"Omugwo" As Unpaid Labor? The Perceptions of Postpartum Caregiving Among Older Grandmothers in Southeast Nigeria.

Background and Objectives: In Nigeria and many Sub-Saharan African countries where the majority are poor and cannot afford formal postpartum care, nursing mothers rely primarily on their mothers or older female relatives for postpartum care. Despite their invaluable contributions, such grandmothers often operate in a reality of inadequate social and institutional support. Yet, little is known about how women perceive this form of traditional care in Sub-Saharan Africa. This study explored the views of older grandmothers in Southeast Nigeria about postpartum caregiving, called "Omugwo." Research Design and Methods: Using a qualitative descriptive inquiry, the author employed criterion-purposive sampling and snowballing to recruit 17 older grandmothers who participated in the interviews, and data were analyzed in themes. Results: Three themes and eight subthemes emerged. The themes cover perceptions supporting the continuity of Omugwo practice irrespective, the influence of culture on Omugwo practice, and the indirect rewards of the practice. Discussion and Implications: The findings of this study could potentially influence postpartum caregiving policies for female older adults in Sub-Saharan Africa and further advance the quality of informal care during postpartum periods in Africa.

Longitudinal Studies of Aging in Sub-Saharan Africa: Review, Limitations, and Recommendations in Preparation of Projected Aging Population.

Background and Objectives: The United Nations has projected a 218% increase in older people in Sub-Saharan Africa (SSA) between 2019 and 2050, underscoring the need to explore changes that would occur over this time. Longitudinal studies are ideal for studying and proffering solutions to these changes. This review aims to understand the breadth and use of longitudinal studies on aging in the SSA regions, proffering recommendations in preparation for the projected aging population. Research Design and Methods: This paper is the third of a four-part series paper of a previous systematic mapping review of aging studies in SSA. We updated the search (between 2021 and 2023) and screened the titles/abstracts and full-text articles by a pair of independent reviewers. Data were extracted using a standardized data-charting form, identifying longitudinal studies in SSA. Results: We identified 193 studies leveraging 24 longitudinal study data sets conducted at 28 unique sites. The World Health Organization's Study on Global AGEing and Adult Health (WHO-SAGE) (n = 59, 30.5%) and Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) (n = 51, 26.4%) were the most used longitudinal data sets. Four studies used more than one longitudinal study data set. Eighteen of the longitudinal study data sets were used only in 1-4 studies. Most (n = 150, 77.7%) of the studies used a cross-sectional analytical approach. Discussion and Implications: Longitudinal studies on aging are sparingly being utilized in SSA. Most analyses conducted across the longitudinal data set were cross-sectional, which hindered the understanding of aging changes that occurred over time that could better inform aging policy and interventions. We call for funding bodies, such as WHO-SAGE, to develop funding competitions that focus on conducting longitudinal analyses, such as structural equation modeling, highlighting changes occurring among the aging population in SSA.

An Exploratory Study of the Situation of Persons with Disabilities in Nigeria: Practice Consideration for Social Workers.

PURPOSE: Disability is one of the various challenges that people face around the world. People with disabilities are confronted with a lot of challenges, and they experience depression, social marginalization, and isolation. The study aims to explore the situation of persons with disabilities in Nigeria. METHOD: To conduct this study, focus group discussions and key informant interviews were used to collect data from 45 purposively selected study participants (40 persons living with disabilities, and 5 chairpersons of a joint association of persons living with disabilities). RESULTS: Findings showed that some of the challenges facing persons living with disabilities in Nigeria include environmental, educational, and socio-economic challenges. DISCUSSION AND CONCLUSION: In conclusion, to overcome some of these challenges social workers should advocate for inclusive strategies and one way this can be realized is by the domestication and implementation of the Discrimination against Persons with Disabilities (Prohibition) Act, 2018.

