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Uneke CJ, Okedo-Alex IN, Akamike IC, Uneke BI, Eze II, Chukwu OE, Otubo KI, Urochukwu HC. Institutional roles, structures, funding and research partnerships towards evidence-informed policy-making: a multisector survey among policy-makers in Nigeria. Health Res Policy Syst 2023; 21:36. [PMID: 37237324 DOI: 10.1186/s12961-023-00971-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/27/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Evidence-informed policy-making aims to ensure that the best and most relevant evidence is systematically generated and used for policy-making. The aim of this study was to assess institutional structures, funding, policy-maker perspectives on researcher-policy-maker interactions and the use of research evidence in policy-making in five states in Nigeria. METHODS This was a cross-sectional study carried out among 209 participants from two geopolitical zones in Nigeria. Study participants included programme officers/secretaries, managers/department/facility heads and state coordinators/directors/presidents/chairpersons in various ministries and the National Assembly. A pretested semi-structured self-administered questionnaire on a five-point Likert scale was used to collect information on institutional structures for policy and policy-making in participants' organizations, the use of research evidence in policy and policy-making processes, and the status of funding for policy-relevant research in the participants' organizations. Data were analysed using IBM SPSS version 20 software. RESULTS The majority of the respondents were older than 45 years (73.2%), were male (63.2) and had spent 5 years or less (74.6%) in their present position. The majority of the respondents' organizations had a policy in place on research involving all key stakeholders (63.6%), integration of stakeholders' views within the policy on research (58.9%) and a forum to coordinate the setting of research priorities (61.2%). A high mean score of 3.26 was found for the use of routine data generated from within the participants' organizations. Funding for policy-relevant research was captured in the budget (mean = 3.47) but was inadequate (mean = 2.53) and mostly donor-driven (mean = 3.64). Funding approval and release/access processes were also reported to be cumbersome, with mean scores of 3.74 and 3.89, respectively. The results showed that capacity existed among career policy-makers and the Department of Planning, Research and Statistics to advocate for internal funds (mean = 3.55) and to attract external funds such as grants (3.76) for policy-relevant research. Interaction as part of the priority-setting process (mean = 3.01) was the most highly rated form of policy-maker-researcher interaction, while long-term partnerships with researchers (mean = 2.61) had the lower mean score. The agreement that involving policy-makers in the planning and execution of programmes could enhance the evidence-to-policy process had the highest score (mean = 4.40). CONCLUSION The study revealed that although institutional structures such as institutional policies, fora and stakeholder engagement existed in the organizations studied, there was suboptimal use of evidence obtained from research initiated by both internal and external researchers. Organizations surveyed had budget lines for research, but this funding was depicted as inadequate. There was suboptimal actual participation of policy-makers in the co-creation, production and dissemination of evidence. The implementation of contextually relevant and sustained mutual institutional policy-maker-researcher engagement approaches is needed to promote evidence-informed policy-making. Thus there is a need for institutional prioritization and commitment to research evidence generation.
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Affiliation(s)
- Chigozie Jesse Uneke
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria.
