Nigerian health workers' views concerning paediatric adherence to anti-retroviral therapy

This study sought to explore the views of healthcare workers regarding paediatric anti-retroviral therapy (ART) adherence in Nigeria. An exploratory descriptive qualitative research design was used to identify and describe healthcare workers’ views in Kano and Lagos, Nigeria. Three focus group discussions were held. The transcribed data was analysed using the framework approach of data analysis. Healthcare providers perceived poverty, illiteracy, stigma and discrimination, inappropriate care approaches, and parental dynamics as factors influencing ART adherence. Recommendations for enhancing paediatric ART adherence levels in Nigeria included: mainstreaming adherence counselling in paediatric ART and adopting a comprehensive family centred care approach were identified as measures for improving paediatric ART adherence. Other measures included free ART services, quality improvement in paediatric ART services, parental empowerment and stigma and discrimination reduction programmes.Health StudiesM.A. (Public Health

Quality of antiretroviral therapy in public health facilities in Nigeria and the perceptions of the end users

The health care industry in Nigeria is increasingly grappling with challenges of meeting end users’ requirements and expectations for quality antiretroviral therapy (ART) service provision. This study sought to explore and describe the quality of antiretroviral therapy in public health facilities in Nigeria and the perceptions of the end users. A descriptive qualitative research design was used in the study in order to generate ideas from end users for improving quality of ART service provision, and prompt additional research activities. Unstructured focus group discussions were conducted with end users (n=64) in 6 locations across the 6 geopolitical zones of Nigeria. Data was analysed using the framework approach because it reflects the original accounts and observations of the end users and the Weft QDA version 1.0.1 software to validate the results. Findings revealed that end users were satisfied with uninterrupted antiretroviral drug supplies, courtesy treatment, volunteerism of support group members and quality counselling services. End users expect public health facilities to accept diagnostic results from collaborating facilities, implement continuous quality improvement (CQI), maintain clean and adequate health infrastructure, reduce end user waiting time, reduce stigma, comprehensively assess end users during each clinic visit and ensure uninterrupted ART services. They also expect effective collaboration between healthcare providers and support group members, to enhance the quality of life of people living with HIV (PLHIV). End users identified the following as quality gaps in ART service provision: weak health facility leadership, non-attractive ART service infrastructure, frequently interrupted laboratory services, demotivated and inadequate health care workers, long waiting time, interrupted medicine supplies and inadequate procedure for complaints management. In conclusion, the following recommendations were proffered: deploy and train additional health care workers, integrate ART into regular health services, improve supply chain management of health commodities, and reduce end user overload in clinics. Finally, a best practice guideline for the provision of end user focused ART service provision was developed.Health StudiesD.Litt. et Phil. (Health Studies

Impact of national culture on aid effectiveness in Nigeria

For nearly 60 years since rich countries started channeling foreign aid resources to Nigeria, aid effectiveness is still being contemplated. This study sought to determine the impact of national culture on aid effectiveness, in order to develop frameworks for aid effectiveness in Nigeria. A combination of the Geert Hofstede’s dimensions of national culture; the Paris Declaration’s principles of aid effectiveness as well as the Easterly and Pfutze’s best practices of aid were used to underpin the study. The analytic survey research design was adopted. Data was collected through computerized self-administered Qualtrics web-based survey, using Likert scale questionnaire. The questionnaire was distributed to all 846 aid workers that composed the sampling frame across the six geographic regions of Nigeria. Out of this number, 416 were returned valid and analyzable. Descriptive (frequencies) and inferential (Chi-square and ANOVA) statistics were utilized for data analysis. In order to increase statistical rigor and control for biases, the Kruskal Wallis test of variance and Mantel-Haenszel procedures were conducted. Of the five principles deployed in this study, participants perceived aid effectiveness in four principle areas. That is, aid alignment to country systems, managing aid for results, country ownership of aid, and mutual accountability of aid. Harmonization of aid emerged from this study as ineffective. Of the four principles of aid effectiveness that were perceived to be effective, country ownership of aid had significant relationship with national culture. Therefore, culture sensitive institutional framework, as well as a conceptual framework for aid effectiveness were proposed for implementation to improve the effectiveness of aid; particularly, promoting culture sensitive ownership and harmonization of aid in Nigeria