Background With a high maternal mortality rate of 1047 deaths per 100,000 live births as of 2020 in Nigeria, it is important to understand the underlying factors contributing to the disparities in maternal healthcare access. This study used the latest Multiple Indicator Cluster Survey (MICS) 2021 to examine regional disparities in Antenatal Care utilization in Nigeria. Methods Data for this study was obtained from the Nigeria MICS 2021, a nationally representative household survey that employed a multistage, stratified cluster sampling design. Information on 6998 women of reproductive age between the ages of 15 - 49 was used. The outcome variable was adequate ANC visits defined by at least four visits while the independent variables were the socioeconomic and demographic factors of the mother. Data was analyzed using Statistical Package for the Social Sciences (SPSS) version 27. Descriptive analyses were done and a multivariable binary logistic model determined the adjusted effect of independent variables on adequate ANC visits at a significance level of 0.05. Results The majority of the respondents were between 15-34 years of age. Inadequate utilization of antenatal care was highest in the North West (35.5%) and generally higher in the Northern region when compared to the Southern region. Women from the North West, North East and North Central regions had an inadequate ANC coverage rate of 35.5%, 31.6%, and 27.3% respectively, while for women from the South-South, South East, and South West it was 14.9%, 10.3% and 10.0% respectively. The regional disparities varied by education, income, parity, and access to internet and health insurance. Women with primary, secondary, and tertiary education from the South-South were 2.2, 1.6, and 6.7 times respectively, more likely to adequately use ANC than those with no formal education. Conclusions We found persisting regional disparities in antenatal care utilization in Nigeria. Hence, a need for evidence-based interventions tailored to address the unique challenges faced by each region to ensure equitable access to maternal healthcare services.

This study assessed the usability, satisfaction, and acceptability of a 5G-enabled telemedicine service among Internally Displaced Persons (IDPs) in Abuja, Nigeria. A quantitative pre–post design was employed, with baseline and endline data collected from 75 participants who completed telemedicine consultations. Structured Likert-scale questionnaires captured demographics, access to mobile devices, and telemedicine outcomes. Data were analyzed using paired-samples t-tests, independent-samples t-tests, one-way ANOVA, and Pearson correlations. Participants were predominantly female (69.3%) and aged 40–49 years (29.3%). Most had secondary education (36.0%), and 60% had lived in the camp for over two years. Only 2.7% reported regular electricity access, while 21.3% owned a device suitable for telemedicine consultations. Mean usability scores increased from 77.16 (SD = 10.68) at baseline to 83.83 (SD = 10.86) at endline (t = 3.85, p < .001). Satisfaction improved from 42.07 (SD = 9.35) to 47.53 (SD = 8.56) (t = 3.60, p = .001), and acceptability rose from 39.08 (SD = 6.12) to 43.03 (SD = 5.19) (t = 4.05, p < .001). While improvements were consistent across age groups, variations were observed by gender, device ownership, and electricity access, with greater gains among males and participants with better access. Strong positive correlations were observed between usability and satisfaction (r = 0.751), usability and acceptability (r = 0.849), and satisfaction and acceptability (r = 0.797). Overall, a nurse- and translator-supported teleconsultation service delivered over a 5G network was feasible and was associated with short-term positive changes in self-reported usability, satisfaction, and acceptability among a self-selected group of IDPs in this resource-constrained setting, despite limited infrastructure and access barriers; in the absence of a control group, causal attribution of these improvements to 5G connectivity specifically is not possible from this design.