| | - Ijeoma Nkem Okedo-Alex
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
| | - Ifeyinwa Chizoba Akamike
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
| | - Bilikis Iyabo Uneke
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
| | - Irene Ifeyinwa Eze
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
| | - Onyekachi Echefu Chukwu
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
| | - Kingsley Igboji Otubo
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
| | - Henry C Urochukwu
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
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Eboreime E, Ogwa O, Nnabude R, Aluka-Omitiran K, Banke-Thomas A, Orji N, Eluwa A, Ezeokoli A, Rotimi A, Eze LU, Offiong V, Odu U, Okonkwo R, Umeh C, Ilika F, Oreh A, Adams FN, Okpani IA, Ogundeji Y, Mbachu C, Obi FA, Badejo O. Engaging stakeholders to identify gaps and develop strategies to inform evidence use for health policymaking in Nigeria. Pan Afr Med J 2022; 43:140. [PMID: 36762150 PMCID: PMC9898774 DOI: 10.11604/pamj.2022.43.140.36754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction recent efforts to bridge the evidence-policy gap in low-and middle-income countries have seen growing interest from key audiences such as government, civil society, international organizations, private sector players, academia, and media. One of such engagement was a two-day virtual participant-driven conference (the convening) in Nigeria. The aim of the convening was to develop strategies for improving evidence use in health policy. The convening witnessed a participant blend of health policymakers, researchers, political policymakers, philanthropists, global health practitioners, program officers, students, and the media. Methods in this study, we analyzed conversations at the convening with the aim to disseminate findings to key stakeholders in Nigeria. The recordings from the convening were transcribed and analyzed inductively to identify emerging themes, which were interpreted, and inferences are drawn. Results a total of 630 people attended the convening. Participants joined from 13 countries. Participants identified poor collaboration between researchers and policymakers, poor community involvement in research and policy processes, poor funding for research, and inequalities as key factors inhibiting the use of evidence for policymaking in Nigeria. Strategies proposed to address these challenges include the use of participatory and embedded research methods, leveraging existing systems and networks, advocating for improved funding and ownership for research, and the use of context-sensitive knowledge translation strategies. Conclusion overall, better interaction among the various stakeholders will improve the evidence generation, translation, and use in Nigeria. A road map for the dissemination of findings from this conference has been developed for implementation across the strata of the health system.
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Affiliation(s)
- Ejemai Eboreime
- Talk Health Real Media Limited, Abuja, Nigeria,,Corresponding author: Ejemai Eboreime, Department of Psychiatry, University of Alberta, Edmonton, Canada.
| | - Oluwafunmike Ogwa
- Systems Development Initiative, Abuja, Nigeria,,Doctorkk Health International, Lagos, Nigeria
| | - Rosemary Nnabude
- Systems Development Initiative, Abuja, Nigeria,,School of Public Health, University of Alberta, Edmonton, Canada
| | - Kasarachi Aluka-Omitiran
- Systems Development Initiative, Abuja, Nigeria,,Department of Community Health Services, National Primary Health Care Development Agency, Abuja, Nigeria
| | - Aduragbemi Banke-Thomas
- School of Human Sciences, University of Greenwich, London, United Kingdom,,London School of Economics and Political Science, London, United Kingdom
| | - Nneka Orji
- Systems Development Initiative, Abuja, Nigeria,,Department of Health Planning, Research and Statistics, Federal Ministry of Health, Abuja, Nigeria
| | - Achama Eluwa
- Systems Development Initiative, Abuja, Nigeria,,Health, Nutrition and Population Global Practice Unit, The World Bank, Washington DC, United States of America
| | - Adaobi Ezeokoli
- Systems Development Initiative, Abuja, Nigeria,,Harvard Kennedy School, Harvard University, Cambridge, Massachusetts, United States
| | - Aanu Rotimi
- Systems Development Initiative, Abuja, Nigeria,,Centre for Accountability and Inclusive Development, Abuja, Nigeria
| | - Laz Ude Eze
- Systems Development Initiative, Abuja, Nigeria,,Talk Health Real Media Limited, Abuja, Nigeria
| | - Vanessa Offiong
- Systems Development Initiative, Abuja, Nigeria,,As Equals, CNN International, Abuja, Nigeria
| | - Ugochi Odu
- Systems Development Initiative, Abuja, Nigeria,,Healthreach limited, Abuja, Nigeria
| | - Rita Okonkwo
- Systems Development Initiative, Abuja, Nigeria,,Institute of Human Virology Nigeria, International Research Center of Excellence, Abuja, Nigeria
| | - Chukwunonso Umeh
- Systems Development Initiative, Abuja, Nigeria,,African Youth Initiative on Population Health and Development (AfrYPoD), Abuja, Nigeria
| | - Frances Ilika
- Palladium, Health Policy Plus Project, Abuja, Nigeria
| | - Adaeze Oreh
- Department of Planning, Research and Statistics, National Blood Transfusion Service, Abuja, Nigeria
| | | | - Ikedichi Arnold Okpani
- School of Population and Public Health, The University of British Columbia, Vancouver, Canada
| | - Yewande Ogundeji
- O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | - Chinyere Mbachu
- Health Policy Research Group, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Felix Abrahams Obi
- Systems Development Initiative, Abuja, Nigeria,,Results for Development (R4D), Nigeria Country Office, Abuja, Nigeria
| | - Okikiolu Badejo
- Systems Development Initiative, Abuja, Nigeria,,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Shabankareh K, Mojiri S, Soleymani MR, Hamidi A, Sajadi HS, Alavi M. Strategies, facilitators, and barriers to interaction between health researchers and policy makers: Protocol for a systematic review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:235. [PMID: 36177411 PMCID: PMC9514246 DOI: 10.4103/jehp.jehp_497_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 10/29/2021] [Indexed: 06/16/2023]
Abstract
This systematic review protocol is developed with the objective to identify the strategies, facilitators, and barriers to interaction between researchers and policy makers to use research evidence in health policy making. It seems that review of interactive methods between researchers and policy makers can help to understand the role of researchers on evidence-informed policy making. Moreover, identifying barriers and facilitators of these interactions can help universities and institutions associated to health policy making in planning to improve the interaction between researchers and policy makers to facilitate evidence-informed policy making.
