Adolescents’ Sexual and Reproductive Healthcare‐Seeking Behaviour and Service Utilisation in Plateau State, Nigeria

The high rate of sexual and reproductive health (SRH) challenges among adolescents in Nigeria has been linked with the poor access to and utilisation of health facilities. This study explores the factors that influence the actual use and willingness to use SRH services among adolescents. Survey questionnaires were administered to 428 adolescents aged 18 to 19 years in six local government areas (LGAs) in Plateau State. The results showed that more than one‐third of the participating adolescents were currently sexually active, slightly more than three‐quarters (76.6%) had never visited health facilities for SRH issues, and more than half (56.0%) were not willing to visit a health facility if they ever had any SRH issues. The most frequent reason for the non‐use of health care facilities for SRH issues by adolescents was a perceived lack of privacy and confidentiality (66.1%), followed by the perceived negative attitude of health care providers (68.2%). However, being sexually active was the only independent covariate of seeking SRH care from health facility (AOR = 005; CI = 0.01–0.49; p = 0.011), while awareness of HIV was a significant covariate of willingness to seek SRH care in a health facility in the future (AOR = 3.17, 95% CI = 1.50–6.70; p = 0.002). We concluded that the utilisation of SRH services and willingness to do so in the future was fairly limited among adolescents in this study. Therefore, there is a need to address the challenges of privacy and confidentiality and commencement of the health promotion of SRH for adolescents ahead of sexual initiation to alleviate the SRH challenges adolescents encounter when sexually active

Healthcare workers’ delivery of adolescent responsive sexual and reproductive healthcare services: an assessment in Plateau state, Nigeria

Background: Adolescents should have access to high quality and responsive sexual and reproductive health, however, it is unclear to what extent the national policy on health and development of adolescent is implemented by health care workers in Plateau State. This study assessed the general availability of sexual and reproductive health services, the delivery of responsive adolescent sexual and reproductive health services and health care worker?s understanding of what constitutes adolescent responsive sexual and reproductive health services. Methods: Using a cross sectional design, we interviewed 409 health care workers selected through a multistage sampling technique, across six Local Government Areas of Plateau State, Nigeria using an interviewer-administered survey questionnaire. Results: The most available sexual and reproductive health services was antenatal and delivery care (69.2%), contraception 25.9% and 14.9% reported post abortion care. Only 1.2% indicated the availability of the four recommended essential sexual and reproductive health services (counselling/information provision, provision of contraceptives, testing/treatment for sexually transmitted infection (STI) /HIV and post abortion care) in their facilities. Little over half (58.4%) felt their facilities were adequate in meeting the sexual and reproductive health needs of adolescent and this was associated with delivery of post abortion care (AOR=3.612; CI=1.886-6.917; p =.001) and providing sexual and reproductive health services to adolescents without parental consent (AOR=3.612; CI=1.886-6.917; p =.001). Most health care workers had poor understanding of adolescent responsiveness of sexual and reproductive health services, understanding better among health workers who provided services without parental consent and in a separate room for privacy and confidentiality. Conclusion: We conclude that adolescent sexual and reproductive health services is not yet as stipulated in the national policy in Plateau State, Nigeria and in general, health workers have poor understanding of what it means to provide adolescent-responsive services

The impact of information sources on COVID-19 vaccine hesitancy and resistance in sub-Saharan Africa

