Assessing Root Causes and Solutions to Address Cross-Programmatic Inefficiencies in a Subnational Health System: A Case Study of Anambra State, Nigeria.

Cross-programmatic inefficiencies are duplications or misalignments that arise from undue fragmentation of health systems by vertical health programs. Identifying and addressing the root causes of cross-programmatic inefficiencies in a health system can ensure more efficient use of resources to make progress toward Universal Health Coverage. This paper examines the root causes of cross-programmatic inefficiencies related to governance and financing in the state health system of Anambra in southeast Nigeria.

Demand and supply side factors that drive delayed referrals from traditional birth attendants to public primary healthcare facilities: Insights from three states in Nigeria.

Despite global efforts encouraging institutional deliveries with skilled attendants, many pregnant women in developing countries such as Nigeria continue to rely on traditional birth attendants (TBAs) for child delivery. Attempts at weeding off TBAs have been firmly resisted by their clients who have developed confidence and trust in their services and herald them as first and trusted responders to child delivery cases. Unfortunately, recent evidence has shown that TBAs in servicing public trust and for other reasons, often do not timely refer their clients to the closest source of formal healthcare-primary healthcare centres (PHCs).

Examining the roles and relationships of actors in community health systems in Nigeria through the lens of the expanded health systems framework.

Background: Community health system (CHS) exists through the actions and activities of different actors within and outside communities. However, these actors, their roles and their relationships with one another have not been properly explored to understand their dynamics in facilitating the effectiveness of CHS. This study identified the actors in CHS, described their roles and their relationships with one another using the expanded health systems framework (EHSF).

Health Workers' Attitudes Toward Adverse Gender Norms and Implications for Young People's Sexual and Reproductive Health in Nigeria.

Background: Adverse gender norms within the health care system are detrimental to the sexual and reproductive health of young people. This study assessed the attitudes of health workers toward adverse gender norms related to intimate partner relationships across three domains: intimate partner violence (IPV); sexuality; and reproductive health behavior.

Methods: A cross-sectional quantitative survey was conducted among 255 health workers in youth-friendly primary health centers in Ebonyi State, Nigeria.