The novel Coronavirus (COVID-19) has adversely affected the already weak health system in Nigeria. The choice of whether to use vertical or integrated approach in solving health problems is determined by the peculiarity of the challenges. Vertical programs imply a variety of specific interventions that have not been fully integrated into the health system. The COVID-19 response in Nigeria still operates almost a vertical approach which is headed by the Federal Government through the Nigeria Centre for Disease Control (NCDC). Vertical healthcare programs address health problems through the application of specific measure(s). However, vertical approach alone has proved insufficient in the containment and control of COVID-19. The health system with the integrated services option is required in the proper management of COVID-19. The development of strategies by policymakers is required in the integration of COVID-19 response into the national health system.
Background: The declaration of COVID-19 as a public health emergency by the World Health Organization necessitated countries across the globe to implement response and mitigation measures. We aimed to assess the Nigerian government's response following six months of detection of COVID-19 in Nigeria. Methods: A narrative review of existing literature on the topic was done. The authors' opinion as experts supporting the COVID-19 pandemic response was included. The review and opinion were summarized, covering six months of the outbreak response in Nigeria. Results: Contact tracing commenced after identifying the index case of COVID-19 in Nigeria but has been faced with challenges such as inadequate equipment and shortage of funds. School closure was implemented barely three weeks after detecting the index case, but the resumption of terminal classes has been announced recently. The Nigerian government implemented restrictions on gatherings involving up to 11 people after three weeks following the detection of the index case of COVID-19. The lack of enforcement and supervision of gatherings and public events made many individuals disregard the restriction measures. Lockdowns on religious gatherings and public events have been recently eased nationwide, and regulatory measures have been put in place. The Nigerian government implemented bans on international travel from all countries, especially high-risk countries. However, the existence of porous borders limited success, which could have been obtained from the travel ban. Conclusion: COVID-19 mitigation measures should be implemented and reinforced as required nationwide and get provided the needed support. References World Health Organization. COVID-19 public health emergency of international concern (PHEIC) global research and innovation forum, 2020 February 12. In: WHO 2020. 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The COVID-19 pandemic has revealed the massive shortcomings of health systems globally, particularly in Nigeria with weak healthcare infrastructure, high population, and chronic high morbidity and mortality from the double burden of infectious and non-infectious causes. Many routine and elective services were suspended or withdrawn, and existing delivery approaches adapted to the evolving COVID-19 pandemic across all the states in Nigeria. Preventive programs such as screening were completely suspended. The vaccination schedules were missed for many children due to the closure of the immunization clinics. Many Nigerian children being liable to infections, alongside a reduction in the possibility of child survival. Funds to manage the COVID-19 pandemic were donated from internal organizations and corporate agencies. However, the modalities involved in the disbursement of these funds were not publicly revealed by the Nigerian government. Therefore, we recommend optimal allocation of inadequate health resources in ways that maximize health care delivery benefits to the greatest number of people, give priority to the worst off, ensure equality and promote continued care provision for non-COVID-19 conditions, including pregnancy and chronic conditions. To ensure the improved trust of Nigerians and donor agencies and organizations, accountability on all funds should be ensured by the Nigerian government. For this cause, such funds should be committed into the hands of trustworthy and expert finance managers and infectious disease experts.
The lockdown measure in Nigeria has been effective in reducing COVID-19 transmission, with the closure of schools, restricted movements, and recommended homestays. In spite of these benefits, the COVID-19 lockdown has resulted in varying levels of distress among individuals. This letter-to-the-editor aimed to describe the prevalence of domestic violence amid the COVID-19 outbreak, as well as strategies for reducing its effects. The social, economic, and financial distress experienced during the COVID-19 lockdown period between March and July, 2020 has increased the prevalence of domestic violence. The financial difficulty associated with the lockdown has been known to precipitate stress and frustration, and subsequent negative coping mechanisms such as substance abuse and depression; all of which are baseline triggers for domestic violence. Domestic violence could result in impaired mental health states and internet addiction among vulnerable population groups especially women and adolescents. To abate these and other untold consequences of the COVID-19 lockdown, we recommend that support systems, such as counselling and psychotherapy sessions, should be instituted for victims of violence, while legislation are implemented for justice to be served to the perpetrators of violence. Also, social safety nets such as food and cash supply should be provided to low-income members of the population to overcome the economic burden which may culminate in violence amid the COVID-19 pandemic.
This cross-sectional design study examined rural-urban fertility differences in The Gambia. We used the 2019-20 Gambia Demographic and Health Survey data. A multi-stage sampling technique was used to select women of reproductive age (8,747 urban & 3,119 rural). Data were analyzed using descriptive statistics, Kitagawa's Decomposition technique, and the negative binomial (NB) model, α = .05. The mean Children Ever Born (CEB) was higher in the rural (3.25 ± 3.02) than in the urban (2.19 ± 2.45) areas. In the urban and rural areas, 82.8% and 95.1% of women aged 45–49 years who had had three children progressed to fourth birth, respectively. The parity progression rate (λ) was lower in the urban (-0.0647) than in the rural (-0.051). The difference between the standardized fertility rates in rural and urban areas was 83.2 in The Gambia, and the effect of the age composition attributable to this difference was 8.11%. The fertility incidence rate ratio (IRR) was 44% (IRR = 1.440, 95% CI [1.371, 1.513], p < .001) higher in the rural than the urban areas. A similar pattern of rural-urban differences in fertility was observed in the full model. Childbearing progression was higher in rural areas than urban areas and rural-urban differences exist in fertility determinants in The Gambia. Thus, rural-urban-specific fertility reduction programs may address the observed fertility differences in the rural and urban areas in The Gambia.
