Jennifer Anyanti - Profile on Academia.edu (original) (raw)

Volume 7 - Issue 6 by Jennifer Anyanti

Background: Prompt and effective case detection and treatment are vital components of the malaria... more Background: Prompt and effective case detection and treatment are vital components of the malaria case management strategy as malaria-endemic countries implement the testing, treating and tracking policy. The implementation of this policy in public and formal private sectors continue to receive great attention while the informal private retail sector (mostly the patent and propriety medicine vendors [PPMVs]) where about 60% of patients with fever in Nigeria seek treatment is yet to be fully integrated. The PPMVs sell artemisinin combination therapies (ACTs) without prior testing and are highly patronized. Without prior testing, malaria is likely to be over-treated. The need to expand access to diagnosis in the huge informal private health sector among PPMVs is currently being explored to ensure that clients that patronize retail drug stores are tested before sales of ACTs. Methods: A cross-sectional multistage study was conducted among 1279 adult clients, 20 years and above, who purchased malaria medicines from 119 selected PPMVs in five administrative areas (States) of Nigeria, namely: Adamawa, Cross River, Enugu, Lagos and Kaduna, as well as the Federal Capital Territory, Abuja. Exit interviews using a standard case report questionnaire was conducted after the purchase of the antimalarial medicine and thick/thin blood smears from the clients' finger-prick were prepared to confirm malaria by expert microscopy. Results: Of the 1279 clients who purchased malaria medicines from the PPMV outlets, 107 (8.4%) were confirmed to have malaria parasites. The malaria prevalence in the various study areas ranged from 3.5% to 16%. A high proportion of clients in the various study sites who had no need for malaria medicines (84%-96.5%) purchased and used antimalarial medicines from the PPMVs. This indicated a high level of over-treatment and misuse of antimalarials. Common symptoms that are widely used as indicators for malaria such as, fever, headache, and tiredness were not significantly associated with malaria. Nausea/vomiting, poor appetite, chills, bitter taste in the mouth and dark urine were symptoms that were significantly associated with malaria among the adult clients (P < .05) but not fever (P = .06). Conclusion: Misuse of ACTs following overtreatment of malaria based on clinical diagnosis occurs when suspected cases of malaria are not prior confirmed with a test. Non-testing before sales of malaria medicines by PPMVs will perpetuate ACT misuse with the patients not benefiting due to poor treatment outcomes, waste of medicines and financial loss from out-of-pocket payment for unneeded medicines. Citation: Nwokolo E, Ujuju C, Anyanti J, et al. Misuse of artemisinin combination therapies by clients of medicine retailers suspected to have malaria without prior parasitological confirmation in Nigeria. Int J Health Policy Manag.

Papers by Jennifer Anyanti

Risk Management and Healthcare Policy, 2020

Introduction: Effective management of hypertension and diabetes through accurate diagnosis and tr... more Introduction: Effective management of hypertension and diabetes through accurate diagnosis and treatment can reduce the risk of complications and early deaths. This study was a descriptive cross-sectional study aimed at determining practices regarding hypertension and type 2 diabetes management among healthcare providers in Kaduna and Imo States, Nigeria. Data were collected using a semi-structured interviewer administered questionnaire consisting of questions across four major domains: 1) screening; 2) diagnosis; 3) pharmacological; and 4) non-pharmacological treatment of hypertension and diabetes. Results: A total of 77 healthcare providers were interviewed and they included; 20 (26.5%) medical doctors, 25 (32.5%) nurses/midwives, 18 (23.4%) community health extension workers and 3 (3.9%) pharmacists. Almost half (46.8%) of the respondents indicated that they prioritize routine blood pressure (BP) checks among all adult patients while only 30 (39.0%) and 8 (10.4%) correctly identified the diagnostic criteria for hypertension and diabetes, respectively. Calcium chain blockers only were the most prescribed medication for treatment of hypertension across all stages of hypertension while metformin (glucophage) was stated as the preferred medication prescribed for controlling blood glucose levels among the respondents. Only 32.5% of the respondents stated that they have a means in place in their facilities to ensure that hypertension and diabetes patients adhere to follow-on visit recommendations. Conclusion: A significant knowledge gap was identified in the diagnosis and treatment of hypertension and diabetes among the respondents due to unavailability of properly outlined management guidelines for these conditions for the different cadres of healthcare workers in Nigeria. There is a need for the development and wide distribution of guidelines highlighting cadre-specific roles for healthcare providers in hypertension and diabetes management and standard operating procedures based on such guidelines should be available at various points of care to ensure better treatment outcomes.

