MSc in Global Health
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/7204
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Item IMPACT OF BOKO HARAM INSURGENCY ON CHILDHOOD MALNUTRITION IN NORTH-EAST NIGERIA(2024-02) Unknown authorThe Boko Haram insurgency has greatly impacted Northern Nigeria negatively, with children suffering a significant amount of health burden as a result, especially in terms of nutrition. Available evidence suggests that malnutrition is a major factor responsible for childhood morbidity and mortality. This dissertation critically explores the link between the Boko Haram insurgency and childhood malnutrition in Northeast Nigeria by thoroughly reviewing existing works of literature and analyzing thematically the prevalence of childhood malnutrition in Northeast Nigeria, the pathway between the Boko Haram insurgency and childhood malnutrition, and providing recommendations to curb the identified challenges. Findings confirm that there is a high prevalence of childhood malnutrition in Northeast Nigeria, and the prevalence is higher when compared to other parts of the country. Also, the presence of the Boko Haram conflict, the proximity, and the duration of the experience of conflicts were found to increase the chances of childhood malnutrition. Furthermore, the poor nutritional outcome of the children was closely linked to the disruption of agriculture, illiteracy and low health awareness, displacement, loss of livelihoods, and the destabilization of the health system, which are all consequences of the Boko Haram-caused insecurity. Maternal education, empowerment, and prioritization of children in nutritional interventions are among the recommended comprehensive approaches to solving the challenge. More importantly, a permanent end to the insurgency and improved governance are long-term solutions that could bring a substantial overall reduction of malnutrition of children in Northeast Nigeria.Item PRESENTING THE STATE OF GOLD MINING AFFAIRS IN GHANA: A SCOPING REVIEW TO INFORM NATIONAL POLICY PRIORITIES.(2024-02-12) Unknown authorBackground: Just like any other mineral rich country, Ghana is burdened with huge economic, health, social, and environmental challenges associated with gold mining activities (GMA). Literature shows massive societal gains as the result of the gold mining industry. However, there is substantial gap in literature on the effects and impact of gold mining on community’s health and livelihood. There is also lack of clarity on the response actions being undertaken by key stakeholders such as the government, mining companies and community members to address negative effects. This review therefore presents an overview of how GMA in Ghana affects communities’ health and livelihood and describes the various response actions that stakeholders have resorted to cope, or deal with the negative effects. Methods: Comprehensive literature searches were conducted in 3 databases (PubMed, Medline, and Scopus) and additional sources of evidence sought from 2 Ghana University databases, grey literature, social media, and websites. Data was extracted and imported into Excel for screening and 33 sources of evidence were included in this review. The scoping review was conducted based on the 6-stage methodological framework by Arksey and O’Malley and JBI Manuel for Scoping Reviews synthesis. The review is reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. Results: The analysis of 33 sources of evidence highlights a growing interest in the gold mining industry, with over one-third (19) of the sources published since 2019. This review reveals the complex, non-linear effects of gold mining activities, encompassing reduced agricultural productivity, land-use conflicts, economic challenges, heightened disease burden, and potential health risks. Furthermore, it delineates the distinct roles played by gold mining corporations, the Ghanaian government, and local communities in addressing the adverse impacts of gold mining activities. Research Implication: While there exists a wealth of data on the environmental and health effects of gold mining in Ghana, much of it is derived from laboratory investigations and cross-sectional studies, with disproportionate attention placed on the activities of illegal miners (Galamsey). There are limited studies from community perspectives, so participatory research with communities is needed. The review also highlights the need for implementation research that will measure the effectiveness of interventions in improving economic livelihood, safety, and health of communities. Conclusion: Living in close proximity to gold mining companies exposes individuals and communities to various adverse effects on their health and livelihoods, even if they are not directly engaged in gold mining activities. Therefore, there is a critical need for a national shift in research, interventions, and policies to achieve an equilibrium between socioeconomic gains and health.Item The role of spousal support as a coping mechanism for pregnant women experiencing trauma during the Covid-19 pandemic in the UK(2024-02-19) Unknown authorThe COVID-19 pandemic significantly damaged pregnant women’s mental health, underscoring the critical need for robust support networks. This research adopted a systematic literature review which was