Towards improving community pharmacy-based mental health services in Nigeria

In Nigeria, there is a prevalence of aversive life circumstances that frequently assail the mental health and well-being of the citizens, mitigating the impact of which necessitates the institution of psychotherapy and other mental health care methods. These responsibilities, however, appear to be much more for pharmacists in low-resource settings where they are the most accessible healthcare professional. Some of these responsibilities include patient confidentiality as well as counseling patients on medication use, lifestyle as well as other personal matters that may arise in relation to their health. Mental health services including psychotherapy provide a range of therapeutic techniques that enable the patients (individual or groups) to develop effective coping strategies towards emotional and psychological difficulties, via methodic interactions with a mental health expert. In this commentary, we share suggestions on how to improve community pharmacy-based mental health services in Nigeria. With the expanding roles and responsibility for pharmacists beyond medication-related concerns comes the challenge of matching up the training of pharmacists with the broadening scope of practice in Nigeria. However, as pertinent as that might be, there are existing knowledge and competency gaps in keeping up with this trend. To correct these shortfalls, we contend that the training curricula for pharmacists in Nigeria be reviewed and/or expanded to provide adequate knowledge for pharmacy undergraduates and pharmacists about non-drug mental health care which will also impact psychotherapy services during their practice especially in the community settings

The use of antibiotics in COVID-19 management: a rapid review of national treatment guidelines in 10 African countries

Antimicrobial resistance is a hidden threat lurking behind the COVID-19 pandemic which has claimed thousands of lives prior to the emergence of the global outbreak. With a pandemic on the scale of COVID-19, antimicrobial resistance has the potential to become a double-edged sword with the overuse of antibiotics having the potential of taking us back to the pre-antibiotic era. Antimicrobial resistance is majorly attributed to widespread and unnecessary use of antibiotics, among other causes, which has facilitated the emergence and spread of resistant pathogens. Our study aimed to conduct a rapid review of national treatment guidelines for COVID-19 in 10 African countries (Ghana, Kenya, Uganda, Nigeria, South Africa, Zimbabwe, Botswana, Liberia, Ethiopia, and Rwanda) and examined its implication for antimicrobial resistance response on the continent. Our findings revealed that various antibiotics, such as azithromycin, doxycycline, clarithromycin, ceftriaxone, erythromycin, amoxicillin, amoxicillin-clavulanic acid, ampicillin, gentamicin, benzylpenicillin, piperacillin/tazobactam, ciprofloxacin, ceftazidime, cefepime, vancomycin, meropenem, and cefuroxime among others, were recommended for use in the management of COVID-19. This is worrisome in that COVID-19 is a viral disease and only a few COVID-19 patients would have bacterial co-infection. Our study highlighted the need to emphasize prudent and judicious use of antibiotics in the management of COVID-19 in Africa

Burundi’s ‘Worst Enemy’: the Country’s Fight Against COVID-19

Coronavirus disease 2019 (COVID-19) has proved to be a severe global public health threat, causing high infection rates and mortality worldwide. Burundi was not spared the adverse health outcomes of COVID-19. Although Burundi’s initial response to the COVID-19 pandemic was criticized, hope arose in June 2020 when the new government instituted a plan to slow virus transmission that included public health campaigns, international travel restrictions, and mass testing, all of which proved effective. Burundi has faced many challenges in containing the virus, the first of which was the lack of initial preparedness and appropriate response to COVID-19. This was exacerbated by factors including shortages of personal protective equipment (PPE), limited numbers of life-saving ventilators (around 12 ventilators as of April 2020), and the presence of only one COVID-19 testing center with less than ten technicians in July 2020. Moreover, as Burundi is amongst the poorest countries in the world, some citizens were unable to access necessities such as water and soap, required for compliance with government recommendations regarding hygiene. Interestingly, Burundi did not implement a nationwide lockdown, allowing mass gatherings and public services to continue as usual due to a firm belief in God’s protection. As the daily confirmed cases have tripled since December 2020, Burundi must prepare itself for the threat of a new wave. Establishing precautionary measures to contain the virus and strengthening the health surveillance system in Burundi would significantly positively impact the prevention and management of COVID-19

Factors Associated with Maternal Near-Miss (MNM) Among Women in Eastern Province, Rwanda