Abstract Depression is a leading contributor to the global burden of disease, yet its recognition and diagnosis remain significantly constrained in low- and middle-income countries (LMICs) due to structural, cultural, and linguistic barriers. This case study examines a lived-experience-informed initiative conducted in Nigeria, exploring how depression is experienced, expressed, and interpreted through Nigerian Pidgin English and how these expressions inform culturally responsive mental health assessment and communication strategies. The initiative engaged six adults with lived experience of depression in repeated, longitudinal group discussions over a 3-month period across South-West and North-Central Nigeria. Through iterative dialogue and participatory reflection, participants generated, refined, and collectively validated culturally grounded expressions of depressive experience, mapping these onto established diagnostic constructs, particularly those represented in the Patient Health Questionnaire-9 (PHQ-9). Findings demonstrate that depression is primarily conceptualised and communicated through idioms of distress such as “life just dey dry” and “you no get ginger,” which reflect disruptions in emotional vitality, motivation, cognition, and socially embedded self-perception. The case highlights how linguistic misalignment between clinical frameworks and everyday communication constitutes a structural barrier to recognition and help-seeking. It further illustrates how participatory language adaptation offers a pathway for enhancing the cultural validity, accessibility, and effectiveness of mental health interventions. The lessons derived provide actionable insights for policymakers, practitioners, and researchers seeking to design scalable, culturally grounded mental health strategies in resource-constrained settings. Information © The Authors 2026

Despite global efforts, inadequate antenatal care (ANC) utilization remains a significant public health challenge in Nigeria. This study examined the determinants of ANC utilization using the 2023/2024 Nigeria Demographic and Health Survey (NDHS). A secondary analysis of 13,026 pregnancies from the NDHS Pregnancy Recode file was conducted. ANC utilization was categorized as no ANC, some ANC (1–7 visits), and appropriate ANC (≥ 8 contacts in line with WHO recommendations). Independent variables included maternal age, residence, region, religion, education, partner’s education and occupation, wealth index, and perceived distance to health facilities. Multinomial logistic regression was used to estimate Relative Risk Ratios (RRR) with 95

The rapid expansion of informal settlements and slums in southwestern Nigeria, particularly along the Lagos-Ogun-Oyo corridor, underscores the critical challenges posed by rapid urbanisation and population growth in this major economic hub of West Africa. This corridor, home to key infrastructure, industries, and economic activities, has seen a significant rise in unplanned communities due to its economic opportunities. In particular, Ogun and Oyo states, both sharing borders with Lagos, have become hotspots of these communities, characterised by inadequate housing, poor sanitation, unsafe drinking water, and heightened vulnerability to climate-related hazards. In this viewpoint, we examine the health and environmental challenges faced by residents in these informal settlements, including respiratory illnesses, waterborne diseases, and climate-related health risks exacerbated by poor air quality and extreme heat. Despite various research efforts, policy reforms, and programmatic interventions, challenges such as limited funding, inadequate enforcement, and a lack of coordination among stakeholders persist. We propose a holistic, multi-sectoral approach that could improve living standards and health outcomes through community empowerment, participatory urban planning, microfinance initiatives, and climate resilience programmes. We note that this requires collaborative efforts from government, non-governmental organisations, and local residents to create sustainable and resilient urban environments.

Introduction:Nigeria ranks second in Africa for the highest number of mpox cases. This study aimed to evaluate the knowledge and awareness of mpox among Nigerians living in endemic regions and their willingness to accept the mpox vaccine when available. Methods:we conducted a cross-sectional study using a multi-stage sampling technique. Data was collected from eligible individuals in Bayelsa, Delta, Lagos, and Rivers, Nigeria, between September 1 and November 30, 2023, using a standardized structured questionnaire. Descriptive analysis was conducted, and inferential analyses were performed using binary logistic regression (p < 0.05). Results:five hundred and twenty-four (524) persons with a mean age of 33.9 ± 10.4 years participated in this study. Fifty-eight percent (58%) were aware of mpox, and 15.5% of participants had heard about the mpox vaccine. Participants from Delta State were 70 percent less likely, while those from Lagos and Rivers States were 2.5 times and 1.04 times, respectively (OR= 2.48, p=0.012; OR= 1.04, p=0.89) more likely to receive the mpox vaccine when compared with participants from Bayelsa State. Eighty-four (84.5%) of respondents were unwilling to take the vaccine if they had to pay for it. Conclusion:although many people were aware of the mpox infection, only a few people were aware of the vaccine. Health intervention programs to improve knowledge of mpox and increase the uptake of mpox vaccines should be co-designed with community stakeholders, while mpox vaccines, when available, should be made accessible at subsidized or at no cost to Nigerians to improve uptake.

