Immunisation services in North-Eastern Nigeria: perspectives of critical stakeholders to improve uptake and service delivery

We investigated the perspectives of parents, health workers (HWs) and traditional medical practitioners (TMPs) on immunisation advocacy, knowledge, attitudes and immuni sation practice and ways of improving immunisation uptake in Borno State, North eastern Nigeria. A cross sectional study analysing quantitative data from the three stakeholders' categories. It was conducted across 18 local government areas of Borno State. A representative sample of 4288 stakeholders (n=1763 parents, n=1707 TMPs, and n=818 HWs aged 20 to 59years, had complete data. The sample has more males: 57.8% (Parents); 71.8% (TMPs) and 57.3% (HWs). The awareness of immunisation schedule among the stakeholders ranged from 87.2 to 93.4%. The study showed that 67.9% of the parent and 57.1% of the health workers had participated in immunisation except the TMPs (27.8%). Across the stake holders' categories, between 61.9 and 72.6% have children who had Adverse Event Following Immunisation (AEFI). The most common AEFI was fever. Safety concerns, preference for herbs and charm, culture and religions, and vaccination perception as a western culture were the major barriers to immunisation uptake. While 63.6 to 95.7% of respondents indicated that community leaders, religious and spiritual leaders and TMPs should be involved in immunisation advo cacy, 56.9 70.4% of them reported that community leaders should be involved in immunisation policy. Upscaling the critical stakeholders' involvement in advocacy, policy devel opment and implementation of immunization activities may improve acceptance, create demand and engender ownership in vulnerable communities of Borno State, Nigeria. AEFI could be detrimental to immunisation access and utilization. Consequently, health education by health workers needs strengthening to minimise vaccine hesitancy.

Immunisation services in North-Eastern Nigeria: Perspectives of critical stakeholders to improve uptake and service delivery.

We investigated the perspectives of parents, health workers (HWs) and traditional medical practitioners (TMPs) on immunisation advocacy, knowledge, attitudes and immunisation practice and ways of improving immunisation uptake in Borno State, North-eastern Nigeria. A cross-sectional study analysing quantitative data from the three stakeholders' categories. It was conducted across 18 local government areas of Borno State. A representative sample of 4288 stakeholders (n=1763 parents, n=1707 TMPs, and n=818 HWs aged 20 to 59years, had complete data. The sample has more males: 57.8% (Parents); 71.8% (TMPs) and 57.3% (HWs). The awareness of immunisation schedule among the stakeholders ranged from 87.2 to 93.4%. The study showed that 67.9% of the parent and 57.1% of the health workers had participated in immunisation except the TMPs (27.8%). Across the stakeholders' categories, between 61.9 and 72.6% have children who had Adverse Event Following Immunisation (AEFI). The most common AEFI was fever. Safety concerns, preference for herbs and charm, culture and religions, and vaccination perception as a western culture were the major barriers to immunisation uptake. While 63.6 to 95.7% of respondents indicated that community leaders, religious and spiritual leaders and TMPs should be involved in immunisation advocacy, 56.9-70.4% of them reported that community leaders should be involved in immunisation policy. Upscaling the critical stakeholders' involvement in advocacy, policy development and implementation of immunization activities may improve acceptance, create demand and engender ownership in vulnerable communities of Borno State, Nigeria. AEFI could be detrimental to immunisation access and utilization. Consequently, health education by health workers needs strengthening to minimise vaccine hesitancy.

Association between patterns of sedentary time and academic performance in adolescents: the mediating role of self-concept.

OBJECTIVE: To analyze the association between the pattern of sedentary time (bouts and breaks) with academic performance, with an emphasis on the mediating role of self-concept. METHODS: Participants in the cross-sectional study were 394 adolescents (208 girls), aged 10-14 years, from sixth grade from Londrina, Paraná, Brazil. The sedentary time pattern was measured through accelerometry. Definitions: sedentary bouts - uninterrupted periods of sedentary behavior; breaks - non-sedentary period between two sedentary bouts. The self-concept was estimated using the Piers-Harris II Inventory. Academic performance was obtained by school grades. RESULTS: Short sedentary bouts were associated with higher academic performance in boys (1-4 minutes: ß=0.035, p=0.007) and girls (1-4 minutes: ß=0.031, p=0.014; 5-14 minutes: ß=0.054, p=0.001). Long bouts (30 minutes) were associated with lower academic performance in boys (ß=-0.023; p=0.011) and girls (ß=-0.032; p<0.001). For girls, total and intellectual self-concept mediated the association between all sedentary pattern and academic performance (bouts 1-4 minutes [total: 39% and intellectual: 42.8%]; bouts 5-14 minutes [total: 21.5% and intellectual: 35.4%]; bouts ≥30 minutes [total: 22.6% and intellectual: 32.3%]; and breaks [total: 38.9% and intellectual: 40.7%]). For boys, the total (56.4%) and intellectual (82.9%) self-concept mediated only the association between bouts of 5-14 minute and academic performance. CONCLUSIONS: The pattern of sedentary time is associated with academic performance in adolescents and this association is mediated by self-concept, especially in girls.

