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CONTEXT Nigeria has the second heaviest burden of Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS) in Africa. There is growing debate in favor of starting HIV/AIDS education early in life in order to equip pupils with the knowledge and skills to delay sexual debut and to utilize appropriate preventive measures thereafter. Objectives: To assess the knowledge and attitude of primary school pupils regarding HIV/AIDS and to determine their attitude towards People living with HIV/AIDS (PLWHAs). Materials and Methods A descriptive cross-sectional study carried out among primary schools pupils. A semi-structured self-administered questionnaire was used to collect data from 275 respondents in primary four to six. The study utilized multi-stage sampling method. Results Out of the 275 respondents recruited, 249 questionnaires were analyzable. Out of the 249 respondents, 116 (46.6%) were males while 133 (53.4%) were females. One hundred and eighty-seven (75.1%) respondents indicated that HIV /AIDS can be contracted through sexual intercourse; 50.1% indicated that it was caused by witches and wizards and 48% indicated that it was due to mosquito bite. More respondents in class six (11.7%) than those in class five (5.2%) and class four (0%) were willing to eat from the same plate with someone with HIV/AIDS. The difference was statistically significant (X2=9.547, df=2, P=0.008). Similarly, more respondents in class six (12.5%) than those in class five (6.4%) and class four (0.4%) indicated that they would live in the same room with someone with HIV/AIDS. The difference was statistically significant (X2=6.605, df=2, P=0.037). Conclusion Majority of respondents demonstrated gaps in knowledge of HIV/AIDS. Majority showed evidence of stigmatizing and discriminating attitude towards PLWHAs. Inclusion of HIV/AIDS education in the school curriculum and attitudinal re-orientation is recommended. more...

Objectives: Better engagement of diverse groups of interest-holders in the development of health guidelines has been proposed to improve their usefulness, implementability, and acceptability. Guidelines shape clinical- or public-health practice decision-making. Trustworthy guidelines are systematically developed documents that include actionable statements based on evidence and a formal, structured and transparent decision process. This paper describes the GIN-McMaster GDC Extension for Engagement to assist developers with engaging multiple interest-holders throughout all topics of guideline development., Study Design and Setting: To produce this checklist extension, we conducted a three-phase mixed methods study. First, we utilized 10 groups of interest-holders to be engaged in health guideline development: patients, the public, providers, program managers, principal investigators, payers/purchasers of health services, payers/funders of health research, policymakers, peer-reviewed journal editors, and product makers identified in previous work and recruited co-leads to represent these groups (n=26 total)., Results: We conducted a series of reviews to identify existing methods and barriers/facilitators for engagement, approaches to managing conflicts of interest, and describing the impacts of engagement on the guideline development process. The results of these reviews informed the development of an online survey for which we received 195 responses. We clarified these results through 43 key informant interviews with interest-holders. The final GDC extension checklist was determined based on consensus methods with our co-leads., Conclusion: This paper presents the GIN-McMaster GDC Extension for Engagement. This checklist provides interest-holder-informed recommendations for providing advice/feedback or participating in decision-making in guideline development., (Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.) more...

Established in 2015, the Multi-Stakeholder Engagement (MuSE) Consortium is an international network of over 120 individuals interested in stakeholder engagement in research and guidelines. The MuSE group is developing guidance for stakeholder engagement in the development of health and healthcare guideline development. The development of this guidance has included multiple meetings with stakeholders, including patients, payers/purchasers of health services, peer review editors, policymakers, program managers, providers, principal investigators, product makers, the public, and purchasers of health services and has identified a number of key issues. These include: (1) Definitions, roles, and settings (2) Stakeholder identification and selection (3) Levels of engagement, (4) Evaluation of engagement, (5) Documentation and transparency, and (6) Conflict of interest management. In this paper, we discuss these issues and our plan to develop guidance to facilitate stakeholder engagement in all stages of the development of health and healthcare guideline development., (© 2023. The Author(s).) more...

