Experiential Narratives of Factors Limiting and Boosting Access to Support Services for Women with Obstetric Fistula in Southeast Nigeria.

PURPOSE: Obstetric fistula is a chronic health condition that leaves affected women battered and traumatized, thereby exposing them to social recluse life as a result of associated discomfort and odor. Support services to those with challenging health conditions are reputed to help cushion the adverse effects on them; thus women with fistula and other chronic diseases receiving adequate support will help them to cope and recuperate from such illnesses. This study explores the factors limiting and boosting access to support services for those with obstetric fistulainNigeria. MATERIALS AND METHOD: Focus Group Discussions and In-depth Interviews were employed to obtain data from 44 participants. The thematic data analysis method was deployed in analyzing the data collected. RESULTS: Factors like the limited number of fistula specialist doctors, poor funding, withdrawal from seeking help, long distance, and discrimination limit patients' access to support services and adequate fistula care. The study highlighted that community involvement in fistula care, adequate funding, training, and retraining of professionals will boost support services for fistula patients. CONCLUSION: The study recommends the adoption of a multidisciplinary approach in the management of obstetric fistula patients including the involvement of not only medical personnel but also social workers, families, groups, and community leaders.

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.

Perspectives of Rural Older Women on the Determinants of Successful Ageing in Southeast Nigeria.

As the global population of older persons continues to increase, the need for improved quality of life and increased life satisfaction has made successful ageing a critical discourse. The concept of successful ageing is subject to socio-cultural interpretations; thus, our study delved into the perspectives of rural older women on the determinants of successful ageing. Data were collected through semi-structured interviews with 15 rural older women aged 65 years and above in Awgu Local Government Area, Enugu State, Southeast Nigeria. Data collected were analysed thematically, and findings revealed that positive social and spiritual relationships were the most critical determinants of successful ageing. Access to and utilisation of digital technology to maintain social ties were also recognised as crucial to the successful ageing of rural older women. Thus, interventions towards successful ageing should focus on improving healthy spirituality, positive social relations and improved connection with social ties through increased access to digital technology.

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.

Forced migration-induced diminished social networks and support, and its impact on the emotional wellbeing of older refugees in Western countries: A scoping review.

As the number of refugees continues to increase globally, so does the number of older adults forced to migrate from their home region to Western countries. Many of these older refugees lose their social networks and support to the events leading to forced migration and may be unable to recreate them once resettled. We used Arksey and O'Malley's (2005) framework to explore how forced migration has diminished the social networks and support of older refugees in Western countries and its impact on their emotional well-being. Eight databases were searched for the review; abstracts were reviewed using Rayyan QCRi(c) before the full-text review. A total of 25 studies were included in the final analysis, and findings revealed that forced migration reduced the quantity of social networks and the quality of social support older refugees received. The reduced social network and support led to social isolation, increased migration-related grief, and mental health challenges. Advances in digital technology are not yet capable of filling the support gap. With this, we hope to inform future research on the social support needs of older refugees and raise awareness of the need for humanitarian support intervention to cushion the impact of the migration-induced loss of social networks and support.

Understanding the impact of digital technology on the well-being of older immigrants and refugees: A scoping review.

Background: The fast-paced development of digital technologies in the areas of social media, pet robots, smart homes, and artificial intelligence, among others, profoundly influence the daily lives of older adults. Digital technology can improve the well-being and quality of life of older adults, older immigrants and refugees who suffer migration-associated stress, loneliness, health and psychosocial challenges. Aims: The aim of this scoping review is to map out extant empirical literature that has examined the implication of digital technology among older refugees and immigrants. Methods: Using a1 five-stage framework, we conducted a scoping review of peer-reviewed empirical studies published in English with no time restrictions. We searched nine databases for the reviews, and abstracts were reviewed using Rayyan QCRi(c) before the full-text review. The comprehensive database search yielded 4134 articles, of which 15 met the inclusion criteria. Results: The results of the review suggest that digital technology is essential to the well-being, quality of life of older immigrants and refugees, especially for maintaining and building new social support networks, navigating opportunities, coping with migration-induced stress through e-leisure, and staying connected to their culture. The literature also revealed poor utilisation of digital technologies amongst older immigrants and refugees, suggesting barriers to access. Conclusion: The study concluded by highlighting the need for more research and interventions that focus on multiple strategies, including education for increased access to and utilisation of digital technology to ensure that more older migrants can benefit from the advantages of digital technology in a safe way.

