Policing is a stressful occupation. Police officers are exposed to stressors that are inherent in the organization and operations of law enforcement. Similar to their counterparts around the world, many Nigeria police officers are exposed to high levels of stress, making them vulnerable to stress-related mental health conditions and other noncommunicable diseases. Despite these risks and their consequences to the health and safety of police officers and the larger society, interventions are currently not available to address this challenge in Nigeria. This pilot study aims to assess the burden of stress from a national sample of police officers and test the feasibility of an intervention for stress prevention, management, and coping mechanisms among police officers in Nigeria. This is a three-phase study: (1) a needs assessment and situational analysis using a convergent parallel, mixed-methods approach to determine the prevalence of stress and mental health burden among 1200 police officers in four randomly selected states in four geopolitical zones of the country, (2) the development of a peer-led intervention for stress prevention, management, and coping mechanism which will be tested using a cluster randomized trial among 200 police officers, and (3) the preliminary evaluation of the intervention based on knowledge about stress management and mental disorders and psychological distress and reduction in stress levels. These measures will be obtained at baseline (T0), immediate (T1), and 6-month post-intervention (T2). Feasibility will be determined based on enrollment rate, attendance, and completion of the group sessions. Multivariable linear regression models taking into account clustering effects will be used to estimate between-group differences in outcome measures. Findings from the study will inform policy review and the development of a pragmatic intervention on stress prevention and management among police officers. This will enhance the policing role of officers, thus contributing to the safety of the communities they serve. PACTR Registry: PACTR202310474721238. Registered on 6 October, 2023. https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=25663 . Protocol version number 1.0 (date: 6 October, 2023).
Poor funding and mismanagement were identified as a major setback to healthcare service delivery in Nigeria and of which is a prominent factor affecting its coverage and quality. This study examined the gap in the utilization of primary healthcare facilities in Lagun Community of Lagelu Local Government Area of Oyo State Nigeria. A cross-sectional study design using multi-stage random sampling technique to select 80 respondents that met the criteria were given the opportunity to participate in the study. A semi-structured questionnaire was used to collect information from respondents. Descriptive statistics and Chi-square were used for data analysis at 0.05 significance level, results showed that mean age of respondents was 30.5±17.0, where majority (97.4%) speaking indigenous Yoruba language. More than half (56.2%) were Christians, 56.6% had secondary education, and two-fifth (40.0%) of respondents being traders. Relationship between utilization and other factors at (X2=1.000, df=1, p=0.183) showed that awareness and availability were good, while accessibility and affordability were below the expectation as recommended by World Health Organization. Also, utilization of facilities that embraced health-for-all projected for the year 2020 millennium development goal would have assisted better improvement in achieving an holistic medical architecture through government and other health agencies proactive approaches if more enlightenment, intervention, health insurance accessibility, unalloyed cooperation of the dwellers with various health professionals anticipating in promoting utilization of health facilities in the community.
This review was carried out to provide a comprehensive overview of efforts toward elimination of mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) with respect to progress, challenges, and recommendations in 21 sub-Saharan African priority countries. We reviewed literature published from 2011 to April 2015 using 3 databases; PubMed, Scopus, and Web of Science, as well as the 2014 Global Plan Progress Report. A total of 39 studies were included. Between 2009 and 2013, there was a 43% reduction in new HIV infections, the final MTCT rate was reduced from 28% to 18%, and antiretroviral therapy (ART) coverage increased from 11% to 24%. Challenges included poor adherence to antiretroviral therapy, poor linkage between mother–child pairs and post-natal healthcare services low early infant diagnosis coverage, low pediatric ART coverage, and high unmet needs for contraceptive services. Future recommendations include identification of key barriers, health system strengthening, strengthening community involvement, and international collaboration. There has been significant progress toward eliminating MTCT of HIV, but more effort is still needed.
Abstract Background : Tuberculosis is the world’s deadliest infectious disease and a leading cause of death in Nigeria. The availability of a functional healthcare system is critical for effective TB service delivery and attainment of national and global targets. This study was designed to assess readiness for TB service delivery in Oyo and Anambra states of Nigeria. Methods: This was a facility-based study with a mixed-methods convergent parallel design. A multi-stage sampling technique was used to select 42 primary, secondary, and tertiary healthcare facilities in two TB high burden states. Data were collected using key informant interviews, a semi-structured instrument adapted from the WHO Service Availability and Readiness Assessment tool and facility observation using a checklist. Quantitative data were analysed using descriptive and inferential statistics while qualitative data were transcribed and analysed thematically. Data from both sources were integrated to generate conclusions. Results: The domain score for basic amenities in both states is 48.8%; 47.0% in Anambra and 50.8% in Oyo state with 95% confidence interval [-15.29, 7.56]. In Oyo, only half of the facilities (50%) have access to constant power supply compared to 72.7% in Anambra state. The overall general service readiness index for both states is 69.2% with Oyo state having a higher value (73.3%) compared to Anambra with 65.4% (p=0.56). The domain score for availability of staff and TB guidelines is 57.1% for both states with 95% confidence interval [-13.8, 14.4]. Indicators of this domain with very low values were staff training for the management of HIV and TB co-infection and training on MDR -TB. Almost half (47.6%) experienced a stock out of TB drugs in the 3 months preceding the study. The overall tuberculosis-specific service readiness index for both states is 75%; this was higher in Oyo (76.5%) than Anambra state (73.6%) (p=0.14). Qualitative data revealed areas of deficiencies for TB service delivery such as inadequate infrastructure, poor staffing, and gaps with continuing education on TB management. Conclusions : The weak health system remains a challenge and there must be concerted actions and funding by the government and donors to improve the TB healthcare systems.