Archives of Public Health, 2022

Background The trio of commonest illnesses and causes mortality among children under five (Malari... more Background The trio of commonest illnesses and causes mortality among children under five (Malaria, Pneumonia and Diarrhea) are easily treatable through timely exposure to cost effective interventions at the community level. Patent and proprietary medicine vendors (PPMVs) are a leading source of care for illnesses among under-five children in Nigeria. This study was designed to explore child health services offering, particularly commodity stocking patterns and case management knowledge for common childhood illnesses among PPMVs in Ebonyi and Kaduna States. Methods A descriptive cross-sectional study was conducted among PPMVs in four local government areas across Ebonyi and Kaduna States. Data was collected using semi-structured interviewer-administered questionnaires. Information was obtained on medicine and supplies, knowledge of common childhood illnesses management and referral practices. Results A total of 374 PPMVs were interviewed; the mean age was 33.7 ± 9.8 years. Among the...

Public health risk implications of endocrine disrupting chemicals in drinking water and aquatic food resources from Nigerian inland waters: a comprehensive systematic review and meta-analysis

Background of the study: The release of anthropogenic (industrial, agricultural and domestic) pol... more Background of the study: The release of anthropogenic (industrial, agricultural and domestic) pollutants with endocrine disruptive effects into the environment represents serious public health concerns. Endocrine disrupting chemicals (EDCs) is a group of environmental pollutants that interfere with hormone synthesis, metabolism, excretion and functions in exposed organisms[1-2] . These interactions eventually produce deleterious consequences on reproduction, development, metabolism, physiology, neurobehavioral disorders[3-10] . In addition, EDCs have been shown to produce effects related to cancers, diabetes, thyroid dysfunction, birth defects, infertility, early onset of puberty in girls, early menopause in women, mortality and morbidity in exposed individuals[11-18] . Accumulating scientific and public health evidence has indicated the common environmental occurrence of EDCs such as phthalate esters (PEs)[19-22] , bisphenol-A (BPA)[23-25] , perfluoroalkyl substances (PFASs)[26] , ...

Health Policy and Planning, 2021

Health interventions introduced as part of donor-funded projects need careful planning if they ar... more Health interventions introduced as part of donor-funded projects need careful planning if they are to survive when donor funding ends. In northeast Nigeria, the Gombe State Primary Health Care Development Agency and implementing partners recognized this when introducing a Village Health Worker (VHW) Scheme in 2016. VHWs are a new cadre of community health worker, providing maternal, newborn and child health-related messages, basic healthcare and making referrals to health facilities. This paper presents a qualitative study focussing on the VHW Scheme’s sustainability and, hence, contributes to the body of literature on sustaining donor-funded interventions as well as presenting lessons aimed at decision-makers seeking to introduce similar schemes in other Nigerian states and in other low- and middle-income settings. In 2017 and 2018, we conducted 37 semi-structured interviews and 23 focus group discussions with intervention stakeholders and community members. Based on respondents’ a...

Nigeria (2008): Report of the Baseline Survey on Knowledge, Attitude, Practice, Coverage and Quality of Coverage of the Female Condom in Nigeria

The study was aimed at obtaining information on knowledge of the female condom among men and wome... more The study was aimed at obtaining information on knowledge of the female condom among men and women in Edo, Delta and Lagos States. The study locations were purposively selected based on the following reasons. Firstly, these states are associated with high contraceptive prevalence rates. Furthermore, the need for family planning services as well as AIDS prevention is high in these states. To be able to carry out the interventions effectively, these states were selected due to the existence of strong CBOs, Oxfam Novib partners such as Girls Power Initiative (GPI) and Lift Above Poverty Organisation (LAPO). Above all, the states were selected based on their relatively high population and high number of HIV infections.

