ABSTRACT
INTRODUCTION: This study examined the effectiveness of mobile phone reminders in improving the completeness and timeliness of childhood immunization. METHOD: We conducted a parallel arm cluster randomized controlled trial in four primary health care facilities in Nigeria. Reminders were sent to eligible participants in the intervention group at specific intervals when their children were scheduled to receive the vaccines administered at the sixth, 10, and 14 weeks after birth. Immunization records of all participants' children were then tracked to assess their immunization status. RESULTS: The immunization status of the intervention (n = 275) and control (n = 261) arms was analyzed. Completeness and timeliness of the vaccine series were significantly higher (p < .001) among children of participants in the intervention (n = 169, 61.5% and n = 138, 50.2%) than those in the control group (n = 35, 13.4% and n = 13, 5%) arm. DISCUSSION: Mobile phone reminders were established to be effective in increasing the completeness and timeliness of childhood immunization.
ABSTRACT
Sexual violence with its enormous negative consequences has become an epidemic most especially among the young populations. An effective danger-proof reporting system is necessary for curbing this menace including use of the internal whistleblowing mechanism. The study employed a concurrent (parallel) mixed method descriptive design for explaining the sexual violence experiences of university students, the intention of staff and students to blow the whistle, and their preferred whistleblowing strategies. A total of 167 students and 42 members of staff (69% males and 31% females, respectively) were randomly selected from four academic departments (50%) of a university of technology in Southwest Nigeria. An adapted questionnaire containing three vignettes on sexual violence and a focus group discussion guide were used for data collection. We discovered that 16.1% of the students reported to have experienced sexual harassment, 12.3% had attempted rape, and 2.6% had experienced rape. Tribe (Likelihood-Ratio, LR = 11.16; p = .004) and sex (χ2 = 12.65; p = .001) were strongly associated with sexual violence experiences. Also, 50% staff and 47% students had high intention. Regression analysis showed that industrial and production engineering students will be 2.8 times more likely to have intention to internally blow the whistle more than other students (p = .03; 95% CI [1.1, 6.97]). Female staff had 5.73 odds of intention more than male staff (p = .05; [1.02, 32.1]). Also, we observed that senior staff will 31% less likely blow the whistle than the junior staff (Adjusted Odd Ratio, AOR = 0.04; [0.00, 0.98]; p = .05). In our qualitative findings, courage was mentioned as a factor necessary for blowing the whistle while anonymous reporting was emphasized for successful whistleblowing. However, the students preferred external whistleblowing. The study has implication for the establishment of sexual violence internal whistleblowing reporting system in higher education institutions.
Subject(s)
Sex Offenses , Whistleblowing , Humans , Male , Female , Universities , Intention , Students , Surveys and QuestionnairesABSTRACT
BACKGROUND: Childhood immunisation coverage is very low in Nigeria (31%) with Zamfara State being amongst the states with the poorest coverage (<10%). Lack of maternal knowledge, attitude, outcome expectations, self-efficacy, cultural beliefs and assumptions of religious regulations of antenatal mothers towards childhood immunisation are the contributory factors to poor childhood immunisation uptake. This study aims is to develop, implement and evaluate the effects of an immunisation health educational intervention with application of Social Cognitive Theory on pregnant women to improve knowledge, attitude, outcome expectations, self-efficacy, cultural beliefs and assumptions on religious regulations regarding childhood immunization uptake in Federal Medical Centre Gusau, Zamfara State, Nigeria. METHODOLOGY: The study will be a single-blind parallel-group randomised controlled trial, where baseline data will be collected from 392 estimated antenatal mothers, after that they will be evenly randomised using randomly generated permuted block sizes (each containing two intervention and two control assignments). The study participants will be antenatal mothers of ages 18 years and above who are in third trimesters and attending Federal Medical Centre Gusau, Zamfara State, Nigeria; during the study period and fulfilled all the inclusion and exclusion criteria. The intervention group will undergo five-health education sessions on immunisation, which will be strictly guided by Social Cognitive Theory-based intervention module: while the control group will receive usual care (standard care). Follow-up data will be collected using the same questionnaire at 6-weeks post-delivery, 10-weeks post-delivery and 14-weeks post-delivery. The generalized linear mixed model will be carried-out to determine the overall effect of the intervention after controlling for 14 potential confounding variables. An intention to treat analysis will also be carried-out. Childhood immunisation uptake is the primary outcome while the secondary outcomes are: improved knowledge scores, attitude scores, outcomes expectation, self-efficacy scores, cultural beliefs scores and assumptions on religious regulations scores. DISCUSSION: The study will be a randomised controlled trial, that focuses on the effects of an immunisation health educational intervention with application of Social Cognitive Theory on pregnant women to improve knowledge, attitude, outcome expectations, self-efficacy, cultural beliefs and assumptions on religious regulations regarding childhood immunisation uptake in Federal Medical Centre Gusau, Zamfara State, Nigeria. TRIAL REGISTRATION: Pan African Clinical Trial Registry PACTR202006722055635. Protocol registered on 09 June 2020.
