Evaluating the effectiveness of online capacity building resources on capacity improvement of local Nigerian NGOs serving orphans and vulnerable children

STATEMENT OF THE PROBLEM: While non-governmental organizations (NGOs) play an important role in providing services, care and support to vulnerable populations, often small and medium sized NGOs in developing countries lack the capacity (i.e., systems and structures) to effectively carry out their functions. Many capacity-building interventions (e.g., staff training and technical assistance) are resource intensive, and not affordable to small and medium NGOs. The objective of this study is to assess the effectiveness of online capacity building resources, a non-conventional and less resource intensive capacity building method, in helping small and medium sized Nigerian NGOs build capacity. METHOD: We conducted a mixed-methods evaluation using a two-arm cluster randomized controlled trial with 72 NGOs across five states in Nigeria. All NGOs received a baseline organizational capacity assessment, using the Measuring Organizational Development and Effectiveness (MODE) tool. Organizational capacity was scored on a scale between 0 and 100, where the higher value indicates higher capacity. The treatment group received written recommendations and online resources on capacity building; the comparison group received only written recommendations. The outcome of interest was the change in the organizational capacity of the NGOs after six months measured using the MODE tool. Also, we conducted in-depth interviews of 25 NGO directors. RESULT: At baseline, young (age ≤ 10 years), and less resourced (annual budget <$25,000) NGOs had weaker organizational capacity. At endline, there was significant improvement in organizational capacity score for NGOs in both the experiment group (15.4 percentage points increase (p<0.0001)) and comparison group (19.1 percentage points increase (p<0.0001)). However, multilevel regression analysis showed no statistically significant difference in organizational capacity improvement between the two groups (p=0.09). Improvement in organizational capacity was inversely associated with baseline organizational capacity (p<0.0001). Qualitative data showed that peer networking, engagement of stakeholders in organizations’ capacity building decision making, and internal task sharing bolstered organizations’ ability to improve capacity. CONCLUSION: Capacity assessment and provision of written capacity building recommendations to NGOs (with or without online resources) helped small and mid-sized NGOs strengthen their organizational capacity within six months. The effectiveness of the intervention is greater among NGOs with weaker organizational capacity at baseline

Public reporting on pharmaceutical industry-led access programs: Alignment with the WHO medicine programs evaluation checklist

There has been increased demand for greater public accountability and transparency of private sector-led global health partnership programs. This study critically reviews and pilot tests the World Health Organization (WHO) medicine program checklist as a framework for public reporting and assessing of programs

Case based rubella surveillance in Abia State, South East Nigeria, 2007–2011

Introduction. Rubella infection has the potential of causing severe fetal birth defects collectively called congenital rubella syndrome (CRS) if the mother is infected early in pregnancy. However, little is known about rubella and CRS epidemiology in Nigeria and rubella vaccines are still not part of routine childhood immunization in Nigeria.Methods. Analysis of confirmed cases of rubella in Abia State, Nigeria from 2007 to 2011 detected through Abia State Integrated Disease Surveillance and Response system.Results. Of the 757 febrile rash cases, 81(10.7%) tested positive for rubella immunoglobulin M (IgM). New rubella infection decreased from 6.81/1,000,000 population in 2007 to 2.28/1,000,000 in 2009 and increased to 6.34/1,000,000 in 2011. The relative risk of rubella was 1.5 (CI [0.98–2.28]) times as high in females compared to males and 1.6 times (CI [0.90–2.91]) as high in rural areas compared to urban areas. Eighty six percent of rubella infections occurred in children less than 15 years with a high proportion of cases occurring between 5 and 14 years.Conclusion. Rubella infection in Abia State, Nigeria is predominantly in those who are younger than 15 years old. It is also more prevalent in females and in those living in rural areas of the state. Unfortunately, there is no surveillance of CRS in Nigeria and so the public health impact of rubella infection in the state is not known. Efforts should be made to expand the rubella surveillance in Nigeria to incorporate surveillance for CRS

The role of patient navigators in building a medical home for multiply diagnosed HIV-positive homeless populations

Context: People living with human immunodeficiency virus (HIV) (PLWH) who are most at risk for falling out of HIV primary care and detectable viral loads include homeless and unstably housed individuals and those codiagnosed with behavioral health disorders. The patient-centered medical home (PCMH) is a model that promotes provision of comprehensive, patientcentered, accessible, coordinated, and quality care for patients. This initiative provided patient navigation to HIV-positive homeless and unstably housed individuals codiagnosed with a mental health or substance use disorder as a means to create an adapted PCMH to meet the specific needs of this population. Objective: The purpose of this analysis was to characterize the roles and responsibilities of patient navigators as part of an effort to create a medical home for homeless and unstably housed PLWH with behavioral health comorbidities. Design: Eighty-one in-depth interviewswith clinic staff and 2 focus groups with patient navigatorswere conducted. Content analysis was performed to identify key roles and responsibilities of the patient navigators. Results: Patient navigators played an important role in creating a PCMH by working with clients to schedule and complete appointments, develop comprehensive care plans, forging critical relationships with providers both within and outside of health care systems, providing holistic support to increase patient self-management, and assisting in achieving housing stability. Conclusions: It may be necessary to adapt the traditional PCMH model to effectively meet the social, behavior health, and medical needs of homeless and unstably housed PLWH with behavioral health comorbidities. A patient navigator who can invest time in supporting and connecting these patients to needed services may be a key component in creating an effective PCMH for this population. These findings highlight the roles and tasks of patient navigators that may contribute to developing a PCMH specific to homeless and unstably housed PLWH with mental health and substance use comorbidities. Implementation of such a model has the potential to improve health outcomes (such as retention in care and viral suppression) for particularly vulnerable PLWH and thereby reduce the burden of HIV infection

The outcome of complementary and alternative medicine use among pregnant women in South-East Nigeria: a multi-centre prospective study

There is a global increasing trend of complementary and alternative medicine (CAM) use among pregnant women. This study aimed at determining the maternal and perinatal outcome of CAM use among the pregnant women in South-East Nigeria. This was a prospective study in which self-administered semi-structured questionnaires were used to collate information from the consenting pregnant women who use CAM and those who did not use CAM from the gestational age of 36 weeks at four hospitals in South-East Nigeria. Both groups were matched for age, parity and address. Every participant was followed up until delivery. Data were analysed using SPSS version 23 (SPSS Inc., Chicago, IL). This study’s ethical clearance number was NHREC/05/01/2008B-FWA00002458-1RB00002323 and it was obtained at UNTH and on February 15 2019. CAM use in pregnancy was associated with low haemoglobin concentration, maternal complications, high caesarean section rate, low birth weight, low APGAR score, large placental weight and high hospital admission of babies when compared with non-CAM users (p value= <.05). In conclusion, CAM use in pregnancy was associated with poor maternal and perinatal health indices, hence the need to implement policies aimed at reversing them.Impact Statement What is already known on this subject? There is an increasing trend of CAM use among pregnant women in the world. Pregnancy is associated with certain conditions that predispose women to CAM use. The clinical indications for CAM use by the pregnant women are nausea and vomiting, labour pain, induction of labour, pedal oedema and waist pain. What the results of this study add? CAM use in pregnancy was associated with low haemoglobin concentration, maternal complications, high caesarean section rate, low birth weight, low APGAR score, large placental weight and high hospital admission of the babies when compared with non-CAM users. What the implications are of these findings for clinical practice and/or further research? CAM use in pregnancy was associated with poor maternal and perinatal health indices, hence the need to implement policies aimed at reversing them