Outcomes In Nigeria Research Articles

Economic growth, air pollution and health outcomes in Nigeria: A moderated mediation model

The third of the sustainable development goals is to ensure healthy living and promote well-being for all by 2030. The Nigerian government has made several efforts at achieving this goal. Economic ...

Educational Attainment and Health Outcomes in Nigeria: A Survey from NDHS (2008 & 2013)

This study simply seeks to analyse the degree to which health status of individuals affect the level of education attained and to adjudicate the influence of socio-demographic and health status on the level of education attained using Nigeria as a case study. The theory adopted in this study is the Grossman model of demand for health. Socio-demographic variables include age, wealth index and type of place of residence; while health-related variables include wellness index, source of drinking water, share toilet with other households, predominance of mosquito net, treatment of water and current marital status. Micro data from the Nigerian Demographic and Health Survey (NDHS) for years 2008 and 2013 are used as a tool to carry out this analysis via SPSS software. Univariate and bivariate analysis are carried out which includes frequency distribution and cross tabulation respectively. Multiple regression is used to analyse the effect of health status and several socio-demographic factors on educational attainment. Health status with socio-demographic factors are found to significantly impact educational attainment in Nigeria in years 2008 and 2013.

Developing equity-focused interventions for maternal and child health in Nigeria: an evidence synthesis for policy, based on equitable impact sensitive tool (EQUIST).

IntroductionAmong the most critical health systems components that requires strengthening to improve maternal, newborn and child health (MNCH) outcomes in Nigeria is the concept of equity. UNICEF has designed the equitable impact sensitive tool (EQUIST) to enable policymakers improve equity in MNCH and reduce disparities between the most marginalized mothers and young children and the better-off.MethodsUsing the latest available DHS data sets, we conducted EQUIST situation and scenario analysis of MNCH outcomes in Nigeria by sub-national categorization, wealth and by residence. We then identified the intervention package, the bottlenecks and strategies to address them and the number of deaths avertible.ResultsEQUIST profile analysis showed that the number of under-five deaths was considerably higher among the poorest and rural population in Nigeria, and was highest in North-West region. Neonatal causes, malaria, pneumonia and diarrhoea were responsible for most of the under-five deaths. Highest maternal mortality was recorded in the North-West Nigeria. Ante-partum, intrapartum and postpartum haemorrhages and hypertensive disorder, were responsible for highest maternal deaths. EQUIST scenario analysis showed that an intervention package of insecticide treated net can avert more than 20,000 under-five deaths and delivery by skilled professionals can avert nearly 17,000 under-five deaths. While as many as 3,370 maternal deaths can be averted by deployment of skilled professionals.ConclusionScaling up integrated packages of essential interventions across the continuum of care, addressing the human resource shortages in rural area and economic/social empowerment of women are policy recommendations that can improve MNCH outcomes in Nigeria.

Sociocultural factors influencing maternal health outcomes in Nigeria

Sociocultural factors influencing maternal health outcomes in Nigeria

Predictors of loss to follow-up in art experienced patients in Nigeria: a 13\xa0year review (2004\u20132017)

BackgroundExpanded access to antiretroviral therapy (ART) leads to improved HIV/AIDS treatment outcomes in Nigeria, however, increasing rates of loss to follow-up among those on ART is threatening optimal standard achievement. Therefore, this retrospective cross-sectional study is aimed at identifying correlates and predictors of loss to follow-up in patients commencing ART in a large HIV program in Nigeria.MethodsRecords of all patients from 432 US CDC Presidents Emergency Plan for AIDS Relief (PEPFAR) supported facilities across 10 States and FCT who started ART from 2004 to 2017 were used for this study. Bivariate and multivariate analysis of the demographic and clinical parameters of all patients was conducted using STATA version 14 to determine correlates and predictors of loss to follow-up.ResultsWithin the review period, 245,257 patients were ever enrolled on anti-retroviral therapy. 150,191 (61.2%) remained on treatment, 10,960 (4.5%) were transferred out to other facilities, 6926 (2.8%) died, 2139 (0.9%) self-terminated treatment and 75,041 (30.6%) had a loss to follow-up event captured. Males (OR: 1.16), Non-pregnant female (OR: 4.55), Patients on ≥ 3-monthly ARV refills (OR: 1.32), Patients with un-suppressed viral loads on ART (OR: 4.52), patients on adult 2nd line regimen (OR: 1.23) or pediatric on 1st line regimen (OR: 1.70) were significantly more likely to be lost to follow-up.ConclusionDespite increasing access to anti-retroviral therapy, loss to follow-up is still a challenge in the HIV program in Nigeria. Differentiated care approaches that will focus on males, non-pregnant females and paediatrics is encouraged. Reducing months of Anti-retroviral drug refill to less than 3 months is advocated for increased patient adherence.

