Health-related quality of life among adults newly diagnosed with pulmonary tuberculosis in Lagos State, Nigeria: a prospective study.

PURPOSE: Tuberculosis (TB) has far-reaching effects on the social, mental, and emotional well-being of patients and consequently, their health-related quality of life (HRQOL). Few studies in Nigeria have examined changes in quality of life over the course of treatment. changes in (PTB) and factors associated with HRQOL. METHODS: A prospective cohort study was conducted with patients recruited from health facilities in Lagos State. The World Health Organization Quality of Life Instrument, Short-Form (WHOQOL-BREF) was used to assess HRQOL. A semi-structured questionnaire was also administered to elicit information on socio-demographic characteristics and the medical and social history of the respondents. Data were analysed using Statistical Package for the Social Sciences (SPSS) version 23. A repeated measures analysis of variance (ANOVA) test with polynomial contrasts was used to assess how domain scores varied over time. Multivariable analysis was conducted using generalized estimating equations (GEE) to assess change in HRQOL and its predictors. RESULTS: Two hundred and ten patients, predominantly male [108 (63.3%)] were recruited. The mean age was 36.7 ± 12.3 years. The HRQOL was impaired in all four domains at baseline. However, HRQOL scores increased over the treatment period with the largest improvement being in the 'environment' domain, where mean scores increased from 45.27 ± 14.59 to 61.28 ± 15.86. The proportion of respondents that expressed satisfaction with their health increased from 13.5% at baseline to 55.7% at the end of treatment. Low socio-economic status, delay in presentation, and an HIV-positive status were found to be significantly associated with reduced HRQOL at baseline (p < 0.05). In the multivariable longitudinal analysis, patients who were employed had higher HRQOL scores while persistent symptoms and a delay in presentation (≥ 4 weeks) were negatively associated with change in HRQOL scores over the course of treatment. CONCLUSION: The HRQOL of respondents progressively improved over the six-month treatment period. However, change in HRQOL was influenced by a delay in presentation and persistence of symptoms. The study also highlights the need for increased recognition of patient-reported outcomes as an adjunct outcome measure.

Case study of a model primary health care program in Nigeria: History, evolution, challenges, and future perspectives.

This short report describes the historical evolution of a pioneer Model PHC programme located in Ogun State, southwest Nigeria, as a direct result of the vision and effort of Professor Olikoye Ransome-Kuti, and his drive to entrench the delivery of primary health care (PHC) in Nigeria. It describes some of the programmes inspired by the PHC philosophy at the Model PHC Centre, some of the challenges faced over the years, and the need to reposition the programme. It exemplifies key principles in PHC and its philosophy that are instructive for health practitioners, policymakers and development practitioners, especially those with interest in resource-poor countries.

"We just have to help": Community health workers' informal task-shifting and task-sharing practices for hypertension and diabetes care in Nigeria.

Introduction: Nigeria's skilled health professional health workforce density is insufficient to achieve its national targets for non-communicable diseases (NCD) which include 25% reduction in the prevalence of diabetes and hypertension, particularly at the primary health care (PHC) level. This places a great demand on community health workers (CHWs) who constitute the majority of PHC workers. Traditionally, CHWs are mainly involved in infectious diseases programmes, and maternal and child health services. Their involvement with prevention and control of NCDs has been minimal. With government prioritization of PHC for combating the rising NCD burden, strengthening CHWs' skills and competencies for NCD care delivery is crucial. Methods: We conducted a mixed methods study to explore the roles and practices of CHWs in the delivery of hypertension and diabetes care at PHC facilities in four states (two each in northern and southern regions) in Nigeria. We reviewed the National Standing Orders that guide CHWs' practices at the PHC facilities and administered a survey to 76 CHWs and conducted 13 focus groups (90 participants), and in-depth individual interviews with 13 CHWs and 7 other local and state government stakeholders. Results: Overall, we found that despite capacity constraints, CHWs frequently delivered services beyond the scope of practice stipulated in the National Standing Orders. Such informal task-shifting practices were primarily motivated by a need to serve the community. Discussion: While these practices may partially support health system functions and address unmet need, they may also lead to variable care quality and safety. Several factors could mitigate these adverse impacts and strengthen CHW roles in the health system. These include a stronger enabling policy environment to support NCD task-sharing, investment in continuous capacity building for CHWs, improved guidelines that can be implemented at the point of care, and improved coordination processes between PHC and higher-level facilities.

Building capacity of primary health care workers and clients on COVID-19: Results from a web-based training.

