKK1 is significantly correlated with calcitonin and shows diagnostic utility for MetS. Elevated BG-OST levels in MetS patients further suggest its potential role in bone metabolism alterations associated with MetS progression.
Clinical Study of Dickkopf-Related Protein 1 and its Relation with Biomarkers of Bone Resorption in Patients with Metabolic Syndrome
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Dietary Diversity Practices of Pregnant Women and Associated Factors among Women Attending Public Hospitals in Gambella Town, Southwest EthiopiaAuthor: Gatjiek Tut WieDOI: 10.21522/TIJPH.2013.14.01.Art021
Dietary Diversity Practices of Pregnant Women and Associated Factors among Women Attending Public Hospitals in Gambella Town, Southwest Ethiopia
Abstract:
Inadequate dietary diversity among pregnant women in Ethiopia remains a major public health concern, with approximately half of the women affected. Understanding context-specific dietary practices and associated factors is essential for effective intervention. This study assessed dietary diversity practices of pregnant women and their determinants among women attending public hospitals in Gambella Town, Southwest Ethiopia. An institution-based prospective cohort design was employed from July 25, 2024, to September 10, 2024, using a single-stage cluster sampling approach. Data were collected using an interviewer-administered questionnaire with KoboCollect software and analyzed in SPSS version 25. Dietary diversity was assessed twice using a 24-hour dietary recall. A modified Poisson regression model was applied, and statistical significance was declared at p < 0.05. All 254 participants completed the first follow-up, yielding a 100% response rate. The prevalence of inadequate dietary diversity practice was 76.4%. Factors significantly associated with being exposed included having at least one child under five years (ARR = 1.27; 95% CI: 1.03–1.57), lack of television in household (ARR = 1.19; 95% CI: 1.02–1.40), lack of antenatal care (ARR = 1.25; 95% CI: 1.02–1.53), gastritis (ARR = 1.29; 95% CI: 1.13–1.47), and meals or snacks frequency of only 1–4 times per day (ARR = 1.41; 95% CI: 1.17–1.69). The prevalence of inadequate dietary diversity practice was high. Strengthening nutrition education through mass media, improving antenatal nutrition counseling on meal frequency and diversity, and enhancing the screening and management of gastritis with smaller, more frequent meals were recommended.
Dietary Diversity Practices of Pregnant Women and Associated Factors among Women Attending Public Hospitals in Gambella Town, Southwest Ethiopia
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Effect of an Educational Intervention on Menstrual Hygiene Knowledge and associated determinants among Female University Students in UgandaAuthor: Josephine NamyaloDOI: 10.21522/TIJPH.2013.14.01.Art022
Effect of an Educational Intervention on Menstrual Hygiene Knowledge and associated determinants among Female University Students in Uganda
Abstract:
Menstrual hygiene management is an important public health concern among young women, but there is a paucity of evidence on theory-based interventions at the university level. This study aimed at determining the effect of an educational Intervention on menstrual hygiene knowledge and associated determinants among female university students in Uganda. A quasi-experimental design based on Social Cognitive Theory and Health Promotion Model was used between October-December, 2025. We surveyed 436 participants from Campus A (Intervention group) and Campus B (Control Group). Propensity Score Matching, Difference-in-Differences approach and logistic regression analysis were done. The statistical significance level was p < 0.05. A theory-based educational intervention significantly enhanced knowledge and reduced sociocultural barriers. Campus A students displayed a significant improvement in their knowledge (baseline: 5.61 +- 0.99; endline: 6.00 +- 0.91; DiD = 0.807, p < 0.001) and less sociocultural barriers (DiD = 0.422, p = 0.001). While the hygiene practices of menstruation were better in both groups, the extra impact of the intervention on practices was not significant (DiD = 0.000, p = 1.000). The translation of knowledge into practice was not significant implying that there might be other interventions needed in addition to the educational intervention. Findings imply that education is necessary but not sufficient for changing menstrual hygiene practices among the study participants.
Effect of an Educational Intervention on Menstrual Hygiene Knowledge and associated determinants among Female University Students in Uganda
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Exploring Hand Hygiene Practices for Preventing Influenza Infections among Batswana University Students during the Peak Pandemic PeriodAuthor: Joyce SetlhabiDOI: 10.21522/TIJPH.2013.14.01.Art023
Exploring Hand Hygiene Practices for Preventing Influenza Infections among Batswana University Students during the Peak Pandemic Period
Abstract:
During influenza pandemics, university settings with huge number of students who are highly active and mobile can become serious outbreak centres. As outbreak management is crucial for disease control, the current research aimed to explore hand hygiene practices to prevent influenza infections among Batswana university students during the peak of the pandemic. A quantitative, cross-sectional study was performed by collecting data from 200 Batswana university students during peak influenza season. Data was analysed using descriptive statistics. The findings showed significant insights on hand hygiene knowledge, attitudes, behaviours and practices of Batswana university students towards preventing influenza infection. The study demonstrates that Batswana university students hold strong positive attitudes, mixed levels of knowledge and compliant behaviours regarding hand hygiene for influenza prevention. The narrowing knowledge–practice gap and resourceful use of soap, water, sanitisers and wipes indicated effective internalisation of technical guidance while low adherence to the 20-second handwashing rule underscored the need for health educational campaigns. Findings also indicated that relying on self-reports, lower confidence in biomedical interventions and persistent structural barriers (costs, facilities, forgetfulness) signals ongoing vulnerabilities. Future research should incorporate objective behavioural or clinical measures, qualitative exploration of vaccine and mask hesitancy, and intervention trials that integrate behavioural practices with improved infrastructural support to ensure effective prevention of influenza.
