Landholders’ Involvement in the Compulsory Acquisition of Land and Compensation Process in Bauchi, Nigeria

This study aims to assess landholder’s involvement in the compulsory acquisition of land on their satisfaction with the compensation process in Bauchi, Nigeria, to identify areas of weakness in the process and propose areas of improvement. The study adopted the use of a quantitative approach and data were collected through a questionnaire survey from 327 landholders affected by the compulsory acquisition and compensation exercise by the Bauchi State Government. The data collected were subjected to descriptive with mean ranking, frequency distribution. The study revealed that before the process of compulsory acquisition landholders were very well involved, during the process of compulsory acquisition they were also involved but at the compensation process, they were not involved at all. It recommended that Landholders should be involved not only in the process of compulsory acquisition but they should be involved in the process of compensation as it will minimize resistance to compulsory

Public Infrastructure Provision in Bauchi Metropolis, Nigeria

This study aims to assess the Public infrastructure provision in Bauchi Metropolis, Nigeria, to propose areas of improvement. The study adopted the use of a quantitative approach and data were collected through a questionnaire survey from 382 house head holds proportionate selected from the target population in Bauchi metropolis. The data collected were subjected to descriptive with mean ranking, frequency distribution. The study revealed that communication facilities were the most provided facility provision, followed by market facilities and water facilities provision. Solid waste disposal facilities and fire protection services were the least facilities provided in the study area. It recommended that public infrastructural facilities provided in the area should be based on the resident’s preference and need

Landholders’ Awareness of Compulsory Acquisition of Land and Compensation Process in Bauchi, Nigeria

This study aims to assess landholder’s awareness of compulsory acquisition of land on their satisfaction with the compensation process in Bauchi, Nigeria, to identify areas of weakness in the process and propose areas of improvement. The study adopted the use of a quantitative approach and data were collected through a questionnaire survey from 327 landholders affected by the compulsory acquisition and compensation exercise by the Bauchi State Government. The data collected were subjected to descriptive with mean ranking, frequency distribution. The study revealed that the respondents are aware of the process before the compulsory acquisition and during the process of compulsory acquisition they were also aware of. This means that the respondents agreed that they were aware of the process/procedures involved in compulsory land acquisition, laws, and procedures guiding compulsory land acquisition and compensation process. It recommended that Landholders should be made more aware of the process involved in compulsory acquisition and compensation not only at inception but up to the end of the exercise

Landholders' Satisfaction with Compulsory Acquisition and Compensation Process in Bauchi, Nigeria

This research aims to assess Landholder's satisfaction with the compulsory acquisition and compensation process in Bauchi to identify areas of weakness in the process and propose areas of improvement. The study adopted the quantitative approach and data collected through questionnaire survey from 327 landholders affected by the compulsory acquisition and compensation exercise by the Bauchi State Government. The data collected were subjected to descriptive with mean ranking, frequency distribution. The study revealed that landholders were very satisfied before the process of compulsory acquisition, during the process of mandatory purchase, they were also happy. Still, during the compensation process, they were very dissatisfied. It recommended that the Government should make the process of compensation more transparent

Economic Impact of Galma Irrigation Scheme on the Farming Community in Dakaci, Zaria Area of Nigeria

Irrigation scheme is introduced for socioeconomic development of the community where it is based. One of such is the Galma Irrigation Fadama Project III around River Galma in Zaria Local Government Area of Kaduna State, Nigeria. The project provides water to surrounding communities for farming. This study was carried out with a view to determine the socioeconomic impact of the irrigation scheme on farming community in Dakaci, Zaria Area of Kaduna State. The study used data acquired from questionnaire survey, interviews and other secondary sources. Relevant data which include method of land acquisition, sources of capital, size of farmland, source of labor, major crops grown, average annual crop yield and average annual income were collected. The data were analyzed using simple descriptive statistics. The study revealed that the irrigation scheme to a large extent boosted crop yields and agricultural production in the area thereby improving the socioeconomic status of the farmers in the area. It is therefore recommended that more of such projects should be introduced to improve agricultural productivity. Moreover, there is the need for timely evaluation and assessment of such projects to maintain their proper functioning. In addition, government should refurbish the canals distributing the water to the farmlands, and also provide credit facilities to the farmers in order to improve their agricultural productivity which would help in ensuring food security for the nation at large

Economic Impact of Galma Irrigation Scheme on the Farming Community in Dakaci, Zaria Area of Nigeria