BACKGROUND: Health care workers (HCWs) in the first line of care play critical roles in providing the correct information about the coronavirus disease to the community. The objective of the study was to determine the effect of virtual training on the knowledge, attitude, and preventive practices among PHC workers and their clients in the prevention and control of coronavirus disease. METHODS: A quasi-experimental intervention virtual training, using a before and after design amongst HCWs and clients was conducted at primary health care facilities in two Local Government Areas of Lagos State. The study instruments were pre-tested questionnaires for both HCWs and their clients. which investigated knowledge of symptoms, modes of disease transmission, methods of prevention, and preventive practices. Changes in knowledge, attitudes, and practices were compared pre-and post-intervention. The level of significance was set at p < 0.05. RESULTS: Sixty-three HCWs (out of 100 recruited at baseline) and 133 clients (out of the initial 226) completed the study. The mean ages of the HCWs and clients were 39.2±9.9 and 30.9±5.0 years respectively. At the baseline, the HCW's knowledge was good in the domains of symptoms, modes of transmission, and preventive measures. The training led to a higher but not significant (p> 0.05) increase in the level of knowledge. Contact with trained HCWs was found to lead to significantly (P < 0.001) higher levels of knowledge, attitudes, and preventive practices. amongst clients. CONCLUSION: The training was effective in improving the knowledge of both the trained HCWs and their clients.

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

INTRODUCTION: Community 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 to ensure quality health coverage across the country. We aimed to identify factors that would motivate CHWs for quality service delivery. METHODS: A discrete-choice experiment was conducted among 300 CHWs across 44 PHC facilities in the Federal Capital Territory, Abuja Nigeria. Based on the literature review and qualitative research, five attributes, namely: salary, educational opportunities, career progression and in-service training, housing and transportation, were included in the experiment. CHWs were presented with 12 unlabelled choice sets, using tablet devices, and asked to choose which of two hypothetical jobs they would accept if offered to them, or whether they would take neither job. Mixed multinomial logistic models were used to estimate stated preferences for the attributes and the likely uptake of jobs under different policy packages was simulated. RESULTS: About 70% of the respondents were women and 39% worked as volunteers. Jobs that offered career progression were the strongest motivators among the formally employed CHWs (ß=0.33) while the 'opportunity to convert from CHW to another cadre of health workers, such as nursing' was the most important motivator among the volunteers' CHWs (ß=0.53). CHWs also strongly preferred jobs that would offer educational opportunities, including scholarship (ß=0.31) and provision of transport allowances (ß=0.26). Policy scenario modelling predicted combined educational opportunities, career progression opportunities and an additional 10% of salary as incentives was the employment package that would be most appealing to CHWs. CONCLUSION: CHWs are motivated by a mix of non-financial and financial incentives. Policy interventions that would improve motivation should be adequate to address various contexts facing different CHWs and be flexible enough to meet their differing needs.

Nigeria in the COVID era: Health system strengthening for national security and prosperity.

The coronavirus disease-19 pandemic has spread to all parts of the world. As of 20 May 2022, over 500 million confirmed cases have occurred with over 6 million deaths. In Nigeria, over 255,000 cases have occurred with more than 3000 deaths. The pandemic has adversely affected virtually all aspects of human endeavour, with a severe impact on the health system. The Nigerian health system was ill prepared for the pandemic, and this further weakened it. The impacts of the pandemic on the health system include disruption of health services, low motivation of the health workforce, unresponsive leadership and poor funding. The national response, though initially weak, was ramped up to expand capacity building, testing, public enlightenment, creation of isolation and treatment centres and research. The funding for the national response was from the government, private sector and multilateral donors. Nigeria must comprehensively strengthen its health system through motivating and building the capacity of its human resources for health, improved service delivery and provision of adequate funding, to be better prepared against future pandemics.

Hepatitis B and C seroprevalence among residents in Lagos State, Nigeria: A population-based survey.