Background Vaccination remains the most powerful weapon against the emergence of new variants of coronavirus (COVID-19). However, false information about COVID-19 vaccines through various platforms including social media remains a major threat to global public health. This study examined the impact of information sources on COVID-19 vaccine hesitancy and resistance in sub-Saharan Africa (SSA). Methods A validated web-based cross-sectional study was conducted from 14 March to 16 May 2021, and was administered in both French and English to 2572 participants aged 18 years and over. Data on sociodemographic characteristics, medical and vaccination history, and the information sources (mainstream media and social media) used by the participants during the pandemic were obtained. There were three main outcomes: The vaccinated group were those who responded in the affirmation (Yes) to the question of whether they have been vaccinated against COVID-19. Those who responded ‘not sure’ or ‘no’ to the question were then asked if they were willing to be vaccinated when the vaccine became available in their home countries. The responses to this follow-up question were used to derive the second and third outcome variables of ‘vaccine hesitancy’ and ‘vaccine resistance’, respectively. A series of logistic regression analyses were used to examine the impact of information sources on the three main outcomes. Results The prevalence of COVID-19 vaccine hesitancy among the participants was lowest among newspaper readers (42%) and highest among TV (72%) and social media users (73%). The prevalence of COVID-19 vaccine-resistance was also lowest among newspaper readers (37%) but highest among social media users (87%). Multivariate analyses revealed that compared to those who did not use these information sources, SSA participants who relied on the radio (aOR 0.83, 95%CI = 0.70, 0.99), TV (aOR 0.80, 95%CI = 0.65, 0.97) and social media (aOR 0.79, 95%CI = 0.65, 0.97) for information during the pandemic were less likely to be hesitant towards taking the vaccines. However, social media users (aOR 2.13, 95%CI = 1.62, 2.80), those who watched TV (aOR 1.40, 95%CI =1.08, 1.80), relied on healthcare workers (HCWs: aOR 1.32, 95%CI = 1.07, 1.63) and families/friends (aOR 1.31, 95%CI = 1.06, 1.61) for COVID-19 related information during the pandemic were more likely to resist taking the COVID vaccines in this study. Participants who relied on the newspaper for information during the pandemic were less likely to resist the vaccines (aOR 0.77, 95%CI = 0.62, 0.95) compared to non-readers of a newspaper. Conclusion We found that all six information sources except radio were strong predictors of the resistance towards COVID-19 vaccination. Further research on how these channels can be used to improve the availability of reliable healthcare information is needed. Investments in these resources will protect people and empower them to make appropriate choices about their health

Acceptance of COVID-19 vaccine among sub-Saharan Africans (SSA): a comparative study of residents and diasporan dwellers

Background: The COVID-19 vaccines are being rolled out across all the sub-Saharan Africa (SSA) countries, with countries setting targets for achieving full vaccination rates. The aim of this study was to compare the uptake of, resistance and hesitancy to the COVID-19 vaccine between SSA locally residents and in the diasporan dwellers. Methods: This was a cross-sectional study conducted using a web and paper-based questionnaire to obtain relevant information on COVID-19 vaccine acceptance. The survey items included questions on demography, uptake and planned acceptance or non-acceptance of the COVID-19 vaccines among SSAs. Multinomial logistic regression was used to determine probabilities of outcomes for factors associated with COVID-19 vaccination resistance and hesitancy among SSA respondents residing within and outside Africa. Results: Uptake of COVID-19 vaccines varied among the local (14.2%) and diasporan (25.3%) dwellers. There were more locals (68.1%) who were resistant to COVID-19 vaccine. Participants’ sex [adjusted relative risk (ARR) = 0.73, 95% CI: 0.58 – 0.93], education [primary/less: ARR = 0.22, CI:0.12 – 0.40, and bachelor’s degree: ARR = 0.58, CI: 0.43 – 0.77]), occupation [ARR = 0.32, CI: 0.25—0.40] and working status [ARR = 1.40, CI: 1.06—1.84] were associated with COVID-19 vaccine resistance among locals. Similar proportion of local and diasporan dwellers (~ 18% each) were hesitant to COVID-19 vaccine, and this was higher among health care workers [ARR = 0.25, CI: 0.10 – 0.62 and ARR = 0.24, CI:0.18—0.32, diaspora and locals respectively]. After adjusting for the potential confounders, local residents aged 29–38 years [ARR = 1.89, CI: 1.26—2.84] and lived in East Africa [ARR = 4.64, CI: 1.84—11.70] were more likely to report vaccine hesitancy. Knowledge of COVID vaccines was associated with hesitancy among local and diasporan dwellers, but perception was associated with vaccine resistance [ARR = 0.86,CI: 0.82 – 0.90] and hesitancy [ARR = 0.85, CI: 0.80 – 0.90], only among the local residents. Conclusions: Differences exist in the factors that influence COVID-19 vaccine acceptance between local SSA residents and thediasporan dwellers. Knowledge about COVID-19 vaccines affects the uptake, resistance, and hesitancy to the COVID-19 vaccine. Information campaigns focusing on the efficacy and safety of vaccines could lead to improved acceptance of COVID-19 vaccines

