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The growing burden of mental, neurological and substance use (MNS) disorders in low-resource settings has prompted efforts to integrate mental health into primary health care (PHC). This study evaluated the implementation and outcomes of a large-scale mhGAP training initiative under the Mental Health in Primary Care (MeHPriC) program in Lagos State, Nigeria. A total of 852 PHC workers from 57 facilities completed a 5-day mhGAP training and a 1-day refresher session. Using a pre-post mixed-methods design, we assessed changes in knowledge, stigma, clinical practice and self-efficacy, with follow-up at five months. Quantitative findings revealed significant improvements in knowledge and attitudes, with enhanced clinical practice reported by 69.1% of participants. Supervision, knowledge gains and self-efficacy emerged as predictors of improved practice. Qualitative data, analyzed using the Consolidated Framework for Implementation Research (CFIR), highlighted increased confidence, reduced stigma and the enabling role of supervision and peer support, alongside persistent barriers such as medication stock-outs and limited referral networks. The study offers robust evidence for the effectiveness of task-sharing approaches when supported by contextual adaptation and system-level readiness. The MeHPriC model demonstrates that government-led mhGAP scale-up in PHC is both feasible and impactful, offering a replicable pathway for mental health integration in other LMICs.
In January 2019, Nigeria enacted the Federal Competition and Consumer Protection Act, which provides for a joint legal framework for both competition and consumer protection. This article examines the theoretical and practical rationale for integrating competition and consumer protection, recognizing that, while related, the two may pursue distinct goals and operate under different principles. It provides a lens to review the issues an African country faces following integration, especially in the broader normative discussion of the goals of competition law. Although there is literature investigating the integration of consumer protection and competition, there is still nothing that examines the place of consumer protection in the wider theoretical context of competition for developing countries, particularly how they balance efficiency with other goals of competition. The article also offers the first academic review of the five-year practice of competition law and its application in Nigeria.
Plant-soil microbial interactions play a central role in maintaining biodiversity and coexistence in terrestrial ecosystems. However, to what extent plant-soil feedbacks (PSFs) operate in tropical Afromontane forests remains unclear. In this study, we conducted a PSF shade house experiment using six tree species exhibiting diverse life-history strategies and abundances in a sub-tropical montane forest in Nigeria. Seedlings were grown under controlled conditions in sterilised soil with or without soil inoculum collected under mature trees of each of the six species. We assessed whether conspecific tree seedlings’ performance was altered in comparison to heterospecific seedlings when grown in the soil of their adult trees. Seedling growth did not significantly differ between inocula from conspecific and heterospecific adults in five of the six species tested, indicating no evidence of PSFs. In Garcinia smeathmannii, we found a significant increase in seedling growth when grown in conspecific soil inocula. Given that no PSFs were observed in five out of six species, our study suggests that PSFs may play a limited role in the performance of some species in this Afromontane ecosystem. Nonetheless, the facilitative interaction noted in Garcinia smeathmannii indicates a nuanced ecological dynamic worth further exploration.
Bipolar disorders are a major cause of disability worldwide, with most of the disease burden attributed to those in low- and middle-income countries, including Nigeria. There is limited evidence on culturally appropriate interventions for bipolar disorders in Nigeria.
Aims
The study aims to examine the feasibility, and acceptability of culturally adapted psychoeducation (CaPE) for treating bipolar disorders.
Method
A randomised controlled trial (RCT) compared CaPE plus treatment as usual (TAU) with TAU alone among 34 persons with bipolar disorders in Jos, Nigeria. CaPE comprised 12 group sessions of in-person psychoeducation lasting approximately 90 min each, delivered on a weekly basis by clinical researchers supervised by clinical psychologists and consultant psychiatrists. The primary outcome was feasibility, measured by participants’ recruitment and retention rates. Other outcomes included acceptability as measured by the Service Satisfaction Scale (SSS), Brief Bipolar Disorder Symptom Scale (BBDSS), Patient Health Questionnaire (PHQ-9) and Quality-of-Life scale (EQ5D). Outcomes were assessed at baseline and weeks 12 and 24. Focus group (n = 10) and individual interviews (n = 5) were conducted with the CaPE + TAU group, recorded, transcribed verbatim and analysed using interpretative phenomenological analysis.
Results
The CaPE+TAU group (n = 17) recorded a high participant recruitment and retention rate of 86% across 12 sessions, and also recorded a higher level of satisfaction with SSS compared with the TAU alone group; 87.5% indicated very satisfied compared with 66.7% indicated not sure in the TAU group. In terms of clinical outcomes, for PHQ-9 scores the intervention group showed a reduction from baseline to end of intervention (EOI) and follow-up, with differences of −12.01 and −7.39, respectively (both P < 0.001). The EQ5D index showed a notable improvement in the intervention group at both EOI and follow-up (P < 0.001). Lastly, BBDS scores decreased significantly in the CaPE+TAU group at both EOI and follow-up, with differences of −21.45 and −15.76 (both P < 0.001).
