Federal Capital Territory Research Articles

Official statistics: Providing data acumen in the advent and continuous presence of COVID-19

COVID-19 has disturbed people’s patterns of life and sources of income, particularly the income of informal sector business operators and households worldwide. As extraordinary policy initiatives are calibrated, the requirement for timely statistics on health and economic development rises. Thus, the purpose of this research is to analyze the Internally Generated Revenue (IGR) available to Nigerian states in 2020 and 2019 by examining the disparities caused by the COVID-19 pandemic and its impact on the country’s approximately 200 million people. The exploratory research approach was used, with a particular emphasis on descriptive and trend analysis of the data acquired during the study periods. According to the findings, 46% of Nigerian states, including the Federal Capital Territory, suffered reductions in IGR generation as the pandemic surged, whereas 35 per cent of the states experienced a corresponding increase in IGR and confirmed COVID-19 infections. However, 16% of the states reported an inverse growth in their IGR as the number of verified COVID-19 cases decreased. To deal with the unprecedented shocks caused by the ongoing existence of COVID-19, which necessitate the tapping of new information and revenue streams, a continual review of countries’ revenue sources is required.

Multilevel analysis of individual- and community-level determinants of birth certification of children under-5 years in Nigeria: evidence from a household survey

Promoting birth certification is central to achieving legal identity for all - target 16.9 of the 2030 Sustainable Development Goals. Nigeria is not on track to achieve this goal with its low coverage of birth certification (BC). This study is aimed at identifying patterns of BC and its associated individual- and community-level factors, using pooled cross-sectional data from three rounds (2008, 2013, and 2018) of the nationally representative Nigerian Demographic and Health Survey. A weighted sample of 66,630 children aged 0–4 years was included, and a two-level multilevel logistic model which accommodates the hierarchical nature of the data was employed. Of the total sample, 17.1% [95% CI: 16.3–17.9] were reported to be certified. Zamfara state (2.3, 95% CI: 0.93–3.73) and the Federal Capital Territory (36.24, 95% CI: 31.16–41.31) reported the lowest and the highest BC rates. Children with an SBA [AOR = 1.283, 95% CI: 1.164–1.413] and with at least one vaccination [AOR = 1.494, 95% CI: 1.328–1.681] had higher odds of BC. The AOR for mothers with at least one prenatal visit was 1.468 [95% CI: 1.271–1.695], and those aged 30–34 years at the time of birth [AOR = 1.479, 95% CI: 1.236–1.772] had the highest odds. Further, the odds of BC increased the most for mothers [AOR = 1.559, 95% CI: 1.329–1.829] and fathers [AOR = 1.394, 95% CI: 1.211–1.605] who were tertiary-educated. In addition, children in middle-income [AOR = 1.430, 95% CI: 1.197–1.707] or rich wealth HHs [AOR = 1.776, 95% CI: 1.455–2.169] or those whose families had bank accounts [AOR = 1.315, 95% CI: 1.187–1.456] had higher odds. Living in non-poor and within close proximity to a registration center (RC) act as protective factors for BC, while living in poor communities [AOR = 0.613, 95% CI: 0.486–0.774] and more than 10kms from an RC reduce the odds of BC [AOR = 0.466, 95% CI: 0.377–0.576]. The study identified several protective and risk factors which policymakers can adopt as strategic areas for universal birth certification. National and sub-national programs should integrate non-formal institutions as well as target child and maternal utilization of healthcare services to promote BC in Nigeria.

DETERMINANTS OF FARMERS’ WILLINGNESS-TO-ACCEPT SEED PRODUCTION TECHNOLOGY AND THEIR POTENTIAL CAPACITY FOR RICE SEED PRODUCTION IN FEDERAL CAPITAL TERRITORY, NIGERIA

The study examined the determinants of farmers’ willingness-to-accept rice seed production technology and their potential capacity for seed production in Federal Capital Territory, Nigeria using primary data collected from 220 rice farming households. Heckman two-stage selection model analysis revealed that willingness-to-accept rice production technology and the potential capacity to produce rice seeds were influenced by certain factors, the results showed that age of the household heads (z = -1.80), dependency ratio (z = -1.77), farming experience (z = 2.68) at 1%, rice farming experience (z = -3.02), income (z = 5.62), land ownership (z = 3.66), family labour (z = 2.28), hired labour (z = -3.11), training in rice farming/production (z = 2.71) and training in rice seed production (z = -2.76) were statistically significant and influenced rice production potential capacity among the rice farming households at in the study area. The study then recommends that proactive land tenure policies and training in agronomic practices are needed to enhance rice seed production capacity of the rice farming households in the Federal Capacity Territory, Nigeria.

