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Yau IB, Zubair Mustapha M, Nwaze E, Nobila O, Maigoro A, Abdullah A, Gamawa A, Meissner P, Albrecht J, Müller O. Improving the timeliness and completeness of childhood vaccination through color-coded bracelets: a pilot study among Fulani tribe populations in Nigeria. J Public Health Afr 2023; 14:2079. [PMID: 37441119 PMCID: PMC10334432 DOI: 10.4081/jphia.2023.2079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 07/03/2022] [Indexed: 07/15/2023] Open
Abstract
Background Childhood immunization remains one of the most cost-effective public health interventions. Globally, millions of children are not being reached with safe and effective vaccines and Nigeria has the highest number of unprotected children. Objective The effects of locally adapted interventions on vaccination timeliness and completeness were studied amongst Fulani populations across 6 health facilities in 2 districts of Bauchi State, Nigeria. Methods The intervention group consisted of newborns who received 5-color-coded bracelets representing different immunization contacts, while the control group had no bracelets. Vaccination rates across contacts were followed for 11 months. In addition, mothers of children in the intervention group were voluntarily recruited as peer-to-peer mobilizers (PPM). Results In this study, 435 children were studied. Vaccination completeness was higher in the intervention group compared to the control group at all contacts during follow-up. The difference was most noticeable at the fifth contact, with 158/256 (62%) children in the intervention group completing, compared to 73/179 (41%) in the control group (P<0.0001). Vaccination timeliness was better in the intervention group compared to the control one, which reached statistical significance at the second and third vaccination contacts (P<0.05). 68% of women volunteered as PPM and recruited 82 additional children for vaccination. Conclusion This study demonstrated the feasibility of a composite intervention (bracelets and PPM) to increase the completeness and timeliness of childhood immunization and provided preliminary evidence for its efficacy among Fulani populations in Nigeria. Findings from this pilot study should be confirmed through a larger cluster randomized controlled trial.
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Affiliation(s)
- Inuwa Barau Yau
- National Primary Health Care Development Agency, Abuja, Nigeria
| | | | - Eric Nwaze
- National Primary Health Care Development Agency, Abuja, Nigeria
| | | | | | - Adamu Abdullah
- Bauchi State Primary Health Care Development Agency, Bauchi, Nigeria
| | - Adamu Gamawa
- Bauchi State Primary Health Care Development Agency, Bauchi, Nigeria
| | - Peter Meissner
- Department of Pediatrics and Adolescent Medicine, Ulm University, Germany
| | - Jahn Albrecht
- Institute of Global Health, Medical School, Ruprecht-Karls-University, Heidelberg, Germany
| | - Olaf Müller
- Institute of Global Health, Medical School, Ruprecht-Karls-University, Heidelberg, Germany
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Shah V, Phillips-Howard P, Hennegan J, Cavill S, Sonko B, Sinjanka E, Camara Trawally N, Kanteh A, Mendy F, Bah AB, Saar M, Ross I, Schmidt W, Torondel B. Puberty health intervention to improve menstrual health and school attendance among adolescent girls in The Gambia: study methodology of a cluster-randomised controlled trial in rural Gambia (MEGAMBO TRIAL). Emerg Themes Epidemiol 2022; 19:6. [PMID: 35842700 PMCID: PMC9287699 DOI: 10.1186/s12982-022-00114-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 06/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Menstrual health (MH) is a recognised global public health challenge. Poor MH may lead to absence from school and work, and adverse health outcomes. However, reviews suggest a lack of rigorous evidence for the effectiveness of MH interventions on health and education outcomes. The objective of this paper is to describe the methods used in a cluster-randomised controlled trial to estimate the effect of a multi-component intervention to improve MH and school attendance in The Gambia. METHODS The design ensured half the schools (25) were randomised to receive the intervention which comprised of the following components: (i) Peer education camps and menstrual hygiene laboratories in schools, (ii) Mother's outreach sessions, (iii) Community meetings, and (iv) minor improvements of school Water Sanitation and Hygiene (WASH) facilities and maintenance. The intervention was run over a three-month period, and the evaluation was conducted at least three months after the last intervention activity was completed in the school or community. The other 25 schools acted as controls. Of these 25 control schools one Arabic school dropped out due to COVID-19. The primary outcome was the prevalence of girls missing at least one day of school during their last period. Secondary outcomes included: Urinary Tract Infection (UTI) symptoms, biochemical markers of UTI in urine, Reproductive Tract Infection symptoms, self-reported menstruation related wellbeing, social support and knowledge, perceptions and practices towards menstruation and MH in target school girls. In addition, a process evaluation using observations, routine monitoring data, survey data and interviews was undertaken to assess dose and reach (quantitative data) and assess acceptability, fidelity, context and possible mechanisms of impact (qualitative data). Cost and cost-effectiveness of the intervention package will also be assessed. CONCLUSION Results will add to scarce resources available on effectiveness of MH interventions on school attendance. A positive result may encourage policy makers to increase their commitment to improve operation and maintenance of school WASH facilities and include more information on menstruation into the curriculum and help in the reporting and management of infections related to adolescent menstruation. Trial Registration PACTR, PACTR201809769868245, Registered 14th August 2018, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3539.
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Affiliation(s)
- Vishna Shah
- Environmental Health Group, Department of Infectious Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Penelope Phillips-Howard
- grid.48004.380000 0004 1936 9764Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA UK
| | - Julie Hennegan
- grid.1056.20000 0001 2224 8486Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | | | - Bakary Sonko
- grid.415063.50000 0004 0606 294XNutrition Theme, MRCG Keneba, Medical Research Council Unit, Banjul, The Gambia
| | - Edrisa Sinjanka
- grid.415063.50000 0004 0606 294XNutrition Theme, MRCG Keneba, Medical Research Council Unit, Banjul, The Gambia
| | - Nyima Camara Trawally
- grid.415063.50000 0004 0606 294XNutrition Theme, MRCG Keneba, Medical Research Council Unit, Banjul, The Gambia
| | - Abdou Kanteh
- Nova Scotia Gambia Association (NSGA), Banjul, The Gambia
| | - Francois Mendy
- Nova Scotia Gambia Association (NSGA), Banjul, The Gambia
| | - Amadou B. Bah
- Nova Scotia Gambia Association (NSGA), Banjul, The Gambia
| | - Momodou Saar
- Nova Scotia Gambia Association (NSGA), Banjul, The Gambia
| | - Ian Ross
- grid.8991.90000 0004 0425 469XEnvironmental Health Group, Department of Infectious Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - Wolf Schmidt
- grid.8991.90000 0004 0425 469XEnvironmental Health Group, Department of Infectious Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - Belen Torondel
- grid.8991.90000 0004 0425 469XEnvironmental Health Group, Department of Infectious Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
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