The role of the Health Policy Research Group at the College of Medicine, University of Nigeria in building collective capacity for the field of HPSR in Enugu State of Nigeria

Magister Public Health - MPH (Public Health)BACKGROUND: Health policy and systems research and analysis (HPSR&A) is central to health systems development as it tries to draw a comprehensive picture of how the health system and broader determinants of health can shape and be shaped by policies. It consists of researchers and practitioners with different levels of knowledge, experience and expertise, and draws upon a blend of disciplines that contribute to better understanding of complex health systems. This diversity of disciplines and competence creates potential risk for lack of clarity and common understanding of HPSR&A, and reflects a need for continuous capacity development at all levels. The Health Policy Research Group (HPRG) of the College of Medicine, University of Nigeria Enugu campus (COMUNEC) has in the past thirteen years undertaken activities that aimed to contribute to building capacity for HPSR&A in Enugu state. AIM: The study examines the contributions of HPRG in building individual, institutional and regional capacity for HPSR&A in Enugu state, using the concept of Communities of Practice as an analytic lens. METHODOLOGY: This is a descriptive cross-sectional study that uses qualitative research methods to examine the contributions of HPRG’s activities in building individual, organizational and regional capacity for HPSR&A, and to explore the factors that have influenced these contributions. The study population consisted of researchers, lecturers, policymakers and practitioners who have been involved in HPSR&A projects undertaken for the past thirteen years in HPRG. Purposive sampling with sequential referral was done and only key informants who met the selection criteria were selected. Data was collected through in-depth key informant interviews and review of relevant project reports and documents, and analysed manually through thematic analysis. Rigour was ensured through reflexivity, audit trail and triangulation of data

Analysis of equity and social inclusiveness of national urban development policies and strategies through the lenses of health and nutrition

INTRODUCTION: Rapid urbanization increases competition for scarce urban resources and underlines the need for policies that promote equitable access to resources. This study examined equity and social inclusion of urban development policies in Nigeria through the lenses of access to health and food/nutrition resources. METHOD: Desk review of 22 policy documents, strategies, and plans within the ambit of urban development was done. Documents were sourced from organizational websites and offices. Data were extracted by six independent reviewers using a uniform template designed to capture considerations of access to healthcare and food/nutrition resources within urban development policies/plans/strategies in Nigeria. Emerging themes on equity and social inclusion in access to health and food/nutirition resources were identified and analysed. RESULTS: Access to health and food/nutrition resources were explicit in eight (8) and twelve (12) policies/plans, respectively. Themes that reflect potential policy contributions to social inclusion and equitable access to health resources were: Provision of functional and improved health infrastructure; Primary Health Care strengthening for quality health service delivery; Provision of safety nets and social health insurance; Community participation and integration; and Public education and enlightenment. With respect to nutrition resources, emergent themes were: Provision of accessible and affordable land to farmers; Upscaling local food production, diversification and processing; Provision of safety nets; Private-sector participation; and Special considerations for vulnerable groups. CONCLUSION: There is sub-optimal consideration of access to health and nutrition resources in urban development policies in Nigeria. Equity and social inclusivity in access to health and nutrition resources should be underscored in future policies

Addressing unmet need for contraceptives among adolescents using community-embedded intervention : highlights of stakeholder engagement meeting

This one-page report provides an overview of the workshop, which included representative stakeholders from all levels in adolescent and sexual health, including the Senior Special Adviser (SSA) to the State Governor on health, the State Coordinator of Sustainable Development Goals (SDG) and the Commissioner for Health. In advance of the research, the meeting generated discussion on adolescent sexual health, and with the help of participants to determine the particular communities to be targeted for the study, as well as implementation sites

A narrative review of evidence to support increased domestic resource mobilization for family planning in Nigeria

Abstract Background Family planning (FP) is an important public health intervention that is proven to reduce unplanned pregnancies, unsafe abortions, and maternal mortality. Increasing investments in FP would ensure stability and better maternal health outcomes in Nigeria. However, evidence is needed to make a case for more domestic investment in family planning in Nigeria. We undertook a literature review to highlight the unmet needs for family planning and the situation of its funding landscape in Nigeria. A total of 30 documents were reviewed, including research papers, reports of national surveys, programme reports, and academic/research blogs. The search for documents was performed on Google Scholar and organizational websites using predetermined keywords. Data were objectively extracted using a uniform template. Descriptive analysis was performed for quantitative data, and qualitative data were summarized using narratives. Frequencies, proportions, line graphs and illustrative chart were used to present the quantitative data. Although total fertility rate declined over time from 6.0 children per woman in 1990 to 5.3 in 2018, the gap between wanted fertility and actual fertility increased from 0.2 in 1990 to 0.5 in 2018. This is because wanted fertility rate decreased from 5.8 children per woman in 1990 to 4.8 per woman in 2018. Similarly, modern contraceptive prevalence rate (mCPR) decreased by 0.6% from 2013 to 2018, and unmet need for family planning increased by 2.5% in the same period. Funding for family planning services in Nigeria comes from both external and internal sources in the form of cash or commodities. The nature of external assistance for family planning services depends on the preferences of funders, although there are some similarities across funders. Irrespective of the type of funder and the length of funding, donations/funds are renewed on annual basis. Procurement of commodities receives most attention for funding whereas, commodities distribution which is critical for service delivery receives poor attention. Conclusion Nigeria has made slow progress in achieving its family planning targets. The heavy reliance on external donors makes funding for family planning services to be unpredictable and imbalanced. Hence, the need for more domestic resource mobilization through government funding

Effects of an intervention to improve sexual and reproductive health on level and predictors of awareness and knowledge of condoms and dual protection amongst adolescents in Nigeria

Abstract Background Adolescents need both information about sexual behaviours and potential risks in order to make the right choices. This study compared adolescents’ level of awareness and predictors of knowledge of condoms and dual protection where a multi-component sexual and reproductive health (SRH) intervention was implemented and in communities where the intervention was not implemented, so as to understand the effect of the intervention on awareness and knowledge and also identify predictors of knowledge of contraception methods. Methods The study was an intervention study that was undertaken in six local government areas (three rural and three urban LGAs) in Ebonyi state, southeast Nigeria. Data were collected from 855 adolescent boys and girls, using a pre-tested interviewer administered questionnaire. Systematic random sampling technique was used to select eligible households from which adolescents were interviewed Analysis of data was carried out using bivariate and multivariate linear regression analyses. The level of statistical significance was determined by a p value of < 0.05. Results The level of awareness of condoms and dual protection was similar in the intervention and non-intervention communities. However, the predictors of knowledge about condoms and dual protection were different between the intervention and non-intervention groups. The multivariate linear regression showed that the higher the level of education, the higher the level of awareness of contraception methods among adolescents (p < 0.05). Likewise, increasing age by one year and working for pay increased the awareness of condoms and dual protection(p < 0.05). Conclusion There was no difference in the level of awareness of pregnancy prevention methods, knowledge of condoms and dual protection in both arms of the study. Higher level of education, increasing age, and working for pay are factors associated with awareness of condom and dual protection. These factors should be prioritized for effective Adolescent sexual and reproductive health (ASRH) programming