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Affiliation(s)
- Khadijeh Shabankareh
- Department of Medical Library and Information Sciences, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahin Mojiri
- Department of Medical Library and Information Sciences, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Soleymani
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Hamidi
- Department of Medical Library and Information Sciences, Faculty of Paramedicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Haniye Sadat Sajadi
- Healthcare Services Management, Knowledge Utilization Research Center, University Research and Development Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mousa Alavi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Shafaghat T, Zarchi MKR, Nasab MHI, Kavosi Z, Bahrami MA, Bastani P. Force field analysis of driving and restraining factors affecting the evidence-based decision-making in health systems; comparing two approaches. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:419. [PMID: 35071625 PMCID: PMC8719555 DOI: 10.4103/jehp.jehp_1142_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 04/02/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND All policies and decisions need evidence examined by scientific methods. Moving toward evidence-based decision-making (EBDM) as a change in organizations, especially health systems (HSs), is inevitable. This study was conducted to identify the factors affecting EBDM in HSs from two approaches and to score them. MATERIALS AND METHODS A mixed-method study was carried out using the force field analysis regarding the change toward EBDM in HS in 2020. This study included six steps to identify and score the key driving forces (DFs) and restraining forces (RFs) to change toward the EBDM in HS: first, finding forces from literature; second, selecting key DFs and RFs through focus group discussion; third, scoring the first group of DFs and RFs by the experts through electronic forms; fourth, determining key DFs and RFs from the managers' perspective using qualitative interviews; fifth, scoring the second group of DFs and RFs by the experts; and sixth, comparison between forces resulted from two approaches. RESULTS According to the literature and experts' opinions, "relevant, reliable, interpretable, and understandable evidence" and "interaction between researchers and decision-makers" were the strongest forces to change, and "lack of organizational commitment and support" and "lack of relevant/high-quality evidence" were the strongest forces against the change toward EBDM in HS. Further, based on managers' perspective and scores by the experts, "suitable supervision and control" and "reforming the planning and decision-making system" were the strongest forces to change, and "inadequate knowledge of the managers and staff about the principles and contents of EBDM" and "issues beyond the authorities of managers" were the strongest forces against the change toward EBDM in HS. CONCLUSIONS Based on the findings, HSs' managers can focus to reduce RFs and promote DFs for implementing EBDM strategies, so they can provide better services by making more efficient decisions.
