Insecurity in northern Nigeria: Implications for maternal and child health

Improving health outcomes by strengthening public sector capacity in social and behaviour change programming in Nigeria: a qualitative study

OBJECTIVE

This paper examines the outcomes of the public sector capacity strengthening (PSCS) approach and how they contribute to the promotion of maternal, newborn, and child health, and nutrition (MNCH+N), family planning (FP) and malaria prevention-related outcomes.

DESIGN

The qualitative study implemented from July to August of 2022 used the outcome harvesting methodology and key informant interviews to elicit information including most significant change (MSC) stories to evaluate project outcomes over 5 years (2017-2022).

SETTING

The study was conducted in Sokoto, Kebbi, Nasarawa, Bauchi and Ebonyi states of Nigeria.

PARTICIPANTS

The study focused on public sector stakeholders who were exposed to the PSCS intervention and were selected from government agencies. Nine study participants were engaged per state, bringing the total number of participants to 45. Data were analysed thematically and elicited MSC stories were analysed for content.

RESULTS

The PSCS approach empowered stakeholders at the individual level to disseminate MNCH+N, FP and malaria prevention messages, monitor health and social and behaviour (SBC) activities and increase the demand for health services. At the organisational level, the approach facilitated coordination of SBC activities, enabled training cascades and promoted adherence to health service guidelines. At the system level, it strengthened ward development committees to address health challenges. Challenges hindering stakeholders' application of PSCS-acquired skills include inadequate workforce, negative attitudes of health workers, funding constraints, cultural barriers, lack of government ownership and limited accessibility.

CONCLUSIONS

This study shows that the PSCS approach is an effective model to scale up capacity for SBC in MNCH+N, FP and malaria prevention programmes. In response to documented supply-side challenges impeding the application of gained knowledge and skill, we recommend inclusive health worker recruitment, sensitisation programmes for health workers, government ownership, improved security, healthcare infrastructure and transportation systems.

A new Fermatean fuzzy Spearman-like correlation coefficient and its application in evaluating insecurity problem via multi-criteria decision-making approach

The problem of insecurity is a global crisis with adverse effects on lives and properties. Fermatean fuzzy correlation coefficient is a dependable method for handling imprecision, which is the main bottleneck of insecurity assessment. A number of Fermatean fuzzy correlation coefficient methods have been developed. Based on Spearman's correlation coefficient, an innovative Fermatean fuzzy correlation coefficient method is built to enhance trustworthy insecurity assessment. The existing Fermatean fuzzy correlation coefficient methods are evaluated, and their shortcomings are identified in order to validate the construction of a new Fermatean fuzzy correlation coefficient method. The drawbacks of the existing methods lead us into building a new Fermatean fuzzy correlation coefficient method by using the Spearman's correlation coefficient approach, which has the potential of overcoming the drawbacks of the existing Fermatean fuzzy correlation coefficient methods. In addition, some theoretical findings are provided to support the strength of the novel Fermatean fuzzy correlation coefficient method and it is shown that the new method satisfies the Fermatean fuzzy correlation coefficient requirements. Furthermore, the novel Fermatean fuzzy correlation coefficient method is applied to assess the insecurity situation in the North-Central Region of Nigeria to furnish intended tourists with relevant travel advice. To demonstrate the inherent significance of the novel Fermatean fuzzy correlation coefficient method, we compare its effectiveness to that of the extant Fermatean fuzzy correlation coefficient methods. The results of the comparison show the superiority of the novel Fermatean fuzzy correlation coefficient method over the existing ones in terms of reliability, consistency, precision and compliance with the Fermatean fuzzy correlation coefficient axioms. Ultimately, it is discovered that the new method can effectively address hesitations related to insecurity assessment.

Factors influencing the decision of Nigerian optometry students to work in rural areas upon graduation: a cross-sectional survey

BACKGROUND

Access to eye care in rural Nigeria remains limited, as most optometrists work in urban areas. This study explores the factors influencing Nigerian optometry students' decision to work in rural settings after graduation.

METHODS

A cross-sectional survey was conducted among 400 optometry students from ten accredited Nigerian universities. The students were surveyed on their preferences regarding rural practice and the factors affecting their decisions.

