The rapid shift to online learning during the COVID-19 pandemic has significantly influenced educational practices worldwide and increased the use of online learning platforms. This systematic review examines the impact of online learning on student engagement and performance, providing a comprehensive analysis of existing studies. Using the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guideline, a thorough literature search was conducted across different databases (PubMed, ScienceDirect, and JSTOR for articles published between 2019 and 2024. The review included peer-reviewed studies that assess student engagement and performance in online learning environments. After applying inclusion and exclusion criteria, 18 studies were selected for detailed analysis. The analysis revealed varied impacts of online learning on student performance and engagement. Some studies reported improved academic performance due to the flexibility and accessibility of online learning, enabling students to learn at their own pace. However, other studies highlighted challenges such as decreased engagement and isolation, and reduced interaction with instructors and peers. The effectiveness of online learning was found to be influenced by factors such as the quality of digital tools, good internet, and student motivation. Maintaining student engagement remains a challenge, effective strategies to improve student engagement such as interactive elements, like discussion forums and multimedia resources, alongside adequate instructor-student interactions, were critical in improving both engagement and performance.

Background: To assess the effectiveness of a wristband for immunization alert (WIA) as a reminder device to caregivers to improve immunization timeliness and reduce drop-outs. Methods: Eight health facilities, selected from two local government areas in Kano state, Northwestern Nigeria, were clustered in a two-arm study involving an intervention group and a control group. Only the caregivers (757) from the intervention group received WIA as an immunization reminder device. Immunization timeliness data were then collected from the control and intervention groups for the period of intervention and analyzed using Microsoft Excel and IBM SPSS version 21. Results: A cohort analysis of caregivers who received WIA at their second visit showed an increase in immunization timeliness from 10% at the second visit to 86% at the third visit and maintained at 66% for the fifth visit. A difference-in-difference analysis of the effect of WIA on immunization timeliness from baseline to end-line in the control and intervention groups showed a positive 30% increase in immunization timeliness associated with the introduction of WIA. Interpretation: Given that immunization timeliness and drop-outs are reported issues of concern in Northwestern Nigeria, the use of the WIA device is a recommended intervention.

Background/Objectives: The Tropis^® ID device (PharmaJet^®), a needle-free injection system, is a World Health Organization prequalified, hand-held device, which delivers intradermal injections without the use of needles and has previously been used for the delivery of fractional doses of inactivated polio vaccine (fIPV) in campaign and house-to-house settings. This implementation research study aimed to comparatively evaluate the vaccine coverage, cost, feasibility, and acceptability of using Tropis for fIPV for routine immunizations in two states in Nigeria (Kano and Oyo). Methods: The study included: (i) a cluster randomized trial (22 intervention facilities using Tropis for fIPV and 30 control facilities using the standard of care [SoC—full-dose IPV]) to assess the effectiveness in terms of improving the coverage of two doses of IPV, using a coverage survey involving 3433 children (aged 3–12 months); (ii) a pre- and post-implementation micro-costing evaluation involving the intervention facilities to estimate the costs; and (iii) mixed methods assessments (post-training assessment, provider survey, key informant interviews, and focus group discussions) to assess the feasibility and acceptability of fIPV delivery using Tropis. Results: The intention-to-treat analysis among the 3433 children surveyed did not show any difference between the intervention and control groups, primarily due to low compliance (approximately 50% of target beneficiaries reported Tropis use). The more relevant per protocol analysis, adjusting for lower compliance, showed that among those vaccinated with Tropis, second dose IPV coverage was 11.2% higher than the SoC. The delivery of fIPV using Tropis compared to the SoC resulted in incremental program cost savings, ranging from USD 0.07 to USD 1.00 per dose, administered across the scenarios evaluated. High acceptability was seen amongst caregivers (94%), and 95% of healthcare workers preferred Tropis over the SoC. Conclusions: Tropis is effective, feasible, acceptable, and saves costs when used as part of routine immunization programs.

