Implementation of Family Life and HIV/AIDS Education in Nigerian Schools: A Qualitative Study on Scope, Delivery and Challenges

This study utilized data from Focus Group Discussions and In-depth Interviews among secondary school students and teachers to examine the scope, delivery and challenges of FLHE implementation within states and across geopolitical zones in Nigeria. Structural Functionalism, Rational Choice and Differential Association theories were adopted as theoretical framework. Results show that several patterns in classroom teaching of FLHE are identifiable across the country. The study found that FLHE is taught at the Junior Secondary and Senior Secondary levels with variations among States on the beginning levels. The main mode of FLHE delivery is classroom instruction; other modes include assembly talk and sensitization by organizations. Despite paucity of Information, Education and Communication materials and inadequate personnel requirement, different stakeholders noted that FLHE has been beneficial to students. Therefore, effective implementation of FLHE will go a long way to ensuring that young people in Nigeria are equipped with necessary information to enable them exhibit the right attitude and behaviour towards sexuality issues. Keywords: FLHE implementation, reproductive health, young people, youth corpers, sexual attitude.RésuméCette étude a utilisé des données provenant des groupes de discussion à cible et des entrevues en profondeur entre élèves et enseignants des écoles secondaires afin d'examiner la portée, l’actualisation et la mise en oeuvre de défis de la VFES au sein des Etats et entre les zones géopolitiques au Nigeria. Le fonctionnalisme structural, le choix rationnel et les théories l’association différentielle ont été adoptés comme cadre théorique. Les résultats montrent que plusieurs tendances dans l'enseignement en classe de la VFES sont identifiables à travers le pays. L'étude a révélé que la VFES est enseigné dans les deux cycles de l’école avec des variations entre les États à l’égard du niveau de commencement. Le principal mode de la réalisation de la VFES est l'enseignement en classe; d'autres modes comprennent des discours pendant la réunion matinale et la sensibilisation par les organisations. Malgré la rareté de l'information, l’éducation et les matériels de communication et les besoins insuffisants en personnel, les différents intervenants ont noté que la VFES a été bénéfique pour les élèves. Par conséquent, la mise en oeuvre effective de la VFES aidera beaucoup à assurer que les jeunes gens au Nigeria sont équipées d’informations nécessaires pour leur permettre de démontrer une bonne attitude et un bon comportement à l'égard des questions de sexualité. Mots-clés: la mise en oeuvre FLHE, santé de la reproduction, les jeunes, jeunesse, attitude sexuell

Work-family conflict: Evaluating the mediating role of personal intervening strategies

Balancing family and work roles places serious demands on working women most especially in African context where women also doubled as home keepers, and this represents a key factor in achieving sustainable productivity (SDG 8.2.3). The study was to expound work-family conflict experiences by married female workers in financial instit utions, and to determine whether personal interventions play a beneficial role to improve productivity. The study adopted social survey with the use of self-administered questionnaire among 730 randomly selected married women bank employees. The study shows that 78.8% of female bankers experience work-family conflict due to strain to keep the jobs and meet up with expected family roles. In the absence of effective workplace relief, several women resort to personal coping strategies this is statistically insignificant and having a negative relationship depicting it is ineffective. The study concludes that the individual or personal intervention-based approach at minimizing work-family conflict could not be adjudged as effective. Therefore, a systematic and robust organization-based approach may be necessary as panacea for work-family conflict within the sector considered and the country as a whole

A population-based cross-sectional study of age-specific risk factors for high risk human papillomavirus prevalence in rural Nigeria

