Publications by authors named "Obinna E Onwujekwe"

Background: Peer education has contributed to increased knowledge and preventive behaviors of adolescents toward reproductive health matters with the unique feature of maintaining peer-to-peer learning ability and sustaining intervention gains. This study examined the factors that predict the agency of in-school adolescents as peer educators on the sexual and reproductive health and rights (SRHR) of adolescents.

Materials And Methods: A cross-sectional study was conducted on 257 adolescent boys and girls, purposively selected from six public secondary schools that had received a package of interventions that aimed to improve peer-to-peer education on SRHR in Ebonyi State, Nigeria.

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Background: This study sought to document and understand facilitators and barriers to producing, translating, and using modeled evidence in decision-making in Burkina Faso, Nigeria, India, and Kenya. We explored researcher-decision-maker engagement mechanisms as key facilitators of evidence use, with a focus on knowledge brokers and boundary organizations.

Methods: The study used sequential mixed methods drawing on data collected from surveys and key informant interviews, complemented by a rapid desk review to map modeling activities and actors.

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Background: Significant gaps in scholarship on the cost-benefit analysis of haemodialysis exist in low-middle-income countries, including Nigeria. The study, therefore, assessed the cost-benefit of haemodialysis compared with comprehensive conservative care (CCC) to determine if haemodialysis is socially worthwhile and justifies public funding in Nigeria.

Methods: The study setting is Abuja, Nigeria.

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Background: Evidence of willingness to pay for kidney replacement therapy is scarce in low-middle-income countries, including Nigeria's Formal Sector Social Health Insurance Programme. The study, therefore, assessed the willingness to pay for haemodialysis among chronic kidney disease patients in Abuja, Nigeria.

Methods: The study adopted a cross-sectional survey design.

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Background: Although the treatment for end-stage renal disease (ESRD) under Nigeria's National Health Insurance Authority is haemodialysis (HD), the cost of managing ESRD is understudied in Nigeria. Therefore, this study estimated the provider and patient direct costs of haemodialysis and managing ESRD in Abuja, Nigeria.

Method: The study was a cross-sectional survey from both healthcare provider and consumer perspectives.

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Background: Coronavirus disease 2019 (COVID-19) exposed weaknesses in the health systems of countries such as Nigeria, which affected the effectiveness of the health system response to the pandemic. This paper provides new knowledge on the level of the availability, effectiveness and equity of resources in response to COVID-19 in Nigeria. This is valuable information for improving the delivery of countermeasures against future pandemics.

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Article Synopsis
  • HIV/AIDS remains a significant public health issue in sub-Saharan Africa, with current efforts falling short of global targets for eradication set by UNAIDS and the SDGs.
  • The study utilized extensive data from various HIV prevalence surveys to estimate localized HIV infection rates across 43 African countries, focusing on specific age and sex groups from 2000 to 2018.
  • Findings revealed wide disparities in HIV prevalence within countries and districts, indicating that age and sex stratification provides more nuanced insights into the epidemic, which can help tailor prevention and treatment efforts more effectively.
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Background: The use of research evidence to inform policy and practice cannot be overemphasized especially in low and middle-income countries (LMICs). To promote the use of research evidence in the provision of health services for enhanced effective control of communicable diseases in developing countries, the World Health Organization (WHO) in collaboration with the Health Policy Research Group (HPRG) commissioned a capacity development workshop in health economics among producers and users of research evidence in the healthcare system of Anambra state, south east Nigeria. This study was aimed to evaluate the impact of the workshop training on selected stakeholders on the use of health economics evidence to inform health policy and practice in the state.

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Article Synopsis
  • The GBD 2019 study systematically estimated the global cancer burden, providing data on incidence, mortality, and disability to help address cancer worldwide.
  • In 2019, an estimated 23.6 million new cancer cases and 10 million cancer deaths occurred globally, marking significant increases in rates since 2010, with cancer becoming a leading cause of both death and disability-adjusted life years (DALYs).
  • The impact of cancer varied across sociodemographic index (SDI) quintiles, with higher SDI areas seeing more new cases, while middle SDI areas experienced more deaths and DALYs, highlighting disparities in cancer burden.
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Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa.

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Objective: To provide an overview of the evidence on the prevalence and pattern of complications among patients treated by traditional bonesetting presenting for modern orthopaedic services in low- and middle-income countries (LMIC).

Methods: Systematic review following PRISMA guidelines. Articles were identified by searching PubMed, Embase, ScienceDirect, SCOPUS, and Web of Science using the keywords "fracture care", "traditional bonesetters" and "complications".

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Health insurance is seen as a pathway to achieving Universal health coverage in low- and middle-income countries. The Nigeria Government has mandated states to set up social health insurance as a mechanism to offer financial protection to her citizens. However, the design of these schemes has been left to individual states.

