Medicine and Health Sciences Commons^™

Pediatric To Adult Healthcare Transitioning For Adolescents Living With Hiv In Nigeria: A National Survey, Okikiolu A. Badejo, William A. Menson, Nadia A. Sam-Agudu, Jennifer Pharr, Salome Erekaha, Tamara Bruno, Gift Nwanne, Olabanjo Ogunsola, Jude Ilozumba, Olusegun Busari, Echezona E. Ezeanolue

Public Health Faculty Publications

Introduction The period of transition from pediatric to adult care has been associated with poor health outcomes among 10–19 year old adolescents living with HIV (ALHIV). This has prompted a focus on the quality of transition services, especially in high ALHIV-burden countries. Due to lack of guidelines, there are no healthcare transition standards for Nigeria’s estimated 240,000 ALHIV. We conducted a nationwide survey to characterize routine transition procedures for Nigerian ALHIV. Materials and methods This cross-sectional survey was conducted at public healthcare facilities supported by five local HIV service implementing partners. Comprehensive HIV treatment facilities with ≥1 year of HIV …

The Impact Of The Boko Haram Insurgency In Northeast Nigeria On Childhood Wasting: A Double-Difference Study, Gillian Dunn

Publications and Research

Background: This research examines the relationship between violent conflict and childhood wasting in Northeast Nigeria, where residents have been subjected to fighting between the Nigerian government and Boko Haram - an extremist Islamist movement - since 2009.

Methods: Using two Demographic and Health Surveys from before and after the Boko Haram insurgency started, a double-difference (difference-in-difference) approach is used to assess the impact of the conflict on mean weight for- height z-scores and the likelihood of wasting.

Results: Results suggest that if children exposed to the conflict had not been exposed, their mean weight-for height z-score would be 0.49 standard …

Findings From Post-Intervention Analysis Of Pre-Eclampsia/Eclampsia In Ebonyi State, Salisu Mohammed Ishaku

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal mortality. Following a landscape analysis to better understand the enormity of this problem across seven states in Nigeria, a cross-cutting intervention was implemented in Cross River, Ebonyi, and Kogi states. Researchers worked with primary healthcare (PHC) providers, policymakers, women’s groups, and community members to increase uptake of underutilized interventions and commodities for the prevention and treatment of PE/E in rural Nigeria. This brief presents study findings from Ebonyi State on post-intervention landscape changes in: programmatic and …

Hiv/Aids: Nigeria, Lauren Tropinski

Global Issues in Public Health

Nigeria has one of the largest prevalence rates of HIV infections in Africa. HIV is a communicable disease that is transmitted by bodily fluids through unprotected sex, using contaminated needles, or mother to child. The most affected populations include heterosexuals who have unprotected sex, followed by sex workers, and men who have sex with men. People will experience three stages of HIV before the last stage referred to as AIDS. Rapid diagnostic tests are used to diagnose the disease. There is no cure for HIV/AIDS. However, people with HIV are given antiretrovirals to keep HIV at a low level throughout …

Exploring The Nigerian Health System's Response To Female Genital Mutilation/Cutting, Otibho Obianwu

Reproductive Health

Although Nigeria has shown a steady long-term decline in female genital mutilation/cutting (FGM/C) prevalence, the practice remains widespread. This study brief outlines the Population Council’s Evidence to End FGM/C research program, which, in collaboration with the Federal Ministry of Health, will conduct a diagnostic assessment in order to: 1) examine how the healthcare sector supports the prevention of FGM/C; 2) determine the role of the healthcare sector in the management of FGM/C-related complications and the quality of care offered to clients; and 3) identify possible solutions for strengthening the healthcare system’s capacity to manage and prevent FGM/C. Findings are intended …

Findings From Post-Intervention Analysis Of Pre-Eclampsia/Eclampsia In Kogi State, Salisu Mohammed Ishaku

