Technical Guidelines for Integrated Disease Surveillance and Response in Nigeria

The goal of IDSR is to improve the ability of LGAs to detect and respond to diseases and conditions that cause high levels of death, illness and disability in the LGA‘s catchment area. Strengthening skills and resources for integrated disease surveillance and response will result in improved health and well-being of communities in the LGA. The general objective of the IDSR strategy is to provide a rational basis for decision-making and implementation of public health interventions that are efficacious in responding to priority diseases and events.

National Action Plan for Health Security, Nigeria

The National Action Plan for Health Security (NAPHS) is a comprehensive multi-sectoral plan that integrates multiple workplans including REDISSE, NCDC Strategy Plan, AMR Action Plan, and immunizations plans, addressing the major gaps identified by the Joint External Evaluation (2017) and Performance of Veterinary Services (2010) assessments, and prioritizing them by national strategiesand risks.

Covid-19 Response Intra-Action Review (IAR) Report, Sierra Leone

This report details the findings of an Intra-Action Review (IAR) that was undertaken on the 22nd
& 23rd September 2020, to review the COVID-19 response in Sierra Leone, focusing in particular on Surveillance, Laboratories, Case Management, Risk Communications, Food and Nutrition and National Coordination.

Key Considerations: Disability-Inclusive Humanitarian Action and Emergency Response in South and Southeast Asia and Beyond

In many settings, people with disabilities face multiple and complex layers of environmental, societal and structural barriers. These barriers can lead to them being disproportionately harmed, neglected and excluded during humanitarian and other emergency responses.1–3 This is especially evident in low- and middle-income countries (LMICs), including Nepal and other South and Southeast Asian nations.4 Limited awareness of the needs of people with disabilities, entrenched social stigma, and inaccessible infrastructure can exacerbate the challenges they face in emergency situations. In addition, there has been little preparation and planning to make disaster and emergency planning disability inclusive.3,5,6
This brief explores disability in the context of humanitarian and public health emergencies in South and Southeast Asia. Its focus is on Nepal, but the principles are universally relevant and can be adapted for any context. It is intended for stakeholders in government, civil society and the humanitarian sector.

Imagining HIV/AIDS: morality and perceptions of personal risk in Nigeria

The disparity between people’s knowledge about HIV/AIDS and the extent to which they take measures to protect themselves is one of the most vexing issues for public health workers and social science analysts. This paper aims to explain some of this discrepancy, using survey and ethnographic data collected among young rural-urban migrants in Aba and Kano, two cities in Nigeria. The paper argues that many young Nigerian migrants do not perceive significant personal risk because they construct the risk of AIDS in ethical and moral terms, projecting immorality and danger onto imaginary others. To understand the way young Nigerians interpret risk, the paper focuses on four related issues: (1) the organization and meaning of sexual relationships; (2) the intersection of gender and ideas about reproduction; (3) the perception of AIDS as a disease without hope; and (4) the importance of religion in young people’s framing of moralities and ethical choices about sexuality and HIV/AIDS.

Discriminate biopower and everyday biopolitics: views on sickle cell testing in Dakar

Many physicians in Senegal and France, where most Senegalese sickle cell specialists are partially trained, assume that genetic testing that could imply selective abortion for people with sickle cell would run counter to the religious and cultural ethics of people living in Dakar. Senegalese affected by this genetic disease, however, often cite “traditional” rationales to indicate why such testing, if offered, might appeal to them. The reluctance of medical practitioners to entertain such testing technologies for their patients evinces a protectionist attitude toward care–an attitude that emerges within a context in which family planning and a blind concentration on HIV/AIDS have created a public health system that completely overlooks sickle cell anemia. This discriminate biopower leaves everyday biopolitics largely in the hands of families faced with this disease. It falls to them to pragmatically calculate the value that genetic testing may,

“Right tool,” wrong “job”: Manual vacuum aspiration, post-abortion care and transnational population politics in Senega

The “rightness” of a technology for completing a particular task is negotiated by medical professionals, patients, state institutions, manufacturing companies, and non-governmental organizations. This paper shows how certain technologies may challenge the meaning of the “job” they are designed to accomplish. Manual vacuum aspiration (MVA) is a syringe device for uterine evacuation that can be used to treat complications of incomplete abortion, known as post-abortion care (PAC), or to terminate pregnancy. The author conducted an ethnography of Senegal’s PAC program between 2010 and 2011. Data collection methods included interviews with 49 health professionals, observation of PAC treatment and review of abortion records at three hospitals, and a review of transnational literature on MVA and PAC. While MVA was the most frequently employed form of uterine evacuation in hospitals, concerns about off-label MVA practices contributed to the persistence of less effective methods such as dilation and curettage (D&C) and digital curettage.