Background: Hepatitis is one of the leading causes of morbidity and mortality, particularly in developing countries. It is often caused by hepatitis B and C, which are both preventable and treatable. Available information on Hepatitis B and C in Nigeria is based primarily on estimates obtained from specific population sub-groups or hospital-based surveys leaving gaps in population-level knowledge, attitudes, and prevalence. This study aimed to assess the knowledge, attitude and associated factors of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections amongst residents of Lagos State. Methodology: This was a community-based descriptive cross-sectional study carried out in all the 20 local government areas of Lagos state using a multistage sampling technique. Data were collected using pre-tested interviewer-administered questionnaires. Blood samples were taken (pinprick) from respondents (n = 4862) and tested using hepatitis B and C surface antigen tests after obtaining informed consent. Results: The overall prevalence of HBV infection in Lagos State was 2.1% while the prevalence of HCV infection was 0.1%. Only about half of all the respondents (50.9%) had heard about hepatitis B before the survey. Knowledge of the specific symptoms of HBV was also very low. For instance, only 28.1% of the respondents knew that yellowness of the eyes is associated with hepatitis while < 1% (0.1%) knew that HBV infection is associated with the passage of yellow urine. The most common source of information about hepatitis was the radio (13.0%). Only 36.2% of the respondents knew that HBV infection could be prevented. Overall, 28.8% of the respondents were aware of the hepatitis B vaccine. Less than half (40.9%) felt it was necessary to get vaccinated against HBV, however, a similar proportion (41.9%) would want to be vaccinated against HBV. Only 2.5% of all the respondents had ever received HBV vaccines while 3.5% had ever been tested for hepatitis B before this survey. There was a statistically significant association between HBV infection and respondents' use of shared clippers and work exposure involving contact with body parts and body fluids (P < 0.05). Conclusion: The knowledge, awareness and risk perception of HBV infection were low, however, almost half of the residents were willing to receive hepatitis B vaccinations if offered. It is recommended that the population-based prevention programmes and regular community-based surveillance be conducted by the public health department of Lagos State Ministry of Health. In addition, the strengthening of routine immunisation and vaccination of high-risk groups should be prioritised.

Lessons for strengthening childhood immunization in low- and middle-income countries from a successful public-private partnership in rural Nigeria.

BACKGROUND: Immunization is a cost-effective public health strategy to reduce vaccine preventable disease, especially in childhood. METHODS: This paper reports the philosophy, service delivery, achievements and lessons learned from an immunization program in rural Nigeria privately financed via a corporate social responsibility initiative from GlaxoSmithKline Biologicals. RESULTS: The immunization program served the community for a 16-y period extending from 1998 until 2015, resulting in an increase in age-appropriate immunization coverage from 43% to 78%. CONCLUSION: In its success, this immunization program exemplified the importance of early and sustained community engagement, integration of strategies to optimize implementation outcomes and effective team building well before some of these principles were accepted and codified in the literature. The project also underscores the important role that the private sector can bring to achieving critical immunization goals, especially among underserved populations and provides a model for successful public-private partnership.

The organisation of primary health care service delivery for non-communicable diseases in Nigeria: A case-study analysis.

As chronic diseases, non-communicable diseases (NCDs) require sustained person-centred and community-based care. Given its direct link to communities and households, Primary Health Care (PHC) is well positioned to achieve such care. In Nigeria, the national government has prioritized PHC system strengthening as a means of achieving national NCD targets. However, strengthening PHC systems for NCDs require re-organization of PHC service delivery, based on contextual understanding of existing facilitators and barriers to PHC service delivery for NCDs. We conducted a mixed method case study to explore NCD service delivery with 13 PHC facilities serving as the cases of interest. The study was conducted in two northern and two southern states in Nigeria-and included qualitative interviews with 25 participants, 13 focus group discussion among 107 participants and direct observation at the 13 PHCs. We found that interprofessional role conflict among healthcare workers, perverse incentives to sustain the functioning of PHC facilities in the face of government under-investment, and the perception of PHC as an inferior health system were major barriers to improved organisation of NCD management. Conversely, the presence of physicians at PHC facilities and involvement of civil society organizations in aiding community linkage were key enablers. These marked differences in performance and capacity between PHC facilities in northern compared to southern states, with those in the south better organised to deliver NCD services. PHC reforms that are tailored to the socio-political and economic variations across Nigeria are needed to improve capacity to address NCDs.

Aligning policymaking in decentralized health systems: Evaluation of strategies to prevent and control non-communicable diseases in Nigeria.

