What makes advocacy work? Stakeholders’ voices and insights from prioritisation of maternal and child health programme in Nigeria

Background The Nigerian government introduced and implemented a health programme to improve maternal and child health (MCH) called Subsidy Reinvestment and Empowerment programme for MCH (SURE-P/MCH). It ran from 2012 and ended abruptly in 2015 and was followed by increased advocacy for sustaining the MCH (antenatal, delivery, postnatal and immunization) services as a policy priority. Advocacy is important in allowing social voice, facilitating prioritization, and bringing different forces/actors together. Therefore, the study set out to understand how advocacy works - through understanding what effective advocacy implementation processes comprise and what mechanisms are triggered by which contexts to produce the intended outcomes. Methods The study used a Realist Evaluation design through a mixed quantitative and qualitative methods case study approach. The programme theory (PT) was developed from three substantive social theories (power politics, media influence communication theory, and the three-streams theory of agenda-setting), data and programme design documentation, and subsequently tested. We report information from 22 key informant interviews including national and State policy and law makers, policy implementers, CSOs, Development partners, NGOs, health professional groups, and media practitioners and review of relevant documents on advocacy events post-SURE-P. Results Key advocacy organizations and individuals including health professional groups, the media, civil society organizations, powerful individuals, and policymakers were involved in advocacy activities. The nature of their engagement included organizing workshops, symposiums, town hall meetings, individual meetings, press conferences, demonstrations, and engagements with media. Effective advocacy mechanism involved alliance brokering to increase influence, the media supporting and engaging in advocacy, and the use of champions, influencers, and spouses (Leadership and Elite Gendered Power Dynamics). The key contextual influences which determined the effectiveness of advocacy measures for MCH included the political cycle, availability of evidence on the issue, networking with powerful and interested champions, and alliance building in advocacy. All these enhanced the entrenchment of MCH on the political and financial agenda at the State and Federal levels. Conclusions Our result suggest that advocacy can be a useful tool to bring together different forces by allowing expression of voices and ensuring accountability of different actors including policymakers. In the context of poor health outcomes, interest from policymakers and politicians in MCH, combined with advocacy from key policy actors armed with evidence, can improve prioritization and sustained implementation of MCH services

Evaluation of risk caused by intake of trace metal through consumption of Pleurotus tuber-regium collected around automobile village in Abia State

ABSTRACT. The bioaccumulation of trace metals in mushrooms poses a health risk to consumers. Despite the fact that mushroom eating has been linked to numerous health advantages, little attention has been paid to the relative health risks associated with trace metal build-up in this nutritional source in Nigeria. Pb, Cd, Fe, Hg and As in Pleurotus tuber-regium collected from mechanic workshops in Umuahia were analysed and the associated health risks for the consumers were evaluated. The trace metal contents in the mushroom and its substrates showed a descending order of Fe > Pb > Cd > As > Hg. The heavy metals concentration ranges in fruity body of the Pleurotus tuber-regium were Fe (62.16-98.17 mg kg-1), Pb (0.18-1.21 mg kg-1), Cd (0.05-0.34 mg kg-1), As (0.25-0.51 mg kg-1) and Hg (0.009-0.021 mg kg-1). The estimation of weekly intake values was lower than PTWIs of mushroom species except for Fe. According to the THQ and the HI calculations for trace metal contents in the mushrooms, mercury did not pose any risk on human health; whereas the other determined trace metals gave THQ values of 1 < THQ < 10 and showed the possibility of long-term risk.                     KEY WORDS: Trace metals. Mushroom, Estimated weekly intake, Target hazard quotient, Bioaccumulation   Bull. Chem. Soc. Ethiop. 2021, 35(2), 229-241. DOI: https://dx.doi.org/10.4314/bcse.v35i2.

Antibacterial activity, phytochemical properties and mineral Content of “Aju Mbaise”decoction: A liquid extract administered to nursing mothers

Background: “Aju Mbaise” is a combination of plant leaves decocted and administered to women after childbirth. The bioactive compounds are not known and claims associated with the use have not been scientifically substantiated.Objective: The study was conducted to evaluate the antibacterial activity, phytochemical properties and mineral composition of “Aju Mbaise” decoction.Methods: Leaves making up Äju Mbaise” were obtained from the Botanical Garden, Department of Forestry and Wildlife Technology, Federal University of Technology, Owerri, Imo State, Nigeria. Their antibacterial activity was determined using the disc-diffusion method with Salmonella typhi, Staphylococcus aureus and Escherichia coli as test isolates. The Minimum Inhibitory Concentration and Minimum  Bactericidal Concentration were determined to establish its antimicrobial potentials. The mineral content was determined using atomic absorption spectrophotometer while phytochemical analysis was conducted using standard analytical methods.Results: The decoction inhibited the growth of Gram negative bacteria used in the study with maximum inhibition observed against E. coli (9.5mm). The Gram positive bacterium, S. aureus was resistant to thedecoction. The decoction contained appreciable amounts of bioactive compounds: alkaloids (5.46%), tannins (2.59%), flavonoids (0.39%), cyanogenic glycoside (0.07%), and saponins (7.50%) as well as  potassium (125.63 mg/100ml), calcium (11.48 mg/100ml), magnesium (8.81 mg/100ml), sodium (3.50 mg/100ml), iron (1.15 mg/100ml), zinc (1.13 mg/100ml), phosphorus (0.90 mg/100ml), copper (0.06 mg/100ml), manganese (0.06 mg/100ml) and chromium (0.05 mg/ml).Conclusion: The decoction contains bioactive compounds believed to be responsible for the observed antibacterial activities. Intake of adequate amounts of the decoction can make some contributions to the macro- and micro-mineral intake of lactating mothers, thus achieving the Recommended Nutrient Intake (RNI) for these minerals. This provides the basis for their folkloric use by nursing mothers.