According to the 2018 Nigeria Demographic and Health Survey, 19

Objectives: Persons with disabilities (PWD) often experience risks associated with HIV/AIDS including unmet needs and overlooked stigmatization. This could be attributed to certain misconceptions such as PWDs are asexual, and cannot enjoy sexual pleasure, among others. Therefore, this paper sought to investigate the extent of disability inclusion in recent National Strategic Plans (NSPs) for HIV/AIDS in West African countries. Methods: This study was a policy review of NSPs in 13 African countries. Relevant indicators in the UN Convention on the Rights of Persons with Disabilities and the UNAIDS International Guidelines on HIV and Human Rights were used. Six indicators (identification of people living with disability (PLWD) as a key population, the inclusion of principles related to PWD within the NSPs on HIV/AIDS, protecting the rights of PWD, recognition of PWD as a vulnerable population at higher risk of HIV and in need of special protection, providing HIV-related support services for PWD and monitoring and evaluating the impact of HIV on PWD). Results: Findings from this study revealed that only 30% of West African countries recognized disability as an issue of concern. Also, 38.5% of these countries recognize the vulnerability of people with disabilities to HIV. However, only a few (7.6%) provided support in the context of special needs, monitoring, and surveillance specifically for persons with disabilities. Conclusion: Most of the West African NSPs are outdated and due for renewal. Therefore, it is necessary to integrate the needs of persons with disabilities within the context of HIV/AIDS in the NSPs. More importantly, support and services should also be prioritized among the vulnerable groups to optimize inclusion.

Objective: To investigate the level of mental health literacy (MHL) along with the prevalence, severity, and determinants of post-traumatic stress disorder (PTSD) and depression among internally displaced persons in IDP in Northern Nigeria.Methods: A cross-sectional research with a well-structured questionnaire translated into Hausa Language was used to assess mental health literacy, depression, and post-traumatic stress disorder among young (13-24 years) internally displaced persons (IDP) in the New Kuchingoro and Durumi IDP camps using Mental Health Literacy Questionnaire (MHLQ), Patient Health Questionnaire (PHQ-9), and the Short Post-Traumatic Stress Disorder Rating Interview (SPRINT) respectively. Data were analyzed using descriptive statistics, Chi-square test, and regression analysis at p<0.05. Statistical Package for Social Sciences (SPSS) Version 25.0 was used for analysis.Result: Of the Six hundred and thirty-seven (637) respondents, 46.5% were between 20-24 years of age, 54.8% were males, 47.1% were students and 32.8% had secondary school education. 72.4% had poor knowledge on Mental Health while 27.6% had good mental health knowledge. Respondents between 15-19 years were 1.6 times more likely to have good mental health literacy (OR=1.625, p=0.044, CI=1.013-2.609). 54.6% were depressed, 19.9% had PTSD symptoms and 16% reported a double burden of depression and PTSD. Respondents involved in petty trading were 14.3 times more likely to have severe depression (OR=14.273, p=0.011, CI=1.832-111.211). Respondents with good mental health literacy were 95.3% and 92.1% times less likely to have PTSD and depression respectively (OR= 0.047, p<0.001, CI=0.015-0.150; OR= 0.079, p<0.001, CI=0.050-0.125). Depressed IDPs were 4.3 times more likely to have PTSD (OR= 4.379, p<0.001, CI=2.735-7.010).Conclusion: Due to the positive impact of high MHL on mental health outcomes, mental health literacy should be encouraged not just for IDPs but for the general population as well as, design and implement interventions to mitigate the effects of displacement on IDPs` mental health.

