Subjective Wellbeing of Community Dwelling Older Adults in Nigeria.

Previous comparative international studies on wellbeing of older adults in Africa have presented figures based on indicators which tend to obscure the variations in terms of wellbeing among the older adults in a particular country. This paper examined the subjective dimension of quality of life of community dwelling elders in Nigeria. It identified factors related to different levels of subjective wellbeing in different parts of the country and among different socio-economic groups.Data for the paper were drawn from a national study on vulnerability of older adults in Nigeria. A sample of 3,696 older adults (55.6% males; 44.4% females; mean age = 69.2, SD = 8.60) was selected through multi-stage systematic random sampling, using the national census enumeration area framework. Data were collected using structured interviews via Open Data Kit (ODK). Subjective Wellbeing was measured using the Flourishing Scale.Multiple linear regression analysis revealed resilience as the main predictor for older adults' subjective wellbeing. Other significant predictors included perceived attitudes towards old age in the respondents' community, ability to meet daily financial needs, independence in Activities of Daily Living (ADL), membership in social and religious groups and location, whether rural, peri-urban or urban.The findings of the study make significant contributions to the existing literature on older adults' wellbeing in Nigeria and provide material for future regional and international comparisons on the subject. The findings also provide data that can be utilized for policies and programme interventions that will be in alignment with the older adults' perceived needs.

Combination prevention package of interventions for reducing vulnerability to HIV among adolescent girls and young women in Nigeria: An action research.

BACKGROUND: Adolescent girls and young women (AGYW) in Nigeria are especially at risk of HIV in Nigeria. Their vulnerability to HIV is linked to multiple concurrent sexual relationships, transgenerational sex, and transactional sex, amongst other factors. These factors have sociocultural contexts that vary across a multi-cultural country like Nigeria. The aim of this study was to use an innovative collaborative approach to develop a minimum HIV prevention package for AGYW which is responsive to sociocultural settings and based on combination HIV prevention. METHODS: We conducted action research to develop and implement actionable HIV prevention intervention models that address AGYW's vulnerabilities to HIV in three Nigerian States and the Federal Capital Territory (FCT) Abuja. The action research adopted the breakthrough series (BTS) collaborative, which accelerates improvement through mutual learning. The BTS implementation involved rapid Plan-Do-Study-Act (PDSA) cycles: an iterative process to plan and implement a basket of interventions. Problems or problematic situations, termed change topics, for which interventions could be carried out were identified in each study location. Using participatory approaches during a series of meetings called learning sessions, specific and innovative interventions, termed change ideas, were developed. These learning sessions were conducted with young women groups and other stakeholders. The change ideas were tested, studied, adapted, adopted, or discarded at each participating site. Exposure to and uptake of the implemented interventions was assessed in the study areas using a household survey with 4308 respondents, 53 focus group discussions, and 40 one-on-one interviews in intervention and control study sites. RESULTS: Five categories of interventions were collaboratively developed, namely: Parental communication; Peer to peer interventions; Facilitator-led interventions; Non-traditional outlets for condoms, and Social media-based interventions. A good reach of the interventions was demonstrated as 77.5% of respondents reported exposure to at least one type of intervention. Nearly half of the respondents reported being exposed to the parental communication interventions, while 45.1% reported being exposed to the youth facilitator-driven interventions. Social media interventions had the lowest penetration. Also, there was between 15 to 20 positive percentage point difference between intervention and control for the uptake of HIV testing, and between 5 to 9 positive percentage point difference for uptake of male condoms. These differences were statistically significant at p<0.001. CONCLUSIONS: Interventions developed through participatory approaches with young people and well-tailored to local realities can improve the acceptability and accessibility of programs that are able to reduce the risk of HIV infection among AGYW.

Factors Associated With Parent-Adolescent Communication on Sexual and Reproductive Health Issues in Urban Slums of Ibadan, Southwest Nigeria.