POVERTY AND HEALTH OUTCOMES IN NIGERIA

The study models the dynamics of poverty as they affect health outcomes in Nigeria. Vector autoregressive econometric approach was used to examine whether health outcomes (life expectancy and ýnfant mortality rate) in Nigeria respond to poverty shock. Empirical evidence from the study indicates that poverty shock does not have any significant impact on health outcome variables. Specifically, variations in health outcomes are not actually due to poverty shocks but due to the health outcome shock. It is therefore recommended that improvement in health outcome of the population is a necessity to poverty reduction in Nigeria.

Use of Appropriate Technology to Improve Cervical Cancer Prevention and Early Detection: Experience in Jos, Nigeria

PURPOSE In absolute numbers, Nigeria is one of the countries with the highest burden and mortality as a result of invasive cervical cancer (ICC), with more than 53 million women at risk. The coverage for available cervical cancer screening by conventional cytology is less than 9% of the population. Also, the lack of a national human papillomavirus vaccination program and organized cervical cancer screening services could partly be responsible for the more than 14,000 new ICC cases and 8,000 deaths attributable to ICC in Nigeria every year. Furthermore, the prevailing challenges of diagnosis at advanced stages in more than 80% of ICC cases with a paucity of trained oncologists and poor treatment infrastructures often result in high death rates. These problems make the use of appropriate technology to improve screening, early detection, and treatment of precancerous conditions a novel strategy for achieving quality cancer care in our setting. The objective of this study was to discuss our experience with use of available and resource-appropriate technology to improve cervical cancer care and outcomes in Jos, Nigeria. METHODS A critical review of cervical cancer prevention, diagnosis, and treatment facilities and outcomes in Nigeria was done. This background information provided justification for the use of resource-appropriate technology for improving quality of cervical cancer prevention and treatment outcomes in resource-limited settings. We also gleaned from specific experiences of cervical cancer screening, follow-up, and treatment of both precancer and early invasive cervical cancer in Jos, Nigeria. RESULTS The main factors responsible for increasing burden and poor cervical cancer outcomes in Nigeria and other resource-limited settings in sub-Saharan Africa include: HIV infection; lack of organized cervical cancer screening programs, with poor coverage even when opportunistic screening is available; weak health care system; illiteracy; and poor human papillomavirus vaccination coverage. Some of the major challenges in treatment of cervical cancer include: late presentation, with poor treatment infrastructures; paucity of trained gynecologic oncologists, medical oncologists, and other disciplines needed to improve quality of cancer care; and poor access to available prevention and treatment services, with limited/no health insurance coverage. CONCLUSION Resource-limited settings should leverage the widespread availability of mobile phones to improve cervical cancer education and scheduling for screening, follow-up, and treatment of precancerous conditions. Also, the use of radio talks can reach women in remote locations. Adoption and use of novel testing technology, such as self-sample collection for human papillomavirus DNA testing, is also advocated. Our team in Jos, with collaboration with Northwestern University, is also looking ahead through molecular research on how epigenetic and microbiome biomarkers could improve prevention and early detection of precancer and ICC as a strategy for improving outcomes in our population. Also, the utility of low-cost treatment modalities, such as battery-operated thermocoagulation, could improve coverage for treatment of cervical precancer. Finally, resource-limited settings should train general gynecologists with interest in oncology to acquire specific competencies for locoregional surgical control, particularly for early-stage cervical cancer. Given the identified challenges, the judicious use of these resource-appropriate technologies may improve quality of cancer care and outcomes in resource-limited settings.

