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Child marriage hinders progress toward population health and development goals. Cost effective interventions that address the root causes of child marriage are needed to speed progress toward ending the practice. Nigeria is home to the largest number of married girls in Africa and many of these girls are members of the Hausa ethnic group, making efforts to tackle this issue particularly urgent among this population. Radio programs have the potential to inform large numbers of people about the harms of child marriage and change their support for the practice at low cost. We will develop a series of radio programs that address gender inequitable attitudes that motivate child marriage among Hausa communities in Ibadan, Nigeria. The content of the series will be based on input from the Hausa community. A baseline survey that measures knowledge of and support for child marriage will be conducted among randomly selected samples of Hausa adults in two cities: Ibadan, which will serve as the intervention site, and Akure, the control site. The radio programs will then air on Hausa-language stations in Ibadan over a three-month period, with the aim of informing persons of the potential harms of child marriage and reducing their support for the practice. A follow-up survey with the same individuals surveyed at baseline will be conducted in both cities. We will measure the impact of this intervention by comparing changes in these outcomes over time in the intervention site (Ibadan) with changes in the same outcomes in the control site (Akure). This study will investigate whether a series of targeted radio programs can reduce support for child marriage. The intervention is readily scalable and cost-effective and, if it effectively shifts attitudes toward child marriage, could represent a promising way of addressing child marriage in Nigeria.

[...]mental health services should be scaled up as an essential component of universal health coverage and should be fully integrated into the global response to other health priorities, including non-communicable diseases, maternal and child health, and HIV/AIDS. [...]barriers and threats to mental health need to be addressed; these include the lack of awareness of the value of mental health in social and economic development, the lack of attention to mental health promotion and protection across sectors, the severe demand-side constraints for mental health care caused by stigma and discrimination, and the increasing threats to mental health due to global challenges such as climate change and growing inequality. [...]mental health needs to be protected by public policies and developmental efforts; these intersectoral actions should be undertaken by each country's leaders to engage a wide range of stakeholders within and beyond health, including sectors in education, workplaces, social welfare, gender empowerment, child and youth services, criminal justice and development, and humanitarian assistance. [...]investments in research and innovation should grow and harness novel approaches from diverse disciplines such as genomics, neuroscience, health services research, clinical sciences, and social sciences, both for implementation research on scaling up mental health interventions and for discovery research to advance understanding of causes and mechanisms of mental disorders and develop effective interventions to prevent and treat them.

Mental health problems affect 10–20% of children and adolescents worldwide. Despite their relevance as a leading cause of health-related disability in this age group and their longlasting effects throughout life, the mental health needs of children and adolescents are neglected, especially in low-income and middle-income countries. In this report we review the evidence and the gaps in the published work in terms of prevalence, risk and protective factors, and interventions to prevent and treat childhood and adolescent mental health problems. We also discuss barriers to, and approaches for, the implementation of such strategies in low-resource settings. Action is imperative to reduce the burden of mental health problems in future generations and to allow for the full development of vulnerable children and adolescents worldwide.

This paper describes a postgraduate training programme in child and adolescent mental health (CAMH) in Nigeria. It explains the background, curriculum development, teaching, evaluation and outcomes. By its 10th year the programme had trained 166 CAMH professionals from 14 African countries. Many of the graduates are running clinical CAMH services in their countries, mostly pioneered by them. They are also conducting CAMH training, including as faculty on the programme, and some are in international CAMH leadership roles. Key success elements of the programme that can be replicated in other low- and middle-income countries include international partnership, adopting a train-the-trainer approach, using a curriculum that covers clinical aspects of CAMH while also developing leadership and research skills, use of free-access training resources, and access to seed funding.

Abbreviations: ADHD, attention deficit hyperactivity disorder; CBT, cognitive behavioural therapy; GRADE, Grading of Recommendations Assessment, Development and Evaluation; LAMIC, low- and middle-income countries; mhGAP, Mental Health Gap Action Programme; mhGAP-IG, mhGAP Intervention Guide ; MNS, mental, neurological, and substance use; WHO, World Health Organization Provenance: Not commissioned; externally peer reviewed. Summary Points * The treatment gap for mental, neurological, and substance use (MNS) disorders is more than 75% in many low- and middle-income countries. * In order to reduce the gap, the World Health Organization (WHO) has developed a model intervention guide within its Mental Health Gap Action Programme (mhGAP). * The model intervention guide provides evidence-based recommendations developed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. * This article presents the management recommendations for MNS disorders, with a link to the World Health Organization website where all the background material may be accessed. * To our knowledge, this is a first exercise involving such an extensive and systematic evaluation of evidence in this area.

