Achieving Health Nigeria Initiative

The World Health Organisation’s Global Action Plan (GAP) on antimicrobial resistance (AMR) emphasises the need for awareness, education, and training of health workers. Globally, there are major gaps in AMR awareness and knowledge among pre-service healthcare professionals. This study evaluated the inclusion of AMR content in pre-service pharmacy curricula across five sub-Saharan African universities. This study was part of the award winning One Health Pan-African Internship Program 2020–2021, hosted by the Ducit Blue Foundation in collaboration with the African Regional Office of the International Pharmaceutical Students Federation (IPSF AfRO). Five universities were included based on their students’ participation in the internship programme. The pre-service pharmacy curricula of the universities were evaluated against the WHO AMR training competency framework, followed by inductive thematic analysis, using Microsoft Excel. Results showed limited progress in the inclusion of AMR content in the pre-service curricula. Though some AMR-related topics were present, they were obscured within other subjects. Those topics included were not well aligned with antimicrobial stewardship (AMS) objectives of the AMR Global Action Plan. There are still major gaps in AMR inclusion in pre-service curricula, which may contribute to the poor AMR outcomes seen in sub-Saharan Africa. Feasibility studies are recommended to assess the costs of designing, upgrading, and implementing new curricula. Training and capacity building for pharmacy lecturers and educators are also needed to update their knowledge on current advances in AMR research. Finally, the integration strategy for implementing the curriculum should include both short-term and long-term plans, with regular monitoring and evaluation to ensure that key AMS goals are embedded at the pre-service level.

Global health emergencies consistently expose and exacerbate vaccine inequities, with high-income countries prioritising their populations and leaving low- and middle-income countries (LMICs) facing delays and shortages. Diseases primarily affecting LMICs receive limited attention from global vaccine developers because of perceived low market value and limited financial return, further entrenching these disparities. Africa's limited investment in vaccine manufacturing has heightened its vulnerability during outbreaks, including yellow fever, Ebola, meningococcal meningitis, mpox, and most recently, coronavirus disease 2019 (COVID-19). This study examines the barriers to vaccine equity in Africa and critically analyses Nigeria's post-COVID-19 efforts to establish a viable, local vaccine manufacturing ecosystem. The research focuses on Nigeria within the broader African vaccine manufacturing landscape, using it as a case study to explore both national and continental dynamics. The study draws on document analysis of strategic plans, regulatory reports, and partnership announcements, complemented by qualitative insights from key informant interviews with stakeholders involved in vaccine policy, regulation, and production in Nigeria and across West Africa. Post-pandemic momentum has catalysed significant shifts: Nigeria has developed a national vaccine manufacturing strategy and secured international partnerships and financing commitments. The regulatory authority, National Agency for Food and Drug Administration and Control (NAFDAC), achieved the World Health Organization (WHO) Maturity Level 3 status, marking critical progress. Nonetheless, persistent gaps remain in research and development capacity, workforce development, regulatory agility, and infrastructure readiness. While Nigeria has made notable progress since the COVID-19 pandemic, sustainable vaccine manufacturing requires long-term investment in research and development, policy reform, skills development, and regional cooperation. Failure to address these challenges systematically risks undermining current gains. This article provides insights to support ongoing and future investments in Nigeria's vaccine manufacturing sector, guiding government policy, international partnerships, and potential investors.

Human Papillomavirus (HPV) is the main cause of cervical cancer, particularly in low- and middle-income countries, yet vaccine uptake remains suboptimal. This study assessed the determinants of HPV vaccine uptake among female junior secondary students in Uyo, Akwa Ibom State, Nigeria. A cross-sectional study was conducted among 400 students from May to July 2024 using multi-stage sampling and structured interviewer-administered questionnaires to gather sociodemographic data and evaluate HPV vaccine knowledge, attitudes, and uptake, including barriers to vaccination. Analysis involved descriptive statistics, chi-square tests, and logistic regression using GraphPad Prism 9, with significance at p ≤ 0.05. The study revealed that 37.3% had poor HPV knowledge, 51.3% had fair knowledge, and 11.5% had good knowledge. Although 90% exhibited positive attitudes, only 36.3% had received at least one vaccine dose, and just 5.5% completed the vaccination series. Determinants of HPV vaccine uptake included being a preadolescent at age 9 (aOR = 4.16, 95% CI 1.86–9.57, p = 0.0006), early adolescence at 10–13 years (aOR = 3.01, 1.66–5.70, p = 0.0004), being in JSS1 (aOR = 2.28, 1.14–4.77, p = 0.0231), or JSS2 (aOR = 3.39, 1.62–7.38, p = 0.0015) while students from the Anang ethnic group were significantly less likely to be vaccinated (aOR = 0.15, 0.04–0.49, p = 0.0032). Barriers included limited awareness, logistical challenges, and safety concerns. Despite favourable attitudes, HPV vaccine uptake and completion among students were low, highlighting urgent needs for targeted interventions and improved vaccine accessibility.

