The politics of abortion rights in the 2022 United States midterm election: Lessons for fledgling democracies around the world.

The United States government, under President Donald Trump, retreated from its traditional role as an exemplar of democracy, defender of press freedom and the rule of law but embraced conspiracy theories, virulent anti-Semites, and authoritarian regimes worldwide. Today, democracy is in crisis and is under assault and in retreat globally. The 2022 United States midterm election has come and is now history with many unexpected outcomes. The three impactful issues during the campaign that produced many upsets were abortion rights, election denialism, and threats to democracy. This editorial examines the history of abortion rights in the United States, the impacts of the Dobbs vs. Jackson ruling on the 2022 midterm election, the threats of election deniers to global democracy, the global status of reproductive health rights, and the lessons of abortion ban for burgeoning democracies worldwide.

Nigeria's 2023 presidential election and the future of healthcare in the country.

On February 25, 2023, Nigerians took a step forward as a democratic state by voting for a new president. The election is history as the ruling party's candidate, Bola Tinubu, was declared the winner. He polled 37% of the vote, his main rival Abubakar Atiku garnered 29%, and Labour's Peter Obi 25%. Only 27% of registered voters came out to vote. International election observers noted that the election lacked transparency and was marred by logistical challenges and multiple incidents of political violence. The currency and fuel shortages in the country burdened many voters and election officials and therefore marginalised many groups, especially women, who continue to face barriers to political office. The outcome of the election is in contention and inconclusive. The aggrieved parties have taken their case to court, so the nation awaits the outcome of the court decision. In this Editorial, AJRH analyses the prospects and implications of Tinubu's presidency for healthcare in Nigeria.

Lived experiences of recovered COVID-19 persons in Nigeria: A phenomenological study.

BACKGROUND: Numerous publications have documented the mode of transmission and prevention of COVID-19 but little or no evidence exists on the experiences of people who survived the infection. OBJECTIVE: This study explored the specific experiences of persons who were infected with COVID-19, but have recovered completely. A secondary objective was to identify essential elements in the lived experiences of such persons, which would be useful in designing appropriate policies and programs for managing the virus in Nigeria. METHOD: The data were collected using in-depth interviews with 21 persons who were diagnosed with the virus and recovered. The data were transcribed and analyzed qualitatively using NVivo software. The experiences of the survivors of COVID-19 were examined under six themes: compliance with prevention measures before being infected, perceptions on how they contracted the virus, the symptoms they experienced, the management of the disease, their experiences with the healthcare system, their emotional experiences, and their recommendations on specific strategies to prevent and manage the virus based on their experiences. RESULTS: The commonly perceived means of contracting the virus were through colleagues, patients, and friends who were infected. The most commonly experienced symptoms were anosmia and fever. The health providers were described as courteous but some of the respondents observed avoidance and fear. Not all the interviewees knew the drugs they were treated with, but some, particularly the medical personnel, identified hydroxychloroquine, azithromycin, vitamin C, Augmentin, among others. Some of the participants used herbal remedies. While some respondents recounted good experiences in the isolation centre, others had unpleasant experiences. Direct and indirect encounters which were perceived as stigmatizing and discriminatory were reported by some respondents. CONCLUSION: We conclude that persons who recovered from COVID-19 in Nigeria had varied experiences relating to the mode of infection, the clinical features, methods of treatment, and psychosocial effects of the virus. These experiences would be useful for designing and implementing appropriate interventions, policies, and programs for managing the pandemic in the country.

Bibliometric profile of the African Academy of Sciences medical and health sciences fellows.

The African Academy of Sciences (AAS) is the preeminent science academy on the African continent, but there is currently no information on the academic productivity of the fellowship members. This study investigated the bibliometric parameters of the AAS medical and health sciences fellows. The demographic information (year of induction, gender, and region of employment in Africa) of the 80 medical and health sciences fellows were obtained from the AAS website. Subsequently, the bibliometric information (total number of publications, H-index scores, citation, and co-authorship counts) were extracted from the Scopus database. The majority of the fellows were from the East (36%) and West (33%) African regions (χ2 = p < 0.001); the North (6%) and Central (4%) regions were vastly underrepresented. Although only 34% of the AAS fellows were women, there was no statistically significant difference (p > 0.05) in the bibliometric parameters of both genders. The year of induction as a fellow and region of employment in Africa significantly (p < 0.05) influenced the bibliometric parameters. For all the fellows combined, their H-index mean (SD) score is 27.9 (17.0), while the median score for the total number of publications is 100, H-index is 27.5, and the citation and co-authorship count is 2,894 and 446, respectively. The fellows from the West African region had the highest number of publications (Mean = 212), citations (Mean = 9,437), and co-authorship count (Mean = 975), and the South African fellows had the highest H-index score (Mean = 40.8). The data presented provide insight into the bibliometric productivity of African scientists compared with their peers from other science academies around the world. Similarly, the data may assist burgeoning scientists aspiring to be AAS fellow set realistic goals toward achieving the stipulated H-index benchmarks.