based on studies published between 2019 and 2024 that examine the coping mechanisms and support systems available to pregnant women in the UK at the time of the pandemic in a comparable environment, assess their efficacy, and consider the function of spouse support. Key findings from a thematic analysis of recent literature show that social isolation, fear of infection, and limitations on birth partners raised the stress, anxiety, and depression levels of expectant mothers. It was discovered that professional, social, and emotional support networks were crucial for reducing these detrimental impacts. Strong social networks, such as those with family and friends, helped people feel less stressed and anxious, while professional health services offered the assurance and care they needed. Prenatal depression and anxiety were shown to be greatly reduced in pregnant women who received supportive spouse connections and good communication. Additionally, pregnant women's difficulties were greatly alleviated by the availability of health resources, such as online support groups and mental health counselling. Enhancing maternity services, boosting social support networks, fostering partner involvement, promoting health and well-being, strengthening emotional and psychological support are just a few of the recommendations. The results provide insightful information for creating focused interventions and policies to support pregnant women during traumatic situations.Item ASSESSING THE RELATIONSHIP OF FOOD SECURITY, CHILD MENTAL HEALTH, AND DEVELOPMENT IN RURAL NIGERIA: A NARRATIVE REVIEW(2024-02-12) Unknown authorAims: This narrative review aims to critically examine existing literature spanning from 2013 to 2023, focusing on unravelling the intricate connections between food security, child mental health, and development in rural Nigerian settings. Methods: Employing a narrative review methodology, this study carefully selected and analysed six key studies. Diverse research designs, including cross-sectional surveys, descriptive study, and prospective study, were utilised to investigate the relationships between food security, child mental health, and development in rural Nigeria. Results/Findings: The outcomes of the selected studies illuminate multifaceted challenges faced by children in the rural areas of Nigeria. Notable disparities in food security, psychological well-being, and dietary diversity across different regions were identified. The findings underscore the urgent need for context-specific interventions and policies tailored toward addressing the unique socio-economic, geographical, and cultural factors influencing child well-being in rural Nigeria. Discussion: The discussion center on the implications of the research findings, emphasizing the pressing need for targeted interventions to address the identified challenges. It explores the complex interplay of socio-economic, geographical, and cultural factors affecting child well-being, with a focus on how these factors contribute to disparities in food security and mental health outcomes. Conclusion: In conclusion, this review should contribute with insights to the academic discourse, providing guidance for future research endeavours and informing evidence-based strategies. The urgent recommendation is the implementation of context-specific interventions and policies to enhance the overall health and development of children in rural Nigerian settings. The discussion also emphasizes the critical importance of addressing factors such as poor road networks and infrastructure in tackling the deepening food crisis. Finally, it acknowledges the alarming rate of population growth compared to food availability, the conclusion therefore emphasizes the need for comprehensive strategies to alleviate the impact on children, who emerge as the major victims in this complex scenario.Item Unpacking the Impact of Weight Bias on the Provision of Healthcare for Individuals with Obesity in the UK(2024-08-05) Unknown authorBackground: Weight stigma, defined as discriminatory attitudes and behaviours directed towards individuals due to their weight or size, represents a pervasive societal phenomenon with profound implications for public health. Despite efforts to promote size acceptance, anti-fat biases persist across institutional and interpersonal settings, contributing to adverse psychological and physical health ramifications for affected individuals. Objective: This study aimed to synthesise findings from a qualitative secondary analysis of the literature to construct an overarching conceptual model elucidating the cyclical, self-perpetuating nature through which weight stigma operates to exacerbate weight gain and obesity. Methods: A thorough review and synthesis of peer-reviewed studies examining weight stigma's manifestations, theoretical mechanisms of impact, psychological and physiological consequences, and intervention considerations was conducted. Findings were theoretically framed using the Weight-Based Social Identity Threat Model. Results: The analysis identified vital themes illustrating how weight stigma becomes internalised by targets, contributing to physiological stress responses and motivating unhealthy coping behaviours paradoxically linked to further weight gain. This self-perpetuating cycle is driven by weight stigma