Urban Local Government Areas Research Articles

Collaborations and Networks Within Communities for Improved Utilization of Primary Healthcare Centers: On the Road to Universal Health Coverage.

Community involvement depends on the level of linked and targeted activities for health by community members. This study examines the collaborations employed within communities to ensure sustainable access and improved use of healthcare in the community. This study was conducted in rural and urban local government areas in Anambra, Kano, and Akwa-Ibom, Nigeria. About 90 in-depth interviews and 12 focus group discussions were conducted with community stakeholders and service users. The findings were transcribed and coded via thematic analysis, guided by the Expanded Health Systems framework. Various horizontal collaborations in communities foster increased use of PHC services; promoting community health. Major horizontal collaborations in these communities were community-led, primary health facility-led, and Individual-led collaborations. Their actions revolved around advocacy, building and renovating PHC centers, equipping facilities, and sensitization to educate community members on the need to utilize services at PHC centers. Strategic involvements and collaborations of local actors within communities give rise to improvements in the utilization of primary healthcare centres, reportedly resulting in improved access to PHC healthcare services for community members.

Sexual and reproductive health information needs; an inquiry from the lens of in-school adolescents in Ebonyi State, Southeast Nigeria

BackgroundIt is important to understand the sexual and reproductive health (SRH) needs of adolescents from the adolescents themselves to address their needs properly. Hence, this paper provides new knowledge on the information needs on SRH among adolescent boys and girls in selected secondary schools in Ebonyi state, southeast Nigeria.MethodA comparative assessment was conducted among adolescent boys and girls in public secondary schools that received a specific school-based SRH intervention (group A) and those that did not receive the intervention (group B). These schools were spread across six urban and rural local government areas in Ebonyi state, southeast Nigeria. A structured interviewer-administered questionnaire was used to collect data from 514 adolescents aged 13 to 18 on their stated needs for SRH information and services. Categorical variables were compared using the Chi-square test, and predictors were determined using logistic regression analysis. The statistical significance was determined at p < 0.05.ResultMajority of the adolescents (82% of intervention group and 92% of non-intervention group) identified puberty and pubertal changes as perceived SRH information need for adolescents (χ2 = 7.94; p-value = 0.01). Adolescents who received SRH intervention have 3.13 (p < 0.001) times the odds of perceiving the need for adolescents to be provided with SRH information than adolescents who did not receive SRH intervention. The odds of perceiving the need for adolescents to be provided with SRH information for adolescents who reside in urban communities are 0.31 (p < 0.001) times the odds for adolescents who resides in rural communities. That is, the perception odds are higher adolescents who reside in rural communities. Multivariate regression of specific SRH information showed the location of residence as a strong predictor of adolescents’ perceived need for information on ‘puberty and pubertal changes’ (OR = 0.30; p = 0.001), ‘safe sex and sexual relations’ (OR = 0.33; p < 0.001) and ‘prevention of pregnancy and use of contraceptives’ (OR = 0.28; p < 0.001). Adolescents in senior secondary school have 2.21 (p = 0.002) times the odds of perceiving the need for adolescents to be provided with specific SRH information than adolescents who are in junior secondary school.ConclusionAdolescents’ age, location of residence, and study group were found to be strong predictors of SRH information needs. This suggests the need for in-school adolescents to be provided with substantial and continuous SRH information for healthy living and making informed SRH choices. In developing SRH interventions that will achieve optimal effectiveness in the lives of adolescents in school, different demographic factors should be considered for context-specific and appropriate strategies.

Individual-level Predictors of Birth Preparedness and Complication Readiness: Urban-Rural Comparison.

