Obinna Onwujekwe

University of Nigeria | UNN · Department of Pharmacology and Therapeutics

Background: Health policymaking is a complex process and analysing the role of evidence is still an evolving area in many low- and middle-income countries. Where evidence is used, it is greatly affected by cognitive and institutional features of the policy process. This paper examines the role of different types of evidence in health policy develo...

West African countries are ranked especially low in global corruption perception indexes. The health sector is often singled out for particular concern given the role of corruption in hampering access to, and utilization of health services, representing a major barrier to progress to universal health coverage and to achieving the health-related Sus...

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 asses...

Background: The need to build capacity for health policy and systems research (HPSR) in low- and middle-income countries has been underscored as this encompasses the processes of decision-making at all levels of the health system. This implementation research project was undertaken in Southeast Nigeria to evaluate whether the capacity-building int...

Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026 Global Burden of Disease 2021 Health Financing Collaborator Network † Show footnotesOpen AccessPublished:January 24, 2023DOI:https://doi.org/10.1016/S2214-109X(23)00007-4 Summary Background The COVID-19 pandemic h...

Background: Security of health facilities in low- and middle-income countries (LMICs) is of vital importance in ensuring that health care can be provided in safe conditions. There is paucity of literature on the issue of threats to the personal safety of primary healthcare (PHC) providers and service users in Nigeria and what should be done. Thus,...

Background There has been an increase in methamphetamine use across the globe, despite widespread control of the drug, prevention, and treatment. Community-based approaches have proven effective in tackling diverse health-related challenges including substance use; however, little is known regarding community programs targeting methamphetamine use....

Background Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustaina...

Patient-centered healthcare is a goal for all health systems. However, given the inherent complexities of the health system as one with many nonlinear and dynamic components, the safety of patients could be affected. Therefore, there is the need to study these complexities to manage them toward optimal service delivery. The present study is a quali...

Background: Primary health centres (PHCs) in Nigeria suffer critical shortages of health workers, aggravated by chronic absenteeism that has been attributed to insufficient resources to govern the system and adequately meet their welfare needs. However, the political drivers of this phenomenon are rarely considered. We have asked how political powe...

Despite substantial declines since 2000, lower respiratory infections (LRIs), diarrhoeal diseases, and malaria remain among the leading causes of nonfatal and fatal disease burden for children under 5 years of age (under 5), primarily in sub-Saharan Africa (SSA). The spatial burden of each of these diseases has been estimated subnationally across S...

Introduction: Sexual and reproductive health of young people involve a lot of stakeholders, traverse different sectors, and cut across all levels of government. For a clearer understanding of the activities of these stakeholders in adolescent sexual and reproductive health (ASRH) services, this paper was designed to explore the positions, attitude...

Background: Studies evaluating immunization data quality and its determinants in low- and middle-income countries are scarce. Aim: Therefore, this study assessed the accuracy of routine immunization data and its associated factors in Enugu State, South-East Nigeria. Materials and methods: This was a descriptive cross-sectional, mixed-method st...

The prevalence of diabetes mellitus and hypertension is increasing yearly in many low- and middle-income countries such as Nigeria. The increasing burden of these noncommunicable diseases has led to an increase in the overall cost of health care. This study aimed at determining the direct and indirect health care costs of diabetes mellitus and hype...

Background: Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age gr...

Background More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehens...

Infection with HIV/AIDS continues to be a major public health concern around the world, particularly in low- and middle-income nations. To assess the effectiveness of structured health education on the prevention of HIV/AIDS risky behaviours among adolescents in secondary school. A pretest-posttest-control group randomized controlled trial where a...

Objectives: This study aims to understand and report on selected health system interventions considered nationally and sub-nationally of particular significance both in terms of COVID-19 responses and in strengthening the health system for the future.Design: A review of published and grey literature, including journals, news/ media and official doc...

Background Sexual and reproductive health choices and behaviors of adolescents are shaped by gender norms and ideologies which are grounded in cultural beliefs. This study examined the perspectives of adolescents about the influence of gender norms and ideologies on sexuality. Methods A cross-sectional study was undertaken in three urban and three...

Background Onchocerciasis is a disease caused by infection with Onchocerca volvulus, which is transmitted to humans via the bite of several species of black fly, and is responsible for permanent blindness or vision loss, as well as severe skin disease. Predominantly endemic in parts of Africa and Yemen, preventive chemotherapy with mass drug admini...

