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1st Prof. Babatunde Osotimehin Legacy Forum

 

The Academy for Health Development (AHEAD) in conjunction with the Partnership For Advocacy in Child and Family Health @ Scale (PASA) organised the 1st edition of the Professor Babatunde Osotimehin Legacy Forum. It was held on the 19th of July, 2019 at the Conference Centre in the University of Ibadan.

In her remarks, Mrs Funke Osotimehin advocated for the education of Family Planning to be extended to not just young and teenage girls, but also to their mothers.

In his goodwill message, the Permanent Secretary, Federal Ministry of health, through his representative Dr Kayode Afolabi recognized the contributions of Prof. Osotimehin to the health sector through his leadership at the National Action Committee on AIDS (NACA), as the Honourable Minister of Health, and as the UNFPA Executive Director. He said the FMOH is committed to ensuring Nigeria achieves the modern contraceptive prevalence rate of 27% by the year 2020.

Dr Omolola Omosehin, speaking on behalf of the UNFPA said the organization would remember Prof. Osotimehin for his tenacious advocacy for the health of women, for gender equality and youth and women empowerment. He described Prof. Osotimehin as a man of vision who was politically astute and incredibly eloquent.

Other goodwill messages came in from guests present, like the Provost of the College of Medicine at the University of Ibadan and the former Vice-Chancellor of Igbenedion University, Professor Eghosa Osarumen.

KEYNOTE ADDRESS

Prof. Otolorin who delivered the keynote address talked about a lot of family planning variables and their impact on the country. He said our rapid population growth is a barrier to our development as our economy is growing below the population growth rate. He identified an inverse relationship between the rate of contraception use and degree of education and economic status and emphasized the needs to improve the numbers.

PANEL DISCUSSION

Discussions by the panel made up of state and private actors in the Family Planning sector surrounded issues such as adopting a multi-sectorial sector-wide approach to implementing administrative and financial policies, public health financing, the role of the private sector in advocacy and implementation of family planning, the factors that affect the use of contraceptives among young people, innovations in the uptake and use of family planning methods and the need for collaboration rather than competition in the advancement of family planning goals.

VOICES FROM THE FIELD

Private organizations and Civil Society Organizations also presented their works and researches around family planning advocacy and implementation across the country.

JOURNAL LAUNCH

The Forum came to an end with a launch of a special edition of the African Journal of Medicine and Medical Sciences Supplement. The edition holds works of about 30 authors and was compiled in honour of Prof. Osotimehin who was a one-time editor of the journal.

A review of the 1st Professor Babatunde Osotimehin Legacy Forum would not be complete without highlighting the camaraderie and warm collegiality among discussants at the event.

PHOTOS FROM THE 1ST PROFESSOR BABATUNDE OSOTIMEHIN LEGACY FORUM

We look forward to your contribution to and participation in next year’s event, which promises to be more exciting still.

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The A, B, C of Tuberculosis in Nigeria

Introduction

TB is currently the leading cause of morbidity and mortality from an infectious disease and while a lot of progress has been made in the identification and treatment of tuberculosis, the WHO still estimates that about 4 million cases   of TB were missed in 2017. Improving basic standards of TB care can attract more patients by ensuring that they receive the care that they deserve and     that providers offer better services, improve adherence, diagnosis and treatment, and reduce lost to follow-up rate, ultimately contributing to  reducing the burden of TB disease.

Nigeria ranks as one of the high-burden TB countries in the world and contributed 4% of all TB cases in 2017, ranking her in the 6th position globally in terms of percentage contribution.

Catching them early

Standards set by the International Standards for Tuberculosis Care (ISTC) provide a reference point for assessing provider or system performance and quality of care which help to identify the current and expected levels of quality in health care delivery. The failure of providers or systems to adhere to the defined standards of diagnosis, care and treatment of TB compromises the quality of services provided to the patients.