Maternal mortality is a major public health problem. Birth preparedness and complication readiness (BP/CR) constitute a veritable strategy for reducing maternal mortality, yet adoption is low with wide urban-rural discrepancies. The objectives of this study were to compare the practice of BP/CR amongst women in rural and urban areas of Rivers State, Nigeria, and determine the individual-level predictors. A facility-based cross-sectional comparative study using a multistage sampling method was employed in the selection of 924 (462 urban and 462 rural) women who gave birth within the last 12 months in urban and rural local government areas. Outcome measures were birth preparedness (defined as undergoing antenatal care (ANC) with a skilled birth provider, voluntary counselling and testing for HIV and saving money for childbirth at an agreed place of delivery with a skilled birth attendant) and complication readiness (defined as being knowledgeable about danger signs, identifying decision-maker, a nearest functional institution in case of emergency, emergency means of transport and funds and a suitable blood donor). Bivariate and multivariate analyses were performed at P < 0.05. The proportion of women who were birth prepared was significantly higher amongst women in urban areas (85.9%; 95% confidence interval [CI]: 82.7%-89.1%) versus rural counterparts (56.7%; 95% CI: 52.2%-61.2%), whereas the proportion of complication readiness was significantly higher in rural (31.8%; 95% CI: 27.6%-36.1%) than urban (18.2%; 95% CI: 15.2%-47.8%) groups. Predictors were possession of secondary educational level or higher (adjusted odds ratio [AOR]: 4.9; 95% CI: 1.5-15.5), being employed (AOR: 2.7; 95% CI: 1.5-15.0) and ANC attendance (AOR: 29.2; 95% CI: 8.8-96.9) in urban, whereas amongst the rural, it was ANC attendance (AOR: 20.0; 95% CI: 9.1-43.7). In urban areas, more women were birth prepared while fewer women were complication ready compared to the women in rural areas, with predictors such as education, employment and ANC attendance in urban areas and only ANC attendance in rural areas. Measures to promote ANC uptake, maternal education and empowerment could promote BP/CR.

Knowledge Level of Rural Dwellers on Sustainable Utilization of Forest Resources in Peri Urban Local Government Areas of Ibadan, Oyo State, Nigeria

Forest resources have been a major source of income for a sizeable number of the populace especially in the rural areas. This study therefore investigated the knowledge levels of rural dwellers on sustainable utilization of forest resources in Peri Urban Local Government Areas of Ibadan, Oyo State in which Oluyole and Akinyele Local Governments were purposively chosen. Using a multi-stage sampling procedure, 200 respondents were randomly sampled from the Study Area and data were collected using a structured questionnaire on their personal characteristics, knowledge level, accessibility and constraints faced in sustainable utilization of forest resources. Majority of the respondent 68.4% were males, had secondary education (34.7%). All the respondents (100%) were involved in forest resources utilization; majority (63.3%) sourced their information from forest workers. The high cost of forest resources (40.8%) ranked as the highest constraint faced in the utilization of forest resources. Significant relationship (x2=15.76; p≤0.05) existed between household size and the knowledge level of respondents on forest resources utilization. Also, there was a significant relationship (r=-0.712, p= 0.000) between knowledge level and constraints associated with sustainable utilization of forest resources. The paper therefore recommends the use of public-private partnerships in creating awareness on sustainable utilization of forest resources.

The family dynamics of children on the streets of Ibadan, Southwest Nigeria.

Children roaming the streets estimated at 1 in 10 by a 2021 United Nation Children's Funds (UNICEF) report is a growing problem, in cities of lower- and middle-income African countries. Studies of street children with no family ties abound, but there is a paucity of studies on children on the street who exist within families and return home daily. We explored the family dynamics of children on the streets of Ibadan, emphasising family structure, resources and relationships. Using an exploratory design based on a qualitative approach 53 participants were interviewed, including children on the streets, parental figures, child-welfare officers and street shop owners. Participants were selected from streets in the five urban local government areas of Ibadan, Nigeria. Recorded data were transcribed, and framework analysis was performed. The family dynamics included family structural problems, poor family resources and poor parent-child relationships. The family structural problems included: broken homes, large families and ambivalence around polygamy as subthemes. Family resources comprised: poor economic resources, poor social resources, educational challenges, cultural ambivalence and spiritual backdrops. The family relationships patterns included: poor adaptability, economic-oriented partnership, poor growth support, poor emotional connection and poor family bonding. The dynamics driving a family's choice for child streetism in Ibadan, mostly to hawk, are devaluation of family life, parenting irresponsibility, and poor filial relationship, underscored by economic constraints and socio-cultural decadence. The results of this research buttress the need for family-level interventions to forestall the escalating phenomenon of child streetism in Ibadan, Nigeria.Contribution:This research highlights the family dynamics of children on the streets, and buttresses family-level interventions are necessary to forestall escalating child-streetism in Ibadan, Nigeria.

