RESUMEN
OBJECTIVE: To explore the experiences and perceptions of barriers of parents and family members of patients with cleft lip and palate in accessing cleft services in remote northwest Nigeria. DESIGN: Face-to-face semi-structured audio recorded interviews were used to obtained qualitative textual data. Thematic analysis using interpretative descriptive techniques was employed to understand the participants' lived experiences with barriers and accessibility to cleft services. SETTING: Participants were from Sokoto, Kebbi and Zamfara states in remote northwest, Nigeria. PARTICIPANTS: Consisted of 22 caregivers (17 parents and 5 extended family members) were purposively sampled between 2017 and 2020. MAIN OUTCOME MEASURES: Barriers experienced while accessing cleft services were identified during thematic analysis. RESULT: Over three quarter of the respondents had patients with both cleft lip and palate and without any previous family history (n = 20). About two-thirds of the participants (n = 15) were females. Most of the interviews were conducted before the surgeries (n = 15). FIVE THEMES EMERGED: lack of information, financial difficulty, misrepresentation from health workers, multiple transportation and previous disappointment. CONCLUSIONS: Areas of poor awareness, misinformation from primary health care workers, financial hurdles, multiple transportation logistics and others were identified. Aggressive broadcasting of information through radio, timely treatment and collaboration with influential religious leaders were emphasized. Support, grants and subsidies from government and voluntary agencies are encouraged to mitigate the huge out of pocket cost of cleft care in the region.
RESUMEN
Background: The high prevalence of the risk factors of head and neck cancer (HNC) amongst senior secondary (high) school students in Nigeria is an issue of serious public health concern. Therefore, this study aimed to assess the knowledge of HNC among them. Methods: This cross-sectional study surveyed 2,530 senior secondary school students in Nigeria, assessed their knowledge of HNC, using a self-administered questionnaire. Data collected were analyzed using the SPSS version 25 software. Results: The mean (±SD) age of the respondents was 16.34 (±2.0) years. More than half (1418; 56.6%) of them were males, 530 (20.9%) were schooling in the north-central geopolitical zone of Nigeria, 1,860 (73.5%) were in public schools, 554 (21.9%) were boarding students, and 817 (33.5%) were in Senior Secondary (SS) 3 class. Only 789 (31.2%) respondents were aware of HNC, out of which: 69.2% of them had below-average scores in their overall assessment on HNC; 256 (32.4%) had ever received education on HNC and 81.2% indicated a positive interest in knowing more about HNC. The factors predicting above-average score on knowledge about HNC among the respondents were: being in SS3 class (OR=1.73; 95% CI=1.17 - 2.56), having been educated about HNC (OR=1.69; 95%CI=1.21 - 2.35) and having the interest to know more about HNC (OR=1.88; 95%CI=1.21 - 2.92). Bivariate analysis showed that these factors had statistically significant association (or relationship) with above-average score on knowledge about HNC (pvalues<0.05). Conclusion: Majority of the surveyed students were willing to know more about HNC. The use of a properly planned massive school-based HNC education programs may go a long way in educating this population group on HNC.
