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Background Nigeria has one of the largest Human Immunodeficiency Virus (HIV) epidemics in the world. Addressing the epidemic of HIV in such a high-burden country has necessitated responses of a multidimensional nature. Historically, community-based organizations (CBOs) have played an essential role in targeting key populations (eg. men who have sex with men, sex workers) that are particularly burdened by HIV. CBOs are an essential part of the provision of health services in sub-Saharan Africa, but very little is known about the management practices of CBOs that provide HIV prevention interventions. Methods We interviewed 31 CBO staff members and other key stakeholders in January 2017 about management practices in CBOs. Management was conceptualized under the classical management process perspective; these four management phases—planning, organizing, leading, and evaluating—guided the interview process and code development. Data analysis was conducted thematically using Atlas.ti software. The protocol was approved by the ethics committees of the National Institute of Public Health of Mexico (INSP), the National Agency for the Control of AIDS in Nigeria (NACA), and the Nigerian Institute for Medical Research (NIMR). Results We found that CBOs implement variable management practices that can either hinder or facilitate the efficient provision of HIV prevention services. Long-standing CBOs had relatively strong organizational infrastructure and capacity that positively influenced service planning. In contrast, fledgling CBOs were deficient of organizational infrastructure and lacked program planning capacity. The delivery of HIV services can become more efficient if management practices are taken into account. Conclusions The delivery of HIV services by CBOs in Nigeria was largely influenced by inherent issues related to skills, organizational structure, talent retention, and sanction application. These, in turn, affected management practices such as planning, organizing, leading, and evaluating. This study shows that KP-led CBOs are evolving and have strong potentials and capacity for growth, and can become more efficient and effective if attention is paid to issues such as hierarchy, staff recruitment, and talent retention.

Background: Cancer is increasing in its prevalence in sub-Saharan Africa. Informal caregivers are key to supporting engagement and interaction with palliative care services, but limited literature on their role impedes development of supportive interventions. Aim: We aimed to understand the role, impact, and support of informal caregivers of patients with advanced cancer when interacting with palliative care services in Nigeria, Uganda, and Zimbabwe. Design: Secondary analysis of qualitative interview transcripts. The dataset was assessed for fit and relevance and framework approach was used. Setting/participants: Interview transcripts of informal caregivers included participants aged over 18 years of age recruited from palliative care services across participating countries. Results: A total of 48 transcripts were analyzed. Mean age was 37 (range 19–75) with equal numbers of men and women. Five themes emerged from the data: (1) caregivers are coordinators of emotional, practical, and health service matters; (2) caregiving comes at a personal social and financial cost; (3) practical and emotional support received and required; (4) experience of interacting and liaising with palliative care services; and (5) barriers and recommendations relating to the involvement of palliative care. Conclusions: The role of informal caregivers is multi-faceted, with participants reporting taking care of the majority of medical, physical, financial, and emotional needs of the care recipient, often in the face of sacrifices relating to employment, finances, and their own health and social life. Efforts to develop comprehensive cancer control plans in sub-Saharan Africa must take account of the increasing evidence of informal caregiver needs.

The global threat which continues to accompany SARS‐CoV‐2 has led to a global response which adopts lockdown and stays home policy as means of curtailing its spread. This study investigates compliance with the Stay Home policy and exposure to COVID‐19 in Nigeria. A survey was conducted from April 4 to May 8, 2020 using a cross‐sectional mixed‐methods approach to elicit responses from 879 participants across six geopolitical zones of Nigeria. Descriptive, χ 2, and multiple regression tests were used to analyze survey data using SPSS, whereas NVivo v12 was used for thematic analysis of qualitative data. States with complete lockdown had 72.4% of respondents complying fully with the policy compared with 44.2% of respondents in zones with the partial lockdown. Market places, classified as high‐risk zones, were the most visited (n = 505; 71.0%). Though compliance was influenced by the nature of lockdown enforced (χ 2 = 70.385, df = 2; p, Key Points Exposure to risk of COVID‐19 infection was conditioned by social and economic realities.The nature of lockdown (partial or complete) influenced compliance with stay Home Policy.Visits among family members was higher in areas with complete lockdown compared to area with partial lockdown.Places classified as high‐risk zones (market and religious centres) were the most patronised.Fear, anxiety and misperception play significant roles in compliance with Stay Home Policy.