Spatial and temporal analysis of road traffic crashes and ambulance responses in Lagos state, Nigeria

BackgroundSub-Saharan African countries, Nigeria inclusive, are constrained by grossly limited access to quality pre-hospital trauma care services (PTCS). Findings from pragmatic approaches that explore spatial and temporal trends of past road crashes can inform novel interventions. To improve access to PTCS and reduce burden of road traffic injuries we explored geospatial trends of past emergency responses to road traffic crashes (RTCs) by Lagos State Ambulance Service (LASAMBUS), assessed efficiency of responses, and outcomes of interventions by local government areas (LGAs) of crash.MethodsUsing descriptive cross-sectional design and REDcap we explored pre-hospital care data of 1220 crash victims documented on LASAMBUS intervention forms from December 2017 to May 2018. We analyzed trends in days and times of calls, demographics of victims, locations of crashes and causes of delayed emergency responses. Assisted with STATA 16 and ArcGIS pro we conducted descriptive statistics and mapping of crash metrics including spatial and temporal relationships between times of the day, seasons of year, and crash LGA population density versus RTCs incidence. Descriptive analysis and mapping were used to assess relationships between ‘Causes of Delayed response’ and respective crash LGAs, and between Response Times and crash LGAs.ResultsIncidences of RTCs were highest across peak commuting hours (07:00-12:59 and 13:00-18:59), rainy season and harmattan (foggy) months, and densely populated LGAs. Five urban LGAs accounted for over half of RTCs distributions: Eti-Osa (14.7%), Ikeja (14.4%), Kosofe (9.9%), Ikorodu (9.7%), and Alimosho (6.6%). On intervention forms with a Cause of Delay, Traffic Congestion (60%), and Poor Description (17.8%), had associations with LGA distribution. Two densely populated urban LGAs, Agege and Apapa were significantly associated with Traffic Congestion as a Cause of Delay. LASAMBUS was able to address crash in only 502 (36.8%) of the 1220 interventions. Other notable outcomes include: No Crash (false calls) (26.6%), and Crash Already Addressed (22.17%).ConclusionsGeospatial analysis of past road crashes in Lagos state offered key insights into spatial and temporal trends of RTCs across LGAs, and identified operational constraints of state-organized PTCS and factors associated with delayed emergency responses. Findings can inform programmatic interventions to improve trauma care outcomes.

Comparison Of Sewage And Solid Waste Disposal Methods Among Households In Urban And Rural Local Government Areas Of Anambra State

Improper sewage and solid waste disposal lead to environmental pollution and increased risk of communicable diseases. This study compared the sanitation and solid waste disposal facilities utilized in selected rural and urban local government areas of Anambra State, Nigeria. This cross-sectional study was conducted among 1310 households and data was collected from household heads or a designated adult representative using of quantitative (questionnaire) and qualitative (KII) data collection methods. The independent variables in this study are the sociodemographic variables and the geographical location of the respondents while the dependent variables are the toilet facilities and solid waste disposal methods. Data from the questionnaire was analyzed using the SPSS version 23 and the hypotheses were tested with the inferential statistics of Chi square at 0.05 level of significance. Most respondents lie between the age group of 31-50 years. Most of the respondents in both the urban (84.4%) and rural(65.0%) areas had secondary education and above but a higher proportion in the urban compared to rural have tertiary education(41.9% versus 22.1%). The difference in educational status was statistically significant (p = 0.0001). There were more business men (46.6%) and civil servants (38.8%) in the urban area than the rural area. Most rural respondents were farmers(41.5%). Many urban household use toilet with sewer connection 152(11.7%) while pit latrine with slab is the most commonly used toilet facility 242 (18.6%). Burning was more commonly used by the rural households (n = 266, 20.5%). Open dumping of refuse and disposal into gullies and water ways were commonly done by the urban households. The gaps that exist between rural and urban areas of Anambra state may present serious health risk and environmental degradation .This issues can be addressed through health education, building more sanitary infrastructure to include the rural areas and enforcing sanitation laws.&#x0D; &#x0D;