Exploring Hand Hygiene Practices for Preventing Influenza Infections among Batswana University Students during the Peak Pandemic Period
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Mismatch Between Perceived and Objective HIV Risk Among Individuals Discontinuing PrEP in Homa Bay and Kisii Counties, KenyaAuthor: Muchele Polycarp MuseeDOI: 10.21522/TIJPH.2013.14.01.Art024
Mismatch Between Perceived and Objective HIV Risk Among Individuals Discontinuing PrEP in Homa Bay and Kisii Counties, Kenya
Abstract:
Pre-exposure prophylaxis (PrEP) is highly effective HIV prevention strategy, yet discontinuation may leave individuals vulnerable. Guided by the Health Belief Model, this study examined whether perceived reductions in HIV susceptibility among PrEP discontinuers aligned with objectively assessed epidemiological risk in Homa Bay and Kisii Counties. A cross-sectional analytical study was conducted among 293 clients, of whom 175 reported a decreased perceived risk. Participants were selected using proportionate stratified random sampling across population groups. HIV risk was objectively evaluated using NASCOP-Risk Assessment Screening Tool (RAST). Descriptive statistics, chi-square and Fisher’s exact tests, and logistic regression were applied to examine alignment between perceived and actual risk and identify predictors of high-risk status. Marked discrepancies were observed between perceived and objective HIV risk. 91.4% of participants who perceived reduced HIV risk were classified as high or substantial risk by RAST. County-underestimation was 94.7% in Homa Bay and 72.0% in Kisii (p < 0.01). Despite reporting reduced perceived risk, many continued to engage in high-risk behaviors, including multiple sexual partnerships (48.4%), condomless sex (28.6%), prior sexually transmitted infections (18.7%), and low consistent condom use (22.5%). County of residence was the only significant predictor of objective high risk (aOR = 0.15; 95% CI: 0.04–0.58); Age, sex, marital status, education, and income were not independently associated. Substantial mismatch between perceived and actual HIV risk exists among PrEP discontinuers, particularly in high-prevalence settings. Strengthened risk assessment, tailored counseling, psychosocial support, and county-specific interventions are critical to prevent premature discontinuation and maintain HIV prevention gains.
Mismatch Between Perceived and Objective HIV Risk Among Individuals Discontinuing PrEP in Homa Bay and Kisii Counties, Kenya
References:
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[12]. Ogolla, M., Nyabiage, O. L., Musingila, P., Gachau, S., Odero, T. M., June, E. O., Ochanda, B., Appolonia, A., Katiku, E., et al., 2023, Uptake and continuation of HIV pre-exposure prophylaxis among women of reproductive age in two health facilities in Kisumu County, Kenya. Journal for International AIDS Society, 023 Mar;26(3):e26069, Doi: 10.1002/jia2.26069.
[13]. Blumenthal, J., Jain, S., Mulvihill, E., Sun, S., Marvin, H., Ellorin, E., Graber, S., Haubrich, R., Morris, S., 2019, Perceived Versus Calculated HIV Risk: Implications for Pre-exposure Prophylaxis Uptake in a Randomized Trial of Men Who Have Sex With Men. J Acquir Immune Defic Synd, 80(2): e23–e29, Doi: 10.1097/QAI.0000000000001888.
[14]. Ongolly, F. K., Dolla, A., Irungu, E. M., Odoyo, J., Wamoni, E., Peebles, K., Mugwanya, K., Mugo, N. R., Bukusi, E. A., Morton, J., Baeten, J. M., O`Malley, G., 2022, “I just decided to stop:” Understanding PrEP discontinuation among individuals initiating PrEP in HIV care centers in Kenya. J Acquir Immune Defic Syndr, 2021 May 1;87(1):e150-e158, Doi: 10.1097/QAI.0000000000002625.
[15]. Gilbert, H. N., Wyatt, M. A., Pisarki, E. E., Mumonge, T. R., Heffron, R., Katabira, E. T., Celum, C. L., Baeten, J. M., Haberer, J. E., Ware Norman, C., 2019, PrEP Discontinuation and Prevention-Effective Adherence: Experiences of PrEP Users in Ugandan HIV Serodiscordant couples. Journal Acquired Immune Deficiency Syndrom, 2019 Nov 1;82(3):265-274, Doi: 10.1097/QAI.0000000000002139.