Why I Have Not Taken the COVID-19 Vaccine" a Descriptive Qualitative Study of Older Adults' Perceived Views of COVID-19 Vaccine Uptake in Nigeria.

Globally, the COVID-19 vaccine uptake is increasing, but slowly among older adults residing in lower and middle-income countries, including Nigeria. Following this, we explored the perceived views of older adults on the uptake of the COVID-19 vaccine in Nigeria. We adopted a qualitative descriptive study design and purposively selected and interviewed 16 retirees of older adults. Data were analyzed using conventional content analysis. Findings show that older adults' willingness to receive the COVID-19 vaccine was dissuaded by their past experiences with the government, religion, and Western media, including affordability and accessibility problems related to vaccination campaigns. Findings also show that the uncertainty about the COVID-19 virus existence and perceptions about COVID-19 vaccine risks influence older adults' decisions regarding vaccine uptake. Finally, older adults' views on getting vaccinated for COVID-19 were positively influenced by the trust they placed in their physicians and other members of their healthcare system. The government should incentivize healthcare workers to serve as a nudge to increase COVID-19 vaccine uptake among older adults in Nigeria.

Social Workers' Involvement in Developing and Implementing Social Programs for Older Adults During the COVID-19 Pandemic in Nigeria: A Concept Paper and Suggestions for Action Plans.

Social workers, especially in the Global North/developed countries such as the United States of America, Australia, Canada, and the United Kingdom, have been actively involved in implementing social programs to improve the psychosocial, health, and wellbeing of older adults during the COVID-19 pandemic. However, this is not the case in the Global South/developing countries like Nigeria, Ghana, etc. This concept paper aims to describe the current state of Nigerian social workers' role in developing and implementing social programs for older adults during the COVID-19 pandemic and to identify action plans for further strengthening their involvement. We systematically reviewed the literature to identify Nigerian social workers' role in developing and implementing social programs for older adults during COVID-19. Our review reflected that social workers are rarely involved in developing and implementing social programs; when involved, their involvement is on a consultation basis, which limits their active involvement in multidisciplinary team of COVID-19 prevention and vaccination ad hoc committees in Nigeria.

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 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.

Perception and Practice of Cervical Cancer Screening Services and the Role of Social Workers in Facilitating Screening Uptake in Enugu State, Nigeria.

OBJECTIVE: We examined the perception and practice of cervical cancer screening among women in Enugu State, Nigeria. METHODS: We employed mixed methods and conveniently sampled women aged >15 years. The quantitative data were subjected to chi-square and regression analysis while the qualitative data were analyzed using thematic analysis. RESULTS: The study findings show that over 57% of the respondents have a positive perception of cervical cancer screening while over 80% revealed that they practice cervical cancer screening. Factors such as education, income, and residence are significant in predicting the practice of cervical cancer screening. CONCLUSION: Therefore, social work strategies to leverage these modifiable predictors in facilitating cervical screening uptake are recommended.

A Mapping Review on the Uptake of the COVID-19 Vaccine among Adults in Africa Using the 5A's Vaccine Taxonomy.

Uptake of a vaccine is complete if individuals are aware of the associated risks of the vaccine, accept the vaccine, and respond positively to the nudges (activation) to increase the uptake, and respond when the vaccine is made accessible and affordable. We mapped systematically the existing literature concerning the 5As-acceptability, accessibility, affordability, awareness, and activation-of COVID-19 vaccination among adults and, specifically, older adults (55 years and older) in Africa. We searched multiple databases from 2020 to December 2021. Using predefined inclusion and exclusion criteria, two reviewers screened citations, conducted title and abstract screening, and extracted data independently. We included 68 articles conducted in 33 African countries, primarily cross-sectional studies (n = 49, 72%). None of the articles focused on older adults only, but 22 articles (32%) included at least one older adult (55 years and older) in their sample size. Acceptance (n = 58, 85%) was the most commonly researched aspect of vaccine uptake, followed by accessibility (n = 17, 25%), awareness (n = 13, 19%), and affordability (n = 5, 7.0%). We found only one report on activation. Factors affecting acceptance of the COVID-19 vaccine in Africa were grouped into sociodemographic factors; knowledge-, attitude-, and belief-related factors; a COVID-19 vaccine efficacy and safety concern factor; and trust in government and public health authorities. The governments of African nations should focus on strategies to influence the modifiable factors identified in this review. More studies are needed to evaluate the impact of nudges (activation) to improve COVID-19 vaccine uptake in African nations.