Is filial care for older adults in Nigeria threatened? Examining concerns from adult offspring providing care.

Filial care for older adults is a normative family practice in Nigeria, heralded by offspring. However, as families continuously evolve away from the extended structure to more nuclear setups, with women contesting traditional domestic roles, strong concerns about filial care are emerging. Our qualitative study investigated filial care using data elicited from 32 adult offspring in Enugu, Nigeria. Narratives reveal that filial care remains the most culturally acceptable and 'feasible' care option for older adults in Nigeria. Notwithstanding challenges constraining the efficiency of filial care, such as changing gender roles, an increase in the ages of adult offspring, uncooperative older adults, deplorable economic conditions, and living arrangements, filial care for older adults abound. Although contested, the paid care option within filial setup was reasonably considered by the participants as an important measure to address the challenges of filial care. In all, participants were unsure about the future of government assistance, hence there is a need to improve filial care by strategically adopting policy and programme directions, with social workers playing potentially pivotal roles.

Social work undergraduates students and COVID-19 experiences in Nigeria.

Following the highly contagious nature of the coronavirus disease and the increase in confirmed cases, the Nigerian government, imposed lockdowns, quarantines, and various social distancing measures to curb the rate of infection. Schools were closed, and examinations were postponed indefinitely. Students of private schools were able to resume academic activities online. However, most public schools could not do so, due to lack of infrastructure. This study aimed to qualitatively investigate the impacts of the novel coronavirus on final-year students of social work, at the University of Nigeria. Data was collected from 20 undergraduates using in-depth interviews. Findings showed that the pandemic had negative effects on different aspects of the students' lives. It was also revealed that some of the students were resilient and were able to use various coping strategies to avoid being overwhelmed by the situation. A policy implication of this study is the need for revitalization of Nigerian public universities, as the continued lockdown of schools shows how public universities are poorly managed in the country. This poor management of public schools has made it impossible for a switch to virtual learning.

Understanding Social and Emotional Loneliness among Black Older Adults: A Scoping Review.

Black older adults' (BOAs) experience of loneliness differs from other ethnic groups because of the disproportionate disadvantages faced across their life course. This scoping review aimed to describe the range of research on loneliness or subjective social isolation among BOAs, identifying the contributing factors to loneliness in this population, based on Weiss' Social provision Framework. Of the 15,345 initial retrieved citations from seven databases and corporate websites, we included 27 studies conducted in the USA, Nigeria, South Africa, Ghana, Canada, the United Kingdom, and Uganda. Studies reporting on BOAs' experience of loneliness focused on the influence of attachment, social integration, opportunity for nurturance, reassurance of worth, guidance, socio-economic factors, health-related factors and behaviors, and technology, media device possession and usage. There is a need for future studies to identify which social provisions (when targeted) could reduce loneliness, allowing clinicians to develop relevant interventions.

'Better to die of disease than die of hunger': the experience of Igwes (traditional rulers) in the fight against the COVID-19 pandemic in rural South-east Nigeria.

