Identifying potential catalysts to accelerate the achievement of Sustainable Development Goals (SDGs) among adolescents living in Nigeria.

Investing in adolescents in Africa holds great promise for the development of the continent. The steps involved in identifying factors linked to interventions that may accelerate the attainment of multiple SDGs for adolescents in Nigeria are described. Data from a survey to investigate the well-being of 1800 adolescents aged 10-19 years in Southwest Nigeria was analysed. A four-step process was employed: 1) Mapping of variables deemed as suitable proxies for SDG targets; 2) Mapping hypothesised protective factors (accelerators) from the study instruments. Consequently, SDG targets related to elimination of hunger, good health, gender equality and peace; and seven accelerators (safe schools, parenting support, good mental health, no survival work, food security, stable childhood, and regular physical activity) were identified; 3) evaluating associations using bivariate analysis and multivariable logistic regression, 4) calculating adjusted probabilities. The mean age of the adolescents was 15.02 ± 2.27 years (48.6% female). Good mental health, not doing survival work, safe schools, stable childhood and parental support were significantly associated with at least two SDG targets. For example, food security was significantly associated with the highest number of SDG outcomes: one SDG target related to child survival (no substance use: x2 = 3.39, p = <0.001); three SDG targets related to educational outcomes (school progression: x2 = 5.68, p = 0.017, ability to concentrate in school: x2 = 26.92, p = <0.001, and school attendance: x2 = 25.89, p = <0.001); and four SDG targets related to child protection (no risky sexual behaviours: x2 = 16.14, p = <0.001, no perpetration of violence: x2 = 15.74, p = <0.001, no community violence: x2 = 39.06, p =<0.001, and no sexual abuse: x2 = 7.66, p = 0.006). Interventions centred around good mental health, not doing survival work, safe schools, small family size, stable childhood and parental support are potential accelerators for the attainment of SDG outcomes by adolescents living in Nigeria.

Lessons of Hope and Resilience: A Co-Produced Qualitative Study of the Experiences of Youth Living with Psychosis During the COVID-19 Pandemic in Nigeria.

Much of the emerging evidence on the impact of COVID-19 on people with psychosocial disabilities comes from high-income countries. This study sought to explore the perceptions and experiences of youths living with psychosis during the COVID-19 pandemic in Nigeria. Using a co-produced research process, a facility-based study was conducted among youth with confirmed diagnosis of a psychotic disorder. In-depth interviews were conducted with 20 participants. Data was transcribed, double-coded and analysed with Atlas.ti using a thematic analysis approach. We found that participants were aware of good evidence-based information on the nature of the disease and the pandemic. Many of them described worsening mental health and disruptions to daily routines. Opportunities for deepening family relationships, skill building, helping others, and extended time for previously neglected self-development activities were described. This study benefitted from co-production with persons with lived experience, which could be harnessed for future research on psychosis.

Accelerating progress towards the sustainable development goals for adolescents in Ghana: a cross-sectional study.

Since the adoption of the sustainable development goals (SDGs) by the United Nations (UN), the search has been on to identify interventions that have effects on multiple SDG-targets simultaneously. Like other developing countries, Ghana has a youthful population and would require creative, urgent, youth-focused interventions to be able to attain the SDGs by 2030. This paper describes the application of the accelerator model on data from a sample of Ghanaian adolescents to identify potential accelerators towards selected SDG targets involving youth. The data for 944 adolescents, 10-19 years (mean age 12.31 ± 3.51 years), extracted from two cross-sectional surveys on children and adolescents aged 6-19 years in Kumasi, Ghana, were analysed in this paper. Variables considered suitable proxies for SDG targets and potential accelerators were identified from the study instruments. Consequently, four aligned SDG targets (good mental health, access to ICT, school completion and no open defaecation) and five accelerators (cognitive stimulation, no relative poverty, low student-teacher ratio, high caregiver education and safe water) were extracted. Associations between accelerators and SDG targets were assessed using multivariable logistic regression adjusting for sociodemographic covariates and multiple testing. Cumulative effects were tested by marginal effects modelling. The three hypothesised accelerators identified were cognitive stimulation, low student-teacher ratio, and no relative poverty. A combination of all three accelerators was associated with a higher likelihood of adolescents having access to Information and Communication Technology (ICT) by +73% (CI 0.72-0.74), no open defecation by +44% (CI 0.43-0.46), school completion by +27% (CI 0.26-0.27) and good mental health by +9% (CI 0.08-0.10). Three hypothesized accelerators showed association across all four SDG aligned targets. The accelerator model has been further validated in this dataset from Ghana. Robust interventions designed around these accelerators may represent an opportunity for achieving the SDGs in Ghana.