PLOS ONE, 2020

Funding: The Gates foundation funded the VHW program through the Society for Family Health, a Non... more Funding: The Gates foundation funded the VHW program through the Society for Family Health, a Non-governmental Organization. Society for Family Health supported this study through the grant received from the Gates Foundation. The funders messages, and influenced husbands and mothers-in-law to support women's' use of MNCH services. VHWs' interventions were perceived to have improved health literacy and the uptake of MNCH services. Participants generally admired the VHW occupation and recommended VHW program scale-up, and for VHWs to be offered basic obstetric training and employment by health facilities or the government. Conclusion The general acceptance and positive views of VHWs from beneficiaries of the program demonstrates the feasibility of the program to improve the uptake of MNCH services.

Implementation Science Communications, 2020

Introduction Hypertensive disorders in pregnancy result in about 76,000 maternal deaths per year ... more Introduction Hypertensive disorders in pregnancy result in about 76,000 maternal deaths per year worldwide. Pre-eclampsia and eclampsia cause the most deaths. Interventions for managing these disorders are available in health facilities. We assess the effect of monitoring pregnant women’s blood pressure (BP) in their homes using village health workers (VHWs) equipped with a BP-measuring device on hypertension in pregnancy, in a resource-poor setting. Also, we assess the VHWs’ competence with the BP device, acceptability and appropriateness of the intervention, and factors that affect the implementation of the intervention. Method This is a mixed method study comprising quantitative and qualitative data collection. We implemented the intervention over 6 months across three local government areas in Gombe state, northeast Nigeria. The Replicating Effective Program (REP) framework guided the development of the implementation strategy. The quantitative data include routine measurement o...

Journal of Tuberculosis Research, 2020

Background: The WHO recommended DOTS has been proven to be very effective in the treatment of tub... more Background: The WHO recommended DOTS has been proven to be very effective in the treatment of tuberculosis (TB) patients. However, despite its effectiveness, non-adherence to the treatment regimen remains a major concern in TB management. This has great consequences which include persistent infectiousness, higher rates of treatment failure, continued transmission, drug resistance, and untimely death. The aim of this study is to examine the factors and behavioural patterns that contribute to treatment adherence among TB patients in Kano State, Nigeria. Methods: A qualitative study design which included two focus group discussions (FGDs) and four key informant interviews (KIIs) were adopted for this study. In total, 20 participants were interviewed comprising 16 focus group discussion participants (8 patients on treatment and 8 individuals who have been cured) divided into two groups and four key informant interviews with 4 health workers in the selected treatment facilities. Data analysis was done by translating and transcribing the responses from the FGDs and KIIs. The transcribed data was analysed using a thematic framework procedure. Results: It was observed that having a good treatment supporter who was effective and very supportive was the most important factor contributing to treatment adherence. Other identified factors that contributed to treatment adherence included: good communication by health personnel, social support from relatives and communities, little or no side effects from drug usage, low cost of transportation to the health facilities, a positive mind set towards drug usage and treatment, support and motivation from health workers, feelings of wellness during treatment, and a balanced diet. All the respondents agreed that treatment adherence had far reaching effects on positive treatment outcomes. Conclusion:

African Journal of Reproductive Health, 2017

Demand for and utilization of women's health services in northern Nigeria are consistently low an... more Demand for and utilization of women's health services in northern Nigeria are consistently low and health indicators in the region are among the poorest in the world. This literature review focuses on social and cultural barriers to contraceptive use, antenatal care, and facility births in northern Nigeria, and influencers of young women's health-seeking behavior. A thorough search of peer reviewed and grey literature yielded 41 publications that were synthesized and analyzed. The region's population is predominantly Muslim, practicing Islam as a complete way of life. While northern Nigerian society is slowly changing, most women still lack formal education, with a significant proportion married in their teens, and the majority neither socially nor economically empowered. The husband largely makes most household decisions, including utilization of healthcare services by members of his household. These practices directly impact women's health-seeking behaviors for themselves and for their children. Programs seeking to improve women's health outcomes in northern Nigeria should involve women's influencers to affect behavior change, including husbands, religious leaders, and others. More research is needed to identify pathways of information that can be utilized by programs designed to increase demand for health services.