In Nigeria, adolescents in urban slums are increasingly at risk of adverse sexual and reproductive health (SRH) outcomes. However, little is known about how individual factors predict parent-adolescent communication on SRH issues in a resource-poor urban setting in Ibadan. Thus, this study investigated individual factors associated with parent-adolescent communication on SRH issues in urban slums of Ibadan, southwest, Nigeria. This study is part of a larger project that explores the socio-ecological factors influencing parent-adolescent communication on SRH issues in selected slums in Ibadan, Nigeria. Within this broader framework, this paper relies on the quantitative data obtained in 10 selected slums. Interviewer-administered structured questionnaire [scripted on open data kits (ODK)] was utilized to collect data from a sample of 796 parent-adolescent dyads. Six SRH topics were investigated to describe the issues discussed. Analytical techniques utilized include; frequency counts, chi-square, and multinomial logistic regression. Parent-adolescent communication regarding SRH issues is not uncommon in urban slums of Ibadan but characterized by indirect communication, threat and warning. Parents and adolescents' age, gender, marital/relationship status, educational attainments and religion played influential role in parent-adolescent communication regarding SRH issues. These factors were identified to be significantly associated with the pattern of parent-adolescent discussion of SRH issues. Age-specific SRH education should be available to adolescents and parents need to be educated on appropriate SRH information and the best way to engage their adolescents on SRH issues.

Between Traditions and Health: Beliefs and Perceptions of Health Effects of Smokeless Tobacco Among Selected Users in Nigeria.

OBJECTIVES: Snuffing or licking of smokeless tobacco (SLT) is one of the oldest traditional practices among the African population. This study aims to investigate the beliefs and practices related to SLT use among users in Nigeria. We also assess the awareness of the health consequences of SLT among users. METHODS: A qualitative technique involving an in-depth interview was employed to collect data from SLT users from selected indigenous Nigerian populations in their traditional settings (Saki, Ile-Ife, Ibadan, and Abuja). The locations were purposively selected based on the researchers' knowledge of the prevalent use of SLT in those areas. A snowball sampling technique was employed to select the respondents. The data were imported into the ATLAS.ti computer software for analysis. The data were analyzed using inductive coding, and the results were presented thematically using network diagrams. RESULTS: The findings revealed that the majority of SLT users believed that the practice had the following health benefits, among others: clearing of eyes and nose, aiding in sleep and rest, protecting against colds and nose bleeds and curing headaches. The users believed that SLT helped them 'feel high' or bold when afraid. The SLT users also believed that it protected them from evil spirit(s) and dangerous reptiles. The users believed that SLT had no negative health consequences, and SLT was generally preferred to smoking cigarettes. CONCLUSION: The study concludes that there is a need to focus on the control of SLT because this product is a major alternative to tobacco smoking among indigenous African populations.

Women's perceptions and reflections of male partners and couple dynamics in family planning adoption in selected urban slums in Nigeria: a qualitative exploration.

BACKGROUND: Nigeria is one of the countries where significant progress has not been recorded in contraceptive uptake despite decades of family planning programs while there are indications that slum dwellers may differ significantly from other urban dwellers in their sexual and reproductive behavior, including family planning uptake. This study therefore examined local notions regarding male partners' involvement in family planning (FP) adoption by women in two selected urban slums areas in Nigeria - Ibadan (Southwest region) and Kaduna (Northwest region). Specifically, the study investigated women's narratives about FP, perceived barriers from male partners regarding FP adoption by the women and how women negotiate male partners' cooperation for FP use. METHODS: Sixteen FGD sessions were conducted with selected groups of men and women, stratified by sex, age group, and FP experience using a vignette to generate discussions. Sessions were facilitated by experienced social scientists and audio-taped, with note-taker also present. The transcribed data were analyzed with Atlas.ti software version 7. Inductive approach was employed to analyze the data. Reasons given for FP attitudes and use are presented in a network format while critical discourse analysis was also used in generating relevant tables. RESULTS: The finding shows that women in the selected communities expressed desire for FP adoption. Three main reasons largely accounted for the desire to use FP: perceived need to space childbirth, family's financial condition and the potential adverse effect of high fertility on the woman's health. Male partners' support for the use of FP by women was perceived to be low, which is due to misconceptions about FP and traditional pro-natalistic beliefs and tendencies. Mechanisms by which women negotiate their male-partner's cooperation for FP adoption include seeking the support of the partner's significant others and advice from older women. CONCLUSION: To significantly improve family planning adoption rates among urban slum dwellers in Nigeria, there is the need to specifically and specially target men alongside their female partners as well as other stakeholders who have significant influences at family and community level.