High-risk pregnancies contribute significantly to maternal morbidity and mortality in rural Nigeria due to fragmented care and weak referral systems. Primary health centers often lack the resources, training, and specialist linkages needed to manage obstetric emergencies effectively. This manuscript proposes a collaborative care model that strengthens the interface between primary care providers and specialist obstetric services to improve outcomes for high-risk pregnancies in rural settings. We describe a theoretical pilot model involving structured task-sharing, digital triage platforms, and referral coordination through designated family physicians. Key components include WhatsApp-based consultation groups, standardized referral protocols, and quarterly case review meetings between primary and tertiary providers. The model outlines measurable outcomes such as improved referral accuracy, reduced time to definitive care, and enhanced provider confidence. It also identifies implementation challenges including transport delays, network connectivity issues, and role ambiguity among providers. Sustainability requires ongoing training, alignment with national maternal health policies, investment in rural infrastructure, and workforce retention strategies. Embedding such models into existing health systems could bridge critical gaps and reduce preventable maternal deaths. A scalable, collaborative model integrating primary and specialist obstetric care holds promise for addressing systemic delays and improving maternal outcomes in rural Nigeria. Institutional commitment and policy alignment are essential for successful implementation. Keywords: High Risk Pregnancy, Maternal Mortality, Family Physicians, Maternal Health, Primary Care.

Many low- and middle-income countries face an acute teacher-training crisis, with severe shortages of qualified teachers and under-resourced professional development (PD) systems. These deficits undermine instructional quality and student learning, perpetuating a global learning crisis. This paper draws on the author’s experience supporting teacher development through Rotary International and USAID in 19 African and Asian countries, highlighting program design elements (contextualized training, coaching, and adaptive curricula), implementation challenges (resource gaps, logistics, teacher turnover), and documented successes (improved classroom practices, student engagement, and retention). We then review scalable, systemic strategies proven effective in resource-poor settings, such as sustained mentoring, school- or community-based professional learning communities, and practice-based coaching. These approaches—especially when integrated with technology and teacher agency—can enhance instructional quality at scale.Finally, we discuss implications for underserved U.S. districts, which share barriers like chronic underfunding and staffing shortages. Adapting global equity-driven models (e.g. teacher residencies, peer networks, ongoing coaching) could help these districts invest in teachers as the most critical lever for improving student outcomes. Keywords: Low-Resource Education Systems, Education Policy Reform, Equity in Teacher Training, Teacher Professional Development.

Digital health technologies are revolutionizing healthcare delivery in Africa and across the globe. However, their impact on improving care for people living with HIV (PLHIV) in Africa has been relatively unexplored. The UNAIDS 95:95:95 targets face stark drawbacks from poor adherence to antiretroviral therapy (ART) and retention in care. Although digital tools have strengthened the HIV care cascade, particularly at the critical stages of initiation, adherence, and retention, their impact and synergistic potential remain uncertain. This review synthesized African evidence to assess the roles and impact of digital monitoring tools for improving ART adherence and retention among PLHIV in Africa. In addition, it summarizes potential facilitators and barriers to integrating these tools into the HIV care continuum in Africa. A literature search was conducted using PubMed, Google Scholar, Embase, and Cochrane Central. The websites of the World Health Organization (WHO) and the Joint United Nations Program on HIV/AIDS (UNAIDS) were also searched for additional data. The searches were restricted to studies published in English from January 2010 to November 2023. The review identified a significant trend towards utilizing mobile phones, SMS, and web-based applications for ART adherence and retention monitoring in Africa, where the use of mobile devices for periodic reminders and remote counseling has boosted HIV adherence in Nigeria, South Africa, and Uganda to about 75%. Novel interventions encompassing electronic pharmacy refill tracking, tele-counseling, and medication electronic monitoring systems such as smart pill containers have been utilized but with sparse usage. These tools have been invaluable in overcoming the barriers to antiretroviral adherence and retention, such as stigma, the digital divide, privacy concerns, and limited healthcare access. Collaboration between key stakeholders like local health professionals and multinationals is crucial to overcoming these barriers. Furthermore, exploring other potential facilitators, such as tailored intervention and community engagement, is vital for maximizing the impact of these technologies.