<p>The World Health Organization (WHO) defines Maternal Near-Miss (MNM) as a situation where a woman nearly dies but survives a life-threatening condition during pregnancy and childbirth. Maternal mortality rate, used to gauge obstetric care quality globally, can aid in achieving the SDG target 3.1, which aims to lower the global maternal mortality ratio below 70 per 100,000 live births. A retrospective cross-sectional design was employed to assess the prevalence and factors associated with MNM at Kirehe District Hospital in Rwanda. 350 women admitted to the hospital's maternity units from January to December 2020 were sampled. Data from patients' medical records was extracted, focusing on demographics, MNM characteristics based on WHO criteria, and clinical outcomes. Statistical analysis was performed with SPSS version 21. Women aged 20-29 constituted the majority, primarily with primary education and working in agriculture. From the 350, 6.3% encountered severe postpartum haemorrhage, 3.1% severe preeclampsia, and 2% uterine rupture. 53.7% underwent cesarean section, 38.9% had vaginal deliveries, and 4.9% experienced abortion. The MNM prevalence for 2020 was 10.2%. Age and marital status correlated with MNM; younger, married, or widowed women exhibited higher MNM rates. Among maternal factors, only labor duration significantly related to MNM. The MNM rate at Kirehe District Hospital remains a concern. Cesarean section was predominant. Age and marital status played pivotal roles in MNM occurrences. Access to enhanced maternal healthcare and improved labor monitoring can mitigate severe complications.</p&gt

Achieving COVID‐19 herd immunity in Rwanda, Africa

Abstract The COVID‐19 pandemic has caused significant disruption to global healthcare systems, including Rwanda's. Rwanda has taken measured actions in response to the pandemic using a multisectoral and one‐government approach. The introduction of the COVID‐19 vaccine boosted the hope of many people but has left debates on the measure of the population required to attain herd immunity. Herd immunity threshold (HIT) was introduced to track progress toward containing COVID‐19. HIT represents the number of people with long‐term immunity from COVID‐19. World Health Organization (WHO) established population vaccination targets for all countries worldwide, which included 40% coverage of the entire population by the end of 2021 and 70% by June 2022. In this paper, we discussed the efforts and progress that have been made so far toward achieving herd immunity in Rwanda

Malaria rapid diagnostic tests in community pharmacies in Rwanda: availability, knowledge of community pharmacists, advantages, and disadvantages of licensing their use

Abstract Background Presumptive treatment of malaria is often practiced in community pharmacies across sub-Saharan Africa (SSA).To address this issue, the World Health Organization (WHO) recommends that malaria Rapid Diagnostic Tests (m-RDTs) be used in these settings, as they are used in the public sector. However, their use remains unlicensed in the community pharmacies in Rwanda. This can lessen their availability and foster presumptive treatment. Therefore, this study investigated the availability of m-RDTs, knowledge of community pharmacists on the use of m-RDTs, and explored Pharmacists’ perceptions of the advantages and disadvantages of licensing the use of m-RDTs in community pharmacies. Methods This was a cross-sectional study among 200 licensed community pharmacists who were purposefully sampled nationwide from 11th February to 12th April 2022. Data was collected using an online data collection instrument composed of open-ended and closed-ended questions. Statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) version 25.0. The chi-square test was used to evaluate the association between the availability of m-RDTs and independent variables of interest. Content analysis was used for qualitative data. Results Although 59% were consulted by clients requesting to purchase m-RDTs, only 27% of the participants had m-RDTs in stock, 66.5% had no training on the use of m-RDTs, and 18.5% were not at all familiar with using the m-RDTs. Most of the participants (91.5%) agreed that licensing the use of m-RDTs in community pharmacies could promote the rational use of antimalarials. The chi-square test indicated that being requested to sell m-RDTs (x2 = 6.95, p = 0.008), being requested to perform m-RDTs (x2 = 5.39, p  = 0.02),familiarity using m-RDTs (x2 = 17.24, p = 0.002), availability of a nurse in the Pharmacy (x2 = 11.68, p < 0.001), and location of the pharmacy (x2 = 9.13, p = 0.048) were all significantly associated with the availability of m-RDTs in the pharmacy. Conclusions The availability of m-RDTs remains low in community pharmacies in Rwanda, and less training is provided to community pharmacists regarding the use of m-RDTs. Nevertheless, community pharmacists had positive perceptions of the advantages of licensing the use of m-RDTs. Thus, licensing the use of m-RDTs is believed to be the first step toward promoting the rational use of antimalarial medicines in Rwanda