[16]. Anyasi, H., Idemudia, A., Badru, T., Onyegbule, S., Isang, E., Sanwo, O., Pandey, S.R., Chiegil, R.,et al., 2024, Discontinuation of HIV oral pre-exposure prophylaxis: findings from programmatic surveillance within two general population HIV programs in Nigeria. BMC Public Health. 2024 May 16;24(1):1325, Doi: 10.1186/s12889-024-18808-z.
[17]. Dzenga, T., Moyo, E., Moyo, P., Kamangu, J., Dzinamarira, T., 2023, Factors influencing the retention of clients in oral pre-exposure prophylaxis (PrEP) care at 3 months after initiation in the Omusati region of Namibia. International Journal of Africa Nursing Sciences, Volume 19, 2023, 100623, https://doi.org/10.1016/j.ijans.2023.100623
[18]. Herns, S., Panwala, R., Pfeil, A., Sardinho, M., Rossi, V., Blumenthal, J., & Hill, L., 2023, Predictors of PrEP retention in at risk patients seen at a HIV primary care clinic in San Diego. International Journal of STD and AIDS, 785–790, 2023 Oct;34(11):785-790, Doi: 10.1177/09564624231179276.
[19]. Garofoli, M., Siguier, M., Robineau, O., Valette, M., Phung, B., Bachelard, A., Rioux, C., Gac, S.L., Digumber, M., Pialoux, G., Ghosn, J., Champenois, K., 2024, Incidence and factors associated with PrEP discontinuation in France. Journal of Antimicrobial Chemotherapy, 2024 Jul 1;79(7):1555-1563, Doi: 10.1093/jac/dkae133.
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Epidemiologic Trends and Determinants of Advanced HIV Disease among People Living with HIV in Zimbabwe (2017-2024): Evidence to Inform an Optimisation FrameworkAuthor: Sandra ChipukaDOI: 10.21522/TIJPH.2013.14.01.Art025
Epidemiologic Trends and Determinants of Advanced HIV Disease among People Living with HIV in Zimbabwe (2017-2024): Evidence to Inform an Optimisation Framework
Abstract:
Advanced HIV Disease (AHD) remains a leading cause of morbidity and mortality among people living with HIV (PLHIV) despite widespread antiretroviral therapy (ART) coverage. This study analysed epidemiologic trends and facility-level determinants of AHD in Zimbabwe to inform targeted programme optimisation strategies. A retrospective analysis of routine District Health Information System 2 (DHIS2) data was conducted across 16 health facilities in Harare and Mashonaland East from 2017 to 2024. AHD was defined in accordance with contemporaneous World Health Organization guidelines, and analyses included descriptive statistics, temporal trend assessment, geographic comparisons, correlation, and multivariable regression. Among 495,166 PLHIV on ART, 4,169 AHD cases were identified. AHD prevalence followed a U-shaped trend, declining from 20.31% in 2017 to 2.20% in 2020, before rising to 16.12% in 2024, reflecting programmatic shifts and COVID-19 disruptions. Rural Mashonaland East recorded significantly higher prevalence than urban Harare (16.53% vs. 9.71%, p=0.002). Facility-level variation was substantial (0.56%–40.23%), with district hospitals bearing a disproportionate burden (β = 15.24, p = 0.001). AHD was positively associated with cryptococcal meningitis (r = 0.419, p = 0.003) and mortality (r = 0.385, p = 0.007), while loss to follow-up was not strongly correlated. Despite strong retention outcomes, persistent challenges in early diagnosis and AHD identification remain. Geographic and facility-level inequities underscore the need for differentiated, equity-focused interventions. Strengthening decentralised screening, particularly for opportunistic infections such as cryptococcal disease and tuberculosis, is essential to reduce preventable mortality and improve clinical outcomes.