Immunization plays a significant role in global health, yet many children in Nigeria do not receive full immunization due to several influencing factors. Therefore, this study examined the trends in Nigeria’s full immunization coverage and identified key predictors that influence full coverage. The data for children aged one to five years, across the six geopolitical zones of Nigeria was retrieved from the 2007, 2011, 2016/17, and 2021 national Multiple Indicator Cluster surveys We analyzed the data using univariate logistic regression. Results were presented as adjusted odds ratios (aORs), and statistical significance was set at 0.05. The results showed that 12,229 children (74.2

Depression is prevalent among internally displaced persons (IDPs). Yet, mental health services are scarce among IDPs in low-and-middle-income countries. This study assessed the effectiveness of a task-shifting based mental health intervention on the severity of depressive symptoms among young IDPs in Northern Nigeria. This was quasi-experimental study design (one-group pre-test and post-test design). The Patient Health Questionnaire (PHQ-9) was used to assess the severity of Depression prior (and after) to the program implementation and 100 young IDPs aged 13-24 years who had mild to moderate Depression were the study participants. The Brave Heart intervention adopted a task-shifting approach where 20 trained community members provided mental health therapy sessions to the participants. Data analysis was done using SPSS version 26. Paired t-test was used to analyze the difference between the baseline and endline scores (p < 0.001). Out of the 83 young IDPs that completed the post-test assessment in this study, some (43.4%) were aged 20-24 years and 51.8% of them were males. There was a significant difference between the depression baseline and endline mean scores across the different age groups (p<0.001), gender (p<0.001), and level of education (p<0.001). There was a significant difference between the overall depression mean score at the baseline and end-line levels (p=0.001). The Brave Heart intervention was effective in reducing the severity of depression among young people living in IDP camps. There is a need for health stakeholders to adopt this program in other hard-to-reach communities where mental health services are scarce.

The resurgence of Mpox (formerly known as Monkeypox) in Africa, marked by a 160% increase in cases and a 19% rise in deaths in 2024 compared to the previous year, is driven by the emergence of a more virulent clade 1b variant. This resurgence, declared a Public Health Emergency of International Concern by the World Health Organization, highlights the persistent challenges in global health equity, particularly in vaccine distribution, public health infrastructure, and surveillance. Drawing from historical lessons, including vaccine inequity during the COVID-19 pandemic and delayed responses in past outbreaks, this paper outlines critical strategies for addressing the current crisis. These strategies include strengthening vaccine equity and access, enhancing community-level surveillance, promoting research and development, implementing comprehensive public health campaigns, and addressing environmental factors that facilitate outbreaks. The paper emphasizes the need for international solidarity and support, proposing the establishment of a global accord to ensure equitable sharing of resources during health emergencies and to prevent low- and middle-income countries from being left behind.

Background: Nigeria records considerable morbidity and mortality from tetanus, predominantly in newborns and women of reproductive age group. This is largely due to poor tetanus toxoid-containing vaccine (TTCV) uptake. This study investigated the factors influencing the uptake of adequate Tetanus toxoid vaccination among women in their last pregnancy in Nigeria. Methods: This descriptive cross-sectional study used data sets extracted from the Nigeria Multiple Indicator Cluster Survey. It includes data collected from 4,855 women, aged 15-49 years across the six geopolitical zones in Nigeria. Data analysis, chi-square test and logistic regression analysis were then performed. Results: Out of the 4,855 women recruited, slightly half of the respondents (51.7%) were between the ages of 25 and 34. All respondents had tetanus injections, the majority of which (86.7%) were adequate. Some factors identified to influence TTCV uptake positively were younger age group (p<0.001, OR=1.377), tertiary education (p<0.001, OR=2.093), wealth (p<0.001, OR=2.217), owning an immunisation card (p<0.001, OR=0.69), exposure to radio and television (p<0.001, OR=1.749), residence in southern Nigeria (p=0.020, OR=1.571), prenatal care (p=0.019, OR=0.585) and delivery in health care facility (p<0.019, OR=0.448). Conclusion: This study found that the TTCV uptake in Nigeria among mothers in their last pregnancy was in keeping with the standard recommended by WHO for any country aspiring to eliminate maternal and neonatal tetanus. However, the lowest uptake was observed in the Northern region. We recommend that national policies on maternal and child care should be reviewed to improve TTCV uptake and aid the elimination of maternal and neonatal tetanus across all geopolitical zones in Nigeria.