INTRODUCTION: The COVID-19 pandemic has had serious health and socioeconomic impacts on people all over the world. It was expected that Africa would be the hardest hit; consequently, Nigeria and other African nations worked with non-government organisations to institute a framework for controlling the spread of the disease and the resultant economic woes. The measures, however, largely focused on urban centres, whereas the spread of the virus and the disease transcended imported urban cases to spread through the rural community. This study explored the experiences of traditional rulers, who are closest to rural people, in the fight against COVID-19. METHODS: A qualitative research design was adopted and data were collected from eight Nigerian traditional rulers through interviews. The collected data were coded inductively using NVivo v12 and were then analysed thematically. RESULTS: Findings showed that the traditional rulers adopted measures such as the use of town criers to raise awareness among rural people about COVID-19. Findings also revealed that the protection measures led to increased economic hardship for rural people in Nigeria. Doubt about the existence of the virus and widespread poverty were found to be the major hindrances in the fight against the pandemic. CONCLUSION: It is recommended that traditional rulers collaborate with the government to make free protective equipment available for poor rural people, and collaborate with youths and religious leaders to properly fight the 'infodemic' through continuous community education and awareness-raising.

Digital and Physical Social Exclusion of Older People in Rural Nigeria in the Time of COVID-19.

As the use of digital technology becomes more widespread across the globe, older people remain among the group with the lowest access and usage. The digital divide may lead to double exclusion as the COVID-19 pandemic has led to limited physical social contact as experts' recommendation of continuous social distancing and lack of access and usage of internet communication will leave older people socially isolated. The aim of this study is to explore how older people in rural Nigeria may be digitally excluded and its impact during the COVID-19 pandemic. Qualitative data was obtained from 11 older people using interviews. The collected data was then transcribed and analyzed thematically. Findings show that older people in rural Nigeria were digitally excluded. However, the older people argued that the digital exclusion is not the reason for their social isolation and loneliness. The study concluded by suggesting how caregivers and social workers can assist rural older people through activity schedule and radio programs designed for older people.

Exploring the Impact of COVID-19 Pandemic on Economic Activities and Well-being of Older Adults in South-eastern Nigeria: Lessons for Gerontological Social Workers.

The novel COVID-19 pandemic and its containment measures such as lockdown and physical distancing are remarkedly affecting older adults' economic activities and well-being in ways deserving of urgent attention. To strengthen caregiving and promote targeted care for older adults during and after the pandemic, this paper investigates the impact of the coronavirus on the economic activities and well-being of older adults in Enugu and Anambra states, Nigeria. Hermeneutic phenomenology was adopted and 16 older adults aged between 60 and 81 years, with a majority of them still working as farmers and traders were phone-interviewed. Findings highlighted four key lessons for gerontological social workers including 1) the fear that impact of the containment measures could kill the older adults faster than the virus; 2) the measures generate a feeling of neglect and marginalization of healthcare needs among older adults; 3) altered positive health-seeking behavior among the older adults; 4) and concern about the absence of functional policy and plan to address the welfare of older adults. Therefore, the central focus of the gerontological social workers and Nigerian polity should not be on how to reduce the spread of the disease alone, but on an application of caution in instituting and implementing the measures.

COVID-19 in Rural Nigeria: Diminishing Social Support for Older People in Nigeria.

Social support provided by family, friends and neighbors has been essential for the survival and wellbeing of older people in Nigeria. However, the reduced social contact between older people and their social network because of the social distancing recommendations and other non-pharmaceutical approaches to protect them from COVID-19 may threaten their social support. Our study investigated the impact of the COVID-19 pandemic on rural older people in Nigeria using qualitative data collected from 11 older adults residing in rural Nigeria through in-depth interviews. The collected data was translated and transcribed, coded using Nvivo12 and analyzed thematically. Findings show that the COVID-19 pandemic has led to a reduction in both material support in the forms of food and money, and intangible support in the forms of assistance, communication and care, due to limited social contact. Furthermore, the economic consequence of the pandemic may have severe implications for the health and wellbeing of older people. Social workers should therefore advocate the distribution of food and care supplies to rural older people to cushion the economic impact of diminishing social support, and also creatively help them maintain social connectedness.