Lessons learned from early implementation of the Growing Expertise in E-health Knowledge and Skills (GEEKS) program in Nigeria, 2019 - 2021.

Introduction: the Growing Expertise in E-health Knowledge and Skills (GEEKS) program is an applied apprenticeship program that aims to improve informatics capacity at various levels of the national health system and create a sustainable informatics workforce. Nigeria adapted the GEEKS model in 2019 as a mechanism to strengthen data quality and use of routine immunization (RI) and vaccine-preventable disease (VPD) surveillance data among Expanded Programme on Immunization (EPI) staff. Since the start of the GEEKS-EPI program, there has not been a formal assessment conducted to measure the extent to which GEEKS-EPI has been able to build local informatics workforce capacity and strengthen RI and VPD surveillance (VPDS) data quality and use in Nigeria. Methods: we conducted a qualitative assessment to inform the extent to which GEEKS-EPI has been able to build informatics skillsets to enhance local workforce capacity, foster collaboration across government agencies, and create a sustainable informatics workforce in Nigeria. In-Depth Interviews (IDIs) and Focus Group Discussions (FGDs) were held with GEEKS-EPI supervisors, mentors, and mentees from previous GEEKS-EPI cohorts. Results: while there were challenges reported during early implementation of the GEEKS-EPI program in Nigeria, particularly early on in the COVID-19 pandemic, participants and supervisors reported that the fellowship provided a framework for building a sustainable RI and VPDS informatics workforce through regular mentorship, peer-to-peer exchanges and Subject Matter Expert (SME)-led trainings. Conclusion: lessons learned from early implementation of GEEKS-EPI in Nigeria will help to inform its implementation in other countries, where strengthened national RI and VPDS informatics capacity is the primary objective.

Non-specialized care of skin disorders: a cross-sectional survey of new patients attending dermatology clinic in a tertiary hospital in Jos, Northcentral Nigeria.

Background: Given the paucity of skin health specialists in Nigeria and the low level of awareness amongst its populace, patients seek for care for skin related disorders from different sources and are given a variety of remedies before accessing specialist care. Objectives: This study was aimed at describing outlets visited and medication received by patients with skin disorders prior to attending the dermatology outpatient clinic in JUTH. Methods: This was a cross sectional study conducted over one year. Information on socio-demography, sources and medication received prior to presentation was obtained and analysed using SPSS 23. Results: The male: female ratio among 166 consenting new patients was 1:1.4. Prior to presentation patients sought care most frequently from Health facilities (68.1%), Patent medicine vendors-PMV (30.7%) and Traditional healers (21.7%). Overall, different steroid preparations were the most commonly used medications (56.6%) across all age groups with fixed combination preparations most frequently used (32.5%). Unconventional substances reportedly used by patients for skin disorders were urine, toothpaste, tomatoes, salt, water in which a life catfish had been kept and fats from a dead dog. Only 21.1% of the patients did not use any medication prior to presentation. Conclusion: There is need to increase capacity in the care of common skin diseases at all levels of the health care system to decrease patronage of unconventional providers. Raising awareness of the general public on the potential dangers of inappropriate treatment of skin diseases and strengthen referral system is imperative to reduce the burden of skin diseases in the country.