Macroeconomic Policies and Health Status in Nigeria

This study investigates macroeconomic policies and health status in Nigeria. With the objective of ascertaining the most viable macroeconomic policy variables on health status of Nigerians, the study utilized secondary annual time series data spanning the period of 37years from 1981 and 2017. To test the existence of unit root in the series, the ADF stationarity test was carried and the result shows that all series were I(0) and I(1). The Johansen Co-integration results from the trace test and maximum eigen value indicate the presence of at least three co-integrating equations in the model, implying that a long run relationship exists between health status and macroeconomic variables. The bound test also corroborates the existence of long run association among the variables. Empirically, the estimates ultimately confirmed that public capital expenditure, domestic debt and financial deepening have long run significant impact on health status in Nigeria. Inflation is the only macroeconomic variable that does affect health status significantly. On the basis of the empirical findings, the study thus recommends that for health outcomes in Nigeria to improve, appropriate macroeconomic policy mix should be focused on capital expenditure, domestic debt and financial inclusion (making funds available to the poor and vulnerable in the society).

The impacts of quantity and quality of health clinics on health behaviors and outcomes in Nigeria: analysis of health clinic census data

BackgroundPast studies have identified that inconvenient access to health clinics is one of the important barriers to health service utilization and health outcomes. However, establishing the link between the lack of access to health clinics and the high maternal and child morbidity and mortality in Nigeria has been a challenge due to the lack of data. This paper overcomes this problem by using the country’s health clinic census data.MethodsUsing the Nigerian health clinic census, we evaluate the intercorrelation between the quantity and the quality of health clinics available across the country. We also examine the correlation between the access to health clinics and health behaviors/outcomes for residents by merging the health clinic census data with data from the demographic and health survey (DHS). The health clinic census data makes it possible to capture the overall geographical allocation of health services across the country as well as their comprehensive relationship with health outcomes.ResultsWe find a strong positive correlation between the quality of a health clinic and the quantity and quality of neighboring clinics. The high quality clinics are concentrated in areas where the density of clinics is high, and where more of the clinics around them are also of high quality. We also find that an increase in access to health clinics of high quality that are in close proximity is significantly and positively correlated with an improvement in health behaviors as well as health outcomes. Women who are more disadvantaged benefit more from the access to high quality clinics than others.ConclusionsHealth clinics of good quality are unevenly distributed geographically in Nigeria. The quality of health clinics should be of a level that can support the promotion of recommended health behaviors and achieve improved health outcomes throughout the country. Further studies are necessary to evaluate the optimal distribution of clinics of good quality, given that residents in less populated areas gain a higher marginal benefit from improved access to health service, despite the higher costs of supplying the service in those areas.

Cross-Border Trade and Infrastructure: A Gender Analysis of Welfare Outcomes in Nigeria

This study provides an ex ante analysis of the welfare effect from the improvement of border road infrastructure in Nigeria. It assesses how changes in the price of food commodities induced by bord...

Mother's nutrition-related knowledge and child nutrition outcomes: Empirical evidence from Nigeria.

BackgroundNutrition outcomes among young children in Nigeria are among the worse globally. Mother’s limited knowledge about food choices, feeding, and health care seeking practices contributes significantly to negative nutrition outcomes for children in most developing countries. Much less is known about the relationship between mother’s nutrition-related knowledge and child nutritional outcomes in rural Nigeria. This paper investigates therefore: (i) the association of mother’s nutrition-related knowledge with nutrition outcomes of young children living in rural Nigeria, where access to education is limited, and (ii) whether mother’s education has a complementary effect on such knowledge in producing positive child nutrition outcomes in such settings.MethodsUsing the Demographic and Health Survey data for Nigeria, we employ both descriptive and regression analyses approaches in analyzing the study’s objectives. In particular, we apply ordinary least square (OLS) to investigate the association of mother’s nutrition-related knowledge with child HAZ and WHZ while controlling for maternal, child, household and regional characteristics. An index was constructed for mother’s nutrition-related knowledge using information on dietary practices, disease treatment and prevention, child immunization, and family planning.ResultsWe found that mother’s knowledge is independently and positively associated with HAZ and WHZ scores in young children. Higher levels of mother’s education, typically above primary, have a significant, positive association with child HAZ and WHZ scores. We argue that mother’s knowledge of health and nutrition may substitute for education in reducing undernutrition in young children among populations with limited access to formal education. However, the present level of mother’s education in rural Nigeria appears insufficient to reinforce knowledge in producing better nutrition outcomes for children.ConclusionsThis study suggests promotion of out-of-school (informal) education, such as adult literacy and numeracy classes where women without formal education can gain health and nutrition knowledge, and practices that could enhance child nutrition outcomes in Nigeria.

