Social consequences of COVID-19 on fertility preference consistency and contraceptive use among Nigerian women: insights from population-based data.

BACKGROUND: Emerging evidence from high income countries showed that the COVID-19 pandemic has had negative effects on population and reproductive health behaviour. This study provides a sub-Saharan Africa perspective by documenting the social consequences of COVID-19 and its relationship to fertility preference stability and modern contraceptive use in Nigeria. METHOD: We analysed panel data collected by Performance Monitoring for Action in Nigeria. Baseline and Follow-up surveys were conducted before the COVID-19 outbreak (November 2019-February 2020) and during the lockdown respectively (May-July 2020). Analysis was restricted to married non-pregnant women during follow-up (n = 774). Descriptive statistics and generalized linear models were employed to explore the relationship between selected social consequences of COVID-19 and fertility preferences stability (between baseline and follow-up) as well as modern contraceptives use. RESULTS: Reported social consequences of the pandemic lockdown include total loss of household income (31.3%), food insecurity (16.5%), and greater economic reliance on partner (43.0%). Sixty-eight women (8.8%) changed their minds about pregnancy and this was associated with age groups, higher wealth quintile (AOR = 0.38, CI: 0.15-0.97) and household food insecurity (AOR = 2.72, CI: 1.23-5.99). Fertility preference was inconsistent among 26.1%. Women aged 30-34 years (AOR = 4.46, CI:1.29-15.39) were more likely of inconsistent fertility preference compared to 15-24 years. The likelihood was also higher among women with three children compared to those with only one child (AOR = 3.88, CI: 1.36-11.08). During follow-up survey, 59.4% reported they would feel unhappy if pregnant. This was more common among women with tertiary education (AOR = 2.99, CI: 1.41-6.33). The odds increased with parity. The prevalence of modern contraceptive use was 32.8%. Women aged 45-49 years (AOR = 0.24, CI: 0.10-0.56) were less likely to use modern contraceptives than those aged 15-24 years. In contrast, the odds of contraceptive use were significantly higher among those with three (AOR = 1.82, CI: 1.03-3.20), four (AOR = 2.45, CI: 1.36-4.39) and at least five (AOR = 2.89, CI: 1.25-6.74) children. Unhappy disposition towards pregnancy (AOR = 2.48, CI: 1.724-3.58) was also a significant predictor of modern contraceptive use. CONCLUSION: Some social consequences of COVID-19 affected pregnancy intention and stability of fertility preference but showed no independent association with modern contraceptive use.

Strengthening health information librarianship in Africa through associations and partnerships: personal reflections in memory of Shane Godbolt.

This paper describes the significant roles Shane Godbolt played in promoting partnerships and collaborations and strengthening the Association for Health Information and Libraries in Africa (AHILA). It presents the personal reflections of each author about Shane, the part she played in their professional and personal lives as well as Shane's vital support for AHILA and AHILA members during her lifetime.

General and tuberculosis-specific service readiness in two states in Nigeria.

BACKGROUND: Tuberculosis is the world's deadliest infectious disease and a leading cause of death in Nigeria. The availability of a functional healthcare system is critical for effective TB service delivery and attainment of national and global targets. This study was designed to assess readiness for TB service delivery in Oyo and Anambra states of Nigeria. METHODS: This was a facility-based study with a mixed-methods convergent parallel design. A multi-stage sampling technique was used to select 42 primary, secondary, and tertiary healthcare facilities in two TB high burden states. Data were collected using key informant interviews, a semi-structured instrument adapted from the WHO Service Availability and Readiness Assessment tool and facility observation using a checklist. Quantitative data were analysed using descriptive and inferential statistics while qualitative data were transcribed and analysed thematically. Data from both sources were integrated to generate conclusions. RESULTS: The domain score for basic amenities in both states was 48.8%; 47.0% in Anambra and 50.8% in Oyo state with 95% confidence interval [- 15.29, 7.56]. In Oyo, only half of the facilities (50%) had access to constant power supply compared to 72.7% in Anambra state. The overall general service readiness index for both states was 69.2% with Oyo state having a higher value (73.3%) compared to Anambra with 65.4% (p = 0.56). The domain score for availability of staff and TB guidelines was 57.1% for both states with 95% confidence interval [- 13.8, 14.4]. Indicators of this domain with very low values were staff training for the management of HIV and TB co-infection and training on MDR -TB. Almost half (47.6%) of the facilities experienced a stock out of TB drugs in the 3 months preceding the study. The overall tuberculosis-specific service readiness index for both states was 75%; this was higher in Oyo (76.5%) than Anambra state (73.6%) (p = 0.14). Qualitative data revealed areas of deficiencies for TB service delivery such as inadequate infrastructure, poor staffing, and gaps with continuing education on TB management. CONCLUSIONS: The weak health system remains a challenge and there must be concerted actions and funding by the government and donors to improve the TB healthcare systems.