Understanding the quality of care will enable policy makers and program implementers to strengthen TB care and prevention, by positively influencing timely diagnosis, treatment adherence, and treatment completion in Nigeria. This brief presents findings from an examination of the adherence of TB services in Nigeria to the international and national standards guidelines to ensure that TB services are delivered in an accessible, timely, safe, effective, efficient and equitable manner.

Quality of Care; Where? How… And then?

Quality of care can be said to consist of three key elements, namely: structure of the resources available at a health facility; process or the interaction between providers and patients; and outcomes or the consequences of care.

In a recent study carried out by the Academy for Health Development (AHEAD) Nigeria, supported by the National Tuberculosis and Leprosy Control Program and Challenge TB project funded by United States Agency for International Development (USAID) and The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), Quality of Care of Tuberculosis was assessed in a total of 144 facilities across 12 states in a bid to understand how care is accessed and received, uncover loopholes and opportunities in the care delivery system and make recommendations for improving the overall access, delivery and outcomes of care and treatment for tuberculosis.

Structure (Where)

Structure includes all of the factors that affect the context or enabling environment in which care is delivered. This includes the physical facility, equipment and human resources as well as organizational characteristics such as staff training and supervision. We measured structure through  the availability of services, infrastructure, capacity of TB providers, and management of TB services.

TB drug supply

The NTBLCP continues to address challenges to the maintenance of an uninterrupted supply of anti-TB drugs by working to improve stock status at the state and LGA levels, train staff on proper anti-TB drug stock management, and advocate at the Federal and State Ministries of Health to improve and expand storage conditions for anti-TB drugs at all levels. TB drug monitoring mechanisms are in place at different levels to ensure an uninterrupted supply of quality-assured anti-TB drugs, which will help prevent the emergence of drug-resistant TB.

Trained TB Care Providers

Staff training is essential for keeping health workers updated with knowledge, skills, and technical competence to maintain high quality or improve the quality of TB care services. This study assessed whether TB providers received any formal or structured in-service training related to the services they offer in the 24 months preceding the survey.  The findings from the facility audit/checklist (with the health facility unit in-charges as respondents) indicate that a majority of staff (73%) received in-service or training updates on TB care and treatment in the last 24 months.

Process (How)

Process is the sum of the interaction between service providers and patients during which structural inputs from the health care system are transformed into health outcomes. Findings presented measured process through the level of TB awareness among TB patients, patient-provider interaction and communication, barriers to TB care and access to follow-up care.

The most common barrier to accessing TB care mentioned by patients is the distance to the facility providing TB diagnosis and treatment (22%). Lack of adherence   to   a   patient’s   treatment   plan   for   TB   can   lead   to   prolonged infectivity, drug resistance and poor treatment outcomes.

Access to follow-up care through Directly Observed Treatment (DOT) seeks to improve adherence to TB treatment by observing patients while they take their anti-TB medication. This study shows that approximately 40% of patients did not have access to DOT.

Patients on treatment who were observed taking their TB medication by a health care provider (DOT)

Outcome (And then)

Outcome in the context of our conceptual framework refers to the effects of health care on patients, including changes in their health status.

Treatment outcome is defined based on the 2013 WHO definitions that have two broad classifications namely; treatment success and unsuccessful treatment  outcomes. In addition, the two classifications are sub-divided into 6 distinct outcomes, namely; cured, treatment completed, died, treatment failure, loss to follow-up, and not evaluated.   The addition of “cured” and “treatment completed’ is defined as treatment success. Patients with PTB with bacteriologically confirmed TB at the beginning of the treatment who had proven negative microbiological results upon completing treatment are defined as cured. Treatment completed is used  for the patients with no evidence of clinical failure, but without the record to show negative microbiological results after taking anti-TB drugs for the prescribed length of time, either because tests were not performed or because no biological material was available (e.g., patient without sputum production). Patients with treatment outcome such as treatment failure, death, loss-to-follow-up and not evaluated are classified as unsuccessful. A patient that failed to appear in the health facility for more than 2 consecutive months after the scheduled appointment is referred to as  lost to follow-up.  If a patient dies for any reason during the treatment, the outcome  is classified as died.

