Teacher characteristics and effective teaching among secondary school teachers in calabar education zone, cross river state nigeria

The study examined the influence of teacher characteristics (teacher qualification and year of teaching experience) on effective teaching among secondary school social studies teachers in Calabar education zone of Cross River State Nigeria. To achieve this objective, two hypotheses were formulated and tested. The survey research design was adopted for the study. The sample consist of One hundred and sixty-four (164) teachers in sixty (60) secondary schools in the zone. One structured questionnaire titled “Teacher Characteristics and Effective Teaching Questionnaire’’ (TCETQ) was developed by the researcher and validated by experts in Sociology of Education and in measurement/Evaluation, it had a reliability coefficient of .75 & .92 developed using split half reliability method. One-way analysis of variance (ANOVA) was the statistical tool used to test the hypotheses at 0.05 level of significance. The result of the analysis revealed that teachers’ qualification and year of experience significantly influence effective teaching. Based on the findings, it was recommended among others that teachers should be encouraged to frequently go for professional development long and short term courses in order to acquire knowledge that can facilitate delivery and those who have spent more years should see the need to give room for mentor-mentee relationship for the betterment of the system. &nbsp

Artemisinin-naphthoquine versus Artemether-lumefantrine for treating uncomplicated plasmodium falciparum malaria in children: A randomized controlled trial of efficacy and safety

Introduction: Artemether-lumefantrine (AL), the most frequently prescribed ACTs for uncomplicated P. falciparum malaria, requires multiple doses which may militate against adherence. It is necessary to evaluate the efficacy and safety of single dose ACT like Artemisininnaphthoquine (ANQ) to enhance adherence.Methods: This was an open label randomized controlled clinical trial. Eligible children were assigned to receive either a single dose of ANQ or six doses of AL following parental consent. A total of 108 children aged 5 – 14years with uncomplicated falciparum malaria were enrolled and assigned as follows: 58 (ANQ) and 50 (AL). Participants were observed for 28 days and clinical and parasitological assessments carried out. Outcomes were  assessed based on World Health Organization protocol.Results: A total of 97 patients completed the study. Overall 28-day cure  rate was 87.0% (47/54) and 81.4% (35/43) for ANQ and AL respectively. One patient (2.2%) in the AL group had Early Treatment Failure while seven (16.3%) had Late Parasitological Failure (LPF). LPF was also reportedin seven (13.0%) patients in the ANQ group. There was no Late Clinical Failure. A mild selflimiting papular rash was noted in one child in ANQ group. There was no serious adverse event.Conclusions: The therapeutic efficacies of ANQ and AL were comparable.A more robust, adequately powered, dose optimization study with  PCR-confirmed parasitological  outcome measures is needed.Key words: Malaria, artemetherlume f a nt r ine , a r t emi s i nin -naphthoquine, adherence, single and multiple dose therap

Effectiveness of a 6-dose regimen of Artemether-Lumefantrine for unsupervised treatment of uncomplicated childhood malaria in Calabar, Nigeria

Background: The six dose regimen of Artemether- Lumefantrine (AL), has high efficacy in clinical trials and is the first -line drug for treating uncomplicated malaria in Nigeria. The complex dosage schedule could militate against its effectiveness.Objective: To assess the effectiveness of AL prescribed under routineoutpatient conditions in the treatment of uncomplicated malaria.Methods: An open label, noncomparative trial to assess the effectivenessof AL in children 6 to 59 months with uncomplicated P. falciparum and parasite density between 1,000 and 250,000/ìL. Enrolled children received 6-dose course of AL (20/120mg tablets). The first dose was administered in the health facility and caregivers were instructed on how to administerthe remaining five doses at home.Results: Of the 1035 screened, 215 eligible children were enrolled and193 completed the study. Twenty two (22) patients withdrew from thestudy (18 were lost to follow-up, 3 violated protocol and 1 withdrewconsent). Adequate clinical and parasitological response (ACPR) was observed in 90.7%; late clinical failure in 7 (3.6%) and late parasitologicalfailure in 11 (5.7%).Conclusion: This study showed high efficacy of AL in treating uncomplicatedP. falciparum malaria in under-fives in Nigeria. Adherence by caregivers to the treatment regimen was quite good and so, should continue to be used in the home setting.Key words: Artemetherlumefantrine, effectiveness, adherence, uncomplicated malaria

Demographic and living conditions of tuberculosis patients receiving directly observed therapy short course(DOTS) in Calabar, Nigeria

