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Key historical landmark research malpractice scandals that shocked the international community (Nazi doctors' experiments, Tuskegee study, Jewish chronic disease experiments, Krugman's Willowbrook hepatitis study) were the origin of the institution of ethics review prior to carrying out research involving humans. Nonetheless, it is plausible that unethical research is ongoing or may have been conducted in recent times that has escaped public notice, especially in the vulnerable low-and middle-income country contexts. The basic constitution of these committees at some point has not been clearly defined, with most scientists declaring political maneuvers at times. These committees today are characterized by bureaucratic bottlenecks, financial interests, inadequate training in research ethics, and lack of control and coordination of their functions. Compulsory and adequate research ethics training for researchers and ethical committee members could guarantee trust, and appreciation of the utmost importance of the latter. The independence of protocol review

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Background Chronic Non-Communicable Diseases (CNCDs) has become a major cause of mortality and disability globally. We explored the coping strategies adopted by CNCD patients and the roles of caregivers in the management of CNCDs in Ghana. Methods This was a qualitative study that adopted an exploratory design. The study was carried out at the Volta Regional Hospital. Purposive convenience sampling procedures were used to sample patients and caregivers. Data for the study were collected using in-depth interview guides. Data were collected among 25 CNCDs patients and 8 caregivers and analysed thematically using ATLAS.ti. Results Patients adopted a variety of strategies to cope with their condition. These strategies were emotion-oriented coping, task-oriented coping, and avoidance-oriented coping. Family members were the main caregivers, who provided social and financial support for patients. Financial challenges, inadequate family support, poor attitudes of health workers, delays at the health facility, unavailability of drugs at the facility, and patients’ non-adherence to the medical advice were major challenges that militated against caregivers’ efforts in supporting patients in the management of their CNCDs. Conclusion We found that patients adopted various strategies to cope with their conditions. The roles of the caregivers in supporting patients in the management practices were identified as very important as they contribute immensely to the financial and social support for the patients in their management of CNCDs. It is crucial that health professionals actively involve caregivers in every aspect of the day-to-day management of CNCDs as these caregivers spend more time with these patients and understand them better.

BackgroundMore than 38.4 million people were living with HIV worldwide in 2021. Sub-Saharan Africa bears two-thirds of the burden, with Nigeria having nearly two million people living with HIV (PLWH). Social support from social networks such as family and friends improve the quality of life, and reduces enacted and perceived stigma, but social support for PLWH remains suboptimal in Nigeria. This study aimed to assess the prevalence of social support and associated factors among PLWH in Nigeria and to test whether stigma reduces types of social support.MethodsThis cross-sectional study was conducted in Lagos State, Nigeria, between the months of June and July 2021. A total of 400 PLWH were surveyed across six health facilities providing antiretroviral therapy. Social support (family, friends, and significant others) and stigma were measured with the Multidimensional Scale of Perceived Social Support and Berger’s HIV Stigma Scale, respectively. Binary logistic regression was used to identify determinants of social support.ResultsMore than half (50.3%) of the respondents had adequate social support overall. The prevalence of family, friends, and significant others support was 54.3, 50.5, and 54.8%, respectively. Stigma (Adjusted Odds Ratio [AOR]: 0.945; 95% Confidence Interval [CI]: 0.905–0.987) was negatively associated with adequate friend support. Female gender (AOR: 6.411; 95% CI: 1.089–37.742), higher income (AOR: 42.461; 95% CI: 1.452–1241.448), and seropositive disclosure (AOR: 0.028; 95% CI: 0.001–0.719) were associated with adequate significant others support. Stigma (AOR:0.932; 95% CI: 0.883–0.983) was negatively associated with adequate support overall. Our findings corroborate the social support theory, as stigma reduces the chance of receiving social support.ConclusionPLWH that enjoy support from families or friends were less likely to be affected by HIV-related stigma. More support is needed by PLWH from family, friends, and significant others to improve the quality of life and reduce stigma among PLWH in Lagos State.

Background: Despite numerous health promotion interventions lately conducted, the human immunodeficiency virus (HIV) remains a major cause of morbidity and mortality in sub-Saharan Africa. It is reported that military personnel have a higher prevalence of HIV, compared with the general population. Condom use remains a cheap, easy-to-use, and effective device to prevent the spread of HIV. Growing evidence, however, suggests its underuse among the military personnel. Methods: The current cross sectional study included 325 consenting male and female soldiers from 8 different battalions. Characteristics of the study participants were summarized using frequencies and proportions. Associations between the studied variables were investigated using the Chi-square test of independency; P values < 0.05 were considered statistically significant. Results were presented in the form of tables and graphs. Data analysis was conducted using SPSS version 20.0. Results: Only 28% of the participants used condom during the last unsafe sexual contact. Over 85% of them reported that condoms were always available. Half (50%) of the participants were ashamed to buy condoms. The most commonly reasons for not using condoms were drunkenness (37.5%), trust in the sexual partner (26.5%), tobacco smoking (11.1%), not interested to use a condom (8.9%), and dislike/refusal of condom use by the partner. Main reasons of inconsistent use of condoms included drunkenness, shyness to buy condoms and unavailability in the respective battalions. Trust in sex partners, condom use/sex related stigma, and alcohol abuse were the major determinants of inconsistent condom use during unsafe sexual relations among Cameroonian soldiers. Conclusions: Unprotected sexual practice amongst Cameroonian soldiers was high. Despite the reported high availability of condoms (85%), only 28% of the study respondents used condoms during their last sexual intercourse with different partners. Consistent condom use was sub-optimal among Cameroonian military staff.

People living in rural areas generally experience adverse health outcomes compared to their urban counterparts. They experience a greater burden of non-communicable diseases including: diabetes, hypertension, stroke, kidney disease, and chronic obstructive pulmonary disease (COPD), have limited access to healthcare services, and experience scarcity in specialized healthcare services. The disproportionately high all-cause mortality experienced by rural residents has been termed “the rural mortality penalty”. With over 90% of the world’s rural population living in Africa and Asia, we argue that the lack of an authoritative and respected global rural health research agenda contributes to increasing health inequalities, given that many of these people are receiving substandard care. There are differences in how rural and urban resident’s experience healthcare. Living in rural settings might not be systematically connected to adverse health outcomes. It is important to clearly articulate the positive health outcomes associated with living in rural settings (e.g., the positive relationship between mental health and strong social ties/green spaces). Indeed, health policies stand the chance of unconsciously excluding the positive outcomes associated with rurality, as well as the rural experiences of health. Defining rural health remains an issue of controversy with a persistent reality regarding the lack of consensus as to what it means for a region or area to be considered as “rural”. We outline the most common definitions of “rural areas” in the literature, as well as the shortcomings of these definitions. By unpacking the meaning of “rural health”, we aim to foster communication among rural health professionals and researchers locally and internationally, as well as highlight the key research and policy implications that could emanate from a “good” definition of rural health. We agree that context remains key when it comes conceptualizing complex subjects like rurality. However, developing minimum criteria to foster communication among rural health researchers is needed. Systematically providing operational definitions of what authors describe as “rural” in the rural health research and policy literature is of utmost relevance.