Stakeholder perspectives on the demand and supply factors driving substandard and falsified blood pressure lowering medications in Nigeria: a qualitative study

ObjectivesAlthough substandard and falsified (SF) blood pressure (BP) lowering medications are a global problem, qualitative research exploring factors driving this in Nigeria has not been reported. This study provides information...

Geospatial Distribution of Waste Dumpsites for Sustainable Solid Waste Management In Abuja Municipal Area Council (AMAC), Federal Capital Territory, Nigeria

Geospatial Distribution of Waste Dumpsites for Sustainable Solid Waste Management In Abuja Municipal Area Council (AMAC), Federal Capital Territory, Nigeria

Awareness: a strategic tool for the implementation of green libraries by academic librarians

This study sought to examine the importance of awareness in the adoption and implementation of green libraries in academic libraries in Nigeria. The key objectives were to determine academic librarians’ awareness of the concept of green libraries, ascertain if greening libraries is a good innovation for adoption and implementation, ascertain reasons for the slow adoption and implementation of green libraries by academic librarians in Nigeria and to identify strategies for enhancing green library implementation in Nigerian academic libraries. The methodology used was the descriptive survey research design while all the 170 academic librarians in the twelve university libraries across the six states of the North Central geo-political zone of Nigeria and the Federal Capital Territory, Abuja formed the population of the study. Questionnaire was used as the instrument for data collection. Data obtained were analyzed using simple percentages, mean scores and standard deviation. Various suggestions were made on how to create awareness and use it as a strategic tool in the implementation of green libraries in academic libraries. The paper concluded that implementing green libraries will enhance the visibility and value of libraries in society by showcasing their ability to contribute significantly to environmental sustainability and development issues, thereby demonstrating their continued relevance to humanity.

Retrospective Characterization of Noma Cases Found Incidentally across Nigeria during Outreach Programs for Cleft Lip from 2011-2020.

Reports of cases of noma in Nigeria remain scarce despite its known and devastating effects on victims. This report presents a retrospective cross-sectional study based on data regarding on patients with noma encountered incidentally during Oral Health Advocacy Initiative outreach on orofacial diseases across 34 states and the Federal Capital Territory in Nigeria over 10 years (2011-2020), which was aimed at contributing to an understanding of the epidemiology of noma in Nigeria. The data were collated and analyzed, and are presented in frequency distribution tables and charts. A total of 7,195 patients with noma were encountered. The northeastern region had the greatest number of patients (n = 1,785, 24.8%) whereas the southwestern region had the least (n = 196, 2.7%). When aggregated by state, Ondo State had the least number of patients (n = 31, 0.4%) whereas Kano State had the greatest (n = 623, 8.7%). Patient age ranged from 3 to 70 years, with a slight male preponderance (56.9%). This report highlights the fact that noma is prevalent in Nigeria but remains neglected, with extensive but preventable physical, emotional, and social debilitation and devastation of the victims across all age groups. There is a need for a more robust survey to determine the true burden of the disease. There is also an urgent need for collaboration between governments and nongovernmental organizations to institute appropriate interventions by way of public education and enlightenment, as well as case detection and early treatment to mitigate the devastating consequences of delayed or poorly managed cases.

Abstract 13217: Optimizing Longitudinal Retention in Care Among Patients With Hypertension in Primary Healthcare Settings: Findings From the Hypertension Treatment in Nigeria Program