Noncommunicable diseases (NCDs) are leading causes of death globally and in Nigeria they account for 29% of total deaths. Nigeria's health system is decentralized. Fragmentation in governance in federalised countries with decentralised health systems is a well-recognised challenge to coherent national health policymaking. The policy response to the rising NCD burden therefore requires strategic intent by national and sub-national governments. This study aimed to understand the implementation of NCD policies in Nigeria, the role of decentralisation of those policies, and to consider the implications for achieving national NCD targets. We conducted a policy analysis combined with key informant interviews to determine to what extent NCD policies and strategies align with Nigeria's decentralised health system; and the structure and process within which implementation occurs across the various tiers of government. Four inter-related findings emerged: NCD national policies are 'top down' in focus and lack attention to decentralisation to subnational and frontline care delivery levels of the health system; there are defective coordination mechanisms for NCD programmes which are underpinned by weak regional organisational structures; financing for NCDs are administratively burdensome and fragmented; and frontline NCD service delivery for NCDs are not effectively being integrated with other essential PHC services. Despite considerable progress being made with development of national NCD policies, greater attention on their implementation at subnational levels is needed to achieve more effective service delivery and progress against national NCD targets. We recommend strengthening subnational coordination mechanisms, greater accountability frameworks, increased and more efficient funding, and greater attention to integrated PHC service delivery models. The use of an effective bottom-up approach, with consideration for decentralization, should also be engaged at all stages of policy formulation.

COVID-19: A review of the effectiveness of non-pharmacological interventions.

COVID-19, a highly infectious disease, caused by a novel virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has brought about an unprecedented threat to global health. First reported in Wuhan, China, in December 2019, it has now spread to all continents of the world becoming a pandemic. There is no known treatment or vaccine for it although many candidate drugs and vaccines are in various clinical trial phases. For now, non-pharmacological interventions (NPIs) have become the mainstay of response for COVID-19 and are being used across the world to flatten the epidemiologic curve with some success. This review focussed on identifying which NPIs have been effective. NPIs that are effective include isolation and quarantine, physical distancing, use of face masks and hand hygiene. These measures are best used in combination and simultaneously. The evidence is that they should be instituted early in the pandemic and for sustained periods. They should also be implemented in the context of the cultural and socioeconomic conditions of the populace. Ineffective NPIs include ultraviolet irradiation and spraying of outdoor spaces and individuals. We recommend that decision makers weigh the evidence carefully, as it applies to the local setting to inform public health decisions.

Health literacy: Prevalence and determinants in Lagos State, Nigeria.

BACKGROUND: Poor health literacy has been associated with poorer physical and mental health function, and higher emergency department and hospital utilizations. The study was conducted to measure the prevalence of health literacy and its determinants among Lagos State residents. METHODS: A descriptive cross-sectional study was conducted in three local government areas in Lagos State. Health literacy was assessed using the Brief Health Literacy Screening tool (BHLS), a three-item tool with possible scores ranging between 3 and 15. Health literacy was classified as inadequate (≤ 9) or adequate (>9). RESULTS: A total of 1831 respondents participated in the study, among whom, 952 (52%) were women. The mean age of respondents was 31.7 (±10.5) years. Three-quarters (74.8%) of respondents had adequate health literacy. Adequate levels of health literacy were associated with being female (OR, 1.35; 95% CI, 1.07-1.71), frequent use of the broad cast media as source of information (OR, 1.33; 95% CI, 1.03-1.70), frequent use of the internet as source of information (OR, 1.49; 95% CI, 1.13-1.96). Adequate health literacy was also associated with having knowledge of a frequently prescribed antibiotic (OR, 1.67; 95% CI, 1.32-2.12) and being more comfortable with the use of the English language (OR, 1.71; 95% CI, 1.32-2.22). CONCLUSION: Gender, the use of broadcast media and the internet are predictive of adequate health literacy and should be taken into consideration in planning health interventions.

Predictors of Client Satisfaction Among Recent Users of Health Services in Lagos, Nigeria.

Client satisfaction is an important measure of quality of care as it provides information on how well health service providers meet clients' values and expectations. The study was cross-sectional and analytical in nature. Data were obtained with the use of an interviewer-administered questionnaire. Respondents (n = 994) were a subset of a larger group of community members recruited for a study on quality of health care who had used a health facility for care within 3 months prior to data collection. A total of 94% of clients were satisfied with services received although client satisfaction rates were higher with private than public health facilities. Waiting time of less than 20 minutes (adjusted odds ratio [AOR] = 9.35, 95% confidence interval [CI] = 2.08-41.67), cheap cost of all services received (AOR = 7.58, 95% CI = 1.95-29.41), and the ability of the health care provider to offer explanations clearly to clients (AOR = 6.21, 95% CI = 1.90-20.41) were predictors of client satisfaction. However, the use of a government-owned hospital (AOR = 0.23, 95% CI = 0.08-0.63) was predictive of client dissatisfaction. Only service characteristics were predictive of client satisfaction. Improvement in service delivery is recommended.