Background: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods:...

Background: Promoting the sub-national ownership of national health initiatives is essential for efforts to achieve national health goals in federal systems where sub-national governments are semi-autonomous. Between 2008 and 2015, Nigerian government implemented a pilot free maternal and child health (MCH) programme in selected states to improve...

Introduction: The high rate of absenteeism among health workers (especially those in primary healthcare) has become an issue of significant concern in Nigeria. It was estimated that 34% of staff are absent at any time, with substantial consequences for their ability to deliver safe and effective care. The available literature points to a diverse ra...

Purpose The purpose of this study is to describe the nature and operations of schools commonly regarded as “Miracle Examination Centres (MECs)” in Nigeria, through the lens of stakeholders in education. This study also assessed stakeholders’ perspectives on the possible solutions to the problem of MECs. Design/methodology/approach The study design...

ABSTRACT Objective: To investigate the effects of six-week cervical traction and infrared therapy on neck pain intensity (PI) and neck disability index (NDI) among individuals with cervical spondylosis. Methods: The study was a non-randomised cross-over cohort design. Forty participants (men=20, and women=20) who were purposively selected, received...

The ability to deliver primary care in Nigeria is undermined by chronic absenteeism but an understanding of its drivers is needed if effective responses are to be developed. While there is a small but growing body of relevant research, the gendered dynamics of absenteeism remain largely unexplored. We apply a gendered perspective to understanding a...

Background Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air p...

Background Community health workers play an important role in linking communities with formal health service providers, thereby improving access to and utilization of health care. A novel cadre of community health workers known as village health workers (VHWs) were recruited to create demand for maternal health services in the Nigerian Subsidy Rein...

The Private Sector Coalition against COVID-19 (CACOVID) was established on the 27th of March 2020 to mobilize private sector resources toward supporting the government's response to the COVID-19 pandemic. More specifically, CACOVID set out to provide leadership functions, raise public awareness, provide buy-in for COVID-19 prevention, and provide d...

For Nigeria to make progress on its commitment to universal health coverage, additional public funding will be required. But more resources alone will not be enough. Government health spending must be more efficient and effective, through more strategic purchasing-a critical policy tool. Studies on health purchasing in Nigeria's health financing sc...

Objectives: This study explored the perceptions of adult stakeholders on adolescents sexual and reproductive health (SRH) needs, variations of perceived needs by different social stratifiers and adolescent's perceived interventions to address these needs. This will provide evidence that could be useful for policy and programme reviews for improvin...

As societies urbanize, their populations have become increasingly dependent on the private sector for essential services. The way the private sector responds to health emergencies such as the COVID-19 pandemic can determine the health and economic wellbeing of urban populations, an effect amplified for poorer communities. Here we present a qualitat...

Background: Improving domestic resource mobilization (DRM) for family planning (FP) can contribute to improving and sustaining maternal health outcomes, especially in such places as Ebonyi State, Nigeria, which has one of the highest unmet needs for FP in the country. This study explored the prospects for increasing government spending on FP in the...

Background Human resources for health (HRH) include a range of occupations that aim to promote or improve human health. The UN Sustainable Development Goals (SDGs) and the WHO Health Workforce 2030 strategy have drawn attention to the importance of HRH for achieving policy priorities such as universal health coverage (UHC). Although previous resear...

Background: There is a rise in the prevalence of mental illness among adolescents and the impact of violence on this rising trend requires to be evaluated. Aim: The aim of the study is to better understand the impact of violence on adolescent's mental health. Materials and Methods: The study was a cross-sectional school-based study. Adolescents in...

Background The widely available informal healthcare providers (IHPs) present opportunities to improve access to appropriate essential health services in underserved urban areas in many low- and middle-income countries (LMICs). However, they are not formally linked to the formal health system. This study was conducted to explore the perspectives of...

Background: There is a rise in the prevalence of mental illness among adolescents and the impact of violence on this rising trend requires to be evaluated. Aim: The aim of the study is to better understand the impact of violence on adolescent's mental health. Materials and Methods: The study was a cross-sectional school-based study. Adolescents in...

