Research priority setting for health policy and health systems strengthening in Nigeria: The policymakers and stakeholders perspective and involvement

Introduction: Nigeria is one of the low and middle income countries (LMICs) facing severe resource constraint, making it impossible for  adequate resources to be allocated to the health sector. Priority setting becomes imperative because it guides investments in health care, health research and respects resource constraints. The objective of this study was to enhance the knowledge and understanding of policymakers on researchpriority setting and to conduct a research priority setting exercise. Methods: A one-day evidence-to-policy research priority setting meeting was held. The meeting participants included senior and middle level  policymakers and key decision makers/stakeholders in the health sector in Ebonyi State southeastern Nigeria. The priorities setting meeting involved a training session on priority setting process and conduction of priority setting exercise using the essential national health research (ENHR) approach. The focus was on the health systems building blocks (health workforce; health finance; leadership/governance; medical  products/technology; service delivery; and health information/evidence). Results: Of the total of 92 policymakers invited 90(97.8%) attended the meeting. It was the consensus of the policymakers that research should focus on the challenges of optimal access to health products and  technology; effective health service delivery and disease control under a  national emergency situation; the shortfalls in the supply of professional personnel; and the issues of governance in the health sector    management.Conclusion:Research priority setting exercise involving  policymakers is an example of demand driven strategy in the health  policymaking process capable of reversing inequities and strengthening the health systems in LMICs

Improving Nigerian health policymakers’ capacity to access and utilize policy relevant evidence: outcome of information and communication technology training workshop

Information and communication technology (ICT) tools are known to facilitate communication and processing of information and sharing of knowledge by electronic means. In Nigeria, the lack of adequate capacity on the use of ICT by health sector policymakers constitutes a major impediment to the uptake of research evidence into the policymaking process. The objective of this study was to improve the knowledge and capacity of policymakers to access and utilize policy relevant evidence. A modified "before and after" intervention study design was used in which outcomes were measured on the target participants both before the intervention is implemented and after. A 4-point likert scale according to the degree of adequacy; 1 = grossly inadequate, 4 = very adequate was employed. This study was conducted in Ebonyi State, south-eastern Nigeria and the participants were career health policy makers. A two-day intensive ICT training workshop was organized for policymakers who had 52 participants in attendance. Topics covered included: (i). intersectoral partnership/collaboration; (ii). Engaging ICT in evidence-informed policy making; use of ICT for evidence synthesis; (iv) capacity development on the use of computer, internet and other ICT. The pre-workshop mean of knowledge and capacity for use of ICT ranged from 2.19-3.05, while the post-workshop mean ranged from 2.67-3.67 on 4-point scale. The percentage increase in mean of knowledge and capacity at the end of the workshop ranged from 8.3%-39.1%. Findings of this study suggest that policymakers' ICT competence relevant to evidence-informed policymaking can be enhanced through training workshop

A Comparison of the Performance of the Midarm Circumference and the Nelson Weight Estimation Formulas in Nigerian Children

Background: In emergencies, two commonly used weight estimation methods are Nelson and mid‑arm circumference (MAC)‑based formulae. Nelson’s method requires the child’s age while the MAC formula offers weight estimation without any prior details of the child, which is useful in our environment due to the lack of proper vital statistics documentation. Methodology: We measured the weight, height, and MAC of 1390 children aged 1–12 years. Values got from the measurements were substituted in MAC and Nelson formulae for weight estimation. The estimated weights were compared to the actual weights of the children. Results: Atotal of 1390 children were enrolled. The mean of enrolled children’s actual weight was significantly higher than the mean weight estimated using MAC and Nelson formula. MAC method overestimated weight in children 1–7 years and underestimated weight in those 8–12 years old. On the other hand, the Nelson formula underestimated weights in children 2–11 years and overestimated weight in 1 and 12-year olds. Conclusions: Both the MAC and Nelson method have their deficiencies in weight estimation. Though the Nelson formula  appears slightly more accurate than the MAC, weight estimates from both methods were mostly within the actual weight agreement limits. Keywords: Actual weight, children, comparison, formulae, mid‑arm circumference, nelso

Management staff’s perspectives on intervention strategies for workplace violence prevention in a tertiary health facility in Nigeria: a qualitative study