How does the public perceive healthcare workers in Lagos? A comparison of health workers in public and private health facilities.

BACKGROUND: The perception of healthcare workers (HCWs) by community members is dependent on the quality of services rendered by HCWs and contributes to utilisation. The objective of the study was to assess the perception of health workers in both public and private facilities by residents of Lagos State. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted using mixed-methods approach. Respondents (n = 2000) were selected using a multistaged sampling technique from four local government areas. An interviewer-administered, pre-tested questionnaire developed for the study was used for data collection and focus group discussions were held. Domains assessed included competence, work attitudes, interpersonal skills and unethical behaviour. A perception index was generated. Data were analysed using the Statistical Package for the Social Sciences version 22, with level of significance set at 0.05 for quantitative data and ATLAS.ti software (Scientific Software, Berlin; version 7) for qualitative data. RESULTS: At least seven out of ten participants (>71%) perceived the HCWs highly in the areas of professional competence, attitude to work, responsiveness and interpersonal skills. Out of a maximum of 12, doctors had the highest mean perception index (10.6 ± 1.9), laboratory scientists had 10.1 ± 2.1, pharmacists had 10.0 ± 2.3 and nurses had 9.6 ± 2.7. A larger proportion of respondents had a significantly better perception of workers in private facilities more than those in government facilities. CONCLUSION: Perception of health workers was high and was better in privately owned facilities. Periodic retraining of health workers and regular assessments of health facilities are recommended.

Characteristics of Mycobacterium Tuberculosis Positive Patients Screened for Drug-Resistant Tuberculosis at a Tertiary Health Facility in Lagos, Nigeria.

BACKGROUND: Nigeria is one of the ten countries with the highest tuberculosis (TB) burden globally and is experiencing an increasing incidence of drug resistance. This study aimed to determine the prevalence of mycobacterium tuberculosis and rifampicin resistance (DR-TB) among patients screened at the TB clinic of a tertiary institution in Lagos, South-West, Nigeria. METHODS: A review of records of 840 patients with suspected drug-resistant TB was carried out from Gene Xpert test clinic register at a tertiary health facility from November 2013 to April 2015. The Data was analyzed with SPSS version 20, Chi square test was used to determine association between DR-TB and the factors examined and the level of significance was set at P < 0.05. RESULTS: MTB detection among all screened suspects was 43.3%. The prevalence of rifampicin resistance was 17.6% among patients that were investigated for DR-TB and this occurred more in the working age group (15-54 years) with male to female ratio of 1.8:1. However, only history of close contact with known DR-TB patient was associated with DR-TB (P < 0.01). CONCLUSION: The burden of DR-TB may be higher than previously thought. Drug resistance testing should be made more available to detect cases and thus control the emerging problem.

Self-reported dental pain and dental caries among 8-12-year-old school children: An exploratory survey in Lagos, Nigeria.

BACKGROUND: Dental pain is considered an important public health problem because it affects the daily life of children. This study was designed to assess the prevalence, associated factors, and impact of dental pain among 8-12-year-old school children in Lagos, Nigeria. SUBJECTS AND METHODS: A cross-sectional survey to determine self-reported dental pain among 8-12-year-old school children using an interviewer-administered questionnaire was conducted. This was followed by a clinical examination to determine the child's oral hygiene status and dental caries status. Chi-square and Fisher's exact tests were used for comparing proportions. Binary logistic regression analysis was also conducted. Statistical significance was set at P < 0.05. RESULTS: Of the 414 children included in the survey, 254 (61.4%) children and 103 (24.9%) children reported experiencing dental pain 3 months and 4 weeks before the survey, respectively. Caries prevalence was 21.0%, whereas mean decayed, missing, and filled tooth index score was 0.4420 (±1.078). A report of pain up to 3 months before the survey was significantly associated with the child's age [odds ratio (OR) = 1.254; confidence interval (CI) = 1.037-1.516; P = 0.019], whereas the type of school attended (OR = 1.786; CI = 1.124-2.840; P = 0.014) and the presence of dental caries (OR = 1.738; CI = 1.023-2.953; P = 0.041) were significantly associated with reporting pain 4 weeks before the survey. CONCLUSION: The prevalence of self-reported dental pain was high among the children surveyed. Report of dental pain was associated with the presence of dental caries. The provision of school oral health services could be useful in reducing the level of untreated caries and possibly dental pain among school children.

A malariometric survey of under-fives residing in indoor residual spraying-implementing and non-implementing communities of Lagos, Nigeria.

