Innovative Technological Approach to Ebola Virus Disease Outbreak Response in Nigeria Using the Open Data Kit and Form Hub Technology.

The recent outbreak of Ebola Virus Disease (EVD) in West Africa has ravaged many lives. Effective containment of this outbreak relies on prompt and effective coordination and communication across various interventions; early detection and response being critical to successful control. The use of information and communications technology (ICT) in active surveillance has proved to be effective but its use in Ebola outbreak response has been limited. Due to the need for timeliness in reporting and communication for early discovery of new EVD cases and promptness in response; it became imperative to empower the response team members with technologies and solutions which would enable smooth and rapid data flow. The Open Data Kit and Form Hub technology were used in combination with the Dashboard technology and ArcGIS mapping for follow up of contacts, identification of cases, case investigation and management and also for strategic planning during the response. A remarkable improvement was recorded in the reporting of daily follow-up of contacts after the deployment of the integrated real time technology. The turnaround time between identification of symptomatic contacts and evacuation to the isolation facility and also for receipt of laboratory results was reduced and informed decisions could be taken by all concerned. Accountability in contact tracing was ensured by the use of a GPS enabled device. The use of innovative technologies in the response of the EVD outbreak in Nigeria contributed significantly to the prompt control of the outbreak and containment of the disease by providing a valuable platform for early warning and guiding early actions.

Inequalities in Access to Healthcare Services among People Living with HIV/AIDS in Nigeria

The study investigated the magnitude of social inequities in access to subsidised healthcare services among people living with HIV and AIDS (PLWHA) in Nigeria. Structured interviews were conducted with 1 056 PLWHA selected from 60 community based support groups in 12 local government areas across 3 Nigerian states and the federal capital territory; using a multi-stage cluster sampling method. Data were collected on socio-economic characteristics of the respondents; awareness about location of health facilities; current health status; distance to facilities; and utilisation and expenditure on healthcare. The socio-economic characteristics of the respondents were used to compare their level of access to healthcare services from antiretroviral therapy (ART) sites and government hospitals. Awareness about location of health facilities was generally high (?79) among the respondents but higher among males; urban dwellers and those in highest wealth class (p 0.05). About 60 of rural PLWHA and 55.2 of those in the lowest wealth class reported illness compared with 49.4 of urban residents and 47.4 of those in the highest wealth class. However; PLWHA in urban areas utilised government hospitals more than those in rural areas while rural PLWHA and those in the lowest wealth class travelled longer distances to ART sites (p 0.05). PLWHA in lowest wealth class and females faced catastrophic health expenditure of 67.6 and 55.5of their monthly income respectively. Social inequities were observed in the subsidised HIV-treatment programme in Nigeria. Expansion of ART sites in rural areas and decentralisation of HIV care at government hospitals will reduce travel distance and transport costs and ensure universal access to healthcare services among PLWHA

Pattern and determinants of morbidity among people living with HIV/AIDS in North Central Nigeria.

The study investigated the nature of self-reported morbidity and determinants of health status among people living with HIV/AIDS (PLWHA) in North Central Nigeria. A multi-stage cluster sampling method was used to select 1,056 adult PLWHA from 60 community-based support groups as respondents to a structured questionnaire. Based on health production function, health status was specified as a function of individual/household characteristics, health-related behaviours and genetic endowment. Descriptive statistics showed that more than half (52.8%, n=558) of the PLWHA reported illness in the last four weeks. The poor, widows and divorcees, and those living in rural areas reported illness more than their non-poor, married and urban counterparts. Logistic regression results indicated that self reported mobility was associated with rural residence (p=.005), greater use of condom (p=.013), and lower CD4 count (p=.007). Programs to promote positive living and access to health care services among PLWHA in Nigeria, especially in rural areas, are recommended.

Inequalities in access to healthcare services among people living with HIV/AIDS in Nigeria.

The study investigated the magnitude of social inequities in access to subsidised healthcare services among people living with HIV and AIDS (PLWHA) in Nigeria. Structured interviews were conducted with 1 056 PLWHA selected from 60 community based support groups in 12 local government areas across 3 Nigerian states and the federal capital territory, using a multi-stage cluster sampling method. Data were collected on socio-economic characteristics of the respondents; awareness about location of health facilities; current health status; distance to facilities; and utilisation and expenditure on healthcare. The socio-economic characteristics of the respondents were used to compare their level of access to healthcare services from antiretroviral therapy (ART) sites and government hospitals. Awareness about location of health facilities was generally high (≥79%) among the respondents but higher among males, urban dwellers and those in highest wealth class (p < 0.05). About 60% of rural PLWHA and 55.2% of those in the lowest wealth class reported illness compared with 49.4% of urban residents and 47.4% of those in the highest wealth class. However, PLWHA in urban areas utilised government hospitals more than those in rural areas while rural PLWHA and those in the lowest wealth class travelled longer distances to ART sites (p < 0.05). PLWHA in lowest wealth class and females faced catastrophic health expenditure of 67.6% and 55.5% of their monthly income respectively. Social inequities were observed in the subsidised HIV-treatment programme in Nigeria. Expansion of ART sites in rural areas and decentralisation of HIV care at government hospitals will reduce travel distance and transport costs and ensure universal access to healthcare services among PLWHA.

Sexual behavior and experience of sexual coercion among secondary school students in three states in North Eastern Nigeria.

BACKGROUND: Interest in the reproductive health of adolescents continues to grow throughout the world. Few studies had explored the reproductive health knowledge, sexual behavior and experience of sexual coercion among secondary school students in North Eastern states of Nigeria. The objectives of this descriptive survey were to collect data to plan appropriate interventions that meet the reproductive health knowledge, service and skills needs of students in Bauchi, Borno and Gombe states. METHODS: Face-to-face interviews were conducted for 624 consenting students who were randomly selected from eighteen secondary schools using an 83-item structured questionnaire. Data were collected on demographic profile, reproductive health knowledge, sexual behavior and experience of sexual coercion. RESULTS: The mean age of the respondents was 16.5 years. There were slightly more males (52%) than females (48%). Students' knowledge about reproductive health was generally low even though girls had better knowledge than boys. Thirteen percent of the entire students had had sexual experience; significantly more males (19%) than females (6%) had done so (p < 0.001). Among boys the age at sexual debut ranged from 10-26 with a mean of 15.7 and median of 16. By contrast, the age at first sex among girls ranged from 10 to 18 years with a mean and median of 16.1 and 17 years respectively. Only 24% of those who were sexually active used a condom during their last sexual encounter. Overall 11% of the students reported that they had been tricked into having sex, 9% had experienced unwanted touch of breast and backside, and 5% reported rape. CONCLUSION: Students low reproductive health knowledge and involvement in risky sexual activities predispose them to undesirable reproductive health outcomes.