Background: Studies evaluating data quality are needed to better identify what interventions might improve the quality of routine immunization (RI) data and use in decision-making. This study evaluated the outcomes of interventions that were implemented to improve the quality and use of RI data for decision-making in Enugu state, Nigeria. Methods:...

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 coll...

Background Strategic healthcare purchasing (SHP), as a critical function of health financing, enhances the optimal attainment of health system goals through the efficient use of financial resources. Countries committed to universal health coverage (UHC) have made progress towards strategic purchasing through relevant reforms in their healthcare fin...

Objectives: Nigeria is one of the 30 high-burden countries for TB and currently, recurrent costs of TB treatment services are largely dependent on donor-funding, with government providing the health facilities. This study aims to assess the benefit incidence of TB treatment services so as to determine if the poor and rural dwellers preferentially...

Background There is rise in the prevalence of mental health illnesses among the adolescent and the impact of violence on this rising trend requires to be evaluated. This is the aim of this study. Methods. The study was a cross-sectional school based study. Adolescents in the selected schools were interviewed using structured questionnaire. Informat...

Objectives To use data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) to estimate mortality and disability trends for the population aged ≥70 and evaluate patterns in causes of death, disability, and risk factors. Design Systematic analysis. Setting Participants were aged ≥70 from 204 countries and terri...

Importance: The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. Objective: To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic...

Background Population-level health and mortality data are crucial for evidence-informed policy but scarce in Nigeria. To fill this gap, we undertook a comprehensive assessment of the burden of disease in Nigeria and compared outcomes to other west African countries. Methods In this systematic analysis, using data and results of the Global Burden o...

Despite limited government budgets for health in many sub-Saharan African countries, some countries have improved health outcomes at low cost by being strategic in allocating and spending available resources. Strategic health purchasing is receiving increasing attention as a way to improve health system performance within financial constraints. Hea...

Well-functioning purchasing arrangements allocate pooled funds to health providers, and are expected to deliver efficient, effective, quality, equitable and responsive health services and advance progress toward universal health coverage (UHC). This paper explores how improvements in purchasing functions in three Nigerian schemes—the Formal Sector...

COVID-19 stretched health systems, exacerbated by concerns about those that are corrupt and lack equity. Twelve (12) health workers and 12 hospital social workers across Nigeria were purposively sampled and virtually interviewed to explore unaccountability and corruption effects on COVID-19 responses. Findings show that corruption and unaccountabil...

Background: Funding measles immunization in a resource constraint setting like Nigeria has been challenging. Nigeria needs a domestic cost data on measles routine immunization to inform measles routine immunization planning. This study assessed the costs and consequences of a dose of measles vaccine to children through routine immunization. Methods...

The quality of the secondary education system in Nigeria is ranked below average by both local and international bodies. Corruption is a major reason for the low ranking and poor performance in secondary schools, and manifests in the form of widespread examination malpractice in Senior Secondary Certificate Examinations (SSCE). Although there is pu...

The impact of COVID-19 on the health and livelihoods of populations in low and middle income countries has been substantial. Some of the measures that have been put in place to reduce infection rates across the general population may exacerbate economic and social hardship. Although governments’ responses to COVID-19 pandemic are intended to reduce...

Despite increasing attention to implementation research in global health, evidence from low- and middle-income countries (LMICs) using realist evaluations, in understanding how complex health programmes work remains limited. This paper contributes to bridging this knowledge gap by reporting how, why and in what circumstances, the implementation and...

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15–39 years) are lacking. To address this...

Certificates obtained after taking Senior Secondary School Certificate Examinations (SSCE) are priority documents that qualify students to be admitted into tertiary level education and are also a minimum requirement to contest in some political elections in Nigeria. ‘Miracle’ Examination Centres (MECs) are rogue/corrupt business outfits that positi...

Background: Adolescent risky sexual behavior is of a public health concern as most outcomes have long-term negative consequences on adolescents’ health and development. Objectives: This study was undertaken to assess the prevalence and sociodemographic determinants of risky sexual behavior among unmarried adolescents in Nigeria. Materials and Metho...

IMPORTANCE The global impact of COVID-19 has led to an increased need to continuously assess disease surveillance tools. The utility of SARS-CoV-2 serologic tools in determining immunity levels across different age groups and locations in helping to quickly assess the burden of COVID-19 with significant health policy implications is unknown. OBJECT...