Living well with HIV in Nigeria? Stigma and survival challenges preventing optimum benefit from an ART clinic.

Thirty years into the HIV pandemic, the interactions of stigma, social and economic survival, and clinical interventions continue to be key to understanding and managing HIV at both personal and societal levels. With antiretroviral therapy, HIV is increasingly a chronic condition requiring lifelong treatment, near-perfect adherence, and support from both social networks and formal services. This study asked: is stigma still a significant problem for people living with HIV (PLHIV) who have secured access to antiretrovirals (ARVs)? How do PLHIV accessing ARVs in Nigeria experience the social, economic and health service supports intended to address their needs? What are the concerns and challenges of PLHIV and health workers regarding these supports? What are the implications for approaches to stigma and discrimination? This qualitative study at the Antiretroviral (ART) Clinic of the Osogbo State Hospital, Osun State, Nigeria involved in-depth interviews with 15 PLHIV who have been attending the clinic for at least one year, and three health workers. The results reveal both the diversity among even a small number of patients, and persistent cross-cutting themes of stigma, discrimination, poverty, and the psychological impacts of insecure livelihoods and well-intentioned but ultimately stigmatizing supports such as selective food parcels. Both population-based interventions against stigma and poverty, as well as micro-level, contextualized attention to patients', families' and health workers' fear of social exclusion and infection at a clinic and community level are needed if patients - and society - are to live well with HIV in Nigeria.

Teachers' perspectives on sexual and reproductive health interventions for in-school adolescents in Nigeria.

High prevalence of early and unprotected sex, resulting in adverse reproductive health outcomes, has been reported among adolescents in Nigeria. While school-based sexual and reproductive health interventions for in-school adolescents is widely recognized, little is known on the kind of involvements desired by teachers and their perceptions of handling students' reproductive health concerns. In this study, the teachers favoured school-based reproductive health education (RHE), but have divers' opinions on what should be included in such RHE. Majority was not willing or comfortable in personal counseling of students but can teach RHE in classroom environment. They support the current approach of expelling pregnant school girls. The article advocates for gender-sensitive and developmental-oriented approaches that will ensure rehabilitation and re-integration of pregnant girls into the school system after their delivery, and recommend the need to build teachers skills and promote students-teachers dialogue in order to optimize school environment for addressing ASRH.

Understanding cybercrime perpetrators and the strategies they employ in Nigeria.

A lot has been written on cybercrime and its prevention, but the problem has proved particularly resilient to remedial action. Desperate and vulnerable individuals in every continent continue to fall into its trap. Despite this, there is dearth of descriptive study that attempts to unravel the strategies employed by the perpetrators in Nigeria, as an important precondition for workable and reliable policy direction to address the problem. This article has filled this gap by using data from 40 cybercrime perpetrators selected with snowballing technique. The findings revealed that most of the cybercrime perpetrators in Nigeria are between the age of 22 and 29 years who were undergraduates and have distinctive lifestyles from other youths. Their strategies include collaboration with security agents and bank officials, local and international networking, and the use of voodoo that is, traditional supernatural power. It was clear that most perpetrators of cybercrime were involved in on-line dating and buying and selling with fake identity among others. The article discussed the need for reorientation of Nigerian youths in higher institutions, and various methods as guiding principles for potential victims. It recommended a complete reorganization of the Nigerian Police Force and Economic and Financial Crime Commission, as some of the officers in the institutions aid and abet cybercrime. It finally suggested a review of the Nigerian law guiding the operations of banking, poster agencies, and various speed post services in the country, as these are necessary preconditions to effectively combat the problem.