IntroductionPalliative care is a clinically and cost‐effective component of cancer services in sub-Saharan Africa (SSA). Despite the significant need for palliative cancer care in SSA, coverage remains inadequate. The exploration of digital health approaches could support increases in the quality and reach of palliative cancer care services in SSA. However, there is currently a lack of any theoretical underpinning or data to understand stakeholder drivers for digital health components in this context. This project addresses this gap through engaging with key stakeholders to determine data and information needs that could be supported through digital health interventions.Methods and analysisThis is a multicountry, cross-sectional, qualitative study conducted in Nigeria, Uganda and Zimbabwe. In-depth interviews will be conducted in patients with advanced cancer (n=20), caregivers (n=15), health professionals (n=20) and policy-makers (n=10) in each of the three participating countries. Data from a total of 195 interviews will transcribed verbatim and translated into English before being imported into NVivo software for deductive framework analysis. The analysis will seek to understand the acceptability and define mechanisms of patient-level data capture and usage via digital technologies.Ethics and disseminationEthics approvals have been obtained from the Institutional Review Boards of University of Leeds (Ref: MREC 18–032), Research Council of Zimbabwe (Ref: 03507), Medical Research Council of Zimbabwe (Ref: MRCZ/A/2421), Uganda Cancer Institute (Ref: 19–2018), Uganda National Council of Science and Technology (Ref: HS325ES) and College of Medicine University of Lagos (Ref: HREC/15/04/2015). The project seeks to determine optimal mechanisms for the design and development of subsequent digital health interventions to support development, access to, and delivery of palliative cancer care in SSA. Dissemination of these findings will occur through newsletters and press releases, conference presentations, peer-reviewed journals and social media.Trial registration numberISRCTN15727711

Objectives The objective of this study was to describe community perceptions of pre-eclampsia and eclampsia in Ogun State. Background: Pre-eclampsia is a common complication of pregnancy and is responsible for high rates of morbidity and mortality, especially in less developed countries. While most studies related to pre-eclampsia and eclampsia have adopted a bio-medical model, this paper adopts a perspective which recognizes the role of the socio-cultural environment. Methods The study was conducted in four Local Government Areas in Ogun State, Nigeria in 2012. Data were obtained through 24 focus group discussions with pregnant women (N = 94), mothers with children less than 5 years old (N = 95), male decision makers (N = 47), community leaders (N = 56), and traditional birth attendants (N = 36). In addition, nine in-depth interviews were conducted with the head of the local traditional birth attendants (N = 4), a local traditional birth attendant (N = 1), and community leaders (N = 4). Results We determined that there are no names for pre-eclampsia in the local language, Yoruba, although ”hypertension” and ”convulsion” as disease entities have local names that are independent of pregnancy status. The cause of pre-eclampsia was perceived to be due to depressive thoughts, and the cause of eclampsia was perceived to result from exposure to cold with a few implicating spiritual forces. While, there seemed to be no local treatment for pre-eclampsia apart from preventive practices, local treatments for eclampsia included the use of herbs, concoctions, incisions, and black soap. Conclusions This study shows that knowledge of pre-eclampsia and its progression to eclampsia is limited. It also reveals a gap in knowledge of the etiology and treatment of the condition. A holistic approach is recommended for sensitization at the community level, acquisition of educational skills by health workers, and the adoption of a community perspective as a sustainable approach to reduce the complications of pregnancy. Disclosures D.O. Akeju: None. M. Vidler: None. O.T. Oladapo: None. D. Sawchuck: None. R. Qureshi: None. P. von Dadelszen: None. O.O. Adetoro: None. K. Dada: None.