An evaluation of the nature and level of musculoskeletal imaging training in physiotherapy educational programmes in Nigeria.

BACKGROUND: Deficiency in musculoskeletal imaging (MI) education will pose a great challenge to physiotherapists in clinical decision making in this era of first-contact physiotherapy practices in many developed and developing countries. This study evaluated the nature and the level of MI training received by physiotherapists who graduate from Nigerian universities. METHODS: An online version of the previously validated Physiotherapist Musculoskeletal Imaging Profiling Questionnaire (PMIPQ) was administered to all eligible physiotherapists identified through the database of the Medical Rehabilitation Therapist Board of Nigeria. Data were obtained on demographics, nature, and level of training on MI procedures using the PMIPQ. Logistic regression, Friedman's analysis of variance (ANOVA) and Kruskal-Wallis tests were used for the statistical analysis of collected data. RESULTS: The results (n = 400) showed that only 10.0% of the respondents had a stand-alone entry-level course in MI, 92.8% did not have any MI placement during their clinical internship, and 67.3% had never attended a MI workshop. There was a significant difference in the level of training received across MI procedures [χ2 (15) = 1285.899; p = 0.001]. However, there was no significant difference in the level of MI training across institutions of entry-level programme (p = 0.36). The study participants with transitional Doctor of Physiotherapy education were better trained in MI than their counterparts with a bachelor's degree only (p = 0.047). CONCLUSIONS: Most physiotherapy programmes in Nigeria did not include a specific MI module; imaging instructions were mainly provided through clinical science courses. The overall self-reported level of MI training among the respondents was deficient. It is recommended that stand-alone MI education should be introduced in the early part of the entry-level physiotherapy curriculum.

The Epidemiology of COVID-19: A Review.

COVID-19 is a new lethal disease with limited information on its transmissibility, the severity of its sequelae, its clinical manifestations, and epidemiology. This commentary analyzed the global epidemiology of COVID-19 among the vulnerable population. The analysis revealed that most pediatric COVID-19 cases are not severe, but related severe illness still occurs in children. All ages of children are susceptible to COVID-19, and no significant gender difference exists. COVID-19 infection during pregnancy produced fatal outcomes for mothers, but less risky for the baby. The hot spot clusters for COVID-19 are the prisons/jails, nursing/group homes, and long-term facilities where most of the vulnerable populations reside. Ethnic minority groups in the USA and UK are disproportionately exposed to COVID-19 infection and death than Caucasians. The difference may be because ethnic minorities are exposed to higher risks at work and the long-standing structural economic and health disparities in the two countries. There are now changes in guidelines on who is qualified to receive ventilators in dire situations in many countries around the world if the healthcare system is overwhelmed.

Maternal death review and surveillance: The case of Central Hospital, Benin City, Nigeria.

BACKGROUND: Despite the adoption of Maternal and Perinatal Death Surveillance and Response (MPDSR) by Nigeria's Federal Ministry of Health to track and rectify the causes of maternal mortality, very limited documentation exists on experiences with the method and its outcomes at institutional and policy levels. OBJECTIVE: The objective of this study was to identify through the MPDSR process, the medical causes and contributory factors of maternal mortality, and to elucidate the policy response that took place after the dissemination of the results. METHODS: The study was conducted at the Central Hospital, Benin between October 1, 2017, and May 31, 2019. We first developed a strategic plan with the objective to reduce maternal mortality by 50% in the hospital in two years. An MPDSR committee was established and the members and all staff of the Maternity Department of the hospital were trained to use the nationally approved protocol. All consecutive cases of maternal deaths in the hospital were then reviewed using the MPDSR protocol. The results were submitted to the hospital Management and its supporting agencies for administrative action to correct the identified deficiencies. RESULTS: There were 18 maternal deaths in the hospital during the period, and 4,557 deliveries giving a maternal mortality ratio (MMR) of 395/100,000 deliveries. This amounted to a seven-fold reduction in MMR in the hospital at the onset of the project. The main medical causes identified were obstetric hemorrhage (n = 10), pulmonary embolism (n = 2), ruptured uterus (n = 2), eclampsia (n = 1), anemic heart failure (n = 1) and post-partum sepsis (n = 2). Several facility-based and patient contributory factors were identified such as lack of blood in the hospital and late reporting with severe obstetric complication among others. Response to the recommendations from the committee include increased commitment of hospital managers to immediately rectify the attributable causes of deaths, the establishment of a couples health education program, mobilization and sensitization of staff to handle pregnant women with great sensitivity, promptness and care, the refurbishing of an intensive care unit, and the increased availability of blood for transfusion through the intensification of blood donation drive in the hospital. CONCLUSION: We conclude that the results of MPDSR, when acted upon by hospital managers and policymakers can lead to an improvement in quality of care and a consequent decline in maternal mortality ratio in referral hospitals.