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Affiliation(s)
- Tahereh Shafaghat
- Student Research Committee, Department of Health Care Management, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Kazem Rahimi Zarchi
- Department of Health Care Management, Health Policy and Management Research Center, School of Public Health, Shahid Saoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hasan Imani Nasab
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Zahra Kavosi
- Health Human Recourses Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahammad Amin Bahrami
- Health Human Recourses Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peivand Bastani
- Health Human Recourses Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
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Loncarevic N, Andersen PT, Leppin A, Bertram M. Policymakers' Research Capacities, Engagement, and Use of Research in Public Health Policymaking. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111014. [PMID: 34769533 PMCID: PMC8583010 DOI: 10.3390/ijerph182111014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 11/16/2022]
Abstract
The use of research in public health policymaking is one of the prerequisites for successfully implemented health policies which have better population health as an outcome. This policy process is influenced by the actors involved under the policy umbrella, with inter-related contextual factors and specific structural and institutional circumstances. Our study investigates how policymakers’ research capacities influence the use of research in the health policy process and identify areas where capacity-building interventions give the most meaning and impact. Furthermore, we investigate policymakers’ research engagement and use this to inform public health policy in the public sector in Denmark. We collect and report data using Seeking, Engaging with, and Evaluation Research (SEER) methodology. Policymakers are reported to have research capacity, but it is questionable how those competences have actually been used in policymaking. Decision-makers were often not aware or did not know about the existing organizational tools and systems for research engagement and use and two third of respondents had not been part of any research activities or had any collaboration with researchers. Overall, research use in public health policymaking and evaluation was limited. As a conclusion, we propose that capacity-building interventions for increasing research use and collaboration in EIPM should be context-oriented, measurable, and sustainable in developing individual and organizational competences.
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Sajadi HS, Majdzadeh R, Ehsani-Chimeh E, Yazdizadeh B, Nikooee S, Pourabbasi A, Lavis J. Policy options to increase motivation for improving evidence-informed health policy-making in Iran. Health Res Policy Syst 2021; 19:91. [PMID: 34098971 PMCID: PMC8186173 DOI: 10.1186/s12961-021-00737-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 05/12/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Current incentive programmes are not sufficient to motivate researchers and policy-makers to use research evidence in policy-making. We conducted a mixed-methods design to identify context-based policy options for strengthening motivations among health researchers and policy-makers to support evidence-informed health policy-making (EIHP) in Iran. METHODS This study was conducted in 2019 in two phases. In the first phase, we conducted a scoping review to extract interventions implemented or proposed to strengthen motivations to support EIHP. Additionally, we employed a comparative case study design for reviewing the performance evaluation (PE) processes in Iran and other selected countries to determine the current individual and organizational incentives to encourage EIHP. In the second phase, we developed two policy briefs and then convened two policy dialogues, with 12 and 8 key informants, respectively, where the briefs were discussed. Data were analysed using manifest content analysis in order to propose contextualized policy options. RESULTS The policy options identified to motivate health researchers and policy-makers to support EIHP in Iran were: revising the criteria of academic PE; designing appropriate incentive programmes for nonacademic researchers; developing an indicator for the evaluation of research impact on policy-making or health outcomes; revising the current policies of scientific journals; revising existing funding mechanisms; presenting the knowledge translation plan when submitting a research proposal, as a mandatory condition; encouraging and supporting mechanisms for increasing interactions between policy-makers and researchers; and revising some administrative processes (e.g. managers and staff PEs; selection, appointment, and changing managers and reward mechanisms). CONCLUSIONS The current individual or organizational incentives are mainly focused on publications, rather than encouraging researchers and policy-makers to support EIHP. Relying more on incentives that consider the other impacts of research (e.g. impacts on health system and policy, or health outcomes) is recommended. These incentives may encourage individuals and organizations to be more involved in conducting research evidence, resulting in promoting EIHP. TRIAL REGISTRATION NA.
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Affiliation(s)
- Haniye Sadat Sajadi
- Knowledge Utilization Research Center, University Research and Development Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Majdzadeh
- Community-Based Participatory-Research Center, Knowledge Utilization Research Center, and School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ehsani-Chimeh
- National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran.
