"I am the one taking care of her and donating blood": lived experiences of role-routines of hospital-based informal caregiving in Nigeria.

PURPOSE: Informal caregivers (ICs) in Africa perform a long list of tasks to support hospitalization care. However, available studies are weak in accounting for the experiences of everyday role-routines of hospital-based informal caregiving (HIC) in under-resourced settings. This article explored the experiences of role-routines among informal caregivers in a Nigerian tertiary health facility. METHODS: The ethnographic exploratory study relied on primary data collected from 75 participants, including 21 ICs, 15 inpatients, 36 hospital staff, and 3 ad-hoc/paid carers in a tertiary health facility in Southwestern Nigeria. RESULTS: ICs perform several essential roles for hospitalized relatives, with each role characterized by a range of tasks. An integrative narrative of everyday routines of HIC as experienced by ICs showed critical complexities and complications involved in seemingly simple tasks of assisting hospitalized relatives with hygiene maintenance, medical investigations, blood donation, resource mobilization, errand-running, patient- and self-care and others. The role-routines are burdensome and ICs' experiences of them revealed the undercurrents of how health systems dysfunctions condition family members to support hospitalization care in Nigeria. CONCLUSION: The intensity and repetitive nature of role-routines is suggestive of "routinization of suffering". We recommend the closing of gaps driving hospital-based informal caregiving in Africa's under-resourced settings.

Health Challenges in Everyday Life of Nigerians in Guangzhou City, China.

The presence of Africans in Chinese cities has made their healthcare-related issues an expanding area of interest. However, previous studies have not thoroughly explored how Africans live through health problems. This article explores the taken for granted aspect using the analytical frameworks of migration as a social determinant of health and phenomenological sociology. Based on interviews with 37 Nigerians in Guangzhou city, it describes how health and illnesses are lived and the ways that language barrier, cost of health care, immigration status and racism and discrimination intertwine with quotidian occurrences to shape the experiences of health challenges. Migrant networks and community structure provided critical assistance, but the context of labour circumstances and undocumentedness can overstretch these critical sources of support. The article exposes how the broader context of being and living in China determine how Africans experience health challenges in Chinese cities.

Scope of health worker migration governance and its impact on emigration intentions among skilled health workers in Nigeria.

The growing trends for skilled health worker (SHW) migration in Nigeria has led to increased concerns about achieving universal health coverage in the country. While a lot is known about drivers of SHW migration, including national/sub-national government's inability to address them, not enough is known about its governance. Underpinning good governance systems is a commitment to human rights norms, that is, principles that enshrine non-discrimination, participation, accountability, and transparency. Hence, this study was aimed at deriving a conceptual framework that captures the scope of SHW migration governance in Nigeria and the extent to which it is human rights based. To describe the scope of SHW migration governance, we conducted an exploratory factor analysis and mapped our findings to themes derived from a qualitative analysis. We also did a multivariate analysis, examining how governance items are related to migration intentions of SHWs. The scope of SHW migration governance in Nigeria can be described across three levels: Constitutional-where policies about the economy and the health workforce are made and often poorly implemented; Collective-which responds to the governance vacuum at the constitutional level by promoting SHW migration or trying to mitigate its impact; Operational-individual SHWs who navigate the tension between the right to health, their right to fair remuneration, living/working conditions, and free movement. Examining these levels revealed opportunities for collaboration through stronger commitment to human right norms. In recognising their role as rights holders and duty bearers at various levels, citizens, health advocates, health workers, community groups and policy makers can work collaboratively towards addressing factors related to SHW migration. Further evidence is needed on how human rights norms can play a visible role in Nigeria's governance system for SHW migration.

Social networks and skilled health worker migration in Nigeria: An ego network analysis.

BACKGROUND: Nigeria provides a good case study for researchers, activists, and governments seeking to understand how social networks can help mitigate the negative impact of skilled health worker (SHW) migration in low and middle-income countries. This study aimed to map the social networks of SHWs and explore how they influence migration intentions. METHODS: We combined semi-structured qualitative interviews with an ego-network analysis of 22 SHWs living in Nigeria, used R-Studio to display and visualise their networks, and NVivo for thematic analysis of transcribed interviews. RESULTS: The network size and frequency of interaction were smaller among SHWs seeking to remain in Nigeria, however when compared to SHWs seeking to migrate, they had ties with a diverse group of stakeholders interested in improving health services. The influence of social networks on SHW migration intentions was observed within the following themes: access to information on migration opportunities, modelling of migration behaviour, support for decision making, and opportunities for policy engagement. CONCLUSION: The social networks of SHWs can aid the diffusion of norms that are relevant for improving SHW migration governance. Through their social networks, SHWs can improve awareness of the challenges associated with SHW migration among state actors and the public.

The role of mentoring in research ecosystems in Sub-Saharan Africa: Some experiences through the CARTA opportunity.

Mentoring is important for improving capacity development in population and public health research in sub-Saharan Africa. A variety of experiences have been documented since Consortium for Advanced Research Training in Africa (CARTA) admitted the first cohort in 2011. However, the experience of mentoring opportunities in CARTA has not been studied. Our study focused on the perceptions, experiences and challenges of mentoring among CARTA fellows. We adopted a descriptive design based on data collected from the fellows using an online semi-structured questionnaire. Out of 143 fellows in the programme, a total of 52 fellows from seven cohorts completed the questionnaire. Fifty-three percent of the respondents were females, more than half belonged to the health sciences while 35% were in the social sciences. Fellows received mentoring from CARTA graduates and experienced researchers in the CARTA network, but they also engaged in peer-mentoring with one another. Teaching, publishing, conference attendance and grant application were considered particularly important in mentoring, but mentors and mentees highlighted personal and social issues such as networking, work-family life balance, and managing stress and time, as challenges. There is a need for more formalised but flexible mentorship initiative in the CARTA fellowship to facilitate enduring relationships for career development.

'I don't want to have a separated home': Reckoning family and return migration among married Nigerians in China.

The growing 'Africans in China' literature has documented the extent and extensiveness of flows from Africa to Chinese cities. However, return migration has not received much attention, and even less is known about the role of the family in return consideration. The article focuses on how married Nigerians reckon return and family in Guangzhou city using data from ethnographic observations and interviews with 25 participants. While the family is central to how married migrants think about return, the dynamics vary among the participants. Migrants whose spouses/children reside in Nigeria complain about being distant from their families and the challenge of unification and 'absentee fatherhood'. Nigerian couples that live in Guangzhou as a family consider the high cost of raising children and the future competitiveness of their children as 'China-educated' as factors in return calculations. Moreover, despite living with their husbands in China, some Nigerian women desire to return to Nigeria to improve their lives, but they did not embark on a return journey to avoid family separation. Among Nigerians in an interracial relationship with Chinese women, the feeling of (un)belongingness resonates in their return consideration owing to poor experiences with access to residence permit and social welfare. While integration issues impact on return migration of married Nigerians in Guangzhou, the transnational practices of the men suggest that a return behaviour would probably accompany return consideration.