Assessing interprofessional and integrated care in providing sexual and reproductive health services to adolescents at primary healthcare level in Nigeria

Purpose: Sexual and reproductive health (SRH) interventions demand diverse services, encompassing medical, social and psychological care to ensure the overall wellbeing of service users. In the absence of multidisciplinary response to SRH interventions, service users could be deprived of crucial SRH services, which could undermine their safety and wellbeing. Based on this knowledge, our study was designed to map the interprofessional space in primary healthcare (PHC) facilities in Ebonyi State, Nigeria that deliver SRH services.Design/methodology/approach: Interviews with 20 health workers and group discussions with 72 young people aged 15–24 years provided the data for the study. We analyzed data deductively, focusing on the assessments of the presence or absence of specific professionals that are typically expected to provide different aspects of SRH services.Findings: We found conspicuous absence of laboratory diagnostic, social care, psycho-cognitive and some medical services expected of primary care. These absences necessitated unnecessary referrals, encouraged breaches in confidentiality, undermined social care and justice, increased cost of care and discouraged young clients from utilizing SRH services provided in PHCs. Our study, therefore, emphasizes the need for integrated care in the delivery of SRH services, which would involve relevant diverse professionals contributing their expertise toward comprehensive care for SRH service users.Originality/value: The study provides human resource insights toward strengthening primary healthcare in Nigeria vis-à-vis efficient delivery of SRH services to guarantee the health security of service users

Socio-demographic and economic determinants of awareness and use of contraceptives among adolescents in Ebonyi State, South-east, Nigeria

Understanding factors that explain levels of awareness and use of contraceptives among adolescents is a critical entry point for improving their sexual and reproductive health. This study assessed the demographic and socioeconomic determinants of awareness and use of contraceptives among adolescents in rural and urban communities in Ebonyi State, Nigeria. A cross-sectional household survey was conducted in three rural and urban communities in August, 2018. Modified cluster sampling technique was used to select eligible households. A total of 1045 adolescents (598 females and 447 males) were randomly selected from the households and interviewed using a pre-tested structured questionnaire. The mean age is 15.4years (15.3 – 15.5) and the median age is 15.5years. Univariate, bivariate and multivariate analysis were undertaken. Statistical significance was set at p-value of <0.05. Majority of respondents, 723 (68.9%), were aware of male condom. Place of residence predicts awareness of contraceptive pills (AOR 0.66, CI 0.48-0.91); schooling predicts awareness of male condoms (AOR 0.57; CI 0.32-0.99). Predictors of awareness of female condoms are place of residence (AOR 0.66, CI 0.47-0.93), gender (AOR 0.57, CI 0.32-0.99) and wealth index (AOR 1.16, CI 1.03-1.30). Demographic and socioeconomic characteristics of respondents did not predict contraceptive use in the last sex. Although awareness of contraceptives is high, utilization is low among sexually active adolescents. Hence, the need to promote access to and utilization of contraceptives through comprehensive contraceptive education to improve adolescents sexual and reproductive health

Examining corruption risks in the procurement and distribution of COVID-19 vaccines in select states in Nigeria

Background: Public health emergencies raise significant concerns about corruption and accountability; however, these concerns can manifest in different ways across diverse locations. For instance, more developed countries with a stronger rule of law may experience more corruption in vaccine procurement, whereas developing countries may experience more corruption at the point of distribution and delivery to end users. This research focuses on corruption concerns in Nigeria, specifically examining the procurement and distribution of COVID-19 vaccines. Methods: This paper utilizes a scoping review and a qualitative research approach. Key informants (n = 40) involved in the procurement and distribution of COVID-19 vaccines across two states in Nigeria were interviewed. Findings from the scoping review were summarized, and collected data were inductively coded and analysed in themes, revealing clear examples of implementation irregularities and corruption in the country’s COVID-19 vaccination processes. Results: Vaccination programme budgeting processes were unclear, and payment irregularities were frequently observed, resulting in vaccinators soliciting informal payments while in the field. Recruitment and engagement of vaccination personnel was opaque, while target vaccination rates incentivized data falsification during periods of vaccine hesitancy. Accountability mechanisms, such as health worker supervision, vaccination data review, and additional technical support provided by donors were implemented but not effective at preventing corruption among frontline workers. Conclusions: Future accountability measures should be evidence-driven based on findings from this research. Personnel recruitment, contracting, budgeting, and remuneration should focus on transparency and accountability.</p

Examining corruption risks in the procurement and distribution of COVID-19 vaccines in select states in Nigeria

Background: Public health emergencies raise significant concerns about corruption and accountability; however, these concerns can manifest in different ways across diverse locations. For instance, more developed countries with a stronger rule of law may experience more corruption in vaccine procurement, whereas developing countries may experience more corruption at the point of distribution and delivery to end users. This research focuses on corruption concerns in Nigeria, specifically examining the procurement and distribution of COVID-19 vaccines. Methods: This paper utilizes a scoping review and a qualitative research approach. Key informants (n = 40) involved in the procurement and distribution of COVID-19 vaccines across two states in Nigeria were interviewed. Findings from the scoping review were summarized, and collected data were inductively coded and analysed in themes, revealing clear examples of implementation irregularities and corruption in the country’s COVID-19 vaccination processes. Results: Vaccination programme budgeting processes were unclear, and payment irregularities were frequently observed, resulting in vaccinators soliciting informal payments while in the field. Recruitment and engagement of vaccination personnel was opaque, while target vaccination rates incentivized data falsification during periods of vaccine hesitancy. Accountability mechanisms, such as health worker supervision, vaccination data review, and additional technical support provided by donors were implemented but not effective at preventing corruption among frontline workers. Conclusions: Future accountability measures should be evidence-driven based on findings from this research. Personnel recruitment, contracting, budgeting, and remuneration should focus on transparency and accountability.</p

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

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

Assessment of Teachers’ Level of Information and Communication Technology Skills and their Attitude to Virtual Teaching: Implication for Library and Information Science Teaching

To ensure effective teaching and learning of Library and information science in schools, adequate information, and communication technology skills of teachers are sacrosanct. Thus, this study assessed the level of information and communication technology abilities among secondary school teachers, as well as their attitudes about virtual teaching. In addition, the investigation was intended to see if there is a link between respondents\u27 attitudes about virtual teaching and their ability to use virtual technologies and whether there is a location gap between the study variables. The study\u27s participants are all secondary school teachers in Nigeria\u27s Anambra state public schools. Multi-stage sampling yielded a sample of 489 teachers. The study employed a descriptive and correlational survey research approach. Descriptive statistics, the t-test, and the Pearson Product Moment Correlation Coefficient were used to examine the data. According to the findings of this study, secondary school teachers in Anambra state have a low level of ICT abilities. Teachers\u27 ICT abilities and attitudes toward virtual teaching are influenced by their location. Teachers\u27 ICT abilities have a strong and favourable association with their attitude toward virtual instruction. These findings implicate the teaching of Library and Information Science in the sense that effective teaching of information science can be achieved when teachers demonstrate good abilities and positive attitudes to virtual teaching

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