Understanding the role of poverty in the continued epidemic of TB in developing countries will provide useful information for the improvement of TB control activities in these areas. A survey of the living conditions of 274 TB patients registered for DOTS at the National Tuberculosis Control Program Centre of the Lawrence Henshaw Memorial hospital Calabar and the Endemic Disease Clinic of the University of Calabar Teaching Hospital, Calabar was conducted to verify the view that poverty influences the incidence and outcome of TB. Using a structured pre-tested self- or interview- administered questionnaire, data were collected from a sample of 274 subjects: males (162/59%) and females (112/41%) within the economically viable age of 15-55 years. Results showed that the number of TB patients in the study decreased with increasing number of children of .3 in the households of subjects. The average income of the 244 (89%) income earners was N6,045.00 ($46.50) a month. Of this number, 170 (70$37.00) monthly. Thirty (11%) had no reliable means of income. Unemployed persons and students constituted the highest percentage of the subjects (18% and 17% respectively). A low socio-economic status and poor housing conditions typified by overcrowding and poor ventilation characterized the TB patients in this study. TB control programs anchored by government and non-governmental agencies need to address poverty reduction as part of their intervention strategies

Effects of engaging communities in decision-making and action through traditional and religious leaders on vaccination coverage in Cross River State, Nigeria: a cluster-randomised control trial

BACKGROUND: Vaccination coverage levels fall short of the Global Vaccine and Action Plan 90% target in low- and middle- income countries (LMICs). Having identified traditional and religious leaders (TRLs) as potential public health change agents, this study aimed at assessing the effect of training them to support routine immunisation for the purpose of improving uptake of childhood vaccines in Cross River State, Nigeria. METHODS: A cluster-randomised controlled study was conducted between 2016 and 2019. Of the 18 Local Government Areas (LGA) in Cross River State, eight (four urban and four rural LGAs) were randomized into the intervention and control study arms. A multi-component intervention involving the training of traditional and religious leaders was implemented in the four intervention LGAs. Baseline, midline and endline surveys collected information on children aged 0-23 months. The effect of the intervention on outcomes including the proportion fully up-to-date with vaccination, timely vaccination for pentavalent and measles vaccines, and pentavalent 1-3 dropout rates were estimated using logistic regression models using random effects to account for the clustered data. RESULTS: A total of 2598 children at baseline, 2570 at midline, and 2550 at endline were included. The intervention was effective in increasing the proportion with at least one vaccine (OR 12.13 95% CI 6.03-24.41p<0.001). However, there was no evidence of an impact on the proportion of children up-to-date with vaccination (p = 0.69). It was effective in improving timeliness of Pentavalent 3 (OR 1.55; 95% CI: 1.14, 2.12; p = 0.005) and Measles (OR 2.81; 96% CI: 1.93-4.1; p<0.001) vaccination. The odds of completing Pentavalent vaccination increased (OR = 1.66 95% CI: 1.08,2.55). CONCLUSION: Informal training to enhance the traditional and religious leaders' knowledge of vaccination and their leadership role can empower them to be good influencers for childhood vaccination. They constitute untapped resources in the community to boost routine immunisation. Pan African Clinical Trial Registry (PACTR) PACTR202008784222254

Cost-effectiveness analysis of an intervention project engaging traditional and religious leaders to improve uptake of childhood immunization in southern Nigeria

Vaccination is a cost-effective public health intervention, yet evidence abounds that vaccination uptake is still poor in many low- and middle-income countries. Traditional and Religious Leaders play a substantial role in improving the uptake of health services such as immunization. However, there is paucity of evidence on the cost-effectiveness of using such strategies. This study aimed to assess the cost-effectiveness of using a multi-faceted intervention that included traditional and religious leaders for community engagement to improve uptake of routine immunisation services in communities in Cross River State, Southern Nigeria. The target population for the intervention was traditional and religious leaders in randomly selected communities in Cross River State. The impact of the intervention on the uptake of routine vaccination among children 0 to 23 months was assessed using a cluster randomized trials. Outcome assessments were performed at the end of the project (36 months).The cost of the intervention was obtained from the accounting records for expenditures incurred in the course of implementing the intervention. Costs were assessed from the health provider perspective. The cost-effectiveness analysis showed that the incremental cost of the initial implementation of the intervention was US$19,357and that the incremental effect was 323 measles cases averted, resulting in an incremental cost-effectiveness ratio (ICER) of US$60/measles case averted. However, for subsequent scale-up of the interventions to new areas not requiring a repeat expenditure of some of the initial capital expenditure the ICER was estimated to be US$34 per measles case averted. Involving the traditional and religious leaders in vaccination is a cost-effective strategy for improving the uptake of childhood routine vaccinations