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal mortality. Following a landscape analysis to better understand the enormity of this problem across seven states in Nigeria, a cross-cutting intervention was implemented in Cross River, Ebonyi, and Kogi states. Researchers worked with primary healthcare (PHC) providers, policymakers, women’s groups, and community members to increase uptake of underutilized interventions and commodities for the prevention and treatment of PE/E in rural Nigeria. This brief presents study findings from Kogi state on post-intervention landscape changes in: programmatic and …

The Rationale And Relevance Of Existing Cadres Of Frontline Health Workers And Potential For New Mid-Level Cadres, Oladimeji Oladepo, Ekechi Okereke, Akinwumi Akinola

Reproductive Health

Front-line health workers (FLHWs) are expected to perform necessary maternal, newborn, and child (MNCH) services appropriately and effectively; however, few studies have investigated the extent to which FLHWs perform requisite primary health care (PHC) services. This study seeks to better understand not only FLHWs’ knowledge and performance of MNCH services, but the factors promoting and inhibiting their services in selected rural local government areas of Nigeria’s Bauchi and Cross River states. It also investigates the potential for a new PHC worker cadre, soliciting stakeholders’ perceptions about its feasibility for addressing maternal and newborn disease burdens in rural communities. The study’s …

Prevalence And Factors Associated With Underutilization Of Antenatal Care Services In Nigeria: A Comparative Study Of Rural And Urban Residences Based On The 2013 Nigeria Demographic And Health Survey, Emmanuel O. Adewuyi, Asa Auta, Vishnu Khanal, Olasunkanmi D. Bamidele, Cynthia P. Akuoko, Kazeem Adefemi, Samson J. Tapshak, Yun Zhao

Research outputs 2014 to 2021

Introduction Antenatal care (ANC) is a major public health intervention aimed at ensuring safe pregnancy outcomes. In Nigeria, the recommended minimum of four times ANC attendance is underutilized. This study investigates the prevalence and factors associated with underutilization of ANC services with a focus on the differences between rural and urban residences in Nigeria. Methods We analyzed the 2013 Nigeria Demographic and Health Survey dataset with adjustment for the sampling weight and the cluster design of the survey. The prevalence of underutilization of ANC was assessed using frequency tabulation while associated factors were examined using Chi-Square test and multivariable logistic …

Feasibility And Acceptability Of Hiv Self-Testing Among Men Who Have Sex With Men In Nigeria, Population Council

HIV and AIDS

HIV self-testing (HIVST) provides an alternative to facility-based HIV testing services, particularly for key populations such as men who have sex with men (MSM), who face barriers to testing due to stigma, discrimination, and criminalization. This brief reports on a study in Nigeria that demonstrates high acceptability for HIVST among MSM. Lessons learned from this study indicate that the scale-up of HIVST in Nigeria must include provision of adequate pre- and post-test counseling information, as well as the availability of helpline support to improve linkage to care for those who test positive. Future research should explore how HIV retesting can …

Reducing Provider-Held Stigma And Improving Young Client Satisfaction In Strengthening Integrated Delivery Of And Access To Comprehensive Hiv And Sexual/Reproductive Health And Support Services For Msm In Lagos, Nigeria, Population Council

HIV and AIDS

Riding on the success of the one-stop shop community health center, in 2016 the Elton John AIDS Foundation engaged the Population Council to implement an integrated model providing comprehensive HIV and sexual and reproductive health and support services to men who have sex with men (MSM) in Lagos, Nigeria. The two-year project was designed to deploy a “hub and spoke” peer-led (or peer navigation) model to integrate comprehensive MSM-friendly HIV and sexual and reproductive health (SRH) services in public health facilities in Lagos state. This brief summarizes findings from the study which sought to reach 9,500 MSM with HIV testing …

Assessing The Feasibility And Acceptability Of Community Health Extension Workers To Treat Hypertension Associated With Pregnancy: An Analysis Of Post-Intervention Findings, Salisu Mohammed Ishaku