Epidemiologic Trends and Determinants of Advanced HIV Disease among People Living with HIV in Zimbabwe (2017-2024): Evidence to Inform an Optimisation Framework
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The Impact of Removing User Fees on Maternal and Child Health Services: A Systematic Review of Quasi-Experimental StudiesAuthor: Peter Kofi TaadiDOI: 10.21522/TIJPH.2013.14.01.Art026
The Impact of Removing User Fees on Maternal and Child Health Services: A Systematic Review of Quasi-Experimental Studies
Abstract:
User fee removal is emerging as a leading strategy to expand access to financial services for maternal and child health (MCH) services. However, whether such policies improve downstream outcomes or equity remains unclear. We conducted a systematic review of quasi-experimental studies evaluating the effects of user fee removal on the MCH continuum of care, mortality outcomes, and equity, guided by PRISMA and an original conceptual framework linking financial barriers to service use, quality, system readiness, and health outcomes. We searched PubMed and Web of Science in August 2025 for studies that used experimental or quasi-experimental designs evaluating user fee removal. Of the 933 records screened, 14 studies met the inclusion criteria; all were quasi-experimental. Narrative synthesis followed SWiM (Systematic Review Without Meta-analysis) guidelines due to heterogeneity, and risk of bias was assessed using ROBINS-I. Free health care policies consistently improved access to antenatal care, facility-based delivery, and skilled birth attendance. Effects on postnatal care and caesarean section were mixed. These improvements did not correspond to significant reductions in maternal mortality, stillbirths, or neonatal mortality. Removing user fees had no immediate effect on the initiation of early antenatal care but showed long-term gains. Some policies closed equity gaps while some unintentionally widened health disparities. Removing user fees significantly increased MCH utilisation, with limited or inconsistent effects on mortality and equity. Our framework clarifies how fee removal brings both benefits and system pressures. Future research should address quality and system readiness to achieve equitable outcomes.
The Impact of Removing User Fees on Maternal and Child Health Services: A Systematic Review of Quasi-Experimental Studies
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HIV Testing Uptake and Risk Behaviors among Youth at Institut Superieur des Techniques Medicales De Kinshasa, Democratic republic of CongoAuthor: Weko Gomer LulendoDOI: 10.21522/TIJPH.2013.14.01.Art027
HIV Testing Uptake and Risk Behaviors among Youth at Institut Superieur des Techniques Medicales De Kinshasa, Democratic republic of Congo
Abstract:
Young people aged 15–24 years represent 37% of new HIV infections globally, with sub-Saharan Africa bearing the highest burden. Students enrolled in health science programs , as future healthcare providers, are critical for HIV prevention efforts, yet limited data exist on their testing behaviors in the Democratic Republic of Congo (DRC). This study assessed HIV testing uptake and associated risk behaviors among students at Institut Supérieur des Techniques Médicales (ISTM) in Kinshasa, DRC. A cross-sectional survey was conducted using systematic sampling. The minimal sample size calculated was estimated at 384 participants, but only 300 students were recruited which may have affected the statistical power and limited generalizability. Self-administered questionnaires assessed HIV testing history, sexual behaviors, substance use, and training background. Data were analysed using IBM SPSS with descriptive statistics and chi-square tests. Among 300 participants, 60% (n=180) were females and 40% (n=120) were males; only 24.7% (n=74) had tested for HIV within the past year, while 58.0% (n=174) had never been tested. Significant gender disparities were observed, with 78.4%(n=235) of recent testers being female versus 21.6%(n=35) male (χ²=15.2, p<0.001). Reported high-risk behaviors included never using condoms 25.3% (n=76), multiple sexual partners in the past 12 months 26.7%(n=54), and recent STD treatment 16.0%(n=33). Despite 69.7% (n=209) having received HIV/STD training, testing uptake remained modest. These findings suggest that HIV testing uptake among ISTM students is suboptimal, considering their potential role in HIV prevention. The coexistence of HIV testing gaps and reported high risk behaviors among study participants underscores the need of targeted interventions particularly those addressing barriers among male students, improving HIV testing uptake and strengthen HIV prevention efforts within this student community.
HIV Testing Uptake and Risk Behaviors among Youth at Institut Superieur des Techniques Medicales De Kinshasa, Democratic republic of Congo
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Trends and Determinants of Postnatal Care Utilization in South-West Nigeria Using NDHS Data (2013-2024)Author: Adeyinka W. OdejimiDOI: 10.21522/TIJPH.2013.14.01.Art028
Trends and Determinants of Postnatal Care Utilization in South-West Nigeria Using NDHS Data (2013-2024)
Abstract:
Despite readily available information on national-level analyses of Postnatal care utilization, there is a paucity of studies on subnational evidence on postnatal care uptake. This study addresses this gap by examining trend PNC uptake across the South-West states in Nigeria using pooled NDHS data from 2013 to 2024. A secondary analysis of pooled data from the Nigeria Demographic and Health Surveys (NDHS) conducted in 2013, 2018, and 2024 with a final unweighted sample size of 5,514. The study outcome variable is the postnatal care utilization within seven days of delivery among women of reproductive age. Sampling weight was applied to estimates while multivariable multilevel logistic regression models were fitted to examine determinants of PNC uptake. Majority of the study respondent resided in urban area (72.1%), with secondary education being the highest maternal level of education (51.7%). The proportion of PNC uptake dropped drastically from 48.9% in 2013 to 23.9% in 2018 and 22.7% in 2024. Maternal level of education (Tertiary education: AOR=2.26; 95% CI=1.64-3.13) significantly increased the likelihood of PNC utilization among women of reproductive age. Findings revealed a disturbing downward slope in PNC utilization especially in 2024 which call for urgent response in programme design and implementation. Efforts should be reinforced in ensuring female education as a critical step to reduce neonatal and maternal mortality.