IntroductionHealth workers have increasingly become victims of workplace violence. However, negligible action has been given to developing workplace violence (WPV) prevention programs in hospital settings in low-middle-income countries. An effective workplace violence prevention program is crucial for preventing violence and managing the consequences of incidents. This study assessed management staff perspectives on intervention strategies for workplace violence prevention in a tertiary health facility in Nigeria.MethodsA qualitative study design was employed to explore the intervention strategies for preventing and managing workplace violence at a tertiary health facility in southeast Nigeria. Six focus group discussions were conducted with thirty-eight management-level staff. The interview transcripts were manually coded according to six predefined constructs of workplace violence: creating interdisciplinary harmony and WPV experiences, causes, prevention, program/policy contents, and implementation strategies. A manual thematic analysis approach was adopted, and the results were presented as narratives.ResultsThe findings revealed recognition, welfare, administrative control, and security as vital strategies for the WPV prevention program. The participants agreed that unanimity among staff could be promoted through respect for all cadres of staff and for people’s perspectives (creating interdisciplinary harmony). Assaults and staff intimidation/victimization (experiences), attributed to unethical/poor health workers’ behaviour and ethnic discrimination (causes), were viewed as preventable by ensuring patients’/caregivers’ welfare through respectful and timely care and staff’s welfare through incentives/remunerations and discouraging intimidation (prevention strategies). Furthermore, the staff expressed that the WPV program should employ administrative controls, including instituting WPV policy/unit, codes of ethics, and standard operating procedures across all workplace facets (program/policy contents), which should be implemented through awareness creation, enforcement of sanctions, and provision of appropriate and adequate security presence in the hospital (policy implementation strategies).ConclusionRespect, patient/staff welfare, administrative control, and security are strong mechanisms to prevent workplace violence in tertiary hospitals. Hospital management should institutionalize workplace violence prevention programs/policies and ensure compliance

A year of genomic surveillance reveals how the SARS-CoV-2 pandemic unfolded in Africa.

The progression of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in Africa has so far been heterogeneous, and the full impact is not yet well understood. In this study, we describe the genomic epidemiology using a dataset of 8746 genomes from 33 African countries and two overseas territories. We show that the epidemics in most countries were initiated by importations predominantly from Europe, which diminished after the early introduction of international travel restrictions. As the pandemic progressed, ongoing transmission in many countries and increasing mobility led to the emergence and spread within the continent of many variants of concern and interest, such as B.1.351, B.1.525, A.23.1, and C.1.1. Although distorted by low sampling numbers and blind spots, the findings highlight that Africa must not be left behind in the global pandemic response, otherwise it could become a source for new variants

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Proverbs and worldviews: An analysis of Ikwo proverbs and their worldviews

This study explores Ikwo proverbs to examine traditional Ikwo worldview(s) that have so far been marginalized in academic research. Specifically, it aims to provide answers to the following research questions: 1. Which Ikwo worldview(s) are expressed in their proverbs? 2. Do such worldview(s) represent the interests of all social groups of the Ikwo society? 3. Why and how should Ikwo proverbs be taught in contemporary school curricula? The first chapter presents the motivational framework for the research. The second chapter reviews the literature, identifies the gap in knowledge and the research questions. Chapter three discusses the theoretical and methodological choices made for collecting and analysing data. Chapter four presents and analyses data for views expressed. Chapter five discusses the views identified in chapter four and the potential application of Ikwo proverbs in a programme of education likely to enhance their understanding and critical interrogation. The analysis has been guided by Winick’s model (2001) as well as the structuralist meaningby- opposition model of Lévi-Strauss (Duranti, 1997). The questionnaire analysis highlights that Ikwo proverbs reflected the views of the predominantly non-literate and rural dwelling male elders at the expense of those of other groups like women and youth. The interview analysis shows that many Ikwo proverbs disseminate views that tend to polarize the society while others tend to enhance consensus and community cohesion. The study identified the liminal space and the consensus-oriented proverbs that represent their views that have been marginalized in contemporary Igbo or other researches as its major contribution to knowledge. In addition to the major gaps in Ikwo research, there is currently no significant consideration of Ikwo proverbs in school or university curricula in Nigeria. This study argues, however, that such proverbs plus other proverbs that look at the full spectrum of Ikwo cultural heritage should be integrated in a programme of education likely to enhance the critical interrogation of key aspects of traditional knowledge and contribute to a reassessment of the importance of Ikwo language and culture, which might ultimately save it from extinction

Transmission Dynamics of Urogenital Schistosomiasis in the Rural Community of Ebonyi State, South Eastern Nigeria

This study accessed the dynamics of urogenital schistosomiasis transmission in Nkalagu Community. A total of 500 mid-day urine samples were collected and transported to Microbiology Laboratory, Ebonyi State University, for analysis. 10ml each of the urine samples was centrifuged at 2500 rpm for 5 minutes. Transmission potential of snail intermediate host of Schistosomes collected from different sampling station at the transmission sites within the study community was equally accessed. The snail species collected were placed individually into a clean beaker with little quantity of water and then subjected to shedding light for 2 hours. Data obtained were entered in excel spread sheet and analyzed using chi square test. The result obtained shows that 205 (41%) out of 500 individuals examined were excreting S. haematobium ova in their urine. The highest prevalence of infection (23%) was found among 11-20-year age groups. Males were more infected (25.4%) than their female counterparts (15.6%), although this was not statistically significant (p > 0.05). A total of 283 snails belonging to two Bulinus species (B. globosus and B. truncatus) were collected from the four sites sampled. Bulinus globosus recorded the highest species abundance (177) with the highest occurrence in site A. 52 (18.4%) out of 283 snails collected were infected with cercariae, and the highest cercariae infection (12.0%) was recorded among B. globosus. With prevalence of 41% among the human population and the prevalence of 18.4% patent infection among the snail intermediate hosts, urogenital schistosomiasis is still a public health problem in the study area and falls within the WHO classification of endemic area. Public health campaign is recommended in order to educate the people on the mode of transmission and control of the disease