Irrigation scheme is introduced for socioeconomic development of the community where it is based. One of such is the Galma Irrigation Fadama Project III around River Galma in Zaria Local Government Area of Kaduna State, Nigeria. The project provides water to surrounding communities for farming. This study was carried out with a view to determine the socioeconomic impact of the irrigation scheme on farming community in Dakaci, Zaria Area of Kaduna State. The study used data acquired from questionnaire survey, interviews and other secondary sources. Relevant data which include method of land acquisition, sources of capital, size of farmland, source of labor, major crops grown, average annual crop yield and average annual income were collected. The data were analyzed using simple descriptive statistics. The study revealed that the irrigation scheme to a large extent boosted crop yields and agricultural production in the area thereby improving the socioeconomic status of the farmers in the area. It is therefore recommended that more of such projects should be introduced to improve agricultural productivity. Moreover, there is the need for timely evaluation and assessment of such projects to maintain their proper functioning. In addition, government should refurbish the canals distributing the water to the farmlands, and also provide credit facilities to the farmers in order to improve their agricultural productivity which would help in ensuring food security for the nation at large

Adverse event following vaccine surveillance in Kaduna State, Northwestern Nigeria (January 2018 - June 2019): analysis of health facility´s records

Introduction: Adverse Events Following Immunization (AEFI) are one of the main reasons for inadequate immunization coverage in Kaduna State, and AEFI underreporting serves as a barrier to achieving goals of global pharmaco-vigilance for vaccine. The purpose of this study is to estimate the completeness of variables in the AEFI line-listing forms, calculate AEFI reporting rates by local government Areas & vaccine type and profile the reported cases according to their reactions. Methods: we conducted a descriptive, cross-sectional, retrospective study of primary surveillance records. We calculated AEFI reporting rates in the State and local government areas and AEFI Vaccine reaction rates to the various antigens. We used Binary logistic regression to determine the association between gender and vaccine reactions. Results: seven thousand eight hundred and twenty-four (7,824) AEFI cases were reported. The completeness of variables on the filled AEFI line-list varied from 21% to 100%. The State had a high AEFI reporting rate of 9.09 per 10,000 administered doses. Fever (<38oC) was the main AEFI reaction. Severe AEFI cases accounted for only 0.89% of the total reported cases. Pentavalent vaccine was the suspect antigen responsible for the highest number of AEFI cases, with a vaccine reaction rate of 44.77 per 10,000 doses. The Zaria Local Government area had the highest AEFI reporting rate, while the Sanga Local Government area had the lowest AEFI reporting rate in the State. The difference between genders in the number of reported AEFI cases was not statistically significant (p>0.05). There were 35% higher odds of occurrence of bleeding among males than among females (aOR:1.354; P-value: p=.012; 95% CI: 1.070-1.715; Nagelkerke-R2-: 0.003). The other reactions were not significantly related to gender. Conclusion: our study shows a higher occurrence of severe AEFI in subjects undergoing pentavalent vaccine. Thiscaused the highest incidence of AEFI. There was no significant association between gender and AEFI reactions

Progression of the first stage of spontaneous labour: A prospective cohort study in two sub-Saharan African countries.

BACKGROUND: Escalation in the global rates of labour interventions, particularly cesarean section and oxytocin augmentation, has renewed interest in a better understanding of natural labour progression. Methodological advancements in statistical and computational techniques addressing the limitations of pioneer studies have led to novel findings and triggered a re-evaluation of current labour practices. As part of the World Health Organization's Better Outcomes in Labour Difficulty (BOLD) project, which aimed to develop a new labour monitoring-to-action tool, we examined the patterns of labour progression as depicted by cervical dilatation over time in a cohort of women in Nigeria and Uganda who gave birth vaginally following a spontaneous labour onset. METHODS AND FINDINGS: This was a prospective, multicentre, cohort study of 5,606 women with singleton, vertex, term gestation who presented at ≤ 6 cm of cervical dilatation following a spontaneous labour onset that resulted in a vaginal birth with no adverse birth outcomes in 13 hospitals across Nigeria and Uganda. We independently applied survival analysis and multistate Markov models to estimate the duration of labour centimetre by centimetre until 10 cm and the cumulative duration of labour from the cervical dilatation at admission through 10 cm. Multistate Markov and nonlinear mixed models were separately used to construct average labour curves. All analyses were conducted according to three parity groups: parity = 0 (n = 2,166), parity = 1 (n = 1,488), and parity = 2+ (n = 1,952). We performed sensitivity analyses to assess the impact of oxytocin augmentation on labour progression by re-examining the progression patterns after excluding women with augmented labours. Labour was augmented with oxytocin in 40% of nulliparous and 28% of multiparous women. The median time to advance by 1 cm exceeded 1 hour until 5 cm was reached in both nulliparous and multiparous women. Based on a 95th percentile threshold, nulliparous women may take up to 7 hours to progress from 4 to 5 cm and over 3 hours to progress from 5 to 6 cm. Median cumulative duration of labour indicates that nulliparous women admitted at 4 cm, 5 cm, and 6 cm reached 10 cm within an expected time frame if the dilatation rate was ≥ 1 cm/hour, but their corresponding 95th percentiles show that labour could last up to 14, 11, and 9 hours, respectively. Substantial differences exist between actual plots of labour progression of individual women and the 'average labour curves' derived from study population-level data. Exclusion of women with augmented labours from the study population resulted in slightly faster labour progression patterns. CONCLUSIONS: Cervical dilatation during labour in the slowest-yet-normal women can progress more slowly than the widely accepted benchmark of 1 cm/hour, irrespective of parity. Interventions to expedite labour to conform to a cervical dilatation threshold of 1 cm/hour may be inappropriate, especially when applied before 5 cm in nulliparous and multiparous women. Averaged labour curves may not truly reflect the variability associated with labour progression, and their use for decision-making in labour management should be de-emphasized