Biologic quality of households' drinking-water in an urban local government area of Oyo State, Southwest, Nigeria

Background: Inadequate access to Water, Sanitation, and Hygiene (WASH) facilities is a global public health issue with several associated illnesses, particularly in developing countries like Nigeria. It is imperative to understand the availabilities of these facilities, to provide baseline data for policy design and implementation. This study assessed access to WASH facilities. It also examined the factors associated with drinking-water contamination by coliform organisms in households within Ogbomoso North Local Government Area, Oyo-State, Nigeria.&#x0D; Methods: Cross-sectional design was employed and a two-stage cluster-sampling method was used to recruit eligible respondents from 100 households. Interviewer-administer, semi-structured questionnaire was used to collect data. Chi-square test and binary logistic regression were used for inferential statistics.&#x0D; Results: Mean age of respondents was 40.5±16.7years, 81.0% of the households practiced open defecation, and 78.9% of those with toilet facilities used pit latrines. The most common water source was borehole (71.6%); available within 5 minutes walking distance to residence of 68.0% of study participants. Sixty-three percent of the households had high drinking water coliform counts. High drinking-water coliform counts were influenced by the presence or absence of toilets facilities (OR=4.61, CI=1.22-1.68), types of toilets (OR=2.63, CI=3.22-5.34), and water sources (OR=0.12, CI=0.47-0.68).&#x0D; Conclusion: Access to good quality water and basic sanitation facilities is sub-optimal in the study setting despite being an urban community. Authors advocate for more vibrant and intentional government efforts at ensuring equitable access to WASH facilities in the Nigerian communities. This is to fast-track the nation's journey towards the actualization of the sustainable development goal (SDG)-6.

Analysis of Police Personnel to Population Growth in Five Urban Local Government Areas in Ibadan Metropolis: A Panacea for Crime Free Environment

Adequate policing to the society enhances free crime and sustainable environment. This study analyses the Availability of Police Personnel to Population Growth of Persons in Five Urban Local Government Areas of Ibadan Metropolis, Oyo State, Nigeria with the purpose of determining the ratio of police personnel’s 2023 to 2023 population of persons’ for the study areas using Malthus Population Growth Model (Exponential Growth Equation). Police personnel’s data were acquire from the Police Divisional Headquarters, Eleyele, Ibadan, Nigeria. The geographic coordinates used to depict the distribution of police stations in each of the five urban local government areas was obtained from Grid3 Nigeria and processed using ArcGIS 10.4. The results revealed an accelerated increase in population in the study area. The results from this study however showed that the ratio of police personnel to population of persons does not meet up with the United Nation’s recommended ratio of 1:450. Generally, from the results, it showed that with the 2023 estimated population growth of 2,014,279 from 1,343,147 in 2006, and the required number of police personnel compared to the number obtained in 2023 from the police headquarters, as well as the number of police stations available, there is a need for the federal government in collaboration with the state government to take necessary actions and preventive control in the study areas so as to avoid constant criminal activities.

Domestic water quality and the discriminatory influence of socio-economic stratification on accessibility to safe water in a part of Osun State, Nigeria

The status of the water supplied to households in an urban local government area in southwest Nigeria was examined. Specific objectives were to characterize household water sources, assess the per capita usage of potable water sources and examine quality of the household water in the area. The purposively selected study area, Olorunda local government area in Osun State, Nigeria (being an urban local government area) was stratified into ‘urban core’ (central business district, CBD or high population density area), ‘transition’ (medium population density area but with less social infrastructure) and ‘sub-urban’ (typically government reserved area and low population density area) based on household density and associative socio-economic status. The methods were a mix of questionnaire administration to heads of 120 households (40 per stratum) and collection of the drinking water samples from the supply sources at four randomly selected households in each stratum. The water samples were analysed for the concentrations of nitrite (NO2-), nitrate (NO3-), fluoride (F-), lead (Pb) and arsenic (As) as well as E-coli bacteria contents based on their importance in determining water quality in urban areas. The results showed that domestic water sources are mainly hand dug well (55.8%), borehole (37.5%) and pipe borne (6.7%). Residents averagely consumed at most 4L of water per day. Furthermore, the investigated chemical parameters varied as NO2 (0.37-0.94 mg/l), NO3 (0.29-0.70 mg/l), and F- (0.003-0.97 mg/l). As and Pb occurred in trace quantities, and there were no pollution threats to consumers. The amount of E coli and total coliform contents were however outside the safe limits for residents, suggesting contamination of household water by the bacteria sources. The study concluded communities with low socio-economic status which do not have access to state-provided tap water source are more likely to consume polluted water than those with high socio-economic status or that are supplied with state-provided tap water. The study advocates improve urban water management for the urban fringe dwellers.

