Objective: "Negotiated standards" describe a level of quality of care that is acceptable and achievable within a specific health system, based on consensus between key stakeholders. This paper presents the development of negotiated standards for effective labor and childbirth care in selected hospitals and communities in Nigeria and Uganda.Methods: A four-step development process involving different methodologies. The process included: (1) review and synthesis of internationally recognized intrapartum clinical principles and practices; (2) primary qualitative research to assess values and preferences of women and healthcare providers, and practices that align with these preferences; (3) draft contextualization of effective and ineffective behaviors to reflect values and preferences; and (4) WHO-mediated negotiations between relevant stakeholders, including community members, providers, and administrators.
Background
Nigeria has one of the highest maternal mortality ratios (MMR) globally with an MMR of 512 (per 100,000 live births) and the proportion of maternal deaths due to non-communicable diseases (NCDs) is increasing. While evidence shows that many of these deaths are preventable, limited attention is being paid to the unique vulnerabilities and experiences of women of reproductive age (WRA) with NCDs and their risk factors, as well as the barriers to the screening, diagnosis, and management of these diseases in Nigeria.
Methods
This study explored the lives of WRA in Lagos and Federal Capital Territory in Nigeria from May to June 2019 using a community-based participatory research (CBPR) methodology called Photovoice which is aligned with CBPR as it includes procedures such as the identification of important community issues, discussion of photo assignments and data analysis. Twenty-four women of reproductive age were provided with digital cameras and trained on how to capture photos that conveyed their current health, healthcare utilization and engagement, and experience journeys. Individual interviews with the women were held for an in-depth exploration of the photographs. The data was then analysed thematically.
Results
Six distinct themes were identified across the barriers highlighted by the women: food and nutrition, home and family, neighborhood-built environment, economic instability, religion and spirituality and low prioritization of self-care. These themes captured the challenge of reduced agency, limited contribution and participation, and a complex relationship between visible and invisible illness.
Conclusion
The perspectives of WRA in Nigeria obtained through this qualitative research provided a strong substratum for understanding the environmental barriers that predispose WRA to NCDs in Nigeria. The results of the study are useful for the improvement of woman-centred services of prevention, diagnosis, and management of NCD risk factors across the maternal and reproductive health care continuum in Nigeria.
Many businesses have been positively impacted by electronic commerce (ecommerce). It has enabled enterprises and consumers to transact business digitally and experience diversity as long as the internet can be accessible and a gadget to surf the internet is available. Several governments have gradually adopted electronic payment throughout the country. The Nigerian government has also done a lot of prodding toward the adoption of a cashless economy, which includes embracing ecommerce. As ecommerce expands, so does actual and attempted fraud through this channel. According to the Nigerian Central Bank, electronic fraud would reach trillions of Naira by 2021. The purpose of this work was to employ logistic regression as a decision-making tool for detecting fraud in e-commerce platforms at the point of sale. The main contribution of this research is a model developed using for detecting fraud at the point of sale on electronic commerce platforms. The accuracy of the result is 97.8 percent. The result of this study will provide key decision makers in ecommerce firms with information on fraud patterns on their ecommerce platforms, this will enable them take quick actions to forestall these fraudulent attempts. Further research should be carried out in developing countries.
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