Strengthening care for emergencies: what is the level of awareness and utilization of Emergency Medical Services (EMS) in FCT, Nigeria?

BACKGROUND: As part of the Federal Government of Nigeria's desire to increase medical coverage among the citizenry, the National Emergency Medical Service and Ambulance Scheme (NEMSAS) was set up and piloted in the FCT in 2022. To gauge the progress so far, this study sought to assess the level and determinants of public awareness and utilization of Emergency Medical Services (EMS) among residents of the Federal Capital Territory, Abuja. METHODS: A cross-sectional study was conducted in June 2023 among 1177 respondents residing in FCT Abuja at the time of the survey. Data was collected by trained research assistants using an interviewer-administered questionnaire and purposive sampling was adopted. The level of awareness and the socio-demographic determinants of the level of awareness in the FCT were assessed. Logistic regression was used to find predictors of EMS awareness and utilization. RESULTS: 57.8% of respondents are aware of EMS, while 42.2% are not. 62.7% are uncertain about the source of information for EMS with only a minority relying on word of mouth (17.7%), traditional media (11.1%), or social media (8.5%). 91.4% have not accessed or utilized EMS via the toll-free emergency line, while only 8.6% reported doing so. There are median EMS awareness and utilization differences across gender, age, location, and employment status of the respondents. Additionally, the multivariate logistic regression showed that age, location, and employment status are significant predictors of EMS awareness and utilization. Males have lower odds of awareness and utilization of EMS compared to females. Furthermore, there was a significant relationship between EMS access and utilization (Chi-square = 80.748, p < 0.001). However, awareness did not necessarily translate to utilization. CONCLUSION: The relationship between EMS awareness and utilization and the unmasked predictors in this paper should be factored into the design of interventions to increase access and utilization of EMS in Nigeria.

An assessment of the effectiveness of an electronic wristband in improving routine immunization timeliness and reducing drop-out.

BACKGROUND: To assess the effectiveness of a wristband for immunization alert (WIA) as a reminder device to caregivers to improve immunization timeliness and reduce drop-outs. METHODS: Eight health facilities, selected from two local government areas in Kano state, Northwestern Nigeria, were clustered in a two-arm study involving an intervention group and a control group. Only the caregivers (757) from the intervention group received WIA as an immunization reminder device. Immunization timeliness data were then collected from the control and intervention groups for the period of intervention and analyzed using Microsoft Excel and IBM SPSS version 21. RESULTS: A cohort analysis of caregivers who received WIA at their second visit showed an increase in immunization timeliness from 10% at the second visit to 86% at the third visit and maintained at 66% for the fifth visit. A difference-in-difference analysis of the effect of WIA on immunization timeliness from baseline to end-line in the control and intervention groups showed a positive 30% increase in immunization timeliness associated with the introduction of WIA. INTERPRETATION: Given that immunization timeliness and drop-outs are reported issues of concern in Northwestern Nigeria, the use of the WIA device is a recommended intervention.

Addressing barriers to accessing family planning services using mobile technology intervention among internally displaced persons in Abuja, Nigeria.

BACKGROUND: Inadequate access to sexual and reproductive health services is prevalent among women of reproductive age in internally displaced people's camps. To address this, we implemented a mobile technology intervention, known as the Linking Underserved Populations to Sexual and Reproductive Health Services, in the Wassa Internally Displaced People's camp, Abuja, Nigeria. OBJECTIVE: This study aimed to assess the impact of the Linking Underserved Populations to Sexual and Reproductive Health Services Intervention in improving sexual and reproductive health services among women of reproductive age in Wassa Internally Displaced People's camp. STUDY DESIGN: A baseline survey was conducted among 105 women of reproductive age in the Wassa camp, followed by the deployment of the Linking Underserved Populations to Sexual and Reproductive Health Services intervention, which delivered family planning messages to camp residents between September 2020 and June 2021. This was followed by an endline survey. The FP utilization data in the camp health post were mined during the period of the intervention and were analyzed using Stata version 15 with a chi-square test performed at a significance level of 5%. RESULTS: Awareness of family planning among women of reproductive age in Wassa camp increased from 54.2% at baseline to 98% at endline. The major reason for refusal of family planning at baseline, which was a lack of spousal consent reduced from 29.5% to 7% at endline. Contraceptive prevalence rate increased from 18.1% at baseline to 26.2% at endline. In addition, 133 new family planning users were recorded at the endline. The uptake of family planning services recorded a strong association with family planning consultations (P<.05; χ2=6.41) and receipt of bulk short message service (P<.05; χ2=4.90). CONCLUSION: Mobile technology interventions are a recommended strategy that can increase family planning awareness and address barriers to family planning uptake.

Integrating health intervention into existing program structure of the neglected tropical diseases: lessons learned from Yobe and Ebonyi states.

Background: Nigeria has a national policy on neglected tropical diseases (NTD) which is coordinated by the Federal Ministry of Health and integrated into the health system at all government levels. A network of grassroots mobilizers, named community drug distributors (CDDs), deliver NTD drugs and commodities to rural and hard-to-reach communities throughout Nigeria. Methods: Interviews with state and local government coordinators of Nigerian NTD programs and focus group discussions with CDDs in Yobe and Ebonyi states were conducted to understand the working modalities of NTD programs in Nigeria to identify the potential of leveraging the NTD structure for additional health interventions such as COVID-19 vaccine rollouts. Collected data was coded and managed on NVivo version 12 using content analysis. Results and discussion: The study found that the NTD committee had the following: a structured planning and coordination process, a community mobilization approach for the effective delivery of routine Mass Administration of Medication (MAM) activities. Challenges encountered included little or no incentives for the CDDs, insecurity, transportation and logistics, and lack of equipment and drug commodities. Nigerian NTD health structures have a wide reach, with a presence in all states and local government areas (LGAs), and this has previously been leveraged to deliver commodities and interventions to rural and hard-to-reach communities for non-NTD health programs and could thus be used similarly for COVID-19 vaccination programs. The enablers of integrating health interventions into the NTD structure are increased availability of finances and manpower, while lack of financial incentives and partners' buy-in were identified as possible. challenges. Conclusion: The study suggests that integrating COVID-19 interventions into the NTD program in Nigeria would be a significant accomplishment, as the existing structure can support future interventions. The study also highlights the efficiency of the NTD program's modalities and processes, indicating that an organized structural system for public health interventions can. increase the services of existing interventions while allowing for the integration of future interventions.