For patients that move to another health clinic regardless of the cause, the outcome is defined as transferred. Patients transferred out are excluded from the analysis because of the challenges of determining the outcome based on the WHO definition. Outcomes are classified as treatment failure if a patient has positive sputum smears throughout the treatment period or at the end of treatment (even if the patient initially converted from positive to negative). Patients without treatment outcomes are classified as not evaluated either because the tests were not performed or have not completed the treatment.

 

RECOMMENDATIONS

A key policy outlined in this study is the need to improve the factors highlighted that affect the quality of care. Availability of proper equipment and an increase in service providers for tuberculosis will be effective in addressing the needs of the number of identified patients and enable better detection and identification  of  otherwise  missing cases. This recommendation can be achieved through the following ways:

  • Collaboration with private health organizations at the state and local government levels for more primary facilities to be set up in the rural areas with emphasis placed on  reduction  of  patients’  commute  time  and  increment  of  health  service providers at

The study showed that only 14% of facilities had been implementing risk assessment for TB infection, prevention, and control annually. This statistic can be improved by including in the supervision carried out by the LGTBLS, the assessment of the availability of other important documents such as up-to-date  TB policies and guidelines.

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ADVANCING ADOLESCENT AND YOUTH REPRODUCTIVE HEALTH ADVOCACY IN NIGERIA THROUGH EVIDENCE-BASED FAMILY AND LIFE PLANNING INITIATIVES (PROJECT AAYRHAN)

A call for expression of interest is being made to youth organisations based in Lagos, with over 10 members, who are engaged in young people programme implementation; youth sexual and reproductive health; HIV/AIDS, family planning and youth advocacy. Eligible organisations with track record that meets the stated criteria should apply. A team of 40 young people would be chosen from across organisations to build the Family Planning Youth Advocates for the project.

Comprehensive training on leadership skills, developing high impact action plans, Lagos State family planning policies and programmes, developing an issue brief and policy brief on family planning issues in Lagos, amongst others, would be held for the Family Planning Youth Advocates. Furthermore, the Youth Advocates would be engaged in programme implementation, conducting research, advocacy visits to policymakers and duty bearers on Family planning in Lagos State during the period of the project.

We believe that if the capacity of young people and organisations with potentials for impact in the Adolescent and Youth Sexual and Reproductive Health (AYSRH)  field is built in identifying, tracking and advocating for youth focused family planning policies in Lagos, then there would be (i) more empowered young people with capacity to drive relevant changes and influence their peers, (ii) awareness and monitoring of the implementation of youth related family planning policies in Lagos, and (iii) effective implementation and accountability of youth related family planning policies in Lagos State.

NEW DATE!
Registration is open until August 7th, 2019!

INSTRUCTION TO PARTICIPATE

1. ELIGIBILITY
* Advocate organisation must have made significant contributions to  family planning  in any of the following categories: Advocacy, Programming/Program Implementation, Research, Service Delivery, Demand Generation, Policy/Government, Media
* Advocate organisation must have staff within the age range of 15 – 30 years old
* Advocate organisation must be committed to release selected staff for project activities within Lagos whenever is required within the project time line of July 2019 to December 2019

2. RECORD A MINUTE PITCH (VIDEO) HIGHLIGHTING HOW YOUR ORGANISATION HAVE MADE SIGNIFICANT CONTRIBUTIONS TO FAMILY PLANNING IN ANY OF THE CATEGORIES ABOVE!

* Follow us @ahead_nigeria on our Social platforms,
* Tag us in your video using hashtag #AheadFPAdvocate
3. Download Statement of Support and Signatures of Head and Key Persons in the Organisation Here. It’s a prequisite for submitting your form!