Conclusions
The RCT of CaPE is a feasible, acceptable and culturally appropriate treatment option for bipolar disorders in Nigeria. Further adequately powered RCTs evaluating the intervention’s clinical and cost-effectiveness are warranted.
This study examined if and how first responders in Nigeria provide Psychological First Aid to emergency victims. Key objectives include assessing first responders’ awareness of Psychological First Aid, determining their level of PFA training and level of PFA utilization with emergency treatment.
Methods
A descriptive cross-sectional survey that adopted a mixed-method approach was utilized. This study was carried out among first responders living in Lagos State, Nigeria. The quantitative aspect of the study consisted of 386 respondents. In contrast, for the qualitative study, 17 participants were selected using snowball sampling across various strata of first responders based on their diverse roles and experience in emergency response.
Results
Findings from this study deduced that 59.6% of respondents were aware of, 27.2% were trained, and 38.3% practiced PFA. However, findings noted a significant difference in awareness based on education, as persons with tertiary education were 4.21 times more likely to be aware than those without (OR = 1.73-10.23). Qualitative findings revealed that respondents lacked access to opportunities to practice PFA due to the absence of protocols in their learning and practice environments.
Conclusions
This study highlights varying levels of awareness and training in Psychological First Aid (PFA) among respondents, indicating both opportunities and challenges in preparedness for emergency response. Strategies that promote PFA awareness among older age groups should be developed, and entry-level first responders should also receive PFA training.
Palliative care is a critical component of healthcare, yet its integration into Nigeria’s health system remains limited. Despite the growing burden of life-limiting illnesses, palliative care is underdeveloped, primarily restricted to tertiary institutions. This review examines the evolution of palliative care in Nigeria, key milestones, persistent challenges, and future directions for strengthening its implementation.
Methods
This narrative review synthesized historical records, policy documents, and literature on palliative care in Nigeria. It examined leadership roles, institutional efforts, and government policies influencing Palliative care growth, while highlighting implementation gaps and opportunities.
Results
Palliative care in Nigeria has evolved from early grassroots efforts to structured institutional services. Key milestones include the establishment of the Hospice and Palliative Care Association of Nigeria (HPCAN), and policy advancements such as the National Policy and Strategic Plan for Hospice and Palliative Care. Despite these developments, challenges persist, including inadequate funding, workforce shortages, limited opioid access, policy implementation gaps, and socio-cultural barriers. Leadership engagement, targeted policy advocacy, and comprehensive capacity-building are essential to overcoming these barriers.
Significance of Results
Sustained efforts are needed to fully integrate palliative care into Nigeria’s healthcare system. Strategic interventions, including enhanced policy implementation, funding mechanisms, workforce development, and community engagement, are critical for ensuring equitable access to PC services. Strengthening collaborations between the government, healthcare institutions, and international partners will accelerate progress, ultimately improving the quality of life for patients with life-limiting illnesses.
There has been recurrent agitation for external self-determination by most of the South-East people of modern Nigeria through the secessionist group the Indigenous People of Biafra (IPOB). This agitation reached crisis point in 2015 with military action which escalated into a violent confrontation, in which the IPOB claimed some of their members were killed. The IPOB’s request for external self-determination fell on deaf ears, however, the counter-claim being that Nigerian territorial integrity cannot be compromised. This article examines the right to self-determination under international law and in the African system, as well as the types of this right that have been identified by scholars and whether the IPOB’s call can be justified. It argues that the type of self-determination sought by the IPOB and the manner in which they seek it may not be attainable under international law, except through a consensus-based process between the Nigerian government and the South-East people of Nigeria.
The application by states of economic principles in education has not produced good results in access to education in low-income and less-developed countries. This prompted UNESCO to designate countries with substantial problems of access to education and illiteracy as the E-9 countries, which include Nigeria. Nigeria’s status as an E-9 country indicates the existence of considerable problems in education, and where necessary, statistical evidence will be used to elucidate Nigeria’s E-9 status. This article argues that the nature of the laws and policy mechanisms that control education in Nigeria suggests that the country seems to be responding to the contemporaneous demands of global programmes of action in education that are predicated on economic principles and driven by the tides of globalization instead of to the requirements of international human rights law.
Excessive consumption of energy drinks poses significant risks, including the development of various non-communicable diseases. This trend is driven by a combination of the desire to remain alert and the strategic use of catchy advertising slogans by manufacturers, particularly targeting young adolescents. Unlike tobacco products, which are similarly linked to such diseases, Nigeria lacks legislation requiring energy drink manufacturers to warn consumers about potential adverse health effects. This paper argues that the absence of such regulation constitutes a violation of the right to health in Nigeria. It concludes by advocating for the Nigerian government to enact laws mandating energy drink manufacturers to include clear health warnings on their products.
