Mapping a research-advocacy-policy agenda on human rights and albinism: a mixed methods project

BACKGROUND

Persons with albinism face challenges to their wellbeing, safety, and security, ranging from vision impairment and skin cancer to stigma and discrimination. In some regions, they also face human rights atrocities including mutilation and murder. Research on human rights and albinism is a relatively new field that has gained momentum since the United Nations appointment of an Independent Expert on the enjoyment of human rights by persons with albinism. In this paper, we present the results of a mixed methods study undertaken to identify priorities for research, advocacy, and policy on albinism and human rights.

METHODS

The first component was a synthesis of peer-reviewed and grey literatures at the nexus of albinism, spiritual/cultural beliefs and practices, and human rights. We then conducted a priority-setting survey, informed by Delphi methods, on extant knowledge-practice gaps and research, advocacy, and policy priorities. Inclusion criteria included demonstrated expertise in the field (e.g., peer-reviewed publications, funded research), membership on national or international associations, or advocacy (civil society organizations) of more than 2 years in albinism and human rights. Thereafter, we gathered leading researchers, policy-makers, and civil society stakeholders for a Roundtable to gain consensus on these priorities.

RESULTS

Access to skin and vision care, and education were not deemed high priority for research, likely because the evidence supporting the need for these is well established. However, they were priorities for advocacy and policy: what is needed is mobilization of this evidence through advocacy and implementation of such services (policy). Other social determinants of health (rurality, poverty, and gender equality) are present as subtext in the findings, more so than priorities for research, advocacy, or policy, despite their preponderance in the lives of persons with albinism. Research was prioritized on stigma and discrimination; advocacy; and witchcraft, but with some differentiation between Global North and Global South priorities. Priorities for research, advocacy, and policy vary in keeping with the explanatory frameworks at play, including how harmful practices and witchcraft are viewed.

CONCLUSIONS

The lived experience of albinism is profoundly shaped by the social determinants of health (SDOH). Threats to the security and well-being of persons with albinism should be viewed through a human rights lens that encompasses the explanatory frameworks at play.

Beyond Economics! The (Evolving) Role of Law in the Eradication of Extreme Poverty

Extreme poverty is a complex and multifaceted challenge that cannot be solely addressed through economic interventions. Traditional economic indicators, such as GDP, do not fully capture the realities of vulnerable populations who often experience discrimination and social exclusion. This has legal and human rights implications, particularly in regions such as Sub-Saharan Africa where extreme poverty is concentrated. In light of these concerns, this article critically examines the existing literature on poverty economics and law and presents an analysis of key data. Ultimately, the article argues for a comprehensive approach that prioritises law and justice as crucial components of efforts to achieve target 1 of the United Nations' Agenda 2030 for Sustainable Development. This approach should entail the establishment of legal frameworks that promote accountability for political actors and protect the rights of the poor.

Awareness and access to mass media sources of information about modern family planning methods among women with disabilities in Nigeria: An analysis of 2018 demographic and health survey

BACKGROUND

Family planning is the foundation of sexual and reproductive health, and necessary for achieving the Sustainable Development Goals. Yet, the needs of women with disabilities and their access to these services have been neglected for decades, especially in Low and Middle-income Countries. To improve utilization of these services among women with disabilities, they have to be aware and informed about the services. This study was conducted to examine awareness and mass media sources of information on family planning between women with and without disabilities.

METHODS

This study used data from the 2018 Nigeria Demographic and Health Surveys (NDHS). Our analytic sample included 26,585 women between 15 and 49 years of age who answered the disability module. We compared demographics and socioeconomic characteristics of women with and without disabilities using the chi-square test for categorical variables. In addition, we conducted logistic regressions to estimate the unadjusted and adjusted odds ratio (with 95% confidence intervals) for level of awareness and mass media sources of information on modern contraceptive methods, using women without a disability as the reference group.

RESULTS

Finding showed that women with disabilities have poor awareness about family planning compared to women without disabilities even after adjusting for all covariates (AOR = 0.42, 95% CI: 0.23-0.76, P < 0.05). We also found that women with disabilities are less likely to receive information about family planning from any of the available mass media channels even after adjusting for covariates (AOR = 0.46, 95% CI: 0.22-0.98, P < 0.05).

CONCLUSIONS

The study revealed that women with disabilities Nigeria have poor awareness about modern family planning methods compared to non-disabled women. They are also less likely to receive information about modern family planning methods compared to non-disabled women. To effectively reach women with disabilities, information barriers must be eliminated, coupled with increased opportunities to access family planning information. Donors, government, and other relevant stakeholders should consider funding inclusive campaigns and explore other mechanisms for disseminating family planning information to women with disabilities.