Background: Health research teams increasingly partner with stakeholders to produce research that is relevant, accessible, and widely used. Previous work has covered stakeholder group identification., Objective: We aimed to develop factors for health research teams to consider during identification and invitation of individual representatives in a multi-stakeholder research partnership, with the aim of forming equitable and informed teams., Design: Consensus development., Participants: We involved 16 stakeholders from the international Multi-Stakeholder Engagement (MuSE) Consortium, including patients and the public, providers, payers of health services/purchasers, policy makers, programme managers, peer review editors, and principal investigators., Approach: We engaged stakeholders in factor development and as co-authors of this manuscript. Using a modified Delphi approach, we gathered stakeholder views concerning a preliminary list of 18 factors. Over two feedback rounds, using qualitative and quantitative analysis, we concentrated these into ten factors., Key Results: We present seven highly desirable factors: 'expertise or experience', 'ability and willingness to represent the stakeholder group', 'inclusivity (equity, diversity and intersectionality)', 'communication skills', 'commitment and time capacity', 'financial and non-financial relationships and activities, and conflict of interest', 'training support and funding needs'. Additionally, three factors are desirable: 'influence', 'research relevant values', 'previous stakeholder engagement'., Conclusions: We present factors for research teams to consider during identification and invitation of individual representatives in a multi-stakeholder research partnership. Policy makers and guideline developers may benefit from considering the factors in stakeholder identification and invitation. Research funders may consider stipulating consideration of the factors in funding applications. We outline how these factors can be implemented and exemplify how their use has the potential to improve the quality and relevancy of health research., (© 2022. The Author(s).) more...

Background: Civil society organizations (CSOs) are important in health care delivery. They have the potential to play significant roles in immunization-related services, such as advocacy, health education, demand creation and resource mobilization. Their roles are often indispensable, diverse and beneficial in reducing infant morbidity and mortality due to vaccine-preventable diseases. This study explored the potential barriers to and facilitators of CSO engagement in increasing immunization coverage in Odukpani Local Government Area of Cross River State, Nigeria., Methods: The study adopted qualitative data collection methods. Twenty-two focus group discussion (FGD) sessions, three in-depth interviews (IDIs) and 26 key informant interviews (KIIs) were conducted. Appropriate guides (FGD guide, IDI guide and KII guide) were used to conduct face-to-face interviews and the discussions. The FGDs, KIIs and IDIs were audio-recorded and transcribed. A framework analysis approach involving five key stages of analysis (familiarization with data, identification of thematic framework, indexing, charting, mapping/interpretation) was used for data analyses and presentation., Results: CSOs encounter barriers in the course of their immunization advocacy, communication and social mobilization due to male child preference, leading to shielding of male children and not allowing them to be given immunization, as well as patriarchy, safety concerns, religious concerns, anti-vaccine misinformation and rumours, low perception of effectiveness and efficacy of vaccines, inaccessibility of localities, low health literacy and superstitious beliefs. Various community structures, such as the institution of the village head, elders' council and town crier (announcer), and the existence of change agents, act as facilitators of immunization advocacy and uptake. Factors such as traditional control mechanisms including masquerades and religion act as either barriers or facilitators depending on the community and the mode of deployment. CSO members are willing to overcome these barriers and leverage the facilitators., Conclusions: For successful engagement in immunization-related services, there are barriers in the study area that CSOs should overcome, such as male child preference and geographic inaccessibility, as well as facilitators that they should leverage such as traditional information dissemination systems and enforcement of compliance by the chiefs and elders' council., (© 2021. The Author(s).) more...

Background and Objective: Immunisation coverage remains sub-optimal, especially in rural hard-to-reach communities in Nigeria. Nigeria's immunisation program suffered set-backs in recent years due to socio-cultural, religious and health system barriers. Grassroots Civil Society Organisations could play a role in addressing some of these barriers with resultant increase in demand for and uptake of immunisation services. The objective of this study was to carry out strengths, weaknesses, opportunities and threats (SWOT) analysis of grassroots civil society organisations regarding engagement for increasing demand for and uptake of immunisation services., Subjects, Materials and Methods: This was a qualitative study. A pre-tested SWOT analysis template was used to collect data from 26 grassroots CSOs in Odukpani local government area (LGA) of Cross River State of Nigeria. The data were manually entered into a matrix made up of four quadrants. The results were presented as tables of frequencies and percentages., Results: The CSOs have the numerical strength to carry out immunisation advocacy, communication and social mobilization. There is pool of non-CSO community members who are willing to volunteer. However, some of the CSOs are not good in record keeping. There are also several security threats due to communal clashes., Conclusion: There are several strengths and opportunities that the CSOs can leverage on while dealing with identified weaknesses and threats in order to contribute towards increasing the demand for and uptake of immunisation services in this community. more...