COVID-19 Transmission due to Mass Mobility Before and After the Largest Festival in Bangladesh: An Epidemiologic Study.

Festivals traditionally result in mass public mobility from large cities to rural or semi-urban areas in low- and middle-Income Countries (LMIC), which are inadequately prepared for tackling the consequences of the COVID-19 pandemic. This study aimed to explore the trend of COVID-19 infection in a peripheral region of Bangladesh during one of the largest festivals to develop an evidence-based hypothesis for its influence on the transmission rate of COVID-19. This study conducted a quantitative analysis of secondary data on COVID-19 collected from the Directorate General of Health Services Bangladesh (DGHS) and divisional director's office in the Mymensingh division. To explore the influence of one of the biggest festivals (Eid-ul-Adha) on the trend of COVID-19 infection, we analyzed data from a week before the festival to 2 weeks following the festival. The infection rate (positive cases per million of the population) and the test positivity rate (positive cases among the total number of conducted diagnostic tests) of each day during this period were calculated both for the Mymensingh region and national level. Both the test positivity rate (TPR) and infection rates in the Mymensingh region demonstrated an increasing trend. The mean test positivity rate of the Mymensingh region on the week before the festival was 9.5%. It increased to a mean test positivity rate of 13% in the following week and further rose to a rate of 17% in the next week. The infection rate of Mymensingh also increased more than 2 folds from the day of the festival (2.0-5.3 cases per million) within the next 2 weeks. The TPR and infection rate on the national level remained similar throughout the study period. Mass mobility during Eid-ul-Adha influences the increased transmission of COVID-19 among the peripheral regions of Bangladesh from the central capital city Dhaka. The findings will help policymakers plan and implement travel restrictions during festivals during the pandemic in LMICs.

Health and wellbeing of indigenous older adults living in the tea gardens of Bangladesh.

BACKGROUND: There are currently 1.5 million indigenous people in Bangladesh, constituting 1.8% of the total population and representing one of the country's most deprived communities. This study explores the health status and quality of life along with their determinants among indigenous older people in Bangladesh in order to fill the knowledge and evidence gap on this topic. METHODS: A mixed-methods approach was deployed in October 2019 in the Sylhet division of Bangladesh which involved a cross-sectional survey among 400 indigenous older adults (200 males, 200 females) from 8 tea gardens using a pre-tested semi-structured questionnaire. Ten in-depth interviews were also conducted with providers of the tea garden health facilities. Descriptive analysis, multiple logistic and multi-nominal linear regression were performed to explore associated factors around health and quality of life. RESULTS: Of the total respondents, the majority (79.5%) had chronic diseases, with visual difficulty being predominant (74%) among the conditions. Almost all (94%) of the respondents experienced delays in receiving treatment and poverty was identified by most (85%) as the primary cause of those delays. Extreme age, being male, living alone and low family income were significantly associated with suffering from chronic conditions. Furthermore, having a chronic condition and extreme age were found to be significantly associated with a low quality of life. Health service providers identified lack of logistical support in the health facilities, the economic crisis and lack of awareness as the major causes of poor health status and poor health seeking behaviour of the indigenous older adults. CONCLUSION: Indigenous older men in extreme old age are more vulnerable to adverse health conditions and poor quality of life. Health literacy and health seeking behaviour is poor among indigenous older adults generally and there is a huge gap in the health services and social supports available to them.