Tuberculosis treatment outcomes and associated factors in two states in Nigeria.

OBJECTIVE: To determine the treatment success rate among TB patients and associated factors in Anambra and Oyo, the two states with the largest burden of tuberculosis in Nigeria. METHODS: A health facility record review for 2016 was conducted in the two states (Anambra and Oyo). A checklist was used to extract relevant information from the records kept in each of the selected DOTS facilities to determine TB treatment success rates. Treatment success rate was defined as the proportion of new smear-positive TB cases registered under DOTS in a given year that successfully completed treatment, whether with bacteriologic evidence of success ('cured') or without ('treatment completed'). Treatment success rate was classified into good (≥85%) and poor (<85%) success rates using the 85% national target for TB treatment outcome. Data were analysed using descriptive statistics and chi-square at P < 0.05. RESULTS: There were 1281 TB treatment enrollees in 2016 in Anambra and 3809 in Oyo (total = 4835). An overall treatment success rate of 75.8% was achieved (Anambra-57.5%; Oyo-82.0%). The percentage cure rates were 61.5% for Anambra and 85.2% for Oyo. Overall, only 28.6% of the facilities in both states (Anambra-0.0%; Oyo-60.0%) had a good treatment success rate. More facilities in Anambra (100.0%) than Oyo (40.0%) had a poor treatment success rate (p < 0.001), as did more private/FBO (100.0%) than public health facilities (60.0%) (p = 0.009). All tertiary facilities had a poor treatment success rate followed by 87.5% of secondary health facilities and 56.5% of primary healthcare facilities (P = 0.035). CONCLUSION: Treatment success and cure rates in Anambra state were below the 85.0% of the recommended target set by the WHO. Geographical location, and level/tier and type of facility were factors associated with this. Interventions are recommended to address these problems.

OBJECTIF: Déterminer le taux de succès du traitement chez les patients TB et les facteurs associés à Anambra et Oyo, les deux Etats avec la plus grande charge de TB au Nigéria. MÉTHODES: Un examen des dossiers des établissements de santé pour 2016 a été réalisé dans les deux Etats (Anambra et Oyo). Une liste de contrôle a été utilisée pour extraire les informations pertinentes des registres conservés dans chacun des établissements DOTS sélectionnés afin de déterminer les taux de succès du traitement antituberculeux. Le taux de succès du traitement a été défini comme la proportion de nouveaux cas de TB à frottis positif enregistrés dans le cadre du DOTS au cours d'une année donnée qui ont terminé le traitement avec succès, que ce soit avec des preuves bactériologiques de succès («guéri¼) ou sans («traitement terminé¼) . Le taux de succès du traitement a été classé en bons (≥ 85%) et mauvais (<85%) taux de réussite en utilisant l'objectif national de 85% pour l'issue du traitement de la TB. Les données ont été analysées à l'aide de statistiques descriptives et du Chi carré à p <0,05. RÉSULTATS: Il y avait 1.281 personnes inscrites au traitement antituberculeux en 2016 à Anambra et 3.809 à Oyo (total = 4835). Un taux de succès global du traitement de 75,8% a été atteint (Anambra, 57,5%; Oyo, 82,0%). Les taux de guérison en pourcentage étaient de 61,5% pour Anambra et de 85,2% pour Oyo. Dans l'ensemble, seuls 28,6% des établissements des deux Etats (Anambra, 0,0%; Oyo, 60,0%) avaient un bon taux de réussite du traitement. Plus d'établissements à Anambra (100,0%) qu'à Oyo (40,0%) avaient un faible taux de réussite du traitement (p <0,001), tout comme plus d'établissements de santé privés/FBO (100,0%) que publics (60,0%) (p = 0,009). Tous les établissements tertiaires avaient un faible taux de réussite du traitement, suivis de 87,5% des établissements de santé secondaires et 56,5% des établissements de soins de santé primaires (p = 0,035). CONCLUSION: Le succès du traitement et les taux de guérison dans l'Etat d'Anambra étaient inférieurs aux 85,0% de l'objectif recommandé fixé par l'OMS. L'emplacement géographique, le niveau et le type d'établissement étaient des facteurs associés à cela. Des interventions sont recommandées pour résoudre ces problèmes.

