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Objective Adolescent deliveries remain a public health problem in most developing countries. The aim of our study was to determine the prevalence, trends and outcome of adolescent deliveries in an urban setting in Cameroon. We carried out a retrospective register analysis over a 6-year period (January 2010–December 2015) at the Saint Albert Le Grand hospital Douala. Results The overall prevalence of adolescent deliveries was 8.2% (662 out of 8056). There was a significant decrease over the 6-year period (p-trend: < 0.05). Adolescents were at higher risk of preterm deliveries (gestational age < 37 weeks; odds ratio [OR], 1.7; 95% confidence interval [CI]; 1.3–2.2; p < 0.01): low birth weight (defined as birth weight < 2650 g, OR; 1.7, CI 1.4–2.2, p < 0.01) and asphyxia at 1st minute (OR, 1.5; 95% CI 1.1–2.2; p = 0.02). There was no difference in delivery outcomes between early and late adolescents. Our results suggest that the prevalence of adolescent deliveries is lower in urban settings. Adolescent deliveries are more likely to result in adverse fetal outcomes than adult deliveries. Measures directed towards the prevention of adolescent pregnancies should be implemented to reduce neonatal morbidity and mortality.

The COVID-19 pandemic has had disproportionate economic and health impacts on self-employed workers in Nigeria, particularly self-employed women and youth. Though uniquely different, the COVID-19 pandemic shares similarities with events such as childbirth, family, and health emergencies. Self-employed young women lack adequate support structures to cope with disruptive life events, which have negative consequences for their well-being. This is concerning, as 86% of women in the Nigerian labor force are self-employed. The project's first objective is to conduct a gendered situational analysis to address the question of how the COVID-19 pandemic and other life events affect the paid and unpaid work and the physical, mental, and social well-being of self-employed young women in Nigeria; their strategies for coping with such events; and how their experiences compare with those of self-employed young men. Informed by this analysis, the second objective is to coproduce and pilot-test a gender-transformative intervention that integrates social protection and promotes well-being. This multimethod project has 3 components. The first is a situational analysis of the impact of the pandemic and other significant life events on the work and well-being of self-employed young women vis-à-vis self-employed young men. This involves qualitative interviews with approximately 60 self-employed young women and men and a digital storytelling initiative to represent some of these stories in video format. Secondary data analysis of the Nigerian General Household Survey and the COVID-19 Longitudinal Phone Survey will be conducted. Furthermore, a scoping review of the impact of significant life events, including the COVID-19 pandemic, on self-employed workers in low- and middle-income countries will be conducted. The second component is the coproduction of interventions involving qualitative interviews with self-employed young women, members of their support network, and policy makers to find out their views on how to support self-employed women. It also entails an analysis of policies relevant to self-employed women in Nigeria and theory of change workshops to create a map for achieving the long-term goal of improving their resilience. Furthermore, a systematic review of interventions to improve the job quality and well-being of self-employed workers will be conducted. The third component is a pilot of the coproduced interventions in a quasi-experimental study involving 300 participants to assess feasibility, acceptability, cost, and potential effectiveness. This project was funded in October 2022. Data collection for the project commenced in May 2023 and will end in November 2025. Data collection for the situational analysis and coproduction of intervention phases have been completed while the pilot of intervention packages is underway. This project will advance knowledge of the impact of the COVID-19 pandemic and other significant disruptive life events on the work and well-being of self-employed young Nigerian women and provide coproduced solutions to mitigate their effects. DERR1-10.2196/69577.

Background Recent reviews have highlighted the need for participatory research to design and evaluate inclusive, community-based interventions that address the diverse needs of people with lived experience of psychosis, within and beyond the health sector. The SUCCEED Africa consortium aims to co-produce a 6-year programme of research across four countries in West (Sierra Leone, Nigeria) and Southeast Africa (Zimbabwe and Malawi). This protocol describes the pilot study in which SUCCEED’s intervention, research tools and processes will be tested on a small scale in each country in preparation for future evaluation research. Methods The SUCCEED intervention comprises peer support, case management and livelihood activities for people with lived experience of psychosis. The pilot uses a before-and-after study design investigating change in subjective quality of life in adults diagnosed with a primary psychotic disorder or another mental disorder with psychotic symptoms who are offered the SUCCEED intervention over a 4-month period. Nested within this study are the following: a baseline assessment of the feasibility, acceptability and face validity of the selected measurement tool and validity of proxy versus self-completion; and a multi-method process evaluation examining key process indicators and implementation, service and client-level outcomes. Methods include the following: baseline cognitive interviews; semi-structed observation and routine monitoring and evaluation of service delivery; endline interviews and focus group discussions; and a comparison of provider competencies at endline. At each of the four pilot sites, participants will include the following: ten people with lived experience of psychosis, recruited from either health services or community settings using purposive sampling to maximise variation; up to ten adult family members (one per participant with lived experience) involved in their care; the peer support worker, community support worker and supervisor responsible for delivering the intervention; and the data collectors. Recruitment will take place in July and August 2023. Discussion To the best of our knowledge, this will be the first study of a community-based intervention incorporating lay-delivered case management, formal peer support and livelihoods activities for people with lived experience of psychosis in sub-Saharan Africa. Findings will be relevant not only to SUCCEED but also to others interested in promoting rights-based approaches to community mental health in low-resource settings. Trial registration US National Library of Medicine (ClinicalTrials.gov), Protocol reference ID 28346. Initially registered retrospectively July 20/2023: In review.