Effective community entry processes influence community participation and acceptance of public health interventions. Though there is a growing body of literature on the importance of community partnerships, there is a lack of pragmatic and practical documentation of the experiences involved in the community entry process as it relates to culturally sensitive topics such as child marriage which can help to support researchers working in this field. This article highlights key themes related to knowledge of the community, effective communication, cultural sensitivity, coproduction and giving feedback which help to build trust between the community members and the research team. Institutional representation, not managing expectations, and lack of clarity, along with personal opinions of community gatekeepers can create challenges for the fostering of trustworthy relationships with the community. These realities must be actively addressed right at the onset of the process between the research team and community stakeholders. Researchers can develop trust, form connections and engage different communities by working with local groups and leaders, using culturally appropriate methods, and addressing community concerns. Future projects working with communities on child marriage in Nigeria and other countries would benefit from the reflections presented in this paper.

Background Neurodevelopmental disorders are a set of conditions that appear early in a child's development, usually before they begin school, and are likely to impair personal, social, academic, or occupational functioning. These conditions are the result of disturbances in brain development caused by genetic, environmental, or rather unknown causes. With the increasing prevalence of neurodevelopmental disorders in low‐ and middle‐income countries such as Nigeria, it is imperative to understand the level of knowledge of primary healthcare workers who, by virtue of being nearest to the people in the community, are the first point of contact for individuals and families seeking healthcare in the community. This study aimed to assess primary healthcare workers' knowledge level about children and adolescents with neurodevelopmental disorders in Abuja, Nigeria. Methods This was a cross‐sectional study where 274 primary healthcare workers (mean 39.8 ± 10.1 years) were recruited from 17 urban and rural primary healthcare centers (PHCs) in Abuja, Nigeria. The Modified Knowledge and Attitude Towards Child and Adolescent Mental Disorders questionnaire was employed to examine knowledge of and attitudes towards children with disorders (ASD, ADHD, and ID), and the data obtained were analyzed. Percentages and frequencies were used to describe the socio‐demographic characteristics of the respondents as well as the knowledge of the respondents in the study. Means and standard deviations were used to present continuous data, while Chi‐square was used to investigate the association between categorical variables. Results Results from the analysis showed that even with longer working experience of 12.4 ± 6.6 years, respondents had poor knowledge of the identification and management of children and adolescents with neurodevelopmental disorders. A significant majority (68.2%) of the respondents agreed that neurodevelopmental disorders in children and adolescent is a result of weak genes that were passed down to them by their parents. Similarly, 89.4% of the respondents report that imbecile and moron are types of neurodevelopmental disorders found in children. Further, (43.1%) of the respondents believe that supernatural power can be used to inflict neurodevelopmental disorders on children and adolescents. Of the 274 respondents in this study, 182 were Primary healthcare workers from rural/village PHCs. Conclusion Primary healthcare workers demonstrated poor or low knowledge of neurodevelopmental disorders. On‐the‐job training (including continuing medical education), retraining, and an upgrade to the school of health curriculum are adjustments relevant to increasing the awareness and knowledge level of primary healthcare workers in identifying and managing children and adolescents with neurodevelopmental disorders. Summary The curriculum content of schools and colleges that train primary healthcare workers should include courses and extensive topics on neurodevelopmental disorders (NDDs) for students' nurses to get acquainted with issues around the identification and management of children and adolescents with neurodevelopmental disorders. The Ministry of Health and other stakeholders in the health profession should encourage and monitor the training and retraining of primary healthcare workers about issues concerning NDDs. The mental health gap action plan should be implemented across all primary healthcare centers in the country. The government (federal, state, and local) should empower primary healthcare centers through infrastructural development to aid assessments and management of NDDs. Cultural beliefs and traditions are still strongly rooted in understanding disability; therefore, collaboration and education of local authorities, religious leaders, and families need to be strengthened.

Background Studies have demonstrated that social skill interventions and classroom supports are effective for pupils with intellectual disability. Such interventions have been demonstrated to reduce the risk of developing mental disorders, majority of which have their onset during the period of youth. Most young people with intellectual disability in low-resource settings do not have access to interventions that would enable or enhance their participation in society. The aim of this study was to investigate the effect of a social skills training for pupils with intellectual disability attending a special school in Southwest Nigeria. Methods Thirty pupils with mild to moderate intellectual disability participated in the study. Utilising the Explore social skills curriculum, teachers were trained to give lessons to the participants 3–4 times a week for 8 weeks in their classrooms. Social skills level of participants was assessed with the Matson evaluation of social skills for individuals with severe retardation (MESSIER) at baseline and immediately after the intervention. Paired t tests, Wilcoxon signed-rank test, Mann–Whitney U test and the Kruskal–Wallis Test were used to assess for pre and post intervention changes in social skills scores and analysis of changes in social skills across socio-demographic variables at p < 0.05. Results The mean age of the participants was 15.70 ± 1.89 years. At baseline, 18 of the participants (63.3 %) had moderate social skills impairment, 2 (6.7 %) had none or minimal impairments and 10 (30 %) had severe impairments. At the end of the intervention, there was a 20 % reduction in the number of participants in the severe social skills impairment category and 13.3 % increase in the number of participants in the ‘none or minimal’ social skills category. The mean pre and post- intervention total social skills scores were 126.63 ± 17.91 and 135.97 ± 20.81 respectively with a mean difference of 9.34 (t = 3.71; p = 0.001). Conclusion The social skills of pupils with intellectual disability who participated in this study improved significantly during the 8 weeks the Explore social skills curriculum was administered. Advocacy should be made for the development and incorporation of social skills curricula into routine teaching of pupils with developmental disabilities.