Knowledge of HIV/AIDS Among Secondary School Adolescents in Calabar -Nigeria

Background:Awareness about HIV/AIDS has been created through the media, workshops, and peer education and printed materials. The aim of this study was to establish the impact of these awareness programmes on student. Method:An observational study using structured questionnaire among secondary school students. Results:About 181 (31.2%) of the adolescents did not know the aetiological agents of HIV/AIDS. Majority, 522 (90%) knew HIV/AIDS was transmitted through sexual intercourse. This level of knowledge was related to sex and class of study. Only 78 (13.4%) of them knew that HIV carriers might look normal. Majority, 519 (89.5%) did not know the features of AIDS. Only a few, 281 (48.4%) of the adolescents knew that avoidance of sex, keeping one sexual partner, 15 (2.6%), use of condom 101 (17.4%) and screening blood before transfusion, 31 (5.3%) could prevent HIV/AIDS transmission. Mass media was the main source of information on HIV/AIDS to these adolescents. About 191, (32.9%) of them believed HIV/AIDS cannot be prevented; 228 (39.3%) felt HIV/AIDS is common among the uneducated; 127 (21.9%) thought it is not common in Nigeria and 143 (24.7%) believed it is not common among the youths. Conclusion:Although awareness on HIV/AIDS is high among Secondary School adolescents in Calabar, the knowledge of the disease is still poor. Mass media as a source of information does not allow in-depth knowledge of the disease. Parents, teachers, as well as Health workers should be more involved in educating the youth on this dreaded disease.Fond: la Conscience de VIH/SIDA a \ue9t\ue9 cr\ue9e par la presse, les ateliers, l'\ue9ducation de pair et les mat\ue9riels imprim\ue9s. Le but de cette \ue9tude \ue9tait d'\ue9tablir l'impact de ces programmes de conscience sur l'\ue9tudiant. M\ue9thode: une \ue9tude d'observation en utilisant le questionnaire structur\ue9 parmi les \ue9tudiants d'\ue9cole secondaire. R\ue9sultats: \ue1 peu pr\ue8s 181 (31,2 %) des adolescents n'ont pas connu les agents a\ue9tiologiques de VIH/SIDA. La majorit\ue9, 522 (90%) a connu que VIH/SIDA a \ue9t\ue9 transmis par les relations sexuelles. Ce niveau de connaissance a \ue9t\ue9 attribu\ue9 au sexe et \ue1 la classe d'\ue9tude. Seulement 78 (13,4 %) d'eux ont connu que les porteurs de VIH peuvent para\ueetre normaux. La majorit\ue9, 519 (89,5 %) n'ont pas connu les caract\ue9ristiques de SIDA. Seulement quelques-uns, 281 (48,4 %) des adolescents ont connu que l'abstinence, gardant un partenaire sexuel, 15 (2,6%), l'usage de pr\ue9servatif 101 (17,4 %) le criblage de sang avant la transfusion, 31 (5,3 %) pourrait emp\ueacher la transmission de VIH/SIDA. Les m\ue9dias \ue9taient la source principale d'information sur VIH/SIDA \ue1 ces adolescents. Environ 191, (32,9 %) d'eux ont cru que VIH/SIDA ne peut pas \ueatre prevenu; 228 (39,3 %) ont pens\ue9 que VIH/SIDA est commun parmi les incultes; 127 (21,9 %) ont pens\ue9 qu'il n'est pas commun au Nig\ue9ria et 143 (24,7 %) ont cru qu'il n'est pas commun parmi les jeunes. Conclusion: bien Que la conscience sur VIH/SIDA est haute parmi les adolescents d'\ue9cole secondaires \ue1 Calabar, la connaissance de la maladie est toujours inad\ue9quate. Les m\ue9dias comme une source d'information ne permet pas la connaissance approfondie de la maladie. Les parents, les enseignants, de m\ueame que les ouvriers de sant\ue9 devrait \ueatre plus impliqu\ue9s dans l'\ue9ducation des jeunes sur cette maladie redout\ue9e

Determinants of Long Immunization Clinic Wait Times in a Sub-Saharan African Country