This study examines the lessons learnt from the implementation of a surge program in Akwa Ibom State, Nigeria as part of the Strengthening Integrated Delivery of HIV/AIDS Services (SIDHAS) Project. In this analysis, we included all clients who received HIV counseling and testing services, tested HIV positive, and initiated ART in SIDHAS-supported local government areas (LGAs) from April 2017 to March 2021. We employed descriptive and inferential statistics to analyze our results. A total of 2,018,082 persons were tested for HIV. Out of those tested, 102,165 (5.1%) tested HIV-positive. Comparing the pre-surge and post-surge periods, we observed an increase in HIV testing from 490,450 to 2,018,082 (p≤0.031) and in HIV-positive individuals identified from 21,234 to 102,165 (p≤0.001) respectively. Of those newly identified positives during the surge, 98.26% (100,393/102,165) were linked to antiretroviral therapy compared to 99.24% (21,073/21,234) pre-surge. Retention improved from 83.3% to 92.3% (p<0.001), and viral suppression improved from 73.5% to 96.2% (p<0.001). A combination of community and facility-based interventions implemented during the surge was associated with the rapid increase in case finding, retention, and viral suppression; propelling the State towards HIV epidemic control. HIV programs should consider a combination of community and facility-based interventions in their programming.

TB and HIV remain a dangerous duo of significant public health concern across the globe. Both diseases require significant community and health system activities to be successfully managed. TB infection control is an important disease prevention strategy among the general population and among people living with HIV, in cost and management. We undertook to assess the situation of TB infection control at three levels of health care in Cross River State of Nigeria. A qualitative method was used to assess TB infection control (TBIC) knowledge, attitudes, and practices of the health care workers at each of the purposefully selected facilities using a semi-structured questionnaire - University of Calabar Teaching hospital, Calabar; Infectious disease Hospital, Calabar and primary Health Centre, Calabar Municipal, between 15th to 31st November, 2019 in the first phase, and an extension to February, 2020 due to delayed ethical clearance from the University of Calabar Teaching hospital. Data was collected and entered on an excel template and cleaned by trained data entry clerks. Charts and color diagrams were developed to compare specific descriptive data. There is wide variation between the written policies of TB infection control and the practices among health workers. Even though there are strong administrative protocols to support TB infection control in the higher levels of care, it is better practiced in the lower level PHC where the protocols were not spelt out.

Background: Intrapartum asphyxia accounts for the deaths of around 280,000 babies per year. Helping Babies Breathe® (HBB) is an evidence-based global neonatal resuscitation training program. HBB utilizes an in-person dissemination model. However, there are challenges to maintaining training fidelity, data collection, and continuous learning and improvement. Aim: The objective is to develop and test an integrated mobile virtual reality (VR) simulation application (eHBB) and data collection tool (mHBS) for healthcare worker training in neonatal resuscitation. Methods: eHBB, a VR training application developed on the Unreal™ platform and accessible on mobile devices …

Non-communicable diseases (NCDs) are a global health concern as they constitute a leading cause of death for both men and women globally. Non-communicable diseases account for 41 million deaths per year and 71% of all deaths worldwide. In many societies, men tend to enjoy more privileges and opportunities than women, however, this does not necessarily result in better health outcomes for them. Masculinity in many cultures is characterized by risk-enhancing behaviors such as intake of alcohol, smoking, self-medication and, lower rates of medical facility usage. These behaviors predispose to Non-communicable diseases and directly influence the prevalence of the disease in the male gender. In this article, we explore the effect of gender characteristics on the prevalence of this increasing global health challenge.