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Improving health outcomes by strengthening public sector capacity in social and behaviour change programming in Nigeria: A qualitative study
No full textObjective: This paper examines the outcomes of the public sector capacity strengthening (PSCS) approach and how they contribute to the promotion of maternal, newborn, and child health, and nutrition (MNCH+N), family planning (FP) and malaria prevention-related outcomes. Design: The qualitative study implemented from July to August of 2022 used the outcome harvesting methodology and key informant interviews to elicit information including most significant change (MSC) stories to evaluate project outcomes over 5 years (2017–2022). Setting: The study was conducted in Sokoto, Kebbi, Nasarawa, Bauchi and Ebonyi states of Nigeria. Participants: The study focused on public sector stakeholders who were exposed to the PSCS intervention and were selected from government agencies. Nine study participants were engaged per state, bringing the total number of participants to 45. Data were analysed thematically and elicited MSC stories were analysed for content. Results: The PSCS approach empowered stakeholders at the individual level to disseminate MNCH+N, FP and malaria prevention messages, monitor health and social and behaviour (SBC) activities and increase the demand for health services. At the organisational level, the approach facilitated coordination of SBC activities, enabled training cascades and promoted adherence to health service guidelines. At the system level, it strengthened ward development committees to address health challenges. Challenges hindering stakeholders’ application of PSCS-acquired skills include inadequate workforce, negative attitudes of health workers, funding constraints, cultural barriers, lack of government ownership and limited accessibility. Conclusions: This study shows that the PSCS approach is an effective model to scale up capacity for SBC in MNCH+N, FP and malaria prevention programmes. In response to documented supply-side challenges impeding the application of gained knowledge and skill, we recommend inclusive health worker recruitment, sensitisation programmes for health workers, government ownership, improved security, healthcare infrastructure and transportation systems
GIRL Center special feature: 2024 impact report
Full text linkThis special feature spotlights GIRL Center\u27s 2024 impact through their three pillars: generating evidence, communicating and convening, and nurturing talent
Climate change and mental health among young people
Full text linkAs part of the Population Council’s work to pursue justice in the face of climate and environmental change, the Population, Environmental Risks, and the Climate Crisis (PERCC) Initiative’s research sheds light on the intersection of climate and young people’s mental health. With the climate crisis intensifying, it is increasingly important to invest in the wellbeing of this generation as their wellbeing is vital to a sustainable future
Evaluation of differentiated service delivery models on HIV treatment retention among key populations in Nigeria: A prospective cohort analysis
No full textIntroduction: Differentiated Service Delivery models (DSD) that cater to the needs of key populations (KP) have shown promise in providing KP-sensitive and KP-tailored care and treatment services. We evaluated the effect of two DSD models on linkage to and retention in treatment in Nigeria. Methods: Between December 2017 and June 2018, newly-diagnosed men who have sex with men (MSM) and female sex workers (FSWs) were enrolled into treatment through two DSD models and followed prospectively for one year. Model 1 was a fully integrated one-stop-shop (OSS) while model 2 was a hybrid HIV prevention and treatment site (DIC). Retention was estimated from drug pick-up records and was defined as being on treatment within 90 days one-year post ART initiation. Cox regression was used to identify the independent effect of the DSD models on retention while probability of being retained in treatment at 1-year was estimated with Kaplan-Meier product limit. Results: A total of 605 newly-diagnosed clients were enrolled into the study (340 in OSS and 265 in DIC; 342 were FSWs, while 263 were MSM). Median age was 26 years for MSM and 30 years for FSWs. Among those linked to treatment, retention was higher in the OSS than in DIC (63% vs. 48%; p = 0.002). Among those not retained, mean days to be lost-to-follow up (LFTU) was 60 days. Controlling for educational level, population type and age, clients who received treatment in M2 were 6 times more likely not to be retained in treatment at the end of 1 year (Hazard ratio 5.89; 95% CI: 1.04–33.16). The Kaplan Meier estimates of the probability of being retained in 6 months, 9 months and 12 months was 0.97, 0.92, 0.80 for the DIC and 1.00, 0.96, 0.91 for the OSS. Conclusion: Linkage to treatment was suboptimal across both models with less than 90% of newly-diagnosed positives initiated on treatment and suggests that facilitated linkage is required to achieve at least 95%. Though retention was higher in the OSS model, both models had an alarmingly short time frame for LTFU and thus intensive monitoring during this phase of treatment is recommended irrespective of the type of DSD. Addressing these gaps will improve service delivery by one stop shops for HIV care and treatment
Vaginal progesterone reduces the risk of preterm birth and adverse perinatal outcomes in singleton gestations with a midtrimester sonographic short cervix (≤25 mm): An updated individual patient data meta-analysis
No full textEnhancing reproductive health among adolescent girls in India: Results of an individualized RCT to study the efficacy of the go Nisha go mobile game