Nigeria has the second highest number of people living with HIV (PLWH) globally, and evidence-based approaches are needed to achieve national goals to identify, treat, and reduce new infections. Youth between the ages of 15-24, including young men who have sex with men (YMSM), are disproportionately impacted by the Nigerian HIV epidemic. The purpose of this study was to inform adaptation of evidence-based peer navigation and mHealth approaches (social media outreach to promote HIV testing; short messaging service text message reminders to promote HIV treatment engagement) to the local context within iCARE Nigeria, a multi-phase study designed to investigate combination interventions to promote HIV testing and care engagement among youth in Nigeria. To elicit expert and community perspectives, a local group of advisors from academia, community, and governmental sectors provided feedback on intervention adaptation, which then informed a series of focus groups with stakeholders in Ibadan, Nigeria. Focus group data were collected over a period of three days in December of 2018. Participants in focus groups included YMSM and HIV-positive youth in care ages 16-24, and HIV service providers from local AIDS service organizations (ASO). Groups were stratified by HIV serostatus, gender, and stakeholder type. Focus group sessions were conducted using a semi-structured interview guide, audio-recorded, transcribed verbatim, and analyzed using a content analysis approach. Local experts recommended intervention adaptations specific to the status of peer navigators as volunteers, peer characteristics (slightly older age, high maturity level, HIV/YMSM status), and intervention characteristics and resources (low navigator to peer ratio; flexible matching by demographic and social characteristics; social media platforms and content). Five focus group discussions with stakeholders, including 27 participants were conducted to elicit feedback on these and other potential adaptations. Youth participants (n = 21) were mean age 20 years (range = 16-24); 76% HIV-positive, 76% men and 48% MSM. Service providers (n = 6) represented both HIV prevention and care services. Participants across stratified subgroups reported largely positive perceptions and high perceived acceptability of both mHealth and peer navigation strategies, and echoed the recommendations of the advisory group for volunteer-based navigators to promote altruism, with a low navigator-peer ratio (1:5). Participants emphasized the need to incorporate minimal mobile data use strategies and popular social media platforms among YMSM (e.g., Facebook, Grindr) for widespread access and reach of the interventions. In Ibadan, Nigeria, stakeholders support the adaptation of combined mHealth and peer navigation strategies to promote HIV testing and care engagement among high-risk youth. Recommended adaptations for the local context reflect concerns about the feasibility and sustainability of the intervention and are expected to improve accessibility and acceptability.

Nigeria is one of six countries with half the global burden of youth living with HIV. Interventions to date have been inadequate as AIDS-related deaths in Nigeria's youth have remained unchanged in recent years. The iCARE Nigeria HIV treatment support intervention, a combination of peer navigation and SMS text message medication reminders to promote viral suppression, demonstrated initial efficacy and feasibility in a pilot trial among youth living with HIV in Nigeria. This paper describes the study protocol for the large-scale trial of the intervention. The iCARE Nigeria-Treatment study is a randomized stepped wedge trial of a combination (peer navigation and text message reminder) intervention, delivered to youth over a period of 48 weeks to promote viral suppression. Youth receiving HIV treatment at six clinical sites in the North Central and South Western regions of Nigeria were recruited for participation. Eligibility criteria included registration as a patient at participating clinics, aged 15-24 years, on antiretroviral therapy for at least three months, ability to understand and read English, Hausa, Pidgin English, or Yoruba, and intent to remain a patient at the study site during the study period. The six clinic sites were divided into three clusters and randomized to a sequence of control and intervention periods for comparison. The primary outcome is plasma HIV-1 viral load suppression, defined as viral load ≤ 200 copies/mL, in the intervention period versus the control period at 48 weeks of intervention. Evidence-based interventions to promote viral load suppression among youth in Nigeria are needed. This study will determine efficacy of a combination intervention (peer navigation and text message reminder) and collect data on potential implementation barriers and facilitators to inform scale-up if efficacy is confirmed. ClinicalTrials.gov number, NCT04950153, retrospectively registered July 6, 2021, https://clinicaltrials.gov/.