Community health care workers in pursuit of TB: Discourses and dilemmas

Community-led tuberculosis (TB) active case finding is widely promoted, heavily funded, but many efforts fail to meet expectations. The underlying reasons why TB symptom screening programs underperform are poorly understood. This study examines Nigerian stakeholders’ insights to characterize the mechanisms, enabling structures and influences that lead programs to succeed or fail. Eight focus group discussions were held with Community Health Workers (CWs) from four models of community-based TB screening and referral. In-depth interviews were conducted with 2 State TB program managers, 8 Community based organizations (CBOs), and 6 state TB and Leprosy Local Government supervisors. Sustainable, supportive models that combine meaningful engagement for communities with effective program stewardship and governance are needed. Crucially effective and successful implementation of community-based TB screening and referral requires a functional public health system to which to refer.

Vaccine anxieties, vaccine preparedness: Perspectives from Africa in a Covid-19 era

Global debates about vaccines as a key element of pandemic response and future preparedness in the era of Covid-19 currently focus on questions of supply, with attention to global injustice in vaccine distribution and African countries as rightful beneficiaries of international de-regulation and financing initiatives such as COVAX. At the same time, vaccine demand and uptake are seen to be threatened by hesitancy, often attributed to an increasingly globalised anti-vaxx movement and its propagation of misinformation and conspiracy, now reaching African populations through a social media ‘infodemic’. Underplayed in these debates are the socio-political contexts through which vaccine technologies enter and are interpreted within African settings, and the crucial intersections between supply and demand. This book explores these through a ‘vaccine anxieties’ framework attending to both desires for and worries about vaccines, as shaped by bodily, societal and wider political understandings and experiences.

Youths’ violent resistance of necropolitical landscape of COVID-19 in Nigeria’s vanishing foodscapes and waterscapes

This article interrogates the necropolitical landscape of COVID-19 in Nigeria. The article explores how the landscape emerges at the intersection of COVID-19 regime and structural violence and materializes in foodscapes and waterscapes of the country. These changes ultimately impose the status of a ‘living-dead’ on ordinary people in Nigeria, undermining the government’s moral ground to implement its COVID-19 regime.

Your Pocket Is What Cures You: The Politics of Health in Senegal

In the wake of structural adjustment programs in the 1980s and health reforms in the 1990s, the majority of sub-Saharan African governments spend less than ten dollars per capita on health annually, and many Africans have limited access to basic medical care. Using a community-level approach, anthropologist Ellen E. Foley analyzes the implementation of global health policies and how they become intertwined with existing social and political inequalities in Senegal.

Xenophobia’s Contours During an Ebola Epidemic: Proximity and the Targeting of Peul Migrants in Senegal

This article examines the effect of geographical proximity on targeting patterns during Ebola-era xenophobic outbursts by Senegalese against a migrant Peul population of Guinean origins. It highlights the limited extent to which epidemics shape the micro-dynamics of outbreaks of xenophobia during public health crises, demonstrating that epidemics are not defining events that inflect inter-group relations.

Women,Peace and Casamance – A field study of how women organisations in Casamance, Senegal are working for peace

Drawing on feminist critical theory, this ethnographic study in Casamance examined how gender roles affect women and women organisations strive for peace. The research shows how embedded gender roles in the Senegalese society and the patriarchal system dominate, making it difficult for women to gain access and agency in the peace process. However, the thesis also shows the diversity of women organisations work and how they strive to gain agency and how they little by little are gaining ground by being organised around a common ground

‘With the kanyaleng and the help of god, you don’t feel ashamed’: women experiencing infertility in Casamance, Senegal

While the precarious situation of women with infertility in Sub-Saharan Africa is well documented, little is known about the ways in which such women show agency despite the challenges that infertility brings to their lives. This study provided a holistic understanding of the experiences of women with infertility living in a rural community in Casamance (Senegal), drawing attention towards both suffering as well as agency.