Debates on dedollarizing and internationalizing China’s currency, the renminbi (RMB), often focus on state-led initiatives such as bilateral currency swaps and Central Bank Digital Currencies while overlooking the role of entrepreneurs utilizing US dollar (USD) alternatives. Ethnographic fieldwork with Nigerian importers of Chinese goods reveals how parallel payment currencies and channels—informal naira-RMB transfers and illicit cryptocurrency transactions—are just as essential in the Global South to decenter US dominance: its currency, institutions, and authority. Analyzing formal monetary policies and local money practices, Liu shows how Nigerian importers cultivate multicurrency fluency, which is vital in an incipient era of political and economic multipolarity.
Reproductive health indicators in many developing countries including Nigeria are poor, and this is due to the less-than-optimum utilization of reproductive healthcare that has been linked to numerous factors including the educational attainment of women and their partners. In societies like Nigeria, marriage is nearly universal and upheld by patriarchal practices, while education is one of the determining factors for the choice of partner in the marriage market, as it also influences household power dynamics. Despite the plethora of studies investigating the link between education and utilization of these services, there is a paucity of research examining educational assortative mating (EAM) and its link to reproductive healthcare utilization. Hence, this study investigated EAM and explored its association with reproductive healthcare utilization from the perspective of family systems theory. Data from the 2018 Nigeria Demographic and Health Survey (n = 19,950) was analysed with frequencies presented and binary logistic regression models fitted. The result showed that high-education (34%) and low-education (46%) homogamy are the most prevalent types of EAM, while 40% of the partnered women reported facility delivery, 11% used modern contraceptives and 20% reported 8+ antenatal care visits. The multivariate analysis showed that compared to women in hypergamy, women in both high-education homogamy and hypogamy are more likely to deliver at a health facility but women in low-education are less likely. Women in both high-education homogamy and hypogamy are more likely, but those in low-education homogamy are less likely to use modern contraceptives. For antenatal care, only women in high-education homogamy are more likely to have 8 or more visits during pregnancy compared to women in hypergamy, while women in low-education homogamy and hypogamy are less likely. These findings provide evidence of the importance of an indicator of social stratification for important family decisions like healthcare utilization.
Millions of young girls in Nigeria have continued to suffer the negative consequences of early marriage such as discontinuation of education and restricting them from achieving their full potential. Successive Nigerian governments have therefore deployed different strategies over the years to mitigate the practice, particularly in the northern part of the country. This study analysed the changes in the pattern of child marriage across space-time in Nigeria using a dataset obtained from the Nigeria Demographic and Health Survey conducted between 2003 and 2018 at a consecutive interval of 5 years. A Bayesian spatio-temporal random effect model with inference based on integrated nested laplace approximation was considered. Whereas the findings demonstrate a reduction in the practice of child marriage over time everywhere in the country, the prevalence remains highest in States such as Kogi, Niger, Federal Capital Territory Abuja, Taraba, and Kaduna, all in the northern part of the country despite the policies, program and interventions by international organisations, Child Right Acts, and Non-governmental organisations. Over the fifteen years, only slight changes were recorded in the Southwest region. Furthermore, higher levels of education, urban residency, household wealth, being a Yoruba, or belonging to a Christian religious group were found to lower the chances of child marriage. State-specific strategic planning would be useful in deploying suitable local solutions to reduce child marriage in Nigeria.
The chapter begins with a review of the historical and current socio-political context for sexual minority and gender diverse (SMGD) individuals living in Nigeria, followed by relevant research on the associations between minority stress and well-being. Given the dearth of research on this topic, a large portion of this chapter focuses on recommendations for future research and practice for those interested in working with SMGD individuals living in Nigeria.
Over the years, the economic relationship between China and African states has continued to grow and this is evident in the volume of Chinese investments in Africa. In the wake of these investments, China and African states have signed bilateral investment treaties (BITs), which aim to promote the development of host states and protect foreign investments from one contracting state in the territory of the other contracting state, thereby stimulating foreign investments by reducing political risk. BITs are unique in character in that they provide substantive protections to foreign investors and a basis for claims by an individual or company against a host state on grounds that such substantive protections have been breached by the host state. To avoid the need to turn to the national courts in the host state for a judicial remedy, BITs usually contain an arbitration clause submitting disputes to a neutral arbitration tribunal. This case study demonstrates one such instance where, in a first-of-its-kind case, a Chinese investor sued Nigeria, an African host state, for breach of its treaty obligations under the China-Nigeria BIT 2001, and throws light on how BITs can be used in the protection of Chinese outbound investments, including in Africa.