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Background: Acute tonsillitis has become one of the main reasons why children visit healthcare facilities in Nigeria. Presently, there is no information on the costs of its treatment, and this study aimed at determining these costs.

Methods: The study was conducted in two hospitals located in southeast Nigeria.

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Background: While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria.

Methods: In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation.

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Background: Measles immunization is critical for reducing the societal burden of the disease, especially among children. However, the costs of the measles supplemental immunization activities, which are the main vaccine deployment strategy, are usually high and financing such immunization activities is a serious challenge in Nigeria. In Nigeria, little or no information exists on the costs of measles supplemental immunization activity for planning and sustenance of immunization programmes.

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Background: Nigeria health sector, like that of other sub-Saharan African countries, increasingly faces critical resource constraints. Thus, there is need to seek for ways of improving efficient use of scarce health resources. The aim of this study was to determine resource utilization rate of teaching hospitals in Southeast Nigeria as a means of estimating their efficiency.

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Background: To determine how socioeconomic factors, such as level of education and employment status, affect patient experiences on quality of care for ambulatory healthcare services in teaching hospitals in southeast Nigeria.

Methods: The study is of a cross-sectional design and exit poll was used to collect its data. A pre-tested structured questionnaire was administered to clients accessing care in the outpatient departments of three tertiary hospitals in Nigeria.

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Article Synopsis
  • Injuries significantly impact global health, with the number of injury deaths rising from approximately 4.26 million in 1990 to about 4.48 million in 2017, despite a decline in age-standardized mortality rates.
  • The Global Burden of Disease study measured both fatal and non-fatal injuries through years of life lost (YLLs) and years lived with disability (YLDs), which were combined into disability-adjusted life years (DALYs).
  • While overall injury incidence increased, age-standardized DALYs decreased, indicating a need for ongoing research focused on injury prevention, better data collection, and improving access to medical care in high-burden areas.
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Background: There has been a successful push towards parasitological diagnosis of malaria in Africa, mainly with rapid diagnostic tests (mRDTs), which has reduced over-prescribing of artemisinin-based combination therapies (ACT) to malaria test-negative patients. The effect on prescribing for test-positive patients has received much less attention. Malaria infection in endemic Africa is often most dangerous for young children and those in low-transmission settings.

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Background: The global burden of road injuries is known to follow complex geographical, temporal and demographic patterns. While health loss from road injuries is a major topic of global importance, there has been no recent comprehensive assessment that includes estimates for every age group, sex and country over recent years.

Methods: We used results from the Global Burden of Disease (GBD) 2017 study to report incidence, prevalence, years lived with disability, deaths, years of life lost and disability-adjusted life years for all locations in the GBD 2017 hierarchy from 1990 to 2017 for road injuries.

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Introduction: Out-of-pocket (OOP) payment adversely affects universal financial risk protection (UFRP) and the achievement of Universal Health Coverage (UHC). Since the introduction of a Formal Sector Social Health Insurance Programme (FSSHIP) in Nigeria, the extent to which it has provided UFRP is still largely unknown. This study therefore assessed this from the perspectives of both enrollees and healthcare providers.

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The health system in many parts of Nigeria has been dysfunctional in several domains including financing, human resources, infrastructure, health management information system and hospital services. In an attempt to scale up Maternal and Child Health (MCH) services and ensure efficiency, Ebonyi State Government in Southeast Nigeria provided funding to mission hospitals across the State as a grant. This study used nonparametric method to assess the effect of this public financing on the efficiency of the mission hospitals.

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Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2-to end preventable child deaths by 2030-we need consistently estimated data at the subnational level regarding child mortality rates and trends.

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Article Synopsis
  • Cancer and other noncommunicable diseases (NCDs) pose a significant threat to global development, with slow progress in addressing these issues highlighted by the recent UN meeting; key barriers include a lack of situational analyses and prioritization for effective action against NCDs.* -
  • The study aims to provide comprehensive data on cancer burden across 29 cancer types in 195 countries from 1990 to 2017, utilizing the Global Burden of Disease (GBD) methods to analyze cancer incidence, mortality, and disability metrics.* -
  • In 2017, there were 24.5 million new cancer cases globally, with significant variations based on socio-demographic factors; the majority of cancer-related disabilities stemmed
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Background: The role of governance in strengthening tuberculosis (TB) control has received little research attention. This review provides evidence of how institutional designs and organisational practices influence implementation of the national TB control programme (NTP) in Nigeria.

Main Text: We conducted a scoping review using a five-stage framework to review published and grey literature in English, on implementation of Nigeria's NTP and identified themes related to governance using a health system governance framework.

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