The Effects of Traditional Medical Practices on Health Care Delivery System in Nigeria. Quantitative Case Study of Ibiaku Issiet Community of Akwa Ibom State, Nigeria

This research investigates the factors influencing the persistent use of traditional medicine and its implications for the acceptance and utilization of modern healthcare in the urban local government area of Ibiaku Issiet, Akwa Ibom State, Nigeria. Sociologists and medical sociologists have expressed concerns about the continued reliance on traditional healers, which often disregards modern scientific methods and facilities. A sample of 150 respondents was randomly selected, and data was collected using a structured questionnaire. The study reveals that the high cost of modern healthcare is a significant challenge rural dwellers face, leading them to seek more affordable traditional medicine. Traditional remedies have effectively catered to the sociocultural preferences and aspirations associated with modern medical care. Nigeria's socio-economic and sociocultural context, characterized by beliefs in witchcraft, spirits, and gods as causes of diseases, make eradicating this deeply rooted cultural heritage futile. Consequently, individuals are more likely to prefer modern medicine to traditional treatment methods. Based on the findings, it is recommended that traditional medicine be granted legal recognition and co-recognition as an official healthcare system in Nigeria. There is a pressing need to enhance the status, funding, and facilities of traditional medical clinics and practitioners and develop comprehensive training programs.

Strengthening local government policies to address health inequities: perspectives from Australian local government stakeholders

BackgroundWith their close connection to community and increasing preventive health remit, local governments are well positioned to implement policies and programs to address health inequities. Nevertheless, there is a lack of evidence of equity-focused policy action in this sector. We aimed to understand how local government representatives approach equity in the development and implementation of health and wellbeing policies and programs, and to identify potential enablers for strengthening an equity focus.MethodsWe conducted semi-structured interviews (June 2022-January 2023) with 29 health directorate representatives from 21 local governments in Victoria, Australia. Representatives were recruited from urban, regional and rural local government areas, with varying levels of socioeconomic position. Data was analysed inductively using Braun and Clarke’s reflexive thematic analysis, informed by social determinants of health theory and a public policy decision making framework.ResultsLocal governments approach health equity in different ways including focusing on priority populations, disadvantaged geographic areas, or by targeting the upstream determinants of health, such as housing and employment. Enabling factors for more equity-oriented local government policy action included those internal to local governments: (i) having a clear conceptualisation of equity, (ii) fostering a strong equity-centric culture, and (iii) developing organisational-wide competency in health equity. External factors related to key stakeholder groups that support and/or influence local governments included: (iv) strong support from community, (v) state government leadership and legislation, and (vi) supportive local partners, networks and NGO’s.ConclusionsLocal governments have a responsibility to implement policies and programs that improve health and reduce health inequities. Local government’s capacity to leverage resources, structures, processes and relationships, internally and across sectors and community, will be key to strengthening equity-oriented local government health policies and programs.

Validation of the Adolescent Health Quality of Care (AHQOC) index for mystery client studies.