RESULTS

The majority of respondents (81.3%) were not inclined to establish their first optometric practice in rural areas, with poor living conditions (26.34%) being the most common deterrent. However, a significant proportion (52.8%) expressed willingness to consider establishing subsequent practices in rural areas. Motivation to help the community (56.6%) and the potential to enhance their optometric practice (74.6%) were key drivers for rural practice. Chi-square test revealed that participants' year of study had a significant influence on their preference to practice in rural areas (p < 0.05). However, there was no significant connection between participants' gender and place of origin, and their preference for rural practice (p > 0.05).

CONCLUSION

While many students, particularly from urban backgrounds, are reluctant to initiate practice in rural areas after graduation, primarily due to concerns over living conditions. In contrast, students from rural backgrounds show a higher likelihood of considering rural practice, especially within NGOs or the public sector. Hence, such factors should be considered by academic institutions and government bodies when designing policies to address workforce imbalances.

Determinants of child survival practice among caregivers in internally displaced persons' camps in Abuja Municipal Area Council, Nigeria

BACKGROUND

Child survival remains a major public health challenge in the sub-Saharan region of Africa, especially Nigeria. The Boko Haram crisis, which has aggravated this, has led to the displacement of many people in the north-eastern region, including children under five. This study investigated the determinants of child survival practice among caregivers in internally displaced persons' (IDP) camps in Abuja Municipal Area Council (AMAC), Nigeria.

METHODOLOGY

A cross-sectional design was used to collect data on determinants of child survival practice from 312 caregivers in five purposively selected IDP camps in AMAC using the snowball sampling technique. Data were analysed using univariate, bivariate, and multivariate statistics at 5% level of significance.

RESULTS

The mean age of respondents was 29.6 ± 6.72 years. There was a significant (p < 0.05) relationship between the predisposing, reinforcing, enabling and environmental factors studied and child survival practice. Findings also indicated that all factors were significant (p < 0.05) predictors of child survival practice with the reinforcing factor being the major predictor (ß = 0.38; t = 6.08).

CONCLUSION

Attention needs to be paid to all factors, particularly the reinforcing factor of social support in order to promote optimal child survival practice among caregivers in AMAC IDP camps. Collaboration with social work professionals would be an added benefit to enhance social support.

Barriers to optimal AEFI surveillance and documentation in Nigeria: Findings from a qualitative survey

Effective spontaneous AEFI reporting is the first step to ensuring vaccine safety. Half of the global population lives in countries with weak vaccine safety monitoring systems, especially in the African, Eastern Mediterranean, and Western Pacific regions. Further, Immunisation services have been upscaled without commensurate effective AEFI surveillance systems. Hence, this study aims to comprehensively investigate the impediments to an effective AEFI surveillance system. Given the programmatic and regulatory implications, understanding these impediments would facilitate the development and implementation of policies and strategies to strengthen the AEFI surveillance system in Nigeria. A qualitative research design (using a grounded theory approach) was employed by conducting ten key informant interviews and two Focus Group Discussion sessions among the study population to identify the barriers impeding optimal AEFI surveillance and documentation in Nigeria. This study found that the AEFI surveillance system is in place in Nigeria. However, its functionality is sub-optimal, and the potential capacity is yet to be fully harnessed due to health systems and socio-ecological impediments. The identified impediments are human-resource-related issues- knowledge gaps; limited training; lack of designated officers for AEFI; excessive workload; poor supportive supervision and attitudinal issues; caregiver's factor; governance and leadership- moribund AEFI committee; lack of quality supervisory visit and oversight and weak implementation of AEFI policy guidance. Others include funding and logistics issues- no dedicated budget provision and weak referral mechanism; insecurity; socio-economic and infrastructural deficits- poverty, geographical barriers, limited ICT skills, and infrastructure; and poor feedback and weak community engagement by the health workers. Findings from this study provide empirical evidence and serve as an advocacy tool for vaccine pharmacovigilance strengthening in Nigeria. Addressing the impediments requires health system strengthening and a whole-of-the-society approach to improve vaccine safety surveillance, restore public confidence and promote vaccine demand, strengthen PHC services, and contribute to attaining UHC and SDGs.