Adolescents’ Sexual and Reproductive Healthcare-Seeking Behaviour and Service Utilisation in Plateau State, Nigeria

The high rate of sexual and reproductive health (SRH) challenges among adolescents in Nigeria has been linked with the poor access to and utilisation of health facilities. This study explores the factors that influence the actual use and willingness to use SRH services among adolescents. Survey questionnaires were administered to 428 adolescents aged 18 to 19 years in six local government areas (LGAs) in Plateau State. The results showed that more than one-third of the participating adolescents were currently sexually active, slightly more than three-quarters (76.6%) had never visited health facilities for SRH issues, and more than half (56.0%) were not willing to visit a health facility if they ever had any SRH issues. The most frequent reason for the non-use of health care facilities for SRH issues by adolescents was a perceived lack of privacy and confidentiality (66.1%), followed by the perceived negative attitude of health care providers (68.2%). However, being sexually active was the only independent covariate of seeking SRH care from health facility (AOR = 005; CI = 0.01–0.49; p = 0.011), while awareness of HIV was a significant covariate of willingness to seek SRH care in a health facility in the future (AOR = 3.17, 95% CI = 1.50–6.70; p = 0.002). We concluded that the utilisation of SRH services and willingness to do so in the future was fairly limited among adolescents in this study. Therefore, there is a need to address the challenges of privacy and confidentiality and commencement of the health promotion of SRH for adolescents ahead of sexual initiation to alleviate the SRH challenges adolescents encounter when sexually active

Adolescent sexual and reproductive health care service availability and delivery in public health facilities of plateau state Nigeria

To assess the availability, accessibility, appropriateness and quality of adolescent sexual and reproductive health (ASRH) services in primary health care (PHC) facilities in Plateau State, Nigeria, a cross-sectional study was conducted in 230 PHC facilities across the three senatorial zones of Plateau state. Primary data were obtained through face-to-face interviews with heads of facilities from December 2018 to May 2019. An adapted questionnaire from the World Health Organization (WHO) was used, covering five domains, to ascertain the extent that ASRH services were available and provided. Very few PHC facilities in the state had space (1.3%) and equipment (12.2%) for ASRH services. The proportion of PHC facilities offering counselling on sexuality was 11.3%, counselling on safe sex was 17%, counselling on contraception was 11.3% and management of gender-based violence was 3%. Most facilities were not operating at convenient times for adolescents. Only 2.6% PHC facilities had posters targeted at ASRH and just 7% of the PHCs had staff trained on ASRH. These findings underscore that the majority of PHC facilities surveyed in Plateau State, Nigeria, lacked dedicated space, basic equipment, and essential sexual and reproductive health care services for ASRH, which in turn negatively affect general public health and specifically, maternal health indices in Nigeria. Structural changes, including implementation of policy and adequate additional training of healthcare workers, are necessary to effectively promote ASRH

Adolescents' Sexual and Reproductive Healthcare-Seeking Behaviour and Service Utilisation in Plateau State, Nigeria