Journal of Global Health Reports, 2019

Back Background ground Studies have demonstrated that trained community health workers can improv... more Back Background ground Studies have demonstrated that trained community health workers can improve access to quality health services for under five children. Under the World Health Organization's Rapid Access Expansion Progamme, integrated community case management of childhood illnesses (iCCM) was introduced in Abia and Niger States, Nigeria in 2013. The objective of the program was to increase the number of children 2-59 months receiving quality life-saving treatment for malaria, pneumonia and diarrhoea by extending case management through community-oriented resource persons (CORPs). We present findings from household surveys comparing baseline and endline data to assess changes in sick child care-seeking, assessment, and treatment coverage provided over the project period in Abia State. Methods Methods A baseline household survey was conducted in May 2014 and an endline survey in February 2017. The surveys used multi-stage cluster sampling of primary caregivers of children aged 2-59 months who had been recently sick with diarrhoea, fever, or cough with difficult breathing. R Results esults Care-seeking from an appropriate provider improved significantly from 69% at baseline to 77% at endline (P<0.01). At baseline, patent and proprietary medicine vendors (PPMVs) (55%) and health centers (34%) were the main providers of care for iCCM services; by endline, CORPs became the main source (48%), followed by PPMVs (36%) and health centers (25%). C Conclusions onclusions Overall, the findings demonstrate improvements in care-seeking. Care-seeking practices shifted over the course of the project, with more caregivers seeking care from CORPs by the end of the project. The findings suggest that scaling up iCCM in Nigeria may improve access to appropriate treatment for under five children living in hard-to-reach areas.

Malaria journal, Dec 15, 2017

Oral artemisinin monotherapy (AMT), an important contributor to multi-drug resistant malaria, has... more Oral artemisinin monotherapy (AMT), an important contributor to multi-drug resistant malaria, has been banned in Nigeria. While oral AMT has scarcely been found for several years now in other malaria-endemic countries, availability has persisted in Nigeria's private sector. In 2015, the ACTwatch project conducted a nationally representative outlet survey. Results from the outlet survey show the extent to which oral AMT prevails in Nigeria's anti-malarial market, and provide key product information to guide strategies for removal. Between August 10th and October 3rd, 2015 a total of 13,480 outlets were screened for availability of anti-malarials and/or malaria blood testing services. Among the 3624 anti-malarial outlets, 33,539 anti-malarial products were audited, of which 1740 were oral AMT products, primarily artesunate (n = 1731). Oral AMT was imported from three different countries (Vietnam, China and India), representing six different manufacturers and 11 different brand...

PloS one, 2018

An estimated 214 million women have unmet need for family planning in developing regions. Improve... more An estimated 214 million women have unmet need for family planning in developing regions. Improved utilization of the private sector is key to achieving universal access to a range of safe and effective modern contraceptive methods stipulated by FP2020 and SDG commitments. Until now, a lack of market data has limited understanding of the private sector's role in increasing contraceptive coverage and choice. In 2015, the FPwatch Project conducted representative outlet surveys in Ethiopia, Nigeria, and DRC using a full census approach in selected administrative areas. Every public and private sector outlet with the potential to sell or distribute modern contraceptives was approached. In outlets with modern contraceptives, product audits and provider interviews assessed contraceptive market composition, availability, and price. Excluding general retailers, 96% of potential outlets in Ethiopia, 55% in Nigeria, and 41% in DRC had modern contraceptive methods available. In Ethiopia, 4...