| | - Bahareh Yazdizadeh
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sima Nikooee
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ata Pourabbasi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - John Lavis
- McMaster Health Forum and Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
- Africa Centre for Evidence, University of Johannesburg, Johannesburg, South Africa
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Okedo-Alex IN, Akamike IC, Olisaekee GO, Okeke CC, Uneke CJ. Identifying advocacy strategies, challenges and opportunities for increasing domestic health policy and health systems research funding in Nigeria: Perspectives of researchers and policymakers. Health Res Policy Syst 2021; 19:41. [PMID: 33752682 PMCID: PMC7983353 DOI: 10.1186/s12961-021-00701-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/03/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction Poor funding for Health Policy and Systems Research (HPSR) is a major constraint to the development, generation and uptake of HPSR evidence in Low and Middle-Income countries. The study assessed the status of HPSR domestic funding and advocacy strategies for improving HPSR funding in Nigeria. It equally explored the knowledge and perception of the domestic funding status of HPSR and the effect of capacity building on the knowledge of domestic funding for HPSR in Nigeria. Methods This was a sub-national study involving policymakers and researchers from Enugu and Ebonyi States in Southeast Nigeria who participated in the sub-national Health Systems Global convening for the African region. A before-after study design (workshop) was utilized. Data collection employed semi-structured questionnaires, group and panel discussions. The workshop facilitated knowledge of HPSR, funding processes, and advocacy strategies for increased domestic funding for HPSR. Pre and immediate post-workshop knowledge assessments were done. Data were analyzed using SPSS version 25 and thematic analysis. Results Twenty-six participants were involved in the study. Half were females (50.0%) and 46.2% were aged 35–44 years. Policymakers constituted 23.1% of the participants. Domestic funding for HPSR in Nigeria was adjudged to be grossly inadequate. Identified barriers to domestic funding of HPSR included bureaucratic bottlenecks, political and policy transitions, and corruption. Potential opportunities centered on existing policy documents and emerging private sector willingness to fund health research. Multi-stakeholder advocacy coalitions, continuous advocacy and researcher skill-building on advocacy with active private sector involvement were the strategies proffered by the participants. Pre-workshop, understanding of the meaning of HPSR had the highest mean ratings while knowledge of budgeting processes and use of legal action to enable opportunities for budget advocacy for HPSR funding had the lowest mean ratings. Following the capacity-building workshop, all knowledge and understanding parameters markedly improved (percentage increase of 12.5%–71.0%). Conclusion This study found that there was paucity of domestic funding for HPSR in Nigeria alongside poor knowledge of budgeting and advocacy strategies among both policymakers and researchers. We recommend the deployment of these identified strategies and wider national and regional stakeholder engagement towards prioritizing and improving domestic funding for HPSR.
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Affiliation(s)
- Ijeoma Nkem Okedo-Alex
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria. .,Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria.
| | - Ifeyinwa Chizoba Akamike
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria.,Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | | | | | - Chigozie Jesse Uneke
- African Institute for Health Policy and Health Systems, Ebonyi State University (EBSU), Abakaliki, Nigeria
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Okedo-Alex IN, Uneke CJ, Uro-Chukwu HC, Akamike IC, Chukwu OE. "It is what I tell her that she will do": a mixed methods study of married men's knowledge and attitude towards supporting their wives' cervical cancer screening in rural South-East Nigeria. Pan Afr Med J 2020; 36:156. [PMID: 32874420 PMCID: PMC7436653 DOI: 10.11604/pamj.2020.36.156.21157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 04/11/2020] [Indexed: 12/22/2022] Open
Abstract
Introduction cervical cancer is a leading cause of death among Nigerian women. Women often require spousal support before attending cervical cancer screening services. This study assessed married men´s knowledge and attitude towards male involvement in cervical cancer screening of their wives. Methods a cross-sectional study using a mixed methods approach was conducted among 245 married men in Izzi, Local Government Area of Ebonyi State, South-East Nigeria. Quantitative data collected using structured, interviewer-administered questionnaires and qualitative data from focus group discussions were triangulated. Data analysis was done using IBM SPSS version 20. Qualitative findings were analysed using thematic analysis. Results the mean knowledge of cervical cancer was 2.06±0.55. Only 2.9% of the respondents had adequate knowledge of risk factors for cervical cancer. Up to 89.8% were willing to approve screening for their spouses. Majority (76.3%) considered screening important in cervical cancer prevention, while 91.4% were willing to pay for the screening test. Most of them exhibited patriarchal tendencies and insisted that their wives must obtain their consent before screening as depicted by the statement “It is what I tell her that she will do”. Previous spousal screening was a predictor of good knowledge (OR = 10.94, 95% CI = 2.44-48.93; P=0.002). Conclusion married men in this study had poor knowledge of cervical cancer. However, they were willing to support cervical cancer screening conditional on their pre-information and consent. Awareness creation activities on cervical cancer screening should incorporate active engagement of husbands in order to promote screening uptake by their wives.