Development of the African Digital Health Library (ADHL): Experience at the Medical Library, University of Ibadan, Nigeria

The African Digital Health Library, (ADHL) is a collaborative project involving five African institutions namely Bamako University of Science and Technology, Kenya Methodist University, Universities of Ibadan, Nairobi, Zambia, and Zimbabwe. The University of Ibadan Nigeria component of the ADHL (ADHL-UI) is described in this paper. Funded by the Office of Global AIDS Coordinator of the United States Department of State, the goal of ADHL-UI is to store, preserve, make accessible through an institutional repository, theses and dissertations by postgraduate students of the institution's College of Medicine. The ADHL-UI has over 1000 theses and dissertations accessible on the internet. Creation of the ADHL-UI, a repository of theses and dissertations in the Medical Library, University of Ibadan, is a major contribution to research development and preservation of institutional scholarly heritage. Effective use by students and faculty will help in reducing duplication of research efforts and create visibility for the authors and the institution.

Awareness and use of reference managers by resident doctors in Nigeria

Reference manager (RM) also known as reference management software (RMS) are tools used by researchers to organize and manage bibliographic references. They are citation tools that enable researchers to track the scientific papers they have read, sources consulted, cited and used to generate a reference list or bibliography. This study investigated the awareness and pattern of use of RM tools by Resident Doctors (RDs) in Nigeria. Cross-sectional survey design was adopted for the study and semi-structured questionnaire was used for the data collection. Respondents' age was 35.9 ± 5.0, (53.8%) were males. Most of the respondents (92.9%) had heard of RM, 49.1% had ever used any RM with Mendeley topping the list (49.1%). However, many of the respondents (42.8%) did not use RM due to lack of requisite skills, while only (35.1%) respondents had ever received formal training on use of RM. Based on the findings of the study, it was recommended that awareness should be regularly created to encourage resident doctors to apply their knowledge of the tools in the management of their references while training should be conducted for those who do not use the tools.

Teaching high school students to use online consumer health resources on mobile phones: outcome of a pilot project in Oyo State, Nigeria.

OBJECTIVE: This project evaluated the outcomes of training high school students to deliver consumer health information to their peers. METHODS: A total of 120 students selected from 7 high schools in Oyo state, Nigeria, received 8 hours of training on consumer health literacy and peer education, which is a process of training volunteers to deliver health information to their peers. The training included hands-on activities using the students' own mobile phones. After the training, peer educators distributed leaflets, showed consumer health information (CHI) websites to others, counseled and referred fellow students, and submitted forms describing these activities. All peer educators completed pre- and post-tests, and 10 were interviewed 4 months after training. RESULTS: After the training, the authors found improvement in the trainees' knowledge of CHI resources and understanding of their roles as peer educators. Most peer educators (72.5%) delivered CHI to their peers after the training, primarily through sharing websites on teen health and other CHI resources. In the interviews, all peer educators reported direct benefits from participating in the project, and many stated that they knew where to find reliable health information. CONCLUSION: Volunteer high school students can be trained to deliver CHI to their peers using mobile phones.

International trends in health science librarianship part 15: West Africa (Ghana, Nigeria, Senegal).

This is the 15th in a series of articles exploring international trends in health science librarianship in the 21st century. It is the third of four articles pertaining to different regions in the African continent. The present issue focuses on countries in West Africa (Ghana, Nigeria and Senegal). The next feature column will investigate trends in North Africa. JM.

Knowledge and utilization of the United States National Library of Medicine's biomedical information products and services among African health sciences librarians.

The United States National Library of Medicine (NLM) has the largest collection of biomedical information products and services in the world. Little is known of the extent to which librarians in sub-Saharan Africa are aware of and use these resources. The study's aim was to assess knowledge and frequency of use of NLM's biomedical information products and services among African librarians. Forty-three of the 50 delegates at the 11th biannual Congress of the Association of Health Information and Libraries in Africa (AHILA) participated in the study. The findings showed that participants' knowledge of NLM information products and services was low and that there is a need for increased awareness and training in the use of NLM's information products and services in order for users on the African continent to effectively benefit from them.

Assessment of Scholarly Publications of Nigerian Health Sciences Researchers in MEDLINE/Pubmed (1996-2007)

Scholarly publications are outcome of research and are important channels for dissemination of research findings by researchers. The main objective of this study was to assess the scholarly publications of Nigerian health sciences' researchers and the journals in which they publish. Health science researchers are health care providers; faculty; medical scientists and other allied health professionals who conduct research in health related fields. Research articles written by Nigerian health sciences' researchers published during 1996-2007 were accessed through the MEDLINE/PubMed database. Both the author affiliation in Address field and Publication date field were used to obtain data on the number and characteristics of publications by the researchers. A total of 7030 articles were published during the period. The number of publications increased from 338 in 1996 to 952 in 2007. Of the 7;030 citations; 2;124 (31) were published in nine Nigerian journals with the African Journal of Medicine and Medical Sciences having the highest (660). However; 17 articles were published in four international multidisciplinary journals namely: British Medical Journal (BMJ); Journal of the American Medical Association (JAMA); Lancet and New England Journal of Medicine (NEJM). Approximately 80 of the publications were Original Research Articles. Nigerian health sciences' researchers are productive in terms of scholarly publications. However; their publications are concentrated more in national journals; some of which are not indexed in any bibliographic database; others are print only; not widely circulated thereby limiting the impact of their research. Development of a national bibliographc database to index articles published in Nigerian journals and publication of more journal in electronic format is recommended

The level of Internet access and ICT training for health information professionals in sub-Saharan Africa.