Why I Have Not Taken the COVID-19 Vaccine” a Descriptive Qualitative Study of Older Adults’ Perceived Views of COVID-19 Vaccine Uptake in Nigeria

Globally, the COVID-19 vaccine uptake is increasing, but slowly among older adults residing in lower and middle-income countries, including Nigeria. Following this, we explored the perceived views of older adults on the uptake of the COVID-19 vaccine in Nigeria. Findings show that older adults’ willingness to receive the COVID-19 vaccine was dissuaded by their past experiences with the government, religion, and Western media, including affordability and accessibility problems related to vaccination campaigns. Findings also show that the uncertainty about the COVID-19 virus existence and perceptions about COVID-19 vaccine risks influence older adults’ decisions regarding vaccine uptake. Finally, older adults’ views on getting vaccinated for COVID-19 were positively influenced by the trust they placed in their physicians and other members of their healthcare system.

Why didn’t you write this in your diary? Or how nurses (mis)used clinic diaries to (re)claim shared reflexive spaces in Senegal

At the intersection between writings and silences, this paper explores the role played by the clinic diaries to mediate ethnographic encounters, and the iterative nature of ‘doing fieldwork’ to produce knowledge in hierarchical health systems. This paper also reflects on the processes through which the diaries created a space where accounts of lived experiences routinely unfolding in health facilities could be shared, in the context of a health system increasingly dominated by metrics, performances and vertical reporting mechanisms.

‘When Migrants Become Messengers’: Affective Borderwork and Aspiration Management in Senegal

This article draws on ethnographic fieldwork to explore how affect and emotions are used in migration awareness campaigns and how local communities respond. ‘Aspiration management’ works to instil a sense in would-be Senegalese migrants that their hopes of migration to Europe are both dangerous and futile. The author argues that affective borderwork works at a different level than other border activities connected to legal and physical migration control. By cultivating particular emotions and morally-embedded geographies, these campaigns promote an inner, self-regulating border in the minds and bodies of people.

What post-abortion care indicators don’t measure: Global abortion politics and obstetric practice in Senegal

This article draws on an ethnography of Senegal’s post-abortion care (PAC) program, conducted between 2010 and 2011, to illustrate how PAC indicators obscure the professional and technological complexities of treating abortion complications in contexts where abortion is illegal. The author argues that PAC strategies, technologies, and indicators must be situated within a global framework of reproductive governance, in which safe abortion has been omitted from maternal and reproductive health care associated with reproductive rights. Ethnographic attention to daily obstetric practices reveals not only how anxieties about abortion ironically suppress the rates of manual vacuum aspiration utilization that purportedly convey PAC quality, but also how they simultaneously give rise to and obscure obstetric violence against women.

West African Migration in the Age of Climate Change : Translocal Perspectives on Mobility from Mali and Senegal

This thesis contributes to the debate on climate change, environment, and migration by scrutinizing conceptual and methodological deficiencies and adopting a migration research perspective. The author uses a multi-sited ethnography in Mali and Senegal to show how human activites shape vegetation, degradation and production on agricultural land. Migration patterns tend to follow long-established networks, with movement patterns circular rather than one-way. The author concludes that the characteristics and perpetuation of people’s translocality, circular migration, and resource flows are determined by intensely interdepending dimensions of necessity, maintaining common identity, and development.

“We are the heroes because we are ready to die for this country”: Participants’ decision-making and grounded ethics in an Ebola vaccine clinical trial

This paper reports findings from social science research carried out in Kambia, Northern Sierra Leone during first year of an Ebola vaccine trial (August 2015–July 2016). The study used a range of qualitative methods to explore participant motivations for volunteering for the study. The authors analyse participants’ perceptions of the risks and benefits of participations, highlighting the importance of a contextual approach, focusing on four types of motivation: altruism; curiosity and hope; health-seeking; and notions of exchange. They argue for the role of social science in developing grounded research ethics and community engagement strategies that can take into account context and local realities.

Vaccine anxieties, vaccine preparedness: Perspectives from Africa in a Covid-19 era

This study used a ‘vaccine anxieties’ framework to consider the socially-embedded reasons why people want or do not want Covid-19 vaccines, and how this intersects with the dynamics of vaccine supply, access and distribution in rapidly-unfolding epidemic situations. Whereas discourses of vaccine hesitancy misrepresent African publics as ignorant or confused, the authors argue that Covid-19 vaccine anxieties make sense given disease, social and political experiences. While growing familiarity with Covid-19 vaccines have eroded some concerns, vaccine preparedness must nevertheless address health system structures and politics.