International journal of health policy and management, Nov 1, 2017

Prompt and effective case detection and treatment are vital components of the malaria case manage... more Prompt and effective case detection and treatment are vital components of the malaria case management strategy as malaria-endemic countries implement the testing, treating and tracking policy. The implementation of this policy in public and formal private sectors continue to receive great attention while the informal private retail sector (mostly the patent and propriety medicine vendors [PPMVs]) where about 60% of patients with fever in Nigeria seek treatment is yet to be fully integrated. The PPMVs sell artemisinin combination therapies (ACTs) without prior testing and are highly patronized. Without prior testing, malaria is likely to be over-treated. The need to expand access to diagnosis in the huge informal private health sector among PPMVs is currently being explored to ensure that clients that patronize retail drug stores are tested before sales of ACTs. A cross-sectional multistage study was conducted among 1279 adult clients, 20 years and above, who purchased malaria medici...

Malaria journal, Dec 12, 2017

Despite the World Health Organization's recommendation of malaria test-treat strategy, which ... more Despite the World Health Organization's recommendation of malaria test-treat strategy, which is the treatment of parasitological confirmed malaria cases with anti-malarials, presumptive diagnosis of malaria remains fairly common in Nigeria. The reasons for this have not been established in Makarfi, Nigeria, despite the high burden of malaria in the area. A study was conducted among caregivers of febrile children less than 5 years presenting for treatment to understand their awareness of malaria diagnostic testing and being offered testing by clinicians, the determinants of these outcomes, and caregivers' perspectives of health workers' testing practices. Using mixed-methods, data was combined from sub-analysis of cross-sectional survey data (n = 295) and focus group discussions (n = 4) with caregivers conducted in Makarfi General Hospital (Kaduna State, Nigeria) and surrounding communities in 2011. Bivariate and multivariate analysis of the quantitative survey data was c...

PloS one, 2017

Many patients with malaria-like symptoms seek treatment in private medicine retail outlets (PMR) ... more Many patients with malaria-like symptoms seek treatment in private medicine retail outlets (PMR) that distribute malaria medicines but do not traditionally provide diagnostic services, potentially leading to overtreatment with antimalarial drugs. To achieve universal access to prompt parasite-based diagnosis, many malaria-endemic countries are considering scaling up malaria rapid diagnostic tests (RDTs) in these outlets, an intervention that may require legislative changes and major investments in supporting programs and infrastructures. This review identifies studies that introduced malaria RDTs in PMRs and examines study outcomes and success factors to inform scale up decisions. Published and unpublished studies that introduced malaria RDTs in PMRs were systematically identified and reviewed. Literature published before November 2016 was searched in six electronic databases, and unpublished studies were identified through personal contacts and stakeholder meetings. Outcomes were e...

Bulletin of the World Health Organization, 2016

To characterize patent and proprietary medicine vendors and shops in Nigeria and to assess their ... more To characterize patent and proprietary medicine vendors and shops in Nigeria and to assess their ability to help improve access to high-quality, primary health-care services. In 2013 and 2014, a census of patent and proprietary medicine shops in 16 states of Nigeria was carried out to determine: (i) the size and coverage of the sector; (ii) the basic characteristics of shops and their staff; and (iii) the range of products stocked for priority health services, particularly for malaria, diarrhoea and family planning. The influence of the medical training of people in charge of the shops on the health-care products stocked and registration with official bodies was assessed by regression analysis. The number of shops per 100 000 population was higher in southern than in northern states, but the average percentage of people in charge with medical training across local government areas was higher in northern states: 52.6% versus 29.7% in southern states. Shops headed by a person with med...

