Stakeholders' hopes and concerns about the COVID-19 vaccines in Southeastern Nigeria: a qualitative study.

BACKGROUND: Equitable access and high uptake of safe and effective vaccines is critical to ending the COVID-19 pandemic. To ensure the success of these vaccines, particularly in many developing and under-developed parts of the world, the concerns of local communities including fears, potency, and levels of acceptance should be addressed. This study assessed community stakeholders' perceptions in parts of Southeastern Nigeria about COVID-19 vaccine, towards engaging them effectively to ensure the success of the vaccination campaigns. METHODS: A qualitative study was conducted involving fourteen stakeholders from the Southeastern geo-political zone of Nigeria selected using purposive sampling. In-depth semi-structured individual interviews lasting about 30 min were used to collect data. Data analysis was informed by a general inductive approach. RESULTS: Stakeholders hoped that the development and roll out of the vaccines will bring COVID -19 to an end, will help to maintain good health and allow people get back to normal life. On the other hand, stakeholders expressed their concerns and worries about the "speed" with which the vaccines are being produced, possibility of future adverse effects from vaccination, misinformation, and level of preparedness in the health system to implement the vaccine campaign. CONCLUSIONS: This study identified that more needs to be done to improve perceptions of those who influence health decisions in communities towards COVID-19 vaccines. This includes firstly, the involvement of the community and religious leaders in vaccine promotion. Secondly, it is imperative to develop and disseminate persuasive messaging on vaccine effectiveness and safety targeted at both health professionals, policymakers, and the community which are culturally sensitive and address identified concerns among health workers. Thirdly, the health systems should be strengthened and system-level interventions that directly target one or more of the WHO's six health system building blocks: service delivery, health workforce, health information systems, access to essential medicines, financing, and leadership/governance.

Rural-urban dimensions of the perception of malaria severity and practice of malaria preventive measures: insight from the 2018 Nigeria Demographic and Health Survey.

Morbidities and mortalities caused by malaria are still a serious issue in Nigeria, with the country accounting for 25% of malaria morbidities and 24% of malaria mortalities globally in 2018. Treated bed nets reduce the incidence of malaria, but not all Nigerians use them. This study aimed to examine the factors associated with treated bed net usage, including perceived severity of malaria, and the rural-urban differences in the relationship between socio-demographic factors and use of treated bed nets in Nigeria. The analytic sample size comprised 40,693 women aged 15-49 years. Poisson regression and bivariable and multivariable analyses were used to test the study hypothesis that women who agreed that malaria could potentially lead to death would be more likely to adopt malaria preventive measures, including treated bed net use. About 48% of the women slept under a treated mosquito net the night before the survey. Those who perceived that malaria could lead to death had a higher likelihood of using a treated bed net in the urban, rural and combined samples. However, in the multivariable model, the association between perceived malaria severity and use of a treated bed net was only significant for rural women (APR=0.964, 95% CI: 0.933, 0.996). The results unexpectedly suggest that rural Nigerian women who perceive malaria to be severe have a lower likelihood of using treated bed nets. Also, rural-urban variations in the relationship between the socio-demographic variables and use of treated bed nets were observed. Policies should consider the observed rural-urban dichotomy in the influence of perceived severity of malaria and other socio-demographic factors on women's use of treated bed nets in Nigeria.

Knowledge, attitude and perception on cervical cancer screening among women attending ante-natal clinic in Owerri west L.G.A, South-Eastern Nigeria: A cross-sectional study.

BACKGROUND: Cancer of the cervix is the second most common cancer in women globally, and it is a major cause of morbidity and mortality among women in developing countries such as Nigeria. The study assessed the knowledge, attitude and perception on cervical cancer screening among women attending ante-natal clinic in Owerri West, south eastern Nigeria. METHOD: This cross-sectional study was conducted using a random sampling technique among 231 respondents attending ante-natal clinic in a cluster of 4 selected public primary healthcare centres. A structured questionnaire was used for data collection, and data obtained was analysed using a descriptive technique, while the chi-square test was used to test for the influence of age and education level on cervical cancer screening. RESULTS: The result showed that there was a high level of awareness (68.8%) of cervical cancer screening. The majority of women (122 (52.8%)) received this information from friends. Although the majority of the participants had heard about the screening, few of them had basic information on the cause of the disease 44 (19%), prevention 32 (13.9%), risk factors 48 (20.8%) and treatment (23.4%) of the disease. Of the 231 women, 59 (25.5%) strongly agreed they were too young to have cervical cancer and hence there was no need for the screening, while a greater proportion (53 (22.9%)) agreed that the screening is only meant for older women (30-45 years). Expensive cost of screening (68 (29.4%)) and invasion of privacy by male doctors (34.6%) were also strong reasons for avoiding screening. The study revealed strong influence of age (χ2 = 104.37; DF = 10; P<0.001) and level of education (χ2=31.63; DF = 6; P<0.001) on awareness of cervical cancer screening. Moreover, educational status had a significant positive influence (χ2= 54.71; P<0.001) on the cause of cervical cancer, with a higher proportion of participants with post-secondary education. CONCLUSION: Awareness of cervical cancer is high, but the perception that it can be treated is quite low, along with fear of the screening outcome. Age and level of education are significant factors of screening for cervical cancer. Educational programmes encouraging participation in cervical cancer screening should consider involving the use of close peers and friends to educate the women on the importance of screening program.