Effect of Nigeria Presidential Task Force on COVID-19 Pandemic, Nigeria.

Nigeria had a confirmed case of COVID-19 on February 28, 2020. On March 17, 2020, the Nigerian Government inaugurated the Presidential Task Force (PTF) on COVID-19 to coordinate the country's multisectoral intergovernmental response. The PTF developed the National COVID-19 Multisectoral Pandemic Response Plan as the blueprint for implementing the response plans. The PTF provided funding, coordination, and governance for the public health response and executed resource mobilization and social welfare support, establishing the framework for containment measures and economic reopening. Despite the challenges of a weak healthcare infrastructure, staff shortages, logistic issues, commodity shortages, currency devaluation, and varying state government cooperation, high-level multisectoral PTF coordination contributed to minimizing the effects of the pandemic through early implementation of mitigation efforts, supported by a strong collaborative partnership with bilateral, multilateral, and private-sector organizations. We describe the lessons learned from the PTF COVID-19 for future multisectoral public health response.

Effectiveness of provider-initiated testing and counseling in increasing HIV testing and counselling utilization and HIV detection rates in Ebonyi State, South-Eastern Nigeria.

HIV testing and counselling is crucial in identifying new HIV cases and linking them to treatment. Provider-initiated testing and counselling can help to increase uptake of HIV testing and counselling and HIV case detection. We implemented provider-initiated testing and counselling in 32 health facilities in Ebonyi State, South-East Nigeria in order to achieve both objectives. Provider-initiated testing and counselling was implemented across the 32 facilities from January to June 2016. Provider-initiated testing and counselling data were compared with the preceding six months (July­December 2015) when only voluntary counselling and testing was done. A total of 11,787 out of 22,153 who visited the outpatient clinics within the intervention period (53%) were tested. In the preceding six months, only 3172 clients were tested via voluntary counselling and testing out of 50,898 clients who visited the outpatient clinics (6.2%). This was a 3.72-fold increase over the numbers tested via voluntary counselling and testing, within a similar time frame. Also, 158 new cases were diagnosed during the period from provider-initiated testing and counselling compared to 24 from voluntary counselling and testing in the preceding six months ­ an increase of 4.65-fold in case detection. Apart from the 11,787 tested through provider-initiated testing and counselling, another 6999 clients were tested through community-based outreaches during the intervention period. Comparison of case detection between both strategies shows that provider-initiated testing and counselling accounted for 158 cases (97%) while outreaches accounted for only five cases (3%). Provider-initiated testing and counselling led to an increase in uptake of HIV testing and counselling services as well as in HIV case detection across the 32 facilities where our programme was implemented.

Integration of Traditional Birth Attendants into Prevention of Mother-to-Child Transmission at Primary Health Facilities in Kaduna, North-West Nigeria.

One of the fundamental challenges to implementing successful prevention of mother-to-child transmission (PMTCT) programs in Nigeria is the uptake of PMTCT services at health facilities. Several issues usually discourage many pregnant women from receiving antenatal care services at designated health facilities within their communities. The CRS Nigeria PMTCT Project funded by the Global Fund in its Round 9 Phase 1 in Nigeria, sought to increase demand for HIV counseling and testing services for pregnant women at 25 supported primary health centers (PHCs) in Kaduna State, North-West Nigeria by integrating traditional birth attendants (TBAs) across the communities where the PHCs were located into the project. Community dialogues were held with the TBAs, community leaders and women groups. These dialogues focused on modes of mother to child transmission of HIV and the need for TBAs to refer their clients to PHCs for testing. Subsequently, data on number of pregnant women who were counseled, tested and received results was collected on a monthly basis from the 25 facilities using the national HIV/AIDS tools. Prior to this integration, the average number of pregnant women that were counseled, tested and received results was 200 pregnant women across all the 25 health facilities monthly. After the integration of TBAs into the program, the number of pregnant women that were counseled, tested and received results kept increasing month after month up to an average of 1500 pregnant women per month across the 25 health facilities. TBAs can thus play a key role in improving service uptake and utilization for pregnant women at primary health centers in the community - especially in the context of HIV/AIDS. They thus need to be integrated, rather than alienated, from primary healthcare service delivery.