Exclusion within exclusion: The experiences of internally displaced older adults in Lugbe camp, Abuja.

As the Boko Haram insurgency-induced conflict in Northeast Nigeria lingers and more people are made homeless, Displaced older persons who have lost their social networks, support systems, status, and roles as a result may experience new challenges at the internally displaced persons (IDPs) camps. Our study explored older adults' experiences of exclusion in the Lugbe IDP camp in Abuja. Data was collected through semi-structured interviews with 14 displaced older adults aged 60 and above who have lived in the camp for five years. The collected data were subsequently transcribed and analysed thematically using NVivo 12. Findings showed that displaced older adults suffered social, economic, and political exclusions. They were also excluded from participating in training programmes that could equip them with the skills to survive in their new environment. Similarly, it was found that the displaced older adults in the study had difficulty connecting with friends and families outside the camp due to their lack of experience in utilising digital technology, resulting in feelings of increased loneliness. Poverty and lack of education were identified as the main predisposing factors for exclusion. Exclusion affected displaced older people's health and life satisfaction. We recommend that organisers/managers of IDP camps ensure that policies and programmes are sufficiently inclusive of and sensitive to the physical and mental well-being of older Internally Displaced Persons. This would be in accordance with the African culture of support and consistent with the United Nations Sustainable Development Goals.

Aging in rural Nigeria: gendered exclusion of rural older adults and its impact on their perceived life satisfaction in South-East Nigeria.

Globally, there is an immense increase in the number of older adults. This can be attributed to an increase in life expectancy brought about by advances in general living standards as well as medicine and healthcare. However, exclusion which is linked to discrimination and access restrictions in areas such as education, employment, housing, and medical care has been identified as one of the challenges facing this increasing demographic. This study explored the exclusion of older rural women in southeast Nigeria and its impact on their life satisfaction. The study used a qualitative method of research to obtain data from a sample of 32 older adults aged 65 years and above through focus group discussions in Nru community in Nsukka Local Government Area of Enugu State. The obtained data were thematically analyzed and the findings showed that many older rural women in the study area are socially excluded at home, churches, and the larger society, with poverty and stereotyping of older rural women as less intelligent identified as the leading factor predisposing them to social exclusion in Nigeria. Results also showed that social exclusion brings about sadness and depression which have severe negative implications on their life satisfaction. Finally, implications of the findings for gerontological social workers through advocacy geared toward changes in social policy and structures that promote ageism were discussed.

Socioeconomic Dynamics in Women's Access and Utilization of Health Technologies in Rural Nigeria.

BACKGROUND: Technology has become a powerful tool for resolving women's health problems hence women's access and use of healthcare technologies have become an important aspect of the Sustainable Development Goals. Though health technologies have improved the lives of women worldwide, in Nigeria, especially in rural settings, use of health technologies remains low. The objective of this study was to examine the socioeconomic dynamics that influence the use of health technologies by women in rural Nigeria. METHODS: A cross sectional survey using qualitative methods to collect data from 147 purposively selected women (15-65 years) was conducted in three rural Local Government Areas in Enugu State. Focus Group Discussion (FGD) and In-depth interview guides were used to collect information from 147 purposively selected women and healthcare workers on access and use of health technologies among women in rural communities. Thematic analytic method was used to analyze the data. RESULTS: The data gathered revealed that there was unavailability of health technologies in some communities studied while many had skeletal provision of health technologies. Bad road networks, cost of transportation and unavailability of health technologies impacted on access. Low socioeconomic status of rural women influenced their use of health technologies. CONCLUSION: Health technologies especially diagnostic technologies are not available in rural communities. Women cannot access what is not available. The study recommends need for the provision of these lifesaving technologies at little or no cost.

Gender differences in family support to older adults and implications for social work in south-east Nigeria.

The increase in the number of older adults in Nigeria is a significant demographic trend, requiring adequate and sustainable attention. Usually, these older adults depend on family members for support due to increasing frailty and/or disengagement from the civil service or other income-earning pursuits. Studies that depict differences in gender vis a vis access to social support from family networks are limited. This study will attempt to contribute to filling this gap. Four focus group discussions and 16 in-depth interviews were conducted on a sample of (N = 56) older adults aged 70 years and above and their 23 to 46 year old family carers. The generated data were analysed in themes. Findings revealed no differences in access to health support by gender; however, females received more financial, emotional as well as material support, and were more involved in social activities than their male counterparts. This study will facilitate a better understanding of gender differences in social support for older adults in Nigeria. This could, in turn, inform inclusive social policies guided by social workers which have greater focus on the needs of older adults.

COVID-19 in Nigeria: Knowledge and compliance with preventive measures.

The novel coronavirus pandemic has upended the world as we knew it and is a concern for governments globally. With cases still surging in different regions around the globe, the level of knowledge of COVID-19 and compliance with preventive measures still differ across cultural regions. Our study explored knowledge of COVID-19 and compliance with preventive measures among community members in Anambra State, Nigeria, using in-depth interviews (IDI). Data were sourced from 36 persons comprising 30 household heads age 48 years and above and six children age 13-17 years. Data were analyzed thematically. Findings revealed that a majority of the respondents believe that the COVID-19 pandemic is more of a hoax than reality. Other findings showed that this poor knowledge negatively affected their compliance with preventive measures to curb the spread of coronavirus. To improve knowledge on the coronavirus pandemic, we recommended dissemination of accurate information to ensure compliance with preventive measures.