Measles remains a critical public health threat in Nigeria, with high incidence rates and low vaccination coverage, particularly in the northern zones. This study identifies the drivers of measles outbreaks in Nigeria and proposes short-term and long-term strategies to combat recurrent measles outbreaks. This study was conducted using a review of existing literature and data on measles outbreaks, vaccination coverage, and healthcare infrastructure in Nigeria. Low vaccination coverage, vaccine hesitancy, inadequate healthcare infrastructure, and socioeconomic determinants are key drivers of measles outbreaks in Nigeria. Short-term strategies include enhancing public awareness and community engagement, improving surveillance and case management, ensuring the availability of medications and medical supplies, and strengthening laboratory diagnostic capacity. Long-term strategies include strengthening routine immunization services, addressing vaccine hesitancy, improving disease surveillance and reporting systems, addressing socioeconomic determinants of health, and fostering multisectoral collaboration and coordination. Measles outbreaks in Nigeria can be combated through a combination of short-term and long-term strategies that address the root causes of the problem. Policy implications include improving measles vaccination coverage, strengthening healthcare infrastructure, and building public and government trust.

Many African nations have developed national eHealth strategies to harness the benefits of digital health solutions. Our study assessed the current state of national eHealth strategies in Africa. A systematic search identified publicly available national eHealth strategy documents published from 2000 to 2023 in Africa. The documents were independently reviewed and scored using the eHealth National Strategy Rating Tool, developed using the WHO-ITU national eHealth strategy toolkit and the Findability, Accessibility, Interoperability and Reusability Guidelines. The eHealth National Strategy Rating Tool covered five domains: (i) eHealth national vision and strategy, (ii) implementation plan, (iii) monitoring and evaluation component, (iv) Findability, Accessibility, Interoperability and Reusability mention and (v) recency of policy development. The study followed a rigorous five-step methodological approach proposed by Arksey & O'Malley (2005). This study found the national eHealth strategies for 34 African countries, with only 16 updated to cover the year 2023 or beyond. Significant variability in the quality and comprehensiveness of national eHealth strategies was observed. Nine countries had 'strong', 17 had 'moderate', and eight had 'weak' eHealth strategies. Critical gaps were identified in the implementation plan, monitoring and evaluation, and the alignment of policies with the Findability, Accessibility, Interoperability and Reusability data principles. Addressing the gaps identified in the development and implementation of national eHealth strategies across Africa by aligning national strategies with global best practices will be crucial for African nations to harness the transformative potential of digital technologies and ensure equitable access to quality healthcare for their populations.

BACKGROUND:70% of children with obesity and overweight live in low-income and middle-income countries. Several interventions have been done to reduce the prevalence of childhood obesity and prevent incident cases. Hence, we did a systematic review and meta-analysis to determine the effectiveness of these interventions in reducing and preventing childhood obesity. METHODS:We conducted a search for randomised controlled trials and quantitative non-randomised studies published on MEDLINE, Embase, Web of Science, and PsycINFO databases between Jan 1, 2010, and Nov 1, 2022. We included interventional studies on the prevention and control of obesity in children up to age 12 years in low-income and middle-income countries. Quality appraisal was performed using Cochrane's risk-of-bias tools. We did three-level random-effects meta-analyses and explored the heterogeneity of studies included. We excluded critical risk-of-bias studies from primary analyses. We assessed the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation. FINDINGS:The search generated 12 104 studies, of which eight studies were included involving 5734 children. Six studies were based on obesity prevention, most of which targeted behavioural changes with a focus on counselling and diet, and a significant reduction in BMI was observed (standardised mean difference 2·04 [95% CI 1·01-3·08]; p<0·001). In contrast, only two studies focused on the control of childhood obesity; the overall effect of the interventions in these studies was not significant (p=0·38). The combined studies of prevention and control had a significant overall effect, with study-specific estimates ranging between 0·23 and 3·10, albeit with a high statistical heterogeneity (I2>75%). INTERPRETATION:Preventive interventions, such as behavioural change and diet modification, are more effective than control interventions in reducing and preventing childhood obesity. FUNDING:None.

