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The new millennium brought renewed attention to improving the health of women and children. In this same period, direct deaths from conflicts have declined worldwide, but civilian deaths associated with conflicts have increased. Nigeria is among the most conflict‐prone countries in Sub‐Saharan Africa, especially recently with the Boko Haram insurgency in the north. This paper uses two data sources, the 2013 Demographic and Health Survey for Nigeria and the Social Conflict Analysis Database, linked by geocode, to study the effect of these conflicts on infant and young child acute malnutrition (or wasting). We show a strong association in 2013 between living close to a conflict zone and acute malnutrition in Nigerian children, with larger effects for rural children than urban children. This is related to the severity of the conflict, measured both in terms of the number of conflict deaths and the length of time the child was exposed to conflict. Undoubtedly, civil conflict is limiting the future prospects of Nigerian children and the country's economic growth. In Nigeria, conflicts in the north are expected to continue with sporadic attacks and continued damaged infrastructure. Thus, Nigerian children, innocent victims of the conflict, will continue to suffer the consequences documented in this study. [ABSTRACT FROM AUTHOR]

Background: With limited government‐sponsored breast screening programmes in developing countries, breast awareness remains the only realistic survival hope for millions. Poor levels of knowledge and preventive practices remain in these countries, and early enlightenment to empower teenage high school girls has been advocated for, recently. This study evaluates ways to ensure sustainability for such an approach. Method: A 6‐month longitudinal, interventional cohort study of 432 high school female students in South‐eastern Nigeria. The efficacies of a video‐assisted face‐to‐face intervention, as well as the use of printed handouts, were evaluated. Results: A total of 317 (73.4%) and 301 (69.7%) valid responses were received from the pre‐intervention (16.8 ± 1.5 years) and post‐intervention (17.2 ± 1.6 years) surveys, respectively. Logistic regression revealed that participants who were "engaged" with the campaigns, either through symposium attendance or by reading handouts, showed significant improvements on most aspects of knowledge regarding the cancer's early symptoms and risk factors, as well as breast self‐examination (BSE). However, the monthly practice of BSE was not significantly increased (Attendees: OR = 1.44, P = 0.18; Handout‐readers: OR = 1.52; P = 0.17). Also, when "engagement" to the respective empowerment activities was disregarded, a chi‐squared analysis comparing the pre‐intervention and post‐intervention groups showed significant improvements on specific knowledge regarding risk factors and early symptoms of breast cancer, as well as BSE techniques and regular monthly practice: χ2 (1, N = 596) = 46.703, P < 0.001. Across multiple parameters, the impact of exclusive face‐to‐face participation was not different to that from the reading of handouts. Conclusion: Face‐to‐face and handout were both effective and of similar impact. However, sustained impact on monthly BSE is doubtful. To surmount this, strategies to ensure ongoing engagements are vital. Perhaps adjusting existing high school curricula to allow repeated yearly teachings on breast cancer and BSE, along with in‐built‐in evaluation systems like examinations and quizzes, are ways of ensuring engagement. [ABSTRACT FROM AUTHOR]

Using a quasi‐experimental design, our study aimed to determine the effectiveness of the 'Eggs Make Kids Sharp & Bright and Strong & Active' demand‐creation campaign in Nigeria. The intervention arm received emotionally compelling radio and television advertisements about eggs, and was exposed to promotional activities and advertising about eggs at points of purchase, schools and health facilities; the comparison arm received no intervention. Children 6–59 months of age (intervention: n = 1359; comparison: n = 1485) were assessed 14 months apart. Intent‐to‐treat analyses with analysis of covariance method assessed the impact of the intervention on caregivers' behaviour towards eggs, caregivers' willingness to pay for eggs, availability of eggs in households, and consumption of eggs by children 6–59 months of age. Analyses were adjusted for possible confounders and perceived effects of COVID‐19 on finances and food consumption. Compared to the comparison arm, the intervention arm showed a greater prevalence of household egg acquisition (odds ratio = 1.34, p < 0.0001), and larger improvements in caregiver self‐efficacy (β = 0.242, p = 0.004) and intent to feed eggs to children (β = 0.080, p = 0.021). No effects were found on children's egg consumption or caregivers' reported willingness to pay for eggs. The lack of impact on child egg consumption despite increased acquisition of eggs and caregiver self‐efficacy suggests that other barriers to child consumption may exist. Additional research should further investigate factors that may influence intrahousehold distribution of eggs and whether these may also influence other nutritious foods. Key messages: An emotionally engaged demand creation campaign around eggs resulted in small improvements in household acquisition of eggs and caregivers' self‐efficacy and intent to feed eggs to their child 6–59 months of age, but did not improve egg consumption in children.Economic hardships imposed by the COVID‐19 pandemic and low interpersonal communication associated with the campaign may have contributed to the lack of effects of egg consumption.Demand generation activities as stand‐alone activities are insufficient in improving egg consumption among children 6–59 months of age in this context. [ABSTRACT FROM AUTHOR]