Journal of Aids and Hiv Research, Jun 12, 2013

Repeated use of female condom is very low in Nigeria. Just three out of ten persons who have ever... more Repeated use of female condom is very low in Nigeria. Just three out of ten persons who have ever used female condoms intend to continue using it. This study conducted in three Nigerian States was aimed at identifying the barriers to repeated and non repeated use of female condom. Among men and women of reproductive age, 16 focus group discussions (FGDs) and 16 in-depth interviews (IDIs) were conducted using structured tools. Key findings showed that first experience with the use of female condom was a major reason for continuing or discontinuing use of female condom. First use experience was influenced by what users were told and the skills they have in wearing female condom. Informed and supported female condom users were willing to repeat its use while those who were not, had "bad" first experiences. Female condom is a unique commodity. Just handing it out without proper education will pose a serious challenge for its continuous and sustained use. Frontline staff should be well informed and educated on the product. First time users should be supported to use the product.

Malaria Research and Treatment, 2014

Background. Malaria during pregnancy is a major public health problem in Nigeria especially in ma... more Background. Malaria during pregnancy is a major public health problem in Nigeria especially in malaria-endemic areas. It increases the risk of low birth weight and child/maternal morbidity/mortality. This paper addresses the impact of radio campaigns on the use of insecticide-treated bed nets among pregnant women in Nigeria. Methods. A total of 2,348 pregnant women were interviewed during the survey across 21 of Nigeria’s 36 states. Respondents were selected through a multistage sampling technique. Analysis was based on multivariate logistic regression. Results. Respondents who knew that sleeping under ITN prevents malaria were 3.2 times more likely to sleep under net (OR: 3.15; 95% CI: 2.28 to 4.33; P<0.0001). Those who listened to radio are also about 1.6 times more likely to use ITN (OR: 1.56; 95% CI: 1.07 to 2.28; P=0.020), while respondents who had heard of a specific sponsored radio campaign on ITN are 1.53 times more likely to use a bed net (P=0.019). Conclusion. Pregnant ...

SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2011

He obtained BSc, MSc and PhD degrees in Statistics/Applied Statistics. He specialises in biostati... more He obtained BSc, MSc and PhD degrees in Statistics/Applied Statistics. He specialises in biostatistics and enjoys teaching statistics at university level. Richard Fakolade is a monitoring and evaluation specialist of public health programs in Nigeria. He has a good knowledge of qualitative and quantitative research methodologies to inform and guide programs, and a master's degree in public policy and administration.

Risk Management and Healthcare Policy, 2020

Archives of Public Health, 2022

Public health risk implications of endocrine disrupting chemicals in drinking water and aquatic food resources from Nigerian inland waters: a comprehensive systematic review and meta-analysis

Health Policy and Planning, 2021

Nigeria (2008): Report of the Baseline Survey on Knowledge, Attitude, Practice, Coverage and Quality of Coverage of the Female Condom in Nigeria

PLOS ONE, 2020

Implementation Science Communications, 2020

Journal of Tuberculosis Research, 2020

African Journal of Reproductive Health, 2017

Journal of Global Health Reports, 2019

Malaria journal, Dec 15, 2017

PloS one, 2018

International journal of health policy and management, Nov 1, 2017

Malaria journal, Dec 12, 2017

PloS one, 2017

Bulletin of the World Health Organization, 2016

Journal of Aids and Hiv Research, Jun 12, 2013

Malaria Research and Treatment, 2014

SAHARA-J: Journal of Social Aspects of HIV/AIDS, 2011

BMC health services research, Jan 5, 2014

To reduce the burden of disease from malaria, innovative approaches are needed to engender behavi... more To reduce the burden of disease from malaria, innovative approaches are needed to engender behavior change. One unobservable, but fundamental trait-preferences for risk-may influence individuals' willingness to adopt new health technologies. We explore the association of risk preferences with malaria care-seeking behavior and the acceptability of malaria rapid diagnostic tests (RDTs) to inform RDT scale-up plans. In Oyo State, Nigeria, adult customers purchasing anti-malarial medications at selected drug shops took surveys and received an RDT as they exited. After an initial risk preference assessment via a simple lottery game choice, individuals were given their RDT result and treatment advice, and called four days later to assess treatment adherence. We used bivariable and multivariable regression analysis to assess the association of risk game choices with malaria care-seeking behaviors and RDT acceptability. Of 448 respondents, 63.2% chose the lottery game with zero variance...