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Effects of antibiotic resistance, drug target attainment, bacterial pathogenicity and virulence, and antibiotic access and affordability on outcomes in neonatal sepsis: an international microbiology and drug evaluation prospective substudy (BARNARDS)

Background Sepsis is a major contributor to neonatal mortality, particularly in low-income and middle-income countries (LMICs). WHO advocates ampicillin–gentamicin as first-line therapy for the management of neonatal sepsis. In the BARNARDS observational cohort study of neonatal sepsis and antimicrobial resistance in LMICs, common sepsis pathogens were characterised via whole genome sequencing (WGS) and antimicrobial resistance profiles. In this substudy of BARNARDS, we aimed to assess the use and efficacy of empirical antibiotic therapies commonly used in LMICs for neonatal sepsis. Methods In BARNARDS, consenting mother–neonates aged 0–60 days dyads were enrolled on delivery or neonatal presentation with suspected sepsis at 12 BARNARDS clinical sites in Bangladesh, Ethiopia, India, Pakistan, Nigeria, Rwanda, and South Africa. Stillborn babies were excluded from the study. Blood samples were collected from neonates presenting with clinical signs of sepsis, and WGS and minimum inhibitory concentrations for antibiotic treatment were determined for bacterial isolates from culture-confirmed sepsis. Neonatal outcome data were collected following enrolment until 60 days of life. Antibiotic usage and neonatal outcome data were assessed. Survival analyses were adjusted to take into account potential clinical confounding variables related to the birth and pathogen. Additionally, resistance profiles, pharmacokinetic–pharmacodynamic probability of target attainment, and frequency of resistance (ie, resistance defined by in-vitro growth of isolates when challenged by antibiotics) were assessed. Questionnaires on health structures and antibiotic costs evaluated accessibility and affordability. Findings Between Nov 12, 2015, and Feb 1, 2018, 36 285 neonates were enrolled into the main BARNARDS study, of whom 9874 had clinically diagnosed sepsis and 5749 had available antibiotic data. The four most commonly prescribed antibiotic combinations given to 4451 neonates (77·42%) of 5749 were ampicillin–gentamicin, ceftazidime–amikacin, piperacillin–tazobactam–amikacin, and amoxicillin clavulanate–amikacin. This dataset assessed 476 prescriptions for 442 neonates treated with one of these antibiotic combinations with WGS data (all BARNARDS countries were represented in this subset except India). Multiple pathogens were isolated, totalling 457 isolates. Reported mortality was lower for neonates treated with ceftazidime–amikacin than for neonates treated with ampicillin–gentamicin (hazard ratio [adjusted for clinical variables considered potential confounders to outcomes] 0·32, 95% CI 0·14–0·72; p=0·0060). Of 390 Gram-negative isolates, 379 (97·2%) were resistant to ampicillin and 274 (70·3%) were resistant to gentamicin. Susceptibility of Gram-negative isolates to at least one antibiotic in a treatment combination was noted in 111 (28·5%) to ampicillin–gentamicin; 286 (73·3%) to amoxicillin clavulanate–amikacin; 301 (77·2%) to ceftazidime–amikacin; and 312 (80·0%) to piperacillin–tazobactam–amikacin. A probability of target attainment of 80% or more was noted in 26 neonates (33·7% [SD 0·59]) of 78 with ampicillin–gentamicin; 15 (68·0% [3·84]) of 27 with amoxicillin clavulanate–amikacin; 93 (92·7% [0·24]) of 109 with ceftazidime–amikacin; and 70 (85·3% [0·47]) of 76 with piperacillin–tazobactam–amikacin. However, antibiotic and country effects could not be distinguished. Frequency of resistance was recorded most frequently with fosfomycin (in 78 isolates [68·4%] of 114), followed by colistin (55 isolates [57·3%] of 96), and gentamicin (62 isolates [53·0%] of 117). Sites in six of the seven countries (excluding South Africa) stated that the cost of antibiotics would influence treatment of neonatal sepsis