inducing psychological identity threat, triggering maladaptive coping efforts that enable additional weight gain and reinforce subsequent stigma exposure. Healthcare professionals emerged as perpetrators of weight bias, potentially compromising care quality. Intervention opportunities included provider training, promoting supportive environments, and policy-level initiatives challenging discriminatory practices. Conclusions: Findings underscore weight stigma as a self-reinforcing public health issue warranting prioritisation of comprehensive, multi-level interventions. Disrupting this vicious cycle through interventions targeting individual, institutional, and societal levels is imperative for improving health outcomes, reducing disparities, and promoting more significant equity for individuals across the weight spectrum. Implementing coordinated efforts to mitigate weight stigma's perpetuation demands a reframing of obesity discourse and healthcare practices.Item NIGERIAN COMMUNITY HEALTH WORKERS’ PERSPECTIVES ON MANAGEMENT PRACTICES AND FACTORS AFFECTING THEIR WELLBEING(2024-07) Unknown authorBackground: Universal Health Care (UHC), affordable, quality healthcare for the global population, is dependent on a Primary Health Care (PHC) approach and the availability of Human Resources for Health (HRH). Nigeria suffers high maternal and child mortality rates, as well as the low life expectancies. How far has she come in her efforts to achieve UHC? How are current PHC systems being managed? How is she ensuring the wellbeing of her frontline workers? Aim: To explore current management practices within the primary healthcare system and the wellbeing of frontline workers from the perspectives of Community Health Workers (CHWs), to better understand and document the realities at PHC level. Methods: This was a narrative qualitative study lending concepts from the phenomenological approach. Participants were selected using non-random sampling methods. Data was collected through one-on-one interviews with CHWs using a semi-structured interview guide. The ensuing data was analysed thematically and using rich, thick description. Findings: Despite several effort to strengthen the health system, there are still gross inadequacies partly due to mismanagement. And in a time of global HRH crisis, Nigeria is sitting on an untapped reserve of unemployed and under-employed health workers. Conclusion: The findings show that Nigeria is still far from achieving UHC. Better governance and stable political buy-in are necessary for sustainably strengthening the system. One possible solution towards building HRH could be to harness the potential of underutilised health workers.Item Social Protection Mechanisms to Address Gender Based Violence (GBV) in South Asia: A systematized literature review(2024-08-05) Unknown authorGender Based Violence (GBV) is a global public health problem, with 1 in 3 women having been subjected to it in their lifetimes. Despite growing evidence of the potential of Social Protection (SP) mechanisms to address GBV, efforts to understand the relationship remain insufficient, especially in low-income settings. A Systematized literature review was conducted to explore the benefits and challenges of using SP mechanisms to address GBV in South Asia, with the aim of reflecting on key takeaways for Sri Lanka. Four electronic databases were searched for literature investigating SP programmes aimed at addressing GBV in South Asia. Of the initial 4825 records identified, a total of eleven were selected as they met the inclusion criteria. Data was extracted and analysed using thematic narrative review, drawing on intersectionality theory. Three types of SP programmes were identified; (1) Microfinance, (2) Cash Transfers and (3) Employment Guarantee Schemes. Benefits mainly included a potential reduction in GBV, dowry related violence and household economic stress; and an increase in women’s agency, mobility, financial inclusion, empowerment, decision making, and bargaining power. Potential challenges comprised of increased violence risk due to male roles being threatened in the household, unchanged women’s status at home and in society, added stress of loan repayment, harassment by loan collectors, and increased workplace and street harassment. Women from lower castes, rural locations, low education background and with less media exposure were found be at more risk. Overall, findings indicate that assumptions that SP programmes aimed at increasing economic empowerment of women will reduce GBV must be approached with greater nuance.Item Policy landscape to act on Vaping Among Adults: a comparative review between United Kingdom, United States and New Zealand.