Background: Armed conflict between the militant Islamist group Boko Haram, other insurgents, and the Nigerian military has principally affected three states of northeastern Nigeria (Borno, Adamawa, Yobe) since 2002. An intensification of the conflict in 2009 brought the situation to increased international visibility. However, full-scale humanitarian intervention did not occur until 2016. Even prior to this period of armed conflict, reproductive, maternal, neonatal, and child health indicators were extremely low in the region. The presence of local and international humanitarian actors, in the form of United Nations agencies and non-governmental organizations, working in concert with concerned federal, state, and local entities of the Government of Nigeria, were able to prioritize and devise strategies for the delivery of health services that resulted in marked improvement of health status in the subset of the population in which this could be measured. Prospects for the future remain uncertain. Methods: Interviews were conducted with more than 60 respondents from government, United Nations agencies, and national and international non-governmental organizations. Quantitative data on intervention coverage indicators from publicly available national surveys (Demographic and Health Surveys (DHS), Multiple Indicator Cluster Surveys (MICS)), National Nutrition and Health Surveys (NNHS)) were descriptively analyzed. Results: Overall, indicators of low reproductive, maternal, neonatal, and child health (RMNCH) status and intervention coverage were found in the pre-intervention period (prior to 2016) and important improvements were noted following the arrival of international humanitarian assistance, even while armed conflict and adverse conditions persisted. Security issues, workforce limitations, and inadequate financing were frequently cited obstacles. Conclusion: It is assumed that armed conflict would have a negative impact on the health status of the affected population, but pre-conflict indicators can be so depressed that this effect is difficult to measure. When this is the case, health sector intervention by the international community can often result in marked improvements in the accessible population. What might happen upon the departure of the humanitarian organizations cannot be predicted with an appreciable degree of certainty.

Investigating the content of communication about food and nutrition in the parent–child dyad can provide insight into how roles and rules associated with food are instantiated within the family context. The current study uses an ecological framework to consider the multiple levels of influence on communication and dietary behavior in families. Interviews (N = 33) were conducted with parents and children from low-income families in two different counties within a Midwestern state. Interview transcripts were analyzed using categories developed from the ecological framework. Geographic information systems technology data also provided information about dyads' external food environment and available food options. Results indicate low levels of communication about food choices between parents and children, as well as low involvement from children in food selection and preparation. Findings also identify the accessibility of healthy food and financial considerations as key barriers to facilitating nutritional choices. Strategies for designing interventions that encourage initiation of familial discussions about food, promote positive nutritional role models, and highlight the importance of positive feedback and rewards for healthy food decision-making behaviors are discussed.

The COVID-19 pandemic has been an historic challenge to public health, and to behavior change programs. There have been challenges in promoting vaccination in LMICs, including Nigeria. One important hypothesis deserving consideration is the ability to obtain vaccination as a potential barrier to vaccination uptake. The MOA (motivation, opportunity, and ability) framework, as illustrated by multiple theories such as COM-B, EAST, and the Fogg model, is a primary theoretical basis for the evaluation of this ability as a factor in vaccination uptake. There is little research on measuring the ability to get vaccinated in LMICs, including on the role of all of the MOA framework. The aim of this study was to develop and evaluate an ability factors index measured through social media-based data collected in Nigeria in late 2021 and early 2022. We present findings from an online survey of 8574 Nigerians and highlight new social media-based data collection techniques in this research. This study found that a new ability factors index comprising 12 items was associated with vaccine uptake independent of measures capturing other components of the MOA framework. This index may serve as a valuable research instrument for future studies. We conclude that a person’s perceived ability to get vaccinated, measured by a newly validated index, is related to vaccination uptake and hesitancy, and that more research should be conducted in this area.