RESUMEN

Pandemics can result in significantly high rates of morbidity and mortality with higher impact in Lower- and Middle-Income Countries like Nigeria. Health systems have an important role in a multi-sector response to pandemics, as there are already concerns that COVID-19 will significantly divert limited health care resources. This study appraised the readiness and resilience of the Nigerian health system to the COVID-19 pandemic, using Oyo State, southwest Nigeria, as a case study. This study was a cross-sectional qualitative study involving key informant and in-depth interviews. Purposive sampling was used in recruiting participants who were members of the Task Force on COVID-19 in the state and Emergency Operations Centre (EOC) members (physicians, nurses, laboratory scientists, "contact tracers", logistic managers) and other partners. The state's health system response to COVID 19 was assessed using the WHO health systems framework. Audio recordings of the interviews done in English were transcribed and thematic analysis of these transcripts was carried out using NVIVO software. Results show that the state government responded promptly by putting in place measures to address the COVID-19 pandemic. However, the response was not adequate owing to the fact that the health system has already been weakened by various challenges like poor funding of the health system, shortage of human resources and inadequate infrastructure. These contributed to the health system's sub-optimal response to the pandemic. In order to arm the health system for adequate and appropriate response during major health disasters like pandemics, fundamental pillars of the health system-finance, human resources, information and technology, medical equipment and leadership - need to be addressed in order to have a resilient health system.

RESUMEN

Low- and middle-income countries are experiencing a transition from a preponderance of infectious to Non-Communicable Diseases (NCDs). Many of the behaviours that produce these risks often commence in late adolescence. The study assessed the prevalence and knowledge of the major risk factors for NCDs among undergraduates in Ibadan Metropolis. This was a comparative cross-sectional study using a systematic random sampling technique. Data were collected using the WHO STEPs questionnaire and were entered and analysed using SPSS version 21. Data were analyzed with descriptive statistics, Chi-square test, and logistic regression at p < 0.05. Of 1,200 undergraduates, 646 (53.8%) were male and 1062 (88.5%) were aged 15-24 years; mean age was 20.4 (+/-3.5) years; 673 (56.1%) lived on campus. Only 3.1% of the respondents were current tobacco smokers. Also, 51.3% of respondents currently take alcohol with 11.2% classified as having excess alcohol use (> 6 standard drinks in one sitting in the last 30 days). About three quarters (70.6%) of respondents were classified as having unhealthy diets based on fruit/vegetable servings per day. Only 29.3% had adequate physical activity. Moreover, 48.3% were classified as having poor knowledge of the risk factors for NCDs. Overall, 99.3% of respondents had at least one behavioural risk factor. Public university undergraduates were more likely to have good knowledge of these risk factors OR 1.485 (95% CI: 1.485-2.398, p < 0.001). Behavioural risk factors for NCDs were prevalent among these undergraduates. Knowledge of NCD risk factors was average and those who attended public universities were more likely to have good knowledge of the risk factors for NCDs.

Asunto(s)

RESUMEN

INTRODUCTION: North-west Nigeria is a traditionally high fertility setting. Increasing attention is being channeled into scaling up the various interventions that can reduce high fertility, including enhancing contraceptive uptake among women of reproductive age. However, in order to improve demand for contraception, understanding the level of awareness, knowledge and perception of WRA to contraceptive use is essential. This study examines the level of knowledge and perception of WRA to contraceptive use. METHODS: A descriptive cross-sectional study was carried out in December 2016 in Kebbi and Sokoto states, North-west Nigeria. Semi-structured questionnaires were administered to 500 women between the ages of 15-49 years in 4 randomly selected local government areas across the states. Data analysis included descriptive and bi-variate statistics. RESULTS: Only 43.8% claimed to be currently using a modern form of contraception; 82.4% were aware of at least one form of contraception, while health personnel formed the major source of information. The most popular and least common modern contraceptive methods were the male condom (86.8%) and vasectomy (26.6%) respectively. A higher proportion of married respondents (88.8%) than those presently single (68.8%) had good knowledge of contraceptives. Perception of contraceptives was mixed, with majority believing that contraceptives should be made available to every woman, despite stating that it contradicted their religious beliefs. CONCLUSION: These results underline the need for policy makers to focus on improving the knowledge of younger age groups on contraceptives and include other information channels such as peer-to-peer discussions to increase awareness.

Asunto(s)

RESUMEN

Nigeria is a signatory to the Framework Convention on Tobacco Control. However, tobacco control efforts have been fraught with challenges. These challenges cannot be presumed to be independent of tobacco industry manipulation. We examined submissions and viewpoints from prominent tobacco control stakeholders across social, administrative, and political strata to identify convergence with tobacco industry viewpoints. We illustrate how these convergences pose a threat to effective tobacco control in Nigeria. A thematic analysis of stakeholder viewpoints was conducted on submissions to the national assembly during the Tobacco Control Bill public hearings and various industry documents. Areas of convergence with tobacco industry narratives were then explored. Significant convergence in views was observed between government agencies, social groups, and the tobacco industry. These were for narratives on constitution of a National Tobacco Control Committee, use of automated vending machines, designation of smoking areas, report to regulatory agencies, and negative effect of tobacco control on trade and poverty. There was evidence of tobacco industry interference in tobacco control efforts, which manifested in some prominent tobacco control stakeholders adopting the narratives of the tobacco industry. We advocate a constant watchfulness over the activities of these stakeholders and a proactive engagement with evidence-based antitobacco dialogue.

Asunto(s)