Plants in the management of male infertility

This review attempts to collate existing data and provide the perspectives for future studies on the effects of plants on the male gonads. For many of these medicinal plants such as Lepidium meyenii, Rupus coreanus, Tribulus terrestres, Panax ginseng, Petasites japonicas, Apium graveolens, Eurycoma longifólia, Pedalium murex, Corchorus depressus, Mucuna pruriens, Astragalus membranaceus, Nigella sativa, Crataegus monogyna, Fagara tessmannii, Phaleria macrocarpa, Anacyclus pyrethrum, Cynomorium songaricum and Morinda officinalis, the mechanism of actions of their active principles and crude extracts has been shown in both laboratory animals, in vitro, and human studies, and includes their antioxidant, anti-inflammatory, spermatogenesis-inducing, aphrodisiac, smooth muscle relaxing and androgenic properties. Several active chemical leads including glucosinolates, anthocyanins, protodioscin, ginsenosides, sesquiterpenes, phyto-oestrogens, quassinoids, diosgenin, thymoquinone, proanthocyanidins and bajijiasu isolated from these plants are known to have target effects on the testis, but efforts have been limited in their application at the clinical level. There still appear to be many more extracts of medicinal plants that have not been characterised to determine the phytochemicals unique to them that have target effects on the gonads. Further, collaborative efforts at isolating pro-drug candidates from medicinal plants for studies at the molecular, cellular and clinical level towards elucidating their mechanisms of action on the testes are therefore warranted in the light of the current male fertility crisis.     

Improving maternal and child health policymaking processes in Nigeria: an assessment of policymakers’ needs,barriers and facilitators of evidence-informed policymaking

Background

In Nigeria, interest in the evidence-to-policy process is gaining momentum among policymakers involved in maternal, newborn and child health (MNCH). However, numerous gaps exist among policymakers on use of research evidence in policymaking. The objective of this study was to assess the perception of MNCH policymakers regarding their needs and the barriers and facilitators to use of research evidence in policymaking in Nigeria.

Methods

The study design was a cross-sectional assessment of perceptions undertaken during a national MNCH stakeholders’ engagement event convened in Abuja, Nigeria. A questionnaire designed to assess participants’ perceptions was administered in person. Group consultations were also held, which centred on policymakers’ evidence-to-policy needs to enhance the use of evidence in policymaking.

Results

A total of 40 participants completed the questionnaire and participated in the group consultations. According to the respondents, the main barriers to evidence use in MNCH policymaking include inadequate capacity of organisations to conduct policy-relevant research; inadequate budgetary allocation for policy-relevant research; policymakers’ indifference to research evidence; poor dissemination of research evidence to policymakers; and lack of interaction fora between researchers and policymakers. The main facilitators of use of research evidence for policymaking in MNCH, as perceived by the respondents, include capacity building for policymakers on use of research evidence in policy formulation; appropriate dissemination of research findings to relevant stakeholders; involving policymakers in research design and execution; and allowing policymakers’ needs to drive research. The main ways identified to promote policymakers’ use of evidence for policymaking included improving policymakers’ skills in information and communication technology, data use, analysis, communication and advocacy.

Conclusion

To improve the use of research evidence in policymaking in Nigeria, there is a need to establish mechanisms that will facilitate the movement from evidence to policy and address the needs identified by policymakers. It is also imperative to improve organisational initiatives that facilitate use of research evidence for policymaking.

     

Promotion of evidence-informed health policymaking in Nigeria: bridging the gap between researchers and policymakers

In Nigeria, the lack of adequate understanding of the complex nature of translating research into policy and the incompatibility existing between researchers and policymakers constitute a great challenge to evidence-informed policymaking. To address these challenges a one-day evidence-to-policy training workshop was organised for policymakers, researchers and other major stakeholders in the health sector in southeastern Nigeria. Of the 104 individuals invited to the workshop 87 (83.6%) attended. The workshop training sessions focused on capacity development for evidence-informed health policy-making and building effective linkages/partnerships. The post-workshop assessment indicated significant improvements in participants' knowledge, their understanding of the health policymaking process and the use of evidence compared to their pre-workshop status. Using a focus group discussion, major strategies identified by participants that can bridge the gap between health policymakers and researchers included: involving both parties in planning and execution of health research and health programmes; promoting dialogue between researchers and policymakers; institutionalising research grants and commissioning research in health ministries; and ensuring that researchers are made to focus on the core needs of policymakers. There is need for further discussion and debate on the researchers and policymakers partnership concept in low income settings.     

Adequacy of resources for provision of maternal health services at the primary health care level in Nnewi,Nigeria

Background:

To determine the adequacy of resources (human and material) for provision of maternal health services at the primary health care (PHC) level in Nnewi, Nigeria.

Materials and Methods:

A cross-sectional study of women utilising maternal health services in four public PHC facilities in Nnewi selected using multistage sampling technique was done. Data was collected using a mix of quantitative and qualitative methods. Quantitative data was analysed using statistical package for social sciences (SPSS) version 16, while qualitative data was reported verbatim, analysed thematically and necessary quotes presented.

Results:

Two hundred and eighty women were studied. The mean age of respondents was 29.2 ± 5.9 years, while 231 (82.5%) were married. Most of them (82.5%) and 184 (66.1%), had their blood pressure and body weight respectively measured, while 196 (70.0%) had tetanus toxoid vaccination. Less than half of the respondents (41.4%) had urine test for sugar, and protein, while 94 (33.8%) had blood test for anaemia. The four facilities studied had most of the equipment and drugs available but in insufficient quantities. In three out of the four facilities, the physical structures were mostly good. None of them is equipped to provide an essential obstetric care (EOC) services, while one medical doctor covered all the facilities studied.

Conclusions:

This study showed that none of the health facilities is equipped with the minimum equipment package, essential drugs nor staff complement required to enable them offer quality maternal health services. With advocacy, technical support and funding, strategies could be implemented to provide quality maternal health services.