Subject(s)
Health Education , Mothers , Pregnancy , Female , Child , Humans , Adolescent , Single-Blind Method , Nigeria , Randomized Controlled Trials as TopicABSTRACT
Background: Maternal mortality reduction remains a world health priority. One of the causes of maternal death is bleeding after childbirth. However, little is known regarding barriers to reporting for postpartum hemorrhage care among postnatal women in Nigeria. Objective: This research aimed to understand the perceived barriers to reporting postpartum hemorrhage care experienced by women and healthcare workers in Birnin Kebbi, North west-Nigeria. Methods: Qualitative case research was employed in this study with face-to-face interviews among ten postnatal women who experienced bleeding and six healthcare workers. Data were collected from September to November 2021. The interviews were all audio-taped, transcribed verbatim, and analyzed using thematic analysis. NVivo Pro Version 12 was applied to organize further and manage the data. Results: Six themes were developed: (1) knowledge deficit, (2) poor attitudes, behaviors, and performances, (3) low socioeconomic status, (4) lack of healthcare personnel, (5) cultural norms, and (6) lack of access to healthcare facilities. Conclusion: The study findings might serve as input for healthcare policymakers and healthcare workers to improve health and reduce maternal mortality. Enhancing knowledge and awareness about reporting process is necessary to improve reporting for postpartum hemorrhage care among women. Training and continuous professional development of health care workers are also highly suggested to enhance the quality of care.
ABSTRACT
Immunization remains one of the most effective public health interventions offering protection for children from vaccine preventable diseases. However, many children living in low- and- middle income countries do not get adequate immunization due to several factors. Mobile phone reminder interventions have shown great potential in enhancing a number of immunization outcomes. However, the evidence supporting its use in these countries is vague. This systematic review was conducted to provide evidence for mobile phone reminder in enhancing immunization uptake, completeness and timeliness. This review was conducted in accordance to the PRISMA recommendations. Three online databases; PubMed, Cochrane Library and African Journals Online, were systematically searched for potentially relevant studies. Screening of records (titles/abstracts from and full-texts) was done using Covidence. Meta-analyses were conducted using the Cochrane Collaboration Review Manager (v5.4). The GRADEpro was used to evaluate the certainty of evidence/summary of findings. Eleven RCTs assessing immunization uptake, completeness and/or timeliness by means of SMS, phone calls or a combination of voice message and SMS were included in both quantitative and qualitative synthesis. Overall, the included studies were of moderate quality. Majority of the included studies indicated that mobile phone reminders were beneficial. Meta-analyses indicated that using mobile phone reminder interventions for the review outcomes was of variable effect with high level of heterogeneity. A combination of voice message and SMS has a greater effect followed by phone calls then SMS reminders for immunization completeness. The use of SMS for immunization uptake and timeliness were largely insignificant (p > 0.05). Furthermore, evidence to support the efficacy of mobile phone reminder from the GRADE synthesis was between low and moderate. Mobile phone reminders, particularly a combination of voice message + SMS and perhaps phone calls appears to be more effective in enhancing immunization outcomes. However, more studies are required in view of methodological inadequacies in existing studies.