Introduction: Previous hypertension research has evaluated retention using cross-sectional study designs. However, longitudinal analyses are likely more useful to identify areas for improving retention. Objective: To describe longitudinal retention patterns among patients with hypertension in primary care in 6 Federal Capital Territory council areas in Nigeria. Methods: The Hypertension Treatment in Nigeria Program implemented a multi-level intervention package in 60 centers in Nigeria. Baseline and follow-up data were collected from January 2020 to December 2021. Healthcare workers scheduled patients for a follow-up appointment at each visit, for which one month was recommended. Retention was measured by the patient presenting to the clinic for a follow-up visit within 7 days of the scheduled appointment. Results: 14,346 patients (68.7% female, mean [SD] age = 49.1 [12.6] years) were included with 61,320 documented visits, among which 14,975 were registration visits and 46,345 were follow-up visits. 9,490 (66.2%) patients had ≥1 follow-up visit. Fig 1 demonstrates longitudinal patterns for 37-day retention by council area, in which Kuje has the highest follow-up rate (55.6%) while variability was seen across areas. The median (IQR) time to the scheduled appointment was 30 days (28, 31), and observed time to follow-up visit was 32 days (29, 42). 40,759 (66.5%) appointments were scheduled ≤ 30 days, 58,773 (95.8%) appointments were scheduled ≤ 37 days, and 282 appointments (0.5%) were scheduled ≥ 60 days after the previous visit. Among documented follow-up visits, 16,524 (35.7%) occurred within 30 days of the prior visit, 32,145 (69.4%) occurred within 37 days, and 31,344 (67.6%) were within 7 days of the scheduled appointment. Conclusions: Retention in hypertension is widely variable within individuals, over time, and across council areas. Longitudinal retention analyses provide robust assessments to develop tailored strategies to improve retention.

Individual and ecological analyses of antenatal care: Prospects for delivery assistance and use of modern family planning in Nigeria.

Despite the availability of healthcare centres for the provision of antenatal care (ANC) services in Nigeria, the services are still underutilized by pregnant women. ANC services not only reduce maternal mortality and birth defects, but also have a strong link to many causes of maternal deaths. This study explored the individual and ecological relationships between antenatal care, skilled birth assistance during delivery, and family planning use across states in Nigeria. This study was a secondary analysis of data from the 2018 National Nutrition and Health Survey (NNHS) carried out among 24,985 women aged 15-49 years in the 36 states and the Federal Capital Territory (FCT) in Nigeria. Analysis was carried out at the level of individual women and at the ecological level. Only 68.3% visited a health professional (doctors, nurses, midwives, community health extension workers, and community health officers) for ANC in the most recent pregnancy before the survey. At delivery, 44.9% were assisted by delivery attendants with about half (50.1%) assisted by non-professional (traditional birth attendants, relatives and friends) during delivery. There was a significant variation in use of modern family planning (FP) across types of ANC provider. There was a strong positive correlation between ANC utilisation and skilled birth attendance (SBA) (r=0.706, p <0.001), and between SBA and FP (r=0.730, p <0.001). These results have implications for the design of appropriate interventions for strengthening the role of healthcare providers to enhance ANC patronage, utilization of safe delivery services and sustained use of reproductive health services.

Assessment of the progress toward elimination of lymphatic filariasis in the Federal Capital Territory- Abuja, Nigeria

Lymphatic filariasis (LF) is a neglected tropical disease caused by threadlike worms (nematodes) that live in the lymphatic vessels of humans. Although three species of filarial parasites (Wuchereria bancrofti, Brugia malayi and Brugia timori) infect humans; 90% of infection is caused by Wuchereria Bancrofti and humans are its exclusive host. Nigeria is one of over 70 countries endemic for Lymphatic filariasis with an estimated 134 million people at the risk of infection. The Federal Capital Territory (FCT), which is endemic for LF, commenced mass drug administration (MDA) using ivermectin (IVM) and albendazole (ALB) in 2011. While MDA is continuing in two Area Councils, in 2020, we assessed the impact of MDA on LF prevalence in two area councils that had achieved five effective annual rounds of MDA. In 2010, a baseline mapping exercise was conducted in all six area councils of FCT-Abuja. The results revealed that four out of the six area councils were endemic for LF, with prevalence ranging from 1.0%-4.0%. The number of persons treated with ivermectin and albendazole in the four Area Councils was documented during annual MDA and population-based cluster surveys were conducted at least once in each area council during the five years of treatment, to verify the reported geographic and programme MDA coverage. This is the number treated divided by the total population eligible to receive treatment (usually &amp;lt;5years). The survey results confirmed that in two area councils (Abaji and Kuje) the coverage exceeded the target of 65% the while two other Councils did not reach the recommended coverage. A pre-transmission assessment survey (pre-TAS) was conducted in one sentinel site and at least one spot check site in Abaji and Kuje in 2019 and were found to have LF antigenemia (LF Ag) &amp;lt; 2% (range 0.0% to 1.99%). In 2020, transmission assessment surveys (TAS) were conducted in the two area councils that previously passed the Pre-transmission assessment survey. The results showed that the two Evaluation units had achieved the LF Ag threshold required to stop MDA. FCT has made significant progress towards LF elimination with two Area Councils qualifying to stop treatment. However, two other area councils still require a further two years of mass drug administration with effective MDA coverage before these area councils qualify for impact assessment.