Trends and Determinants of Postnatal Care Utilization in South-West Nigeria Using NDHS Data (2013-2024)
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[16]. Ahmed, T., Roberton, T., Vergeer, P., Hansen, P. M., Peters, M. A., Ofosu, A. A., Mwansambo, C., Nzelu, C., Wesseh, C. S., Smart, F., Alfred, J. P., Diabate, M., Baye, M., Yansane, M. L., Wendrad, N., Mohamud, N. A., Mbaka, P., Yuma, S., Ndiaye, Y., Sadat, H., Uddin, H., Kiarie, H., Tsihory, R., Mwinnyaa, G., de Dieu Rusatira, J., Amor Fernandez, P., Muhoza, P., Baral, P., Drouard, S., Hashemi, T., Friedman, J., Shapira, G., 2022, Healthcare utilization and maternal and child mortality during the COVID-19 pandemic in 18 low- and middle-income countries: an interrupted time-series analysis with mathematical modeling of administrative data. PLoS Med, 19(8), e1004070, https://doi.org/10.1371/journal.pmed.1004070
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Family Functioning and its Association with Alcohol Use Disorder among Adolescents in Southwestern Uganda: A Cross-Sectional StudyAuthor: Novatus NyemaraDOI: 10.21522/TIJPH.2013.14.01.Art029
Family Functioning and its Association with Alcohol Use Disorder among Adolescents in Southwestern Uganda: A Cross-Sectional Study
Abstract:
This study investigates the association between family functioning and the severity of alcohol use disorders (AUD) among adolescents in Southwestern Uganda. Focusing on dimensions such as family cohesion, adaptability, communication, and satisfaction, the research explores how familial relationships and sociodemographic factors influence adolescent alcohol use. A cross-sectional study was conducted from September to December 2019 in Ibanda District, involving 308 adolescents aged 10 to 19 years. Participants were selected through multistage sampling, and data were collected using the Alcohol Use Disorders Identification Test (AUDIT) and the Family Adaptability and Cohesion Evaluation Scale IV (FACES IV). Ordered logistic regression was used to assess predictors of AUD severity. The findings revealed that 21.1% of participants were classified as hazardous drinkers, 9.1% as harmful drinkers, and 9.7% as dependent drinkers. Higher levels of family cohesion were associated with increased odds of more severe AUD classification (OR = 1.14, p<0.001), suggesting possible enabling or permissive dynamics in certain family contexts. In contrast, higher levels of adaptability (OR = 0.79, p<0.001) and satisfaction (OR = 0.82, p= 0.003) were protective against severe alcohol use. Additionally, lower household income, non-nuclear living arrangements, and unstable family structures were significantly associated with greater AUD severity. These findings underscore the critical role of family dynamics and socioeconomic conditions in shaping adolescent alcohol use behaviours. The study highlights the need for family-centred and context-sensitive interventions that strengthen adaptability and satisfaction within the family unit, while also addressing underlying structural vulnerabilities.
Family Functioning and its Association with Alcohol Use Disorder among Adolescents in Southwestern Uganda: A Cross-Sectional Study
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Community Health Workers’ Integration Models and Health System Integration Effectiveness for Universal Health Coverage in Sub Saharan Africa: A Systematic ReviewAuthor: Sowo Anita LebbieDOI: 10.21522/TIJPH.2013.14.01.Art030
Community Health Workers’ Integration Models and Health System Integration Effectiveness for Universal Health Coverage in Sub Saharan Africa: A Systematic Review
Abstract:
In sub-Saharan Africa (SSA), evidence suggests that many low and middle-income countries face severe shortages and uneven distribution of health workers, medicines and infrastructure, resulting in poor quality services and serious gaps in coverage for essential health care. In addressing the human resources gaps of trained health professionals, Community Health Workers (CHWs) were recruited and integrated in the health system and they are increasingly regarded as central actors in achieving Universal Health Coverage (UHC) and strengthening primary health care (PHC) in SSA. Evidence from existing studies shows that community health workers have the greatest impact when they are well integrated across the main health system building blocks. Estimates of Community Health Worker (CHW) density vary widely across Sub-Saharan Africa, ranging from about 11.2 to 59.5 CHWs for every 10,000 people. These differences depend largely on how many hours CHWs work and the scope of services they provide. However, integration models differ widely across nations with mixed outcomes in service provision, equity, and sustainability. Three models of integration dominated: government-driven, hybrid, and Non-Governmental Organisation-driven (NGO). Government-driven models have 40% higher levels of sustainability than donor-based models and cost-effectiveness ratios of $1.20 per capita per annum, for example in Ethiopia and Ghana, among others. Successful CHW integration is context-dependent model selection, with no single model likely to be optimal for every situation; success depends on close adaptation to the local health system and community context.