Reproductive Health

This brief reports on a study that tested the feasibility of tasking community health extension workers (CHEWs) with detecting and managing hypertension, and prescribing an oral antihypertensive drug at primary health care (PHC) facilities in Nigeria as part of a package of care for women with pre-eclampsia and eclampsia (PE/E). This evaluation measured improvements in knowledge retention and increases in early detection, prevention, and management of PE/E. Findings indicate that trained CHEWs working at intervention PHCs can correctly identify, differentiate, and manage normal, mild, moderate, and severe hypertension. These findings are important contributions to implementing Nigeria’s national task-shifting policy at …

Engaging Community Women's Groups For Improved Uptake Of Antenatal Care Services In Cross River State, Nigeria: An Analysis Of Post-Intervention Findings, Salisu Mohammed Ishaku

Reproductive Health

The Ending Eclampsia project seeks to understand the potential of underutilized and promising interventions that increase access to services, particularly improving community referral systems. This brief reports on a study in Nigeria’s Cross River state that aimed to test the feasibility of women’s group leaders delivering health information for pre-eclampsia and eclampsia (PE/E), referral, and other antenatal care (ANC) services to their peers, to increasing access to quality maternal and newborn health services. Women’s group findings suggest that community engagement is a critical model for information sharing and is an adaptable, acceptable model for increasing PE/E prevention and danger-sign recognition …

Reducing Barriers To Accessing Fistula Repair: Implementation Research In Ebonyi, Pooja Sripad, Emmanuel Nwala, Vandana Tripathi

Reproductive Health

Female genital fistula is preventable and surgically treatable, but women who lack access to quality health care often live with fistula for many years. For every 1,000 births, an estimated 2.11 women develop fistula in Nigeria and despite the establishment of internationally accredited national fistula centers across the country, the majority of women live with unrepaired fistula. The Population Council, in collaboration with EngenderHealth and the Fistula Care Plus project, conducted implementation research to understand whether a comprehensive information, screening, and referral intervention reduces transportation, communication, and financial barriers to accessing preventive care, detection, and treatment of fistula in Ebonyi …

Reducing Barriers To Accessing Fistula Repair: Implementation Research In Katsina, Pooja Sripad, Emmanuel Nwala, Vandana Tripathi

Reproductive Health

Female genital fistula is preventable and surgically treatable, but women who lack access to quality health care often live with fistula for many years. For every 1,000 births, an estimated 2.11 women develop fistula in Nigeria and despite the establishment of internationally accredited national fistula centers across the country, the majority of women live with unrepaired fistula. The Population Council, in collaboration with EngenderHealth and the Fistula Care Plus project, conducted implementation research to understand whether a comprehensive information, screening, and referral intervention reduces transportation, communication, and financial barriers to accessing preventive care, detection, and treatment of fistula in Katsina …

Findings From Post-Intervention Analysis Of Pre-Eclampsia/Eclampsia In Cross River State, Salisu Mohammed Ishaku

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal mortality. Following a landscape analysis to better understand the enormity of this problem across seven states in Nigeria, a cross-cutting intervention was implemented in Cross River, Ebonyi, and Kogi states. Researchers worked with primary healthcare (PHC) providers, policymakers, women’s groups, and community members to increase uptake of underutilized interventions and commodities for the prevention and treatment of PE/E in rural Nigeria. This brief presents study findings from Cross River State on post-intervention landscape changes in: programmatic …

Understanding Medicalisation Of Female Genital Mutilation/Cutting (Fgm/C): A Qualitative Study Of Parents And Health Workers In Nigeria, Otibho Obianwu, Adetayo Adetunji, Osasuyi Dirisu

Reproductive Health

This community-based, cross-sectional qualitative study was conducted in four communities in Nigeria’s Delta, and was conceptualized to address gaps in our understanding of medicalization of female genital mutilation/cutting (FGM/C) and to provide critical evidence needed to effectively design abandonment interventions. The study findings reveal that the social norms driving FGM/C practice remain entrenched despite a shift to medicalization. They also reflect the tendency of parents and health workers to view FGM/C, whether traditional or medicalized, as a minor procedure with few complications and significant benefits that would positively impact a daughter’s future status as a wife and mother. Findings reveal …