ASSESSMENT OF INVESTMENT D ECISIONS AND FINANCIAL PERFORMANCE OF SMALL AND MEDIUM ENTERPRISES IN FEDERAL CAPITAL TERRITORY, NIGERIA

This study evaluated the Assessment of Investment Decisions and Financial Performance of Small and Medium Enterprises in the Federal Capital Territory, Nigeria. Multi-stage sampling technique was adopted and used. Data were collected through the use of structured questionnaires from 400 sampled SMEs. Data were analyzed using, Descriptive Statistics, Correlation Matrix and Logit Regression Model. The results show there is a positive correlation between annual return i.e. financial performance and new property acquisition and a negative correlation existed with new plant and acquisition. The result of the logit model shows that the factors influencing investment decisions among SMEs were the coefficient of education (P&lt;0.01) probability level. The coefficient of the competition level was negative and statistically significant at (P &lt;0.05). Furthermore, the coefficient of the initial investment capital (P&lt;0.05). The coefficient of the infrastructure was positive and statistically significant at (P&lt;0.05). Therefore, the study recommends that Policy should be formulated towards educating and training SMEs owners to have more knowledge about business enterprise operations in order to be able to assess their financial performance, external funding and capital should be provided to SMEs at a lower and affordable interest rate, SMEs owners should be encouraged to be willing to invest more into their business to expand their business for more profit, local polices and local infrastructure to enhance SMEs participation in Federal Capital Territory AMAC should be provided. Media blitz could also be harnessed to augment policy awareness among SMEs.

Mycotoxin Profile of Honey and Dry-Cured Meat (Kilishi) for Export in Abuja, Nigeria

Animal products are not immune to contaminants and could render them not safe for local consumption or unacceptable for export. This study aimed to ascertain the prevalence and profile of Aflatoxins (AFs), Ochratoxins (OTs) and Fumonisins (FBs) contamination in honey and dry-cured meat (kilishi) intended for export in the Federal Capital Territory (FCT) of Nigeria. Ninety (90) samples of each animal product were collected and analyzed. Mycotoxins were determined using High-Performance Liquid Chromatography (HPLC) quantitative techniques. According to the investigation, none of the honey samples for export from the FCT Abuja was positive for Aflatoxin B1 (AFB1) and Aflatoxin B2 (AFB2) contaminants. The occurrence of Ochratoxin A (OTA) was most prevalent in the samples of honey from Abuja East, but with the greatest average concentration (62.87 μg/Kg) in the samples from Abuja South. In samples from the Abuja South zone, the prevalence of AFB1 and AFB2 in the kilishi was relatively high (73.33% and 66.67% respectively). Also, OTA and Ochratoxin B (OTB) were detected at varying levels in the cured meat. Dry-cured meat sold in Abuja Nigeria to consumers and for export is found not safe due to Aflatoxin B1 and B2, OTA and OTB contamination level which was above the EU maximum limit. The regulatory bodies in the country should always carry out routine monitoring to guarantee that marketed products from animals are consumable and also exportable.

Governance and Institutional Drivers of Ecological Degradation in Urban River Ecosystems: Insights from Case Studies in African Cities

The degradation of rivers in urban landscapes is alarming and impaired their ecological functions and the services they provide to society. In African cities, urban rivers are among the most degraded ecosystems, yet ecologically sustainable utilisation of river resources can contribute to and support sustainable urban development. In this paper, we identify and analyse key governance and institutional drivers of ecological change in urban river systems in the Swartkops catchment in South Africa and the Federal Capital Territory (FCT) in Nigeria. Our results indicate that poor ecological conditions of rivers in the two urban landscapes can be attributed to: (1) a lack of system view of the water value chain and associated infrastructure, (2) ambiguity in roles, responsibilities, and poor accountability, (3) prioritizing short-term social–economic–political agenda over long-term environmental sustainability goals, (4) institutional silos and failure of cooperative governance, and (5) over-centralised, top-down, state-centric governance processes. Strengthening the interactions between actors in the science, policy and practice domains, mainstreaming planning with rivers in integrated urban development plans, and strengthening cooperative and polycentric governance across administrative scales are key governance and institutional processes needed to address the trajectory of urban ecological degradation. Our paper sheds light on the fundamental role of strengthening governance and institutional processes for steering urban rivers toward sustainable paths for city resilience.