BACKGROUND: Indoor residual spraying (IRS) is used as part of the integrated vector management strategy for the control of malaria in Lagos, Nigeria. The purpose of this study was to compare the malariometric indices of children under 5 years old living in IRS-implementing and non-IRS-implementing communities of Lagos, Nigeria. METHODS: The study was a community-based, comparative, cross-sectional study of 480 children under five recruited using a multi-stage sampling method. Data on each child were collected using a household questionnaire administered to the consenting care-giver of each selected child. Each child underwent a comprehensive physical examination. On-the-spot malaria rapid diagnostic testing and haemoglobin estimation to assess parasitaemia and anaemia, respectively, were also carried out. Risk factors for parasitaemia and anaemia were identified using multivariate logistic regression. RESULTS: A total of 238 children were studied in the IRS-implementing group while 242 children were studied in the non-IRS-implementing group. The IRS -implementing community had a lower level of parasitaemia (1.3 %) compared to the non-IRS-implementing community (5.8 %) (p < 0.001). There was no significant difference in anaemia, spleen rate and fever in the IRS-implementing group (10.9, 9.7 and 5 %) and the non-IRS-implementing group (9.9, 8.8 and 8.7 %), respectively. Residing in an IRS-implementing community was associated with lower odds of parasitaemia (OR 0.17, p < 0.01). Sleeping under a bed net was the only factor associated with anaemia (p < 0.01). CONCLUSION: IRS has led to a reduction in the level of parasitaemia in the under-fives in the study areas.

A survey of knowledge and reporting practices of primary healthcare workers on adverse experiences following immunisation in alimosho local government area, Lagos.

BACKGROUND: A descriptive cross-sectional survey was conducted among healthcare workers offering immunisation services in primary healthcare facilities in Alimosho Local Government Area, Lagos, Nigeria, on knowledge and reporting practices of healthcare workers on adverse events following immunisations (AEFIs). MATERIALS AND METHODS: A pre-tested, close-ended, self-administered questionnaire was used to assess knowledge and reporting practices on AEFI. Data were analysed using Statistical Package for Social Sciences (SPSS) version 16. Knowledge of healthcare workers was scored and graded as <50% - poor, 50-74% - fair and ≥75% - good. Reporting practices on AEFI was classified as good if it was reported within 24 h of seeing one.P= 0.05 was considered statistically significant. RESULTS: One hundred and sixty-four healthcare workers duly completed and returned their questionnaires. The mean age was 39.5 ± 2.64 years and mean post-qualification experience was 12.2 ± 2.33 years. Over 80% of the healthcare workers knew that fever, pain, redness and swelling at injection site were clinical signs and symptoms of AEFI, and 93% knew about filling an adverse event form to report an AEFI. Overall, nearly 80% of respondents had fair/good knowledge on AEFI. Fifty-five (33.5%) healthcare workers had encountered an AEFI and 31 (56.4%) reported such within 24 h. There was a significant relationship between being younger healthcare workers and knowledge on AEFIs (P = 0.029). No healthcare worker characteristics were significantly associated with good reporting practices on AEFI. CONCLUSION: Respondents' knowledge and reporting practices on AEFI were average.

Youth friendly health services in a rural community of Lagos, Nigeria: are the youths receptive?

BACKGROUND: Globally, the youths constitute a major segment of most societies particularly in developing countries. This study was undertaken to assess the perception and practices related to youth friendly health services (YFHS) by in-school adolescents in a rural community of Lagos, Nigeria. METHODS: A descriptive cross-sectional survey was conducted on 400 proportionately selected consenting respondents from the senior classes of the three secondary schools in Agbowa community. A pre-tested interviewer-administered questionnaire was used for data collection and analysis was done with the aid of statistical software. RESULTS: Most of the respondents were in the age range of 12-15 years with mean age being 15.33±1.54 years. About half (46.8%) of the respondents correctly described adolescents as persons between the ages of 10 and 19 years. The majority (83.2%) of the respondents first heard about the Youth Friendly Health facilities from parents, guardians and friends. However, only few of the respondents had ever visited a Youth Friendly Center. A good location, convenient hours and comfortable surroundings were the most appealing aspects of YFHS. The provision of a seminar room and educational materials (60.8% and 70.8%, respectively) are important to the respondents. Reproductive health (56.8%) was the most preferred health education topic chosen by the respondents. CONCLUSION: Sensitization of the youths in the Agbowa community about youth friendly health services and provision of such services would be useful in reducing risky practices and improving their health.