How Context Matters: Change and Persistence of Homophobic Attitudes among Cameroonian Migrants in Switzerland

Debates on human rights in recent years have brought to the fore stark fault lines between African countries, where societal intolerance towards homosexuality is prevalent, and Western countries, which hold more tolerant views towards homosexuality. As contention rages around African identity and homosexuality, one interesting question calls for attention: how do the attitudes of Africans towards homosexuality evolve—or not—when they migrate from their home context to a more open society where homosexuality is widely accepted? This study draws on Herek’s ‘attitudes toward lesbians and gay men scale’ (ATLG) to investigate homophobia among Cameroonians at home compared to Cameroonian migrants in Switzerland and uses in-depth interviews to understand the reasons for any change in or persistence of attitudes. Survey data shows that Cameroonian migrants in Switzerland portray significantly less homophobia compared to Cameroonians living at home. Qualitative analysis identified four factors that contributed to change in attitudes among Cameroonian migrants: (i) experiencing racial prejudice and xenophobia prompted self-reflection about their own prejudices towards others; (ii) witnessing, first-hand, the huge infrastructure and development gap between their host and home country exposed anti-homosexuality politics back home as a needless distraction from actual development priorities; (iii) greater opportunities to meet and interact with gay people in the host country challenged long-held home-grown stereotypes about homosexuality; and (iv) non-discrimination standards and codes of conduct in the workplace in the host country encouraged conformity and shifts towards greater tolerance.

Associations between sexual identity, living with disability, bully victimisation, and HIV status and intimate partner violence among residents in Nigeria

Background

The aim of the study was to determine the associations between sexual identity, disability and HIV status and bullying victimisation, and a history of physical, emotional and sexual violence in Nigeria.

Methods

This was a secondary analysis of a primary dataset generated through an online survey conducted between February 7 and 19, 2021. The 3197 participants for the primary study were recruited through snowballing. The dependent variables were physical, emotional and sexual violence. The independent variables were sexual identity (heterosexual and sexual minority), HIV status (negative, positive and unknown), bullying victimisation (yes/no) and living with disability (yes/no). A multivariate logistic regression model was developed for each form of IPV. Each model was adjusted for age, sex assigned at birth, marital status and education level.

Results

Respondents living with HIV had higher odds for physical (AOR: 2.01; 95% CI: 1.46–2.76; p < 0.001), sexual (AOR: 2.17; 95%CI: 1.55–3.05; p < 0.001), and emotional (AOR: 1.59; 95%CI: 1.24–2.06; p < 0.001) violence. Also, those with history of bullying victimisation had higher odds for physical (AOR: 3.79; 95%CI: 2.86 – 5.68; p < 0.001), sexual (AOR: 3.05; 95%CI: 2.27 – 4.10; p < 0.001) and emotional (AOR: 2.66; 95%CI: 2.10 – 3.37; p < 0.001) violence. In addition, females had higher odds of physical (AOR: 1.52; 95%CI: 1.13–2.043; p < 0.001) and sexual (AOR: 1.83; 95%CI: 1.34 – 2.50; p < 0.001) violence; and respondents cohabiting (AOR: 1.95; 95%CI: 1.12 – 3.28; p = 0.012) had higher odds for emotional violence. Respondents who were married have significantly lower odds of experiencing physical (AOR: 0.66; 95%CI: 0.45 – 9.60; p = 0.029), sexual (AOR: 0.40; 95%CI: 0.26 – 0.62; p < 0.001) and emotional (AOR: 0.68; 95%CI: 0.50 – 0.93; p = 0.015) violence when compared to singles. Younger respondents also had lower odds of experiencing sexual violence (AOR: 0.97; 95%CI: 0.95–0.99; p = 0.016).

Conclusion

HIV positive status and bullying victimisation seem to increase the risk for all forms of IPV while the experience of IPV did not differ by sexual identity and disability status. The associations between age, sex, marital status and IPV may suggest moderating roles of the factors taking cognisance of the cultural context of these relationships. Future relational analysis is necessary to further understand the pathways for the associations found between the variables in this study.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14186-6.

Experiencing Intimate Partner Violence (IPV) Is Associated with Psychosocial Health Problems Among Gay, Bisexual, and Other Men Who Have Sex with Men (GBMSM) in Nigeria, Africa

