Bosede O. Adejugbe is a US-based researcher at Utah State University specialising in Demography and Social and Health Inequality. In this interview with IFEDAYO OGUNYEMI, she spoke on the growing disparities affecting availability and accessibility of healthcare by young, marginalised and vulnerable communities.
HOW did your background studies at Obafemi Awolowo University influence your research on social and health inequalities?
My educational background and research experiences at Obafemi Awolowo University, Ile-Ife, Nigeria, greatly shaped my interest in demography and social and health inequality particularly, among vulnerable groups and marginalised communities. The diverse socioeconomic and health issues of Nigeria presented real-world challenges that I encountered while studying as an undergraduate till I bagged a doctoral degree in Demography and Social Statistics. These experiences, research, and fieldwork opportunities solidified my focus on these areas. In addition to offering practical experience in data collecting, analysis, and the policy implications of research findings, the mentorship and collaborations at OAU were crucial in helping me advance my competence in using empirical research to address social and health concerns.
Speaking of vulnerable populations, can you discuss some of the key health disparities your research highlighted for this group of people?
First is the limited access to comprehensive sexual and reproductive health education. Another one is the disparities in contraceptive use, leading to misinformation, increased risks of STIs, and unintended pregnancies. I also found that socioeconomic disparities affect health outcomes, with those from lower socioeconomic backgrounds facing barriers to accessing quality healthcare. In a collaborative study published in the Ife Social Science Review, it was revealed that young mothers with low socioeconomic status were less likely to utilise quality maternal healthcare services and this was more pronounced in marginalised communities¬ – the rural areas. The study highlighted disparities such as limited healthcare facilities and a shortage of professional health personnel in those areas.
What specific challenges do couples in Nigeria face regarding maternal health, and how can these be addressed through research and policy?
There are the challenges of limited access to quality prenatal and maternal healthcare services, shortage of trained medical personnel, and inadequate healthcare infrastructure. Teenage mothers in particular, often lack regular prenatal check-ups due to financial constraints or lack of awareness. Religious beliefs also hinder the use of modern contraceptive methods. The government should invest in healthcare infrastructure and training, ensure services are sufficient but accessible and affordable, and support comprehensive family planning and maternal health education to address these problems. Additionally, for the government to effectively close the identified gaps, policies that are informed by academic research findings should be taken into consideration.
The Intervention for Strengthening Research Training in Nigeria, where you managed large-scale research projects, secured a $99,000 fund. What can you tell us about this project and how it impacts your study on marginalised and vulnerable populations?
The ItSTRETO project, funded by the Consortium for Advanced Research Training in Africa, aimed to strengthen research capacity at OAU to support high-quality research and encourage interdisciplinary collaborations. As the programme officer for the project for three years, I organised quarterly workshops and seminars on research methodologies and academic publishing where academic professionals from various disciplines taught these topics. The skills and resources gained from this initiative enabled me to conduct high-quality research for my doctoral dissertation on unintended pregnancy and pregnancy termination among adolescent girls in marginalised communities. My findings highlighted the vulnerabilities of adolescent girls and provided policymakers with data to support their right to make informed decisions about reproductive health. I published a paper from my doctoral dissertation in the hardcopy edition of the Journal of Population Association (hardcopy) of Nigeria in Vol. 7 No 1 (2023). The paper is titled “Abortion Practices Among Adolescent Girls in North-West, Nigeria: Do Interpersonal and Household Pressures Matter?”
What role does sexual and reproductive health play in the well-being of Nigerian youths, and how can your research contribute to improving SRH services?
Sexual and reproductive health is crucial for the overall well-being of Nigerians and not only the youth, helping to prevent unwanted pregnancies, reduce STIs, and improve mental health. My publication in the hardcopy edition of the Journal of Population Association advocated for comprehensive SRH education, equipping young people with the knowledge to make informed decisions about their health. Further, a recent study I conducted, funded by the Consortium of the Centre for Research, Evaluation Resources and Development, the Academy for Health Development, and the Guttmacher Institute, USA, investigated the capacity of health facilities to provide post-abortion care. My findings called for adequately equipping the health facilities with post-abortion care services and equipment and that these services should be provided “regardless of whether abortion is restricted in a particular setting and without the threat of criminal prosecution or punitive measures” – the 2022 World Health Organisation Abortion Guideline.
How has your experience managing large-scale research projects in Nigeria influenced your approach to researching health disparities?
Managing large-scale research projects like the ItSTRETO initiative and the post-abortion care project has significantly influenced my approach to researching health disparities. These experiences highlighted the need for building research capacity, involving community members and stakeholders, and collaborating with experts from different fields to address complex health disparities. My management of these projects also emphasised the importance of ethical considerations in research, especially when working with marginalised groups. Additionally, my research demonstrated the power of data in influencing health policy, providing evidence-based recommendations to improve reproductive health services and education programs for young people in Nigeria.
What are some critical areas you believe more research is needed to address health and social inequalities affecting youths?
One critical area often overlooked is research on the availability and accessibility of mental health services for youths, particularly pregnant teenagers who may drop out of school when an unwanted pregnancy sets in. Second is research on sexual and reproductive health education among Nigerian youths and the effectiveness of current SRH programmes. Research should also focus on the inclusivity of disabled youths in health matters. Residing in the US, I have found that people with disabilities often face similar neglect in healthcare policies. As the first author, I co-authored and published a policy brief, emphasising the need for public awareness and inclusive healthcare practices. In the same vein, more research should investigate the sexual health needs of disabled youths. I am currently working on a study titled “Examining the Perception of People with Disabilities on Physicians’ Engagement with Their Sexual Health,” which aims to identify gaps in healthcare treatment and suggest ways to increase inclusivity and address the sexual health needs of people with disabilities.
Reflecting on your participation in international conferences, what insights have you gained that could be applied to improve public health outcomes for young people in Nigeria?
The first is the importance of involving academic scholars and their findings in political decision-making strategies. Unfortunately, Nigeria lags in this area, and bridging the gap requires establishing formal collaboration mechanisms, and fostering a culture of evidence-based policy within government institutions. Collaboration between various sectors is another crucial insight. Developing robust systems for monitoring and evaluating health programmes, organising periodic capacity-building programmes for health personnel, and promoting youth involvement in public health initiatives are other important insights that could improve public health outcomes in Nigeria.
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