Community Health Workers’ Integration Models and Health System Integration Effectiveness for Universal Health Coverage in Sub Saharan Africa: A Systematic Review
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The Role of a Father in Access to Maternal and Child Health Services in Ethiopia: A Neglected Key to SurvivalAuthor: David DakDOI: 10.21522/TIJPH.2013.14.01.Art031
The Role of a Father in Access to Maternal and Child Health Services in Ethiopia: A Neglected Key to Survival
Abstract:
Children's survival and health critically depend on supportive adults, particularly their parents. Sub-Saharan Africa and Central and Southern Asia bear the highest burden of maternal, stillbirth, and neonatal deaths. Ethiopia ranks 5th globally among countries accounting for 60% of these deaths. The major underlying causes are harmful gender norms, biases and inequalities. This study identifies factors affecting male involvement in Maternal and Child Health (MCH) care in Ethiopia and proposes strategies to enhance father's contributions to maternal and child survival. Methodologically, an extensive literature review and critical analysis of existing studies, health policies, and reports related to MCH, and father’s role was conducted. Despite Ethiopia's health system improvements that incorporate life-cycle services, significant inequalities persist by economic status, education, residence, and gender. Political commitment to reducing stillbirths remains insufficient. Key barriers to male involvement include health facility factors (inaccessibility, unwelcoming environments, disrespectful care), sociodemographic characteristics (age, education, occupation), low income, and deep-rooted cultural norms relegating MCH to women's domain. In conclusion, the crucial role of father’s in MCH care is widely acknowledged yet underexplored in the policy. Ethiopian men's hesitancy to engage in MCH significantly impacts survival outcomes. Implementing policies promoting male involvement – such as father-friendly clinics, targeted education campaigns, and couple-based antenatal care – can strengthen health systems and improve family well-being.
The Role of a Father in Access to Maternal and Child Health Services in Ethiopia: A Neglected Key to Survival
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Understanding Socio-Demographic, Environmental, and Behavioral Factors Associated with Malaria Infection Among Children Under Five Years in Tanzania: A Rapid ReviewAuthor: Hamad NnimboDOI: 10.21522/TIJPH.2013.14.01.Art032
Understanding Socio-Demographic, Environmental, and Behavioral Factors Associated with Malaria Infection Among Children Under Five Years in Tanzania: A Rapid Review
Abstract:
Malaria is a global public health concern and remains one of the major causes of morbidity and mortality among children under five in sub-Saharan Africa, with Tanzania bearing a substantial share of the burden. Although multiple studies have examined risk factors, evidence on socio-demographic, environmental, and behavioral determinants remains fragmented. A comprehensive synthesis of this evidence is critical to guide context-specific interventions. This rapid review synthesised studies published between January 2021 and December 2025 to identify factors associated with malaria infection among children under five. Data on study characteristics and key findings were extracted systematically, verified, and synthesized narratively. The results were organised into socio-demographic, environmental, and behavioural determinant domains. Twenty-one studies met inclusion criteria. Cross-sectional designs predominated (n=8, 38%), followed by randomized trials (n=5, 24%). Most studies were community-based (n=19, 91%) and focused either exclusively on children under 5 (n=8, 38%) or on mixed-age groups (n=6, 29%). Malaria infection among children under five in Tanzania is consistently associated with child age, maternal education, and household socio-economic status. Environmental factors such as housing quality, sanitation, and proximity to mosquito breeding sites, along with behavioral factors including ITN use, care-seeking, and nighttime outdoor exposure, also influence risk. These determinants interact within ecological and socio-economic contexts, underscoring the need for integrated, context-specific interventions. Strengthening vector control, improving housing and environmental conditions, promoting protective behaviors, and addressing socio-economic inequities are key to reducing malaria. This review provides evidence to guide targeted interventions and future research for accelerating malaria control in Tanzania.
Understanding Socio-Demographic, Environmental, and Behavioral Factors Associated with Malaria Infection Among Children Under Five Years in Tanzania: A Rapid Review
References:
[1]. World Health Organization, 2025, Malaria, Available from: https://www.who.int/news-room/fact-sheets/detail/malaria.
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[6]. Akowe, E., Ahman, Q. O., Agbata, B. C., Joseph, S. O., Senewo, E. O., Danjuma, A. Y., Yahaya, D. J., 2025, A novel malaria mathematical model: integrating vector and non-vector transmission pathways, BMC Infectious Diseases, 25(1), https://doi.org/10.1186/s12879-025-10653-8.
[7]. Savi, M. K., 2022, An Overview of Malaria Transmission Mechanisms, Control, and Modeling, Medical Sciences, 11(1), https://doi.org/10.3390/medsci11010003.
[8]. Adam, J., Luoga, P., Nyamhanga, T., Makunenge, C., Ayubu, M., 2025, Prevalence and determinants of malaria among children aged 6–59 months in Tanzania: a nationwide cross-sectional study, Malaria Journal, 24(1), https://doi.org/10.1186/s12936-025-05409-3.
