Before the pandemic struck, Dr Ahmed Sarki, a Senior Instructor based at AKU-SONAM in Uganda, working on a school health project (SHP) in Northern Nigeria, had been planning to host a rigorous 5-day research symposium to connect policy-makers and researchers in the adolescent health space. However, after the pandemic started taking effect on the continent, the SONAM instructor wondered how he could continue working to improve the lives of young people in Northern Nigeria remotely.
The SHP is funded by the Global Challenges Research Fund (GCRF) and is a collaboration between Family and Youth Health Initiative (FAYOHI - a public health non-governmental organization operating in Northern Nigeria), Professor Lesley Smith (Professor of Women's Public Health) and Dr Franklin Onukwugha (Research Fellow Global Adolescent Reproductive Health) based at the University of Hull, UK and John Young and Andy Nobes at the International Network for Advancing Science and Policy (INASP).
The overall aim of the SHP is to understand health awareness, beliefs and behaviours of adolescents attending secondary schools in Jigawa and Kano States, Nigeria to co-produce a culturally sensitive health literacy/health promotion intervention for adolescents in Northern Nigeria. Thereafter, they intend to work with local government and non-government agencies to develop a cost-effective and sustainable health literacy intervention in Jigawa and Kano States that could be scaled-up to other states within Northern Nigeria. Dr Sarki and the team believe that co-designing an intervention with all relevant stakeholders ensures the planned intervention will be culturally relevant and therefore acceptable to pupils, parents, teachers, community leaders, practitioners and policymakers, maximising the chance of success.
This project aims to target adolescents aged 10-19 years early on and equip them with relevant and culturally appropriate health literacy as they transition into adulthood to be better equipped to deal with the common challenges of drug addiction and substance misuse, rape/sexual violence, nutrition, and girl-child education.
As COVID-19 sent everyone scampering indoors, it became increasingly difficult for Dr Sarki and his team to conduct research and continue working on the SHP as various African governments declared varying levels of lockdown. In Uganda, where he is based, the President had declared an initial total lockdown, which increased the complexity of coordinating physical interventions for young people in Nigeria. However, Dr Sarki and the SHP team thought hard about how it might still be possible to continue and moved online. They designed and ran a series of remote webinars, one on August 6 and another on August 13, 2020, to bring various stakeholders in adolescent health together to discuss how they could collectively develop interventions to reduce maternal and infant mortality among adolescents in Northern Nigeria. The webinars gathered representatives from the Ministries of Health, Education, and Women Affairs, researchers and policymakers from Jigawa and Kano States of Nigeria, University of Hull (UK) and INASP.
According to Dr Sarki, one of the main objectives of the symposium-turned-webinars was to “develop a knowledge ecosystem within the region where policymakers work with local researchers and utilise locally generated evidence to formulate policies relevant to reproductive and adolescent health" and was sceptical that it would be possible to do that in a virtual environment. But it worked remarkably well.
The webinars exposed one of the main challenges why many interventions do not address the core needs of adolescents in Northern Nigeria and that was the gap between the policymakers and local researchers.
It also emerged that researchers may have problems translating their findings to policymakers largely due to jargons as well as the fact that research often takes time, yet policymakers have to make prompt decisions. On the other hand, researchers shared that the policymakers often make decisions without sufficient evidence, among several other factors. They, however, agreed on what the constraints to improving adolescent healthcare are, especially the need for education on all fronts.
And despite the unfamiliar technology and internet instability due to heavy rain, all stakeholders were able to express their views and contribute their suggestions. In many ways, Dr Sarki found it easier to host the event online. He mused that “in fact, it was easier to split participants up into small breakout rooms via zoom and reconvene afterwards than it is to get people back together during a normal face-to-face event."
It emerged that more research needs to be done on adolescents in Northern Nigeria particularly because of the high maternal and infant mortality rates so that interventions are timely and accurate. Similarly, there was consensus on the need to conduct health literacy on adolescents so that they can take care of themselves and each other and take control of their health. Lastly, it is important to use a participatory approach in carrying out research on adolescents which involves asking them what they were interested in learning more about and how they would like to participate. In the longer term, the project aims to identify entry points for and design a health literacy/health promotion intervention for adolescents in Northern Nigeria delivered in after-school health clubs involving peer health champions and peer-to-peer learning.
The webinar ended on a high note with the researchers and policymakers acknowledging the need to collaborate as well as the importance of health literacy programmes to improve the health outcomes of adolescents in Northern Nigeria.