(2024-08-05) Unknown authorThis study examines vaping policy landscapes in the UK, the US, and New Zealand, focusing on the complexities and differences in their approaches. The UK prioritizes harm reduction and consumer safety, with 6.4% of young adults reporting vaping. The US grapples with fragmented policies and increasing vaping rates, which have reached 20% among young adults. New Zealand emphasizes evidence-based policies and preventive measures, with 11% of young adults vaping. The comparative review explores adopted policies, assesses the impact of regulations like non- taxation, advertising rules, and age limits on vaping prevalence and perceptions, and identifies unintended consequences. Using a case study approach, the study explores specific environments, regulations, and behaviors regarding vaping among adults in the selected countries. Search following PRISMA guidelines was conducted across prominent scientific databases and additional sources to comprehensively explore the existing body of research related to vaping up to 2024. Findings reveal that the UK's harm reduction strategy has effectively reduced smoking rates to 13.9% while maintaining low adult vaping prevalence at 6.4%. The US faces ongoing challenges due to regulatory inconsistencies and mixed evidence on vaping's role in smoking cessation, with smoking rates at 14% and vaping rates at 20% among young adults. New Zealand has successfully reduced smoking rates to 9.4% through integrated tobacco control strategies and evidence-based public health campaigns, although adult vaping remains a concern at 11% despite strict preventive measures. In conclusion, the study emphasizes the importance of cohesive, evidence-driven regulatory approaches that align public health goals with consumer access and industry innovation. Recommendations include adopting clear, consistent regulations, focusing on public health education, and ensuring that policies are adaptable to new evidence and emerging trends.Item EXPLORING THE SOCIAL SUPPORT FOR PERSONS WITH DISABILITY IN NIGERIA: A NARRATIVE REVIEW OF CHALLENGES AND OPPORTUNITIES FOR ACTION(2024-08-05) Unknown authorBackground: Nigeria has a high prevalence of disability, with one in every ten households affected. The social model of disability suggests that societal exclusion, rather than impairments themselves, poses significant problems for PWDs. Cultural and traditional attitudes in Nigeria are largely negative towards PWDs, contributing to high barriers to their inclusion. Aims/objectives: This study aims to identify the social support or protection available for persons with disability in Nigeria, challenges and recommendations listed across relevant literature. Methods: Narrative analysis was done after comprehensive data searches were conducted using Pubmed, EBSCOhost to access Medline, Cinahl Plus, APA PsycArticles and APA PsycInfo databases and Google Scholar database. Three Hundred Fifty-Nine data sources were screened, and Twenty sources of evidence included in this review. Result: The findings of this review were broken down into two sections such as the governmental support for persons with disability and challenges identified and the non-governmental/community support and challenges identified and organised using the principles of the disability inclusion and accountability framework put forward by the World Bank. There is limited governmental support for PWDs: Nigeria passed a disability legislation but implementation is lagging. There is support from non-governmental sources, but this is challenged by lack of partnership with government. It is also problematic, because it reaffirms harmful stereotypes instead of being empowering. Conclusion and Recommendations: This research presents an up-to-date review on PWDs and supports available in Nigeria. Recommendations include advocacy efforts by civil society and social workers to mount pressure on the government for proper implementation of the disability legislation and for more research directed towards PWDs.Item Retail Pharmacists’ Practices that Contribute to Antimicrobial Resistance in South West Nigeria.(2024-08) Unknown authorIntroduction: Antimicrobial resistance (AMR) accounts for over 700,000 deaths annually and over 263,000 deaths in Nigeria. Objectives: To assess how retail pharmacists’ antibiotic dispensing, purchasing, and disposal practices in South West Region in Nigeria, contribute to antibiotic resistance (ABR) in Nigeria. Method: This is a secondary data analysis of research by Arkland Health Initiative that assessed retail pharmacists’ practices in Nigeria. A subset of the data from the South West region was analysed. Responses collected over a 5-point Likert scale underwent descriptive analysis using SPSS while quotes were analysed using thematic analysis. Results: Almost half (42.7%) of the pharmacists reported dispensing antibiotics without prescription, and only 57.3% always or often performed quality checks to identify substandard or falsified (SF) medicines, which have been associated with AMR. Pharmacists reported never buying medicines not accredited by NAFDAC (53.1%) or from the open market (63.5%), reducing exposure to SF antibiotics. Maximum academic qualifications, years of experience, non-pharmacy ownership of pharmacy, and frequency of consulting ethical guidelines were not statistically associated with pharmacists dispensing antibiotics without prescriptions (P-value > 0.05). Findings revealed that non-prescription antibiotic dispensing (NPAD) was primarily driven by economic reasons, as well as the fear of losing customers, managerial pressure, and poor regulation. This research is limited by a small sample size (n=96) caution is advised in generalising findings. Conclusion: Providing grants to manage retail pharmacies, training on antimicrobial stewardship, imposing sanctions on pharmacists who dispense antibiotics without prescription, and improved regulation are recommended to limit NPAD.