Support and unmet needs of patients undergoing multidrug-resistant tuberculosis (MDR-TB) treatment in southern Nigeria.

Multidrug-resistant tuberculosis (MDR-TB) is presently a major public health threat. MDR-TB patients face diverse financial and psychosocial difficulties. Researchers conducted in-depth interviews based on interview guides with 42 participants. Data were analyzed using categorization, coding, generation of themes, and thematic memo writing. The key findings were as follows: Out of the 42 patients, 30 (71.4%) were males and 12 (28.6%) were females. All patients received financial stipends for transport and monthly social support. The patients however needed more financial support than they received (suggesting high unmet financial needs). Patients suffered depressive mood before and during treatment but received inadequate mental health/psychosocial care and treatment. Patients developed hearing impairment as a major adverse drug reaction, but the care and treatment they received were inadequate. In conclusion, the programmatic support provided for MDR-TB patients' financial and mental health/psychosocial needs and auditory drug side effects fell short of their need. Programmes for control of MDR-TB should increase budgetary allocations and ramp up mechanisms for provision of mental health/psychosocial support and care/treatment for drug side effects.

Coping strategies of families of persons with learning disability in Imo state of Nigeria.

BACKGROUND: Coping with a relative with a learning disability could be a stressful experience for family members. The present study is aimed at exploring the coping strategies adopted by families in trying to make meaning of their situation. METHOD: A qualitative study design using focus group discussions (FGDs) was adopted. Ten FGD sessions were held with family members of persons with a learning disability. RESULTS: Findings revealed patterns of family coping to include problem-focused, emotion-focused, and spiritual/religious-focused. Also, coping responses to a learning disability varied based on the level of information available to families about the condition of their relative. In some cases, interspousal relationship was strained due to stress. CONCLUSION: It was recommended that families of persons with a learning disability need social support and professional help from social workers to facilitate the adoption of more positive-oriented coping strategies by family members.

Knowledge of public health challenge of open defecation in rural areas of South-East Nigeria: Implications for social workers

Background: Practice of open defection has growing health concerns especially on rural dwellers and is among leading causes of diarrhea, typhoid fever, cholera, stunting and responsible for the death of children under 5 years in Nigeria. This study seeks to examine knowledge of public health challenges of open defecation among rural residents in south-east Nigeria and implications for social work. Data source and methods: Focus group discussions and in-depth interviews were used for data collected from 52 respondents in Nsukka and Udenu LGAs of Enugu State. Thematic analysis was adopted and phrases with contextual connotations were pulled as illustrative quotes. Results: Lack of toilet facilities makes community members engage in the practice despite knowledge of its public health implications. Conclusions: The study recommends strengthening of government's efforts to eradicate the practice; incorporating social workers as facilitators in public health regulations and advocacy in sensitising households to provide their own toilets

An evaluation of innovative community-based approaches and systematic tuberculosis screening to improve tuberculosis case detection in Ebonyi State, Nigeria.

BACKGROUND: National tuberculosis (TB) programmes globally rely heavily on passive case finding for detecting TB in the community as advocated by the World Health Organization (WHO). TB case detection is low in Nigeria despite improvement in TB services and coverage. METHODS: A retrospective evaluation of an active case-finding intervention utilizing community-based approaches and targeted systematic TB screening in Ebonyi State, Nigeria was done. The analysis was performed using Epi Info. RESULTS: Using community-based and health-facility-based systematic screening strategies, 218,751 persons were screened, with 19.7% of them being presumptive TB cases. Among these, 23,729 (55.1%) submitted sputum samples for microscopy, and 764 (3.2%) had smear-positive TB. In addition, 683 individuals were diagnosed with other forms of TB using X-ray and clinical evaluation giving a total of 1447 all forms of TB cases. The overall number needed to screen (NNS) to find one person with all forms of TB through the project was 151. The NNS was 53 for general outpatients, 88 through contact tracing, and 110 among HIV-infected persons. CONCLUSIONS: Active case-finding strategies achieved good yields though early loss to follow-up was high. Active case finding is recommended for integration into national TB control policy and practice.

Sociocultural Factors Associated With Abuse of Mentally Impaired Persons in Imo State, Nigeria.

This study examined sociocultural factors associated with abuse of mentally impaired persons (MIP) in Imo state, Nigeria. A cross-sectional survey of 1,147 persons aged 10 years and above who had at least one MIP in their household was conducted. Six in-depth interviews and 21 focus group discussion (FGD) sessions with 160 study participants comprising adult male and female members of the communities, respectively, were conducted. The study established that a multitude of cultural and social factors shape the attitude of individuals toward mental impairment and MIPs. It was found that cultural perceptions of the cause of mental impairment as supernatural and evil forces were widespread within the study communities. Among those surveyed, 74.6% were aware that MIPs are victims of abuse. Perpetrators identified were mostly relatives and persons close to MIPs. The findings provide useful insights into gaps in conventional understanding of mental impairment and abuse of MIPs in Imo State.