Covert contraceptive use is a strategy to avoid unintended pregnancy. However, evidence regarding the multilevel factors linking past experiences of unintended pregnancy with covert contraceptive use is limited. The objective of this study was to identify the compositional and contextual factors associated with covert contraceptive use among women with a prior unintended pregnancy. Framed by the socio-ecological model, a cross-sectional study was conducted using data from Round 5 of the Performance Monitoring and Accountability 2020 project in Nigeria. Non-pregnant women aged 15–49 years who reported a previous mistimed or unwanted pregnancy were included (N = 1631). Multilevel logistic regression models with random intercepts were specified to investigate the relationship between covert contraceptive use and compositional and contextual factors. Approximately 4.54% (95% CI = 3.28–6.25) of women reported covert contraceptive use. At the individual level, having less than secondary education (aOR = 5.88, 95% CI = 1.20–28.72) and being single (aOR = 11.29, 95% CI = 2.93–43.56) were associated with higher odds of covert contraceptive use. There was no significant association between covert contraceptive use and the type of unintended pregnancy (mistimed: aOR = 3.13, 95% CI = 0.88–11.13). At the community level, living in a community with average poverty levels (aOR = 6.18, 95% CI = 1.18–32.55) and high exposure to family planning mass media (aOR = 6.84, 95% CI = 1.62–29.11) were associated with higher odds of covert contraceptive use. Measures of variation showed significant variation in covert contraceptive use across communities. Further research is warranted to better understand the underlying mechanisms in these observed associations and variations in covert contraceptive use among women following the experience of an unintended pregnancy. Additionally, there is a need to design family planning strategies that integrate community-level structures.
This article evaluates the application of probation orders in Nigeria. It offers a detailed discussion of international legal frameworks for probation and in particular discusses penal provisions that provide for probation, while noting innovations provided by the Administration of Criminal Justice Act 2015, the Administration of Criminal Justice Laws of States and the Nigerian Correctional Services Act 2019. The article highlights the benefits, terms and conditions and duties of a probation officer and the application of probation in Nigeria. Complementarily, it discusses Kenya as a jurisdiction, where judicial activism and other underpinning factors have occasioned a robust application of probation. The article also identifies noticeable gaps which hinder the robust application of probation in Nigeria and proffers solutions by way of recommendations.
This study examines Nigeria’s National Information Technology Development Agency Code of Practice for Interactive Computer Service Platforms as one of Africa’s first push towards digital and social media co-regulation. Already established as a regulatory practice in Europe, co-regulation emphasises the need to impose duties of care on platforms and hold them, instead of users, accountable for safe online experiences. It is markedly different from the prior (and existing) regulatory paradigm in Nigeria, which is based on direct user regulation. By analysing the Code of Practice, therefore, this study considers what Nigeria’s radical turn towards co-regulation means for digital policy and social media regulation in relation to standards, information-gathering, and enforcement. It further sheds light on what co-regulation entails for digital regulatory practice in the wider African context, particularly in terms of the balance of power realities between Global North platforms and Global South countries.
One of the issues for determination in All Progressives Congress v Bashir Sheriff and Others was whether the first respondent won the primary election that was conducted according to the Electoral Act 2022. This issue, however, was not addressed because the Supreme Court set aside the suit because the first respondent failed to initiate it through the proper originating process. This decision contrasts with its previous judgment in Ekanem v The Registered Trustees of the Church of Christ the Good Shepherd, where it held that an inappropriate originating process does not undermine the competence of a suit. By departing from this previous decision, this note argues that there is a high possibility that the Supreme Court may have aided in the subversion of the Constitution. It recommends that the Electoral Act 2022 be amended to restrict the court's authority to dismiss election disputes if they were initiated through inappropriate originating processes.
The 1943 Tour of Eight West African editors to London formed a major event in World War II United Kingdom–West Africa relations. The tour is often understood in terms of the symbolic importance of Azikiwe's landmark Memorandum on the Atlantic Charter. This article argues that we should reappraise our understandings of the tour and pay closer attention to African actors and networks beyond the Colonial Office. We must understand Britain as a periphery to a West African social, cultural, and political centre. The tour reveals how Britain was mediated in West African terms. Existing historiography focused on Azikiwe's Memorandum or decision-making within Whitehall has ignored both the importance of the tour in West Africa and the diversity of Africans in Britain involved in the tour. The present article focuses on African responses to the tour and, drawing on the historiography of print culture and wartime African mobilities, prioritises African-authored sources. Cumulatively, it situates the tour within an evolving historiography of global mobilities in WWII Nigeria. Rather than simply seeking to unite the metropole and colony in a single field, the article suggests that we must consider more deeply the ways that Africans provincialized the metropole, while centring African colonies.