Assessing implementation fidelity of community based integrated mass drug administration for neglected tropical disease control in Kano State, Nigeria

A research report submitted to faculty of health sciences in partial fulfillment of the requirement for the degree of Master of Science in Epidemiology in the field of implementation science University of the Witwatersrand, Johannesburg. November, 2017.Background There is a dearth of information about how well this intervention is conducted in communities (implementation fidelity) as fidelity data are not included in routine program data. Therefore, this study measured the implementation fidelity of mass drug administration for onchocerciasis, lymphatic filariasis, and soil transmitted helminthiasis control, described factors affecting it, and determined the relationship between identified factors and implementation fidelity. Methodology A cross sectional survey was conducted in Nassarawa and Gezawa local government areas of Kano State, Nigeria, where a total 348 community directed distributors were interviewed. Scores were calculated by linearly combining responses obtained using Likert scales. Mean and median of implementation fidelity score were computed. Also, the mean of key determinants were calculated. Adjusted and unadjusted general linear regression models were then fitted to determine the relationship between implementation fidelity and identified determinants. Results The mean(SD) implementation fidelity score was 55.39(8.10) and median(IQR) was 56(60 - 49). Minimum implementation fidelity score obtained was 36 and maximum score was 72. The mean(SD) quality of delivery score, intervention complexity score, facilitation strategy score and participant responsiveness score were 16.77(2.74), 11.03(3.04), 8.83(0.99) and 4.62(0.52) respectively. Evidence of association between some factors and implementation fidelity score were found at p < 0.05. They include: intervention complexity (Adj Coef: -0.62(-0.93 to -0.30), iv facilitation strategies (Adj Coef:-1.68(-3.05 to -0.32), participants responsiveness (Adj Coef: 2.99(1.58 to 4.39), knowledge of NTD (Adj Coef: 0.75(0.36 to 1.13), CDD selection by local government staff (Adj Coef: 7.48(2.85 to 12.11), CDD who volunteered (Adj Coef: 8.38(4.59 to 12.16) CDD with formal training in a health-related field (Adj Coef: 7.34(2.61 to 12.07), and CDD participation in other public health activities (Adj Coef: -6.16(-9.49 to -2.83). Conclusion This study demonstrated the feasibility of measuring implementation fidelity of mass drug administration. In addition, key determinants such as intervention complexity and participant responsiveness were found to be important factors affecting implementation fidelity and could be the target of future implementation strategies.LG201

Socio-Demographic Determinants of Poverty in Nigeria and its Gender Differentials

Poverty reduction is one of the greatest challenges facing international community and it is an invaluable requirement for sustainable development. This study was conducted to empirically examine the influence of socioeconomic as well as demographic variables on households’ vulnerability to social exclusion or deprivation with more emphasis on gender inequality. The study employed binary probit regression analysis of poverty as well as Oaxaca-Blinder decomposition to examine factors responsible for inequality with respect to socio-economic fortunes among Nigerian households. Evidence from the study revealed that socio-demographic variables as well as labor characteristics are strong determinants of poverty in the country, and the findings confirmed to the theoretical propositions on causes of poverty. However, empirical results from the Oaxaca-Blinder decomposition show that female headed households are more disadvantaged in terms of socioeconomic deprivation than the male headed households. The study concluded by presenting concluding remarks and policy implications for policymakers toward poverty reduction in Nigeria

SOCIO - ECONOMIC DETERMINANTS OF HOUSEHOLDS FUEL CONSUMPTION IN NIGERIA

Attainment of universal access to affordable, reliable, sustainable and modern energy is one of the goals for Sustainable Development Goals (SDGs). Existing data and statistic suggest that high proportion of households in less developed countries heavily rely on solid fuels for domestic requirements. Also, recent data revealed that in Nigeria over 70 percent of households depend on fuel wood for cooking which indicate the task ahead of policy makers in the country for ensuring access to efficient sources of energy before the expiration of sustainable development goals. In this study we empirically examined socio-economic factors that influence households’ likelihood of energy consumption in Nigeria. In order to achieve our specific objectives, we adopt 2013 demographic health survey dataset for Nigeria and multinomial logistic regression was conducted in analyzing the factors affecting households’ decision for energy demand. Evidence from the study revealed that demographic characteristics, economic status, public awareness and social variables are strong determinants of households’ energy choice in the country and conformed to the propositions of “Energy Ladder Hypothesis”. We concluded by presenting concluding remarks and policy implications for decision making toward ensuring access to affordable, sustainable and efficient energy in Nigeria

Assessing the awareness and perception of waqf among business owners in Gombe State, Nigeria