Aids Effectiveness and Developmental Outcomes in Nigeria

In spite of several attempts by donors, financial institutions, government and the society at large to eradicate age-old poverty, Nigeria has walloped in generational poverty as a result of many contending factors among which mismanagement of aid and grant obtainable are leading contenders. In evaluating its objectives, this paper adopts the Augmented Dickey-Fuller test to ascertain the order of integration of the variables and Autoregressive distributed lag (ARDL) approach to account for the short run and long run dynamics of a level relationship between economic growth and foreign aid alongside relevant macroeconomic indicators. Findings reveal that there exist a long run relationship among economic growth and foreign aid to Nigeria. The paper finds out that gross capital formation significantly impacts on economic growth positively. Foreign aid exhibits a positive relationship, but it is not seen to determine economic growth in Nigeria. The study concludes that past aid to Nigeria has not been effective or it does not constitute what drives growth in the country. It also invalidates the applicability of the Two-Gap Theory squabble for Nigeria, since foreign aid is seen not to be significant. Keywords: Aids Effectiveness, Economic Growth, Bounds Testing, Nigeria. JEL Codes: C32, F35, O11

Public Health Expenditure, Economic Growth and Health Outcomes in Nigeria

It is argued that while increase in budgetary allocation to social services is highly desirable, it is not sufficient to guarantee enhancement in better health outcome. This paper links public health expenditure, economic growth and health outcomes and the causality among them using Nigeria data. The finding suggests increase in public health expenditure has decreased infant mortality rate while infant mortality rate is negatively correlated with economic growth. Interestingly, the direction of causality among public health expenditure, infant mortality rate and growth is unidirectional, from public health expenditure to growth.

Public Health Expenditures, Environmental Pollution and Health Outcomes: Evidence from Nigeria

The role of health in the development of a nation cannot be overemphasized. While the concept of health status and the impact of public health expenditure have continued to generate scholarly debates, this study contributes to the debate with the incorporation of the role of the environment as a determinant of health status in Nigeria. With the objective of examining the impact of Public Health Expenditures and Pollution on Nigerians Health Status, annual secondary time series data spanning 37 years (1981-2017) collected from Central Bank of Nigeria statistical bulletin and World Development Indicator were analyzed using the ARDL technique. The result shows that Public Expenditures on Health has a positive and significant impact on health outcomes in Nigeria. Again, environmental pollution as proxied by per capita CO2 emission has a negative and significant effect on health outcome in the country. Economic growth rate was found to have positive impact but insignificant in enhancing life expectancy (proxy for health outcome) in Nigeria. On the basis of the empirical findings, it is recommended that the government should sustain the flow of resources to the health sector and improve on environmental practices through the formulation of new national environmental policies and better awareness campaign through the deployment of community health extension workers (CHEW).

Panoptic Overview of Triple-Negative Breast Cancer in Nigeria: Current Challenges and Promising Global Initiatives.