Previous research has shown high rates of intimate partner violence (IPV) among gay, bisexual, and other men who have sex with men (GBMSM). Experiencing IPV may predispose GBMSM to psychosocial health problems. A vast majority of the research on IPV among GBMSM have been conducted in North America and Europe. To date, no published studies that we are aware of have investigated the prevalence and correlates of IPV among GBMSM in West Africa. To fill this gap in research, the present study investigated the prevalence of IPV and its' association with psychosocial health problems in a large multicity sample of community-recruited GBMSM in Nigeria. Bivariate and multivariable logistic regression analyses were utilized to examine associations between sociodemographic characteristics, psychosocial health problems, sexual risk, and experiences of IPV (N = 389). The prevalence of experiencing emotional, physical, sexual, monitoring behaviors, and controlling behavior were 45%, 31%, 20%, 55%, and 22% respectively. Experiencing all types of IPV, except physical violence, was significantly associated with increased odds of having depressive symptoms (Adjusted OR [AOR] 1.79-2.63; 95% confidence interval [CI]: 1.08-4.60) and anxiety (AOR 1.63-2.63; 95% CI: 1.01-4.18). Experiencing emotional violence (standardized beta [β] = 0.21; standard error [SE] SE = 0.44), physical violence (β = 0.14; SE = 0.48), and controlling behaviors (β = 0.11; SE = 0.54) was associated with increased odds of loneliness. Experiencing all types of IPV was associated with history of suicide thoughts (AOR 2.20-3.68; 95% CI: 1.28-6.32) and suicide attempt (AOR 2.36-3.42; 95% CI: 1.20-6.75). Additionally, we observed a dose-response relationship, whereby increasing number of IPV was associated with a higher likelihood of reporting psychosocial health problems. Lastly, after adjusting for other psychosocial health problems and demographic characteristics, there remained a significant association between experiencing IPV and reporting a history of suicide thoughts and suicide attempt. Consequently, it is imperative that health interventions aimed at improving psychosocial health of GBMSM explore experience and perpetration of IPV.

Private Sector Investment in Infrastructure in Sub-Saharan Africa Post-COVID-19: The Role of Law

Sub-Saharan Africa (SSA) is the lowest income region of the world with a considerable number of low-income countries. The region is challenged by a massive infrastructure deficit. In recent years, the governments of the countries in the region have expressed the desire to bridge the huge gap in infrastructure assets through a partnership with the private sector using the public-private partnership model. However, the advent of the Coronavirus (COVID-19) pandemic which has resulted in unplanned public sector expenditure poses a new kind of hurdle to climb for states in the region. As such, there is a need for governments in SSA to create and sustain efficient opportunities for private sector investment in infrastructure procurement and maintenance. This article adopted the doctrinal legal research method as well as review of literature in the examination of the role of law in creating a healthy and sustainable business environment for private sector participation in infrastructure financing and operation in a post-COVID-19 era in the SSA region. The article recommends among others, the enactment of legislation to create an enabling environment for raising domestic capital for the purposes of private sector-led public infrastructure procurement as well as the implementation of strategies suited for developing economies to attain successful outcomes in private sector backed infrastructure procurement.

Associations between sexual orientation, financial security and relationships with family and peers during the COVID-19 pandemic in Nigeria

Background: This study aimed to determine whether factors associated with financial insecurity during the COVID-19 pandemic were associated with worsening relationships with family, peers and friends of sexual minorities living in Nigeria. Methods: Data were collected using an online survey conducted from 29th June to 31st December 2020. The outcome variable was the quality of relationship with family, friends and peers during the COVID-19 pandemic. The explanatory variables were the sexual orientation (lesbian, gay, bisexual, heterosexual), COVID-19 status, and financial security (job loss or reduced/lost wages because of the COVID-19 pandemic). Multilevel logistic regression analysis models with robust estimation were built and used to assess the association between the outcome and explanatory variables. The models were adjusted for sociodemographic profile (age, sex at birth, education status). Results: Being a sexual minority was associated with higher odds of worsened relationship with family (AOR: 1.49) and friends and peers (AOR: 2.38) during the pandemic. Having COVID-19 symptoms but not getting tested was significantly associated with higher odds of reporting worsening of the relationship with family (AOR: 1.69) and history of job loss (AOR: 1.68), while having formal education (p<0.05) was significantly associated with lower odds of reporting worsening of the relationship with family. The factors significantly associated with higher odds of reporting worsened relationship with friends and peers were testing positive for COVID-19 (AOR: 1.60), reduced wages (AOR: 1.24), and being older (AOR: 1.01). Attaining a college/university education was significantly associated with lower odds of worsened relationship with friends and peers (AOR: 0.31). Conclusions: The COVID-19 pandemic may increase the risk of negative disruptions in the relationships with family, friends and peers, especially for sexual minorities. National COVID-19 response programs should include plans to support those who face social disruption in managing the crisis.

Coronavirus disease 2019 (COVID-19) and individuals with intellectual and developmental disabilities in Nigeria

This article chronicles the present situation of coronavirus disease 2019 (COVID-19) on individuals with intellectual and developmental disabilities (IDD) in Nigeria. A systematic search was conducted on three bibliographic databases: MEDLINE Complete, Web of Science and Scopus, and supplemented with grey literature searches to assess studies on the effect of COVID-19 on these individuals in Nigeria with data on this group from December 2019 to July 2020. There were no studies found concerning individuals with IDD in Nigeria. This article argues for an urgent call to action by Nigerian policymakers to make data available to help understand the impact of COVID-19 and to develop and implement appropriate interventions. This article provides steps to support and care for these individuals in Nigeria. Forecasting models are recommended which offer better approaches in yielding accurate predictions and provide valuable decisions in the event of future threats and infectious disease outbreak in Nigeria.