The reemergence of the monkeypox (MPX) virus poses a serious threat to global health security. While the first human case was reported in Democratic Republic of Congo in 1970, a recent outbreak of this disease in May 2022 has gone 'viral,' spreading to most continents and occurring in nonendemic countries. Outside Africa, there have been reports of cases of MPX in countries such as Singapore in May 2019, Israel in September 2018, UK in September 2018, among others which have been traced back to importation of infected wild rodents from Africa. The Centers for Disease Control and Prevention (CDC) recommends that the standard laboratory facility to carry out MPX tests is Biosafety Containment Level (BSL)-2 working standards if the laboratory staff has taken smallpox vaccine within the last 3 years and BSL-3 working standards if the laboratory staff has not taken the smallpox vaccine. However, African countries have a shortage of BSL laboratories. Hence, there is a need to improve the integrated surveillance of the MPX virus, strengthen diagnostic capacity, capacity building of health workforce, public education programs, fund research, and development, among others. Leveraging a 'One Health' approach will offer fresh insight into the human-animal-environment interface and boost the understanding on the possibility and mechanisms of spillback and reverse zoonosis as well as disease severity and risk factors for severe disease as well as its epidemiology in various subpopulations. Not leaving Africa behind in the prevention, diagnosis, and management of MPX is important to stopping the spread and reemergence of this virus.

# Background Despite the potential benefits of the Minimum Acceptable Diet (MAD) guidelines, the uptake has been low in many parts of Africa, where malnutrition is on the rise. This study assessed the predictors and the status of MAD among children aged 6-23 months in Nigeria. # Methods This quantitative cross-sectional study used data from the nationally representative Nigeria Multiple Indicator Cluster Survey (MICS), 2021. From the dataset, 2622 children were eligible for the study. The outcome variable was MAD while the explanatory variables were grouped into child variables, maternal variables, and household variables. Data were analyzed using SPSS version 26 and univariate analysis, chi-square tests, and bivariate logistic regression were used for inferential statistics. # Results More than one-third (40.7%) of the mothers do not feed their children with a Minimum Acceptable Diet. There was a highly significant relationship between the status of the Minimum Acceptable Diet by region (0.0001), age of the child (0.0001), media exposure (0.001), and institutional delivery (0.042). Logistics regression shows that children from the Northeast, Northwest, south-south, and Southwest are 16%, 16%, 12%, and 41% less likely to receive Minimum Acceptable Diet respectively, and children from the south-eastern region are 60% more likely to receive Minimum Acceptable Diet than children from the Northcentral region. Children aged 6-12 months are 88% more likely to receive a Minimum Acceptable Diet than children aged 12-23 months. # Conclusions Geographical region, child's age, exposure to media, and delivery in a health facility were significant predictors of MAD among children. Therefore, interventions should be channelled towards ensuring increased delivery in healthcare facilities and adequate exposure to media to sensitize women on the MAD.

Introduction In sub-Saharan Africa, children have been reported to have the highest mortality rate, accounting for about 68-86 deaths per 1000 live births. The low immunization rate has made children more vulnerable to diseases such as diarrhea, pneumonia, measles, and many diseases, which has increased the mortality rate among children under-5 years. The objective of this study was to assess the factors that determine the uptake of childhood immunization among rural mothers in Nigeria. Methods This study extracted data from the 2018 National Demographic and Health Survey (NDHS) database and 1426 women (15-49 years) from across the six geopolitical regions of Nigeria were included in the study. The descriptive and inferential data analysis was carried out using the SPSS version 26. Results Slightly above half of the respondents (54%) in the South East are between the ages of 24-34 years. Mothers aged 35-44 years were 1.76 times more likely to receive complete immunization for their children (OR=1.76, CI=1.25-2.48) compared to mothers aged 15-24 years. Mothers who visited antenatal clinics 1-8, and 9 and above times were 4.6 and 8.2 times respectively more likely to receive complete immunization for their children (OR=4.58, CI=3.17-6.61; OR=8.21, CI=5.06-13.31) compared to mothers who did not visit antenatal clinics. Conclusions The findings showed that age, region, education, wealth index, and the number of visits to ANC are the major determinants of the completion of immunization. Interventions should be geared at addressing and educating rural mothers, especially those who are less likely to complete immunization for children.