ABSTRACT
Objectives: This study aims to understand and report on selected health system interventions considered nationally and sub-nationally of particular significance both in terms of COVID-19 responses and in strengthening the health system for the future. Design: A review of published and grey literature, including journals, news/ media and official documents, was conducted from 1st December 2019 to 31st December 2020. The reviewers read and extracted relevant data using FACTIVA in a uniform data extraction template. Responses that related to service delivery were captured. Setting: The assessment considered responses at the national and two state levels: Lagos and Enugu, representing the epicentre and a low COVID-19 burden centre. Inclusion criteria: Documents and news that mentioned COVID-19 response, particularly service delivery aspects, were included in this review. Results: The identified interventions were mostly technical support targeted at health workers: including training of about 17,000 health workers, supervising and engaging more health workers, upgrading laboratories and building new ones to improve screening and diagnosis, and motivation of health workforce with incentives. Furthermore, the influx of philanthropic contributions improved the data and information systems supply of medicines, medical products and non-pharmaceutical protective materials through local production. The presence of political will and the government's efforts in health system's response to COVID-19 facilitated these interventions. Conclusions: Interventions of state and non-state actors have strengthened the health systems to some extent. However, more needs to be done to sustain these gains and make the health system resilient to absorb unprecedented shocks.
Subject(s)
Health Systems , Delivery of Health Care , COVID-19ABSTRACT
Background: Obesity results mainly from changes in diet and physical activity and currently being regarded as a global epidemic. It comes at a cost, affecting physical, social and psychological health and having deleterious impact on psychological development, academic and social performance of an affected child. The aim is to determine the burden of psychosocial disorders among the overweight and obese children in our environment. Methods: A descriptive cross sectional study carried out among secondary school children aged 10-18 years in Enugu metropolis. Sampling involved stratified and multi-staged methods. The height and weight of selected subjects were measured and their BMI calculated. An adapted, semi-structured, self-administered questionnaire was used. Information sought included socio-demographics and psychometric measurements. Data was analyzed using SPSS version 19. Analytical test of significance was done using Chi square test at p value of ≤ 0.05. Results: Of 200 students studied, 136 (68%) were females and 64 (32%) were males. Most (157) were in the age range of 10-14 years old. Sixty seven were overweight while 133 were obese with most of the children’s parents belonging to the upper socioeconomic class. One hundred and nineteen of them had one emotional and/or social problem of depression, anxiety, low self-esteem, discrimination and stigma, giving a prevalence rate of 59.5%. Thirty five (54.7%) males and 81 (61.8%) females had at least one emotional and/or social problem (χ2 = 0.905, p = 0.342). Between the children aged 10-14 and 15-18 years, 56.1% and 72.1% respectively experienced at least one psychosocial disorder (χ2 = 3.605, p = 0.058). Emotional and social disorders was commoner among the upper class and difference was statistically significant (χ2 = 6.375, p = 0.041). Conclusion: The burden of emotional disorders among overweight and obese children in Enugu metropolis is high. Socioeconomic class is associated with emotional disorders.