Interventions for adolescents and adults with psychosis in Africa: a systematic review and narrative synthesis.

Background: The Global Burden of Disease attributable to psychotic disorders in African countries is high and has increased sharply in recent years. Yet, there is a scarcity of evidence on effective, appropriate and acceptable interventions for schizophrenia and other psychotic disorders on the continent. Methods: We carried out a systematic review and narrative synthesis of peer-reviewed literature evaluating the impact of non-pharmacological interventions for adolescents and adults (10-65 years) in African countries. Two reviewers independently double-screened all articles and performed data extraction and quality appraisal using standardized tools. Results: Of the 8529 unique texts returned by our search, 12 studies were identified for inclusion, from seven countries: Egypt, Ethiopia, Ghana, Kenya, Nigeria, South Africa and Sudan. They evaluated a range of interventions with one or more clinical, psychological or psychosocial, education or awareness or traditional or faith-based components, and were delivered by either mental health specialists or non-specialist health workers. Ten of the 12 included studies reported significant, positive effects on a range of outcomes (including functioning, symptoms and stigma). Nearly half of the interventions were based out of health facilities. Based on quality appraisals, confidence in these studies' findings is only rated low to medium. Conclusion: Further research is needed to develop and evaluate interventions that meet the diverse needs of people with psychosis, within and beyond the health sector.

Medication Adherence Interventions for Cardiovascular Disease in Low- and Middle-Income Countries: A Systematic Review.

PURPOSE: The burden of cardiovascular diseases (CVD) is high in low- and middle-income countries (LMICs). Medications are integral to the management and control of CVD; however, suboptimal adherence impacts health outcomes. This systematic review aims to critically examine interventions targeted at improving medication adherence among persons with CVD in LMICs. METHODS: In this systematic review, we searched online databases PubMed, Embase, and CINAHL for studies that evaluated a medication adherence intervention for CVD, reported adherence as an outcome measure, were conducted in LMICs and reported the strategy or tool used to measure adherence. We included articles published in English, available in full text, peer-reviewed, and published between 2010 and 2020. RESULTS: We included 45 articles in this review. The majority of the studies implemented counseling and educational interventions led by nurses, pharmacists, or community health workers. Many of the studies delivered medication-taking reminders in the form of phone calls, text messages, short message services (SMS), and in-phone calendars. Multi-component interventions were more effective than unifocal interventions. Interventions involving technology, such as mobile phone calls, electronic pillboxes, and interactive phone SMS reminders, were more effective than generic reminders. The outcomes reported in the studies varied based on the complexity and combination of strategies. When interventions were implemented at both the patient level, such as reminders, and at the provider level, such as team-based care, the effect on medication adherence was larger. CONCLUSION: In LMICs, medication adherence interventions among persons with CVD included a combination of patient education, reminders, fixed-dose combination therapy and team-based care approach were generally more effective than singular interventions. Among patients who had CVD, the medication adherence interventions were found to be moderately effective. Future studies focusing on improving medication adherence in LMICs should consider non-physician-led interventions and appropriately adapt the interventions to the local context.