[9]. Mwaiswelo, R. O., Mmbando, B. P., Chacky, F., Molteni, F., Mohamed, A., Lazaro, S., Mkalla, S. F., Samuel, B., Ngasala, B., 2021, Malaria infection and anemia status in under-five children from Southern Tanzania where seasonal malaria chemoprevention is being implemented, PLOS ONE, 16(12), https://doi.org/10.1371/journal.pone.0260785.
[10]. Bofu, R. M., Santos, E. M., John, B., Kahamba, N., Swilla, J., Njalambaha, R., Kelly, A. H., Lezaun, J., Christofides, N., Okumu, F. O., Finda, M. F., 2023, The Needs and Opportunities for Housing Improvement as a Malaria Intervention in Southern Tanzania, https://doi.org/10.21203/rs.3.rs-2431993/v1, https://www.researchsquare.com/article/rs-2431993/v1.
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Barriers and Facilitators of Mental Health Well-Being Among Postnatal Mothers: A Systematic ReviewAuthor: Simone Roberts KentDOI: 10.21522/TIJPH.2013.14.01.Art033
Barriers and Facilitators of Mental Health Well-Being Among Postnatal Mothers: A Systematic Review
Abstract:
The postnatal mothers experience mental health challenges which include depression, anxiety, and stress. Although frequency is markedly higher in low- and middle-income countries (LMICs), systemic and cultural barriers often impede help-seeking and access to care, even as various facilitators promote resilience and recovery. This systematic review aims to assess the barriers and facilitators to mental health and well-being among postnatal mothers in St. Vincent and the Grenadines, synthesising findings from both qualitative and quantitative studies. A thorough, systematic search was conducted in electronic databases, including EBSCOhost, PubMed, PsycARTICLES, Google Scholar, and ScienceDirect, for studies published between January 2015 and April 2025. Studies included in this review are qualitative, quantitative, or mixed methods. The identified themes were categorized as individual, interpersonal, organizational, community and societal. The systematic review included eighteen studies. The main barriers were as follows: (1) Individual: low mental health literacy, stigma, and fear of judgment; (2) Interpersonal: lack of partner or family support; (3) Organizational: healthcare systems focused predominantly on infant physical health, poor provider communication, and fragmented referral pathways; (4) Community: cultural norms discouraging disclosure of emotional distress; and (5) Societal: financial constraints, geographical inaccessibility, and under resourced mental health services. The main facilitators included: strong social support networks, perceived self-efficacy, culturally sensitive and integrated care models, peer support programs, and technology-enabled interventions. By focusing on the unique culture within regions like the Caribbean, researchers can build a support system that ensures no mother has to struggle through the postnatal period alone.
Barriers and Facilitators of Mental Health Well-Being Among Postnatal Mothers: A Systematic Review
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Health System Maturity: A Narrative Review of Existing Maturity ModelsAuthor: Higenyi EmmanuelDOI: 10.21522/TIJPH.2013.14.01.Art034
Health System Maturity: A Narrative Review of Existing Maturity Models
Abstract:
Various health system maturity models have been elaborated in literature but none offers a unified and integrated perspective to facilitate comparison of maturity levels across different health systems. Such a unified and universal health system maturity model would enable various stakeholders-national governments, international agencies, scholars and researchers, and other interested parties to gain insight into maturity of individual health systems while also permitting quantitative and qualitative comparisons across systems. It would facilitate progress tracking and systematic improvement at global, national and sub-national levels. This article explored and examined the various models for health system maturity and proposes robust criteria and framework for health system maturity assessment. Basing on the purpose, functions and goal of the health system, ten (10) maturity dimensions were synthesized to form a benchmark for the critical review of the existing maturity models and constitute a bedrock for the unified and integrated maturity assessment framework. The dimensions are: Universal Health Coverage; Continuity of Care; Continuum of Care; Population Health Status; Quality Management; Responsiveness; Resilience; Partnerships and Collaborations; Global Participation and Integration; and Sustainability. A critical review of the existing maturity models indicated that none of the maturity models covers all the health system maturity dimensions thus confirming the need for the synthesis of a unified and integrated framework for health system maturity assessment. The information from the review was used to formulate metrics and performance indicators for each dimension, thereby giving rise to the proposed comprehensive assessment framework.