Background: Nigeria has a national policy on neglected tropical diseases (NTD) which is coordinated by the Federal Ministry of Health and integrated into the health system at all government levels. A network of grassroots mobilizers, named community drug distributors (CDDs), deliver NTD drugs and commodities to rural and hard-to-reach communities throughout Nigeria.Methods: Interviews with state and local government coordinators of Nigerian NTD programs and focus group discussions with CDDs in Yobe and Ebonyi states were conducted to understand the working modalities of NTD programs in Nigeria to identify the potential of leveraging the NTD structure for additional health interventions such as COVID-19 vaccine rollouts. Collected data was coded and managed on NVivo version 12 using content analysis.Results and discussion: The study found that the NTD committee had the following: a structured planning and coordination process, a community mobilization approach for the effective delivery of routine Mass Administration of Medication (MAM) activities. Challenges encountered included little or no incentives for the CDDs, insecurity, transportation and logistics, and lack of equipment and drug commodities. Nigerian NTD health structures have a wide reach, with a presence in all states and local government areas (LGAs), and this has previously been leveraged to deliver commodities and interventions to rural and hard-to-reach communities for non-NTD health programs and could thus be used similarly for COVID-19 vaccination programs. The enablers of integrating health interventions into the NTD structure are increased availability of finances and manpower, while lack of financial incentives and partners’ buy-in were identified as possible. challenges.Conclusion: The study suggests that integrating COVID-19 interventions into the NTD program in Nigeria would be a significant accomplishment, as the existing structure can support future interventions. The study also highlights the efficiency of the NTD program’s modalities and processes, indicating that an organized structural system for public health interventions can. increase the services of existing interventions while allowing for the integration of future interventions.

: The primary goal of program communication in public health is to influence behaviors. It also aims to raise awareness and ultimately improve health outcomes. Under the umbrella of program communication exist three interconnected, interrelated, and mutually supportive communication aspects: advocacy, communication, and social mobilization (ACSM). While advocacy involves promoting political dedication and holding authorities accountable for fulfilling commitments and achieving success, social mobilization brings together various sectors and individuals to raise awareness and demand for a specific program. This study aimed to understand the operationalization and challenges of ACSM activities among health workers addressing COVID-19 and routine immunization in Nigeria. The study used a qualitative study design. In-depth interviews were conducted among health workers in the ACSM unit of the state’s primary health care system, using a two-tier approach. The recorded interviews were transcribed in Microsoft Word format by professional transcribers and coded using Dedoose. A total of 38 health care workers across six states were selected to participate in this study. Our study found that ACSM coordination structures existed across the six states. Routine ACSM activities were either funded by the government or local development partners implementing programs. Lack of technological devices, unavailability of funds, unavailability of data tools, and lack of technological skills are major barriers to ACSM operationalization. This study highlighted the critical role of government and agency funding in sustaining ACSM activities. However, barriers that hinder the effective operationalization of ACSM efforts remain. Therefore, the results support the need for strategic investment in technology, staff capacity building, and appropriate resource allocation to overcome these barriers.

Background: Malaria rapid diagnostic tests (RDTs) have improved case management and surveillance across sub-Saharan Africa by reducing presumptive treatment and enhancing diagnostic specificity. However, healthcare workers’ (HCWs) concerns about limitations of RDTs, the lack of other diagnostic tools and patient expectations may result in non-adherence to RDT outcomes in treatment decisions. This study aimed to determine associations between HCW characteristics and the accuracy of recording malaria RDT results. Methods: A multi-country, mixed-methods observational study was conducted in 64 public health facilities across Benin, Côte d’Ivoire, Nigeria, and Uganda between June and December 2023. HCW demographic characteristics, attitudes and perceptions of RDTs, and proficiency performing RDTs were collected via surveys and structured observations. Completed RDTs were photographed, interpreted by a trained panel, and compared with health facility registers. Multivariable logistic regression models were used to identify factors associated with misrecording. Results: Among more than 100,000 RDTs performed by 499 HCWs, 5.1–7.3% of results were misrecorded as positive, and 0.7–3.7% were misrecorded as negative. The test positivity rate (TPR) was highest in Côte d’Ivoire (59.7%) and lowest in Nigeria (45.3%). Overall agreement on RDT results between the external panel and the result recorded by HCWs in the health facility register ranged from 90.2% in Nigeria to 94.3% in Benin. Misrecording of negative or invalid results as positive varied by country. In Benin, older HCWs and those with stronger malaria knowledge were less likely to misrecord, but HCWs who believed patients should still be treated after a negative test were more likely to do so. In Côte d’Ivoire, community health workers had higher odds of misrecording, while higher education reduced the risk. In Nigeria, medical auxiliary staff were less likely to misrecord than other cadres. In Uganda, misrecording was more common in high-volume, high-positivity facilities and among HCWs recently observed by a supervisor. Conclusion: Misrecording of RDT results is influenced by a combination of individual, contextual, and systemic factors, with differing patterns for results misrecorded as positive and negative. Improving malaria surveillance will require interventions that address both HCW behaviour and broader facility- and system-level influences.