A Qualitative Analysis of the Commercial Broiler System, and the Links to Consumers' Nutrition and Health, and to Environmental Sustainability: A South African Case Study

Food systems face growing challenges to meet targets of Zero Hunger (SDG 2), and South Africa is no exception given its triple burden of malnutrition, foodborne disease outbreaks, and threats of climate change to food production. Broiler meat is South Africa's most affordable meat option, supporting household food and nutrition security. Although considered healthier and less environmentally harmful than ruminant meat, it is not without food safety risks and environmental impacts. This research aimed to present the foremost commercial broiler system narratives in South Africa, around targets of SDG 2, and to discuss key considerations for policymakers. Twenty-nine key informants and stakeholders, purposively selected to cover a wide range of opinions, participated in semi-structured interviews. Transcripts underwent a qualitative framework analysis. Results showed a highly efficient system, dominated by a small number of interlinked large-scale actors, vulnerable to competition from cheaper imports, yet pressurized to maintain high food safety and environmental impact standards, with a price-sensitive consumer base. Existing policies lack integration and enforcement capacity, and are undermined by siloed government departments, and mistrust and power struggles between public and private sectors. We propose removal of silo walls, and trust building through participatory policy development, with collaborative and transformative public-private partnerships that are designed to build capacity to deliver sustainable solutions.

More Than Just Assistive Devices: How a South African Social Enterprise Supports an Environment of Inclusion

Appropriate assistive technology has the potential to considerably enhance quality of life, access to health and education, and social and economic participation for people with disabilities. Most disabled people in the world live in low- and middle-income countries where access to assistive devices and other support is severely lacking. There is little evidence that describes contextually relevant approaches to meeting these needs, particularly in African countries. We provide a detailed description of a South African organisation which has manufactured mobility and seating devices for children with disabilities since 1992. The Shonaquip Social Enterprise (SSE) also trains and builds capacity among a wide range of stakeholders (caregivers, health workers, educators, government, and communities) to acknowledge and advocate for the wellbeing of disabled children and adults, and works closely with government to strengthen existing service provisions. Using examples from the SSE, we highlight a number of useful principles to consider when trying to provide for the needs of people with disabilities, particularly in low-resource settings. While access to assistive devices is important, devices have limited capacity to improve participation if the broader environment is overly restrictive and stigmatising. Improved access to devices ought to be situated within a range of broader efforts to increase the inclusion and participation of people with disabilities.

Managers' Conceptions and Their Effects on the Perception of Employees with Disabilities

The research aimed to identify managers' conceptions of disability and the relationship that was established between these conceptions and their perception of the persons with disabilities (PWD) performance, bond, benefits of hiring, and training needs. 257 managers answered a questionnaire in order to identify conceptions of disability in organizations. Descriptive statistics, factorial analysis, and hierarchical analysis of grouping were performed while using IBM Statistic 20.0.0. The results show that managers who have the spiritual and the conception based on inclusion perceive the insertion of PWD as beneficial to the organization. Those who conceive disability as a question of normality perceive the PWD performance as inferior to those without disabilities, which implies that PWDs should be segregated; and, the managers who perceive disability as a social problem are likely to place PWDs in the workplace according to their potential. The results can be fruitfully used by managers, human resources' professionals, academics, and the society to promote inclusion.

Are they not Nigerians? The obligation of the state to end discriminatory practices against persons with disabilities

Nigeria has ratified several international instruments that protect the rights of, and guarantee freedom from discrimination of persons with disabilities (PWD). Despite the above, the country is yet to fully implement the appropriate measures required to achieve the objective of protecting PWD. Successive administrations since the return to civil administration in the country in 1999 have not fulfilled the mandate in the 1999 Constitution of the Federal Republic of Nigeria (as amended) dealing with disability rights. While the passing into law in January 2019 of the Discrimination Against Persons with Disabilities (Prohibition) Act 2018 is commendable, it only reflects the pressure on the Federal Government of Nigeria by disability rights advocates and PWD. This article aims to, among others, highlight the plight of PWD in Nigeria, the need to protect their rights and guarantee their freedom from discriminatory practices. To achieve this aim, a review of international and domestic instruments, as well as literature on the subject, is undertaken. The article proposes that the Nigerian government should aim towards inclusivity and accommodation of PWD. For example, instead of merely establishing special schools for PWD, there should be a design to allow for the training of teachers to meet the needs of special children in regular schools.