BACKGROUND: Information and Communication Technologies (ICTs) are important tools for development. Despite its significant growth on a global scale, Internet access is limited in sub-Saharan Africa (SSA). Few studies have explored Internet access, use of electronic resources and ICT training among health information professionals in Africa. OBJECTIVE: The study assessed Internet access, use of electronic resources and ICT training among health information professionals in SSA. METHODS: A 26-item self-administered questionnaire in English and French was used for data collection. The questionnaire was completed by health information professionals from five Listservs and delegates at the 10th biannual Congress of the Association of Health Information and Libraries in Africa (AHILA). RESULTS: A total of 121 respondents participated in the study and, of those, 68% lived in their countries' capital. The majority (85.1%) had Internet access at work and 40.8% used cybercafes as alternative access points. Slightly less than two-thirds (61.2%) first learned to use ICT through self-teaching, whilst 70.2% had not received any formal training in the previous year. Eighty-eight per cent of respondents required further ICT training. CONCLUSIONS AND RECOMMENDATIONS: In SSA, freely available digital information resources are underutilized by health information professionals. ICT training is recommended to optimize use of digital resources. To harness these resources, intergovernmental and non-governmental organizations must play a key role.

Use of the Internet for health information by physicians for patient care in a teaching hospital in Ibadan, Nigeria.

BACKGROUND: The Internet is the world's largest network of information, communication and services. Although the Internet is widely used in medicine and has made significant impact in research, training and patient care, few studies had explored the extent to which Nigerian physicians use Internet resources for patient care. The objective of this study was to assess physicians' use of the Internet for health information for patient care. METHOD: 172 physicians at the University College hospital (UCH) Ibadan, Nigeria; completed a 31-item, anonymous, standardized questionnaire. The Epi-Info software was used for data analysis. RESULTS: The mean age of the respondents was 31.95 years (SD 4.94). Virtually all (98%) the respondents had used the Internet; 76% accessed it from cyber cafes. E-mail was the most commonly used Internet service (64%). Ninety percent of the respondents reported they had obtained information from the Internet for patient care; of this number, 76.2% had searched a database. The database most recently searched was MEDLINE/PubMed in 99% of cases. Only 7% of the respondents had ever searched the Cochrane Library. More than half (58.1%) perceived they had no confidence to download full-text articles from online sources such as the Health Internetwork Access to Research Initiative (HINARI). Multiple barriers to increased use of the Internet were identified including poor availability of broadband (fast connection speed) Internet access, lack of information searching skills, cost of access and information overload. CONCLUSION: Physicians' use of the Internet for health information for patient care was widespread but use of evidenced-based medicine resources such as Cochrane Library, Up-to-date and Clinical Evidence was minimal. Awareness and training in the use of EBM resources for patient care is needed. Introduction of EBM in the teaching curriculum will enhance the use of EBM resources by physicians for patient care.

Computer and internet use by first year clinical and nursing students in a Nigerian teaching hospital.

BACKGROUND: The internet is an important source of up-to-date medical information. Although several studies in different countries have explored the extent to which health science students use the computer and the internet, few researches are available on this subject in Nigeria. The aim of this study was to assess the uptake of computer and internet by health science students studying in the country. METHODS: One hundred and eighty three first year medical and nursing students of the University College Hospital, Ibadan, Nigeria, completed a-25 item questionnaire during routine Library Orientation Program in the medical library. The EPI-Info software was used for data analysis. RESULTS: The mean ages for medical students and the student nurses were 22 and 24.6 years respectively. Overall, 42.6% of the entire sample could use the computer, 57.4% could not. While more than half (58%) of the medical students are computer literate, majority (75.9%) of the student nurses are not. Slightly more than two thirds (60.7%) of the entire students had ever used the internet, 33. 9% had not. E-mail was the most popular of internet services used by the students (76.4%) and the cyber café was the common place where students had accessed these services. The students' mean scores on a 15-point perceived self-efficacy scale for internet-related tasks was 3.8 for medical and 0.7 for nursing students (p = 0.00). Students who are computer literate had superior mean scores (4.8) than those without (0.6) (p = 0.000). CONCLUSION: First year clinical and nursing students in Ibadan Nigeria have not fully utilised the opportunity that the use of computer and internet offer for medical education. Improved efforts such as inclusion of computer education in medical and nursing curricular and establishment of computer laboratories are required to increase the student's access to computers and internet.