The high rate of sexual and reproductive health (SRH) challenges among adolescents in Nigeria has been linked with the poor access to and utilisation of health facilities. This study explores the factors that influence the actual use and willingness to use SRH services among adolescents. Survey questionnaires were administered to 428 adolescents aged 18 to 19 years in six local government areas (LGAs) in Plateau State. The results showed that more than one-third of the participating adolescents were currently sexually active, slightly more than three-quarters (76.6%) had never visited health facilities for SRH issues, and more than half (56.0%) were not willing to visit a health facility if they ever had any SRH issues. The most frequent reason for the non-use of health care facilities for SRH issues by adolescents was a perceived lack of privacy and confidentiality (66.1%), followed by the perceived negative attitude of health care providers (68.2%). However, being sexually active was the only independent covariate of seeking SRH care from health facility (AOR = 005; CI = 0.01–0.49; p = 0.011), while awareness of HIV was a significant covariate of willingness to seek SRH care in a health facility in the future (AOR = 3.17, 95% CI = 1.50–6.70; p = 0.002). We concluded that the utilisation of SRH services and willingness to do so in the future was fairly limited among adolescents in this study. Therefore, there is a need to address the challenges of privacy and confidentiality and commencement of the health promotion of SRH for adolescents ahead of sexual initiation to alleviate the SRH challenges adolescents encounter when sexually active

Adolescents' Sexual and Reproductive Healthcare-Seeking Behaviour and Service Utilisation in Plateau State, Nigeria

The high rate of sexual and reproductive health (SRH) challenges among adolescents in Nigeria has been linked with the poor access to and utilisation of health facilities. This study explores the factors that influence the actual use and willingness to use SRH services among adolescents. Survey questionnaires were administered to 428 adolescents aged 18 to 19 years in six local government areas (LGAs) in Plateau State. The results showed that more than one-third of the participating adolescents were currently sexually active, slightly more than three-quarters (76.6%) had never visited health facilities for SRH issues, and more than half (56.0%) were not willing to visit a health facility if they ever had any SRH issues. The most frequent reason for the non-use of health care facilities for SRH issues by adolescents was a perceived lack of privacy and confidentiality (66.1%), followed by the perceived negative attitude of health care providers (68.2%). However, being sexually active was the only independent covariate of seeking SRH care from health facility (AOR = 005; CI = 0.01-0.49; p = 0.011), while awareness of HIV was a significant covariate of willingness to seek SRH care in a health facility in the future (AOR = 3.17, 95% CI = 1.50-6.70; p = 0.002). We concluded that the utilisation of SRH services and willingness to do so in the future was fairly limited among adolescents in this study. Therefore, there is a need to address the challenges of privacy and confidentiality and commencement of the health promotion of SRH for adolescents ahead of sexual initiation to alleviate the SRH challenges adolescents encounter when sexually active

Adolescent Sexual and Reproductive Health Care Service Availability and Delivery in Public Health Facilities of Plateau State Nigeria

To assess the availability, accessibility, appropriateness and quality of adolescent sexual and reproductive health (ASRH) services in primary health care (PHC) facilities in Plateau State, Nigeria, a cross-sectional study was conducted in 230 PHC facilities across the three senatorial zones of Plateau state. Primary data were obtained through face-to-face interviews with heads of facilities from December 2018 to May 2019. An adapted questionnaire from the World Health Organization (WHO) was used, covering five domains, to ascertain the extent that ASRH services were available and provided. Very few PHC facilities in the state had space (1.3%) and equipment (12.2%) for ASRH services. The proportion of PHC facilities offering counselling on sexuality was 11.3%, counselling on safe sex was 17%, counselling on contraception was 11.3% and management of gender-based violence was 3%. Most facilities were not operating at convenient times for adolescents. Only 2.6% PHC facilities had posters targeted at ASRH and just 7% of the PHCs had staff trained on ASRH. These findings underscore that the majority of PHC facilities surveyed in Plateau State, Nigeria, lacked dedicated space, basic equipment, and essential sexual and reproductive health care services for ASRH, which in turn negatively affect general public health and specifically, maternal health indices in Nigeria. Structural changes, including implementation of policy and adequate additional training of healthcare workers, are necessary to effectively promote ASRH