PurposeTriple-negative breast cancer (TNBC) is the most deadly form of breast cancer (BC) today. TNBC treatment is fraught with challenges because of the extensive interpatient heterogeneity in clinical behavior and scarcity of stratifying biomarkers and actionable targets. Women of African ancestry face a disproportionate burden resulting from this disease, which affects them earlier and more aggressively and has a higher propensity to spread and resist conventional treatments. A much higher proportion of Nigerian patients with BC have TNBC compared with patients with BC in the United States and Europe.MethodsThis article spotlights Nigeria as an example of a nation wherein genetic and nongenetic spheres of influence intersect to affect the prevalence of this disease, the scale of its challenge, and its toll.ResultsStudies have illuminated the inherently different tumor biology of Nigerian TNBCs, which show distinct genetic variants and gene expression patterns compared with European or European-American TNBCs. Parallels are apparent between TNBC phenotypes among African Americans and Nigerians, implicating the common thread of shared genetic ancestry between these populations. Reproductive, lifestyle, socioeconomic, and cultural factors also shape TNBC outcomes in Nigeria, as do resource constraints in Nigerian health care and research sectors.ConclusionIncreasing our understanding of how these factors contribute to poorer outcomes among Nigerian women may uncover valuable insights and strategies in alleviating the TNBC burden in many countries of the world and help reduce the racial disparity in BC-related outcomes here in the United States. Importantly, this review also highlights collaborative global and local initiatives that converge expertise and resources to advance research on effective management of TNBC in diverse populations.

Ethnicity and Election Outcomes in Nigeria: Interrogating the 2015 Presidential Election

Ethnicity and Election Outcomes in Nigeria: Interrogating the 2015 Presidential Election

Economic Diversification: Imperative for Trade and Industrial Policies in Nigeria

Abstract The sharp and continuous decline in crude oil prices since the mid-2014, along with the lackluster efforts at diversifying the sources of revenue and foreign exchange in the economy, incontrovertibly led to the recession that greeted Nigeria in the second quarter of 2016 as manifested by fiscal crisis. Hence this study examines the imperative of economic diversification in trade and industrial policies in Nigeria. In order to characterize the pattern of trade and industrial transformation in the diversification process, we adopted the augmented version of Kaldor’s first law which establishes a link between manufacturing output and economic growth. Based on annualized secondary time series, spanning from 1970 to 2015, obtained from the CBN statistical bulletin of various years, the study employed the contemporary econometric techniques of cointegration and error correction mechanism, within the framework of the Autoregressive Distributed Lag (ARDL) model as proposed by Pesaran et al (2001) in achieving its objective. The results show that manufacturing output, crude petroleum and natural gas production, as well as mining production have significant positive longrun impact on economic growth in Nigeria. This implies that economic diversification-based industrial policies will definitely bring about the desired economic outcomes in Nigeria. We therefore conclude that trade and industrial policies should be geared towards diversification of the economy.

Improving Reading and Numeracy Outcomes in Nigeria Through Strategic Trust Building

Non-governmental development organizations working with local government and community partners are often challenged by conflicting understandings of education practice and learning due to social, cultural, and political factors. Building trust so that education programs are implemented in equal partnership with communities is vital for addressing these challenges and, ultimately, achieving positive learning outcomes for students.

Returns to Controlling a Neglected Tropical Disease: Schistosomiasis Control Programme and Education Outcomes in Nigeria

Using the rollout of the schistosomiasis campaign in Nigeria as a quasi-experiment, we examine the impact of the disease control programme on school-age children education outcomes. Schistosomiasis is a parasitic disease caused by infections from a small worm. Its most severe effects hamper growth and cognitive development of children. The mass campaign targeted four states that saw large reduction in the infectious disease afterwards. Using difference-in-differences strategy, we find that the cohort exposed to the treatment in rural areas accumulated an additional 0.6 years of education compared to cohort not exposed to the treatment. Moreover, the impact of the schistosomiasis treatment is mainly on girls residing in rural areas.

The Need for Societal Investment to Improve Cervical Cancer Outcomes in Nigeria: A commentary.

Although cervical cancer is a preventable cancer with a well-known natural history, it remains a huge burden in developing countries of sub-Saharan Africa where organized cervical cancer screening services are lacking. Developed countries that have invested on providing organized screening programs have made substantial progress in reducing both incidence and mortality due to cervical cancer. Implementing evidence-based interventions such as human papillomavirus (HPV) vaccination of young girls, early detection and treatment of premalignant conditions of the cervix through conventional Pap cytology, HPV screening or visual aided inspection with acetic acid could significantly reduce incidence of new cases at population level. Societal investment for such preventive services and provision of effective treatment for those diagnosed at early stages will yield economic benefits in reducing premature deaths of women at the prime of their productive lives. From a societal perspective, this should be a priority area for national investment towards the achievement of sustainable development in Nigeria and similar settings in Africa.