The Adolescent Health Quality of Care (AHQOC) index is a tool designed to evaluate the quality of facility-based adolescent sexual and reproductive health (ASRH) services. This descriptive cross-sectional study aimed to validate the AHQOC index in 27 primary and secondary public health facilities located in a rural and an urban local government area (LGA) of Ogun State, Nigeria. To conduct the study, 12 mystery clients (MCs) were recruited and performed 144 visits to the health facilities. The MCs were young males and females who were seeking information on premarital sex, pregnancy prevention, sexually transmitted infections (STIs), and contraception. The validity, and reliability of the AHQOC index were evaluated using exploratory factor analysis, Cronbach's Alpha, and intra-class correlation coefficient tests. The Kaiser-Meyer-Olkin test result for the initial 37-item pool was 0.7169, and the final tool retained 27 items with a Cronbach's Alpha of 0.80. Two subscales of the index had Cronbach's Alpha of 0.76 and 0.85. The intra-rater consistency assessed by the intra-class correlation coefficient was 0.66 (0.10-0.92) p = 0.001 for the urban LGA and 0.72 (0.37-0.91) p = 0.001 for the rural LGA. Positive and statistically significant relationships were observed between the full scales and subscales and the validity item (MC ranking of health worker on proficiency from 1 to 10). The results of this study demonstrate that the validated AHQOC index is a valuable tool for assessing the quality of ASRH services in public health facilities.

Physical, mental and healthcare issues of children on the street of Ibadan, Nigeria.

Most street children studied in lower- and middle-income African countries are without family links. However, the majority of street children are children on the street, living with families during the night and spending their day-time on the streets. The health of this majority group is poorly captured in the literature despite the growing epidemic of child streetism. To explore the health of children on the street of Ibadan using multiple qualitative studies. A street in each of the five urban local government areas of Ibadan Oyo State, Nigeria. Participants comprising of children on the street, parental figures, street shop owners and child-welfare officers were purposively selected and interviewed. Interviews were audio recorded, transcribed, and thematically analyzed. Using triangulated data from 53 interviews, the study found that the children on the streets of Ibadan experienced many health challenges. Outstanding are poor carbohydrate-based diet, open defaecation with consequent infections, physical injuries and few deaths from road traffic accidents. Sexual, verbal and substance abuse were common although few children acquired resilience to adversity. The children had poor health-seeking behaviour and resorted to patent medicine dealers or tradomedical practitioners on the streets. This study bridged some gaps in the literature regarding the health of children on the streets in Nigeria. The straddling of children between the family and street has cumulative health consequences as depicted in this study.Contribution: This research can inform family-level intervention and primary health care plans to forestall the health challenges of children on the streets.

Preparedness of primary health care facilities on implementation of essential non-communicable disease interventions in Osun State South-West Nigeria: a rural–urban comparative study

BackgroundGlobal response to the growing burden of non-communicable diseases (NCDs) in developing countries includes the development of WHO Package of Essential Non-communicable Disease Interventions (WHO PEN) for Primary Health Care (PHC). The study assessed the level of preparedness of PHC facilities on implementation of essential NCD interventions in rural and urban Local Government Areas (LGAs) of Osun State, Nigeria.MethodsThe study was a comparative cross-sectional survey. Information was collected from heads of 33 rural and 33 urban PHC facilities and through direct observation on the domains of staff training, basic equipment, diagnostics and essential medicines for cardiovascular diseases, diabetes and chronic respiratory diseases (CRDs) using a semi-structured interviewer administered questionnaire.ResultsManual sphygmomanometer was found in similar proportions (84.8%) of PHC facilities in rural and urban LGAs. Glucometer was available in 45.5% of the PHC facilities in urban and 33.3% of the PHC facilities in the rural LGAs, the difference was not statistically significant (χ2 = 1.015; p = 0.314). Basic equipment for CRDs were not available in majority of PHC facilities in both locations. Moduretic tablets were the most reported essential NCD medicines, available in 15% of PHC facilities in rural LGAs and none in urban LGAs. The anti-diabetic medicines were not available in any of the PHC facilities in both locations. More than 90% (≥ 30) of the PHC facilities in both locations were not prepared to implement essential interventions for each NCD across domains of staff training and essential medicines. Overall, 97.0% of the PHC facilities in the rural LGAs and all the PHC facilities in urban LGAs were not prepared on implementation of essential interventions for the three NCDs.ConclusionThe level of preparedness of the PHC facilities on implementation of essential NCD interventions in the rural and urban LGAs of Osun State is very low. Government needs to strengthen the PHC system by providing needed essential medicines, basic diagnostics, equipment, and training of clinical health care workers for implementation of essential NCD interventions in the state.