<p>Abstract</p> <p>Background</p> <p>Cervical cancer, caused by persistent infection with carcinogenic human papillomavirus (HR-HPV), is particularly prevalent in Sub-Saharan Africa and is associated with a high mortality rate. Some studies in West Africa, including our own, have found unusually high HR-HPV across all ages with a slight peak in older women. This increased prevalence at older ages may complicate screen-and-treat programs, which are implemented in regions where HPV prevalence declines with age and typically target women between 30-49 years. A better understanding of the determinants of high HR-HPV prevalence at older ages is needed. The goal of this study is to explore risk factors for HR-HPV prevalence by age among women in our population-based study in Irun, a rural town in southwestern Nigeria.</p> <p>Methods</p> <p>1,420 women were administered a clinic-based questionnaire regarding sexual and reproductive behavior, marital status (including co-wives), and malaria exposure. Logistic regression compared questionnaire responses and PCR positivity for a set of 13 carcinogenic HR-HPV types. Results were stratified by age (15-29, 30-45, 46-55, and 56+ years).</p> <p>Results</p> <p>Birth control use and age at first pregnancy were associated with HR-HPV (<it>p-value </it>= 0.03 and 0.05, respectively). Early age at sexual debut and multiple sex partners were risks for HR-HPV, but did not reach significance (<it>p-value </it>= 0.1 and 0.07, respectively). Neither self-reported malaria nor presence of co-wives in the household was associated with HR-HPV (<it>p-value </it>= 0.85 and 0.24, respectively). In age sub-categories, early age at sexual debut was a significant risk factor for HR-HPV among women 35-45 years (<it>p-value = 0.02</it>). Early age at first pregnancy remained a significant risk factor for women aged 56+ years (<it>p-value </it>= 0.04). Greater than 2 sex partners and use of birth control were associated (though not significantly) with HR-HPV in women aged 30-45 (<it>p-value </it>= 0.08, respectively).</p> <p>Conclusions</p> <p>In this high-risk region with elevated HR-HPV prevalence at older ages, we confirmed previously described, behavioral determinants of HR-HPV. There was no association with self-reported malaria or co-wives, which we had hypothesized might correlate with HR-HPV at older ages.</p

Gender-related power differences, beliefs and reactions towards people living with HIV/AIDS: an urban study in Nigeria

<p>Abstract</p> <p>Background</p> <p>Although there are an increasing number of studies on HIV-related stigma in Nigeria, very little research has focused on how power differences based on gender perpetuate the stigmatization of people living with HIV/AIDS (PLWHA) and how these gender differences affect the care that PLWHA receive in health care institutions. We explore gender-related beliefs and reactions of society, including health care professionals (HCPs), with regard to PLWHA, using Connell's theoretical framework of gender and power (1987). With Connell's structural theory of gender and power (financial inequality, authority and structure of social norms), we can describe gender differences in stigmatization of PLWHA.</p> <p>Method</p> <p>We conducted in-depth semi-structured interviews, lasting 60 to 90 minutes, with 100 persons (40 members of the general public, 40 HCPs and 20 PLWHA) in Port Harcourt, Nigeria. The interviews were tape-recorded and transcribed verbatim. The Nvivo 7 computer package was used to analyze the data.</p> <p>Results</p> <p>There are similarities and differences between the general public and HCPs towards PLWHA in gender-related beliefs and reactions. For instance, although association with promiscuity and power differences were commonly acknowledged in the different groups, there are differences in how these reactions are shown; such as HCPs asking the female PLWHA to inform their partners to ensure payment of hospital bills. Women with HIV/AIDS in particular are therefore in a disadvantaged position with regard to the care they receive.</p> <p>Conclusion</p> <p>Despite the fact that men and women with HIV/AIDS suffer the same illness, clear disparities are apparent in the negative reaction women and men living with HIV/AIDS experience in society. We show that women's generally low status in society contributes to the extreme negative reactions to which female PLWHA are subject. The government should create policies aimed at reducing the power differences in family, society and health care systems, which would be important to decrease the gender-related differences in stigma experienced by PLWHA. Interventions should be directed at the prevailing societal norms through appropriate legislation and advocacy at grassroots level with the support of men to counter laws that put women in a disadvantaged position. Furthermore, development of a policy that encourages equality in access to health care for all patients with HIV/AIDS by applying the same conditions to both men and women in health care institutions is recommended. There is a need to protect women's rights through implementing support policies, including paying attention to gender in the training of HCPs.</p

Epidemic History and Evolutionary Dynamics of Hepatitis B Virus Infection in Two Remote Communities in Rural Nigeria

