Clinical and health systems research are essential for advancing global healthcare. Engaging and training medical students in research will foster lifelong evidence-based practice, particularly for the emerging healthcare workforce. This study investigates the involvement of Nigerian medical students in research, identifying key opportunities and barriers to enhance their engagement. This cross-sectional, descriptive study used an online survey targeting recent graduates from 42 accredited Nigerian medical schools. A purposive sampling approach selected one federal, state, and private institution from each of Nigeria’s six geopolitical zones. Data were collected between February and June 2024 using a face-validated online questionnaire, which gathered quantitative data and free-text recommendations. The survey was distributed through WhatsApp groups. Descriptive statistics and thematic analysis were employed to explore trends in the data. Ethical approval was obtained from the Jos University Teaching Hospital ethics review board (JUTH/DCS/IREC/127/XXXI/871). Informed consent was secured from each participant prior to participation. Of the 429 respondents (270 men, 159 women) from 15 universities across all six zones, 92% participated in research during medical school. Men engaged in more research projects than women (p = 0.03). Most respondents participated in two projects, usually group-based, with limited individual projects. Few had presented (20%) or published (17%) their research. Proficiency was highest in developing appropriate research methodologies (54%), while data analysis was the most challenging aspect of research (42%). Participation in research was supported by adequate mentorship for most participants (64%), whereas time constraints(74%), lack of research funding (55%), and inadequate research training (31%) were the main barriers to involvement. Regional differences were noted, with the highest participation by students in the South-South geo-political zone (98%) and the lowest in the South-West (85%). Learners from the South-West had more opportunities to present research at conferences, while those from the South-East had the fewest. Participants advocated for integrating more research opportunities into the medical curriculum, emphasising early skill development, expanding mentorship and networking opportunities, and offering grants to support students in conducting innovative research. There is a pressing need to enhance structured research opportunities in Nigerian medical education, especially for female medical students. This includes expanding access to training in data analysis, increasing publication and presentation opportunities, and integrating research skills early in the curriculum while addressing barriers like time constraints. Not applicable.

Background: Strengthening health systems through planned safety and quality improvement initiatives is an imperative to achieve more equitable, resilient, and effective care. And yet, years of organizational behavior research demonstrate that change initiatives often fall short because managers fail to account for organizational readiness for change. This finding remains true especially among surgical safety and quality improvement initiatives in low-income countries and middle-income countries. In this study, our aim was to psychometrically assess the construct validity and internal consistency of the Safe Surgery Organizational Readiness Tool (SSORT), a short survey tool designed to provide change leaders with insight into facility infrastructure that supports learning and readiness to undertake change. Materials and methods: To demonstrate generalizability and achieve a large sample size (n=1706) to conduct exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), a collaboration between seven surgical and anesthesia safety and quality improvement initiatives was formed. Collected survey data from health care workers were divided into pilot, exploration, and confirmation samples. The pilot sample was used to assess feasibility. The exploration sample was used to conduct EFA, while the confirmation sample was used to conduct CFA. Factor internal consistency was assessed using Cronbach’s alpha coefficient. Results: Results of the EFA retained 9 of the 16 proposed factors associated with readiness to change. CFA results of the identified 9 factor model, measured by 28 survey items, demonstrated excellent fit to data. These factors (appropriateness, resistance to change, team efficacy, team learning orientation, team valence, communication about change, learning environment, vision for sustainability, and facility capacity) were also found to be internally consistent. Conclusion: Our findings suggest that communication, team learning, and supportive environment are components of change readiness that can be reliably measured prior to implementation of projects that promote surgical safety and quality improvement in low-income countries and middle-income countries. Future research can link performance on identified factors to outcomes that matter most to patients.