Health System Maturity: A Narrative Review of Existing Maturity Models
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Donor Dependency and Health-Service Sustainability: A Meta-Analysis & Systematic Review of the Great Mundri, Western Equatoria State, South SudanAuthor: Zakaria Kenneth Kaunda KaidriDOI: 10.21522/TIJPH.2013.14.01.Art035
Donor Dependency and Health-Service Sustainability: A Meta-Analysis & Systematic Review of the Great Mundri, Western Equatoria State, South Sudan
Abstract:
South Sudan's health sector relies heavily on external support, yet the magnitude of donor dependency and its impact on service sustainability remains poorly quantified. This systematic review and meta-analysis examined donor dependency in Great Mundri County's health system and its effects on service coverage. A PRISMA-guided systematic search of MEDLINE, Embase, Web of Science, Scopus, and Google Scholar (2005-2024) yielded 1,243 records. After screening, 37 studies met inclusion criteria, with 12 containing extractable quantitative data for meta-analysis. Random-effects models generated pooled estimates and assessed heterogeneity. Donors financed 78% (95% CI 70-85; I² = 64%) of recurrent health-sector costs in Great Mundri. Donor withdrawal was associated with significant declines in skilled birth attendance (pooled decline: 23 percentage points, 95% CI 15-31), childhood immunization coverage (pooled decline: 19 percentage points, 95% CI 12-26), and essential drug availability (pooled decline: 34 percentage points, 95% CI 26-42). Community engagement initiatives showed protective effects, reducing the magnitude of service decline by 40-60%. Nearly four-fifths of health financing remains donor-derived, with abrupt funding transitions leading to substantial reductions in service coverage. Enhanced community engagement and gradual donor transition strategies may mitigate negative impacts on health service sustainability in fragile settings.
Donor Dependency and Health-Service Sustainability: A Meta-Analysis & Systematic Review of the Great Mundri, Western Equatoria State, South Sudan
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Strengthening Anaemia Data Systems in Africa: Challenges, Innovations, and Policy OpportunitiesAuthor: Elodia Cheutou SiewoueDOI: 10.21522/TIJPH.2013.14.01.Art036
Strengthening Anaemia Data Systems in Africa: Challenges, Innovations, and Policy Opportunities
Abstract:
Anaemia is a major public-health challenge in Africa, affecting over one-third of women of reproductive age and nearly half of pregnant women (World Health Organization (WHO), 2025). Despite global and continental commitments to halve anaemia by 2030, progress has stalled, largely due to weak data systems that hinder timely, evidence-based action. This paper reviews anaemia data in Africa, examining how indicators are collected, integrated, and used within health-information systems. Drawing on the literature, policy frameworks, and country examples, it explores opportunities to strengthen surveillance through digital health innovations and governance reforms. Findings reveal persistent fragmentation between surveys, routine health systems, and laboratory data, leading to incomplete and delayed reporting. Emerging solutions such as the District Health Information System (DHIS2) nutrition modules, improved lab interoperability, mobile community reporting, and regional scorecards offer practical integration pathways. However, anaemia-specific indicators remain absent in several platforms, including the Economic Community of West African States (ECOWAS) Sexual, Reproductive, Maternal, Newborn, Child, and Adolescent Health (SRMNCAH) scorecard. Updating these tools to align with WHO’s Comprehensive Framework and the African Union’s Anaemia Reduction Framework (2023–2030) is critical. Strengthening anaemia data systems requires investment in governance, interoperability, and analytical capacity rather than creating parallel mechanisms. Embedding anaemia indicators within existing digital-health infrastructures can transform fragmented data into actionable intelligence, enabling governments to monitor progress, address inequities, and accelerate reductions by 2030, contributing to the global target of reducing anaemia among women of reproductive age by 50% from the 2012 baseline.
Strengthening Anaemia Data Systems in Africa: Challenges, Innovations, and Policy Opportunities
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Assessment of Emergency Preparedness and Response Using One Health Approach in Juba, South SudanAuthor: Angelo Goup Thon KouchDOI: 10.21522/TIJPH.2013.14.01.Art037
Assessment of Emergency Preparedness and Response Using One Health Approach in Juba, South Sudan
Abstract:
Emerging and re-emerging public health threats such as zoonotic diseases, outbreaks, and environmental hazards continue to challenge South Sudan’s fragile health system. This study, titled “Assessment of Emergency Preparedness and Response Using One Health Approach in Juba, South Sudan,” evaluates the extent to which the One Health (OH) framework integrating human, animal, and environmental health, has been applied to strengthen emergency preparedness and response (EPR) capacities in Juba, Republic of South Sudan. A mixed-methods approach was employed, combining quantitative data from structured questionnaires administered to 378 respondents across key sectors (human health, animal health, and environment) with qualitative data from 20 key informant interviews and document reviews of national preparedness plans. Results revealed that while awareness of the OH approach was moderate (67%), its operationalization within emergency preparedness structures remained limited due to fragmented coordination, inadequate funding, and weak intersectoral collaboration. Surveillance and laboratory capacities improved, yet joint outbreak investigations and data sharing remained inconsistent. However, the study found positive trends in multisectoral training initiatives and policy alignment efforts supported by international partners. The study concludes that adopting a fully functional One Health model could significantly enhance South Sudan’s emergency preparedness and response (EPR) systems. Strengthening institutional coordination, capacity building, and resource mobilization across sectors is critical for building resilience against health emergencies in Juba and beyond.
Assessment of Emergency Preparedness and Response Using One Health Approach in Juba, South Sudan
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