In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries.
Methods
GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution.
Findings
Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI.
Interpretation
As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve.
Physical inactivity contributes to the global burden of non-communicable diseases. The pattern of physical activity in adulthood are often established during adolescence and sedentary behaviours in the early years could influence the development of diseases later in life. Studies on physical activity in Nigeria have focused largely on individual behaviours and the effects of school-based interventions have not been well investigated. The aim of the proposed study is to identify factors influencing; and evaluate the effects of a multi-level intervention on the physical activity behaviours of in-school adolescents in Oyo state, Nigeria. The study will adopt a cluster randomised controlled trial design and schools will serve as the unit of randomisation. The sample size is 1000 in-school adolescents aged 10–19 years. The study will be guided by the socio-ecological model and theory of reasoned action and baseline data will be obtained through a mixed methods approach comprising a cross sectional survey to document the self-reported physical activity levels coupled with objectively measured physical activity levels using pedometers for a subset of the sample. Other measurements including weight, height, waist and hip circumferences, fitness level using the 20-m shuttle run test (20-mSRT) and blood pressure will be obtained. The schools’ built environment and policy support for physical activity will be assessed using structured questionnaires coupled with key informant interviews and focus group discussions with the school authorities. Baseline findings will guide the design and implementation of a 12-week multi-level intervention. The primary outcome measures are self–reported and 7-day objectively measured physical activity. Other secondary outcome measures are body-mass-index for age, waist-to-hip ratio, cardioresiratory fitness and blood pressure. The association between behavioural factors and physical activity levels will be assessed. Follow-up measurements will be taken immediately after the intervention and 3-months post intervention. Physical activity behaviours of adolescents in Nigeria are influenced by multiple factors. There is an urgent need for effective school-based interventions with a potential to improve the physical activity behaviours of adolescents in Nigeria and other low and middle income countries. Pan African Clinical Trial Registry. Trial registration number: PACTR201706002224335 , registered 26 June 2017.
Harmful alcohol use is a modifiable risk factor contributing to the increasing burden of non-communicable diseases and deaths and the implementation of policies focused on primary prevention is pivotal to address this challenge. Policies with actions targeting the harmful use of alcohol have been developed in Nigeria. This study is an in-depth analysis of alcohol-related policies in Nigeria and the utilization of WHO Best Buy interventions (BBIs) and multi-sectoral action (MSA) in the formulation of these policies. A descriptive case study design and the Walt and Gilson framework of policy analysis was utilized for the research. Components of the study included a scoping review consisting of electronic search of Google and three online databases (Google Scholar, Science Direct and PubMed) to identify articles and policy documents with no language and date restrictions. Government institution provided documents which were not online. Thirteen policy documents, reports or articles relevant to the policy formulation process were identified. Other components of the study included interviews with 44 key informants (Bureaucrats and Policy Makers) using a pretested guide. The qualitative data were coded and analyzed using thematic analysis. Findings revealed that policy actions to address harmful alcohol use are proposed in the 2007 Federal Road Safety Act, the Non-communicable Diseases Prevention and Control Policy and the Strategic Plan of Action. Only one of the best buy interventions, (restricted access to alcohol) is proposed in these policies. Multi-sectoral action for the formulation of alcohol-related policy was low and several relevant sectors with critical roles in policy implementation were not involved in the formulation process. Overall, alcohol currently has no holistic, health-sector led policy document to regulate the marketing, promotion of alcohol and accessibility. A major barrier is the low government budgetary allocation to support the process. Nigeria has few alcohol-related policies with weak multi-sectoral action. Funding constraint remains a major threat to the implementation and enforcement of proposed policy actions.
Abstract Background Myopia, or short-sightedness, affects many young people globally. The condition has witnessed a significant increase, especially among adolescents and young adults. By 2050, almost half of the global population may suffer from it. The youth population, particularly in Nigeria, shows higher prevalence rates of myopia, necessitating investigations into knowledge, behavioural lifestyles, and prevention among undergraduates. The study examined the knowledge, behavioural lifestyle, and prevention strategies related to myopia among undergraduates in the University of Ibadan. Methods A cross-sectional survey was conducted at the University of Ibadan, among 401 undergraduates from 10 faculties selected through a multistage sampling technique. Data on knowledge of myopia, behavioural lifestyles, and preventive measures were collected using a semi-structured, self-administered questionnaire. Analysis was done using SPSS software, employing both descriptive and inferential statistics, which includes Chi-square and Kruskal-Wallis tests at α0.05 . Results Respondents’ age was 21.7 ± 2.8, 64.8% were males and 35.2% were females. About 53.9% of the respondents demonstrated good knowledge of myopia. Less than half, (46.5%) reported using digital devices for more than 3 hours daily without breaks, while 31.6% admitted to reading under dim light more than 5 times a week. Almost two-fifth of the respondents, (45.9%) demonstrated good preventive measures against myopia. Significant associations were identified between knowledge levels and socio-demographic characteristics, including age, gender, faculty, and monthly allowance. Additionally, there was an association between knowledge levels and lifestyle behaviours, and the practice of preventive measures. Conclusion The study showed that the University of Ibadan undergraduates have knowledge gaps about myopia, along with common lifestyle behaviours contributing to it. It also highlights the need for targeted educational interventions to improve undergraduates' knowledge about myopia, promote healthier lifestyle behaviours, and encourage the adoption of effective preventive measures among university students. To address these gaps, it's crucial to include myopia education in the General Studies (GST) curriculum. This should cover causes and prevention, and promote eye-friendly habits. Additionally, students should have easy access to eye care services. Collaboration between health professionals and the university is essential for a comprehensive approach to eye health education.
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