Priorities and barriers for ageing well:results from stakeholder workshops in rural and urban Rwanda

Background: The National Older Person's Policy of 2021 in Rwanda highlights the need for social protection of older populations. However, there is a lack of local knowledge regarding the priorities and challenges to healthy aging faced by older people and their caregivers. Objectives: This study aimed to identify and compare the needs and priorities of older people and other stakeholders involved in caring for them in rural and urban areas of Rwanda. Methods: The study was conducted in two locations, Kigali (urban) and Burera district (rural). Each site hosted two separate one-day workshops with older people (60 years) and stakeholders (all ages). Discussions were held in plenary and roundtable-groups to generate a list of the top 4 prioritized responses on areas of importance, priorities/enablers to be addressed, and obstacles to living a healthy and active life for older people. The research team identified similarities between stakeholder and older people's responses in each area and a socio-ecological model was used to categorize findings.Results: There were substantial differences in responses between rural and urban areas and between older people and stakeholders. For each question posed, in each rural or urban area, there was only agreement between stakeholders and older people for a maximum of one response. Whereas, when comparing responses from the same participant groups in urban or rural settings, there was a maximum agreement of two responses, with two questions having no agreement in responses at all. Responses across all discussion-areas were mostly categorized within the Societal level, with Individual, Relationship, and Environment featuring less frequently.Conclusion: This study highlights the need for contextually curated interventions to address the concerns of older adults and their caregivers in rural and urban settings. An inclusive and multidimensional approach is needed to conquer the barriers that impede healthy aging, with input from various stakeholders.<br/

Priorities and barriers for ageing well:results from stakeholder workshops in rural and urban Rwanda

Background: The National Older Person's Policy of 2021 in Rwanda highlights the need for social protection of older populations. However, there is a lack of local knowledge regarding the priorities and challenges to healthy aging faced by older people and their caregivers. Objectives: This study aimed to identify and compare the needs and priorities of older people and other stakeholders involved in caring for them in rural and urban areas of Rwanda. Methods: The study was conducted in two locations, Kigali (urban) and Burera district (rural). Each site hosted two separate one-day workshops with older people (60 years) and stakeholders (all ages). Discussions were held in plenary and roundtable-groups to generate a list of the top 4 prioritized responses on areas of importance, priorities/enablers to be addressed, and obstacles to living a healthy and active life for older people. The research team identified similarities between stakeholder and older people's responses in each area and a socio-ecological model was used to categorize findings.Results: There were substantial differences in responses between rural and urban areas and between older people and stakeholders. For each question posed, in each rural or urban area, there was only agreement between stakeholders and older people for a maximum of one response. Whereas, when comparing responses from the same participant groups in urban or rural settings, there was a maximum agreement of two responses, with two questions having no agreement in responses at all. Responses across all discussion-areas were mostly categorized within the Societal level, with Individual, Relationship, and Environment featuring less frequently.Conclusion: This study highlights the need for contextually curated interventions to address the concerns of older adults and their caregivers in rural and urban settings. An inclusive and multidimensional approach is needed to conquer the barriers that impede healthy aging, with input from various stakeholders.<br/

Harnessing the potential of African youth for transforming health research in Africa

Africa faces a significant burden of infectious diseases, including Malaria and HIV/AIDS, along with an increasing prevalence of non-infectious diseases such as diabetes and cancer. This dual health challenge is amplified by socioeconomic difficulties, restricted access to healthcare, and lifestyle changes, thus present unique scientific needs. Effectively addressing these issues requires a skilled scientific workforce adept in comprehensive healthcare strategies. This analysis explores the critical landscape of health research in Africa, emphasizing the unique opportunity presented by the continent’s youthful population, projected to reach almost 1 billion by 2050. The youth’s innovative potential and fresh perspectives offer a chance to overcome development barriers in health research. Nevertheless, challenges such as under-resourced education, limited research training, inadequate mentorship, and funding difficulties persist. This paper urgently calls upon African leaders, international partners, and stakeholders to prioritize health research, mobilize funding, forge strategic partnerships, and empower the youth as essential steps to capitalize on the continent’s dynamic youth for breakthrough health outcomes. Such investments are vital not just for health but for the overall economic, social, and strategic growth of the continent. Through shared responsibility and a united effort, the potential of African youth can be harnessed, leading to transformative research, improved health outcomes, and a prosperous future. This perspective represents the collective voice of passionate young researchers and advocates across Africa, calling for a new era of health research on the continent