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Affiliation(s)
- Ijeoma Nkem Okedo-Alex
- African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria.,Department of Community Medicine, Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - Chigozie Jesse Uneke
- African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
| | - Henry Chukwuemeka Uro-Chukwu
- African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
| | - Ifeyinwa Chizoba Akamike
- African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria.,Department of Community Medicine, Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - Onyedikachi Echefu Chukwu
- African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
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Onwujekwe O, Mbachu C, Etiaba E, Ezumah N, Ezenwaka U, Arize I, Okeke C, Nwankwor C, Uzochukwu B. Impact of capacity building interventions on individual and organizational competency for HPSR in endemic disease control in Nigeria: a qualitative study. Implement Sci 2020; 15:22. [PMID: 32299484 PMCID: PMC7164165 DOI: 10.1186/s13012-020-00987-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 04/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The need to build capacity for health policy and systems research (HPSR) in low- and middle-income countries has been underscored as this encompasses the processes of decision-making at all levels of the health system. This implementation research project was undertaken in Southeast Nigeria to evaluate whether the capacity-building intervention improves the capacity to produce and use research evidence for decision making in endemic disease control. METHODS Three training workshops were organized for purposively selected participants comprising "producers of evidence" such as health research scientists in three universities and "users of evidence" such as policy makers, program managers, and implementers in the public health sector. Participants also held step-down workshops in their organizations. The last workshop was used to facilitate the formation of knowledge networks comprising of both producers and users, which is a critical step for getting research into policy and practice (GRIPP). Three months after the workshops, a subset, 40, of workshop participants was selected for in-depth interviews. Information was collected on (i) perceptions of usefulness of capacity-building workshops, (ii) progress with proposed research and research uptake activities, (iii) effects of these activities on evidence-informed decision making, and (iv) constraints and enablers to implementation of proposed activities. RESULTS Most participants felt the workshops provided them with new competencies and skills in one or more of research priority setting, evidence generation, communication, and use for the control of endemic diseases. Participants were at different stages of planning and implementing their proposed research and research uptake activities, and were engaging across professional and disciplinary boundaries to ensure relevance and usefulness of outputs for decision making. Key enablers of successful implementation of activities were positive team dynamics, good balance of competencies, effective communication and engagement within teams, team leader's capacity to innovate, and personal interests such as career progress. Lack of funding, limited decision space, organizational bureaucracies, and poor infrastructure were the key constraints to the implementation of proposed activities. Lack of mentorship and continuous support from trainers delayed progress with implementing proposed activities. CONCLUSIONS The capacity-building interventions contributed to the development of a critical mass of research scientists, policy makers, and practitioners who have varying levels of competencies in HPSR for endemic disease control and would require further support in carrying out their medium and long-term goals.
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Affiliation(s)
- Obinna Onwujekwe
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria
- Health Policy Research Group, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Chinyere Mbachu
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria.
- Department of Community Medicine, University of Nigeria Enugu campus, Nsukka, Nigeria.
| | - Enyi Etiaba
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria
- Health Policy Research Group, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Nkoli Ezumah
- Health Policy Research Group, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Uchenna Ezenwaka
- Health Policy Research Group, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Ifeyinwa Arize
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria
- Health Policy Research Group, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Chinyere Okeke
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria
- Department of Community Medicine, University of Nigeria Enugu campus, Nsukka, Nigeria
| | - Chikezie Nwankwor
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria
- Health Policy Research Group, University of Nigeria Nsukka, Nsukka, Nigeria
| | - Benjamin Uzochukwu
- Department of Health Administration and Management, University of Nigeria Enugu campus, Nsukka, Nigeria
- Department of Community Medicine, University of Nigeria Enugu campus, Nsukka, Nigeria
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