Using Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) Framework to Assess the Effect of a Multicomponent Intervention on Routine Immunization Data Quality in Lagos State

ABSTRACT Background: Quality data can be used to monitor immunization program performance and targets, reveal reasons for poor program performance, and provide evidence for decision-making at the frontlines. Challenges hampering immunization data quality include weak human resource capacity, weak monitoring supervision, and nonexistent or ineffectual feedback on data quality and use, especially at subnational levels. Interventions bordering on upskilling of available human resource capacity and supportive supervision can improve immunization system performance. We implemented a multicomponent intervention (training, supportive supervision, and peer mentoring) among health workers in Lagos to assess the reach (proportion of immunization staff who were reached), adoption (proportion of immunization staff who participated and completed the intervention), and effectiveness (data accuracy, completeness, timeliness, and quality index (QI) scores) of a multicomponent intervention on immunization data quality in Lagos State. Methods: This was a quasi-experimental study that employed a mixed-methods (quantitative and qualitative) approach to assess the reach, effectiveness, and adoption of the interventions. A pre- and posttest design was employed for the quantitative aspect of the study. The reach and adoption were assessed using a process indicator questionnaire, while the effectiveness of the intervention was assessed using the Data Quality Assessment (DQS) tool to obtain the accuracy ratio (AR) and detect any significant variation in the data recorded in the health facility (HF) registers, tally sheets, and District Health Information System version 2 for the pre- and post-intervention period. A total of 32 key informant interviews (KIIs) (eight KIIs in each local government area (LGA)) were conducted with respondents being key workers who were purposively selected. Data from both methods were triangulated and used to support the findings. Results: The study had a reach of 91% and a participation and completion (adoption) rate of 100%. At the HF level, the accuracy of data submitted (tally sheet vs immunization register) showed the most significant improvement from pre-intervention (11.8%) to post-intervention (100%) in one LGA, Second rural Local Government Area (R-IKD 2). Facilities in two LGAs, such as First urban Local Government Area U-IKJ 1 (64.7% to 94.1%) and Second urban Local Government Area U-LM 2 (88.2 to 100%) LGAs, showed the most significant improvement in timeliness and completeness of submitted reports, respectively. For QI scores, at the LGA level, the most significant improvement was recorded in the evidence of using the data domain (50% to 100%) for one LGA, U-IKJ 1. Conclusion: Challenges that hamper immunization data quality such as weak human resource capacity, weak monitoring, and supervision can be improved with a multicomponent intervention targeted at upskilling available human resource capacity and supportive supervision to strengthen immunization system performance.

Financial Strain and Prenatal Depression Among Pregnant Women in Ibadan, Nigeria

Introduction: Although mothers’ mental health is receiving more attention, little remain known about the impact that financial strain may have on the mental health of expectant mothers. This is crucial in low- and middle-income countries because vulnerable populations are disproportionately affected by high rates of poverty, insufficient social safety nets, and unstable economies. Aims: This study examined the potential role that financial strain may play in prenatal depression while also taking into account the potential mediating roles of food insecurity, intimate relationship violence, and social support. Methods: To gather the data, a cross-sectional survey of 519 pregnant women in the second and third trimesters were selected methodically from a pool of women awaiting routine antenatal care from one primary health care center in each of the five urban local government areas of Ibadan metropolis. The Edinburgh Postnatal Depression Scale was used to measure prenatal depression. Using parallel and serial mediation models, the relationship between the variables – financial strain, intimate partner violence, food insecurity, social support, and prenatal depression – was examined. Results: Of the participants in this study, 28.1% reported having symptoms of depression during their pregnancy. The results also show that prenatal depression and financial strain are related, with each of the three mediators operating in a parallel and sequential causal order. The results of the mediation point to a causal chain with moderate effects. Conclusions: Interventions should evaluate the effects of integrating mental health services and social needs assessments into antenatal and primary health care.