Key Population Size Estimation to Guide HIV Epidemic Responses in Nigeria: Bayesian Analysis of 3-Source Capture-Recapture Data.

Nigeria has the fourth largest burden of HIV globally. Key populations, including female sex workers, men who have sex with men, and people who inject drugs, are more vulnerable to HIV than the general population due to stigmatized and criminalized behaviors. Reliable key population size estimates are needed to guide HIV epidemic response efforts. The objective of our study was to use empirical methods for sampling and analysis to improve the quality of population size estimates of female sex workers, men who have sex with men, and people who inject drugs in 7 states (Akwa Ibom, Benue, Cross River, Lagos, Nasarawa, Rivers, and the Federal Capital Territory) of Nigeria for program planning and to demonstrate improved statistical estimation methods. From October to December 2018, we used 3-source capture-recapture to produce population size estimates in 7 states in Nigeria. Hotspots were mapped before 3-source capture-recapture started. We sampled female sex workers, men who have sex with men, and people who inject drugs during 3 independent captures about one week apart. During hotspot encounters, key population members were offered inexpensive, memorable objects unique to each capture round. In subsequent rounds, key population members were offered an object and asked to identify objects received during previous rounds (if any). Correct responses were tallied and recorded on tablets. Data were aggregated by key population and state for analysis. Median population size estimates were derived using Bayesian nonparametric latent-class models with 80% highest density intervals. Overall, we sampled approximately 310,000 persons at 9015 hotspots during 3 independent captures. Population size estimates for female sex workers ranged from 14,500 to 64,300; population size estimates for men who have sex with men ranged from 3200 to 41,400; and population size estimates for people who inject drugs ranged from 3400 to 30,400. This was the first implementation of these 3-source capture-recapture methods in Nigeria. Our population size estimates were larger than previously documented for each key population in all states. The Bayesian models account for factors, such as social visibility, that influence heterogeneous capture probabilities, resulting in more reliable population size estimates. The larger population size estimates suggest a need for programmatic scale-up to reach these populations, which are at highest risk for HIV.

Factors Associated with Diarrheagenic Escherichia Coli Infection among Children with Diarrhea in Kwali, Federal Capital Territory, Nigeria

Factors Associated with Diarrheagenic Escherichia Coli Infection among Children with Diarrhea in Kwali, Federal Capital Territory, Nigeria

A simplified structure-from-motion photogrammetry approach for urban development analysis

Despite the increasing availability of remote sensing imagery, spatial data of adequate spatio-temporal resolution for urban development analysis and urban planning remains inadequate in some places. Structure-from-Motion (SfM) photogrammetry provides a low-cost option to generate such data at the desired spatial resolution. This study thus presents a simplified approach for mapping and performing urban development analysis in a suburban area (Kuje) in Abuja, Federal Capital Territory, Nigeria. Here, we compared a Google Earth® historical imagery of 2005 (baseline data) with SfM-derived imagery of 2019 (recent data) to quantify the rate and magnitude of urban development in the area. The Ground Control Points (GCPs) survey achieved a Root Mean Square Error (RMSE) of 31.01 mm and 24.34 mm in planimetry and elevation respectively while the SFM survey achieved an RMSE of 21.11 mm, 25.35 mm and 96.06 mm in the X, Y & Z coordinate axes respectively, which are within the acceptable limit (<10 cm). The urban development analysis revealed that over the past 14 years, an average of 8 buildings were constructed per year. The area also witnessed an increase in the construction of roads and an associated decline in the green areas. In addition, the building height assessment revealed that land is not being used parsimoniously. The findings in this study demonstrate the viability of SfM photogrammetry in creating digital maps for small suburban areas and in performing urban development analysis. Furthermore, the results obtained can aid town planners and development authorities to make informed decisions about urban development issues in the area.