Unintended consequences of the ‘bushmeat ban’ in West Africa during the 2013-2016 Ebola virus disease epidemic.

Following the 2013-2016 outbreak of Ebola virus disease (EVD) in West Africa, governments across the region imposed a ban on the hunting and consumption of meat from wild animals. This injunction was accompanied by public health messages emphasising the infectious potential of wild meat, or ‘bushmeat.’ Using qualitative methods, we examine the local reception and impact of these interventions. Fieldwork was focused in 9 villages in the Eastern and Southern provinces of Sierra Leone between August and December 2015.

Unintended consequences of implementing non-pharmaceutical interventions for the COVID-19 response in Africa: experiences from DRC, Nigeria, Senegal, and Uganda

The coronavirus (COVID 19) pandemic is one of the most terrifying disasters of the 21st century. The non-pharmaceutical interventions (NPIs) implemented to control the spread of the disease had numerous positive consequences. However, there were also unintended consequences—positively or negatively related to the nature of the interventions, the target, the level and duration of implementation. This article describes the unintended economic, psychosocial and environmental consequences of NPIs in four African countries.

Understanding Women’s Needs for Weather and Climate Information in Agrarian Settings: The Case of Ngetou Maleck, Senegal

This paper demonstrates that even at the village level, women have different climate and weather information needs, and differing abilities to act on that information. Preconceived connections between identities and vulnerability hinder the ability to address the climate-related development and adaptation needs of the most vulnerable. The authors argue instead that the design and implementation of effective gender-sensitive climate services must start with the relevant social differences that shape people’s livelihoods decisions and outcomes, including but not limited to gender.

Treatment success or failure in children and adolescents born with HIV in rural Senegal: An anthropological perspective

The article presents the results of an anthropological study that aims to examine the modalities of medical and social care for CALHIV, identify the various structural and social determinants of treatment failure or success, and ascertain their respective influence. The ethnographic survey was conducted between July 2020 and November 2021 in 11 of the 14 regions of Senegal and in 15 health facilities (11 health centers and 4 regional hospitals). Situations of treatment failure or success are the result of favorable or unfavorable configurations that bring into play various actors—children, parents, health care professionals—and their interactions with and in varying sociocultural and structural contexts. The studyunderscores the contribution of anthropology to the analysis and understanding of care systems. The authors argue for a differentiated approach to strengthening the skills of health facility staff, taking into account the specificity of each site.

Traditional healers in Nigeria: perception of cause, treatment and referral practices for severe malaria.

Malaria remains one of the main causes of mortality among young children in sub-Saharan Africa. In Nigeria traditional healers play an important role in health care delivery and the majority of the population depend on them for most of their ailments. The aim of this study was to investigate the perceptions of traditional healers regarding causes, symptoms, treatment of uncomplicated malaria and referral practices for severe malaria with a view to developing appropriate intervention strategies aimed at improving referral practices for severe malaria.

The symbolic violence of ‘outbreak’: A mixed methods, quasi-experimental impact evaluation of social protection on Ebola survivor wellbeing

Despite over 28,000 reported cases of Ebola virus disease (EVD) in the 2013-16 outbreak in West Africa, we are only beginning to trace the complex biosocial processes that have promoted its spread. Important questions remain, including the effects on survivors of clinical sequelae, loss of family and livelihood, and other psychological and social trauma. Conducting a survey and in-depth interviews to assess participants’ wellbeing and food security, the authors show how short-term social protection during the vulnerable period post-discharge can pay dividends two years later. They conclude with a discussion of how terms such as “outbreak” and “epidemic” do symbolic violence by creating the illusion that social suffering ends when transmission of a pathogen ceases.

‘The Suffering is Too Great’: Urban Internally Displaced Persons in the Casamance Conflict, Senegal

The paper addresses the dearth of studies of displaced people living in urban areas of sub-Saharan Africa through a survey of a particular group of internally displaced persons (IDPs) created by Senegal’s Casamance conflict. Analysis of survey data shows how IDPs used pre-existing rural–urban migration chains and social integration processes. IDP livelihood activities are, however, more urban-based even than those of ordinary townsfolk dur to reduced access to primary production sites.

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