Download Statement of Support

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Starting Right at School (StaRS): To This Point

The Starting Right at School (StaRS) Project is a study aimed at understanding the gender socialization norm among very young adolescents. It is funded by the International Development Research Centre (IDRC) and implemented in three different countries. In Nigeria, it is currently being carried out by the Academy for Health Development (AHEAD) in Osun state, Nigeria.

The project which is comprised of 3 stages; baseline, intervention and endline phases has just rounded up the baseline phase.

BASELINE

STEP 1: FIELD WORK

In January following a week-long training of research assistants, field work was carried out in 8 selected schools (5 served as control schools and 3 served as intervention schools). Using a questionnaire developed by the World Health Organization and adapted by AHEAD, the researchers sought to understand the young adolescents’ point of view on sexual and reproductive health, gender norms, bullying and violence and other matters regarding gender socialization. A total of 1032 adolescents were interviewed.

Following this, a few of the young adolescents were selected and taught the art of photovoice and how it can be used as a tool for advocacy.

The students then went into their schools and communities and identified and photographed issues surrounding sexual and reproductive health, gender socialization and gender norms.

STEP 2: ANALYSIS

The study analysis showed that of the 1032 students interviewed in the 8 schools studied, 3.49% of students had had sexual intercourse while about 9.3% claimed to have friends or know someone who had had sexual intercourse.

The boys who reported experiencing bullying were about 82.3% of those interviewed and 81.3% of girls interviewed reported the same. This is similar to global statistics.

STEP 3: COMMUNITY DIALOGUE

In June, after analysis of the results had been done, AHEAD invited the students, parents, teachers and principals, school board, education commission and other stake holders to a community dialogue to present the findings from the study, the challenges and risks from the captured gendered norms and their proposed solutions to effectively tackling these issues.The Community dialogue was opened by the Permanent Secretary of State Universal Basic Education Board, represented by the Osun State Middle Schools Director, Mrs A. K. Oladimeji who thanked AHEAD for the initiative. She reminded teachers that a lot of students have more belief in them than in their parents and that even though gender roles are mostly determined by culture, parents and religions, the negative ones need to be rectified.

AHEAD gave a presentation on the objectives of the study and the different stages of the project. It was explained that the community dialogue signified the end of the first stage, the base-line stage and that it would be followed by the implementation and the end-line stages.

A presentation by the students followed immediately, explaining the photos they had taken using photovoice to depict issues surrounding gender socialization and gender norms that they identified in their schools and communities; the pictures were grouped in five thematic areas:

  • Water and Sanitation Hygiene (WASH) Matters, which included pictures of unsanitary toilets and environments,
  • Violence and Bullying which showed images of male and female students bullying their colleagues and students fighting.
  • Safe Environment, revealed pictures of unsafe play areas and potentially dangerous areas in the schools.
  • Gender Equality which depicted images of unfair and unequal treatment of female students such as, boys at play while girls were doing chores, and
  • Gender Sexuality showing images including those of segregation of male and female students in the class and at play.

Days 2 and 3 were aimed at developing interventions; Dr Obioma Uchendu of the Inspire Network gave an insightful presentation on violence in children and adolescents and shared the seven inspire strategies for addressing this problem.

A member of the AHEAD team gave a presentation on identifying and promoting the opportunities that exist for the fostering of gender equity in schools using the Gender Equity Movement in Schools (GEMS) as a reference.

Stakeholders were grouped according to the schools they represented and they discussed and outlined the gender socialization challenges faced by their schools in order of priority; they also shared their visions for the schools and designed a road map tailored after evidence-based strategies for gender-socialization for the realization for the visions shared.

We are moving to the second phase of the StaRS Project; the implementation phase.This will consist of the collaboration of the organization and the school stakeholders to judiciously and effectively channel the funds into selected appropriate and sustainable interventions. Implementation will run for about 6 months after which the endline phase of the project will commence and this will be a post-implementation analysis of the project, its impact and recommendations on sustainability and future projects.

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