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The aim of this study was to explore knowledge, practice of risk and guidelines of the novel corona virus disease (COVID-19) infection among the eye care practitioners and the potential associated factors. A cross-sectional self-administered online survey was distributed via emails and social media networks between 2nd and 18th May 2020 corresponding to the week of the lockdown in Nigeria to eye care practitioners (ECPs). Data for 823 respondents were analyzed. Knowledge and risk practice were categorized as binary outcome and univariate and multivariate linear regression were used to examine the associated factors. The mean score for COVID-19-related knowledge of public health guidelines was high and varied across the ECPs. Ophthalmic Nurses, Ophthalmologists and Optometrists showed higher COVID-19-related knowledge than other ECPs (p < 0.001), particularly those working in the private sector. More than 50% of ECPs stated they provided essential services during the COVID-19 lockdown via physical consultation, particularly the Ophthalmologists. Most respondents reported that the guidelines provided by their Association were useful but expressed their lack of confidence in attending to patients during and after the COVID-19 lockdown. Compared to other ECPs in Nigeria, more Ophthalmic Nurses received training in the use of Personal Protective Equipment (PPE). This survey is the first to assess knowledge, attitudes and practice in response to the COVID-19 pandemic in Nigeria. ECPs in Nigeria displayed good knowledge about COVID-19 and provided eye care services during the COVID-19 lockdown in Nigeria, despite the majority not receiving any training on the use of PPEs with concerns over attending to patients. There is need for the government to strengthen health systems by improving and extending training on standard infection prevention and control measures to ECPs for effective control of the pandemic and in the future as essential health workers.

Background: The outbreak of coronavirus disease (COVID-19) has created a global public health crisis and non-compliance with public health measures to contain the infection poses a challenge to Sub-Saharan African governments. This study investigated the associations between compliance and public opinion on COVID-19 public health containment measures across selected SSA countries. Method: Anonymous online cross-sectional survey was administered to 1779 adults (18 years and older) during the mandatory lockdown period in most African countries (April 18 - May 16, 2020). Respondents were recruited via Facebook, WhatsApp, and authors' networks. Data on participants' socio-demographics, their opinions regarding the precautionary measures against COVID-19, and their compliance with preventive measures were collected. Multiple logistic regression analysis was used to examine the association between compliance and public opinions about COVID-19. Results: Respondents who did not think that public health authorities in their countries were doing enough to control the C0VID-19 outbreak were more likely to attend crowded places (aOR 1.75, 95% CI 1.30-2.35). Those who thought COVID-19 would not remain in their countries (aOR 0.48, 95% CI 0.24 - 0.96) and those who thought self-isolation is not needed during the pandemic (aOR 0.29, 95% CI 0.13 - 0.65) were less likely to encourage others to comply with the strategies put in place to prevent the spread of the disease. Participants who thought the COVID-19 outbreak was dangerous and those wearing medical masks were found to wash their hands with soap under running water. Conclusion: The study showed that public opinion influenced the compliance of individuals to public health measures for containment and mitigation of COVID-19. There is a need to improve compliance by the public.

Mental health and emotional responses to the effects of COVID-19 lockdown in sub-Saharan Africa (SSA) are of serious public health concern and may negatively affect the mental health status of people. Hence, this study assessed the prevalence of mental health symptoms as well as emotional reactions among sub-Saharan Africans (SSAs) and associated factors among SSAs during the COVID19 lockdown period. This was a web-based cross-sectional study on mental health and emotional features from 2005 respondents in seven SSA countries. This study was conducted between 17 April and 17 May 2020 corresponding to the lockdown period in most SSA countries. Respondents aged 18 years and above and the self-reported symptoms were feeling anxious, being worried, angry, bored and frustrated. These were the main outcomes and were treated as dichotomous variables. Univariate and multivariate logistic regression analyses were used to identify the factors associated with these symptoms. We found that over half (52.2%) of the participants reported any of the mental health symptoms and the prevalence of feeling bored was 70.5% followed by feeling anxious (59.1%), being worried (57.5%), frustrated (51.5%) and angry (22.3%) during the COVID-19 pandemic. Multivariate analysis revealed that males, those aged >28 years, those who lived in Central and Southern Africa, those who were not married, the unemployed, those living with more than six persons in a household, had higher odds of mental health and emotional symptoms. Similarly, people who perceived low risk of contracting the infection, and those who thought the pandemic would not continue after the lockdown had higher odds of mental health and emotional symptoms. Health care workers had lower odds for feeling angry than non-healthcare workers. During the COVID-19 lockdown periods in SSA, about one in two participants reported mental health and emotional symptoms. Public health measures can be effectively used to identify target groups for prevention and treatment of mental health and emotional symptoms. Such interventions should be an integral component of SSA governments' response and recovery strategies of any future pandemic.

Comprehensive epidemiological data on prevalence, trends, and determinants of the use of unskilled birth attendants (traditional birth attendants (TBAs) and other unskilled birth attendants) are essential to policy decision-makers and health practitioners, to guide efforts and resource allocation. This study investigated the prevalence, trends, and drivers of the utilization of unskilled birth attendants during democratic governance in Nigeria from 1999 to 2018. The study used the Nigeria Demographic and Health Surveys data for the years 1999 (n = 3552), 2003 (n = 6029), 2008 (n = 28,647), 2013 (n = 31,482), and 2018 (34,193). Multivariate multinomial logistic regression was used to investigate the association between socioeconomic, demographic, health-service, and community-level factors with the utilization of TBAs and other unskilled birth attendants in Nigeria. Between 1999 and 2018, the study showed that the prevalence of TBA-assisted delivery remained unchanged (20.7%; 95% CI: 18.0–23.7% in 1999 and 20.5%; 95% CI: 18.9–22.1% in 2018). The prevalence of other-unskilled-birth-attendant use declined significantly from 45.5% (95% CI: 41.1–49.7%) in 2003 to 36.2% (95% CI: 34.5–38.0%) in 2018. Higher parental education, maternal employment, belonging to rich households, higher maternal age (35–49 years), frequent antenatal care (ANC) (≥4) visits, the proximity of health facilities, and female autonomy in households were associated with lower odds of unskilled birth attendants' utilization. Rural residence, geopolitical region, lower maternal age (15–24 years), and higher birth interval (≥2 years) were associated with higher odds of unskilled-birth-attendant-assisted deliveries. Reducing births assisted by unskilled birth attendants in Nigeria would require prioritized and scaled-up maternal health efforts that target all women, especially those from low socioeconomic backgrounds, those who do not attend antenatal care, and/or those who reside in rural areas.