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We aimed to compare plotting accuracy and interpretation of weight gain patterns in average and small infants on road-to-health (RTH) and the new World Health Organization (WHO) growth charts in Enugu, Nigeria. Child health staff plotted standard weights on both formats. Twelve plotted charts were created, permutating three different weight trajectories (fast, steady, and slow) ending at two attained weights (average and small), with each plotted on both chart formats. Respondents were shown four of these charts and asked to describe the weight gain pattern shown and what action this pattern would prompt. There were 222 respondents, of whom 78% were hospital based; 54% were nurses, 32% medical doctors, and 13% nutritionists. Plotting accuracy was good on both the WHO and RTH charts, but rating of weight gain was generally poor. On the RTH chart, slow weight gain was correctly recognized in only 19% average and 35% small infants, and responses were not significantly associated with the pattern shown. On the WHO charts, slow weight gain was correctly recognized in 40% average and 65% small infants ( p = .002 and <.001), but they were also more likely to rate small children with normal growth as slow weight gain. In a logistic regression model, final weight predicted a slow weight gain rating more strongly (OR = 2.4; 1.8-3.2) than an actual slow weight gain pattern (OR 1.8; 1.1-1.6). Health staff seemed unable to recognize slow weight gain and were influenced more by current weight than actual weight gain pattern, though the new WHO format improved recognition. [ABSTRACT FROM AUTHOR]

As part of a breastfeeding promotion intervention trial in Nigeria, we provided one cell phone per group of 5–7 microcredit clients and instructed the group's cell phone recipient to share weekly breastfeeding voice and text messages with group members. We measured the feasibility and acceptability of using group cell phones by conducting semi‐structured exit interviews with 195 microcredit clients whose babies were born during the intervention (target group), in‐depth interviews with eight phone recipients and nine non‐phone recipients, and 16 focus group discussions with other microcredit clients. Women in the target group said the group phone worked well or very well (64%). They were motivated to try the recommended practices because they trusted the information (58%) and had support from others (35%). Approximately 44% of target women reported that their groups met and shared messages at least once a week. Women in groups that met at least weekly had higher odds of exclusive breastfeeding up to 6 months (OR 5.6, 95% CI 1.6, 19.7) than women in groups that never met. In‐depth interviews and focus group discussions indicated that non‐phone recipients had positive feelings towards phone recipients, the group phone met participants' needs, and messages were often shared outside the group. In conclusion, group cell phone messaging to promote breastfeeding among microcredit clients is feasible and acceptable and can be part of an effective behaviour change package. [ABSTRACT FROM AUTHOR]

Suboptimal complementary feeding practices have a detrimental impact on a child's growth, health and development in the first two years of life. They lead to child malnutrition, which contributes to the high prevalence of stunting (38%) and underweight (28%) reported for children <5 years of age in Sub- Saharan Africa. This study analysed complementary feeding practices in four anglophone West African countries ( Ghana, Liberia, Nigeria and Sierra Leone) using the most recent Demographic and Health Surveys. The study covered 12 623 children aged 6-23 months from four anglophone West African countries ( Ghana: 822 children: Liberia: 1458 children, Nigeria: 8786 children and Sierra Leone: 1557 children). Four complementary feeding indicators were examined against a set of individual-, household- and community-level factors, using multiple regression analysis. Multivariate analyses found that lack of post-natal contacts with health workers, maternal illiteracy and geographical region were common determinants of delayed introduction of solid, semi-solid or soft foods across all four countries. Predictors for minimum dietary diversity, minimum meal frequency and minimum acceptable diet included children aged 6-11 months, administrative/geographical region, poorer household income and limited access to media. The authors recommend that the four anglophone West African countries studied should prioritise efforts to improve complementary feeding practices in order to reduce child morbidity and mortality. Interventional studies on complementary feeding should target those from poor and illiterate households. [ABSTRACT FROM AUTHOR]

Objective Caries is a major oral health problem children with efforts focused on promoting use of caries prevention methods. The aim of the study is to assess the effect of a school-based oral health education programme on use of oral self-care measures for reducing caries. Methods A structured school-based oral health education programme was implemented in six schools in Ile-Ife, Nigeria for 4 years. At the end of the project, information was sought from school children in their last year and final 2 years of studies on the use of fluoridated toothpaste, consumption of sugar-containing snacks more than once a day, frequency of tooth brushing and flossing, and time of the last dental check-up. Predictors of the use of preventive oral health practices for caries were determined. Results School children who received the intervention were more likely to report frequent use of fluoride-containing toothpastes ( P < 0.001), more likely to brush twice a day ( P = 0.03), less likely to consuming sugar-containing snacks less than once a day ( P = 0.03) and less likely to use dental floss once a day ( P < 0.001) when compared to the control group. Conclusion This long term school based educational programme was able to increase school children's use of fluoride-containing toothpaste and twice daily tooth brushing, which are critical tools for reducing the risk of caries. [ABSTRACT FROM AUTHOR]