Background: Pathogen surveillance is vital for managing infectious diseases in Africa, where high disease burdens necessitate advanced tools like genomics and bioinformatics. While these technologies enable early detection, resistance monitoring, and targeted interventions, yet their adoption is hindered by limited training and educational resources. This scoping review maps existing training programmes in genomics and bioinformatics for pathogen surveillance in Africa, identifying gaps and opportunities to enhance capacity-building. Methods: Following PRISMA-ScR guidelines, we systematically searched databases (PubMed, Embase, Scopus, etc.) and grey literature for articles which described the design, implementation, delivery, or evaluation of a specific genomics/bioinformatics training programme or discussed training needs or status published between November 2014 and December 2025. Eligible articles focused on genomics or bioinformatics training for pathogen surveillance in Africa. Data were extracted on programme characteristics, outcomes, challenges, and recommendations, with findings synthesised narratively and thematically. Results: Of 2491 identified articles, 40 were included, spanning 2014–2025. These comprised case studies (45%), opinion pieces (27.5%), reviews (15%), cross-sectional studies (10%), and a methodological study (2.8%). Twenty-three articles detailed specific training programmes, predominantly short-term (e.g., 2–14 days), with 60.9% of the training programmes covering both genomics and bioinformatics. Training programmes were mostly carried out in African countries (91.3%), often funded by external agencies like NIH (26.1%) and Wellcome Trust (13%). Key outcomes included enhanced technical skills (21.7%) and career development (17.4%). Challenges included inadequate infrastructure, skill gaps, and theoretical-heavy curricula, while opportunities encompassed virtual delivery, collaborative networks, and open-access resources. Seventeen studies were included as they examined training status and deficiencies in Africa, highlighting limited expertise and brain drain, and recommending investment in infrastructure, expansion of curricula, and development of local trainers. Conclusion: Genomics and bioinformatics training in Africa is growing but remains fragmented, donor-dependent, and resource-constrained. Sustainable capacity-building requires institutionalising training within academic systems, increasing government investment, and leveraging open-access and regional networks. These findings provide a foundation for policymakers and educators to develop targeted, inclusive programmes, strengthening Africa’s pathogen surveillance capabilities. Clinical trial number: N/A.

Lack of access to potable water, poor sanitation and hygiene, and ineffective vector control measures catalyse the spread of infectious diseases. This study aimed to assess access to safe water, sanitation and hygiene practices, and housing conditions in a rural community in North-Central Nigeria. Additionally, it sought to examine the interplay between these factors and the incidence of infectious diseases. This was a cross-sectional observational study set in the rural Mangu community. Ethical approval was obtained from the Plateau State Ministry of Health, and informed consent was sought from an adult representative of each sampled household. Data were collected using interviewer-administered questionnaire during walk-through home visits. A total of 772 individuals from 139 households and 100 houses were surveyed. Household sizes ranged from two to 26 individuals, and rooms had between one and seven occupants. One-fifth of the houses (n=19/100) had no access to improved sources of drinking water and relied on unprotected dug wells and streams. Sewage disposal was largely through open defecation (n=73/100) and nearly all houses (n=98) practised open dumping/burning. Febrile illness and diarrhoea were reported in residents of 71% and 40% of the houses, respectively, in the previous six months. Residents who used water from unimproved sources were four times more likely to experience a febrile illness (OR: 3.99; 95% CI: 1.11-15.7). In Mangu community of North-Central Nigeria, prioritising access to safe drinking water and improving sanitation and hygiene practices would reduce the burden of infectious diseases, especially in children.

Background: Clinical and health systems research is essential for advancing global healthcare. Engaging and training medical students in research will foster lifelong evidence-based practice, particularly for the emerging healthcare workforce. This study investigates the involvement of Nigerian medical students in research, identifying key opportunities and barriers to enhance their engagement. Methods: This cross-sectional, descriptive, mixed-methods study used an online survey targeting recent graduates from 42 accredited Nigerian medical schools. A purposive sampling approach selected one federal, state, and private institution from each of Nigeria’s six geopolitical zones. Data were collected between February and June 2024 using a face-validated online questionnaire distributed via WhatsApp groups. Descriptive statistics and thematic analysis were employed to explore trends in the data. Ethical approval was obtained by the Jos University Teaching Hospital ethics review board (JUTH/DCS/IREC/127/XXXI/871), and participants provided informed consent. Results: Of the 429 respondents (270 men, 159 women) from 15 universities across all six zones, 92% participated in research during medical school. Men engaged in more research projects than women (p=0.03). Most respondents participated in two projects, usually group-based, with limited individual projects. Few had presented (20%) or published (17%) their research. Proficiency was highest in developing appropriate research methodologies (54%), while data analysis was the most challenging aspect of research (42%). Participation in research was supported by adequate mentorship for most participants (64%), whereas time constraints(74%), lack of research funding (55%), and inadequate research training (31%) were the main barriers to involvement. Regional differences were noted, with the highest participation by students in the South-South geo-political zone (98%) and the lowest in the South-West (85%). Learners from the South-West had more opportunities to present research at conferences, while those from the South-East had the fewest. Participants advocated for integrating more research opportunities into the medical curriculum, emphasising early skill development. Conclusion: There is a pressing need to enhance structured research opportunities in Nigerian medical education, especially for women. This includes expanding access to training in data analysis, increasing publication and presentation opportunities, and integrating research skills early in the curriculum while addressing barriers like time constraints. Clinical trial number: not applicable.