The wait time clients spend during immunization clinic visits in low- and middle-income countries is a not well-understood reported barrier to vaccine completion. We used a prospective, observational design to document the total time from client arrival-to-discharge and all sequential provider-client activities in 1 urban, semi-urban, and rural immunization clinic in Nigeria. We also conducted caregiver and provider focus group discussions to identify perceived determinants of long clinic wait times. Our findings show that the time from arrival-to-discharge varied significantly by the clinic and ranged between 57 and 235 minutes, as did arrival-to-all providers-client activities. Focus group data attributed workflow delays to clinic staff waiting for a critical mass of clients to arrive for their immunization appointment before starting the essential health education talk or opening specific vaccine vials. Additionally, respondents indicated that complex documentation processes caused system delays. Research on clinic workflow transformation and simplification of immunization documentation is needed

Using and improving the PHISICC paper-based tools in the health facility laboratories: examples of Human Centered Design taking systems thinking into practice, in Côte d'Ivoire and Nigeria

BackgroundHealth workers in low- and middle-income countries are increasingly demanded to collect more and more data to report them to higher levels of the health information system (HIS), in detriment of useful data for clinical and public health decision-making, potentially compromising the quality of their health care provison. In order to support health workers' decision-making, we engaged with partners in Côte d'Ivoire, Mozambique and Nigeria in a research project to conceive, design, produce, implement and test paper-based health information tools: the PHISICC tools. Our aim was to understand the use of PHISICC tools by health workers and to improve them based on their feedback.MethodsThe design Health Facility Laboratories (HF Labs) in Côte d'Ivoire and in Nigeria were set up after months of use of PHISICC tools. Activities were structured in three phases or 'sprints' of co-creative research. We used a transdisciplinary approach, including anthropology and Human Centered Design (HCD), observations, shadowing, structured interviews and co-creation.ResultsHealth workers appreciated the standardization of the tools across different health care areas, with a common visual language that optimized use. Several design issues were raised, in terms of formats and contents. They strongly appreciated how the PHISICC registers guided their clinical decision-making and how it facilitated tallying and counting for monthly reporting. However, adherence to new procedures was not universal. The co-creation sessions resulted in modifications to the PHISICC tools of out-patient care and postnatal care.DiscussionAlthough health systems and systemic thinking allowed the teams to embrace complexity, it was the HCD approach that actually produced a shift in researchers' mind-set: from HIS as data management tools to HIS as quality of care instruments. HCD allowed navigating the complexity of health systems interventions due to its capacity to operate change: it not only allowed us to understand how the PHISICC tools were used but also how to further improve them. In the absence of (or even with) an analytical health systems framework, HCD approaches can work in real-life situations for the ideation, testing and implementation of interventions to improve health systems and health status outcomes

Does an innovative paper-based health information system (PHISICC) improve data quality and use in primary healthcare? Protocol of a multicountry, cluster randomised controlled trial in sub-Saharan African rural settings

INTRODUCTION: Front-line health workers in remote health facilities are the first contact of the formal health sector and are confronted with life-saving decisions. Health information systems (HIS) support the collection and use of health related data. However, HIS focus on reporting and are unfit to support decisions. Since data tools are paper-based in most primary healthcare settings, we have produced an innovative Paper-based Health Information System in Comprehensive Care (PHISICC) using a human-centred design approach. We are carrying out a cluster randomised controlled trial in three African countries to assess the effects of PHISICC compared with the current systems. METHODS AND ANALYSIS: Study areas are in rural zones of Côte d'Ivoire, Mozambique and Nigeria. Seventy health facilities in each country have been randomly allocated to using PHISICC tools or to continuing to use the regular HIS tools. We have randomly selected households in the catchment areas of each health facility to collect outcomes' data (household surveys have been carried out in two of the three countries and the end-line data collection is planned for mid-2021). Primary outcomes include data quality and use, coverage of health services and health workers satisfaction; secondary outcomes are additional data quality and use parameters, childhood mortality and additional health workers and clients experience with the system. Just prior to the implementation of the trial, we had to relocate the study site in Mozambique due to unforeseen logistical issues. The effects of the intervention will be estimated using regression models and accounting for clustering using random effects. ETHICS AND DISSEMINATION: Ethics committees in Côte d'Ivoire, Mozambique and Nigeria approved the trials. We plan to disseminate our findings, data and research materials among researchers and policy-makers. We aim at having our findings included in systematic reviews on health systems interventions and future guidance development on HIS. TRIAL REGISTRATION NUMBER: PACTR201904664660639; Pre-results