Purpose – The literature about the dynamics of Muslims' awareness and perception of waqf has been generally scarce,especially in Nigeria. As renewed efforts are emerging to develop a new waqf regime in the country, this study examines this aspect in Gombe metropolis, Nigeria, with a view to identifying the key factors shaping people's perception and awareness towards waqf. Design/methodology/approach – To achieve the objective of this study, primary data were collected through a survey among 494 business owners in the Gombe metropolis. The data were then analysed using probit and Tobit regression models. Findings – The study found that altruistic behaviour, religiosity level, educational level and young age are among the factors that determine people's perception and awareness towards donating to waqf among business owners in Gombe. Altruism and young age embolden businesspersons to recognise the effectiveness of waqf institutions in solving socioeconomic challenges. Practical implications – The findings of this study imply that waqf has huge potential in the study area and that with well-structured, organized waqf education programmes within the business community using diverse avenues, a robust waqf sector can be developed. Originality/value – As far as the study area and the entire Nigerian Islamic economics and finance landscape is concerned, the study has explored a novel research area. Given the infant stage of empirical studies on waqf in Nigeria, there are virtually no previous attempts to examine the awareness and perception of businesspersons towards waqf; variables that are key to the development of an effective sector

Evolutionary Trends in the Landscape of Hausa Open Spaces: Key Enablers of Habe City Planning Mythology

This study took the ‘origin-pattern-function’ of landscape progression as the central theoretical framework and conducted a systematic study on the evolution of open-space landscape patterns in Habe cities, situated between the river Niger and the river Benue in northern Nigeria. This study aimed to explore the embedded landscape cosmology in Hausaland and the origins of its historic mythology. A descriptive research and review approach was adopted, to explain and interpret prevailing practices, existing circumstances, attitudes, reasons, and on-going processes. It unveils the planning of open spaces and houses according to an ancient cosmology that organized towns during the Habe Hausa Dynasty. The open spaces appear to be a sphere of convergent and divergent forces that maintain a delicate balance, whereas the outcrop hills of central Hausaland are domicile places with religious appeal and better defensibility. Further, the physical effects of Islamic influence are visible in the landscape of Hausa cities, such as locating a mosque in the heart of the city as well spatial expressions of the practice of the seclusion of women. The study also revealed that the concept of triple outdoor space in the landscape of Habe cities is identical with that of the traditional Hausa family dwellings enclosed by a compound wall with a gate. This paper presents the key enablers of the Hausa cities’ transformation into commercial, administrative, religious, and agricultural centers. It recommends that in the event of landscape development without certain public guidelines or natural practices, complicated mediation measures should be invoked if disorder is not to prevail. It finally seeks a comprehensive application of local practices and innovative methods with the aim of averting vulnerability of urbanization

Evolutionary Trends in the Landscape of Hausa Open Spaces: Key Enablers of Habe City Planning Mythology

This study took the ‘origin-pattern-function’ of landscape progression as the central theoretical framework and conducted a systematic study on the evolution of open-space landscape patterns in Habe cities, situated between the river Niger and the river Benue in northern Nigeria. This study aimed to explore the embedded landscape cosmology in Hausaland and the origins of its historic mythology. A descriptive research and review approach was adopted, to explain and interpret prevailing practices, existing circumstances, attitudes, reasons, and on-going processes. It unveils the planning of open spaces and houses according to an ancient cosmology that organized towns during the Habe Hausa Dynasty. The open spaces appear to be a sphere of convergent and divergent forces that maintain a delicate balance, whereas the outcrop hills of central Hausaland are domicile places with religious appeal and better defensibility. Further, the physical effects of Islamic influence are visible in the landscape of Hausa cities, such as locating a mosque in the heart of the city as well spatial expressions of the practice of the seclusion of women. The study also revealed that the concept of triple outdoor space in the landscape of Habe cities is identical with that of the traditional Hausa family dwellings enclosed by a compound wall with a gate. This paper presents the key enablers of the Hausa cities’ transformation into commercial, administrative, religious, and agricultural centers. It recommends that in the event of landscape development without certain public guidelines or natural practices, complicated mediation measures should be invoked if disorder is not to prevail. It finally seeks a comprehensive application of local practices and innovative methods with the aim of averting vulnerability of urbanization

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021:a systematic analysis for the Global Burden of Disease Study 2021

BackgroundRegular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations.MethodsThe Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates—with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds.FindingsThe leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles.InterpretationLong-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere.FundingBill &amp; Melinda Gates Foundation.<br/

SPARC 2018 Internationalisation and collaboration : Salford postgraduate annual research conference book of abstracts

Welcome to the Book of Abstracts for the 2018 SPARC conference. This year we not only celebrate the work of our PGRs but also the launch of our Doctoral School, which makes this year’s conference extra special. Once again we have received a tremendous contribution from our postgraduate research community; with over 100 presenters, the conference truly showcases a vibrant PGR community at Salford. These abstracts provide a taster of the research strengths of their works, and provide delegates with a reference point for networking and initiating critical debate. With such wide-ranging topics being showcased, we encourage you to take up this great opportunity to engage with researchers working in different subject areas from your own. To meet global challenges, high impact research inevitably requires interdisciplinary collaboration. This is recognised by all major research funders. Therefore engaging with the work of others and forging collaborations across subject areas is an essential skill for the next generation of researchers

Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016