BACKGROUND: In Nigeria, hepatitis B virus (HBV) infection has reached hyperendemic levels and its nature and origin have been described as a puzzle. In this study, we investigated the molecular epidemiology and epidemic history of HBV infection in two semi-isolated rural communities in North/Central Nigeria. It was expected that only a few, if any, HBV strains could have been introduced and effectively transmitted among these residents, reflecting limited contacts of these communities with the general population in the country. METHODS AND FINDINGS: Despite remoteness and isolation, approximately 11% of the entire population in these communities was HBV-DNA seropositive. Analyses of the S-gene sequences obtained from 55 HBV-seropositive individuals showed the circulation of 37 distinct HBV variants. These HBV isolates belong predominantly to genotype E (HBV/E) (n=53, 96.4%), with only 2 classified as sub-genotype A3 (HBV/A3). Phylogenetic analysis showed extensive intermixing between HBV/E variants identified in these communities and different countries in Africa. Quasispecies analysis of 22 HBV/E strains using end-point limiting-dilution real-time PCR, sequencing and median joining networks showed extensive intra-host heterogeneity and inter-host variant sharing. To investigate events that resulted in such remarkable HBV/E diversity, HBV full-size genome sequences were obtained from 47 HBV/E infected persons and P gene was subjected to Bayesian coalescent analysis. The time to the most recent common ancestor (tMRCA) for these HBV/E variants was estimated to be year 1952 (95% highest posterior density (95% HPD): 1927-1970). Using additional HBV/E sequences from other African countries, the tMRCA was estimated to be year 1948 (95% HPD: 1924-1966), indicating that HBV/E in these remote communities has a similar time of origin with multiple HBV/E variants broadly circulating in West/Central Africa. Phylogenetic analysis and statistical neutrality tests suggested rapid HBV/E population expansion. Additionally, skyline plot analysis showed an increase in the size of the HBV/E-infected population over the last approximately 30-40 years. CONCLUSIONS: Our data suggest a massive introduction and relatively recent HBV/E expansion in the human population in Africa. Collectively, these data show a significant shift in the HBV/E epidemic dynamics in Africa over the last century

Like Mother(-in-Law) Like Daughter? Influence of the Older Generation’s Fertility Behaviours on Women’s Desired Family Size in Bihar, India

This paper investigates the associations between preferred family size of women in rural Bihar, India and the fertility behaviours of their mother and mother-in-law. Scheduled interviews of 440 pairs of married women aged 16–34 years and their mothers-in-law were conducted in 2011. Preferred family size is first measured by Coombs scale, allowing us to capture latent desired number of children and then categorized into three categories (low, medium and high). Women’s preferred family size is estimated using ordered logistic regression. We find that the family size preferences are not associated with mother’s fertility but with mother’s education. Mother-in-law’s desired number of grandchildren is positively associated with women’s preferred family size. However, when the woman has higher education than her mother-in-law, her preferred family size gets smaller, suggesting that education provides women with greater autonomy in their decision-making on childbearing

Assessment of Opportunities and Expert Counselling Intervention for Persons With Female Genital Cutting in Oyo State, Nigeria

Study Objective: Female genital cutting (FGC) has been identified as one of the most common harmful traditional practices that affect femalesrsquo psychological well-being in Nigeria. The aim of this study was to establish the existence of psychological complications due to FGC and the provision of opportunities and expert counselling especially for those at the adolescent stage. Design: The Input-Process-Outcome evaluation model and the survey research design were adopted. Purposive and simple random sampling techniques were used to select participants for the study. Two qualitative (FGC In-depth Interview and FGC Focus Group Discussion Guides) and one quantitative instrument (Female Genital Cutting Update Training Rating Scale [FGC-UDTRS]) were developed by the researchers while a second quantitative instrument (FGC Opportunities and Expert Counselling Rating Scale [FGC-OECRS]) was adapted for collection of data from relevant respondents. Setting: Healthcare providers were engaged in one-on-one discussions on the existence of psychological complications due to FGC, especially among females with FGC in their adolescence years while females with FGC participated in focus group discussion sessions to express their views on FGC and psychological experiences associated with the practice. Relevant quantitative instruments were administered to both groups of participants to establish the outcome of update training on opportunities and expert counselling assessed by HCPs for the provision of psychosocial support services. Participants: Healthcare providers and females with FGC from five (5) primary healthcare centres/maternal health centres participated in the study. These were selected from the two Local Governments Areas (LGAs) of intervention in Oyo State i.e. Ibadan North East and Lagelu LGAs. Interventions: Intervention activities included update training on opportunities and expert counselling for HCPs and the establishment of Maternal Health Counselling Centres (MHCCs) to facilitate psychosocial support services for females with FGC. Main Outcome Measure(s): Narrative analysis was used to analyse qualitative instruments while quantitative instruments were analysed using Simple Linear Regression. Results and Conclusions: Evidence from the study shows a high level of psychological complications due to FGC these were very much associated with the practice by affected females. Effectiveness of update training for healthcare providers is evident in the high rate of psychosocial support assessed at the various maternal health centres. Hence, constant and relevant update training should be embarked on for healthcare providers, in order for appropriate psychosocial support services to be rendered to females with FGC