Legislative Immunity in Nigeria and the Arrest of Senator Rochas Okorocha by the Economic and Financial Crimes Commission: Interrogating the Law against the Sentiments

It is not unusual in Nigeria for persons to engage in confrontation with law enforcement officers in Nigeria at the point of attempt to arrest them. This nation became saddled with this development on the evening of the 24th day of May 2022 when virtually all the television channels in Nigeria and the social media was agog with live pictures from the Abuja, Federal Capital Territory residence of His Excellency Senator Rochas Okorocha. The operatives of the Economic and Financial Crimes Commission (hereinafter referred to as EFCC) with the Nigerian Police in an attempt to arrest the senator encountered resistance as he refused to surrender himself to the law enforcement agents but rather locked all the entrances to his residence. Reasonable force was deployed and some part of the roof and ceiling was pulled off in order to secure access to before he was arrested. This paper seeks to question the propriety or impropriety of the destruction of his property in an attempt to arrest the Senator without warrant of arrest; to examine the immunity of the senator from arrest being a serving senator and a former Governor of a State under the Nigerian laws in comparison with what obtains in foreign jurisdictions.

Resource Use Efficiency and Profitability Analysis of Tomato Production (Lycopersicum Esculetum Species) in Federal Capital Territory, Nigeria

This study evaluated resource use efficiency and profitability analysis of tomato production in Federal Capital Territory, Nigeria. The specific objectives were to: determine the socio-economic characteristics of tomato farmers; analyze the cost, returns and profitability of tomato production, evaluate factors influencing output of tomato production, estimate resource use efficiency of tomato production, and identify the constraints facing tomato farmers in the study area. Multi-stage sampling technique was used. Primary data were collected through the use of well-structured questionnaires administered to 100 sampled tomato farmers. Data were analyzed using the following tools of analysis; descriptive statistics, gross margin analysis, financial analysis, Cobb-Douglas production functional model and resource use efficiency index. The results show that 83% of sampled tomato farmers were male. About 54% of the sampled respondents were above 41years of age. Majority 79% of the sampled respondents had less than 5 members per household. The results of costs and return analysis show that total average revenue realized by tomato farmers in the study area was about N146,430.00 and total variable cost was N23,057.30. The cost of labour was about N 16,416 representing 70% of the proportion of the cost of tomato production in the study area. The gross margin obtained was N123,372.7 with operating ratio of 1.58 and rate of return on investment of 5.38 respectively. Factors influencing total output of tomato in the study area were household size (P&lt;0.01), farm size (P&lt;0.01), seed input (P&lt;0.05), and labour input (P&lt;0.01). Seed input, labour input, and chemical inputs were underutilized. The results further show that the sampled farmers encountered the following constraints in the cause of tomato production in the study area, land tenure system, lack of good road, inadequate capital, high cost of input and lack of price control. Therefore, the following recommendations were made; financial institutions should provide affordable financial support to tomato farmers and also encourage female farmers to participate in tomato production, improved seed varieties should be made available to farmers for increase in productivity, agricultural extension agents should be provided and organize training on post-harvest practices in order to increase farmers’ incomes and minimize tomatoes wastages in the study area, tomato farmers should form themselves into cooperatives in order for them to assess inputs and subsidies from the government, and also pool their resources together for easy access to inputs and negotiate price.

Rural electrification in Africa: a case study of Yebu community solar minigrid

Using field observation and focus group semi-structured interviews, we explored rural electrification dynamics within a rural community setting. We investigated the issues surrounding the emergence, deployment, operation and management of solar minigrid technology within Yebu community in the Federal Capital Territory, north-central Nigeria, and the associated issues that emerged over time. The study revealed that: (1) many solar minigrid energy access interventions do not have a viable business and sustainability plan that guarantees long term impact; (2) a lack of participatory decision making by all concerned stakeholders (from the project conception stage) has hindered the potential of many solar minigrid energy access projects to achieve their intended developmental and economic benefits. The paper concludes by highlighting the key recommendations that can help address these challenges.

It is not all about salary: a discrete-choice experiment to determine community health workers’ motivation for work in Nigeria

IntroductionCommunity health workers (CHWs) constitute the majority of primary healthcare (PHC) workers in Nigeria, yet little is understood about their motivations or the most effective interventions to meet their needs...