Sustainable Development in Smart and Resilient Local Government Areas: An Empirical Investigation of Victoria, Australia

Experts always seek for improving the development and management of multidimensional urban systems, including those of sustainability, smartness, and resiliency. These dimensions are the main keywords in related research to model and predict better development in urban and regional areas; there are overlapped concepts, common attributes, and parallel processes in existing indices designed for each of those keywords, which might not be an ideal option for the status quo. Therefore, there is a need to find a balance between these concepts/indices and identify an integrated development strategy that addresses smart, resilient, and sustainable development demands. For this purpose, first of all, attributes and themes used to develop the development indices are collected from the recent literature. Secondly, a semantic text mining technique is used to discover commonly used attributes among the collected ones. Thirdly, Principal Component Analysis (PCA) is used to investigate the correlation between the selected attributes to reduce or merge similar attributes. Fourthly, after collecting data and normalizing calculated scores for each LGA, a k-means clustering method is used to identify LGAs with similar development behaviour. And finally, the developed index is implemented in Victoria, Australia as a case study that includes 79 regional and urban local government areas. Evaluation of the results (comparing the results with two existing studies) indicated the success of the proposed index in bringing smartness, resiliency and sustainability indices under a united and comprehensive development index.

Assessment of the Capacity of Patent and Proprietary Medicine Vendors to Provide Contraceptive Services to Adolescents in Kaduna State, Nigeria

The contraceptive Prevalence Rate among adolescents has remained extremely low in Kaduna State due to limited access to health facilities with youth-friendly services. Patent and Proprietary Medicine Vendors (PPMV) are the most widespread health facilities and the first point of access for family planning commodities in Nigeria. Providing contraceptive services to adolescents requires specific sets of skills and an environment that are youth friendly. This study examines the capacity of PPMV to offer contraceptive services to adolescents. The study used a cross-sectional descriptive design. We interviewed 462 PPMV selected from urban and sub-urban Local Government Areas (LGA) of Kaduna State using a multistage random sampling technique. Data analysis was based on percentages conducted with SPSS software, version 20. Findings from the assessment show that PPMV are a mix of professionals and lay providers. 43.1% possess a qualification in Nursing, midwifery, or community health, and 18.8% have received specific training on contraceptive services. 91.6% are dispensing contraceptives that are suitable for adolescents, and 97.4% are willing to acquire additional training to provide adolescent-friendly contraceptive services for both the married and unmarried. The study equally shows that most PPMVs have private space (70.1%) for confidential counselling and operate seven days a week (86.6%) and twelve or more hours a day (83.3%). Pharmacists Council of Nigeria should consider expanding the scope of contraceptive services that PPMV can provide based on their training.

Acceptance of COVID-19 Vaccine among Adults in Two Urban Local Government Areas of Kwara State, North Central Nigeria

BackgroundCovid-19 has unquantifiable negative impacts on the world’s socio-economic parameters. The rapid discovery of vaccines to fight this pandemic is a monumental scientific breakthrough.Study objectiveThe study assessed willingness of adult Nigerians to accept Covid-19 vaccine and elucidated on factors influencing such decisions.MethodologyCross-sectional design was employed among 400 respondents recruited using multi-stage random sampling technique in Ilorin, Kwara-State, Nigeria. Pretested interviewer-administered, semi-structured questionnaire was used for data collection. Both descriptive and inferential statistics were carried out.ResultsMean age ±SD of respondents was 40.85±13.75 and 215 (53.7%) of them were males. Those who possessed good knowledge of Covid-19 were 321 (80.3%), but few respondents had misconceptions regarding its causation. Attitude to Covid-19 vaccination was positive in 360 (90%) of the respondents, 278 (69.5%) were willing to accept the vaccine. Respondents’ Covid-19 knowledge and attitude to its vaccination were the main determinants of willingness to receive the vaccine.ConclusionThe Nigerian government urgently needs to leverage on the positive attitude of the people to fully implement its covid-19 vaccination policies which can ensure effective coverage and equitable access to the revolutionary Covid-19 vaccines. Awareness campaign on practice of other preventive measures should be sustained to produce a synergistic control effort.Rwanda J Med Health Sci 2022;5(2):127-140