Scaling up Access to Misoprostol at the Community Level to Improve Maternal Health Outcomes in Ethiopia, Ghana, and Nigeria

Over the past decade (2004–2014), the Population and Reproductive Health area of the MacArthur Foundation has focused on supporting projects aimed at reducing maternal mortality. In particular, it has supported efforts to use misoprostol to prevent postpartum hemorrhage, the anti-shock garment to aid in the treatment of hemorrhage, and magnesium sulfate to decrease deaths from eclampsia. In recent years, the Foundation has invested in a range of research and evaluation efforts to better understand these interventions, their effectiveness, and the extent to which successful pilot projects have been scaled up.In 2014, the Foundation commissioned the Public Health Institute to evaluate the grants it had made to increase community-based access to misoprostol for postpartum hemorrhage prevention in Ethiopia, Ghana, and Nigeria. Specifically, the Foundation was interested in documenting the models and approaches used and the progress toward scaling up the respective models in the three countries. Between June and November 2014, the evaluation team reviewed grantee reports, proposals, and the literature; interviewed key informants and global, national, and local stakeholders; conducted focus group discussions with local stakeholders; and made observations during site-visits in each country. From this the team produced case study reports relating to misoprostol use in each country. This report is a synthesis of those three case studies, highlighting the common findings across the projects, identifying differences, and interpreting the lessons learned for broader use and scale up of misoprostol at the community level in Africa and globally

The State of Education in Nigeria

Over the years, Nigeria has expressed a commitment to education, in the belief that overcoming illiteracy and ignorance will form a basis for accelerated national development. The paper describes the state of education in Nigeria and posits that aside from lack of access, infrastructures, teaching and learning materials, the greatest challenge facing education is inadequate funding by federal, states and local governments, to the extent that funding has been in response to the conditionality imposed by international financial institutions.NESG Economic Indicators Vol. 12 (3) 2006: pp. 9-1

NESG BOOK REVIEW: A Review of Niger Delta Human Development Report

In this thought-provoking review of the 2006 UNDP Niger Delta Human Development Report, the author examines the multidimensional nature of the problems of the Niger Delta and its effect on income, education, life expectancy of the host communities, and environmental sustainability, which has undermined the enormous possibilities for development. Consequently, the writer believes that development agencies can lend their assistance through the creation of an enabling environment in the region for the emergence of a coalition of change agents that will place people at the centre of development.NESG Economic Indicators Vol. 12 (4) 2006: pp. 56-6

Democratisation, Political Inclusion, and Systemic Justice: The Effects of Youth Movements on Social and Political Change in Nigeria

This study examines the effects of youth movements on social and political change in Nigeria, using the student movement in the 1980s/90s, the #NotTooYoungToRun movement (2016–date), and the #EndSARS movement (2017–2020) as case studies. Eight activists actively involved in these movements were interviewed, and the interview findings were complemented with data from various secondary sources, including the academic literature, social media posts, civil society publications, and media reports. Using a social constructionist lens and leveraging the theories of framing and political opportunity structure, the study found that, despite wider structural issues, youth movements have driven change in relation to democratisation, political inclusion, and systemic justice. In the process of driving these changes, youth consciousness has also increased. The study highlights the collective power of Nigerian youth and emphasises the need for sustained efforts to drive more substantive changes in the country. On a broader level, the study also shows how young people organise to effect change, fighting against state violations and pushing for the realisation of their human rights. These insights are valuable for activists, researchers, policymakers, and all those interested in advancing human rights

PHAGE AMPLIFICATION TECHNOLOGY AND ANTI-TUBERCULOUS DRUG SUSCEPTIBILITY TESTING IN NIGERIA

The emergence of multi-drug resistant tuberculosis (MDR-TB) defined as combined resistance to the two most effective anti-tuberculosis drugs, rifampicin and isoniazid, threatens to create a public health hazard of unprecedented proportion. The fact that MDR-TR is more difficult and expensive to cure creates the need for prompt diagnosis. Conventionally, the proportion method on Lowenstein Jensen (L J) medium is used in most developing countries as the ‘gold standard' in the drug susceptibility testing of Mycobacterium tuberculosis (MTB) and it takes 3-4 weeks to give results from an MTB culture. The use of phage as a diagnostic is fast gaining ground today. It involves targeting viable MTB cells from culture with a specific mycobacteriophage. After a one-hour incubation, it is treated with an antivirus to destroy the phages that are not protected with the bacilli. Upon addition of cells of growing, non-pathogenic Mycobacterium smegmatis (sensor cells), progeny phage from the MTB cells infect the sensor cells, thus amplifying the effect of the phage. When plated in an agar medium overnight, plaques occur in the cell lawn indicating the presence of viable MTB in an original sample. A comparison is made between the number of plaques produced in a drug-free control and a sample incubated in the presence of the drug. While the presence of plaques beyond a cut-of point indicates drug resistance, the absence of plaques indicates that the drug destroyed MTB cells. Overall accuracy from several trials so far conducted is put at 97-98% compared with the ‘gold standard'. With the phage amplification method, antituberculosis drug susceptibility results are obtained from MTB culture within 48 hours as opposed to the L J proportion method, which gives resulted in 3 to 4 weeks. Also, phage, as a diagnostic, is much more applicable in Nigeria laboratories than newer, rapid methods which requires specially dedicated instrumentation and are therefore very expensive. Phage amplification technology requires no special equipment and the results can be read visually. Key words: Tuberculosis, drug susceptibility, phage, treatment, FASTPlaque-TB, rifampicin (Af J Clinical & Exp Microbiology: 2003 4(2): 67-78

HIV/AIDS in Nigeria: Rethinking Women's Vulnerabilities beyond the Biomedical Paradigm

HIV/AIDS has emerged as a major bane of sustainable development in Africa. In addition to hindering further development, it is indeed turning back the hands of the clock. HIV/AIDS is, for Africa, much more than another medical problem as it creates hunger, illiteracy, and poverty and constitutes a security risk. These factors in turn augur well for further spread of HIV/AIDS and other diseases. Nigeria, the most populous country in Africa, bears 10% of the African burden of 28 million out of about 37 million people living with HIV/AIDS worldwide. A growing concern is the disproportionate increase in the number of women living with HIV/AIDS in Africa. This paper critically examines factors that promote the vulnerability of women to HIV infection under the patriarchal system in Africa, with a focus on Nigeria. Key WordS:Human rights, HIV/AIDS, patriarchy. [Nig. Jnl Health & Biomedical Sciences Vol.2(1) 2003: 1-6

Saving the lives of women, newborns, and children: a formative study examining opportunities to improve reproductive, maternal, neonatal, and child health outcomes in Nigeria

Despite economic growth in Nigeria, maternal and infant mortality rates remain among the highest in the world. Civil society organisations (CSOs) play a critical role in ensuring governmental accountability to fulfil commitments that improve health outcomes for women, newborns, and children. This formative study was undertaken to identify: a) policy advocacy priorities b) advocacy challenges, and, c) opportunities for strategic advocacy. Methods consisted of a desk review of key reproductive, maternal, neonatal, child and adolescent health (RMNCAH) policies, surveys with CSOs working on RMNCAH, and key informants from non-governmental organisations (NGOs), and United Nations agencies. Participants identified the need for improved funding for RMNCAH policy implementation, increased civil society input in policy creation, and greater accountability. Increased investment in advocacy capacity building and accountability play an important role in improving health outcomes in Nigeria.Keywords: Maternal health, Reproductive health, Infant mortality, Advocacy, Accountability, Civil Societ