Objective Stillbirth measures provide means to assess adequacy of maternal and perinatal care in a given population. The aim of this study was to describe the determinants of stillbirth in Douala general hospital, Cameroon. Results Determinants of stillbirth in this hospital are: maternal age ≥35 years (OR 1.79, 95% CI 1.26–2.54, p = 0.001), pre-eclampsia/eclampsia (OR 2.97, 95% CI 0.87–8.89, p value of 0.03), diabetes in pregnancy (OR 9.97, 95% CI 1.15–86.86, p = 0.03), stillbirth in previous pregnancies (OR 3.94, CI 2.02–7.7, p < 0.0001), inter-pregnancy interval >2 years (OR 2, 06 CI 1.22–3.49; p = 0,006), referral from another hospital (OR 14.16, 95% CI 7.08–28.3, p < 0.0001), gestational age <37 (OR 19.9, 95% CI 12.3–32.2, p < 0.0001) and >42 (OR 6.27, 95% CI = 0.86–45.2, p = 0.096), congenital malformation (OR 11.09, 95% CI 3.2–38,5, p < 0.0001) and birth weight <2500 g (p < 0.0001).

As part of the formative work of the SUCCEED Africa consortium, we followed a participatory process to identify existing gaps and resources needed for the development and implementation of a rights-based intervention for people with lived experience of psychosis in Malawi, Nigeria, Sierra Leone and Zimbabwe.In 2021, we conducted a desk review of published and grey literature on psychosis in the four SUCCEED countries. Using an adapted version of the PRIME situation analysis template, data were extracted across the five domains of the WHO Community-Based Rehabilitation (CBR) Matrix: health, education, livelihoods, social and empowerment. This was supplemented with insights from personal communications with key stakeholders and the lived and professional experiences of team members.Findings indicate that people with lived experience of psychosis have limited access to services and opportunities across the five CBR domains. Participation in social, religious, empowerment and political activities is restricted due to stigma and a lack of advocacy.People with lived experience of psychosis in SUCCEED countries are not generally able to access support in line with essential components of CBR. There is a need for their greater inclusion in policy and advocacy activities.

Mental health problems are a barrier to the well-being of youth living with HIV. Many youth living with HIV in Nigeria face peculiar biopsychosocial vulnerabilities that predispose them to mental health problems including depression and substance use. In addition to improving treatment outcomes like medication adherence and linkage to care, peer engagement has shown some promise in improving the social and emotional well-being of this population. Mobile health (mHealth) interventions like SMS text messaging medication reminders may also contribute to better outcomes in youth living with HIV. Emerging evidence suggests that combination interventions may be more effective than single interventions in improving key HIV testing and treatment outcomes among youth in Nigeria. This study aims to explore the impact of Intensive Combination Approach to Rollback the Epidemic in Nigerian Adolescents (iCARE Nigeria) study-an mHealth and peer navigation intervention primarily aimed at medication adherence and viral suppression-on depressive symptoms and substance use among youth living with HIV in Nigeria. A single-arm clinical trial was conducted at the Infectious Disease Institute, College of Medicine, University of Ibadan, Nigeria- primarily to improve medication adherence and viral suppression among youth living with HIV attending its HIV clinic. The intervention combined peer navigation and daily, 2-way, text message medication reminders delivered over a period of 48 weeks. Participants were screened at baseline and follow-up visits (24 and 48 weeks) for depression and substance use using standardized measures. Paired t tests and McNemar tests were used to investigate the change in depressive symptoms and the change in the proportion of participants reporting substance use over time, respectively. All 40 enrolled participants (n=20, 50% male; mean age 19.9 y, SD 2.5 y) completed baseline and follow-up visits at week 24, while 37 (92.5%) participants completed the week 48 visit. Compared with baseline, there were significantly fewer self-reported depressive symptoms observed at 48 weeks (mean 2.89 vs 2.08; t36=2.04, 95% CI 0.006-1.615) but not at 24 weeks (mean 2.89 vs 2.62; t36=0.47, 95% CI -0.74 to 1.44). There were fewer self-reports of substance use at weeks 24 and 48 when compared to baseline, but these were not statistically significant (odds ratio [OR] ∞, 95% CI 0.189-∞ and OR 3.0, 95% CI 0.24-157.49, respectively). These findings suggest a statistically significant reduction in depressive symptoms among youth living with HIV over the 48-week intervention period that may be due to the iCARE Nigeria intervention. However, given limitations such as low levels of depressive symptoms at baseline, small sample size, and the lack of a control group, future studies such as the randomized stepped wedge evaluation of the iCARE intervention are needed to provide better insights into these exploratory findings.