Association between patterns of sedentary time and academic performance in adolescents: the mediating role of self-concept / Associação entre o padrão do tempo sedentário e o desempenho acadêmico em adolescentes: o papel mediador do autoconceito

Abstract Objective: To analyze the association between the pattern of sedentary time (bouts and breaks) with academic performance, with an emphasis on the mediating role of self-concept. Methods: Participants in the cross-sectional study were 394 adolescents (208 girls), aged 10-14 years, from sixth grade from Londrina, Paraná, Brazil. The sedentary time pattern was measured through accelerometry. Definitions: sedentary bouts — uninterrupted periods of sedentary behavior; breaks — non-sedentary period between two sedentary bouts. The self-concept was estimated using the Piers-Harris II Inventory. Academic performance was obtained by school grades. Results: Short sedentary bouts were associated with higher academic performance in boys (1-4 minutes: β=0.035, p=0.007) and girls (1-4 minutes: β=0.031, p=0.014; 5-14 minutes: β=0.054, p=0.001). Long bouts (30 minutes) were associated with lower academic performance in boys (β=-0.023; p=0.011) and girls (β=-0.032; p<0.001). For girls, total and intellectual self-concept mediated the association between all sedentary pattern and academic performance (bouts 1-4 minutes [total: 39% and intellectual: 42.8%]; bouts 5-14 minutes [total: 21.5% and intellectual: 35.4%]; bouts ≥30 minutes [total: 22.6% and intellectual: 32.3%]; and breaks [total: 38.9% and intellectual: 40.7%]). For boys, the total (56.4%) and intellectual (82.9%) self-concept mediated only the association between bouts of 5-14 minute and academic performance. Conclusions: The pattern of sedentary time is associated with academic performance in adolescents and this association is mediated by self-concept, especially in girls.

Resumo Objetivo: Analisar a associação entre o padrão do tempo sedentário (bouts e breaks) e o desempenho acadêmico, com ênfase no papel mediador do autoconceito. Métodos: Participaram deste estudo transversal 394 adolescentes (208 moças), de 10 a 14 anos, da sexta série de Londrina, Paraná, Brasil. O padrão do tempo sedentário foi obtido por meio de acelerometria. Definições: bouts sedentários — períodos ininterruptos em comportamento sedentário; breaks — período não sedentário entre duas séries sedentárias. O autoconceito foi estimado usando o Inventário Piers-Harris II. O desempenho acadêmico foi obtido pelas notas escolares. Resultados: Bouts sedentários curtos foram associados com maior desempenho acadêmico em rapazes (1-4 minutos: β=0,035, p=0,007) e moças (1-4 minutos: β=0,031, p=0,014; 5-14 minutos: β=0,054, p=0,001). Bouts longos (30 minutos) foram associados a menor desempenho acadêmico em rapazes (β=-0,023; p=0,011) e moças (β=-0,032; p<0,001). Para as moças, o autoconceito total e intelectual mediou a associação entre todos os padrões sedentários e o desempenho acadêmico (bouts de 1-4 minutos [total: 39% e intelectual: 42,8%]; bouts de 5-14 minutos [total: 21,5% e intelectual: 35,4%]; bouts ≥30 minutos [total: 22,6% e intelectual: 32,3%]; e breaks [total: 38,9% e intelectual: 40,7%]). Para os rapazes, o autoconceito total (56,4%) e intelectual (82,9%) mediaram apenas a associação entre bouts de 5-14 minutos e desempenho acadêmico. Conclusões: O padrão do tempo sedentário está associado ao desempenho acadêmico em adolescentes, e essa associação é mediada pelo autoconceito, principalmente em moças.

Relationship between sociodemographic characteristics of stroke survivors and poststroke motor performance

Background: Motor impairment is a frequent presentation of stroke leading to partial or total loss of function of a body part usually limbs. Objective: This study investigated poststroke motor performance and its association with sociodemographic and clinical characteristics of stroke survivors. Materials and Methods: Ninety-four stroke survivors from two selected physiotherapy clinics in Maiduguri participated in this study. Data form was used to obtain information on sociodemographic and clinical characteristics of the participants while the Short-Form Fugl Meyer scale was used to obtain the information on motor performance of the participants. Descriptive statistics of mean, standard deviation, frequency, and percentage were used to summarize the data. Chi-square test of association was used to analyze motor performance and its association with sociodemographic and clinical characteristics of the participants. Results: The mean age and poststroke duration of the participants were 52.65 ± 12.70 years and 26.32 ± 32.70 months, respectively. Of the entire participants, 55 (58.5%) were male, 49 (52.1%) were employed, and 33 (35.1%) had Qur'anic education. Forty (42.6%) had a duration of stroke between 3 and 12 months. Gender (χ2 = 12.72, P = 0.002) and educational level (χ2 = 17.77, P = 0.023) were significantly associated with motor performance. Age, employment status, and duration of stroke showed no significant association with motor performance. Conclusion: The outcome of this study suggests that female gender and "no educational" attainment were associated with poor motor performance among stroke survivors in Maiduguri. Gender and educational level can influence motor impairment after stroke and should represent an essential part of assessment during stroke rehabilitation

Physical activity profile of Nigeria: implications for research, surveillance and policy.

Appraising the status of physical activity surveillance, research and policy in Nigeria is relevant to national and regional public health actions on physical activity promotion and non-communicable disease control. This study aimed to 1) evaluate the physical activity profile of Nigeria and 2) propose strategies for improving physical activity in the country. The Global Observatory for Physical Activity-GoPA! with inputs from local experts systematically collected sociodemographic and physical activity surveillance, national policy and research indicators data for Nigeria in 2014. The Nigerian Country Card highlighting the status of these indicators was developed in 2015 and launched in 2016. Prevalence of physical activity among Nigerian adults was 78% (female=76%, male=79%). There was no physical activity surveillance system and national plan, and no empirical data on the proportion of all deaths directly due to physical inactivity in Nigeria. Few (n=7) articles related to physical activity and public health were published in 2013 and the country occupied the 38th position in the global research ranking, contributing about 0.24% to physical activity research worldwide. Implementing national physical activity plans and multi-sectorial collaborations between government and non-governmental partners are needed to improve physical activity surveillance, research and policy in Nigeria and other African countries with similar physical activity gaps.