No full textBackground: Adolescent girls in India face significant barriers to accessing sexual and reproductive health (SRH) information and services. Digital interventions, particularly mobile-based ones, promise to deliver SRH education in a fun and engaging manner. These can be offered privately directly to the adolescent, allowing players to ‘experience’ the outcomes of their choices, receive tailored feedback, and the option to ‘try again’. Methods: This study evaluated the efficacy of “Go Nisha GoⓇ” (GNG), a low-end smartphone-based digital game for adolescent girls in India, using a two-armed, encouragement-led, randomized controlled trial (RCT). The study involved 1950 participants from Patna, Jaipur, and Delhi NCR. The intervention group received encouragement to play GNG, while the control group did not. Key constructs measured included menstrual health management (MHM), contraception knowledge, and agency. Data were collected at baseline and a ten-week follow-up. Results: The intervention group showed significant improvements in various MHM parameters, contraception knowledge, and agency outcomes compared to the control group. Overall, 1697 out of 1993 participants completed the study after ten weeks (85%). The intervention group’s awareness of menstrual hygiene products increased from 33 to 92%, while comprehensive knowledge of oral contraceptive pills (OCPs) rose from 2 to 17% (p \u3c 0.0001). Confidence in negotiating contraception use increased from 60 to 85% (p \u3c 0.0001), and the attitude of refusing sex when not ready improved from 61 to 85% (p \u3c 0.0001).The subjects in the game group showed high levels of satisfaction with the app, with 74% discussing the game with others and 66% recommending it. The belief in negotiating marriage decisions with parents also improved more in the intervention group than in the control group. Conclusion: The findings of the first-ever RCT outcome evaluation for a digital mobile game app for enhancing SRH education among adolescent girls in low-resource settings support the efficacy of digital games for health like GNG. The game’s engaging and interactive format effectively communicated complex and sensitive SRH information, empowered participants, and encouraged (p \u3c 0.0001) critical health behaviors through informed decision-making. Future studies could explore the long-term sustainability of behavior changes induced by such interventions and their effectiveness across different settings and populations
Optimized intranasal delivery of segesterone acetate progestin to the brain using nanoemulsions and microemulsions
No full textSegesterone acetate (SA) is a selective and potent progesterone receptor agonist with potential application in the treatment of neurological diseases, such as multiple sclerosis and stroke. In this study, a microemulsion (ME) and three nanoemulsions (NEs) with a target SA concentration of 0.48 mg/g were developed for intranasal administration and extensively characterized regarding their physicochemical properties, stability, antimicrobial activity, and safety (in primary cortical cells, Hen’s Egg Test, MucilAir™ model and in rats). Plasma and brain SA levels were measured 30 and 60 min after intranasal administration in male rats.
The ME and the different NEs exhibited a droplet mean diameter of approximately 20 nm and 100 nm, respectively, with a low polydispersity index (≤ 0.1). Depending on their composition, they had neutral, positive, or negative zeta potentials and varying viscosities. The NEs exhibited good chemical and physical stability for 150–180 days at 4 °C, while the ME required a reduction in initial SA concentration to avoid drug precipitation. The NEs also demonstrated antimicrobial activity, although not ensuring effective antimicrobial preservation. The ME was the least cytotoxic of the formulations in vitro. No significant impairment of olfactory function or histopathological evidence of toxicity was observed in rats following single or repeated administrations of the ME and neutral NE at doses up to 40 µg/kg of SA. After a single intranasal administration of 40 µg/kg, SA brain concentrations exceeded 4 ng/g at 30 min, with no significant differences observed among the different formulation strategies. Notably, the ME led to a higher brain-to-plasma ratio (~ 7) at 30 min and thereby is a promising strategy to increase brain targeting
How frontline communities are protecting SRHR amid climate change: Community solutions and regional insights—Slide deck
No full textApplying Global Evidence to Foster Young People’s Thriving in the US: A Framework for Action
No full textThis blog post originally appeared on the Population Council’s website in October 2025
Effect of malaria training on community healthcare providers’ compliance with malaria treatment guidelines in Nigeria using propensity score matching
No full textCommunity Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) are important primary sources of care for many Nigerians. They are the first line of contact for those seeking advice or treatment for childhood fever. However, the process needs to be strengthened and aligned with the World Health Organization (WHO) malaria treatment guidelines, as these providers currently diagnose based solely on symptoms.
The dataset includes 1,118 CPs and PPMVs who were assessed at baseline from eight states in Nigeria. This comprises of 816 CPs and PPMVs in five intervention states who were self-selected into the study, after expressing interest in participating in the PHC training and the comparison group of 302 CPs and PPMVs drawn from a waiting list of individuals in three other states that were yet to be trained by the IntegratE project in PHC services, using simple random sampling. Baseline and 6-month follow-up data were collected between February 2022 and March 2023, using a structured self-administered questionnaire from both the intervention and comparison groups. The purpose of the study was to examined the effect of the training on relevant outcomes and provided tangible evidence that may inform course correction during project implementation in Nigeria