To tackle these compounding challenges and take advantage of all that the 21st century has to offer, it will be necessary to draw on the power, ideas, and leadership capabilities of young people to reimagine and recreate a healthier, fairer, and just planet. Investments across adolescence—ie, the period between age 10 years and 24 years—will reap a triple dividend, with benefits for young people today, for the adults they will become, and for the next generation of children whom they will parent. Strengthen community systems that promote mental health and wellbeing Develop innovative approaches to address complex and emerging health threats in partnership with adolescents Against these advances, strikingly little progress has been made in reducing adolescent non-communicable diseases in every region of the world, with rises globally in obesity-related diseases and mental disorders in young people.

One of the most recognized factors of maternal and neonatal outcome pertaining to the peripartum period is the duration of labour. Finding a drug that will decrease the duration of labour with no effects on mother and foetus will be welcomed. Thereby in this study we aimed to evaluate the effects of phloroglucinol on the duration of the active phase of labour. We did a single blinded placebo controlled randomised 1:1 parallel designed superiority trial between January and June 2017 in Douala general hospital. Participants greater than 18 years with singleton uncomplicated pregnancy who consented following randomisation, were administered either 80mg/8ml intravenous phloroglucinol or 8ml of sterile water when in active labour. The primary outcome was the duration of labour. Modified intention to treat analysis was done with the level of significance set at a p value of 0.05. 122 participants received the intervention. The mean total duration labour in the treatment and placebo group were 216.8 ± 38.7 and 358.5 ± 65.8 respectively (p value = 0.243). The mean duration of the active phase of labour in the treatment and placebo group were 183.0±35.6 and 316.0±52.2 respectively (p value = 0.046). The mean rate of cervical dilatation in the treatment and placebo group were 2.1 ± 0.4 and 1.3 ± 0.4 respectively (p value = 0.322). There was no difference in maternal and foetal outcomes between the two groups. Phloroglucinol shortens the duration of active phase of labour by about 2 hours (42%). It is safe to mother and baby and does not cause adverse foetal or maternal outcomes.

Background With 60% of Africa’s population under the age of 25 years, investing in youth will accelerate progress towards achieving the Sustainable Development Goals (SDGs). The United Nations concept of ‘Development Accelerators’ is operationalized by examining factors associated with multiple SDGs among adolescents in Nigeria. Methodology Through data collected on the health of 1800 adolescents in Southwest Nigeria (Ibadan), ten SDG targets were identified. Accelerator protective factors that could lead to the attainment of two or more SDG targets were identified. Associations were assessed using multivariable logistic regression adjusting for sociodemographic covariates and multiple testing. Cumulative effects were tested by marginal effects modelling. Results Participants’ mean age was 15.02 years (SD = 2.27). Family (parenting support), environmental (no survival work and food security) and school (safe schools) related factors emerged as development accelerators. For seven of the identified SDG-aligned targets, a combination of two or more accelerator factors showed cumulative positive associations, suggesting accelerator synergies with a combination of three accelerators showing the greatest increase. For instance, perceiving the school environment as safe, being food secure and having optimal mental health was associated with an 67% chance of not using psychoactive substances. While with safe school alone it was 39% (29%-51%), with food security alone it was 42% (31%-54%) and with optimal mental health alone it was 54% (42%-66%). Conclusion Several development accelerators related to family, environmental and school factors can have additive effects on the attainment of the SDGs amongst adolescents in Nigeria. This has practical and policy utility in the fastest growing economy in Africa.

Much of the emerging evidence on the impact of COVID-19 on people with psychosocial disabilities comes from high-income countries. This study sought to explore the perceptions and experiences of youths living with psychosis during the COVID-19 pandemic in Nigeria. Using a co-produced research process, a facility-based study was conducted among youth with confirmed diagnosis of a psychotic disorder. In-depth interviews were conducted with 20 participants. Data was transcribed, double-coded and analysed with Atlas.ti using a thematic analysis approach. We found that participants were aware of good evidence-based information on the nature of the disease and the pandemic. Many of them described worsening mental health and disruptions to daily routines. Opportunities for deepening family relationships, skill building, helping others, and extended time for previously neglected self-development activities were described. This study benefitted from co-production with persons with lived experience, which could be harnessed for future research on psychosis.