Advocacy for research evidence in academic public policy development

The World Ranking of Universities The impetus for this review came from reading the July 2019 Webometrics global survey of universities. The Webometrics survey is embraced widely in Africa, but it is less respected around the world when compared to more influential reviews like the Academic Ranking of World Universities, UK Times Higher Education World University Rankings and QS World University Rankings. The low prestige is because Webometrics consider primarily institution web-presence and activities instead of the quality of instruction, student learning, and research productivity; the central core functions of the universities. In the most recent Webometrics survey, the University of Cape Town is the first mentioned university in Africa but ranked number 274 in the world1. The study also revealed the dominance of South African universities, capturing nine of the top ten institutions in Africa. The University of Ibadan first listed Nigerian university, ranked number 17 in Africa and number 1,233 in the world; outperformed by the University of Ghana, which ranked 16 in Africa and 1,209 globally. After perusing through the report, I immediately called a colleague to share the bad news of the overall poor performance of African universities. We both agreed that the result of the survey is symbolic of the quality of education decline in Nigeria; a country with an educational system that was once the envy of most African nations. Given the dismal ranking of Nigerian universities, our conversation quickly shifted to another equally important academic topic - the recurring and apathetic lack of evidence when private and government establishments in Africa put forth public policies. As I begin to write this review, the motion picture by Jerry Maguire titled "Show me the Money" immediately came to mind. The film is a Hollywood romantic comedy-drama sports movie that grossed more than $273 million and ranked ninth highest in revenue in 1996. Cuba Gooding Jr. won the Academy Award for best-supporting actor role while Tom Cruise won the Golden Globes for best actor in a motion picture musical or comedy. He also bagged three other Guild Awards for his performance in the movie. But this review is not about Tinseltown, the land of make-believe. It is about the need to use empirical data when formulating public policies. For two decades now, evidence-based practice is globally accepted across different academic disciplines. Despite these developments, many academic policy decisions are still made in a vacuum without bibliometric research evidence by many science academies and government establishments in particular

Understanding HIV risk behaviors in prison: a qualitative study among recently released inmates.

PURPOSE: - The purpose of this paper is to explore HIV risk behaviors of inmates during incarceration and gain an in-depth understanding of the context within which these behaviors occur. DESIGN/METHODOLOGY/APPROACH: - In total, 47 recently released ex-offenders participated in focus group discussions that explored the contexts surrounding inmate engagement in HIV risk behaviors in prison. Data were analyzed using NVivo 7 and results were organized into themes. FINDINGS: - Inmates engaged behaviors that could predispose them to HIV infection. These behaviors include unprotected sexual intercourse, transactional sex, injection drug use, tattooing, and body piercing. The results of this study show that the contexts within which risk behaviors occur among inmates are complex, involving inmates, corrections staff, and visitors. The reasons why inmates engage in risk behaviors are also myriad: finance; addiction; boredom; deprivation; prison culture; slack security and monitoring; indifference by correctional officers; and violence. PRACTICAL IMPLICATIONS: - Prevention of risk behaviors and ultimately HIV transmission in prison requires a multi-dimensional ecological approach that focusses on the inmates, prison staff, prison system, policies, and policy makers. ORIGINALITY/VALUE: - This paper attempts to explore HIV risk behaviors of prison inmates. It is of value to health professionals, security agents, administrators, and non-governmental organizations that work with the incarcerated population.

HIV prevention and education in state prison systems: an update.

The prevalence rate of HIV infection in jails and prisons is approximately 5 times the rate in the U.S. general population. The authors surveyed state prison officials to assess HIV testing and HIV prevention policies--specifically voluntary testing, group HIV prevention counseling, and peer education--in the 50 states and to determine whether those policies are associated with the characteristics of the state and its prison population.

Provider-initiated (Opt-out) HIV testing and counselling in a group of university students in Ile-Ife, Nigeria.

OBJECTIVES: The Provider Initiated HIV (Opt-out) Testing and Counselling model has rarely been tested in Nigeria. This study assessed its feasibility and uptake among a sample of Nigerian university undergraduate students. METHODS: Two hundred and fifty-two Nigerian university students were offered rapid 'opt-out' HIV tests. The participants were also interviewed using a self-administered questionnaire. Data were analysed using descriptive statistics. RESULTS: Two hundred and fifty-one (99.6%) students accepted to be tested and only one (0.4%) refused testing. The commonest reason given for accepting rapid 'opt-out' testing was the desire to find out HIV status (93.2%). Only 24 (9.5%) students had previously ever been tested for HIV; among the 228 (90.5%) respondents who had not, the commonest reasons given for not testing were lack of knowledge of where to go to (25%), fear of testing positive (24%), and perception of being unlikely to have been exposed to HIV (18%). CONCLUSION: HIV 'opt-out' testing holds the prospect for rapidly increasing the coverage of HIV testing and other preventive interventions among university students in Nigeria. However, waiting time before testing and the poor disposition of medical staff to add on the burden of HIV 'opt-out' tests remain potential barriers to its roll-out.